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Mild proteinuria in patients with unilateral kidney  

Microsoft Academic Search

Summary Arterial blood pressure, 24 h urinary excretion, and glomerular filtration rate (GFR) in 24 patients with unilateral kidney were compared with an age and sex matched control group of healthy persons. Of the patients with unilateral kidney, 13 were uninephrectomized and 11 patients had a congenital unilateral kidney. The 24 h urinary protein excretion in patients with one kidney

G. Oberle; H. P. H. Neumann; P. Schollmeyer; W. H. Boesken; R. A. K. Stahl



Unilateral Gigantomastia Related to Juvenile Fibroadenoma with Idiopathic Thoracic Scoliosis  

Microsoft Academic Search

A 15-year-old girl was referred to our Department by the orthopedic surgeons, showing a massive unilateral gigantomastia of her right breast and a progressive idiopathic thoracic scoliosis. Ventral positioning of the patient for the planned scoliosis correction was impossible without prior treatment of the hypertrophic breast.In the first operation the fibroadenoma with a total weight of 3020 g was resected

Dolores Wolfram; Hannes Behensky; Hildegunde Piza-Katzer



Increased oxidative stress in mouse kidneys with unilateral ureteral obstruction  

Microsoft Academic Search

Increased oxidative stress in mouse kidneys with unilateral ureteral obstruction.BackgroundUnilateral ureteral obstruction (UUO) is a well-established experimental model of renal injury leading to interstitial fibrosis. The molecular and cellular mechanism(s) of interstitial fibrosis in UUO kidney is beginning to be elucidated. Oxidative stress has been implicated in the pathogenesis of various forms of renal injury; however, little is known about

Noritaka Kawada; Toshiki Moriyama; Akio Ando; Megumu Fukunaga; Toshio Miyata; Kiyoshi Kurokawa; Enyu Imai; Masatsugu Hori



Unilateral anomalies of kidney development: why is left not right?  

Microsoft Academic Search

Abnormal renal development results in congenital anomalies of the kidney and urinary tract. As many studies suggest that renal malformations are more often found on the left side, a meta-analysis was performed on the distribution of five different unilateral anomalies: multicystic dysplastic kidney, renal agenesis\\/aplasia, renal ectopia, pelviureteral junction obstruction, and non-obstructive non-refluxing megaureter. Of these anomalies, the left side

Michiel F Schreuder



Unicornuate uterus and unilateral ovarian agenesis associated with pelvic kidney  

Microsoft Academic Search

In this report, we present a case of unilateral müllerian and ovarian agenesis associated with pelvic kidney. The patient was a 27-year-old woman who complained of an inability to conceive. We performed a hysterosalpingogram, hysteroscopy, laparoscopy, and an excretory urogram (IVP). At laparoscopy, we found an unicornuate uterus without a rudimentary horn. The right round ligament, fallopian tube, and ovary

B. Mülayim; O. Oral


Thoracic outlet syndrome: another cause for unilateral palmar hyperhidrosis  

Microsoft Academic Search

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

Oya Özdemir; Levent Özçakar



Autosomal dominant polycystic kidney disease with ectopic unilateral multicystic dysplastic kidney  

PubMed Central

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



Fasudil attenuates interstitial fibrosis in rat kidneys with unilateral ureteral obstruction  

Microsoft Academic Search

This study was designed to investigate possible effects of the Rho-kinase inhibitor, fasudil, on the progression of renal failure in rats with unilateral ureteral obstruction. The renal failure markers monitored were the extent of renal interstitial fibrosis and that of macrophage infiltration. In kidneys with unilateral ureteral obstruction, interstitial fibrosis was observed, using Sirius-Red staining, on day 16 after unilateral

Shin-ichi Satoh; Tamami Yamaguchi; Asako Hitomi; Norihiro Sato; Kazumi Shiraiwa; Ichiro Ikegaki; Toshio Asano; Hiroaki Shimokawa



Factors influencing the progression of renal damage in patients with unilateral renal agenesis and remnant kidney  

Microsoft Academic Search

Factors influencing the appearance and progression of renal damage in patients with unilateral renal agenesis and remnant kidney.BackgroundAlthough some studies have shown that the risk to develop proteinuria and renal insufficiency is increased in patients with a remnant kidney (RK) or unilateral renal agenesis (URA), other patients maintain normal renal function and negative proteinuria, and the reasons to explain these




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


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

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



Performance of locomotion and foot grasping following a unilateral thoracic corticospinal tract lesion in monkeys (Macaca mulatta)  

Microsoft Academic Search

Six adult monkeys (Macaca mulatta) received a unilateral lesion of the lateral corticospinal tract (CST) in the thoracic spinalcord. Prior to surgery, the animalswere trained to perform quadrupedal stepping on a treadmill, and item retrieval with the foot. Whole body kinematics and electromyogram (EMG) recordings were made prior to, and at regular intervals over a period of 12 weeks after

Gregoire Courtine; Roland R. Roy; Joseph Raven; John Hodgson; Heather Mckay; Hong Yang; Hui Zhong; Mark H. Tuszynski; V. Reggie Edgerton



Increased E-cadherin expression in the ligated kidney following unilateral ureteric obstruction  

Microsoft Academic Search

E-cadherin expression in the kidney is used as a surrogate marker of epithelial mesenchymal transition for the testing of various antifibrotic strategies. Here we reexamined E-cadherin expression in the kidneys of rats with unilateral ureteric obstruction, which was previously reported to decrease in parallel with the development of tubulointerstitial disease in this widely used experimental model of renal fibrosis and

Neil G Docherty; Isabel Fuentes Calvo; Mark R Quinlan; Fernando Pérez-Barriocanal; Barry B McGuire; John M Fitzpatrick; R William G Watson



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

Microsoft Academic Search

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

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



Unilateral “Oligoméganéphronie” with agenesis of the contralateral kidney, studied by microdissection  

Microsoft Academic Search

The clinical, laboratory and anatomo-pathological observations of a case of unilateral congenital oligonephronic renal hypoplasia with hypertrophy of the nephrons studied by light microscopy and microdissection are reported. The glomeruli were found to be two-and-a-half times as large as normal. Microdissection confirmed the present of larger but fewer nephrons. The “Oligoméganéphronie” of one kidney was accompanied by agenesis of the

B. Griffel; S. Pewzner; M. Berandt



Quest for the missing kidney in the "treasure chest": report of a thoracic kidney in a child with recurrent diaphragmatic hernia.  


The thoracic cavity is the rarest location of all the renal ectopic sites. We report a rare case of an acquired thoracic kidney associated with a previous congenital diaphragmatic hernia in a child with nephrotic syndrome. Although only 13 cases of the thoracic kidney in the pediatric age group have been described in worldwide reports during the past 25 years, we present the first to be associated with a recurrent diaphragmatic hernia. The classification, differential diagnosis, and management options of this rare form of ectopia are discussed. PMID:23642934

Adam, Ahmed; De Villiers, Mariza; Van Biljon, Gertruida



Renal agenesis and unilateral nephrectomy: what are the risks of living with a single kidney?  


The long-term outlook for patients with unilateral renal agenesis or following unilateral nephrectomy in childhood is controversial. Animal studies suggest that the resultant compensatory increase in glomerular filtration might lead to progressive damage to the remaining renal tissue and may generate hypertension. Human studies addressing these concerns are limited in number and are difficult to interpret because they are small, retrospective, or cross sectional with significant variations in duration and completeness of follow-up. The published studies suggest that renal function remains stable for several decades in the majority of subjects. The clinical significance of mild-grade proteinuria and hypertension seen in some patients is unknown. Longitudinal studies are needed to understand the long-term effect and significance of the several pathophysiological changes observed in the solitary kidney. PMID:18612657

Hegde, Shivaram; Coulthard, Malcolm G



Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem.  


An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI) revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome. PMID:22382228

Malaki, Majid; Nemati, Masood; Shoaran, Maryam



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

PubMed Central

The internal organs of rats and rabbits were clearly imaged noninvasively using a deeply penetrating reflection-mode photoacoustic imaging system. This imaging system had previously been found to provide an imaging depth limit of ?38 mm. In the thoracic cavity, major blood vessels connecting to the heart were imaged, and the right atrium was imaged as deeply as ?8 mm. In the abdominal cavities, the kidney and vena cava inferior were also imaged in situ. The vena cava inferior ?13.7 mm deep was imaged. The kidney of a New Zealand white rabbit was also imaged. This study shows the deep internal organ imaging capability of the system in animals. This technology can potentially be used to study tumors in internal organs, and be adapted to clinical diagnosis.

Song, Kwang Hyun; Wang, Lihong V.



Distinct effects on long-term function of injured and contralateral kidneys following unilateral renal ischemia-reperfusion  

PubMed Central

Salt-sensitive hypertension and chronic kidney disease (CKD) following recovery from acute kidney injury (AKI) may occur secondary to incomplete repair, or by activation of circulating factors stimulated by injury. We created two types of renal injury induced by unilateral ischemia-reperfusion (I/R); in a direct/ipsilateral AKI group, rats were subjected to unilateral I/R and the untouched contralateral kidney was removed by unilateral nephrectomy after 5 wk to isolate effects on the injured kidney. In the remote/contralateral AKI group, the injured kidney was removed after 5 wk to isolate effects on the untouched kidney. When these animals were subsequently challenged with elevated dietary sodium for an additional 4 wk (0.4 to 4%), both remote/contralateral and direct/ipsilateral AKI rats manifested a significant increase in blood pressure relative to sham-operated controls. Similarly, in acute studies, both ipsilateral and contralateral kidneys had impaired pressure natriuresis and hemodynamic responses. Reductions in vascular density were observed following direct/ipsilateral injury, but were not observed in the remote/contralateral kidney. However, both remote/contralateral and direct/ipsilateral kidneys contained interstitial cells, some of which were identified as activated (low CD62L/CD4+) T lymphocytes. In contrast, only the direct/ipsilateral AKI group demonstrated significant CKD following exposure to elevated salt. This was characterized by a significant reduction in creatinine clearance, an increase in albuminuria, and a dramatic expansion of interstitial inflammation. Taken together, these data suggest that the salt-sensitive features of AKI on hypertension and CKD are segregable such that effects on hemodynamics and hypertension occur independent of direct renal damage. However, prior direct injury to the kidney is required to elicit the full manifestation of CKD induced by elevated sodium intake.

Leonard, Ellen C.; Tonade, Deoye; Friedrich, Jessica L.; Goenka, Shreevrat



Matched comparison of radical nephrectomy vs. nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney  

Microsoft Academic Search

Objective: To report the long-term follow-up of a matched comparison of radical nephrectomy (RN) and nephron-sparing surgery (NSS) in patients with single unilateral renal cell carcinoma (RCC) and a normal contralateral kidney.Patients and Methods: Between August 1966 and March 1999, 1492 and 189 patients with unilateral RCC and a normal contralateral kidney underwent RN and NSS, respectively. Patients with renal

WKO Lau; ML Blute; AL Weaver; VE Torres; H Zincke



Effects of melatonin on partial unilateral ureteral obstruction induced oxidative injury in rat kidney  

PubMed Central

Aim: This experimental study was designed to produce ischemia-reperfusion injury in rat kidney by performing partial unilateral ureteral obstruction (PUUO) and investigated the effects of melatonin on the levels of oxidative injury parameters. Materials and Methods: Twenty-four adult male rats were randomly divided into three groups as follows; control group (Group 1); only nephrectomy and blood (5 ml) drawn from vena cava inferior, PUUO group (Group 2); PUUO (10 days)+ipsilateral nephrectomy after recovery of PUUO+blood from vena cava inferior VCI, melatonin treated group (Group 3); PUUO (10 days)+melatonin (1/2 hr before release, 50 mg/kg, ip)+ipsilateral nephrectomy after recovery of PUUO+blood from VCI. The left ureter was embedded into the psoas muscle to create PUUO. After 10 days, PUUO was recovered and ipsilateral nephrectomies were performed for biochemical analysis of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and protein carbonyl (PC) in the tissues and blood was drawn from inferior vena cava to study the same parameters in systemic circulation. The results were compared statistically. Results: The blood levels of MDA, NO, and PC were increased in the PUUO group in comparison to the sham-operated group (P<0.05). Melatonin treatment reduced MDA, NO, and PC levels in blood after PUUO recovery, but statistically significance consisted only for MDA and NO (P<0.05). The antioxidant enzyme activities (SOD, GSH-Px) were increased in the PUUO group (P<0.05). Melatonin treatment reduced SOD and GSH-Px activities in comparison with the sham-operated control group (P<0.05). Similarly, renal tissue levels of MDA, NO, and PC were increased in the PUUO group in comparison with the sham-operated group (P<0.05). Melatonin treatment ameliorated MDA, NO, and PC levels in renal tissue after PUUO recovery only MDA was statistically significant (P<0.05). Antioxidant enzyme activities (SOD, CAT, and GSH-Px) were increased in the PUUO group. Melatonin treatment caused reduction in SOD, CAT, and GSH-Px activities in comparison to the sham-operated control group (P<0.05). Conclusion: The results of this study showed that experimentally induced PUUO caused oxidative stress in rat kidney and melatonin treatment reduced oxidative stress and therefore may have a preventive effect on PUUO induced oxidative kidney damage in rats.

At?lgan, Dogan; Parlaktas, Bekir S.; Uluocak, Nihat; Erdemir, Fikret; F?rat, Fatih; Erkorkmaz, Unal; Saylan, Oguzhan



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


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

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



Renal agenesis and unilateral nephrectomy: what are the risks of living with a single kidney?  

Microsoft Academic Search

The long-term outlook for patients with unilateral renal agenesis or following unilateral nephrectomy in childhood is controversial.\\u000a Animal studies suggest that the resultant compensatory increase in glomerular filtration might lead to progressive damage\\u000a to the remaining renal tissue and may generate hypertension. Human studies addressing these concerns are limited in number\\u000a and are difficult to interpret because they are small,

Shivaram Hegde; Malcolm G. Coulthard



Quantitative SPECT of 99mTc-DMSA Uptake in Kidneys of Infants with Unilateral Ureteropelvic Junction Obstruction: Assessment of Structural and Functional Abnormalities  

Microsoft Academic Search

We evaluated individual renal function using quantitative SPECT of dimercaptosuccinic acid (DMSA) uptake by the kidneys (QDMSA) in infants with unilateral ureteropelvic junction (UPJ) obstruction and compared our findings with infants without obstruction. Methods: QDMSA was performed on 13 infants (mean age of 2.8 ±2.8 mo) with unilateral UPJ obstruction and on 15 age-matched controls without obstruction. Results: Con trol

David Groshar; Moshe Wald; Boaz Moskovitz; Elias Issaq; Ofer Nativ


Renal Function and Solitary Kidney Disease: Wilms Tumour Survivors versus Patients with Unilateral Renal Agenesis  

Microsoft Academic Search

Aims: To test the hypothesis that Wilms tumour survivors (WTs) experience increased disturbance in renal function, even after prompt treatment, compared to patients with unilateral renal agenesis (URA). Methods: To assess the renal function of 30 WTs and 17 individuals with URA, the estimated glomerular filtration rate (eGFR) was calculated using the Schwartz and Filler formulas as well as the

Joanna Stefanowicz; Ewa Aleksandrowicz; Anna Owczarzak; Anna Balcerska



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

Microsoft Academic Search

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

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



Kidney function in adults born with unilateral renal agenesis or nephrectomized in childhood  

Microsoft Academic Search

We have evaluated the long-term prognosis in an unselected group of adult patients either uni-nephrectomized in childhood because of hydronephrosis or born with unilateral renal agenesis. Thirty-six patients aged 7–47 years were followed for 7–40 years. In 23 control subjects aged 20–47 years the glomerular filtration rate (GFR) and thep-aminohippuric acid clearance (CPAH) did not change significantly with age. In

Ingrid Wikstad I; Gianni Celsi; Lars Larsson; Peter Herin; Anita Aperia



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

PubMed Central

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

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



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

Microsoft Academic Search

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

Anup Kumar; Saurabh Mishra; P. N. Dogra



Imaging Kidney in Conscious Rats with High-Frequency Ultrasound and Detection of Two Cases of Unilateral Congenital Hydronephrosis  

Microsoft Academic Search

A quick noninvasive screen of laboratory animal organ phenotype by high-resolution ultrasound is useful in biomedical research and new drug discovery. During new drug testing, imaging animal at the conscious state avoiding anaesthesia does not only speed up the screening process, but also avoids the potential compounding interaction of anaesthetic agents with the new drugs. The feasibility of imaging kidney

Yi-Xiang J. Wang; Graham Betton; Eike Floettmann; Elizabeth Fantham; Graham Ridgwell



Hemiurothorax following diaphragmatic hernia and kidney prolapse in a cat.  


A 3-year-old cat was presented with increasing dyspnoea over the past four days. Unilateral pleural effusion was diagnosed and a modified transudate was drained several times. Surgical exploration revealed intra-thoracic prolapse of the left kidney and partial herniation of the spleen through a dorsal, circumferential diaphragmatic tear. Biochemical analysis of the pleural fluid confirmed urothorax. Due to excessive fibrin deposit on the well-vascularised kidney it was impossible to re-establish left urinary pathways. Left-sided nephrectomy and diaphragmatic herniorrhaphy were performed. Postoperative recovery was uneventful and complete. This is the first report of an urothorax in veterinary medical literature. PMID:12670434

Störk, C K; Hamaide, A J; Schwedes, C; Clercx, C M; Snaps, F R; Balligand, M H




PubMed Central

Radioautographs of infiltrative cells in the kidneys of (Lewis x BN)F1 rats labeled with tritiated thymidine (TdR3H) before the subcapsular injection of parental (Lewis) thoracic duct lymphocytes (TDL) showed a predominantly host-proliferative response by 4 days after grafting. The immediate renal incorporation of TdR3H was used to measure the local graft-vs.-host (GVH) reactions. Substantial reactions could still be induced in the face of the considerable degree of leukopenia after 400 R whole body ?-irradiation. These results suggest that radioresistant cells are capable of carrying on the appropriate host activities and that the weakness of GVH reactions induced after higher doses of irradiation may be due to impairment of the mitotic mechanism of host cells. The importance of circulating leukocytes as a source of immunogenic stimulation was nevertheless substantiated by inducing local GVH reactions with Lew TDL in chimeric parental-type rats that had been repopulated with F1 bone marrow. This result also emphasizes the nonspecific nature of tissue destruction in the renal GVH reaction in confirmation of Elkins. In this and other situations in which B cells were the predominant F1 type elements available for interaction with parental-type TDL the reactions were nearly equivalent or equivalent to those in the appropriate controls. Typical local GVH reactions could be induced in heavily irradiated hosts by an inoculum of combined parental and F1-type TDL in the apparent absence of mononuclear phagocytes. The possible relationship between the activation of host lymphocytes, the involvement of B cells, and the nonspecific nature of tissue damage in the renal GVH is discussed.

Volkman, Alvin



Unilateral renal cystic disease in adults  

Microsoft Academic Search

Unilateral renal cystic disease ( URCD) is Cases morphologically indistinguishable from autosomal dominant polycystic kidney disease (ADPKD) except Case 1 for its unilaterality. Unlike ADPKD, URCD patients A 31-year-old man visited the ADPKD clinic with show neither a genetic background nor progressive pain in the right flank. He had been experiencing a deterioration in renal function; thus, the diVerential mild,

Dae Yeon Hwang; Curie Ahn; Jung Geon Lee; Seung Hyup Kim; Ha Young Oh; Yong Yim Kim; E. S. Lee; Jin Suk Han; Suhnggwon Kim; Jung Sang Lee


Epidemiologic characteristics of kidney malformations  

Microsoft Academic Search

Infants with kidney agenesis or dysgenesis, infants with cystic kidneys, and infants with horse-shoe kidneys were studied, based on data from three large and population-based congenital malformation registers: a total of 2666 infants among 5.83 million births. There is a strong variability between programs of the rates of registered unilateral kidney malformations and these are strongly over-represented in dead infants

John Harris; Elisabeth Robert; Bengt Källén



[Thoracic actinomycosis].  


Actinomycosis is an infectious disease distributed all over the world. Males are affected three times more than females; the incidence of the disease is higher in adults than in children. The main causative agent is Actinomyces israelii, which can be found in the oropharynx of healthy persons. Therefore actinomycosis represents always an endogenous infection, often in connection with other bacteriae. The thoracic manifestation amounts to approximately 15 percent of all cases. The main clinical symptoms are pain, fever, cough, fatigue, and weight loss. The blood picture shows an increased number of white blood cells with a left shift in the differential white blood cell count. Furthermore, there is a strongly raised erythrocyte sedimentation rate. Radiographs demonstrate no typical patterns of pulmonary abnormalities. For the diagnosis there is a need of anaerobic cultures, in second line histological examination of tissue specimens. Differential diagnosis of actinomycosis includes chronic pneumonias caused by other rare germs and neoplasms. After early onset antibiotic long term treatment a good prognosis may be expected. Penicillin represents the antibiotic of first choice. PMID:2689757

Fuchs, D; Katenkamp, D; Prauser, H; Zintl, F; Hermann, J



Free insulin-like growth factor-1 and unilateral complete ureteral obstruction in the rat  

Microsoft Academic Search

Objectives. To determine the effect of unilateral ureteral obstruction on renal free insulin-like growth factor-1 (IGF-1) content in the kidneys and the possible role of free IGF-1 in compensatory growth in the nonobstructed kidney in an experimental model.Methods. The content of free IGF-1 and total protein in the obstructed and nonobstructed kidneys were measured 7 days after unilateral ureteral obstruction.

T. Ahmet Serel; Alim Ko?ar; Mehmet Taho?lu



Society of Thoracic Surgeons  


... cardiothoracic surgery by following the links below: Adult Cardiac Surgery Valve Repair/Replacement Surgery Lung/Thoracic Surgery Esophageal ... Choosing Wisely® What is a Thoracic Surgeon? Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk ...


Blunt thoracic trauma.  


Blunt thoracic trauma represents a significant portion of trauma admissions to hospitals in the United States. These injuries are encountered by physicians in many specialities such as emergency medicine, pediatrics, general surgery and thoracic surgery. Accurate diagnosis and treatment improves the chances of favorable outcomes and it is desirable for all treating physicians to have current knowledge of all aspects of blunt thoracic trauma. Cardiothoracic surgeons often treat the most severe forms of blunt thoracic injuries and we review the aspects of blunt thoracic trauma that are pertinent to the practicing cardiothoracic surgeon. PMID:18420123

Weyant, Michael J; Fullerton, David A



Successful unilateral thoracoscopy for bilateral ectopic mediastinal parathyroidectomy.  


Ectopic parathyroid glands are frequently located in the thymus and may become hyperplasic in patients with secondary hyperparathyroidism. When medical management fails, surgical removal is required, using either a traditional open sternotomy approach or video-assisted thoracic surgery (VATS). We were able to excise large, bilateral, mediastinal parathyroid glands using only left VATS. To the authors' knowledge, this is the first reported case of the use of unilateral thoracoscopic subtotal thymectomy for the excision of bilateral ectopic mediastinal parathyroid glands. PMID:20376735

Fama', F; Berry, M G; Linard, C; Gioffre'-Florio, M; Metois, D



What Is a Thoracic Surgeon?  


... Thoracic Surgeon? The American Board of Thoracic Surgery (ABTS) maintains standards for the practice of thoracic surgery ... a sub-specialty certificate in addition to the ABTS certification. Some surgeons choose to focus their clinical ...


Kidney Cysts  


... fluid-filled sac. There are two types of kidney cysts. Polycystic kidney disease (PKD) runs in families. In PKD, the cysts ... kidney failure, dialysis or kidney transplants. Acquired cystic kidney disease (ACKD) usually happens in people who are on ...


Results of Nephrectomy in Hypertension Associated with Unilateral Renal Disease  

PubMed Central

Nephrectomy has been carried out in 34 patients with hypertension associated with unilateral parenchymal renal disease (28 with unilateral pyelonephritis, 3 tuberculosis, 2 hypoplasia, and 1 adenocarcinoma). In 13 of the patients the blood pressure was corrected, in four it was improved, and in 17 it was unaffected. The intravenous pyelogram (by the infusion technique with nephrotomography if necessary) and renogram give adequate information in most patients with unilateral parenchymal renal disease but may need to be supplemented by aortography, or retrograde pyelography, or divided renal function studies in a few special circumstances. When the function of the damaged kidney is less than 25% of the total (which is well maintained), and the contralateral kidney is intact, nephrectomy is recommended provided the hypertension is significant; success is more likely in younger patients with a short history of hypertension.

Luke, R. G.; Kennedy, A. C.; Briggs, J. D.; Struthers, N. W.; Stirling, W. Barr



Endoscope-assisted minimally invasive transforaminal thoracic interbody fusion.  


Surgical treatment of thoracic disc herniation is technically challenging from anterior, lateral or posterior approaches. Because of the deeply located thoracic discs and non-retractable thoracic thecal sac, standard anterior and lateral procedures for discectomy require extensive tissue dissection causing prolonged lengths of stay in hospital. In this video, the authors present a case of calcified disc herniation at the level of T10/11 causing paraplegia and voiding difficulty. The patient was operated on via an endoscope-assisted minimally invasive transforaminal thoracic interbody fusion (EA-TTIF). The herniated disc and calcification were removed through a 26-mm tubular retractor, under microscopes via a unilateral transpedicular approach. The endoscopes were used for direct visualization of the ventral thecal sac and confirmation of complete decompression. After the operation, the patient's neurological function completely recovered. Minimally invasive EA-TTIF is a viable and effective option for the surgical management of thoracic disc herniation. Thoracic interbody fusion can be achieved through a minimally invasive approach from the back. The video can be found here: PMID:23829841

Liao, Chih-Hsiang; Wu, Jau-Ching; Huang, Wen-Cheng; Wang, Wei-Hsin; Chang, Peng-Yuan; Cheng, Henrich; Yang-Shih



Unilateral Extrapedicular Vertebroplasty and Kyphoplasty in Lumbar Compression Fractures : Technique, Anatomy and Preliminary Results  

PubMed Central

Objective A single balloon extrapedicular kyphoplasty has been introduced as one of the unilateral approaches for thoracic compression fractures; however, the unilateral extrapedicular technique in the lumbar area needs a further understanding of structures in the lumbar area. The purpose of the present study is to describe methods and pitfalls of this procedure based on the anatomy of the lumbar area and to analyze clinical outcome and complications. Methods Anatomical evaluation was performed with 2 human cadavers. A retrospective review of unilateral extrapedicular approaches yielded 74 vertebral levels in 55 patients that were treated with unilateral extrapedicular vertebroplasty and kyphoplasty. Radiographic assessment included the restoration rate of vertebral height and correction of kyphosis. Results Anatomical evaluation indicates that the safe needle entry zone of bone for the extrapedicular approach was located in the supero-lateral aspect of the junction between the pedicle and vertebral body. The unilateral extrapedicular procedure achieved adequate pain relief with a mean decreases in pain severity of 7.25±1.5 and 2.0±1.4, respectively. Complications were 1 retroperitoneal hematoma, 6 unilateral fillings and 3 epidural leak of the polymethylmethacrylate. Conclusion The method of a unilateral extrapedicular approach in kyphoplasty and vertebroplasty in the lumbar area might be similar to that in thoracic approach using a route via the extrapedicular space. However, different anatomical characteristics of the lumbar area should be considered.

Cho, Sung-Min; Nam, Yong-Suk; Cho, Byung-Moon; Lee, Sang-Youl; Oh, Sae-Moo



Endoscopic thoracic sympathectomy  


Endoscopic thoracic sympathectomy (ETS) is surgery to treat sweating that is much heavier than normal. This condition ... hyperhidrosis . Usually the surgery is used to treat sweating in the palms or face. The surgery stops ...


Diffuse unilateral subacute neuroretinitis.  


Diffuse unilateral subacute neuroretinitis (DUSN) is a usually unilateral inflammatory disease characterized by an insidious, usually severe loss of peripheral and central vision. Clinical characteristics are manifested in early and late stages. Parasites of different sizes and several species of nematodes have been reported as the etiology of DUSN without conclusive evidence about the specific agent. Because serologic testing has been variable, the definitive diagnosis is made when the clinical characteristics of DUSN are found in conjunction with an intraocular worm. Laser photocoagulation, pars plana vitrectomy, thiabendazole, and albendazole have been used to treat DUSN with variable success. PMID:23244243

Arevalo, J Fernando; Arevalo, Fernando A; Garcia, Reinaldo A; de Amorim Garcia Filho, Carlos Alexandre; de Amorim Garcia, Carlos Alexandre



Sonar and its Use in Kidney Disease in Children  

Microsoft Academic Search

The basic principles of diagnostic ultrasound or sonar are given, together with the special technique required for scanning newborn infants and small children for kidney abnormalities.Illustrative examples of the potential of this procedure, both in diagnosis and in monitoring changes include a normal neonatal and preadolescent kidney, unilateral renal agenesis, duplex kidney, renal cyst, polycystic disease, nephroblastoma, and examples of

E. A. Lyons; A. V. Murphy; G. C. Arneil



Unilateral cleft foot deformity  

Microsoft Academic Search

A 17-year-old girl with unilateral atypical cleft foot deformity is reported. In this case the deformity was associated with deafness, mandibular retrognathia and congenital bilateral temporomandibular joint luxation. Family history of cleft foot deformity was not found. A syndactylization procedure with shortening of the big toe was done. The temporomandibular joint luxation was also corrected.

T. Kolda?; F. ?irin; T. Hayirho?lu



Kidney Failure  

MedlinePLUS Videos and Cool Tools

... following are diseases that can lead to ESRD: • diabetes • hypertension • lupus • repeated kidney infections • kidney stones • kidney ... are at risk of ESRD: • known kidney diseases: • diabetes • hypertension • lupus Some dietary restrictions may be needed ...


Kidney Transplantation  


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


[Thoracic aortic aneurysm].  


Thoracic aortic aneurysms (TAA) are the most common pathology of the thoracic aorta. TAA are occuring with increasing incidence (10.4 cases per 100,000 person years) and are most commonly caused by atherosclerosis. There are also hereditary, inflammatory and infectious pathogenic factors. A TAA initially causes no symptoms and is therefore usually diagnosed as an incidental finding. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are the diagnostic tools of choice for diagnosis and treatment planning. The mean growth rate of TAA is estimated to be 0.10 to 0.42 cm per year. A diameter of 6 cm is considered to be an indication for surgery. Besides medicinal therapy, thoracic endovascular aortic repair (TEVAR) nowadays offers certain advantages compared to conventional open repair. The same applies to the region of the aortic arch. Follow up examinations after TEVAR are of major importance in order to ensure long-term therapeutic success. PMID:22476134

Kotelis, D; Geisbüsch, P; Hakimi, M; Böckler, D



Bilateral thoracic paravertebral block: potential and practice.  


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

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



Nitric oxide in unilateral ureteral obstruction: Effect on regional renal blood flow  

Microsoft Academic Search

Nitric oxide in unilateral ureteral obstruction: Effect on regional renal blood flow.BackgroundUreteral obstruction (UO) is characterized by reduced blood flow and loss of tissue mass in the involved kidney(s). Vasoactive mediators interact to produce an initial hyperemia, followed by a sustained decrease in renal blood flow in the obstructed kidney. Nitric oxide (NO) has been shown to play a central

Nicholas J Hegarty; Leonie S Young; Caitriona N Kirwan; Amanda J O'Neill; David M Bouchier-Hayes; Paul Sweeney; R William G Watson; John M Fitzpatrick



Unilateral rhythmic testicular movements.  


A male patient came to our clinic because of a continuous up and down movement of his right testis, which was present even during sleep. The nature and localization of the unilateral rhythmic cremasteric activity is investigated by electrophysiological methods. Investigations of the cremasteric muscles and genitofemoral nerve determined that the movement was similar to myokymia. The localization of this peculiar spontaneous movement is probably in motor fibers somewhere between the L1-L2 motor neuron pool, motor roots and/or the genitofemoral nerve. PMID:20591560

Bademkiran, Fikret; Acarer, Ahmet; Aydogdu, Ibrahim; Ertekin, Cumhur



Unilateral Hydronephrosis and Renal Damage after Acute Leukemia  

PubMed Central

A 14-year-old boy presented with asymptomatic right hydronephrosis detected on routine yearly ultrasound examination. Previously, he had at least two normal renal ultrasonograms, 4 years after remission of acute myeloblastic leukemia, treated by AML-BFM-93 protocol. A function of the right kidney and no damage on the left was confirmed by a DMSA scan. Right retroperitoneoscopic nephrectomy revealed 3 renal arteries with the lower pole artery lying on the pelviureteric junction. Histologically chronic tubulointerstitial nephritis was detected. In the pathogenesis of this severe unilateral renal damage, we suspect the exacerbation of deleterious effects of cytostatic therapy on kidneys with intermittent hydronephrosis.

Simanauskiene, Egle; Daugelaviciene, Valentina; Laurinavicius, Arvydas; Mickys, Ugnius; Simonyte, Vaida; Vaitkeviciene, Goda; Verkauskas, Gilvydas



Kidney Diseases  


... urine until you go to the bathroom. Most kidney diseases attack the nephrons. This damage may leave kidneys ... or medicines. You are at greater risk for kidney disease if you have diabetes, high blood pressure, or ...


Role of nitric oxide in renal tubular apoptosis of unilateral ureteral obstruction  

Microsoft Academic Search

Role of nitric oxide in renal tubular apoptosis of unilateral ureteral obstruction.BackgroundThe obstructed kidney in unilateral ureteral obstruction (UUO) is characterized by renal atrophy and tissue loss, which is mediated by renal tubular apoptosis. We sought to determine whether NO is involved in renal tubular apoptosis in vitro and in vivo.MethodsRat renal tubular epithelial cells (NRK-52E) were subjected to mechanical

Akira Miyajima; Jie Chen; Dix P. Poppas; E. Darracott Vaughan; Diane Felsen



Vascular Thoracic Outlet Syndrome  

Microsoft Academic Search

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

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



Intramedullary thoracic tuberculoma  

Microsoft Academic Search

Study design:Case report.Objective:To report a rare case of intramedullary thoracic tuberculoma.Setting:China Rehabilitation Research Center, Beijing, China.Case report:A 42-year-old Chinese man presented with the complaints of weakness of the lower extremities and urinary retention. Neurological examinations confirmed the motor dysfunction of the lower extremities and hypesthesia in areas below the T8 dermatome. Results from laboratory studies were normal and X-ray over

Y D Liu; F Y Wang; J M Xu; Y Guan; H Guan



Signs in thoracic imaging.  


Radiologic signs are recognizable, characteristic patterns used to describe abnormalities visualized on imaging modalities that ultimately aid in the diagnosis and subsequent treatment of disease. This pictorial essay discusses 23 classic roentgenographic signs used in thoracic imaging. Its purpose is to be used as an educational review for residents, whether they are beginning their training or preparing for certification exams, and serve as a refresher and a reference to the practicing radiologist. PMID:16538167

Marshall, Geoffrey B; Farnquist, Brenda A; MacGregor, John H; Burrowes, Paul W



The Congenital and Acquired Solitary Kidney  

PubMed Central

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

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



Regulation of Aquaporins and Sodium Transporter Proteins in the Solitary Kidney in Response to Partial Ureteral Obstruction in Neonatal Rats  

Microsoft Academic Search

Unilateral ureteral obstruction (UUO) impairs function of the obstructed kidney, and the contralateral nonobstructed kidney compensates depending on the degree and duration of UUO. This study aimed to determine the hemodynamic and molecular changes in the solitary kidney in response to partial ureteral obstruction (PUO) where any compensation from the contralateral kidney was eliminated so that all observed changes in

Sukru Oguzkan Topcu; Rikke Nørregaard; Michael Pedersen; Guixian Wang; Troels Munch Jørgensen; Jørgen Frøkiær



Solitary Kidney  


... kidneys remove wastes and extra water from the blood to form urine. Urine flows from the kidneys to the bladder through the ureters. Most people can live a normal, healthy life with one kidney. Taking precautions is wise to protect the kidney function you do have. [ ...


Unilateral lower leg purpura.  


We present a case of an extensive, purpuric eruption on the lower leg with peculiar clinical findings in 55-year-old woman with rheumatoid arthritis. The purpuric lesions were present unilaterally on the left lower leg, where prominent varices and telangiectasia were noted. Histological examination revealed a perivascular infiltration of lymphocytic cells and eosinophils and extravasation of erythrocytes in the upper and middle dermis. There was no evidence of vasculitis. The eruption responded well to treatment with hemostatic agents and elastic stockings. Based on the clinical and histological findings, we concluded that the main pathophysiology of the purpuric eruption is an extravasation of erythrocytes related to increased venous pressure secondary to venous stasis. PMID:23374958

Ogawa, Satoshi; Oka, Masahiro; Kunisada, Makoto; Nishigori, Chikako



The unilateral stapes gusher.  


A stapes gusher is an alarming situation occurring during stapes surgery for mixed hearing loss. It is characterized by the sudden profuse flow of cerebrospinal fluid in the middle ear and external ear canal after opening the vestibule of the inner ear. An adult patient with unilateral stapes gusher is described; he was operated on both ears with a good hearing result on both sides. The stapes on the side with the cerebrospinal fluid leak was malformed, especially in the posterior crus--a finding which may suggest the possibility of a stapes gusher. The small-hole stapedotomy is a safe technique when dealing with a profuse cerebrospinal fluid leak, and it enables the closure of the leak with additional tamponade of the oval niche and the achievement of a good hearing result. PMID:15506322

Rebol, Janez



Renal aplasia is the predominant cause of congenital solitary kidneys  

Microsoft Academic Search

Renal aplasia is the predominant cause of congenital solitary kidneys.BackgroundCongenital solitary kidneys, which are susceptible to renal failure, have been considered mostly due to unilateral renal agenesis and partly due to renal aplasia. Risk of familial recurrence and of other associated anomalies is known to be much higher in renal agenesis than in renal aplasia. However, differential diagnosis between the

Masahiro Hiraoka; Hirokazu Tsukahara; Yuusei Ohshima; Kenkou Kasuga; Yoshinori Ishihara; Mitsufumi Mayumi



Clinical significance of unilateral sinusitis.  

PubMed Central

In general, the etiologic factors of chronic paranasal sinusitis are systemic conditions such as nutrition, predisposition, allergy, and local factors such as nasal anatomic conditions. Among these factors, the development of unilateral sinusitis is a model case verifying the influence of local factors. In my study of 640 cases over a certain period of time, a comparison was made between 161 cases of unilateral sinusitis and 479 cases of bilateral sinusitis in order to verify the effects of local factors in the development of this disease. Patients with a history of previous sinus surgery or tumors were eliminated from the cases. 1. The male-female incidence rate, and the age distribution of the patients at the initial visit showed no prominent differences between unilateral and bilateral cases. 2. It was found that a larger number of cases of unilateral sinusitis had a duration of less than one year as compared to bilateral sinusitis which were longer than and year. Therefore it can be said that the duration of unilateral sinusitis is usually shorter than that of bilateral sinusitis. 3. In unilateral cases the patients with moderate to severe nasal septal deviation, one number of patients with septal deviation towards the diseased side was twice as high as that on the non-affected side. 4. The incidence rate of polyps occurring in the middle meatus was shown to be about twice as high in bilateral cases as in unilateral cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Shin, H. S.



Linkage study of a large family with autosomal dominant polycystic kidney disease with reduced expression  

Microsoft Academic Search

We describe a large three generation family with autosomal dominant polycystic kidney disease (PKD). Ultrasonographic screening of 60 family members revealed 20 individuals, whose age ranged from ten to eighty years, with one or several cysts in only one kidney and 7 individuals with cysts in both kidneys. Transmission of unilateral cysts seems to be autosomal dominant, although there are

Lucien Bachner; Marie Claude Vinet; Roger Lacave; Marie Claude Babron; Eric Rondeau; Jean Daniel Sraer; Dominique Chevet; Jean-Claude Kaplan



Experiences with Extracorporeal Shock Wave Lithotripsy in Patients with a Solitary Kidney  

Microsoft Academic Search

Between March 1985 and January 1990, 43 patients with stones in solitary kidneys were treated by extracorporeal Shockwave lithotripsy (ESWL) in our department. The most common cause of unilateral kidney absence was previously surgical removal of the kidney. The primary treatment modality was ESWL in all patients; the need for auxiliary procedures was higher than in general stone patients. Of

K. Sarica; R. Köhle; G. Kunit; J. Frick




Microsoft Academic Search

Continuing improvements in instrumentation, anesthetic and surgical techniques, and post- operative management allow the thoracic surgeon to operate on the oldest patients with the expectation of successful outcomes. However, when elderly patients require thoracic sur- gery and scarce resources in support of such specialized care must be allocated, the need to provide care to younger patients may become a factor

Joseph LoCicero III; John Yee


Thoracic spine x-ray  


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


Pacing for Unilateral Diaphragm Paralysis  

Microsoft Academic Search

Symptoms of unilateral diaphragmatic paralysis can range from sleep-related symptoms to exert ional dyspnea or orthopnea.\\u000a At times unilateral diaphragm paralysis is found on routine chest radiograph alone when an elevated hemidiaphragm is seen.\\u000a Ventilatory failure will usually only result if there is bilateral diaphragmatic involvement. When diaphragmatic paralysis\\u000a is suspected, confirmatory testing is done by inspiratory fluoroscopy (sniff test)

Raymond P. Onders


Kidney removal  


... surgery of the kidney. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, Pa: Saunders Elsevier; ... surgery of the kidney. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, Pa: Saunders Elsevier; ...


Kidney Dysplasia  


... affect the normal kidney. For example, one urinary birth defect causes blockage at the point where urine normally drains from the kidney into the ureter. Another birth defect causes urine to flow from the bladder back up ...


Kidney Biopsy  


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


Kidney School  


... online Download & print En Español Listen Module 11 - Sexuality and Fertility Maintaining a healthy sex life and ... kidney disease. Learn how kidney disease can affect sexuality and fertility—and what you can do about ...


Kidney transplant  


Renal transplant; Transplant - kidney ... Barry JM, Jordan ML, Conlin MJ. Renal transplantation. In: Wein AJ, ed. Campbell-Walsh Urology . 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 40. Kidney Disease: Improving Global Outcomes ( ...


Kidney Cancer  


... body). There are several types of kidney cancer: Renal cell carcinoma. Renal cell carcinoma makes up about 85% of kidney ... lead to the bladder. The treatment options for renal cell carcinoma are discuss later in this guide. ...


Kidney Infection  


... empty your bladder when urinating, such as a kidney stone, structural abnormalities in your urinary system or, in men, an ... can identify underlying and potentially treatable causes. Recurrent kidney ... such as a structural abnormality. Your doctor may refer you to a kidney ...


Thoracic cardiovascular trauma.  


Trauma is the third leading cause of death in the United States and the leading cause for persons under 40 years of age; chest trauma accounts for more than 25% of these deaths. Rates of trauma to the chest--both blunt and penetrating--are rising because of the continuing development of high-speed transportation and because of increasing inner-city violence combined with ready availability of handguns. But treatment has improved; even injury to the heart is no longer considered invariably lethal. This review describes the spectrum of injuries to the pericardium, heart, aorta, and thoracic arteries and veins, exclusive of iatrogenic trauma and high-velocity gun shot injuries caused by military weapons. The role of imaging is described. PMID:3302291

Godwin, J D; Tolentino, C S



Unilateral parathyroid exploration.  


Unilateral neck exploration (UNE) for primary hyperparathyroidism can be done with the same excellent results as bilateral neck exploration (BNE) with decreased operative time and postoperative complications with a good preoperative localization study. One hundred six charts were reviewed retrospectively in patients operated on between May 1989 and October 1996 with primary hyperparathyroidism. Seventy-seven of these patients had preoperative ultrasounds (US) performed by a radiologist interested in parathyroid ultrasonography. UNE was performed if the operative findings were consistent with the US and a normal gland was identified on the same side. If a normal gland was not identified on the initial side or there was a question of hyperplasia a BNE was performed. Forty-six of the 77 patients had UNE, and 31 had BNE. Sixty-nine of these patients were found to have accurate US. Based on these results there is a 90 per cent accuracy rate for US performed by an interested radiologist. Comparing operative times between patients with UNE and BNE, there was a statistical difference (P = 0.001). Complications were also recorded in each group. Patients with UNE had a 22 per cent complication rate, whereas patients with BNE had a 45 per cent complication rate. This difference was statistically significant (P = 0.04) (Fisher's exact test). The majority of complications were asymptomatic and symptomatic hypocalcemia. Two patients in the BNE group experienced transient hoarseness. The advantages of UNE include reduced morbidity, decreased operative time and avoidance of scarring in the contralateral neck. In the total study population (n = 106), 99 patients (93.4%) had a single adenoma. An accurate, noninvasive, low-cost preoperative localization study is necessary to practice UNE for primary hyperparathyroidism. Parathyroid US, done by an interested radiologist, with a 90 per cent accuracy rate, meets all these criteria. PMID:9655284

Vogel, L M; Lucas, R; Czako, P



Osteopontin regulates renal apoptosis and interstitial fibrosis in neonatal chronic unilateral ureteral obstruction  

Microsoft Academic Search

Congenital obstructive nephropathy is a major cause of renal insufficiency in children. Osteopontin (OPN) is a phosphoprotein produced by the kidney that mediates cell adhesion and migration. We investigated the role of OPN in the renal response to unilateral ureteral obstruction (UUO) in neonatal mice. OPN null mutant (?\\/?) and wild-type (+\\/+) mice were subjected to sham operation or UUO

K H Yoo; B A Thornhill; M S Forbes; C M Coleman; E S Marcinko; L Liaw; R L Chevalier



Thoracic Anesthesia in the Elderly  

Microsoft Academic Search

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

Anne C. Kolker


[Unilateral hemiarcus lipoides corneae inferior].  


We document a case of unilateral hemiarcus lipoides, which developed de novo 10 months after trabeculectomy in the left eye of a 54-year-old woman. The involved eye showed heterochromia complicata Fuchs and had undergone intracapsular cataract extraction 11 years and trabeculectomy one year earlier. Except for intermittent hypercholesterolemia, the patient did not present any signs of systemic disease. The possible roles of relative ocular hypotony and modified aqueous circulation after trabeculectomy in the development of unilateral hemiarcus lipoides are discussed. PMID:2280570

Naumann, G O; Küchle, M



Kidney Stones  

Microsoft Academic Search

This chapter provides a concise summary of the epidemiology, clinical significance, pathophysiology, diagnosis, and secondary\\u000a preventive, medical management of kidney stone disease. Specific emphasis is placed on the contribution of diet on kidney\\u000a stone risk and examples are given for potential dietary interventions to prevent kidney stones. Specific pharmacological therapies\\u000a with their corresponding pathophysiological mechanism of action are reviewed. A

Orfeas Liangos; Bertrand L. Jaber


Unilateral anhidrosis: a rare presentation of atrial myxoma?  


A 50-year-old Chinese woman, non-smoker, presented with a 6-month history of increased sweating on the right side of her face, exertional chest tightness and breathlessness. Although the patient presented with increased sweating on the right, further history and examination revealed unilateral, left-sided anhidrosis, left partial ptosis and miosis consistent with Horner's syndrome. The patient was subsequently investigated with thoracic CT to assess for an apical lung mass (Pancoast tumour). A CT chest ruled out a mediastinal tumour, however, it revealed a large 60×41 mm soft tissue mass arising from the left atrium, protruding across the mitral valve into the left ventricle, suspicious of an intracardiac tumour. The patient was referred urgently for cardiothoracic assessment at a tertiary referral centre and successful open resection was performed. Histology confirmed an atrial myxoma. The patient developed postoperative atrial fibrillation but otherwise made a full recovery. PMID:23230264

Gould, Justin



Transdermal hyoscine induced unilateral mydriasis.  


The authors present a case of unilateral mydriasis in a teenager prescribed transdermal hyoscine hydrobromide (scopolamine) for chemotherapy induced nausea and vomiting. The authors discuss the ocular side-effects associated with this particular drug and delivery system and the potential use of transdermal hyoscine as an antiemetic agent in this group. PMID:22605696

Hannon, Breffni; Jennings, Valerie; Twomey, Marie; O'Reilly, Maeve



Isolated unilateral temporalis muscle hypertrophy  

Microsoft Academic Search

A case of isolated unilateral temporalis muscle hypertrophy is presented. A review of the literature revealed only one report of temporalis hypertrophy, probably caused by psychogenic muscle hyperactivity. The temporalis muscle hypertrophy in the patient described was idiopathic and its management was surgical.

A. Serrat; J. M. García-Cantera; L. M. Redondo



Complications of thoracic radiotherapy.  


The issue of toxicity is a primary concern for chest irradiation, because it is a dose-limiting toxicity and because in some circumstances it can alleviate the survival benefit of radiation therapy. Potential acute and delayed side effects can compromise the patients' prognosis and generate significant morbidity. Here we review on chest complications of radiation therapy, with focus on cardiac and pulmonary radio-induced side effects. Most radiographic changes associated with thoracic irradiation are asymptomatic. However, chest irradiation generated by treatment of breast cancer, bronchopulmonary malignancies, or mediastinal lymphoma has been associated with a risk of acute radiation pneumonitis and late lung fibrosis. An increasing number of clinical studies suggest that some dosimetric factors (e.g. V20, V30, mean lung dose) should be considered for limiting the risk of lung toxicity. Improvements in radiation techniques as well as changes in indications, volumes and prescribed doses of radiation therapy should help to better spare lungs from irradiation and thus decreasing the risk of subsequent toxicity. Numerous other contributing factors should also be considered, such as chemotherapeutic agents, smoking, tumor topography, or intrinsic sensitivity. Cardiac toxicity is another clinically relevant issue in patients receiving radiation therapy for breast cancer or for lymphoma. This life threatening toxicity should be analyzed in the light of dosimetric factors (including low doses) but also associated systemic agents which almost carry a potential for additive toxicity toward myocardium or coronaries. A long-term follow-up of patients as well as an increasing knowledge of the underlying biological pathways involved in cardiac toxicity should help designing effective preventing strategies. PMID:23972736

Chargari, Cyrus; Riet, François; Mazevet, Marianne; Morel, Eric; Lepechoux, Cécile; Deutsch, Eric



Your Kidneys  


... Pee The waste that is collected combines with water (which is also filtered out of the kidneys) to make urine (pee). As each kidney makes urine, the urine slides down a long tube called the ureter (say: yu - REE-ter) and collects in the bladder, a storage sac that holds the urine. When the bladder ...


Kidney Cancer  


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 ...


Renoprotective effects of telmisartan after unilateral renal ablation in rats  

PubMed Central

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

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



Thoracic sympathicolysis for primary hyperhidrosis  

Microsoft Academic Search

Background  Bilateral upper thoracic sympathectomy or sympathicolysis, currently the standard treatment for palmar or axillary hyperhidrosis,\\u000a is regarded as a safe procedure. This study evaluates the quantitative and qualitative incidence of intraoperative and postoperative\\u000a complications resulting from bilateral thoracic sympathicolysis.\\u000a \\u000a \\u000a \\u000a Methods  From 1996 to 2004, 458 consecutive patients with primary hyperhidrosis underwent surgery. These patients comprised 143 men\\u000a (31.2%) and 315 women

J. Moya; R. Ramos; R. Morera; R. Villalonga; V. Perna; I. Macia; G. Ferrer



Genetics of thoracic aortic aneurysms.  


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

Jondeau, Guillaume; Boileau, Catherine



Thoracic venous congestion caused by thoracic disc herniation.  


We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix-Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery. PMID:23785652

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



Thoracic venous congestion caused by thoracic disc herniation  

PubMed Central

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

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



Testing for Kidney Disease  


... and Kidney Disease Additional Kidney Information Testing for Kidney Disease Early kidney disease usually does not have signs ( ... how often you should be tested. Testing for Kidney Disease Overview Understanding GFR Understanding Urine Albumin Videos Testing ...


Noncompliance unilateral maxillary molar distalization:.  


The aim of this prospective study was the three-dimensional (3-D) analysis of tooth movements after unilateral upper molar distalization by means of a noncompliance intraoral appliance, the Keles slider. This appliance exerts a distalizing force of 150 g at approximately the level of the center of resistance of the upper first molar. Twelve patients (six girls and six boys with a mean age of 13.1 years) with a unilateral Class II molar relationship participated in the study. Dental casts were taken immediately before placement and after removal of the appliance. The casts were digitized using a 3-D surface laser scanner and superimposed on a predefined area of the palate. The average unilateral upper first molar distal movement was 3.1 mm (range: 2.4 to 5.3 mm). Anchorage loss was expressed by a 2.1 mm (range: 0.8 to 3.8 mm) proclination of the central incisors and a 6.1 degrees mesial inclination of the ipsilateral first premolar (range: 1.7 degrees to 12.3 degrees ). There was approximately 1 mm of midline deviation toward the contralateral side and a 1.6 mm (range: 0.8 to 2.3 mm) buccal displacement of the contralateral first premolar. A substantial variation was observed among patients. Noncompliance unilateral upper molar distalization was an efficient treatment approach. There was, however, a substantial anchorage loss. Case selection is strongly recommended because significant anterior crowding, ectopic canines, or spacing can lead to significant anchorage loss. PMID:16637715

Mavropoulos, Anestis; Sayinsu, Korkmaz; Allaf, Ferdi; Kiliaridis, Stavros; Papadopoulos, Moschos A; Keles, Ahmet Ozlem



Unilateral punctate porokeratosis - Case report*  

PubMed Central

This case report involves a 20-year-old man with unilateral punctate porokeratosis. The patient presented an 8-year history of numerous asymptomatic keratotic papules and pits with linear distribution on his left pal-mar surface and fifth finger of the left hand. Histopathological examination of the keratotic plug revealed findings of distinct epidermal depressions containing cornoid lamellae. This report review draws attention to differential diagnoses of punctate porokeratosis.

Teixeira, Vera Barreto; Reis, Jose Pedro; Vieira, Ricardo; Tellechea, Oscar; Figueiredo, Americo



Serum and glucocorticoid-regulated kinase 1 is upregulated following unilateral ureteral obstruction causing epithelial–mesenchymal transition  

Microsoft Academic Search

Obstructive nephropathy leads to chronic kidney disease, characterized by a progressive epithelial-to-mesenchymal cell transition (EMT)-driven interstitial fibrosis. To identify the mechanisms causing EMT, we used the mouse model of unilateral ureteral obstruction and found a rapid and significant increase in serum- and glucocorticoid-regulated kinase-1 (SGK1) expression in the kidneys with an obstructed ureter. Knockout of SGK1 significantly suppressed obstruction-induced EMT,

Jizhong Cheng; Luan D Truong; Xiaoqian Wu; Dietmar Kuhl; Florian Lang; Jie Du



Damage control surgery for thoracic injuries  

Microsoft Academic Search

Damage control of thoracic injuries begins frequently with an emergency department thoracotomy via an anterolateral incision. Bleeding and air leaks are quickly temporised. As opposed to abdominal damage control where most injuries can be temporised, most thoracic injuries require initial definitive repair. Thus, the goal of thoracic damage control is to perform the least definitive repair using the fastest and

Michael F Rotondo; Michael R Bard



A study on evaluation of 3D virtual rabbit kidney models by multidetector computed tomography images  

Microsoft Academic Search

Objectives: This study was performed to reveal biometric peculiarities of New Zealand rabbit kidneys by means of three- dimensional (3D) reconstruction of multidetector computed tomography (MDCT) images. Methods: Under general anaesthesia, the kidneys of eight rabbits of both sexes were scanned by high resolution imaging using a general diagnostic MDCT. The thoracic and lumbar vertebrae of the rabbit were used

Emrullah Eken; Yahya Paksoy; Kamil Befloluk



Kidney Problems  


... and bases and many other chemicals (such as electrolytes) in your blood and tissues, and to eliminate ... problems from kidney disease may include: Fluid and electrolyte imbalance – e.g., too much or too little ...


Kidney Facts  


... the kidneys is to remove waste from the body through the production of urine. They also help to regulate blood pressure, blood volume and the chemical (electrolyte) composition of the blood. Content on this page requires ...


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

Microsoft Academic Search

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

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



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

Microsoft Academic Search

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

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



Unilateral spinal anaesthesia in a patient with Osteogenesis Imperfecta with a lower leg fracture: a case report.  


Osteogenesis Imperfecta is a rare, genetically determined disease with several possible complications in anaesthesia. Anaesthesiologists therefore pay special attention to the treatment of patients suffering from Osteogenesis Imperfecta since they commonly suffer from a difficult airway and intraoperative positioning difficulties. We report here the case of unilateral spinal anaesthesia in a patient suffering from Osteogenesis Imperfecta type I. A 28-year-old patient diagnosed with Osteogenesis Imperfecta type I was admitted to the hospital due to lower leg fracture requiring surgical treatment. The patient had blue sclerae, triangular-shaped face, macroglossia, scoliosis of thoracic and lumbar parts of the spine, pectus carinatum and thrombocytopenia. Upon the correction of thrombocytopenia, unilateral spinal anaesthesia with hyperbaric levobupivacain was chosen in order to avoid possible complications typical for general anaesthesia. Consequently, unilateral spinal anaesthesia with a customized local anesthetic could be consdered as a safe anesthetic method for such patients. PMID:24060019

Baranovic, Senka; Lubina, Ivan Zvonimir; Vlahovic, Tomislav; Bakota, Bore; Maldini, Branka



Why are thoracic operations postponed?  

PubMed Central

Aim To investigate and present the reasons that cause the postponement of thoracic surgical operations. Methods We retrospectively included in the study all patients submitted to elective thoracic surgery in our department during the 4-year period 2007-2010 and noted all cases of postponement after official inclusion in the operating schedule. Results 81 out of a total of 542 patients (14.9%) scheduled for elective thoracic operation had their procedure postponed. The reasons were mainly organisatory (in 42 cases, 51.85%), which in order of significance were: shortage in matching erythrocyte units, shortage in anaesthetic/nursing staff and unavailability in operating rooms. The rest of the cases (39, 48.1%) were postponed due to medical reasons, which in descending order of significance were: respiratory infections and exacerbations of COPD, cardiological problems, misregulation of antiplatelet/antithrombotic drugs and infections from other systems (gastrointestinal, urinary, etc.). Elderly male patients planned for major/oncologic surgery were most possible to have their operation postponed for medical reasons. Discussion-Conclusions Thoracic operations are postponed owed to organisatory as well as medical reasons, the latter mainly affecting elderly, morbid patients awaiting for major/oncologic surgery.



Fractures of the thoracic spine  

Microsoft Academic Search

Of 98 patients with fracture of the thoracic spine (Th1–Th11) treated at the Central Hospital of Tampere in 1968–1975, 75 (77%) were seen after an average of 5 years and 4 months. Nearly half (49%) the injuries were sustained in road accidents and 36% were due to falling. Anterior wedge fracture was present in 91 %. Two patients died in

M. Härkönen; M. Kataja; P. Lepistö; T. Paakkala; H. Pätiälä; P. Rokkanen



Epidemiology of thoracic aortic dissection  

Microsoft Academic Search

Thoracic aortic dissection (TAD) is estimated to occur at a rate of 3–4 cases per 100,000 persons per year and is associated with a high mortality. Reported rates are probably underestimates of the true incidence of TAD because of difficulties in diagnosis. The incidence of TAD appears to have been increasing over time. TAD is most common in men and

Ludivine Russell; Scott A. LeMaire



Treatments of unilateral neglect: A review  

Microsoft Academic Search

Pierce SR, Buxbaum LJ. Treatments of unilateral neglect: a review. Arch Phys Med Rehabil 2002;83:256-68. Objectives: To review the existing literature on treatments of unilateral neglect, to synthesize findings, and to offer recommendations for future studies. Data Sources: Computerized databases including MEDLINE and PsychINFO. Study Selection: All studies investigating treatment(s) of unilateral neglect. Data Extraction: Authors reviewed design and other

Samuel R. Pierce; Laurel J. Buxbaum



Consequences of Unilateral Hearing Loss: Cortical Adjustment to Unilateral Deprivation  

PubMed Central

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

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



Kidney removal - series (image)  


Nephrectomy may be recommended for: kidney deformities (birth defects: congenital abnormalities) injury (trauma) disease infection hypertension tumor removal of kidney from donor for kidney transplant


Sonographic long-term study: paediatric growth charts for single kidneys  

Microsoft Academic Search

Aims:To explore the clinical course of children with “single kidney” (defined as either a solitary or single functioning kidney) with reference to renal function (glomerular filtration rate (GFR) and proteinuria), body height and particularly sonomorphological features.Patients and methods:This retrospective monocentric study evaluated 119 children with a solitary or single functioning kidney (>90% unilateral function on isotope scan) between 1997 and

E M Spira; C Jacobi; A Frankenschmidt; M Pohl; C von Schnakenburg



Pharmacokinetic optimization of immunosuppressive therapy in thoracic transplantation: part I  

PubMed Central

Although immunosuppressive treatments and therapeutic drug monitoring have significantly contributed to the increased success of thoracic transplantation, there is currently no consensus on the best immunosuppressive strategies. Maintenance therapy typically consists of a triple-drug regimen including corticosteroids, a calcineurin inhibitor (cyclosporine or tacrolimus) and either a purine synthesis antagonist (mycophenolate mofetil or azathioprine) or a mTOR inhibitor (sirolimus or everolimus). The incidence of acute and chronic rejection and of mortality after thoracic transplantation is still high compared to other types of solid organ transplantation. The high allogeneicity and immunogenicity of the lungs justify the use of higher doses of immunosuppressants, putting lung transplant recipients at a higher risk for drug-induced toxicities. All immunosuppressants are characterized by a large intra- and inter-individual variability of their pharmacokinetics and by a narrow therapeutic index. It is essential to know their pharmacokinetic properties and to use them for treatment individualization through therapeutic drug monitoring (TDM) in order to improve treatment outcome. Unlike the kidneys and the liver, the heart and the lungs are not directly involved in drug metabolism and elimination, which may be the cause of pharmacokinetic differences between patients from all these transplant groups. TDM is mandatory for most immunosuppressants, and has become an integral part of immunosuppressive drug therapy. It is usually based on trough concentrations (C0) monitoring, but other TDM tools include the area under the concentration-time curve over the dosing interval (AUC0-12) or over the first 4 hours post-dose (AUC0-4), as well as other single concentration-time points, such as the concentration 2 hours after dosing (C2). Given the peculiarities of thoracic transplantation, a review of the pharmacokinetics and TDM of the main immunosuppressants used in thoracic transplantation is presented in this article. Even more so than in other solid organ transplant populations, their pharmacokinetics is characterized by wide inter- and intra-individual variability in thoracic transplant recipients. The pharmacokinetics of cyclosporine in heart and lung transplant recipients has been explored in a number of studies, but less is known about that of mycophenolate and tacrolimus in these populations, while there are also hardly any studies on the pharmacokinetics of sirolimus and everolimus. Given the increased use of these molecules in thoracic transplant recipients, their pharmacokinetics deserves to be explored more in depth. There is very little data, some of which is conflicting, on the practices and outcomes of the TDM of immunosuppressants after thoracic transplantation. The development of sophisticated TDM tools dedicated to thoracic transplantation are awaited, in order to evaluate accurately and precisely patients’ exposure to drugs in general and in particular, to immunosuppre ssants. Finally, large cohort TDM studies definitely need to be conducted in thoracic transplant patients, in order to identify the most predictive exposure indices, and their target values, and to validate the clinical usefulness of improved TDM in these conditions.

Monchaud, Caroline; Marquet, Pierre



Thoracic aortic aneurysms and dissections: endovascular treatment.  


The treatment of thoracic aortic disease has changed radically with the advances made in endovascular therapy since the concept of thoracic endovascular aortic repair was first described 15 years ago. Currently, there is a diverse array of endografts that are commercially available to treat the thoracic aorta. Multiple studies, including industry-sponsored and single-institution reports, have demonstrated excellent outcomes of thoracic endovascular aortic repair for the treatment of thoracic aortic aneurysms, with less reported perioperative morbidity and mortality in comparison with conventional open repair. Additionally, similar outcomes have been demonstrated for the treatment of type B dissections. However, the technology remains relatively novel, and larger studies with longer term outcomes are necessary to more fully evaluate the role of endovascular therapy for the treatment of thoracic aortic disease. This review examines the currently available thoracic endografts, preoperative planning for thoracic endovascular aortic repair, and outcomes of thoracic endovascular aortic repair for the treatment of both thoracic aortic aneurysms and type B aortic dissections. Mt Sinai J Med 77:256-269, 2010. (c) 2010 Mount Sinai School of Medicine. PMID:20506451

Baril, Donald T; Cho, Jae S; Chaer, Rabih A; Makaroun, Michel S


The practice of thoracic surgery in Canada  

PubMed Central

The objective of the consensus conference of the Canadian Association of Thoracic Surgeons (CATS) was to define the scope of thoracic surgery practice in Canada, to develop standards of practice, to define training and resource requirements for the practice of thoracic surgery in Canada and to determine appropriate waiting times for thoracic surgery care. A meeting of the CATS membership was held in September 2001 to address issues facing thoracic surgeons practising in Canada. The discussion was facilitated by an expert panel of surgeons and supplemented by a survey. At the end of the meeting, consensus was reached by the membership regarding the issues outline above. The membership agreed that the scope of practice includes diagnosis and management of conditions of the lungs, mediastinum, pleura and foregut. They agreed that appropriate training in thoracic surgery included completion and certification in general or cardiac surgery prior to completing a 2-year program in thoracic surgery. The membership supported the Canadian Society of Surgical Oncology recommendations for management of cancer patients that new patients should be seen within 2 weeks of referral and cancer therapy initiated within 2 weeks of consultation. Thoracic surgical care is best delivered by 2 or 3 fully certified thoracic surgeons, in regional centres linked to a cancer centre and trauma unit. The establishment of a critical mass of thoracic surgeons in each centre would lead to improved quality and delivery of care and allow for adequate coverage for on-call and continuing medical education.

Darling, Gail E.; Maziak, Donna E.; Clifton, Joanne C.



MRI detection of atrophic kidney in a hypertensive child with a single kidney  

Microsoft Academic Search

The role of magnetic resonance imaging (MRI) in the work-up of secondary causes of pediatric hypertension is typically restricted to that of renovascular causes where main renal artery stenosis is suspected. We report a case of a 10-year-old female child with hypertension, who was thought to have unilateral renal agenesis, because only a solitary left kidney could be visualized on

Rudolph P. Valentini; Scott Langenburg; Abubakr Imam; Tej K. Mattoo; J. Michael Zerin



Sonar and its Use in Kidney Disease in Children  

PubMed Central

The basic principles of diagnostic ultrasound or sonar are given, together with the special technique required for scanning newborn infants and small children for kidney abnormalities. Illustrative examples of the potential of this procedure, both in diagnosis and in monitoring changes include a normal neonatal and preadolescent kidney, unilateral renal agenesis, duplex kidney, renal cyst, polycystic disease, nephroblastoma, and examples of mild and severe hydronephrosis. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10FIG. 11FIG. 12

Lyons, E. A.; Murphy, A. V.; Arneil, G. C.



Selective control of sympathetic pathways to the kidney, spleen and intestine by the ventrolateral medulla in rats.  

PubMed Central

1. Electrical activity of multifibre renal, splenic, mesenteric and greater splanchnic nerves and 13th thoracic white rami was recorded in artificially respired, urethane-anaesthetized rats. Discharge of neurones in the rostral ventrolateral medulla was blocked by unilateral microinjections of the inhibitory amino acid glycine and effects on the electrical activity of these sympathetic nerves were compared. 2. Blockade of the rostral ventrolateral medulla caused greater decreases in discharge of renal than splenic nerves and had no consistent effect on mesenteric nerves. This blockade also decreased the discharge of the preganglionic white rami more than that of the preganglionic splanchnic nerves. 3. Postganglionic responses to rostral ventrolateral medulla blockade were always greater than preganglionic responses. 4. The arterial pressure and renal nerve responses to rostral ventrolateral medulla blockade in urethane-anaesthetized rats were not different from those in rats anaesthetized with alpha-chloralose. 5. These findings demonstrate that pre- and postganglionic sympathetic pathways to the kidney are more dependent upon excitatory drive from the rostral ventrolateral medulla than pathways directed to the spleen and intestine.

Hayes, K; Weaver, L C



Chronic Kidney Diseases  


... pressure at a healthy level. Continue Kinds of Kidney Diseases Like any complicated machine, not all kidneys work ... to work the way they should. How Are Kidney Diseases Diagnosed? Kidney problems are often not noticed at ...


Kidney Filtering  

NSDL National Science Digital Library

In this activity, students filter different substances through a plastic window screen, different sized hardware cloth and poultry netting. Their model shows how the thickness of a filter in the kidney is imperative in deciding what will be filtered out and what will stay within the blood stream.

Integrated Teaching And Learning Program



Microsoft Academic Search

In this paper we study the contact problem for small and large dee ctions of thin elastic plate, the lateral displacement of which are constrained by a presence of a unilateral support. The problems considered here are systems of nonlinear variational inequalities in transverse displacement w and stress of points on the middle plane of the plate. The unilateral constraint

Aliki D. Muradova-Contadaki; Georgios E. Stavroulakis


Endovascular Stent in Traumatic Thoracic Aortic Dissection  

PubMed Central

Traumatic thoracic aortic injury is typically fatal. However, recent improvements in pre-hospital care and diagnostic modalities have resulted in an increased number of patients with traumatic aortic injury arriving alive at the hospital. Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury. We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.

Jang, Mi Ok; Kim, Ju Han; Oh, Sang Ki; Lee, Min Goo; Park, Keun Ho; Sim, Doo Sun; Hong, Young Joon; Ahn, Youngkeun



Thoracic extruded disc mimicking spinal cord tumor  

Microsoft Academic Search

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

Bikash Bose



Acute unilateral facial nerve palsy.  


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

Yeong, Siew Swan; Tassone, Peter



Fast track endoscopic thoracic sympathicotomy.  


The length of hospital stay is an important factor of cost and psychological discomfort in the treatment of hyperhidrosis by endoscopic thoracic sympathicotomy (ETS). Our experience enrolls 1587 patients operated on an outpatient basis in the last 10 years and seven months. This study aimed to confirm that ETS can be performed on an outpatient basis. Fifty-two consecutive patients (30 males and 22 females) were submitted to ETS under general anesthesia using a single lumen endotracheal tube, with lung collapse by intrapleural injection of CO(2). The sympathetic chain and the communicating rami were severed at different levels according to hyperhidrosis location. Patients were physical state American Society of Anesthesiologists 1 and 2. Age varied between 13 and 55 years (27.3 +/- 10.2 years). They were monitored with ECG, SPO2, NIBP, expired CO(2), sevoflurane analyzer, and airway pressure. Normal saline (40.0 +/- 2.7 ml/kg) was infused intravenously. The drugs used were propofol, alfentanil, rocuronium, ondansetron, dexamethasone, dipyrone, cetoprofene and sevoflurane. Anesthesia and post-operative data were analyzed. Post-operative thoracic X-rays were taken in 20 patients before discharge. Anesthesia lasted 67.2 +/- 20.8 minutes, and the surgical procedure took 46.3 +/- 20.9 minutes. The patients stayed 18.0 +/- 11.0 minutes in the post-anaesthetic care unit and were discharged from hospital after 150.3 +/- 43.1 minutes. The only abnormal post-operative event observed was insignificant residual carbothorax, found in 2 (10%) of the thoracic X-rays taken. In conclusion, this study confirmed that ETS can be performed safely on an outpatient basis. PMID:14673677

Duarte, João Bosco Vieira; Kux, Peter; Castro, Carlos H V; Cruvinel, Marcos G C; Costa, José R R



Solitary kidney.  


The study provides the pediatric practitioner with a tool to determine whether the child with an apparently normal solitary kidney requires an in-depth investigation. Medical records from January 1, 1995 to December 31, 2006 identified 96 children with solitary kidneys and showed 78 with a normal appearing, hypertrophied solitary kidney. Study groups included (1) children 1 to 2 years, (2) girls older than 2 years and boys 2 to 13 years, and (3) boys older than 13 years. Serum creatinine concentrations and estimated glomerular filtration rate were calculated for each group. The mean serum creatinine concentrations in group 1 was 0.4+/-0.1 mg/dL, group 2 was 0.6+/-0.2 mg/dL, and group 3 was 1.1+/-0.2 mg/dL. An estimated glomerular filtration rate 2 SD below the mean suggests further investigation. An estimated glomerular filtration rate 2 SD below the mean was 78 mL/min/1.73 m(2) in group 1, 73 mL/min/1.73 m(2) in group 2, and 70 mL/min/1.73 m(2) in group 3. PMID:18698097

Hellerstein, Stanley; Chambers, Luke



Fluid management in thoracic surgery.  


Better understanding of the pathophysiology of acute lung injury (ALI) and the hazards inherent to extremes in volume status has led efforts toward goal-directed, individualized therapies designed to achieve optimal hemodynamic status. The role for colloids both as a volume expander and potential protective agent against ALI is receiving revived interest. The evidence for the impact of fluid therapy is encouraging and supports the undertaking of properly designed perioperative fluid trials in thoracic surgeries. Such work offers hope that optimal fluid strategies can be defined and reduce the adverse events that have affected patients having lung resection. PMID:23089500

Searl, Cait P; Perrino, Albert



Proteinuria, hypertension and chronic renal failure in X-linked Kallmann's syndrome, a defined genetic cause of solitary functioning kidney  

Microsoft Academic Search

type, renal agenesis, the kidney is absent (2). In an Background. Anosmia and hypogonadotrophic hypo- autopsy study of 9200 individuals dying of incidental gonadism are the classic features of X-linked causes, unilateral agenesis was noted in seven (3), Kallmann's syndrome, a disorder caused by mutations whereas another, radiological, series identified no renal of KAL, a gene expressed during kidney and

Veronique Duke; Richard Quinton; Isky Gordon; Pierre M. G. Bouloux; Adrian S. Woolf


Abscopal and Direct Effects of Whole-Body X-Irradiation: Rat Kidney Mitotic Activity and DNA Content after Uninephrectomy.  

National Technical Information Service (NTIS)

The effect on kidneys of X radiation at doses ranging from 500 rad to 4000 rad and measured in unilaterally nephrectomized weanling (24-25 days old) and yound adult (80 days old) rats. Kidney mitotic activity 2-3 days following uninephrectomy was compared...

L. W. Wachtel L. J. Cole V. J. Rosen



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

PubMed Central

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

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



Bilateral internal thoracic artery grafting  

PubMed Central

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



Development of Thoracic Surgery in Iran  

Microsoft Academic Search

pleural space.3 - 5 During the middle decades of the 20th century, thoracic surgery was separated and developed in Iran as a branch of general surgery. Today, thoracic operations in Iran are performed by surgeons who are trained in chest surgery and the quality of care is comparable to worldwide practice. Presented here is a brief history of development of

Azizolah Abbasi-Dezfouli; Aboulghasem Daneshvar-Kakhki; Mehrdad Arab; Mohammad-Behgam Shadmehr; Sepehr Abbasi


Advancements in robotic-assisted thoracic surgery.  


Advancements in robotic-assisted thoracic surgery present potential advantages for patients as well as new challenges for the anesthesia and surgery teams. This article describes the major aspects of the surgical approach for the most commonly performed robotic-assisted thoracic surgical procedures as well as the pertinent preoperative, intraoperative, and postoperative anesthetic concerns. PMID:23089504

Steenwyk, Brad; Lyerly, Ralph




PubMed Central

In this brief presentation of some recent advances in thoracic surgery a number of miscellaneous topics which deserve consideration at this time are discussed. Among these are acidosis during anesthesia for thoracic operations, the problem of esophagitis in relation to surgery, recent improvements and reorientations in pulmonary operations, and some comments on operations upon the heart and great vessels.

Maier, Herbert C.



Moebius' syndrome with unilateral cerebellar hypoplasia  

Microsoft Academic Search

A case is reported of a child with Moebius' syndrome who also has unilateral cerebellar hypoplasia. We suggest that this combination of abnormalities could result from a vascular disruption occurring in the basilar artery early in its development.

M G Harbord; J P Finn; M A Hall-Craggs; E M Brett; M Baraitser



Unilateral temporalis muscle hypertrophy: case report.  


A case of unilateral temporalis muscle hypertrophy is presented. It is suggested that the aetiology of this condition is the same as that in cases of masseteric hypertrophy, and treatment is supportive only. PMID:2124600

Wilson, P S; Brown, A M



Make the Kidney Connection  


... Get Involved Overview Family Reunion Initiative Kidney Sundays Facebook Activity Like Newsletter Sign Up Receive kidney health ... 301) 402-8182 facebook twitter youtube Learn about Kidney Disease | Living with ...


Chronic Kidney Disease  


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 ...


Acute kidney failure  


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 ...


Diabetic Kidney Problems  


... 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 ...


Kidney and Urologic Diseases  


... Urea Nitrogen ) C Calcitriol (See Chronic Kidney Disease-Mineral and Bone Disorder ) Cardiovascular Disease and CKD (for ... Nutrition (for health care professionals) Chronic Kidney Disease-Mineral and Bone Disorder Chronic Kidney Disease: What Does ...


Fractures of the Thoracic and Lumbar Spine  


... such as a car crash or fall from height. Men experience fractures of the thoracic or lumbar ... energy trauma, such as: Car crash Fall from height Sports accident Violent act, such as a gunshot ...


Interaction between descending input and thoracic reflexes for joint coordination in cockroach: I. descending influence on thoracic sensory reflexes.  


Tethered cockroaches turn from unilateral antennal contact using asymmetrical movements of mesothoracic (T2) legs (Mu and Ritzmann in J Comp Physiol A 191:1037-1054, 2005). During the turn, the leg on the inside of the turn (the inside T2 leg) has distinctly different motor patterns from those in straight walking. One possible neural mechanism for the transformation from walking to inside leg turning could be that the descending commands alter a few critical reflexes that start a cascade of physical changes in leg movement or posture, leading to further alterations. This hypothesis has two implications: first, the descending activities must be able to influence thoracic reflexes. Second, one should be able to initiate the turning motor pattern without descending signals by mimicking a point farther down in the reflex cascade. We addressed the first implication in this paper by experiments on chordotonal organ reflexes. The activity of depressor muscle (Ds) and slow extensor tibia muscle (SETi) was excited and inhibited by stretching and relaxing the femoral chordotonal organ. However, the Ds responses were altered after eliminating the descending activity, while the SETi responses remain similar. The inhibition to Ds activity by stretching the coxal chordotonal organ was also altered after eliminating the descending activity. PMID:18094976

Mu, Laiyong; Ritzmann, Roy E



Chlorzoxazone inhibits contraction of rat thoracic aorta  

Microsoft Academic Search

Chlorzoxazone has been reported to activate the intermediate-conductance, Ca2+-activated K+ channels in aortic endothelial cells and to relax the artery. The aim of the present study was to characterize the chlorzoxazone-induced relaxation of rat thoracic artery. Chlorzoxazone did not affect the tension of the thoracic artery rings at rest, but relaxed the precontraction induced by 1 ?M noradrenaline in an endothelium

De-Li Dong; Yan Luan; Tie-Ming Feng; Chang-Long Fan; Peng Yue; Zhi-Jie Sun; Rui-Min Gu; Bao-Feng Yang



Thoracic disc herniation and spinal cord injury.  


A 52-yr-old male developed progressive thoracic myelopathy after a fall. At laminectomy using the standard posterior approach, he was found to have a herniated thoracic disc compressing the spinal cord. Postoperatively, he was paraplegic. We had a series of three such patients. This paper discusses the problems associated with discectomy using the standard posterior approach and reviews the literature about the alternative approaches for surgical treatment available today. PMID:3179014

Hegde, S; Staas, W E



Thoracoscopic Approaches to the Thoracic Spine  

Microsoft Academic Search

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

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



Thoracic Involvement in Non-Hodgkin Lymphoma  

Microsoft Academic Search

\\u000a Non-Hodgkin lymphoma (NHL) is known to involve multiple intra- and extrathoracic sites. Radiologic evidence of thoracic disease\\u000a occurs in 45–48% of patients with NHL (Castellino et al. 1996; Romano and Libshitz 1998); the frequency at autopsy is 73% (Vieta and Craver 1941). Although the most common manifestation of thoracic lymphoma is intrathoracic nodal involvement, it can occur at multiple\\u000a extranodal

Pamela J. Dipiro; Philip Costello


Transgenic Expression of Nonclassically Secreted FGF Suppresses Kidney Repair  

PubMed Central

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

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



Gene expression profile in streptozotocin-induced diabetic mice kidneys undergoing glomerulosclerosis  

Microsoft Academic Search

Gene expression profile in streptozotocin-induced diabetic mice kidneys undergoing glomerulosclerosis.BackgroundTo elucidate the molecular mechanism of diabetic nephropathy, a high-density DNA filter array was employed to survey the gene expression profile of streptozotocin-induced diabetic CD-1 (ICR) mouse kidneys.MethodsTen-week-old CD-1 male mice were divided into four groups: (1) control, (2) unilaterally nephrectomized (UX) mice, (3) streptozotocin (STZ)-induced diabetic (STZ) mice, and (4)

Jun Wada; Hong Zhang; Yoshinori Tsuchiyama; Keita Hiragushi; Kazuyuki Hida; Kenichi Shikata; Yashpal S. Kanwar; Hirofumi Makino



Two Cases of Unilateral Ashy Dermatosis  

PubMed Central

Ashy dermatosis is a typically asymptomatic disease of unknown origin that causes symmetrical gray spots to appear on the trunk and extremities. We report 2 cases of ashy dermatosis with unilateral distribution. To our knowledge, only 5 cases of ashy dermatosis with unilateral lesion have been reported so far. Case 1: an 11-year-old woman presented with asymptomatic slate-gray pigmented plaques on the left trunk and left upper arm. The skin biopsy specimen demonstrated a mild lymphohistiocytotic infiltrate in the upper dermis with epidermal and dermal melanosis. Q-Switched ruby laser did not improve such lesions. Case 2: a 21-year-old man was referred to our hospital because of asymptomatic slate-gray pigmented plaques on the left trunk and left upper arm. Histopathological findings were compatible with a mild lymphocytic infiltration with melanin incontinence in the upper dermis. The mechanism that governs unilateral distribution of ashy dermatosis, including in our cases, remains unclear.

Imanishi, Hisayoshi; Tsuruta, Daisuke; Kobayashi, Hiromi; Ishii, Masamitsu; Nakagawa, Koichi



Electroretinogram findings in unilateral optic neuritis.  


To report the electrophysiological findings in patients with unilateral optic neuritis (ON), with particular reference to the electroretinogram (ERG). A retrospective analysis of full-field ERG, pattern ERG (PERG) and pattern visual evoked potential findings from 46 patients with clinical and electrophysiological findings in keeping with unilateral ON. ISCEV standard ERGs did not significantly differ between the optic neuritis and fellow eyes, nor between patients with and without MS. Differences were present in the N95 component of the PERG, which was significantly lower in the affected eye, and the pattern reversal visual evoked potential, which showed significantly longer peak time (latency) in the affected eye. In addition, there was a significant difference between patients with and without multiple sclerosis (MS). No significant inter-ocular asymmetry in ISCEV standard ERGs was present in these cases of unilateral optic neuritis, either as a clinically isolated syndrome or as part of multiple sclerosis. All ERGs recorded were normal. PMID:22038575

Fraser, Clare L; Holder, Graham E



Unilateral magnetic stimulation of the phrenic nerve.  

PubMed Central

BACKGROUND--Electrical stimulation of the phrenic nerve is a useful non-volitional method of assessing diaphragm contractility. During the assessment of hemidiaphragm contractility with electrical stimulation, low twitch transdiaphragmatic pressures may result from difficulty in locating and stimulating the phrenic nerve. Cervical magnetic stimulation overcomes some of these problems, but this technique may not be absolutely specific and does not allow the contractility of one hemidiaphragm to be assessed. This study assesses both the best means of producing supramaximal unilateral magnetic phrenic stimulation and its reproducibility. This technique is then applied to patients. METHODS--The ability of four different magnetic coils to produce unilateral phrenic stimulation in five normal subjects was assessed from twitch transdiaphragmatic pressure (TwPDI) measurements and diaphragmatic electromyogram (EMG) recordings. The results from magnetic stimulation were compared with those from electrical stimulation. To determine whether the magnetic field affects the contralateral phrenic nerve as well as the intended phrenic nerve, EMG recordings from each hemidiaphragm were compared during stimulation on the same side and the opposite side relative to the recording electrodes. The EMG recordings were made from skin surface electrodes in five normal subjects and from needle electrodes placed in the diaphragm during cardiac surgery in six patients. Similarly, the direction of hemidiaphragm movement was evaluated by ultrasonography. To determine the usefulness of the technique in patients the 43 mm mean diameter double coil was used in 54 patients referred for assessment of possible respiratory muscle weakness. These results were compared with unilateral electrical phrenic stimulation, maximum sniff PDI, and TwPDI during cervical magnetic stimulation. RESULTS--In the five normal subjects supramaximal stimulation was established for eight out of 10 phrenic nerves with the 43 mm double coil. Supramaximal unilateral magnetic stimulation produced a higher TwPDI than electrical stimulation (mean (SD) 13.4 (2.5) cm H2O with 35 mm coil; 14.1 (3.8) cm H2O with 43 mm coil; 10.0 (1.7) cm H2O with electrical stimulation). Spread of the magnetic field to the opposite phrenic nerve produced a small amplitude contralateral diaphragm EMG measured from skin surface electrodes which reached a mean of 15% of the maximum EMG amplitude produced by ipsilateral stimulation. Similarly, in six patients with EMG activity recorded directly from needle electrodes, the contralateral spread of the magnetic field produced EMG activity up to a mean of 3% and a maximum of 6% of that seen with ipsilateral stimulation. Unilateral magnetic stimulation of the phrenic nerve was rapidly achieved and well tolerated. In the 54 patients unilateral magnetic TwPDI was more closely related than unilateral electrical TwPDI to transdiaphragmatic pressure produced during maximum sniffs and cervical magnetic stimulation. Unilateral magnetic stimulation eliminated the problem of producing a falsely low TwPDI because of technical difficulties in locating and adequately stimulating the nerve. Eight patients with unilateral phrenic nerve paresis, as indicated by a unilaterally elevated hemidiaphragm on a chest radiograph and maximum sniff PDI consistent with hemidiaphragm weakness, were all accurately identified by unilateral magnetic stimulation. CONCLUSIONS--Unilateral magnetic phrenic nerve stimulation is easy to apply and is a reproducible technique in the assessment of hemidiaphragm contractility. It is well tolerated and allows hemidiaphragm contractility to be rapidly and reliably assessed because precise positioning of the coils is not necessary. This may be particularly useful in patients. In addition, the anterolateral positioning of the coil allows the use of the magnet in the supine patient such as in the operating theatre or intensive care unit. Images

Mills, G H; Kyroussis, D; Hamnegard, C H; Wragg, S; Moxham, J; Green, M



Kidney Disease of Diabetes.  

National Technical Information Service (NTIS)

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD). Diabetes is the most co...



Kidney Stones  

PubMed Central

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

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



Thoracic complications of esophageal disorders.  


Abnormalities of the esophagus are common, and complications associated with these disorders and diseases can involve the mediastinum, tracheobronchial tree, and lungs. The most common complications include mediastinitis secondary to esophageal perforation or postoperative anastomotic leak, or both; empyema due to fistula formation; and aspiration pneumonia. The authors reviewed the radiologic appearances of those and other common thoracic complications associated with esophageal disorders to facilitate early detection, diagnosis, and management. Computed tomographic (CT) findings of acute mediastinitis secondary to esophageal perforation may include esophageal thickening, extraluminal gas, pleural effusion, single or multiple abscesses, and extraluminal contrast medium. The radiologic manifestations of pneumonia secondary to tracheoesophageal fistula are variable, depending on the spread and severity of the aspiration. The most common radiographic pattern is that of bronchopneumonia with scattered air-space opacities. CT has been regarded as the imaging modality of choice for the evaluation of suspected esophagopleural fistula, because the site of communication between the pleural space and the esophagus can often be seen. An awareness of the radiologic manifestations of these complications is thus required to facilitate early diagnosis. PMID:12376614

Giménez, Ana; Franquet, Tomás; Erasmus, Jeremy J; Martínez, Santiago; Estrada, Pilar



Cardiac complications of thoracic irradiation.  


Adjuvant radiation therapy in the management of early stage breast cancer, Hodgkin's disease, and to a lesser extent other thoracic malignancies has led to a significant improvement in disease-specific survival. Cardiovascular disease is now the most common nonmalignancy cause of death in radiation-treated cancer survivors, most often occurring decades after treatment. The spectrum of radiation-induced cardiac disease is broad, potentially involving any component of the heart. The relative risk of coronary artery disease, congestive heart failure, valvular heart disease, pericardial disease, conduction abnormalities, and sudden cardiac death is particularly increased. Over the years contemporary techniques have been introduced to reduce cardiac morbidity and mortality in radiation-treated cancer survivors; however, the long-term effects on the heart still remain unclear, mandating longer follow-up. Awareness and early identification of potential cardiac complications is crucial in cancer survivors, with the management often being quite complex. This review examines the epidemiology of radiation-induced cardiac disease together with its pathophysiology and explores the available treatment strategies and the potential utility of various screening strategies for affected cancer survivors. PMID:23583253

Jaworski, Catherine; Mariani, Justin A; Wheeler, Greg; Kaye, David M



Trilateral retinoblastoma with unilateral eye involvement.  


Trilateral retinoblastoma (TRb) is a rare combination of unilateral or bilateral retinoblastoma with an ectopic midline intracranial neuroblastic neoplasm (primitive neuroectodermal tumour) usually in the area of pineal gland or sellar region. TRb can occur with both familial and sporadic forms of retinoblastoma. An occurrence of this rare tumour in a 12-year-old boy who had unilateral retinoblastoma in association with ectopic suprasellar primitive neuroectodermal tumour (PNET) is reported here. To the best of our knowledge, this is the first case report in Pakistan on TRb with suprasellar mass. PMID:23901719

Shah, Irfanullah; Baig, Adnan; Razzaq, Abdul; Faruqi, Anum; Ali, Aun; Khan, Faraz Qayyum



Unilateral diaphragmatic paralysis: an electrophysiological study.  

PubMed Central

An electrophysiological study was carried out on four patients with unilateral diaphragmatic paralysis. Whereas neurogenic involvement of the paralysed hemidiaphragm was roughly similar in all cases, neurogenic patterns could be detected in the normally moving contralateral hemidiaphragm in three cases, and the degree of involvement could be correlated with the respiratory state of the patients. EMG also showed that the neuropathic process affected the limb muscles. Thus unilateral diaphragmatic paralysis may be, at least in some cases, the localised expression of a more diffuse neuropathy, perhaps a peculiar form of neuralgic amyotrophy.

Lagueny, A; Ellie, E; Saintarailles, J; Marthan, R; Barat, M; Julien, J



[Diffuse unilateral subacute neuroretinitis (DUSN): current update].  


Diffuse unilateral subacute neuroretinitis (DUSN) is a form of uveitis that can potentially lead to blindness. In Brazil and other parts of South America, diffuse unilateral subacute neuroretinitis is an important cause of posterior uveitis in children and healthy young adults. If diagnosed and treated in early stage, allows a resolution of symptoms with improvement of visual acuity. If the disease progresses to the late stage, can result in significant visual loss. In this study, through a literature review, we describe the main characteristics of this disease, including the following aspects: history, etiology, physiopathology, clinical features, diagnosis, differential diagnosis and treatment. PMID:24061842

Rosa, Alexandre Antonio Marques; Rodrigues Neto, Taurino Dos Santos



A curious case of unilateral spider nevi, cirrhosis and stroke: unilateral nevoid telangiectasia syndrome.  


A 55-year-old Caucasian man presented with unilateral right facial spider nevi. Relevant medical history included a right-sided cerebrovascular accident (CVA) in 1997 and decompensated alcoholic liver disease, diagnosed in 2007. The literature describes approximately 100 cases of unilateral spider nevi associated with different aetiologies, grouped under 'unilateral nevoid telangiectasia syndrome' (UNTS). This is a rare presentation of a commonly observed sign in clinical practice. This case offers an opportunity to explore the origins of spider nevi and highlights the benefit of sharing knowledge in order to help elucidate the potential mechanisms underlying common signs. PMID:24087800

Park, J J; Yeo, J M; Hayes, P



[Vincristine-induced unilateral ptosis: Case report and review of the literature].  


We report the case of a 31-month-old girl, treated by the ifosfamide-vincristine-actinomycin chemotherapy protocol for vaginal rhabdomyosarcoma, who developed a unilateral left ptosis on day 36 of chemotherapy, i.e. 7days after the fifth vincristine dose (1.5mg/m(2) or 0.90mg). The cumulative vincristine dose was thus 4.50mg. The remainder of the neurological and systemic examinations were unremarkable. Laboratory testing and thoracic-cervical-cranial CT were normal. Other causes of ptosis were excluded. The ptosis decreased a few days after the infusion of vincristine and re-increased just after a new dose. It finally resolved upon lowering the dose of vincristine. According to our observations, the role of vincristine in the pathogenesis of this ptosis appears "likely". In such cases, maintenance of treatment is possible with adjustment of vincristine doses, but requires regular follow-up. PMID:23896211

Batta, B; Trechot, F; Cloché, V; George, J-L; Angioi, K



Unilateral Beau's lines associated with a fractured olecranon.  


We report a case of unilateral Beau's lines developing after an olecranon fracture of the right elbow. Unilateral Beau's lines are an uncommon phenomenon but have been previously reported after trauma to the wrist, hands, forearm and elbow. PMID:20546225

Avery, Helen; Cooper, Hywel L; Karim, Amin



Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations.  


Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery. PMID:21386942

Chua, Nicholas H L; Gültuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C



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

PubMed Central

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

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




Microsoft Academic Search

PurposePreviously the upper urinary tract anatomy has been characterized in Danforth mice spontaneous murine mutation. This mutation results in unilateral renal agenesis in 30% of the heterozygous offspring. Whether compensatory renal growth occurs in the remaining solitary kidney was assessed.




Twist Relates to Tubular Epithelial-Mesenchymal Transition and Interstitial Fibrogenesis in the Obstructed Kidney  

Microsoft Academic Search

Epithelial-mesenchymal transition (EMT) is a critical step in renal fibrosis. It has been recently reported that a transcription factor, Twist, plays a pivotal role in metastasis of breast tumors by inducing EMT. In this study, we examined whether Twist relates to renal fibrogenesis including EMT of tubular epithelia, evaluating Twist expression level in the unilateral ureteral obstruction (UUO) model. Kidneys

Yujiro Kida; Kinji Asahina; Hirobumi Teraoka; Inna Gitelman; Tetsuji Sato



Unilateral masseteric hypertrophy. A case report.  


Masseteric hypertrophy (MH) is a relatively common condition seen in the dental office. Patients often present with a complaint of a "swollen cheek" or are referred with a tentative diagnosis of parotid gland swelling. MH is usually bilateral, but the unilateral nature of this reported case led to a tentative diagnosis of parotid gland disease. PMID:20863041

Furdui-Carr, Gabriela; Mandel, Louis


Unilateral masseter muscle hypertrophy: a case report.  


Masseteric hypertrophy is a benign increase in the size of the masseter muscle, secondary to muscle hypertrophy. It produces facial asymmetry and is important in the differential diagnosis of other entities. The aim of this article is to report a case of unilateral masseteric muscle hypertrophy. The characteristics and diagnostic features of such alterations and options for treatment will be presented. PMID:12553622

Trujillo, Roberto; Fontão, Flávia Noemy Gasparini Kiatake; de Sousa, Simone Maria Galvão


[Unilateral primary adrenal lymphoma: a case report].  


The authors report a case of unilateral primary adrenal lymphoma presenting with abdominal and dorsal pain. Primary lymphoma of the genitourinary tract, specifically adrenal localisation, is a rare disease. CT is the current best imaging modality for evaluating retroperitoneal masses and improving detection, characterization as well as assessing extension. Diagnosis is based on histology. PMID:15669567

Devaux, M; Ragu, N; Lacheheub, K; Thiebaut, C; Lopez, F M



Unilateral pulmonary artery agenesis with vertebral anomaly.  


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

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



Deep seabed mining and unilateral legislation  

Microsoft Academic Search

Mining and other kinds of exploitation of the deep seabed and the ocean floor as well as the subsoil thereof are fairly new developments, made possible by modern technology. It is contended here that unilateral exploitation of these areas beyond the limits of national jurisdiction is not authorized by existing principles, by the common heritage of mankind concept, or by

Gonzalo Biggs



Unilateral regional odontodysplasia with ipsilateral mandibular malformation.  


Regional odontodysplasia is a rare developmental anomaly with an unknown cause. This disorder involves both the ectodermal and mesodermal dental layers. The affected teeth generally cannot be rehabilitated for functional use; therefore, the treatment of choice is extraction with prosthetic replacement. A unique case of unilateral regional odontodysplasia with ipsilateral mandibular malformation is reported. PMID:2356083

Raez, A G



Heart rate differences between right and left unilateral electroconvulsive therapy.  

PubMed Central

Left and right unilateral electrode placements were alternately applied in electroconvulsive therapy given to 21 men with melancholia. Accompanying heart rate elevations were greater following right unilateral treatment than left unilateral, apparently because of longer persistence of peak rates. This is consistent with right cerebral hemisphere superiority in the control of heart rate activity in neurologically intact humans.

Swartz, C M; Abrams, R; Lane, R D; DuBois, M A; Srinivasaraghavan, J



Omi/HtrA2 protease is associated with tubular cell apoptosis and fibrosis induced by unilateral ureteral obstruction  

PubMed Central

Kidney fibrosis, a typical characteristic of chronic renal disease, is associated with tubular epithelial cell apoptosis. The results of our recent studies have shown that Omi/HtrA2 (Omi), a proapoptotic mitochondrial serine protease, performs a crucial function in renal tubular epithelial apoptotic cell death in animal models of acute kidney injury, including cisplatin toxicity and ischemia-reperfusion insult. However, the role of Omi in tubulointerstitial disease-associated fibrosis in the kidney remains to be clearly defined. We evaluated the potential function and molecular mechanism of Omi in ureteral obstruction-induced kidney epithelial cell apoptosis and fibrosis. The mice were subjected to unilateral ureteral obstruction (UUO) via the ligation of the left ureter near the renal pelvis. UUO increased the protein level of Omi in the cytosolic fraction of the kidney, with a concomitant reduction in the mitochondrial fraction. UUO reduced the X-linked inhibitor of apoptosis protein (XIAP), a substrate of Omi, and pro-caspase-3, whereas it increased cleaved poly(ADP-ribose) polymerase (cleaved PARP) and the number of terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL)-positive cells. When mice were treated with ucf-101, an inhibitor of the proteolytic activity of Omi (6.19 ?g/day ip), on a daily basis beginning 2 days before UUO and continuing until the end of the experiment, the Omi inhibitor protected XIAP cleavage after UUO and reduced the increment of PARP cleavage and the numbers of TUNEL-positive cells. Furthermore, the Omi inhibitor significantly attenuated UUO-induced increases in fibrotic characteristics in the kidney, including the atrophy and dilation of tubules, expansion of the interstitium, and increases in the expression of collagens, ?-smooth muscle actin, and fibronectin. In conclusion, Omi/HtrA2 is associated with apoptotic signaling pathways in tubular epithelial cells activated by unilateral ureteral obstruction, thereby resulting in kidney fibrosis.

Kim, Jinu; Kim, Dong Sun; Park, Mae Ja; Cho, Hee-Jung; Zervos, Antonis S.; Bonventre, Joseph V.



The vertical expandable prosthetic titanium rib implant for the treatment of thoracic insufficiency syndrome associated with congenital and neuromuscular scoliosis in young children.  


Expansion thoracoplasty and vertical expandable prosthetic titanium rib (VEPTR; Synthes Spine Co., West Chester, Pennsylvania, USA) implantation is a new method for the treatment of thoracic insufficiency syndrome and congenital spinal deformity in children. The longitudinal rib implant expands the thorax and indirectly corrects spinal deformity, thus allowing spinal, thoracic and probably lung growth. VEPTR has been used since 1989 in San Antonio, USA, and was introduced to Europe in 2002. This paper describes the preliminary experience with the European patients. Fifteen children with progressive scoliosis had a VEPTR implantation at a mean age of 6 years (11 months to 12 years). Nine children had thoracic insufficiency syndrome due to unilateral unsegmented bars (n = 4), absent ribs (n = 1), hemivertebrae (n = 2) or bilateral fused ribs (n = 2). Six children had severe thoracolumbar scoliosis and pelvic obliquity due to neuromuscular scoliosis. After VEPTR implantation, families and patients reported improvement of the thoracic insufficiency syndrome and better sitting abilities in the neuromuscular patients, as well as radical cosmetic improvement. There were three complications (skin breakage, lumbar hook displacement, rib fracture) after performing fifteen primary VEPTR implantations and 13 expansion surgeries in eight patients. Our experience suggests that expansion thoracoplasty and VEPTR implantation is a safe and efficient method for the treatment of thoracic insufficiency syndrome in young children with severe scoliosis. PMID:15931035

Hell, Anna K; Campbell, Robert M; Hefti, Fritz



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


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

Maruschke, M; Hakenberg, O W



Thoracic Duct Embolization for Chylous Leaks  

PubMed Central

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

Chen, Eric; Itkin, Maxim



Keep Your Kidneys Healthy: Catch Kidney Disease Early  


... Keep Your Kidneys Healthy Soothing a Sore Throat Wise Choices Links Protect Your Kidneys If you’re at risk for kidney disease—especially if you have diabetes, high blood pressure, or a family history of kidney failure— ...


Thoracic inlet compression due to amiodarone induced goitre.  

PubMed Central

We report a case of amiodarone induced toxic goitre, presenting with thoracic inlet obstruction which required surgical intervention. Though thyrotoxicosis caused by amiodarone is recognised, to our knowledge thoracic inlet compression has not been previously described.

Samanta, A.; Jones, G. R.; Burden, A. C.; Barrie, W. W.



Anterior Wedging of the Mid-Thoracic Vertebral Body  


... Questions Question : What is anterior wedging of the mid-thoracic vertebral body? Robert H. Shmerling, M.D. ... the side, the shape looks more triangular. The "mid-thoracic" vertebra is in the middle of the ...


The present and future of thoracic surgery within the European Association for Cardio-Thoracic Surgery (EACTS).  


On 10 February 2012, a Strategic Conference was organized by the European Association for Cardio-Thoracic Surgery (EACTS) in Windsor during the inauguration of the newly acquired EACTS house. In this review, the present and future of thoracic surgery are discussed. With the creation of the Thoracic Domain, thoracic surgery has been strengthened and made clearly visible within the general EACTS structure. A clearly identified thoracic track is provided during the Annual Congress. Specific working groups have been created that deal with varying topics of thoracic surgery and diseases of the chest. The European School of Cardiothoracic Surgery has been restructured, providing not only theoretical but also practical education in thoracic surgery. At national and international levels, interdisciplinary cooperation is encouraged. Harmonization of thoracic training within Europe is necessary to allow better exchange between different countries. Guidelines dealing with specific thoracic procedures should be further developed. The Thoracic Domain of EACTS will remain a key player in promoting thoracic surgery in Europe and internationally, and in providing high-level scientific output, education and training in thoracic surgery and diseases of the chest, which requires continuous, close cooperation between thoracic and cardiothoracic surgeons. PMID:23148068

Van Schil, Paul E



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

PubMed Central

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

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



Kidney Histology Rules Matrix

Kidney Histo Kidney Histology Coding Rules – Matrix C649 (Excludes lymphoma and leukemia M9590 – 9989 and Kaposi sarcoma M9140) Rule Pathology/Cytology Specimen Histology Behavior Notes and Examples Code SINGLE TUMOR H1 None or the pathology


Diabetes and Kidney Disease  


... Home Kidney Disease A to Z Health Guide Diabetes and Kidney Disease Diabetes mellitus, usually called diabetes, ... of your body. Are there different types of diabetes? The most common ones are Type 1 and ...


Chemotherapy for Kidney Cancer  


... cancer Next Topic Targeted therapies for kidney cancer Chemotherapy for kidney cancer Chemotherapy (chemo) uses anti-cancer ... have already been tried. Possible side effects of chemotherapy Chemo drugs work by attacking cells that are ...


Kidney Replacement Therapy  


... clear. Some doctors believe that, at least in African Americans, cadaver kidneys all "take" equally well. How hard ... to fail. If the new kidney does develop diabetic nephropathy, it too will take many years to ...


Nephrectomy (Kidney Removal)  


... if you're a suitable candidate. Criteria for donating include: 18 years of age or older Compatible blood type with kidney transplant recipient Generally good health Two well-functioning kidneys No history of high blood pressure, kidney disease, diabetes, certain ...


Degenerative disease of the thoracic spine in central India  

Microsoft Academic Search

Thoracic spondylosis, better termed 'degenerative thoracic spine disease', is rare and failure to recognize it is mainly due to its rarity and to the complexity of symptomatology which can lead to prolonged and continued morbidity. During the past 4 years, the authors have treated 28 patients with thoracic spine degeneration with varied clinical manifestations, ranging from local pain, radiculopathy to

S R Mitra; S G Gurjar; K R Mitra



Vertebroplasty in the Mid and Upper Thoracic Spine  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Vertebroplasty performed in the mid- and upper thoracic spine presents technical challenges that differ from those in the lower thoracic and lumbar region. We herein report results of percutaneous vertebroplasty for treatment of painful, osteoporotic compression fractures in the mid- and upper thoracic spine. METHODS: Retrospective chart review identified vertebroplasty treatments performed for painful osteoporotic compression fractures

David F. Kallmes; Patricia A. Schweickert; William F. Marx; Mary E. Jensen



Accuracy of Pedicle Screw Placement in Thoracic Spine Fractures  

Microsoft Academic Search

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

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



Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm  

Microsoft Academic Search

Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. These may be primary fistulas, in cases of thoracic aortic aneurysm without previous repair, or secondary fistulas occurring after surgical repair of thoracic aortic aneurysm. Surgical treatment has been successful in a small number of cases of primary aortoesophageal

Michael J Reardon; Robert J Brewer; Scott A LeMaire; John C Baldwin; Hazim J Safi



Unilateral seminoma in a dromedary camel.  


A 10-year-old, clinically healthy, male dromedary camel had presented a history of progressive unilateral testicular enlargement over the past 5 years. The animal had mated with 32 females during that period; all had conceived. The sex ratio of his offspring was one male to 31 females. Ultrasound examination of the right testicle revealed a diffusely heterogeneous parenchyma with no identifiable normal testicular tissue. The enlarged testicle was surgically removed. Macroscopically, the testicle had a glistening pink surface and contained multiple soft, bulging nodules. Histopathologically, a well-differentiated, diffuse seminoma was diagnosed. In conclusion, this study describes the fertility, sex ratio, clinical findings and ultrasonographic imaging in a male dromedary camel affected with unilateral testicular seminoma. PMID:22646829

Ali, A; Ahmed, A F; Mehana, E E; El-Tookhy, O; Al-Hawas, A



Isolated unilateral post-traumatic internuclear ophthalmoplegia.  


A patient developed an isolated unilateral internuclear ophthalmoplegia (INO) after head trauma. An uncommon complication of closed head trauma, INO usually occurs bilaterally and is often associated with other neurologic deficits. The mechanism may be shear injury caused by angular acceleration leading to downward displacement of the posterior brainstem downward, stretching of the nerve fibers of the medial longitudinal fasciculus, or compression and tearing of its arterial supply. PMID:11725189

Chan, J W



Unilateral ovarian agenesis and fallopian tube maldescent  

Microsoft Academic Search

Unilateral ovarian agenesis (UOA) and fallopian descent problems are very rare congenital defects. We present an unusual\\u000a case of UOA associated with fallopian-tube maldescent discovered incidentally during a laparotomy in a female infant for a\\u000a persistent heterogeneous right ovarian cyst refractory to needle aspiration. A necrotic, hemorrhagic paratubal cyst was found\\u000a associated with a normal right adnexa. The left ovary

A. Dueck; D. Poenaru; M. A. Jamieson; I. K. Kamal



Unilateral molar distalization with a modified slider.  


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

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



Functioning unilateral adrenocortical carcinoma in a dog  

PubMed Central

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

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



Functioning unilateral adrenocortical carcinoma in a dog.  


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

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



Retrograde replacement of the thoracic aorta.  

PubMed Central

A technique is described for replacement of the entire thoracic aorta. In this "pull-through" technique, which utilizes hypothermic circulatory arrest, the graft is implanted in a retrograde fashion, thus providing protection for the spinal cord and brain and avoiding injury to the vagus and phrenic nerves.

Cooley, D A



Thoracic BB injuries in pediatric patients.  


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

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



Bilateral thoracic paravertebral block for abdominoplasty.  


Thoracic bilateral paravertebral block is a technique commonly used in the ambulatory setting for numerous plastic surgery procedures. Paravertebral block has not been reported with abdominoplasty surgery. This case series explores this anesthetic technique in the inpatient and day patient setting. PMID:18346612

Rudkin, Glenda E; Gardiner, Sarah E; Cooter, Rodney D



Acoustic thoracic images for transmitted glottal sounds.  


Sound transmission has been of interest for many years in an attempt to study the structure of the lung and different researches have shown that artificial sounds produce a lateralization of sound information at the thoracic surface. Most of these studies have use non-simultaneous recording and input sounds introduced at the mouth or other thoracic points. In this paper, we present acoustic thoracic images, for transmitted glottal sounds, formed by a multichannel system with an array of 5x5 microphones. The study was done using 4 healthy subjects and 4 subjects having diffuse interstitial pneumonia. In both groups of subjects, it was found that the thorax behaves as a lowpass filter depending on the physical properties of its components, and that the transmitted acoustic thoracic imaging (TATHI) could reflect such properties. In most of the healthy subjects right to left asymmetries and heterogeneous apical to basal distribution were found. In patients the lateral dominance was lost and an intensity increment in the frequency band of 300 to 600 Hz was revealed. We conclude that TATHI permits to observe easily the spatial extension of the disease through sound transmission. PMID:18002746

Charleston-Villalobos, S; González-Camarena, R; Chi-Lem, G; Aljama-Corrales, T



Thoracoscopic repair of thoracic spine trauma  

Microsoft Academic Search

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

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



Combining Targeted Therapies for Thoracic Cancers

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


Immunomodulatory Effects of Anesthetics during Thoracic Surgery  

PubMed Central

Background. One-lung ventilation (OLV) during thoracic surgery may induce alveolar cell damage and release of proinflammatory mediators. The current trial was planned to evaluate effect of propofol versus isoflurane anesthesia on alveolar and systemic immune modulation during thoracic surgery. Methods. Fifty adult patients undergoing open thoracic surgery were randomly assigned to receive propofol (n = 25) or isoflurane (n = 25) anesthesia. The primary outcome measures included alveolar and plasma concentrations of interleukin-8(IL-8) and tumour necrosis factor-? (TNF-?), whereas secondary outcome measures were alveolar and plasma concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), and changes in alveolar albumin concentrations and cell numbers. Results. Alveolar and plasma concentrations of IL-8 and TNF-? were significantly lower in the isoflurane group, whereas alveolar and plasma concentrations of MDA were significantly lower in the propofol group. Alveolar and plasma SOD levels increased significantly in the propofol group whereas they showed no significant change in the isoflurane group. Furthermore, the isoflurane group patients developed significantly lower alveolar albumin concentrations and cell numbers. Conclusion. Isoflurane decreased the inflammatory response associated with OLV during thoracic surgery and may be preferable over propofol in patients with expected high levels of proinflammatory cytokines like cancer patients.

Mahmoud, Khaled; Ammar, Amany



Epidural anesthesia in awake thoracic surgery.  


Despite the indisputable and well-known advantages of general anesthesia in thoracic surgery, this can trigger some adverse effects including an increased risk of pneumonia, impaired cardiac performance, neuromuscular problems, mechanical ventilation-induced injuries, which include barotrauma, volotrauma, atelectrauma, and biotrauma. In order to reduce the adverse effects of general anesthesia, thoracic epidural anesthesia has been recently employed to perform awake thoracic surgery procedures including coronary artery bypass, management of pneumothorax, resection of pulmonary nodules and solitary metastases, lung volume reduction surgery, and even transsternal thymectomy. The results achieved in this early series have been encouraging, although indications and many pathophysiologic aspects remain to be elucidated. In this review we have tried to provide a first-step analysis of the anecdotal reports available in the literature on this topic. We also desired to provide insights into the main physiologic effects of awake thoracic surgery with epidural anesthesia, with particular attention to the several issues raised by its application in patients with chronic obstructive pulmonary disease, which can represent one of the most stimulating challenges in this setting. PMID:17467287

Mineo, Tommaso Claudio



Spontaneous intracranial hypotension secondary to anterior thoracic osteophyte: Resolution after primary dural repair via posterior approach  

PubMed Central

INTRODUCTION Spontaneous intracranial hypotension (SIH) is an uncommon syndrome widely attributed to CSF hypovolemia, typically secondary to spontaneous CSF leak. Although commonly associated with postural headache and variable neurological symptoms, one of the most severe consequences of SIH is bilateral subdural hematomas with resultant neurological deterioration. PRESENTATION OF CASE We present the case of a patient diagnosed with SIH secondary to an anteriorly positioned thoracic osteophyte with resultant dural disruption, who after multiple attempts at nonsurgical management developed bilateral subdural hematomas necessitating emergent surgical intervention. The patient underwent a unilateral posterior repair of his osteophyte with successful anterior decompression. At 36 months follow up, the patient reported completely resolved headaches with no focal neurological deficits. DISCUSSION We outline our posterior approach to repair of the dural defect and review the management algorithm for the treatment of patients with SIH. We also examine the current hypotheses as to the origin, pathophysiology, diagnosis and treatment of this syndrome. CONCLUSION A posterior approach was utilized to repair the dural defect caused by an anterior thoracic osteophyte in a patient with severe SIH complicated by bilateral subdural hematomas. This approach minimizes morbidity compared to an anterior approach and allowed for removal of the osteophyte and repair of the dural defect.

Veeravagu, Anand; Gupta, Gaurav; Jiang, Bowen; Berta, Scott C.; Mindea, Stefan A.; Chang, Steven D.



Assessment of renal function in mice with unilateral ureteral obstruction using 99mTc-MAG3 dynamic scintigraphy  

PubMed Central

Background Renal scintigraphy using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) is widely used for the assessment of renal function in humans. However, the application of this method to animal models of renal disease is currently limited, especially in rodents. Here, we have applied 99mTc-MAG3 renal scintigraphy to a mouse model of unilateral ureteral obstruction (UUO) and evaluated its utility in studying obstructive renal disease. Methods UUO mice were generated by complete ligation of the left ureter. Sham-operated mice were used as a control. Renal function was investigated on days 0, 1, 3, and 6 post-surgery using dynamic planar imaging of 99mTc-MAG3 activity following retro-orbital injection. Time-activity curves (TACs) were produced for individual kidneys and renal function was assessed by 1) the slope of initial 99mTc-MAG3 uptake (SIU), which is related to renal perfusion; 2) peak activity; and 3) the time-to-peak (TTP). The parameters of tubular excretion were not evaluated in this study as 99mTc-MAG3 is not excreted from UUO kidneys. Results Compared to sham-operated mice, SIU was remarkably (>60%) reduced in UUO kidneys at day 1 post surgery and the TACs plateaued, indicating that 99mTc-MAG3 is not excreted in these kidneys. The plateau activity in UUO kidneys was relatively low (~40% of sham kidney’s peak activity) as early as day1 post surgery, demonstrating that uptake of 99mTc-MAG3 is rapidly reduced in UUO kidneys. The time to plateau in UUO kidneys exceeded 200 sec, suggesting that 99mTc-MAG3 is slowly up-taken in these kidneys. These changes advanced as the disease progressed. SIU, peak activity and TTPs were minimally changed in contra-lateral kidneys during the study period. Conclusions Our data demonstrate that renal uptake of 99mTc-MAG3 is remarkably and rapidly reduced in UUO kidneys, while the changes are minimal in contra-lateral kidneys. The parametric analysis of TACs suggested that renal perfusion as well as tubular uptake is reduced in UUO kidneys. This imaging technique should allow non-invasive assessments of UUO renal injury and enable a more rapid interrogation of novel therapeutic agents and protocols.



Regulation of aquaporins and sodium transporter proteins in the solitary kidney in response to partial ureteral obstruction in neonatal rats.  


Unilateral ureteral obstruction (UUO) impairs function of the obstructed kidney, and the contralateral nonobstructed kidney compensates depending on the degree and duration of UUO. This study aimed to determine the hemodynamic and molecular changes in the solitary kidney in response to partial ureteral obstruction (PUO) where any compensation from the contralateral kidney was eliminated so that all observed changes in the kidney tissue occurred in the kidney with PUO. Newborn rats were subjected to unilateral left nephrectomy (UNX) within the first 48 h of life and a subset of UNX rats was subjected to severe PUO of the right kidney at day 14. Renal blood flow and whole kidney volume were measured with MRI at week 10. The renal protein abundance of aquaporin 1 (AQP1), AQP2 and AQP3 as well as Na,K-ATPase, NaPi-2 (type 2 sodium-phosphate cotransporter) and NHE3 (type 3 sodium-proton exchanger) were examined by immunoblotting and immunocytochemistry. At 10 weeks of age, the protein abundance of AQP2, AQP3, Na,K-ATPase, NaPi-2 and NHE3 were increased in response to PUO. In contrast, AQP1 expression was markedly decreased compared to sham-operated rats. These findings were confirmed by immunohistochemistry. GFR, urine osmolality and urine sodium excretion were reduced and kidney weight increased in response to PUO. In conclusion, the present study demonstrated major changes in the protein abundance of renal AQP1, AQP2 and AQP3 and sodium transporters in the solitary PUO kidney. These changes were paralleled by decreased urinary sodium excretion and a significant reduction in urinary osmolality from the obstructed kidney, suggesting a functional association between the molecular changes and the ability of the obstructed kidney to handle sodium and water in this solitary kidney model. PMID:21677414

Topcu, Sukru Oguzkan; Nørregaard, Rikke; Pedersen, Michael; Wang, Guixian; Jørgensen, Troels Munch; Frøkiær, Jørgen



Congenital unilateral absence of orbit with anophthalmos and partial arhinia.  


Congenital unilateral absence of orbit is a very rare clinical entity. An 18 month old female child with an unilateral absence of orbit with clinical anophthalmos and partial arhinia is presented. X-ray of the skull revealed an absence of the bony orbit on the left side. Unlike previously described cases of absence of the orbit, this maldevelopment is unilateral and present in an otherwise normal thriving child. PMID:1841889

Shorey, P; Lobo, G


Role of proteinuria in the regulation of renal renin-angiotensin system components in unilateral proteinuric rats.  


Renin-angiotensin system (RAS) overactivity has been implied in progressive renal function loss. We investigated whether changes in the renal expression of RAS components are specifically associated with the proteinuric kidney. Unilateral adriamycin-induced proteinuria was obtained by clamping the left renal artery before injection of adriamycin. In control animals, both left and right renal arteries were clamped. Twelve weeks later, mRNA expression of RAS components was determined in both kidneys. In the affected and non-affected kidney of the unilateral proteinuric rat, we demonstrate up-regulation of angiotensin- converting enzyme (ACE) mRNA (213%+22 and 188%+24 of controls, respectively), up-regulation of transforming growth factor beta (TGF-beta) mRNA (956%+229 and 418%+56) and down-regulation of angiotensin type 2 receptor (AT2-R) mRNA (24%+5 and 20%+5). The expression of angiotensin type 1 receptor (AT1-R) mRNA and inositol 1,4,5- trisphosphate receptor type I (IP3R-I) mRNA were unchanged. In conclusion, renal expression of ACE, AT2-R, and AT1-R mRNA is not mediated by protein leakage. Local intrarenal protein leakage did influence renal TGF-beta mRNA expression. PMID:12692752

Deelman, Leo E; Navis, Gerjan; de Boer, Erik; Wietses, Mirian; de Zeeuw, Dick; Henning, Robert H



Unilateral cerebellar hypoplasia with different clinical features.  


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

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



Unilateral trifid mandibular condyle: a case report.  


Trifid mandibular condyle is an exceptionally rare entity, diagnosed accidentally on radiographic examination. Its etiology is controversial. Dental professionals should have knowledge of this anatomic abnormality and of the problems caused by it in normal function, as well as appropriate treatment modalities. In the literature, only three such cases have been reported. The current case report (the fourth reported) is of a unilateral trifid condyle reported in a 37-year-old woman seeking treatment for a missing tooth. A panoramic radiograph accidentally revealed a discrete modification of the right mandibular condyle. Computed tomography (CT) with 3-D construction was done to confirm the diagnosis. PMID:21370772

Warhekar, Ashish M; Wanjari, Panjab V; Phulambrikar, Tushar



Unilateral absence of latissimus dorsi muscle.  


Latissimus dorsi (LD) is the broadest muscle of the back responsible for extension and adduction of shoulder. The authors report a case of isolated unilateral absence of the latissimus dorsi muscle observed during an ablative surgical procedure and flap reconstruction. The left LD muscle was completely absent in our patient and no tendon fibers belonging to this muscle could be observable on further dissection. The surrounding muscle anatomy was normal and in place suggesting a developmental etiology for its absence. Awareness of this possible variation is of importance in considering reconstructive options. PMID:22431308

Izadpanah, Ali; Babaei, Sepideh; Luc, Mario; Zadeh, Teanoosh



Some remarks on unilateral matrix equations  

SciTech Connect

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

Cerchiai, Bianca L.; Zumino, Bruno



Congenital Horner's syndrome with unilateral facial flushing.  

PubMed Central

Two patients with congenital Horner's syndrome had unilateral facial flushing. Both showed pupillary supersensitivity to epinephrine as well as anhidrosis on the affected side of the face and neck. Facial skin temperature after exercise increased on the intact side, but decreased on the affected side. Thermal vasodilation in the major portions of the face is regulated by sympathetic vasodilator fibres, and less predominantly by adrenergic vasoconstrictor fibres. The asymmetry of facial flushing may have been caused by impaired sympathetic vasodilation and further intensified by active vasoconstriction due to supersensitivity to circulating catecholamine on the affected side.

Saito, H



Metallization thickness in bilateral and unilateral Finlines  

NASA Astrophysics Data System (ADS)

The theory and numerical results are presented to the effective dielectric constant and characteristic impedance of bilateral and unilateral finlines with metallization thickness. The full wave analysis of the transverse transmission line — TTL method is used to determine the electromagnetic fields of the structure in Fourier transform domain — FTD. Applying the suitable boundary conditions and the moment method, a homogeneous matrix system is obtained and the effective dielectric constant is extracted. The characteristic impedance is obtained using the relation between the voltage in slot and the transmitted power. Computational programs are developed to obtain numerical results to the effective dielectric constant and characteristic impedance.

Fernandes, Humberto César Chaves; Martins de Souza, Eduardo Amorim; de Souza Queiroz Júnior, Idalmir



Endovascular repair of thoracic aortic pathology.  


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

Kiguchi, Misaki; Chaer, Rabih A



Acute Aortic Syndromes and Thoracic Aortic Aneurysm  

PubMed Central

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

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



Endovascular repair of thoracic aortic aneurysm  

PubMed Central

A thoracic aortic aneurysm (TAA) is a potentially life-threatening condition with structural weakness of the aortic wall, which can progress to arterial dilatation and rupture. Today, both an increasing awareness of vascular disease and the access to tomographic imaging facilitate the diagnosis of TAA even in an asymptomatic stage. The risk of rupture for untreated aneurysms beyond a diameter of 5.6 cm ranges from 46% to 74% and the two-year mortality rate is greater than 70%, with most deaths resulting from rupture. Treatment options include surgical and non-surgical repair to prevent aneurysm enlargement and rupture. While most cases of ascending aortic involvement are subject to surgical repair (partially with valve-preserving techniques), aneurysm of the distal arch and descending thoracic aorta are amenable to emerging endovascular techniques as an alternative to classic open repair or to a hybrid approach (combining debranching surgery with stent grafting) in an attempt to improve outcomes.

Akin, Ibrahim; Kische, Stephan; Rehders, Tim C.; Nienaber, Christoph A.; Rauchhaus, Mathias



Thoracic endovascular aortic repair for aortobronchial fistula.  


The objective was to provide a systematic review of outcomes of thoracic endovascular aortic repair for aortobronchial fistula. A literature search identified 134 patients. The technical success rate was 93.2%. The overall 30-day mortality was 5.9%. After a mean follow-up of 17.4 months, the aortic-related mortality was 14.3%. Recurrence of the aortobronchial fistula was observed in 11.1% of the patients. Thoracic endovascular aortic repair of aortobronchial fistulas appears to be a viable alternative with excellent short-term results. Strict follow-up and aggressive adjunctive measures are needed to treat ongoing infection to prevent late related mortality. PMID:23916807

Canaud, Ludovic; Ozdemir, Baris Ata; Bahia, Sandeep; Hinchliffe, Robert; Loftus, Ian; Thompson, Matt



Thoracic Aortic Dissection: Are Matrix Metalloproteinases Involved?  

PubMed Central

Thoracic aortic dissection, one of the major diseases affecting the aorta, carries a very high mortality rate. Improving our understanding of the pathobiology of this disease may help us develop medical treatments to prevent dissection and subsequent aneurysm formation and rupture. Dissection is associated with degeneration of the aortic media. Recent studies have shown increased expression and activation of a family of proteolytic enzymes—called matrix metalloproteinases (MMPs)—in dissected aortic tissue, suggesting that MMPs may play a major role in this disease. Inhibition of MMPs may be beneficial in reducing MMP-mediated aortic damage associated with dissection. This article reviews the recent literature and summarizes our current understanding of the role of MMPs in the pathobiology of thoracic aortic dissection. The potential importance of MMP inhibition as a future treatment of aortic dissection is also discussed.

Zhang, Xiaoming; Shen, Ying H.; LeMaire, Scott A.



Altered expression of epithelial sodium channel in rats with bilateral or unilateral ureteral obstruction.  


The roles of epithelial sodium channel (ENaC) subunits (alpha, beta, and gamma) in the impaired renal reabsorption of sodium and water were examined in rat models with bilateral (BUO) or unilateral ureteral obstruction (UUO) for 24 h or with BUO followed by release of obstruction and 3 days of observation (BUO-3dR). In BUO rats, plasma osmolality was increased dramatically, whereas plasma sodium concentration was decreased. Immunoblotting revealed a significantly decreased expression of alpha-ENaC (57 +/- 7%), beta-ENaC (19 +/- 5%), and gamma-ENaC (51 +/- 10%) as well as 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) in the cortex and outer medulla (C+OM) compared with sham-operated controls. This was confirmed by immunohistochemistry. BUO-3dR was associated with polyuria and impaired renal sodium handling. The protein abundance and the apical labeling of alpha-ENaC were significantly increased, whereas beta- and gamma-ENaC as well as 11beta-HSD2 expression remained decreased. In UUO rats, expression of alpha- and beta-ENaC and 11beta-HSD2 decreased in the C+OM in the obstructed kidney. In contrast, the abundance and the apical labeling of alpha-ENaC in the nonobstructed kidneys were markedly increased, suggesting compensatory upregulation in this kidney. In conclusion, alpha-, beta-, and gamma-ENaC expression levels are downregulated in the obstructed kidney. The expression and apical labeling of alpha-ENaC were increased in BUO-3dR rats and in the nonobstructed kidneys from UUO rats. These results suggest that altered expression of alpha-, beta-, and gamma-ENaC may contribute to impaired renal sodium and water handling in response to ureteral obstruction. PMID:17475897

Li, Chunling; Wang, Weidong; Norregaard, Rikke; Knepper, Mark A; Nielsen, Søren; Frøkiaer, Jørgen



Kidney stones and pregnancy.  


Kidney stones are common and do not spare the pregnant population. Although a simple stone event is usually straightforward in the general population, it is complex during pregnancy. Acute nephrolithiasis is associated with a unique set of complications during pregnancy and, because of imaging limitations, diagnosis is challenging. Multidisciplinary care is the key in proper management decisions. The pathophysiology of kidney stone formation in the pregnant state is also unique. Herein, we discuss the complexity of kidney stones and pregnancy. PMID:23928391

Semins, Michelle J; Matlaga, Brian R



Potency after unilateral nerve sparing surgery: a report on functional and oncological results of unilateral nerve sparing surgery  

Microsoft Academic Search

The objective of the study was to evaluate unilateral nerve sparing prostate surgery. Patient files of men who underwent unilateral nerve sparing radical prostatectomy were analyzed retrospectively after a minimum follow-up period of 18 months. Of 46 patients who received unilateral nerve sparing surgery, 14 (30.4%) regained full potency after surgery. In 92.9% of these patients, recovery occurred within a

F Van der Aa; S Joniau; D De Ridder; H Van Poppel



Supraclavicular Approach for Thoracic Outlet Syndrome  

Microsoft Academic Search

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

Julia K. Terzis; Zinon T. Kokkalis



Fractures of the Thoracic and Lumbar Spine  

Microsoft Academic Search

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

Robert N. Hensinger; Clifford L. Craig


Updated Perspectives on Neurogenic Thoracic Outlet Syndrome  

Microsoft Academic Search

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

Paul J. Christo; Kai McGreevy



Thoracic Paravertebral Block for Breast Surgery  

Microsoft Academic Search

standardized general anesthetic (GA) or thoracic PVB (levels T1-7). Procedural data were collected, as well as verbal and visual analog pain and nausea scores. Verbal postoperative pain scores were significantly lower in the PVB group at 30 min (P 5 0.0005) ,1h( P 5 0.0001), and 24 h (P 5 0.04) when compared with GA. Nausea was less severe in

Stephen M. Klein; Arthur Bergh; Susan M. Steele; Gregory S. Georgiade; Roy A. Greengrass



Two-Level Thoracic Disc Herniation  

Microsoft Academic Search

We report a rare case of two-level thoracic disc herniation that occurred in a 48-year-old woman. She was referred with a 10-month history of pain on the right side of the thorax. On examination, she had hypoesthesia and hypalgesia in the right T6-T8 dermatomes. An MRI scan revealed a large herniated disc at the T7\\/8 level and a smaller herniated



Managing Dissections of the Thoracic Aorta  

PubMed Central

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




Kidney Disease and Diabetes  


... Introduction Cardiovascular Disease & Diabetes Peripheral Artery Disease & Diabetes Kidney Disease & Diabetes Cholesterol Abnormalities & Diabetes • Understand Your Risk for Diabetes • Symptoms, Diagnosis & ...


Glycosphingolipids and kidney disease.  


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

Mather, Andrew R; Siskind, Leah J



Kidney disease in cardiology.  


Focusing on the convergence of cardiology and nephrology, this article marks the second year of NDT's section on Kidney Diseases beyond Nephrology. The clinical themes highlighted by the articles chosen for review include risk stratification and diagnosis of ischemic heart disease in severe chronic kidney disease and endstage renal disease patients, trials to reduce the risk of acute kidney injury (particularly contrast nephropathy) occurring with the invasive diagnosis and treatment of ischemic heart disease, and new data on the special clinical characteristics of dialysis patients with acute myocardial infarction. Finally, two clinical trials focusing on cardiovascular disease in severe kidney disease patients will be briefly highlighted. PMID:18079149

Herzog, Charles A



Notch3 and kidney injury: never two without three.  


Notch receptors and their canonical ligands are transmembrane proteins of the EGF-like family, expressed in the cell surface. Notch receptors are synthesized as single peptides and undergo three sequential proteolytic cleavage steps before rendering an active transcription factor, the Notch intracellular domain (NICD). Ligand binding facilitates release of NICD by ?-secretase. Evidence for the role of the Notch pathway in kidney injury comes from studies on activation of Notch by canonical ligands in cultured cells, on inhibition/targeting of ?-secretase in culture or in vivo, on genetic deletion of common Notch pathway proteins such as CSL, or descriptions of increased transcription of Notch target genes in kidney injury. Inhibitors of ?-secretase prevent fibrosis in experimental kidney injury. However, these drugs may modulate other signalling systems beyond Notch and are toxic in human trials. Information regarding the specific contribution of each receptor to kidney injury may help design better targeted therapeutic approaches. In this regard, overexpression of NICD1, NCID2, NICD3 or NICD4 elicits biological responses in cultured renal cells that include cell proliferation, apoptosis, and inflammatory and profibrotic responses, depending on the particular NICD. Furthermore, immunostaining for NICD1, NICD2, and NICD4 suggestive of receptor activation has been observed in glomerular and tubular cells in human and experimental kidney disease. Delayed conditional Notch1 or Notch2 inactivation facilitates cyst formation, and NICD1 overexpression in podocytes or tubular cells promotes glomerulosclerosis and interstitial fibrosis. Kidney injury is a feature of human Notch2 mutations and CADASIL patients with mutated Notch3 may display renal injury. Notch3-/- mice display increased sensitivity to angiotensin II-induced kidney injury but are less sensitive to tubular injury, inflammation, and fibrosis following unilateral ureteral obstruction. The recent availability of blocking antibodies specific for Notch1, Notch2, and Notch3 may help to elucidate the therapeutic potential of specific targeting of individual Notch receptors in kidney disease. PMID:22952000

Sanchez-Niño, Maria Dolores; Ortiz, Alberto



Successful transplantation of marginally acceptable thoracic organs.  

PubMed Central

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

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



36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Unilateral delay, suspension, or modification...Authorizing Instruments § 223.235 Unilateral delay, suspension, or modification...Service may compensate a person for the unilateral delay, suspension or...



36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...  

Code of Federal Regulations, 2010 CFR

...2009-07-01 2009-07-01 false Unilateral delay, suspension, or modification...Authorizing Instruments § 223.235 Unilateral delay, suspension, or modification...Service may compensate a person for the unilateral delay, suspension or...



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

Code of Federal Regulations, 2010 CFR

...false Capital stock requirements; unilateral redemption of excess stock. 950...11 Capital stock requirements; unilateral redemption of excess stock. ( stock in the Bank. (b) Unilateral redemption of excess capital...



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

Code of Federal Regulations, 2010 CFR

...false Capital stock requirements; unilateral redemption of excess stock. 950...11 Capital stock requirements; unilateral redemption of excess stock. ( stock in the Bank. (b) Unilateral redemption of excess capital...



Dissecting aneurysm in a patient with autosomal dominant polycystic kidney disease.  


Autosomal dominant polycystic kidney disease (ADPKD) is primarily associated with renal failure, but it also causes systemic diseases, including cysts of other systemic organs and cerebral or visceral aneurysm. To make matters worse, life-threatening aortic diseases are associated with ADPKD in some cases. However, only a few reports of ADPKD-associated with thoracic aortic dissection have been published. Herein, we present a case of dissecting aneurysm in a patient with hypertension and ADPKD. He had been followed up for type B aortic dissection for six years. Preoperative creatinine level ranged from 2.1 to 2.4 mg/dl. We performed replacement of the thoracic aorta with prosthetic graft successfully, and postoperatively, dialysis was not required.It is very important for us to recognize the relationship between ADPKD and thoracic aortic dissection, which can cause high mortality and morbidity rates. PMID:22293308

Fukunaga, Naoto; Yuzaki, Mitsuru; Nasu, Michihiro; Okada, Yukikatsu



Quadratic finite element methods for unilateral contact problems  

Microsoft Academic Search

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

Patrick Hild; Patrick Laborde



Stereopsis and binocular vision after surgery for unilateral infantile cataract  

Microsoft Academic Search

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

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



Opportunism and unilateral commitment: the moderating effect of relational capital  

Microsoft Academic Search

Purpose – This paper focuses on the decision by firms to commit and to invest unilaterally. It is concerned with the intriguing question as to whether unilateral commitments are mechanisms that help a firm manage risks in alliance relationships in a proactive manner. Design\\/methodology\\/approach – The hypotheses are tested with survey data on 344 alliance relationships of European biotechnology small

Hélène Delerue-Vidot



Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

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

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



A MEG Study Of Gamma Oscillations During Unilateral Movement  

Microsoft Academic Search

Recent studies have found the consistent contralateral high gamma activities in sensorimotor cortex in adults during a unilateral finger movement. However, no study has ever reported the same phenomenon in children. We hypothesized that the contralateral high gamma activities also exist in children during a unilateral finger movement. Sixty normal children (6-17 years old) were studied with a 275-channel MEG

Xiaolin Huo; Jing Xiang




Microsoft Academic Search

OBJECTIVE: To report pattern of unilateral nasal obstruction caused by sino-nasal neoplasms seen in two teaching hospitals in Sindh, Pakistan. DESIGN: A case series. SETTING: Ear, Nose and Throat (ENT) departments of Jinnah Postgraduate Medical Centre, Ka- rachi and People's Medical College, Nawabshah between June 1995 to June 1998. METHODS: This study included 51 patients who presented with unilateral nasal

Syed Mosaddaque Iqbal; Syed Iqbal Hussain


Unilateral fixtures for sheet-metal parts with holes  

Microsoft Academic Search

In this paper, we introduce unilateral fixtures , a new class of fixtures for sheet-metal parts with holes. These fixtures use cylindrical jaws with conical grooves that facilitate part alignment; each jaw provides the equivalent of four point contacts. The fixtures are unilateral in the sense that their actuating mechanisms are restricted to one side\\/surface of the part, facilitating access

Kanakasabapathi Gopalakrishnan; Ken Goldberg; Gary M. Bone; Matthew J. Zaluzec; Rama Koganti; R. Pearson; P. A. Deneszczuk



Kidney Disease (and Oral Health)  


Kidney Disease Oral Effects At the Dentist Oral Effects People with kidney disease often have other health issues. They often have compromised immune systems, so they may be more likely to get infections. People with renal (kidney) problems may have ...


Dextrocardia and coronal alignment of thoracic curve: a population study  

Microsoft Academic Search

The objective of this study was to evaluate the coronal alignment of the thoracic spine in persons with dextrocardia. Generally,\\u000a the thoracic spine is slightly curved to the right. It has been suggested that the curve could be triggered by pulsation forces\\u000a from the descending aorta. Since no population study has focused on the alignment of the thoracic spine in

Kaj Tallroth; Martina Lohman; Markku Heliövaara; Arpo Aromaa; Paul Knekt; Carl-Gustaf Standertskjöld-Nordenstam



Thoracic endovascular stent grafting inhibits aortic growth: an experimental study  

Microsoft Academic Search

Objective: Dilatation of the aorta at the landing zone site may be exaggerated by the radial force of stent grafts potentially limiting long-term results of endovascular therapy. We evaluated growth patterns and morphology of the thoracic aorta in young piglets after thoracic stent-graft placement. Methods: Eight domestic piglets (37±2kg) had an endovascular stent graft placed in the proximal descending thoracic

Michael P. Siegenthaler; Ramazan Celik; Joerg Haberstroh; Pietro Bajona; Heike Goebel; Kerstin Brehm; Wulf Euringer; Friedhelm Beyersdorf



Unilateral thyroidectomy for the treatment of benign multinodular goiter  

PubMed Central

BACKGROUND Benign multinodular goiter (MNG) is one of the most commonly treated thyroid disorders. While bilateral resection is the accepted surgical treatment for bilateral MNG, the appropriate surgical resection for unilateral MNG continues to be debated. Bilateral resection generally has lower recurrence rates but higher complication rates than unilateral resection. Therefore, the purpose of this study was to define the recurrence and complication rates of unilateral and bilateral resections in order to determine the appropriate intervention for patients with unilateral, benign MNG. METHODS We reviewed a prospectively maintained database of all patients who underwent a thyroidectomy for treatment of benign MNG at a single institution between May 1994 and December 2011. All patients with bilateral MNG were treated with bilateral resection. Surgical treatment for unilateral MNG was determined by surgeon preference, with all but one surgeon opting for unilateral resection to treat unilateral MNG. Data were reported as means ± standard error of the mean. Chi-squared analysis was used to determine statistical significance at a level of p<0.05. RESULTS A total of 683 patients underwent thyroidectomy for MNG. Of these patients, 420 (61%) underwent unilateral resection and 263 patients (39%) underwent total thyroidectomy. The mean age was 52±17 years, and 542 patients (79%) were female. The mean follow-up time was 46.1±1.9 months. The rate of recurrent disease was similar between unilateral (2%, n=10) and bilateral (1%, n=3) resections (p=0.248). Unilateral resection patients had a lower total complication rate than patients with bilateral resections (8% vs. 26%, p<0.001); however, there was no difference in the rate of permanent complications (0.2% vs. 1%, p=0.133). Thyroid hormone replacement was rare in unilateral resection patients, but necessary in all patients with bilateral resection (19% vs. 100%, p<0.001). CONCLUSIONS Patients that had unilateral resections endured less overall morbidities than those who had bilateral resections, and their risk of recurrent disease was similar. They were also significantly less likely to require lifelong hormone replacement therapy post-operatively. Although bilateral resection remains the recommended treatment for bilateral MNG, this data strongly supports the use of unilateral thyroidectomy for the treatment of unilateral, benign MNG.

Bauer, Philip S.; Murray, Sara; Clark, Nicholas; Pontes, David S.; Sippel, Rebecca S.; Chen, Herbert



Unilateral carpal tunnel syndrome and space-occupying lesions.  


To assess the association between unilateral carpal tunnel syndrome and space-occupying lesions, 128 patients have been reviewed. They were divided into bilateral, subclinical (unilateral signs and symptoms, and bilateral slowing in the median nerve conduction) and unilateral carpal tunnel syndrome. Space-occupying lesions were investigated on the basis of physical examination and wrist imaging using plain radiographs and ultrasonograms. Of 20 patients with unilateral carpal tunnel syndrome, space-occupying lesions were found in seven (occult ganglion in five and occult calcified mass in two). In contrast, none of 89 patients with bilateral carpal tunnel syndrome and 19 with subclinical carpal tunnel syndrome had space-occupying lesions. We conclude that careful examination and wrist imaging on suspicion of local pathology, especially a space-occupying lesion, are needed when the condition is unilateral and the aetiology is not clear from the history and on physical examination. PMID:8308434

Nakamichi, K; Tachibana, S



Calculated thoracic volume as related to parameters of scoliosis correction.  


The parameters in adolescent idiopathic scoliosis correction (longitudinal height gain, coronal and sagittal plane changes) that correlate most closely with an increase in thoracic volume are reported. With pre- and postoperative radiographs of matched patients having straight Harrington distraction rods and contoured Luque rods, coordinates were digitized and the change in thoracic volume was calculated in ten subjects undergoing surgery for right thoracic curves. An increase in volume (7% increase in Harrington rod and 16% among Luque rod patients) was most closely correlated with a change in thoracic kyphosis toward physiologic ranges. PMID:3381136

Ogilvie, J W; Schendel, M J



Evaluation of unilateral cage-instrumented fixation for lumbar spine  

PubMed Central

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



Keep Your Kidneys Clear: Kicking Kidney Stones  


... prone than women. Age is also a factor. The chance of getting a kidney stone rises as men enter their 40s and continues to rise into their 70s. For women, the risk peaks in their 50s. Each day, about ...


Scoliosis curve correction, thoracic volume changes, and thoracic diameters in scoliotic patients after anterior and after posterior instrumentation  

Microsoft Academic Search

Thoracic volume was calculated in 50 adolescent patients operated on for severe idiopathic thoracic scoliosis. In 25, anterior instrumentation was used (group 1), and posterior instrumentation in the other 25 patients (group 2). Calculation of thoracic volume was made from measurements of pre-operative and post-operative radiographs. The mean spinal curvature in group 1 was 73ᆠ.4° before the operation, and 19ᆣ°

V. Kova?; A. Puljiz; M. Smerdelj; M. Pecina



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


Impaired renal function may occur in experimental animals following surgical removal of most functioning renal tissue ("hyperfiltration injury"). Although end-stage renal disease is uncommon among long-term survivors of unilateral, non-syndromic Wilms tumor, concern has been expressed that there may be an increased risk of less serious, but progressive, renal function impairment among these individuals. The recent development of equations for estimating glomerular filtration rate (eGFR) has facilitated the study of renal function in Wilms tumor survivors. However, the estimating equations were developed to categorize individuals with chronic kidney disease and have significant limitations with regard to the accuracy of individual GFR estimates. These limitations must be considered when utilizing the estimating equations in cross-sectional or longitudinal evaluations of renal function in cohorts of patients who have been treated successfully for Wilms tumor or other childhood cancers. Pediatr Blood Cancer 2013;60:1929-1935. © 2013 Wiley Periodicals, Inc. PMID:24039069

Green, Daniel M



Autophagy and apoptosis in tubular cells following unilateral ureteral obstruction are associated with mitochondrial oxidative stress.  


Tubular epithelial loss has been shown to be responsible for the formation of atubular glomeruli leading to nephron decomposition and interstitial fibrosis in obstructive uropathy. Cells undergoing apoptosis and autophagic cell death play an important role in this process, yet the mechanisms are not fully understood. In this study, we aimed to investigate whether autophagy cooperating with apoptosis is associated with mitochondrial damage and whether oxidative stress plays an important role in the loss of tubular epithelium following unilateral ureteral obstruction. In this model, we demonstrated that there is coexistence of autophagy and apoptosis with tubular atrophy in obstructed proximal tubules. After unilateral ureteral obstruction (UUO), autophagy in proximal tubular cells was enhanced steadily up to 7 days in the obstructed kidney and declined thereafter, while apoptosis was induced in a time-dependent manner from 3 to 14 days. Mitochondrial structure and number also changed during UUO. Lipid peroxidation products, NOX4, and NADPH oxidase activity were also increased in the obstructed renal cortex, and peaked at 7 days. In vitro, we showed that H2O2 induced mitochondrial injury leading to autophagy and apoptosis through the Beclin 1 pathway and interference with Bcl-2 expression. Thus, our data demonstrate that oxidative stress leading to mitochondrial damage and driven autophagy-dependent cell death and apoptosis are important mechanisms of tubular decomposition in obstructive nephropathy. PMID:23314838

Xu, Yanfang; Ruan, Shiwei; Wu, Xiaonan; Chen, Hong; Zheng, Ke; Fu, Binbin



Unilateral Idiopathic Macular Telangiectasia with Choroidal Neovascularization.  


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

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



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


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

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



Potency after unilateral nerve sparing surgery: a report on functional and oncological results of unilateral nerve sparing surgery.  


The objective of the study was to evaluate unilateral nerve sparing prostate surgery. Patient files of men who underwent unilateral nerve sparing radical prostatectomy were analyzed retrospectively after a minimum follow-up period of 18 months. Of 46 patients who received unilateral nerve sparing surgery, 14 (30.4%) regained full potency after surgery. In 92.9% of these patients, recovery occurred within a period of 18 months. Age is the single most important factor in the recuperation of potency after unilateral nerve sparing surgery. Most of the patients (84.8%) reported the ability to achieve orgasm. Of eight patients with positive section margins, two had positive section margins at the spared side only. Unilateral nerve sparing surgery remains a feasible treatment option for prostate cancer. PMID:12664068

Van der Aa, F; Joniau, S; De Ridder, D; Van Poppel, H



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


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

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



Biomechanical allometry in hominoid thoracic vertebrae.  


Considerable differences in spinal morphology have been noted between humans and other hominoids. Although comparative analyses of the external morphology of vertebrae have been performed, much less is known regarding variations in internal morphology (density) and biomechanical performance among humans and closely related non-human primates. In the current study we utilize density calibrated computed tomography images of thoracic vertebral bodies from hominoids (n=8-15 per species, human specimens 20-40 years of age) to obtain estimates of vertebral bone strength in axial compression and anteroposterior bending and to determine how estimates of strength scale with animal body mass. Our biomechanical analysis suggests that the strength of thoracic vertebral bodies is related to body mass (M) through power law relationships (y proportional, variant M(b)) in which the exponent b is 0.89 (reduced major axis) for prediction of axial compressive strength and is equal to 1.89 (reduced major axis) for prediction of bending strength. No differences in the relationship between body mass and strength were observed among hominoids. However, thoracic vertebrae from humans were found to be disproportionately larger in terms of vertebral length (distance between cranial and caudal endplates) and overall vertebral body volume (p<0.05). Additionally, vertebral bodies from humans were significantly less dense than in other hominoids (p<0.05). We suggest that reduced density in human vertebral bodies is a result of a systemic increase in porosity of cancellous bone in humans, while increased vertebral body volume and length are a result of functional adaptation during growth resulting in a vertebral bone structure that is just as strong, relative to body mass, as in other hominoids. PMID:19427672

Hernandez, C J; Loomis, D A; Cotter, M M; Schifle, A L; Anderson, L C; Elsmore, L; Kunos, C; Latimer, B



The reported thoracic injuries in Homer's Iliad.  


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

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



The reported thoracic injuries in Homer's Iliad  

PubMed Central

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



Vestibular Perception following Acute Unilateral Vestibular Lesions  

PubMed Central

Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s2 and velocity steps of 90°/s (acceleration 180°/s2). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any ‘perceptual noise’ added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced – asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of perceptual processes (ultimately cortical) participating in vestibular compensation, suppressing asymmetry acutely in unilateral vestibular lesions.

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



Digital subtraction angiography of the thoracic aorta  

SciTech Connect

Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.



[Mycotic aneurysm of the descending thoracic aorta].  


A 55-year-old man was admitted with severe back pain and saccular aneurysm of the descending aorta on computed tomography. Laboratory examinations showed elevated serum C-reactive protein of 16.98 mg/dl. Graft replacement of the descending thoracic aorta was performed on an emergency basis, and a latissimus dorsi muscle flap was wrapped around the implanted graft. Because Streptococcus pneumoniae was detected in the resected tissue, proper antibiotic therapy was administrated. The patient recovered uneventfully, without any sign of infection. PMID:23117356

Nogami, Eijiro; Rikitake, Kazuhisa; Ohnishi, Hiroyuki; Miho, Takahiro; Kuroki, Jun



Recent advances in radiotherapy for thoracic tumours  

PubMed Central

Radiation Oncology technology has continued to advance at a rapid rate and is bringing significant benefits to patients. This review outlines some of the advances in technology and radiotherapy treatment of thoracic cancers including brachytherapy, stereotactic radiotherapy, tomotherapy and intensity modulated radiotherapy. The importance of functional imaging with PET and management of movement are highlighted. Most of the discussion relates to non-small cell lung cancer but management of mesothelioma and small cell lung cancer are also covered. This technology has substantial benefits to patients in terms of decreasing toxicity both in the short and longer term.

Poole, Christopher M.; Pratt, Gary



Paucity of intrahepatic bile ducts, solitary kidney and atrophic pancreas with diabetes mellitus: Atypical Alagille syndrome?  

Microsoft Academic Search

Abstract  A child with the tentative diagnosis of Alagille syndrome is reported. Additional renal abnormalities are unilateral kidney\\u000a agenesis and a kidney with subcortical cysts with decreased function. At the age of 5 years, insulin-dependent diabetes mellitus\\u000a developed, with the pancreas being atrophic and negative pancreatic islet cell antibodies.\\u000a \\u000a \\u000a \\u000a Conclusion  This observation extends the picture of Alagille syndrome and suggests an overlap

K. Devriendt; L. Dooms; W. Proesmans; F. de Zegher; E. Eggermont; V. Desmet



Kidney biopsies can be used for estimations of glomerular number and volume: a pig study  

Microsoft Academic Search

In this study, we wanted to evaluate the use of kidney biopsies for estimation of N(glom) and V(glom) in both healthy and chronically diseased kidneys. Danish Landrace pigs with mean weight of 29 kg (range: 25–35 kg)\\u000a were either subjected to unilateral ureteral obstruction (UUO) or non-obstruction (healthy). N(glom) and V(glom) was estimated by design-based methods using biopsies, N(glom)biopsy and V(glom)biopsy. From

Anders Bergh Lødrup; Kristian Karstoft; Thomas Heide Dissing; Michael Pedersen; Jens Randel Nyengaard



Acute kidney injury.  


Essential facts About one in five patients who are emergency admissions to hospital will present with acute kidney injury (AKI), a condition that involves the loss of kidney function over hours or days. Despite its prevalence, there are low levels of awareness and education about AKI among healthcare professionals. Care is often below the standard it should be, with only a third of patients receiving adequate investigations, according to a 2009 report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD). AKI used to be known as acute renal failure. The term encompasses a wide range of injury to the kidneys, not just failure. PMID:24063464



Urological anomalies in children with renal agenesis or multicystic dysplastic kidney  

Microsoft Academic Search

This study aimed to determine the frequency of associated urological abnormalities in children with unilateral renal agenesis\\u000a (RA) or multicystic dysplastic kidney (MCDK). In total, 38 children (10 girls, 28 boys) were studied: 21 with RA and 17 with\\u000a MCDK. In 14 children (37%) anomalies of the urinary tract were suspected prenatally in ultrasound studies. In the remaining\\u000a 24 children

Gra?yna Krzemie?; Maria Roszkowska-Blaim; Izabella Kostro; Julita Wojnar; Monika Karpi?ska; Renata S?kowska



Unilateral Auditory Neuropathy Caused by Cochlear Nerve Deficiency  

PubMed Central

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

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



A contusive model of unilateral cervical spinal cord injury using the infinite horizon impactor.  


While the majority of human spinal cord injuries occur in the cervical spinal cord, the vast majority of laboratory research employs animal models of spinal cord injury (SCI) in which the thoracic spinal cord is injured. Additionally, because most human cord injuries occur as the result of blunt, non-penetrating trauma (e.g. motor vehicle accident, sporting injury) where the spinal cord is violently struck by displaced bone or soft tissues, the majority of SCI researchers are of the opinion that the most clinically relevant injury models are those in which the spinal cord is rapidly contused.(1) Therefore, an important step in the preclinical evaluation of novel treatments on their way to human translation is an assessment of their efficacy in a model of contusion SCI within the cervical spinal cord. Here, we describe the technical aspects and resultant anatomical and behavioral outcomes of an unilateral contusive model of cervical SCI that employs the Infinite Horizon spinal cord injury impactor. Sprague Dawley rats underwent a left-sided unilateral laminectomy at C5. To optimize the reproducibility of the biomechanical, functional, and histological outcomes of the injury model, we contused the spinal cords using an impact force of 150 kdyn, an impact trajectory of 22.5° (animals rotated at 22.5°), and an impact location off of midline of 1.4 mm. Functional recovery was assessed using the cylinder rearing test, horizontal ladder test, grooming test and modified Montoya's staircase test for up to 6 weeks, after which the spinal cords were evaluated histologically for white and grey matter sparing. The injury model presented here imparts consistent and reproducible biomechanical forces to the spinal cord, an important feature of any experimental SCI model. This results in discrete histological damage to the lateral half of the spinal cord which is largely contained to the ipsilateral side of injury. The injury is well tolerated by the animals, but does result in functional deficits of the forelimb that are significant and sustained in the weeks following injury. The cervical unilateral injury model presented here may be a resource to researchers who wish to evaluate potentially promising therapies prior to human translation. PMID:22871686

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



Unilateral Versus Bilateral Neck Exploration for Primary Hyperparathyroidism  

PubMed Central

Objective To compare unilateral and bilateral neck exploration for primary hyperparathyroidism in a prospective randomized controlled trial. Summary Background Data Based on the assumption that unilateral neck exploration for a solitary parathyroid adenoma should reduce operating time and morbidity, a variety of minimally invasive procedures have challenged the idea that bilateral neck exploration is the gold standard for the surgical treatment of primary hyperparathyroidism. However, to date, no open prospective randomized trial has been published comparing unilateral and bilateral neck exploration. Methods Ninety-one patients with the preoperative diagnosis of primary hyperparathyroidism were randomized to unilateral or bilateral neck exploration. Preoperative scintigraphy and intraoperative parathyroid hormone measurement guided the unilateral exploration. Gross morphology and frozen section determined the extent of parathyroid tissue resection in the bilateral group. The primary end-point was the use of postoperative medication for hypocalcemic symptoms. Results Eighty-eight patients (97%) were cured. Histology and cure rate did not differ between the two groups. Patients in the bilateral group consumed more oral calcium, had lower serum calcium values on postoperative days 1 to 4, and had a higher incidence of early severe symptomatic hypocalcemia compared with patients in the unilateral group. In addition, for patients undergoing surgery for a solitary parathyroid adenoma, unilateral exploration was associated with a shorter operative time. The cost for the two procedures did not differ. Conclusions Patients undergoing a unilateral procedure had a lower incidence of biochemical and severe symptomatic hypocalcemia in the early postoperative period compared with patients undergoing bilateral exploration. Unilateral neck exploration with intraoperative parathyroid hormone assessment is a valid surgical strategy in patients with primary hyperparathyroidism with distinct advantages, especially for patients with solitary parathyroid adenoma.

Bergenfelz, Anders; Lindblom, Pia; Tibblin, Sten; Westerdahl, Johan



Thoracic spinal cord compression by ligamentum flavum ossifications  

Microsoft Academic Search

Thoracic Spinal Cord Compression by Ligamentum Flavum Ossifications. Ossification of the ligamentum flavum is common in Japan but rare in Western countries. Myelopathy of variable severity is a possible complication. Extension of the lesions over several levels at the thoracic spine is exceedingly rare.  We report a new case in a 50-year-old man who had slowly progressive spinal cord compression

Ali Akhaddar; Abdelaziz Mansouri; Ibtissame Zrara; Miloudi Gazzaz; Mohamed Maftah; Brahim Mostarchid; Said Benomar; Mohamed Boucetta



Anterior dual rod instrumentation in idiopathic thoracic scoliosis  

Microsoft Academic Search

For anterior correction and instrumentation of thoracic curves single rod techniques are widely used. Disadvantages of this technique include screw pullouts, rod fractures and limited control of kyphosis. This is a prospective study of 23 consecutive patients with idiopathic thoracic scoliosis treated with a new anterior dual rod system. Aim of the study was to evaluate the safety and efficacy

Ulf R. Liljenqvist; Viola Bullmann; Tobias L. Schulte; Lars Hackenberg; Henry F. Halm



Complications after endovascular stent-grafting of thoracic aortic diseases  

Microsoft Academic Search

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

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



Stented elephant trunk method for multiple thoracic aneurysms  

Microsoft Academic Search

Stent-grafting and open graft replacement was introduced to reduce the complications of suture anastomosis in the descending aorta. We applied this technique in the treatment of a patient with multiple thoracic aneurysms. The elephant trunk procedure was used for thromboexclusion. A single branched graft was placed easily without twisting. In patients with aneurysms at both the proximal and distal thoracic

Shinji Miyamoto; Tetsuo Hadama; Hirofumi Anai; Hidenori Sako; Osamu Shigemitsu



Upper thoracic spinal fractures in trauma patients — a diagnostic pitfall  

Microsoft Academic Search

The diagnosis of upper thoracic spinal fractures in multiple-trauma patients remains a challenge. The clinical findings are often difficult to detect, especially in the presence of other (extremity) fractures, head injuries or in patients on respiratory support.The findings of chest radiographs and plain spinal films are described in a series of 23 patients with an upper thoracic spinal fracture. Radiographs

Edwin J. R van Beek; Henk D Been; Kees-Jan Ponsen; Mario Maas



Thoracic spine: anatomical and biomechanical considerations for manual therapy  

Microsoft Academic Search

SUMMARY. Interactions between thoracic spine posture and mobility are believed to play a role in the development of spinal pain syndromes. Accordingly, appropriate and effective manual therapy management is dependent on a sound knowledge of the anatomy and biomechanics of this region of the vertebral column. This paper reviews the primary anatomical influences on thoracic posture, mobility and stability. The

S. J. Edmondston; K. P. Singer



[Systemic and regional analgesia in patients undergoing major thoracic surgery].  


Effective, aggressive treatment of pain accompanied with thoracic surgery is important and beneficial for patients, since severe postoperative pulmonary complications and long-term pain will be reduced. In this systematic issue evidence-based strategies in preventing and treating pain after thoracic surgery will be reviewed. PMID:22968987

Loop, Torsten



Fibrinogen is an Independent Marker for Thoracic Aortic Atherosclerosis  

Microsoft Academic Search

The fibrinogen level is an independent risk factor for coronary events and stroke, but no detailed data are available concerning fibrinogen and atherosclerotic disease of the thoracic aorta. This prospective study using multiplane transesophageal echocardiography examined the relation between atherosclerotic thoracic aortic plaque and fibrinogen level. One-hundred forty-eight patients (65 ± 11 years) with valvular heart disease underwent multiplane transesophageal

Christophe Tribouilloy; Marcel Peltier; Laurent Colas; Michele Senni; Olivier Ganry; Jean-Luc Rey; Jean-Philippe Lesbre



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

PubMed Central

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

Kaiser, L R



Thoracic duct and cisterna chyli: evaluation with multidetector row CT  

PubMed Central

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

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



Acute arterial occlusion - kidney  


... long enough to cause kidney failure. Tests include: Duplex Doppler ultrasound exam of the renal arteries to ... blood clotting disorders. Controlling diseases related to atherosclerosis (hardening of the arteries) may reduce your risk.


Medullary Sponge Kidney  


... eds. Campbell's Urology. Vol. 3. 8th ed. Philadelphia: WB Saunders Company; 2002: 1925-1994. 2 Grantham JJ, ... Rector's The Kidney. Vol. 2. 6th ed. Philadelphia: WB Saunders Company; 2000: 1699-1730. [ Top ] What are ...


Polycystic kidney disease.  


Polycystic kidney disease, an inherited systemic disorder, is characterized by the development of multiple cysts in the kidneys and other organs. Patients can present at any age, but more often come to clinical attention (unless there is a family history) after age 30. Patients who are diagnosed before age 30 have a worse renal survival. Although palpation of the abdomen occasionally provides a clue to the presence of polycystic kidney disease, radiographic procedures most often suggest the diagnosis. Mutations in the PKD1 or PKD2 genes give rise to cyst formation. Flank pain, hematuria, polyuria, nephrolithiasis, urinary tract infections, and hypertension may be part of the syndrome of polycystic kidney disease. It is the fourth most common cause of end-stage renal disease. Blood pressure treatment goals are less than 130/80 mm Hg. Treatment should include the use of angiotensin-converting enzyme inhibitors. PMID:16227765

Fall, Pamela J; Prisant, L Michael



Kidney (Renal) Abscess  


... topics for this letter X X-ray Y Yeast Infections Z no topics for this letter Kidney ( ... An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract. urine: Liquid waste ...


Kidneys and Urinary Tract  


... the body's red blood cell production (red blood cells carry oxygen throughout the body). In addition, the kidneys help regulate the acid-base balance (or the pH) of the blood and body fluids, which is ...


Kidney Role-Plays.  

ERIC Educational Resources Information Center

|Describes a study of the effectiveness of using role-play in teaching the functions of the kidney to secondary science students. Results suggest that the teaching technique is effective. (Author/WRM)|

Johnson, Gillian



Diabetes and kidney disease  


Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Nephropathy - diabetic; Diabetic nephropathy ... a higher risk for kidney problems. People of African-American, Hispanic, and American Indian origin are also more ...


Organ Facts: Kidney / Pancreas  


... the kidneys is to remove waste from the body through the production of urine. They also help to regulate blood pressure, blood volume and the chemical (electrolyte) composition of the blood. The pancreas is a five ...


History and current status of mini-invasive thoracic surgery  

PubMed Central

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

He, Jianxing



History and current status of mini-invasive thoracic surgery.  


Mini-invasive thoracic technique mainly refers to a technique involving the significant reduction of the chest wall access-related trauma. Notably, thoracoscope is the chief representative. The development of thoracoscope technique is characterized by: developing from direct peep to artificial lighting, then combination with image and video technique in equipments; technically developing from diagnostic to therapeutic approaches; developing from simpleness to complexity in application scope; and usually developing together with other techniques. At present, the widely used mini-invasive thoracic surgery refers to the mini-open thoracic surgery performed mainly by using some instruments to control target tissues and organs based on the vision associated with multi-limb coordination, which may be hand-assisted if necessary. The mini-invasive thoracic surgery consists of three approaches including video-assisted thoracic surgery (VATS), video-assisted Hybrid and hand-assisted VATS. So far the mini-invasive thoracic technique has achieved great advances due to the development in instruments of mini-invasive thoracic surgery which has the following features: instruments of mini-invasive thoracic surgery appear to be safe and practical, and have successive improvement and diversification in function; the specific instruments of open surgeries has been successively developed into dedicated instruments of endoscopic surgery; the application of endoscopic mechanical suture device generates faster fragmentation and reconstruction of organ tissues; the specific delicated instruments of endoscopic surgery have rapid development and application; and the simple instruments structurally similar to the conventional instruments are designed according to the mini-incison. In addition, the mini-invasive thoracic technique is widely used in five aspects including diseases of pleura membrane and chest wall, lung diseases, esophageal diseases, mediastinal diseases and heart diseases. However, there remain many problems in specifications and trainings, economic cost, conservation and innovation. Therefore, particular attention should be paid to these problems. Nevertheless, the promotion of thoracic surgery appears promising in the future. PMID:22263074

He, Jianxing



Institutional report - Thoracic general The use of Blake drains following general thoracic surgery: is it an acceptable option?  

Microsoft Academic Search

As a method of chest drainage, we analyzed the extended utility of silastic flexible drains (Blake drains, Ethicon, Inc., Somerville, NJ) for general thoracic surgery. In 420 cases of general thoracic surgery, Blake drains were used. To examine the utility of Blake drains, we investigated the diseases for which they were used, their effectiveness in addressing postoperative complications. The treated

Hiroshige Nakamura; Yuji Taniguchi; Ken Miwa; Yoshin Adachi; Shinji Fujioka; Tomohiro Haruki


Unilateral lobectomy for Hurthle cell adenoma.  


Considerable controversy exists regarding the ability to predict the biologic behavior of Hurthle cell tumors. Some have found the clinicopathologic criteria used to differentiate benign from malignant lesions to be unreliable and have advocated total thyroidectomy for all Hurthle cell neoplasms. From January 1980 to December 1995, 39 patients had surgery for Hurthle cell tumors of the thyroid. The surgical pathologic findings were reviewed by an experienced pathologist (JP). Eight patients had histologic findings of capsular or vascular invasion consistent with carcinoma and had total thyroidectomy. Four of these patients had postoperative evidence of residual disease and were treated by radiation ablation. No evidence of invasion was found in 31 patients diagnosed with Hurthle cell adenoma. Twenty-three of these patients had unilateral lobectomy; total thyroidectomy was done in the remaining 8 patients, 5 of whom were found to have an associated papillary carcinoma at the time of operation. There were no operative deaths or significant morbidity. Twenty-two adenomas (71%) were found in females, whereas males had malignant tumors in 6 of 8 cases (P = 0.025). The mean age of adenoma patients is 54.1 years, and that of the carcinoma patients is 55.8 years. Mean size of benign tumors was 2.8 cm and of malignant tumors 4.1 cm (P = 0.04). Four of seven (57%) carcinomas were larger than 4 cm as compared with 6 of 30 (20%) adenomas (P = 0.069). Follow-up has ranged from 1 month to 15 years, with a mean of 3.2 years. There have been no deaths, and no patients with Hurthle cell adenoma have had evidence of recurrence or metastases during follow-up. Our data suggest that carcinoma patients tend to be male and tumor size is larger. An association was found when trying to predict malignancy by using 4 cm as a threshold size. We conclude that pathologic evidence of capsular or angioinvasion can accurately differentiate benign from malignant tumors. Unilateral thyroid lobectomy is adequate therapy for the treatment of Hurthle cell adenoma, with total thyroidectomy reserved for those patients with histologically proven carcinoma. PMID:9697901

Wasvary, H; Czako, P; Poulik, J; Lucas, R



Masseteric hypertrophy associated with administration of anabolic steroids and unilateral mastication: a case report.  


In this report we present a patient with unilateral masseteric hypertrophy who used anabolic steroids and was chewing entirely unilaterally for 1 month. Computed tomography and histologic examination were used to confirm the diagnosis. The combined action of unilateral mastication and anabolic steroid use is probably responsible for the rapid development of unilateral masseteric hypertrophy. PMID:11709687

Skoura, C; Mourouzis, C; Saranteas, T; Chatzigianni, E; Tesseromatis, C



Masseteric hypertrophy associated with administration of anabolic steroids and unilateral mastication: A case report  

Microsoft Academic Search

In this report we present a patient with unilateral masseteric hypertrophy who used anabolic steroids and was chewing entirely unilaterally for 1 month. Computed tomography and histologic examination were used to confirm the diagnosis. The combined action of unilateral mastication and anabolic steroid use is probably responsible for the rapid development of unilateral masseteric hypertrophy. (Oral Surg Oral Med Oral

Cornilia Skoura; Costas Mourouzis; Theodosios Saranteas; Emmy Chatzigianni; Christina Tesseromatis



Epidural haematoma and unilateral exophthalmos—a review  

Microsoft Academic Search

Summary Based on 9 cases in the literature and one of our own a review is made on the occurrence of an association of an intracranial epidural haematoma with unilateral exophthalmos. The possible pathogenesis of this infrequent phenomenon is discussed.

F. Umansky; Sh. Pomeranz



Unilateral thalamic infarction and vertical gaze palsy: cause or coincidence?  


Although vertical gaze palsy (VGP) is commonly associated with lesions of the rostral mesencephalon, there is some evidence that VGP may also be caused by a unilateral thalamic lesion. The case of a 68-year-old man with persistent upward gaze palsy after a unilateral thalamic infarction, demonstrated on computed tomography and magnetic resonance imaging scans, is presented. Subsequent high-resolution magnetic resonance scanning, however, showed involvement of the rostral mesencephalon as well. The authors suggest that in previous patients with VGP ascribed to a unilateral thalamic infarction, a coexisting mesencephalic involvement may have been missed because of inappropriate imaging techniques. Strong evidence of unilateral thalamic infarction as a cause of VGP is still lacking. PMID:10870929

van der Graaff, M M; Vanneste, J A; Davies, G A



The S-locus and unilateral incompatibility.  


Plants have many ways to regulate the type of pollen that arrives on the stigma surface. Once there, further control mechanisms regulate compatibility. The latter controls are largely based on biochemical interactions that support compatible pollination and prevent incompatible matings. S-RNase-based self-incompatibility (SI) systems are the most phylogenetically widespread mechanisms for controlling pollination. Studies of Nicotiana establish a firm link between SI and unilateral interspecific incompatibility. Although implicated in both inter- and intraspecific compatibility, S-RNase operates through at least three distinct genetic mechanisms that differ in their dependence on non-S-RNase factors. Identification and characterization of these non-S-RNase factors is currently an area of active research. Searching for genetic and biochemical interactions with S-RNase can identify candidate non-S-RNase factors. HT-protein is one factor that is required for S-allele-specific pollen rejection in the Solanaceae. Major style arabinogalactan proteins such as TTS interact biochemically with S-RNase. These glycoproteins are known to interact with compatible pollen tubes and have long been suggested as possible recognition molecules. Their binding to S-RNase implies a link between stylar systems for compatibility and incompatibility. Thus, genetic and biochemical studies suggest a highly networked picture of pollen-pistil interactions. PMID:12831479

Hancock, C Nathan; Kondo, Katsuhiko; Beecher, Brian; McClure, Bruce



Congenital Unilateral Hypoplasia of Depressor Anguli Oris  

PubMed Central

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

Ulualp, Seckin O.; Deskin, Ronald



The S-locus and unilateral incompatibility.  

PubMed Central

Plants have many ways to regulate the type of pollen that arrives on the stigma surface. Once there, further control mechanisms regulate compatibility. The latter controls are largely based on biochemical interactions that support compatible pollination and prevent incompatible matings. S-RNase-based self-incompatibility (SI) systems are the most phylogenetically widespread mechanisms for controlling pollination. Studies of Nicotiana establish a firm link between SI and unilateral interspecific incompatibility. Although implicated in both inter- and intraspecific compatibility, S-RNase operates through at least three distinct genetic mechanisms that differ in their dependence on non-S-RNase factors. Identification and characterization of these non-S-RNase factors is currently an area of active research. Searching for genetic and biochemical interactions with S-RNase can identify candidate non-S-RNase factors. HT-protein is one factor that is required for S-allele-specific pollen rejection in the Solanaceae. Major style arabinogalactan proteins such as TTS interact biochemically with S-RNase. These glycoproteins are known to interact with compatible pollen tubes and have long been suggested as possible recognition molecules. Their binding to S-RNase implies a link between stylar systems for compatibility and incompatibility. Thus, genetic and biochemical studies suggest a highly networked picture of pollen-pistil interactions.

Hancock, C Nathan; Kondo, Katsuhiko; Beecher, Brian; McClure, Bruce



Asymmetric vestibular evoked myogenic potentials in unilateral Menière patients  

Microsoft Academic Search

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

C. M. Kingma; H. P. Wit



Unilateral ectopic breast tissue on vulva in an adult female.  


Among the ectopic breasts, an ectopic breast tissue on vulva is an extremely rare case, especially in adult period. To our knowledge only 38 cases of ectopic breast tissue on vulva are documented in the world literature, out of which only 10 cases of unilateral ectopic breast tissue on vulva has been reported. Because of its rarity here we report a case of unilateral ectopic breast tissue on vulva in an adult female. PMID:23904730

Deshmukh, Santoshkumar Nagnath; Maske, Audumbar N; Deshpande, Akshay P; Shende, Shweta P



Evaluation of unilateral cage-instrumented fixation for lumbar spine  

Microsoft Academic Search

BACKGROUND: To investigate how unilateral cage-instrumented posterior lumbar interbody fusion (PLIF) affects the three-dimensional flexibility in degenerative disc disease by comparing the biomechanical characteristics of unilateral and bilateral cage-instrumented PLIF. METHODS: Twelve motion segments in sheep lumbar spine specimens were tested for flexion, extension, axial rotation, and lateral bending by nondestructive flexibility test method using a nonconstrained testing apparatus. The

Ti-Sheng Chang; Jia-Hao Chang; Chien-Shiung Wang; Hung-Yi Chen; Ching-Wei Cheng



Grip Force Coordination during Bimanual Tasks in Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

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

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



Nitric oxide inhibits norepinephrine stimulated contraction of human internal THORAcIC artery and rat aorta  

Microsoft Academic Search

The effect of nitric oxide (NO) on norepinephrine-induced vascular contraction was evaluated using segments of rat aorta and human internal thoracic artery (ITA) and the NO donor, SNAP. NO levels were measured directly using an amperometric probe. Concentrations of NO greater than 2 nM were required to reduce vascular contraction induced by 100 nM norepinephrine (NE). Exposure of the aortic

George B. Stefano; Jose Murga; Herbert Benson; Wei Zhu; Thomas V. Bilfinger; Harold I. Magazine



Thoracic outlet syndrome: current concepts of treatment.  

PubMed Central

This current concept of treatment of the Thoracic Outlet Syndrome based on a personal experience with 304 patients, resulted in complete (85%) or partial (7%) relief of symptoms in 92% of operated patients. The diagnosis centers upon a thorough history and the exclusion of other causes of arm and shoulder pain utilizing a strict flow pattern of differential diagnosis. Angiography and electromyography are of limited value and are only performed in selected cases. Operation should be reserved for the thoroughly evaluated patient who continues to have pain despite adequate conservative therapy. Transaxillary removal of the first rib, fibromuscular bands and cervical rib, when present, is the operation of choice. Images Fig. 2. Fig. 7. Fig. 8. Fig. 10.

Kelly, T R



Solitary lymphoblastic lymphoma of the thoracic spine.  


Non-Hodgkin's lymphoma rarely originates from bone, and even more infrequently from a vertebral body. Lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma, and results from an abnormality in adaptive immune cells. A 27-year-old man presented with a two-month history of night sweats, weight loss, and severe back pain. Radiological studies demonstrated an osteolytic lesion compressing the subarachnoid space at the T11 level. Posterolateral fusion with decompression was performed and a pathologic examination confirmed lymphoblastic lymphoma of the B-cell precursor type. To our knowledge, this is the first report of solitary lymphoblastic lymphoma from B-cell precursors in of the thoracic spine. Herein, we discuss the presenting symptoms and the management of this rare case of lymphoblastic lymphoma. PMID:23346332

Park, Dong Am; Park, Sang Gon; Kim, Seok Won



Solitary Lymphoblastic Lymphoma of the Thoracic Spine  

PubMed Central

Non-Hodgkin's lymphoma rarely originates from bone, and even more infrequently from a vertebral body. Lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma, and results from an abnormality in adaptive immune cells. A 27-year-old man presented with a two-month history of night sweats, weight loss, and severe back pain. Radiological studies demonstrated an osteolytic lesion compressing the subarachnoid space at the T11 level. Posterolateral fusion with decompression was performed and a pathologic examination confirmed lymphoblastic lymphoma of the B-cell precursor type. To our knowledge, this is the first report of solitary lymphoblastic lymphoma from B-cell precursors in of the thoracic spine. Herein, we discuss the presenting symptoms and the management of this rare case of lymphoblastic lymphoma.

Park, Dong Am; Park, Sang Gon



Thoracic Computed Tomography Findings in Malignant Mesothelioma  

PubMed Central

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

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



Delayed Onset of Thoracic SCIWORA in Adults  

PubMed Central

Spinal cord injury (SCI) without radiographic abnormality (SCIWORA) is estimated to account for 1-9% of the occurrence of SCI. Of these, cervical SCIWORA in children is common, but thoracic SCIWORA delayed onset in adult is much less common. We experienced a case of 38-years old male patient with lower extremity weakness; he had fallen down a week earlier before the investigation. At the time of admission, motor grade was 4 with voiding incontinence and ambulated with cane. He presented progressive weakness from G4 to G3 and hypoesthesia was below T8 dermatome and ambulated with wheelchair. Whole spine and lumbar MRI findings showed no abnormality and electrodiagnostic findings showed normal NCS, however, abnormal SEP on both the tibial nerves. After steroid therapy and proper rehabilitation program for 2 weeks, lower extremity strength was improved from G4 to G3, voiding was continent, and ambulation reached cane gait.

Park, Man-Choon; Bok, Soo-Kyung; Lee, Soo-Jin; Ahn, Dong-Heun



Respiratory displacement of the thoracic aorta: physiological phenomenon with potential implications for thoracic endovascular repair.  


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. PMID:19434450

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



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

SciTech Connect

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

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



A reappraisal of adult thoracic surface anatomy.  


Accurate surface anatomy is essential for safe clinical practice. Numerous inconsistencies in clinically important surface markings exist between and within anatomical reference texts. The aim of this study was to investigate key thoracic surface anatomical landmarks in vivo using computed tomographic (CT) imaging. High-resolution thoracic CT scans from 153 supine adults (mean age 63, range 19-89 years; 53% female) taken at end tidal inspiration were analyzed by dual consensus reporting to determine the surface anatomy of the sternal angle, central veins, heart, lungs, and diaphragm. Patients with kyphosis/scoliosis, distorting space-occupying lesions, or visceromegaly were excluded. The position of the cardiac apex, formation of the brachiocephalic veins, and vertebral levels of the sternal angle, xiphisternal joint, and aortic hiatus were consistent with commonly accepted surface markings although there was a wide range of normal variation. In contrast, common surface markings were markedly inaccurate for the following: the position of the tracheal bifurcation, aortic arch, and azygos vein termination (below the plane of the sternal angle at T5-T6 vertebral level in most individuals); the superior vena cava/right atrial junction (most often behind the fourth costal cartilage); the lower border of the lung (adjacent to T12 vertebra posteriorly); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T11 in most). Surface anatomy must be reappraised using modern imaging in vivo if it is to be evidence based and fit for purpose. The effects of gender, age, posture, respiration, build, and ethnicity also deserve greater emphasis. PMID:22576938

Mirjalili, S Ali; Hale, Samuel J M; Buckenham, Tim; Wilson, Ben; Stringer, Mark D



Video-Assisted Thoracic Surgery Study Group.  


Both patients and the medical profession are quick to embrace new technology, particularly when it may replace an existing surgical procedure. Unfortunately, the rapidity of acceptance is rarely associated with careful evaluation. Laparoscopy is a recent example of such widely embraced technology. Studies of laparoscopy that yielded good comparative data to more traditional methods were slow to accrue. This led to the exposure of its shortcomings through governmental reports and the lay press. To prevent this from happening in thoracoscopy, two types of studies are required so that valid conclusions about the new technology can be drawn. The first is an accounting of the new technology as procedures evolve around it. The data collected in such a study should contain basic information, including the indications for the procedure, how it was performed, procedure length, associated complications, and patient outcome. Such information provides a broad profile of the technology, emphasizing from the outset its potential strengths and weaknesses. The second type of study involves a more detailed concurrent comparison of the specific procedures utilizing this technology to the established traditional methods. Such randomized studies help to firmly establish through scientific process the place of the new technology. The Video-Assisted Thoracic Surgery Study Group was organized in early 1992 to address these concerns. From an initial four surgeons the group has grown to include more than 41 institutions. Currently the group is collecting data in a registry and has established three clinical trials to evaluate video-assisted thoracic surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8379782

LoCicero, J



[Flexible endoscope in thoracic surgery: CITES or cVATS?].  


Early pain and persistent parietal disorders remains a major unresolved problem in thoracic surgery. Thoracotomy and the use of multiple ports in most Video Assisted Thoracic Surgery (VATS) procedures are the major cause of this persistent pain. For the last decade, a few publications describing the use of either single incision VATS and cervical thoracic approaches have been reported without significant results in comparison with current used techniques. Intercostals compression during surgery and early after by intercostals chest tube placement, are probably the major cause of postoperative pain. Flexible endoscope is currently used in several surgeries and will take more and more importance in our daily use in thoracic surgery. Instrument flexibility allows its use through minimally invasive approaches and offers a very interesting intra-thoracic navigation. We describe here the first use in France of a flexible endoscope in thoracic surgery through a single cervical incision to perform simultaneous exploration and biopsies of the mediastinum and right pleura using the original approach of Cervical Incision Thoracic Endoscopic Surgery (CITES). PMID:24041974

Assouad, J; Fénane, H; Masmoudi, H; Giol, M; Karsenti, A; Gounant, V; Grunenwald, D



Donor kidney volume and outcomes following live donor kidney transplantation.  


Pre-donation kidney volume and function may be crucial factors in determining graft outcomes in kidney transplant recipients. We measured living donor kidney volumes by 3D helical computed tomography scanning and glomerular filtration rate (GFR) by (125)I-iothalamate clearances in 119 donors, and correlated these values with graft function and incidence of acute rejection at 2 years post-transplantation. Kidney volume strongly correlated with GFR (Pearson r= 0.71, p < 0.001). Body size and male gender were independent correlates of larger kidney volumes, and body size and age were predictors of kidney function. The effects of transplanted kidney volume on graft outcome were studied in 104 donor-recipient pairs. A transplanted kidney volume greater than 120 cc/1.73 m(2) was independently associated with better estimated GFR at 2 years post-transplant when compared to recipients of lower transplanted kidney volumes (64 +/- 19 vs. 48 +/- 14 mL/min/1.73 m(2), p < 0.001). Moreover, recipients of lower volumes had a higher incidence of acute cellular rejection (16% vs. 3.7%, p = 0.046). In conclusion, kidney volume strongly correlates with function in living kidney donors and is an independent determinant of post-transplant graft outcome. The findings suggest that (1) transplantation of larger kidneys confers an outcome advantage and (2) larger kidneys should be preferred when selecting from otherwise similar living donors. PMID:16468974

Poggio, E D; Hila, S; Stephany, B; Fatica, R; Krishnamurthi, V; del Bosque, C; Goldfarb, D; Herts, B; Dennis, V W; Heeger, P S; Braun, W



Endovascular Repair of a Ruptured Descending Thoracic Aortic Aneurysm  

PubMed Central

Endovascular aneurysm repair has considerable potential advantages over the surgical approach as a treatment for thoracic aortic rupture, in part because open surgical repair of ruptured thoracic aortic aneurysms is associated with high mortality and morbidity rates. We describe the successful endovascular deployment of stent-grafts to repair a contained rupture of a descending thoracic aortic aneurysm in an 86-year-old man whose comorbidities prohibited surgery. Two months after the procedure, magnetic resonance angiography showed a patent stent-graft, a patent left subclavian artery, and complete exclusion of the aneurysm.

DeFrain, Michael; Strickman, Neil E.; Ljubic, Branimir J.; Dougherty, Kathryn G.; Gregoric, Igor D.



Postural Compensation for Unilateral Vestibular Loss  

PubMed Central

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

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



Perception of colour in unilateral tritanopia.  

PubMed Central

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

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



Synchronous absolute EIT in three thoracic planes at different gravity levels  

NASA Astrophysics Data System (ADS)

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

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



Erk in Kidney Diseases  

PubMed Central

Acute or chronic kidney injury results from various insults and pathological conditions, and is accompanied by activation of compensatory repair mechanisms. Both insults and repair mechanisms are initiated by circulating factors, whose cellular effects are mediated by activation selective signal transduction pathways. Two main signal transduction pathways are activated during these processes, the phosphatidylinositol 3? kinase (PI-3K)/mammalian target of rapamycin (mTOR) and the mitogen-activated protein kinase (MAPK) cascades. This review will focus on the latter, and more specifically on the role of extracellular signal-regulated kinase (ERK) cascade in kidney injury and repair.

Feliers, Denis; Kasinath, Balakuntalam S.



[Dialysis and kidney transplantation].  


In the Federal Republic of Germany more than 22,000 patients receive renal replacement therapy. More than 6000 patients live with a functioning graft. Thus the Federal Republic of Germany holds leading position of internationally high standard. Since 1969 the non profit-organisation KfH major contributions to secure dialysis treatment; since 1976 KfH was engaged in the organisation of kidney transplantation. Future goals are the strengthening of reliable and secure dialysis facilities as well as--at least--2400 kidney transplantations per year in the FRG. This figure represents the approximate number of new uremic patients to be treated each year. PMID:2316100

Ketzler, K; Schoeppe, W



Obesity and kidney transplantation.  


Obesity confers increased risk for graft loss and death among renal transplant recipients. However the relationship of changes in body weight and composition to outcome on the transplant waitlist and post-transplantation is not straightforward. Strategies to manage weight in the waitlisted patient and after kidney transplantation must be performed in the context of a multidisciplinary approach and individualized based on risk factors in particular patients. Although retrospective studies offer considerable insights into the relationship between obesity and kidney transplant outcome, causal inferences must be made with great caution. PMID:23374892

Srinivas, Titte R; Meier-Kriesche, Herwig-Ulf



Source of kidney determines blood pressure in young renal transplanted rats.  


Recipients of a renal graft from adult stroke-prone spontaneously hypertensive rat (SHRSP) but not normotensive Wistar-Kyoto rat (WKY) donors have been shown to develop posttransplantation hypertension. To investigate whether hypertension would also travel with the kidneys from young prehypertensive SHRSP and whether the age-related increase in blood pressure in F1 hybrids (F1H) bred from SHRSP and WKY parents was attenuated by early bilateral nephrectomy and transplantation of a WKY kidney, we transplanted kidneys from 14 male SHRSP and 16 WKY donors aged 35-42 days to young male F1H. Recipients had both native kidneys removed. Fifteen unilaterally nephrectomized nontransplanted F1H served as controls. At the time when kidneys were harvested for transplantation, systolic blood pressures in young SHRSP and WKY donors were not significantly different (114 +/- 5 vs. 113 +/- 3 mmHg). After transplantation, recipients of an SHRSP kidney rapidly developed posttransplantation hypertension with systolic blood pressures above 180 mmHg at 3 mo after transplantation. In contrast, systolic blood pressure in recipients of a WKY kidney rose only slightly with increasing age and remained significantly lower than in non-transplanted controls. Transplanted rats exhibited normal weight gain, and renal function (glomerular filtration rate, renal blood flow) in grafted kidneys was well preserved; plasma renin activity was reduced compared with nontransplanted controls. These data demonstrate that 1) hypertension can be transmitted to normotensive recipients by transplantation of a kidney from young prehypertensive SHRSP donors and 2) the age-related increase in arterial pressure in F1H is attenuated by early bilateral nephrectomy and transplantation of a WKY kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8342608

Kopf, D; Waldherr, R; Rettig, R



Vertical expandable prosthetic titanium rib for thoracic insufficiency syndrome  

Microsoft Academic Search

PurposeThe vertical expandable prosthetic titanium rib (VEPTR) thoracoplasty is a new technique devised for the treatment children with thoracic insufficiency syndrome. This study describes our initial experience with this device.

John H. T. Waldhausen; Gregory J. Redding; Kit M. Song



Biomechanics of cantilever “plow” during anterior thoracic scoliosis correction  

Microsoft Academic Search

Background contextAnterior instrumentation is often used for correction of thoracic scoliosis. Loss of spinal correction may occur after failure at the bone–implant interface, and forces on the bone–implant interface during scoliosis correction remain unclear.

Andrew T. Mahar; David S. Brown; Richard S. Oka; Peter O. Newton



Endovascular Repair of Descending Thoracic Aortic Aneurysm  

PubMed Central

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



Kidney Failure and Vascular Disease  


... 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 ...


Kidney Disease: A Hidden Risk  


... Sign up for our FREE magazine, Kidney Living Organ Donation & Transplantation Be An Organ Donor Living Donation Donor ... Net Foundation. Verify here HOME Kidney Disease Patients Organ donation & Transplantation Professionals Events Advocacy Donate


FastStats: Kidney Disease  


... Data Related Links Accessibility NCHS Home FastStats Home Kidney Disease (Data are for the U.S.) Morbidity Number of noninstitutionalized adults with diagnosed kidney disease: 4.4 million Percent of noninstitutionalized adults with ...


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 ...


Kidney Failure: What to Expect  


... The kidneys also make hormones and balance the minerals in the blood. When the kidneys stop working, ... that rapid changes in the body’s water and mineral balance can cause problems. Muscle cramps and hypotension— ...


Prediction of prolonged ventilatory support in blunt thoracic trauma patients  

Microsoft Academic Search

ObjectiveTo identify predictors of prolonged (>7 days) mechanical ventilation (MV) in patients with blunt thoracic trauma.DesignProspective analysis of consecutive patients.SettingAdult intensive care unit (ICU) in a teaching, tertiary-care hospital.Patients and participantsSixty-nine patients (53 men, 16 women) with thoracic trauma having a median age of 35 (range 17–85) years and a median injury severity score (ISS) of 29 (range 14–41) were

Ioanna Dimopoulou; Anastasia Anthi; Michalis Lignos; Efstratios Boukouvalas; Evangelos Evangelou; Christina Routsi; Konstantinos Mandragos; Charis Roussos



Unusual thoracic CT manifestations of osteosarcoma: review of 16 cases  

Microsoft Academic Search

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

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



Living with Kidney Cancer  


... in a way that helps accommodate your lower energy levels can help, and you should try to limit your physical demands before, during, and after treatment for kidney cancer. Treatment for anemia (below-normal levels of red blood cells) can help, as can exercise regimens, nutrition, and ...


Spontaneous Kidney Allograft Rupture  

Microsoft Academic Search

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

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



Neurology and the kidney  

Microsoft Academic Search

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

D J Burn; D Bates



Kidney Development Contract.  

National Technical Information Service (NTIS)

A simplified version of a logic artificial kidney control unit has been developed to further simplify its operation and avoid confusion by the patients due to 'too many lights and buttons.' The cost for the system including a 200 liter tank and coil recir...

W. J. Kolff J. D. Andrade R. L. Kirkham F. S. Hammill G. Bown



Imaging for kidney stones  

Microsoft Academic Search

Imaging investigations play a vital role in the management of patients with kidney stones. The techniques available include plain x-ray of the abdomen, ultrasound scan, intravenous urogram, computed tomography (CT) and magnetic resonance imaging, amongst others. All of these techniques have their own individual roles to play and also have limitations. CT has been establishing itself as the imaging technique

P. N. Rao



Aquaporins in kidney pathophysiology  

Microsoft Academic Search

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

Yumi Noda; Eisei Sohara; Eriko Ohta; Sei Sasaki



'Unilateral' decision making and patient participation in primary care.  


Using conversation analysis as a method, we examine patients' responses to doctors' treatment decision deliveries in Finnish primary care consultations for upper respiratory tract infection. We investigate decision-making sequences that are initiated by doctors' 'unilateral' decision delivery (Collins et al. 2005). In line with Collins et al., we see the doctors' decision deliveries as unilateral when they are offered as suggestions, recommendations or conclusions that make relevant patients' acceptance of the decision rather than their further contributions to the decision. In contrast, more 'bilateral' decision making encourages and is dependent in part on patient's contributions, too (Collins et al. 2005). We examine how patients respond to unilaterally made decisions and how they participate in and contribute to the outcome of the decision-making process. Within minimal responses patients approve the doctor's unilateral agency in decision making whereas within two types of extended responses patients voice their own perspectives. 1) In positive responses they appraise the doctor's decision as appropriate; 2) in other instances, patients may challenge the decision with an extended response that initiates a negotiation on the decision. We suggest that, firstly, unilateral decision making may be collaboratively maintained in consultations and that, secondly, patients have means for challenging it. PMID:23264979

Ijäs-Kallio, Taru; Ruusuvuori, Johanna; Peräkylä, Anssi



Normal and abnormal spine and thoracic cage development  

PubMed Central

Development of the spine and thoracic cage consists of a complex series of events involving multiple metabolic processes, genes and signaling pathways. During growth, complex phenomena occur in rapid succession. This succession of events, this establishment of elements, is programmed according to a hierarchy. These events are well synchronized to maintain harmonious limb, spine and thoracic cage relationships, as growth in the various body segments does not occur simultaneously at the same magnitude or rate. In most severe cases of untreated progressive early-onset spinal deformities, respiratory insufficiency and pulmonary and cardiac hypertension (cor pulmonale), which characterize thoracic insufficiency syndrome (TIS), can develop, sometimes leading to death. TIS is the inability of the thorax to ensure normal breathing. This clinical condition can be linked to costo-vertebral malformations (e.g., fused ribs, hemivertebrae, congenital bars), neuromuscular diseases (e.g., expiratory congenital hypotonia), Jeune or Jarcho-Levin syndromes or to 50% to 75% fusion of the thoracic spine before seven years of age. Complex spinal deformities alter normal growth plate development, and vertebral bodies become progressively distorted, perpetuating the disorder. Therefore, many scoliotic deformities can become growth plate disorders over time. This review aims to provide a comprehensive review of how spinal deformities can affect normal spine and thoracic cage growth. Previous conceptualizations are integrated with more recent scientific data to provide a better understanding of both normal and abnormal spine and thoracic cage growth.

Canavese, Federico; Dimeglio, Alain



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


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

Nagata, Koji; Yamashita, Hironori; Miyazaki, Mitsue



Stem cells in the kidney  

Microsoft Academic Search

Stem cells in the kidney. The kidney is derived from the ureteric bud and the metanephrogenic mesenchyme, and these two progenitor cells differentiate into more than 26 different cell types in the adult kidney. The ureteric bud contains the precursor of the epithelial cells of the collecting duct and the renal mesenchyme contains precursors of all the epithelia of the

Qais Al-Awqati; Juan A. Oliver



Inflammation in Acute Kidney Injury  

Microsoft Academic Search

Ischemia-reperfusion injury (IRI) is one of the major causes of acute kidney injury (AKI) and evidence supporting the involvement of both innate and adaptive immunity in renal IRI has accumulated in recent years. In addition to leukocytes, kidney endothelial cells promote inflammation after IRI by increasing adhesion molecule expression and vascular permeability. Kidney tubular epithelial cells increase complement binding and

Gilbert R. Kinsey; Li Li; Mark D. Okusa



Kidney Disease: Improving Global Outcomes  

Microsoft Academic Search

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

Bertram L. Kasiske; Kai-Uwe Eckardt



Acute kidney injury  

PubMed Central

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



The changes of relative position of the thoracic aorta after anterior or posterior instrumentation of type I Lenke curve in adolescent idiopathic thoracic scoliosis  

Microsoft Academic Search

The risk of impingement of the aorta associated with thoracic vertebral screw or pedicle screw instrumentation in the treatment\\u000a of thoracic scoliosis has been an important concern. To understand this phenomenon more systematically, the relative position\\u000a of the aorta with reference to the thoracic vertebrae in right thoracic adolescent idiopathic scoliosis (AIS) following anterior\\u000a and posterior spinal instrumentation was analyzed

Weijun Wang; Zezhang Zhu; Feng Zhu; Bin Wang; Winnie C. W. Chu; Jack C. Y. Cheng; Yong Qiu



Endovascular management of thoracic aortic aneurysms.  


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. PMID:21290125

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



Conduits for coronary bypass: internal thoracic artery.  


This second report in the series on coronary artery bypass presents the authors experience and personal views on the internal thoracic artery (ITA) which date to 1966. There has been a very gradual evolution in the acceptance of this conduit which was initially compared with the saphenous vein and viewed as an improbable alternative to it. As is common with concepts and techniques which are 'outside the box' there was skepticism and criticism of this new conduit which was more difficult and time consuming to harvest for the surgeon who had to do it all. It was viewed as small, fragile, spastic and its flow capacity was questioned. Only a few surgeons employed it because of these issues and some of them would frequently graft it to the diagonal artery as it was thought not to supply adequate flow for the left anterior descending unless it was small. After a decade, angiographic data revealed superior patency to vein grafts. Even this evidence and survival benefit reported a few years later did not convince many surgeons that their concerns about limitations justified its use. Thus widespread adaption of the ITA as the conduit of choice for the anterior descending required another decade and bilateral use is only now expanding to more than 5% of patients in the US and somewhat faster in other countries. PMID:23275918

Barner, Hendrick B



Speciation and diurnal variation of thoracic, fine thoracic and sub-micrometer airborne particulate matter at naturally ventilated office environments  

Microsoft Academic Search

Thoracic (PM10), fine thoracic (PM2.5) and sub-micrometer (PM1) airborne particulate matter was sampled during day and night. In total, about 100 indoor and outdoor samples were collected for each fraction at ten different office environments. Energy-dispersive X-ray fluorescence spectrometry and ion chromatography were applied for the quantification of some major and minor elements and ions in the collected aerosols. During

Benjamin Horemans; René Van Grieken



Unilateral Opercular Infarction Presenting with Foix-Chavany-Marie Syndrome.  


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

Ohtomo, Ryo; Iwata, Atsushi; Tsuji, Shoji



Unilateral midbrain infarction causing upward and downward gaze palsy.  


We report on a 47-year-old-woman who developed sudden complete loss of vertical saccades, smooth pursuit, and vestibular eye movements bilaterally. MRI revealed a unilateral midbrain infarct involving the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) and spared the posterior commissure (PC). The lesion is presumed to have interrupted the pathways involved in vertical gaze just before they decussate, inducing an anatomically unilateral but functionally bilateral lesion. Previous reports of bidirectional vertical gaze palsy have shown lesions involving the PC or both riMLFs. This case is the first to show that a unilateral lesion of the riMLF and the INC that spares the PC may cause complete bidirectional vertical gaze palsy. PMID:16966933

Alemdar, Murat; Kamaci, Senol; Budak, Faik



Unilateral hippocampal damage impairs spatial cognition in rats.  


Unilateral temporal lobectomy to treat seizure disorders in humans often results in cognitive impairment after the surgery. To determine the potential utility of a rodent model of unilaterally induced cognitive deficits, the present experiment evaluated spatial cognition in adult rats after either left or right hemisphere lesioning of temporal neocortex and underlying hippocampal regions. Evaluation of performance in the eight arm radial maze revealed that both lesioned groups committed more reference memory errors than did nonoperated controls. Working memory errors did not differ statistically between groups. The production of a spatial learning deficit by unilateral damage suggests that this rodent model could serve to test potential improvements in interventional strategies aimed at attenuating cognitive effects of the surgical treatment. PMID:10938560

Port, R L; Finamore, T L; Noble, M M; Seybold, K S


Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis.  


The introduction of prenatal ultrasonography as a screening method entails an increasing number of infants diagnosed with prenatal hydronephrosis. Ureteropelvic junction obstruction accounts for 35% of prenatal hydronephrotic cases. Urinary tract obstruction that occurs during early kidney development affects renal morphogenesis, maturation and growth, and in the most severe cases this will ultimately cause renal insufficiency. A major challenge in the clinical management of these patients is to preserve renal function by selection of the 15%-20% who require early surgical intervention, leaving those for whom watchful waiting may be appropriate because of spontaneous resolution/stabilization without significant loss of renal function. Today, this requires medical surveillance, including repetitive invasive diuretic renograms relying on arbitrary threshold values, and therefore there is a need for non-arbitrary, non-invasive urinary biomarkers that may be used as predictors for renal structural changes and/or decreasing renal function, and thereby provide the surgeon with more clear indications for surgical intervention. In this review, we summarize the currently well-known facts about urinary biomarkers in ureteropelvic junction obstruction concerning renal function, and we also suggest potential novel urinary biomarkers. PMID:21220211

Madsen, Mia Gebauer; Nørregaard, Rikke; Frøkiær, Jørgen; Jørgensen, Troels Munch



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


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

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



Hyponatremic-hypertensive syndrome: think of unilateral renal artery stenosis.  


Hyponatremic hypertensive syndrome (HHS) is an uncommon disorder, in which hypertension is associated with profound hyponatremia. It is mostly encountered in adults with unilateral renal artery stenosis. Although renovascular hypertension is one of the commonest causes for severe hypertension in children, HHS is rarely reported in childhood. The authors report a 9-y old boy with hypertensive emergency and severe hyponatremia due to unilateral renal artery stenosis who was successfully managed by vascular stenting of the affected vessel. Prompt recognition of this disorder can be life-saving and can subsequently lead to appropriate referral and treatment as in the present case. PMID:23152163

Pandey, Meenu; Sharma, Rajni; Kanwal, Sandeep Kumar; Chhapola, Viswas; Awasthy, Neeraj; Mathur, Atul; Kumar, Virendra



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

SciTech Connect

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

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



Thoracic pedicle subtraction osteotomy for fixed sagittal spinal deformity.  


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

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



Increased lymphatic flow in the thoracic duct during manipulative intervention.  


The thoracic pump and the abdominal pump are osteopathic manipulative (OM) lymphatic pump techniques frequently used by osteopathic physicians to treat patients with infections (eg, pneumonia, otitis media). Although there is a widely accepted belief among the osteopathic medical profession that increasing lymphatic flow is beneficial, no measurements of lymph flow during osteopathic manipulative treatment have been reported. The authors surgically instrumented five mongrel dogs to record lymphatic flow in the thoracic duct (TDF) and cardiac variables during three intervention protocols. After recovery from surgery, canine subjects were placed in a standing-support sling, and TDF, cardiac output, mean aortic blood pressure, and heart rate were recorded during two randomized 30-second sessions of manipulative intervention using the osteopathic thoracic pump and abdominal pump techniques on two successive days. Lymph flow in the thoracic duct increased from 1.57+/-0.20 mL x min(-1) to a peak TDF of 4.80+/-1.73 mL x min(-1) during abdominal pump, and from 1.20+/-0.41 mL x min(-1) to 3.45+/-1.61 mL x min(-1) during thoracic pump. Lymph flow in the thoracic duct and cardiac variables were also recorded for canine subjects during physical activity (ie, treadmill exercise at 3 miles per hour at 0% incline). During physical activity, TDF increased from 1.47+/-0.33 mL x min(-1) to 5.81+/-1.30 mL x min(-1). Although cardiac variables did not change significantly during manipulative intervention with lymphatic pump techniques, cardiac output and heart rate did increase during physical activity. The authors conclude that physical activity and manipulative intervention using thoracic pump and abdominal pump techniques produced net increases in TDF (P<.05). PMID:16314677

Knott, E Marty; Tune, Johnathan D; Stoll, Scott T; Downey, H Fred



Divergent phenotype of rat thoracic and abdominal perivascular adipose tissues.  


Perivascular adipose tissue (PVAT) is implicated as a source of proatherogenic cytokines. Phenotypic differences in local PVAT depots may contribute to differences in disease susceptibility among arteries and even regions within an artery. It has been proposed that PVAT around the abdominal and thoracic aorta shares characteristics of white and brown adipose tissue (BAT), respectively; however, a detailed comparison of the phenotype of these PVAT depots has not been performed. Using young and older adult rats, we compared the phenotype of PVATs surrounding the abdominal and thoracic aorta to each other and also to epididymal white and subscapular BAT. Compared with young rats, older rats exhibited greater percent body fat (34.5 ± 3.1 vs. 10.4 ± 0.9%), total cholesterol (112.2 ± 7.5 vs. 58.7 ± 6.3 mg/dl), HOMA-insulin resistance (1.7 ± 0.1 vs. 0.9 ± 0.1 a.u.), as well as reduced ACh-induced relaxation of the aorta (maximal relaxation: 54 ± 10 vs. 77 ± 6%) (all P < 0.05). Expression of inflammatory genes and markers of immune cell infiltration were greater in abdominal PVAT than in thoracic PVAT, and overall, abdominal and thoracic PVATs resembled the phenotype of white adipose tissue (WAT) and BAT, respectively. Histology and electron microscopy indicated structural similarity between visceral WAT and abdominal PVAT and between BAT and thoracic PVAT. Our data provide evidence that abdominal PVAT is more inflamed than thoracic PVAT, a difference that was by and large independent of sedentary aging. Phenotypic differences in PVAT between regions of the aorta may be relevant in light of the evidence in large animals and humans that the abdominal aorta is more vulnerable to atherosclerosis than the thoracic aorta. PMID:23389108

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



Investigation of pulsatile flowfield in healthy thoracic aorta models.  


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

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



Kidney amino acid transport  

Microsoft Academic Search

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

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



Endovascular management of traumatic thoracic aortic injuries  

PubMed Central

Background Endovascular surgery has recently been extended to the treatment of blunt traumatic aortic injuries. Since most of these injuries occur at the aortic isthmus, graft fixation in proximity to the origin of the left subclavian artery (LSA) has been a concern. Covering the LSA with graft fabric lengthens the proximal fixation site and should minimize proximal endoleaks. We therefore wished to evaluate the feasibility and safety of endovascular repair of thoracic aortic injuries after blunt trauma, both with and without deliberate coverage of the LSA. Methods At a tertiary care teaching hospital in London, Ont., we reviewed our experience with endovascular repair of 7 traumatic aortic injuries. We reviewed the technical success rate and the incidence of left subclavian coverage. Major morbidity, including rates of paraplegia and death were noted. The patients were followed-up with serial CT to look for endoleaks, stent migration or aneurysm growth and to determine whether they had symptoms related to left subclavian coverage. Results The time from injury to treatment ranged from 7 hours to 7 days (mean 36 h). The mean Injury Severity Score was 36. All injuries were at the aortic isthmus, and among the 7 patients treated, 6 had deliberate coverage of the LSA. One patient underwent carotid-to-subclavian artery bypass, but the other 5 did not. There were no cases of paraplegia; 1 patient had symptoms of claudication in the left arm but did not want revascularization. No procedure-related complications occurred, and all patients survived the event. Follow-up ranged from 2 to 30 (mean 13) months, and no endoleaks, stent migration or aneurysm expansion were noted in follow-up. Conclusions Although long-term results are unknown, we conclude that endovascular repair of traumatic aortic injuries after blunt trauma can be performed safely with low morbidity and mortality and that coverage of the LSA without revascularization is tolerated by most patients.

Lawlor, D. Kirk; Ott, Michael; Forbes, Thomas L.; Kribs, Stewart; Harris, Kenneth A.; DeRose, Guy



Why the kidney?  


Severe erythrocytosis is associated with increased whole blood viscosity and impaired blood flow. Since a reduced blood flow will cause tissue hypoxia and since tissue hypoxia is associated with increased synthesis of erythropoietin, erythrocytosis per se should cause an increase in the rate of red cell production. This, however, does not occur and severe erythrocytosis in patients with polycythemia vera does not lead to increased synthesis of erythropoietin. We propose here that the reason for this discrepancy is that decreased blood flow to the kidneys, the site of erythropoietin synthesis, does not cause renal tissue hypoxia. The oxygen tension in the kidneys is to a great extent determined by the consumption of oxygen used for sodium reabsorption and since sodium reabsorption is roughly proportional to glomerular filtration, a decreased flow of blood should be matched by a decreased oxygen consumption leaving the tissue tension of oxygen unchanged. Consequently, the location of an oxygen sensor in the kidneys controlling erythropoietin production appears to be most fortuitous since it prevents the development of a vicious circle, with erythrocytosis causing more erythrocytosis. PMID:4058620

Erslev, A J; Caro, J; Besarab, A



Minimally invasive kidney transplantation.  


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

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



Connexins and the kidney.  


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

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



Excessive thoracic computed tomographic scanning in sarcoidosis.  

PubMed Central

BACKGROUND--The clinical value of computed tomographic (CT) scanning of the chest in the initial assessment of sarcoidosis was investigated. METHODS--One hundred consecutive patients referred to the sarcoidosis outpatient services of the Mount Sinai Medical Center, New York from 1990 to 1992 with a presumptive diagnosis of sarcoidosis were studied. The diagnosis was subsequently confirmed in all by a positive tissue biopsy sample or the Kveim-Siltzbach test. Clinical and laboratory data of each patient were reviewed. Chest radiographs were classified according to the classical stages of sarcoidosis. Thirty five of the 100 patients had a CT scan of the chest performed before presentation. The CT scans were compared with the presenting clinical data and standard chest radiographs in order to determine if they yielded useful additional information regarding diagnosis or treatment. RESULTS--The chest CT scan revealed no additional clinically relevant information compared with conventional chest radiographs in any of the 35 studies performed. In two patients mediastinal adenopathy was detected by CT scan which was not seen on standard radiographs. Two patients thought to exhibit hilar adenopathy and pulmonary infiltrations by standard radiography had no parenchymal disease on the CT scan. Bilateral parenchymal infiltrates were seen in one patient which were interpreted as unilateral infiltrates by standard radiographs. The variance between conventional radiographs and CT scans in these five patients was not clinically valuable. CONCLUSIONS--CT scans of the chest do not add clinically useful information to the standard chest radiographs in the initial assessment of sarcoidosis in patients presenting with the typical standard radiological patterns. CT scanning of the thorax is indicated in patients with proven or suspected sarcoidosis when the standard chest radiographs are normal or not typical of sarcoidosis, when signs or symptoms of upper airway obstruction are present, when the patient has haemoptysis, if there is a suspicion of a complicating second intrathoracic disease, or the patient is a candidate for lung transplantation.

Mana, J; Teirstein, A S; Mendelson, D S; Padilla, M L; DePalo, L R



Anesthesia for thoracic surgery: A survey of middle eastern practice  

PubMed Central

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

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



Robotic kidney implantation for kidney transplantation: initial experience  

Microsoft Academic Search

Despite improvements in minimally invasive techniques over recent decades, kidney implantation into the iliac fossa has remained\\u000a a domain of open surgery. However, it was hypothesized that it would be feasible to perform robotic transplant kidney implantation\\u000a as a means of reducing surgical trauma. Two robotic kidney transplantations into the iliac fossa were attempted in human cadavers.\\u000a In the first

Monika E. Hagen; Francois Pugin; Pascal Bucher; Jean Fasel; Sheraz Markar; Philippe Morel



Impaired griplift synergy in children with unilateral brain lesions  

Microsoft Academic Search

Summary Children with spastic hemiplegia have impaired dexterity in the affected extremity. The purpose of the present study was to investigate whether the force co-ordination pattern during precision grip in 13 children between 4 and 10 years of age with predominant unilateral brain lesions is related to manual dexterity and to the location and size of the brain lesion. The

Hans Forssberg; Ann-Christin Eliasson; Christine Redon-Zouitenn; Eugenio Mercuri; Lilly Dubowitz



Coupling of FM Systems to Individuals with Unilateral Hearing Loss.  

ERIC Educational Resources Information Center

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)

Kopun, Judy G.; And Others



Unilateral parathyroidectomy: the role of thallium-technetium subtraction scans.  


The rationale for using the thallium-technetium subtraction scan as a preoperative localizing study in previously untreated patients with primary hyperparathyroidism is presented. The concept of unilateral parathyroidectomy is also presented, and the role of preoperative localizing studies in this approach to parathyroid surgery is carefully analyzed. PMID:2165235

Davis, R K; Hoffmann, J; Dart, D; Datz, F L



Unilateral Forced Nostril Breathing Affects Dichotic Listening for Emotional Tones  

ERIC Educational Resources Information Center

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

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



Animal model of unilateral ventilator-induced lung injury  

Microsoft Academic Search

Objective: To design, im- plement, and test a selective lung ventilator for setting a rat model of unilateral ventilator-induced lung in- jury (VILI). Design and setting: In- terventional animal study in a uni- versity laboratory for animal re- search. Subjects: Anesthetized and paralyzed male Wistar rats. Inter- ventions: A selective ventilator de- signed to apply varying tidal volume, PEEP, and

Ramon Farre; Susana Granell; Mar Rotger; Anna Serrano-Mollar; Daniel Closa; Daniel Navajas



Weight changes associated with unilateral STN DBS and advanced PD  

Microsoft Academic Search

Weight gain following bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson disease (PD) has been characterized previously, but little is known about changes in weight following unilateral STN DBS. Weight gain of approximately 10kg at one year after bilateral STN DBS for PD has been noted in previous studies, and PD in the absence of DBS has been

Harrison C. Walker; Michael Lyerly; Gary Cutter; Johnson Hagood; Natividad P. Stover; Stephanie L. Guthrie; Barton L. Guthrie; Ray L. Watts



Postural control in Parkinson's disease after unilateral posteroventral pallidotomy  

Microsoft Academic Search

Summary Postural control changes were studied in 27 patients the patients were in the 'on' state, LOS posturography variables of average time to target, average path length with Parkinson's disease after unilateral posteroventral deviation, and the number of targets missed were the pallidotomy (PVP). Patients were evaluated before PVP only variables significantly improved at 3 months post- and at 3,

Deborah Roberts-Warrior; Averell Overby; Joseph Jankovic; Sharon Olson; Eugene C. Lai; J. K. Krauss; Robert Grossman



IQ Decline Following Early Unilateral Brain Injury: A Longitudinal Study  

ERIC Educational Resources Information Center

|We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with…

Levine, Susan C.; Kraus, Ruth; Alexander, Erin; Suriyakham, Linda Whealton; Huttenlocher, Peter R.



Unilateral asterixis due to a lesion of the ventrolateral thalamus.  

PubMed Central

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

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



Dissociation between Awareness and Spatial Coding: Evidence from Unilateral Neglect  

Microsoft Academic Search

Prevalent theories about consciousness propose a causal relation between lack of spatial coding and absence of conscious experience: The failure to code the position of an object is assumed to prevent this object from entering consciousness. This is consistent with influential theories of unilateral neglect following brain damage, according to which spatial coding of neglected stimuli is defective, and this

Barbara Treccani; Roberto Cubelli; Roberta Sellaro; Carlo Umiltà; Sergio Della Sala



Abnormal /sup 201/Tl limb scan due to unilateral tremor  

SciTech Connect

A abnormal intra- and interextremity distribution pattern on /sup 201/Tl was observed on the limb scan of a patient with a unilateral tremor. This is ascribed to the increased blood flow in the muscles responsible for the tremor. The suggestion is made that the existence of tremor should be considered as a possible explanation for unexpected abnormalities on /sup 201/Tl limb scintigrams.

Simons, M.; Schelstraete, K.; Bratzlavsky, M.



Development and Evaluation of Unilateral and Bilateral Cardiac Assist Devices.  

National Technical Information Service (NTIS)

The objective of this program is to develop and evaluate unilateral and bilateral cardiac assist devices which will ultimately be used for temporary and chronic cardiac support. A family of pumps has been developed and used as right and left heart assist ...

J. T. Keiser W. F. Bernhard



The 1994 Haiti intervention: A unilateral operation in multilateral Clothes  

Microsoft Academic Search

Observers of United States (US) interventions have almost universally characterized the 1994 Haiti intervention as multilateral, a model for how international cooperation can achieve common security goals. A closer analysis of the intervention reveals that the planning and execution of the intervention were almost entirely unilateral and therefore cost the US few if any of the theoretical costs of coalition

Sarah E. Kreps



Memory for Emotional Words Following Unilateral Temporal Lobectomy  

Microsoft Academic Search

We recently reported that patients who had received unilateral temporal lobectomy, including the amygdala and hippocampus, show impaired acquisition in a fear conditioning task (LaBar, LeDoux, Spencer, & Phelps, 1995), indicating a deficit in emotional memory. In the present paper, we examined performance of these patients on two verbal, emotional memory tasks in an effort to determine the extent of

Elizabeth A. Phelps; Kevin S. LaBar; Dennis D. Spencer



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

Microsoft Academic Search

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

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



Stimulated intrauterine insemination in women with unilateral tubal occlusion  

PubMed Central

Objective To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

Yi, Gwang; Suh, Chang Suk; Kim, Seok Hyun



Unilateral congenital elbow luxation in a Cavalier King Charles Spaniel.  


A 7-week-old, intact female, Cavalier King Charles Spaniel was evaluated for nonweight bearing lameness of the right forelimb. Type III unilateral congenital elbow luxation was diagnosed radiographically. After surgical reduction, temporary placement of a transarticular pin, and external splinting of the joint, full weight bearing was achieved. Radial head subluxation persisted. PMID:15600161

McDonell, Heather L



Unilateral masticatory muscle hypertrophy with mandibular ramus hyperostosis  

Microsoft Academic Search

Acquired masseteric muscle hypertrophy is a benign diagnosis that is often made clinically as a result of consultation for facial asymmetry. However, there may need to investigate for existing salivary gland pathology when history is not compelling for known causes not compelling for known causes of unilateral masticatory muscle hypertrophy. Differentiation of masticatory muscle hypertrophy from congenital hemifacial hypertrophy, partial

Opeyemi O. Daramola; Mary Lou Sabino; Valerie A. Flanary


Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

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

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



Management of Young Children with Unilateral Hearing Loss  

ERIC Educational Resources Information Center

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

McKay, Sarah



IQ decline following early unilateral brain injury: A longitudinal study  

Microsoft Academic Search

We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with larger lesions, but children

Susan C. Levine; Ruth Kraus; Erin Alexander; Linda Whealton Suriyakham; Peter R. Huttenlocher



IQ Decline Following Early Unilateral Brain Injury: A Longitudinal Study  

ERIC Educational Resources Information Center

We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with…

Levine, Susan C.; Kraus, Ruth; Alexander, Erin; Suriyakham, Linda Whealton; Huttenlocher, Peter R.



Three cases of IgG4-related orbital inflammation presented as unilateral pseudotumor and review of the literature.  


IgG4-related disease is an emerging disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. In IgG4-related disease, tumor-like lesions develop in multiple organs, such as the lacrimal gland, salivary gland, lung, pancreas, kidney, and lymph nodes. We report here three cases of IgG4-related orbital inflammation that presented as unilateral pseudotumors. The patients all were men, with an age range of 65-75 years. The patients had been pointed out unilateral intra-orbital masses, and histopathological examinations revealed marked accumulation of IgG4-positive plasma cells (IgG4/IgG ratio: 51.1-71.6 %) with fibrosis. But storiform fibrosis was seen in only one case, and no obliterative phlebitis was seen. The serum levels of IgG4 were increased to 178-670 mg/dL. The masses had well-defined homogeneous signal intensities, and they were hypo-intense on T1-weighted MR images and iso-intense on T2-weighted MR images. Gadolinium enhanced mass lesions in two cases. All orbital mass lesions responded well to corticosteroid treatment. PMID:23138265

Origuchi, Tomoki; Yano, Hiroki; Nakamura, Hideki; Hirano, Akiyoshi; Kawakami, Atsushi



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

Microsoft Academic Search

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

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



Blockade of CCR2 Ameliorates Progressive Fibrosis in Kidney  

PubMed Central

Fibrosis is a hallmark of progressive organ diseases. Monocyte chemoattractant protein (MCP)-1, also termed as macrophage chemotactic and activating factor (MCAF/CCL2) and its receptor, CCR2 are presumed to contribute to progressive fibrosis. However, the therapeutic efficacy of MCP-1/CCR2 blockade in progressive fibrosis remains to be investigated. We hypothesized that blockade of CCR2 may lead to the improvement of fibrosis. To achieve this goal, we investigated renal interstitial fibrosis induced by a unilateral ureteral obstruction in CCR2 gene-targeted mice and mice treated with propagermanium or RS-504393, CCR2 inhibitors. Cell infiltrations, most of which were F4/80-positive, were reduced in CCR2 knockout mice. In addition, dual staining revealed that CCR2-positive cells were mainly F4/80-positive macrophages. Importantly, CCR2 blockade reduced renal interstitial fibrosis relative to wild-type mice. Concomitantly, renal transcripts and protein of MCP-1, transforming growth factor-?, and type I collagen were decreased in CCR2-null mice. Further, this CCR2-dependent loop for renal fibrosis was confirmed by treatment with CCR2 antagonists in a unilateral ureteral obstruction model. These findings suggest that the therapeutic strategy of blocking CCR2 may prove beneficial for progressive fibrosis via the decrease in infiltration and activation of macrophages in the diseased kidneys.

Kitagawa, Kiyoki; Wada, Takashi; Furuichi, Kengo; Hashimoto, Hiroyuki; Ishiwata, Yoshiro; Asano, Masahide; Takeya, Motohiro; Kuziel, William A.; Matsushima, Kouji; Mukaida, Naofumi; Yokoyama, Hitoshi



Risk of hypertension with multicystic kidney disease: a systematic review  

PubMed Central

Background: Children with multicystic kidney disease (MCKD) are increasingly managed conservatively, and are followed up throughout childhood because of the risk of hypertension highlighted in some reports. With this risk still poorly defined, the strategy and the duration of follow up do not seem to be based on evidence. Methods: Systematic review of the literature for all published cohort studies (prospective and retrospective) of children diagnosed to have unilateral MCKD and managed conservatively. Exclusion criteria were bilateral MCKD, and nephrectomy (not for hypertension) during the follow up period. For children with MCKD, the probability of developing hypertension during the follow up period was estimated. Results: From 29 reviewed studies, six cases of hypertension developed in 1115 eligible children. The mean probability of a child with unilateral MCKD developing hypertension was therefore 5.4 per 1000 (95% CI estimated at 1.9 to 11.7 per 1000). Conclusion: Although the risk of hypertension in MCKD is low, the results of this study do not allow firm recommendations on the frequency and duration of blood pressure measurement follow up for these children. Large prospective cohort studies with a very long duration of follow up are needed.

Narchi, H



Resorption of thoracic disc herniation. Report of 2 cases.  


The authors describe 2 cases of thoracic disc herniation, resulting in acute myelopathy without bladder dysfunction or progressive muscular weakness; the herniated disc apparently resorbed without surgical intervention. Thoracic disc herniations are less frequent than cervical or lumbar disc herniations and are usually associated with severe neurological deficits. In these 2 cases, the herniated discs exhibited marked decreases in size, corresponding to a favorable clinical outcome within a few months after the initiation of conservative treatment with prostaglandin E(1) and/or steroids in conjunction with physical therapy. The authors conclude that thoracic herniated discs are capable of undergoing natural resorption and that conservative treatment could be indicated, even in the presence of moderate myelopathy, when the myelopathy is not accompanied by bladder dysfunction or progressive muscular weakness. PMID:18312085

Haro, Hirotaka; Domoto, Toru; Maekawa, Shingo; Horiuchi, Tadahiro; Komori, Hiromichi; Hamada, Yoshiki



Posteriorly migrated thoracic disc herniation: a case report  

PubMed Central

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



An isolated long thoracic nerve injury in a Navy Airman.  


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

Oakes, Michael J; Sherwood, Daniel L



Deadly dozen: dealing with the 12 types of thoracic injuries.  


Although most thoracic trauma may be treated non-operatively, major thoracic trauma accounts for 25% of trauma deaths. Except for provision of a definitive airway and/or relief of a tension pneumothorax with a needle decompression, the vast majority of thoracic trauma is best served with "load and go," high-flow oxygen, placement of an IV line and administration of crystalloid solutions as the clinical scenario would indicate. Understanding the mechanism of injury is helpful in establishing both prehospital and in-hospital management priorities. Patients who sustain a single penetrating wound to the chest have the best survivability after a resuscitative thoracotomy. Practicing chest assessment skills is vital to being a good prehospital provider. Ultrasound, NIRS tissue oxygenation and telemedicine will likely become more commonly employed as prehospital monitoring options. PEEP, or "over bagging," may exacerbate a simple or open pneumothorax, converting it to a tension pneumothorax. PMID:23342703

Cipolle, Mark; Rhodes, Michael; Tinkoff, Glen



UK national survey of thoracic ultrasound in respiratory registrars.  


Thoracic ultrasound training has become part of the respiratory medicine curriculum. Data on training, access to teaching and achievement of competency in thoracic ultrasound by respiratory specialty trainees are scarce. Using the web-based kwiksurveys, we surveyed current respiratory specialty trainees (STs) in the UK. 177 responses were recorded. Nearly three-quarters of trainees had access to bedside ultrasound but only 15.3% had regular ultrasound training. Overall, 28.8% had achieved level 1 competency but only 44.4% of trainees at ST6 and above were level 1 competent. The majority of respiratory trainees have access to thoracic ultrasound but structured training is limited, with only a small proportion of trainees attaining level 1. More structured training and mentoring is needed to enable trainees to achieve the required competencies. PMID:23908507

Sutherland, T J T; Dwarakanath, A; White, H; Kastelik, J A



Supraclavicular long thoracic nerve decompression for traumatic scapular winging.  


Scapular winging resulting from long thoracic nerve palsy is a painful, disabling condition often associated with periscapular weakness and decreased active shoulder range of motion. Observation, therapy, and symptomatic treatment have customarily been the recommended treatment, often with disappointing results. Recently, encouraging results have been reported following decompression of the long thoracic nerve. Six patients who underwent a supraclavicular long thoracic nerve decompression from 2008 to 2010 for painful posttraumatic scapular winging were identified retrospectively. Four males and two females with a mean age of 28 years at the time of surgery were treated for an average of 9 months following injury. Mean follow-up was 16 months following surgery. All patients had decreased pain, disability, and scapular winging, and improved shoulder range of motion. One patient had recurrence following a second injury. This procedure has resulted in good outcomes without the morbidity associated with tendon or nerve transfer. PMID:24063798

Schippert, David W; Li, Zhongyu



Experimental aerobic-anaerobic thoracic empyema in the guinea pig.  


The clinical and pathological features of experimental aerobic-anaerobic thoracic empyema in the Duncan-Harley guinea pig are described. Thoracic empyema development and early death (less than 14 days after bacterial inoculation) were noted after various concentrations and species were inoculated into the pleural space with a piece of umbilical tape, which was used as a cofactor. The effect of concomitant hemothorax was also tested. Gram-negative infection was found to have a more virulent course than Gram-positive infection in the thoracic cavity. Moreover, these findings support the thesis that intrathoracic inoculation of anaerobic bacteria, even in combination with other anaerobic species, fails to produce clinical empyemas. However, anaerobic bacteria appear to enhance synergistically the virulence of sublethal and subempyema-forming concentrations of aerobic bacteria such as Staphylococcus aureus and Escherichia coli. PMID:3548615

Mavroudis, C; Ganzel, B L; Cox, S K; Polk, H C



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

PubMed Central

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

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



Renoprotective effects of hepatocyte growth factor in the stenotic kidney.  


Renal microvascular (MV) damage and loss contribute to the progression of renal injury in renal artery stenosis (RAS). Hepatocyte growth factor (HGF) is a powerful angiogenic and antifibrotic cytokine that we showed to be decreased in the stenotic kidney. We hypothesized that renal HGF therapy will improve renal function mainly by protecting the renal microcirculation. Unilateral RAS was induced in 15 pigs. Six weeks later, single-kidney RBF and GFR were quantified in vivo using multidetector computed tomography (CT). Then, intrarenal rh-HGF or vehicle was randomly administered into the stenotic kidney (RAS, n = 8; RAS+HGF, n = 7). Pigs were observed for 4 additional weeks before CT studies were repeated. Renal MV density was quantified by 3D micro-CT ex vivo and histology, and expression of angiogenic and inflammatory factors, apoptosis, and fibrosis was determined. HGF therapy improved RBF and GFR compared with vehicle-treated pigs. This was accompanied by improved renal expression of angiogenic cytokines (VEGF, p-Akt) and tissue-healing promoters (SDF-1, CXCR4, MMP-9), reduced MV remodeling, apoptosis, and fibrosis, and attenuated renal inflammation. However, HGF therapy did not improve renal MV density, which was similarly reduced in RAS and RAS+HGF compared with controls. Using a clinically relevant animal model of RAS, we showed novel therapeutic effects of a targeted renal intervention. Our results show distinct actions on the existing renal microcirculation and promising renoprotective effects of HGF therapy in RAS. Furthermore, these effects imply plasticity of the stenotic kidney to recuperate its function and underscore the importance of MV integrity in the progression of renal injury in RAS. PMID:23269649

Stewart, Nicholas; Chade, Alejandro R



Rat kidney porphobilinogen deaminase kinetics  

Microsoft Academic Search

Background and aims: Acute intermittent porphyria (AIP) is an inherited disease resulting from a reduced activity of the enzyme porphobilinogen deaminase (PBG-D). The kidney is an important target for numerous porphyrinogenic drugs and it may contribute to the clinical manifestations of porphyric attacks. An evaluation of kidney PBG-D role in the AIP pathophysiology requires detailed information on kidney PBG-D properties,

Guillermo Noriega; Guillermo Mattei; Alcira Batlle; Adela Ana Juknat



The Fornix in Patients with SeizuresCaused by Unilateral Hippocampal Sclerosis: Detectionof Unilateral Volume Loss on MR Images  

Microsoft Academic Search

OBJECTIVE. Because some of the axons of the fonnix originate in the pyramidal cells of the hippocampus, we hypothesize that neuronal loss within the hippocampus may result in wallenian degeneration and subsequent atrophy of the Ipsilatenal fornix. Using high-resolution MR imaging, we evaluated the size of the fonnix In patients who had lateralizing partial complex temporal lobe seizures after unilateral

G. Nicholas Baldwin; Jay S. Tsuruda; Kenneth R. Maravilla


Intracortical inhibition and facilitation with unilateral dominant, unilateral nondominant and bilateral movement tasks in left and right handed adults  

PubMed Central

Purpose To investigate intracortical inhibition and facilitation in response to unilateral dominant, nondominant and bilateral biceps activation and short-term upper extremity training in right and left-handed adults. Methods Paired-pulse transcranial magnetic stimulation was used to measure intracortical excitability in motor dominant and nondominant cortices of 26 nondisabled adults. Neural facilitation and inhibition were measured in each hemisphere during unilateral dominant, nondominant and bilateral arm activation and after training in each condition. Results No differences were seen between right and left- handed subjects. Intracortical facilitation and decreased inhibition were seen in each hemisphere with unilateral activation/training of contralateral muscles and bilateral muscle activation/training. Persistent intracortical inhibition was seen in each hemisphere with ipsilateral muscle activation/training. Inhibition was greater in the nondominant hemisphere during dominant hemisphere activation (dominant arm contraction). Conclusion Strongly dominant individuals show no difference in intracortical responses given handedness. Intracortical activity with unilateral and bilateral arm activation and short-term training differs based on hemispheric dominance, with the motor dominant hemisphere exerting a larger inhibitory influence over the nondominant hemisphere. Bilateral activation and training has a disinhibitory effect in both dominant and nondominant hemispheres.

Waller, Sandy McCombe; Forrester, Larry; Villagra, Federico; Whitall, Jill



Kidney amino acid transport.  


Near complete reabsorption of filtered amino acids is a main specialized transport function of the kidney proximal tubule. This evolutionary conserved task is carried out by a subset of luminal and basolateral transporters that together form the transcellular amino acid transport machinery similar to that of small intestine. A number of other amino acid transporters expressed in the basolateral membrane of proximal kidney tubule cells subserve either specialized metabolic functions, such as the production of ammonium, or are part of the cellular housekeeping equipment. A new finding is that the luminal Na(+)-dependent neutral amino acid transporters of the SLC6 family require an associated protein for their surface expression as shown for the Hartnup transporter B(0)AT1 (SLC6A19) and suggested for the L: -proline transporter SIT1 (IMINO(B), SLC6A20) and for B(0)AT3 (XT2, SLC6A18). This accessory subunit called collectrin (TMEM27) is homologous to the transmembrane anchor region of the renin-angiotensin system enzyme ACE2 that we have shown to function in small intestine as associated subunit of the luminal SLC6 transporters B(0)AT1 and SIT1. Some mutations of B(0)AT1 differentially interact with these accessory subunits, providing an explanation for differential intestinal phenotypes among Hartnup patients. The basolateral efflux of numerous amino acids from kidney tubular cells is mediated by heteromeric amino acid transporters that function as obligatory exchangers. Thus, other transporters within the same membrane need to mediate the net efflux of exchange substrates, controlling thereby the net basolateral amino transport and thus the intracellular amino acid concentration. PMID:19184091

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



Kidney donation after cardiac death  

PubMed Central

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

Akoh, Jacob A



[Human physiology: kidney].  


The content of human physiology as an independent part of current physiology is discussed. Substantiated is the point that subjects of human physiology are not only special sections of physiology where functions are inherent only in human (physiology of intellectual activity, speech, labor, sport), but also in peculiarities of functions, specificity of regulation of each of physiological systems. By the example of physiology of kidney and water-salt balance there are shown borders of norm, peculiarities of regulation in human, new chapters of renal physiology which have appeared in connection with achievements of molecular physiology. PMID:21061667

Natochin, Iu V


Oxygen tension correlates with regional blood flow in obstructed rat kidney.  


As renal tissue oxygen tension (P(O(2))) is determined by the balance between oxygen supply and consumption, direct tissue P(O(2)) measurements are essential when evaluating the presence of hypoxia. The present study aimed at evaluating invasively and continuously the renal medullary and cortical tissue P(O(2)) by novel fibre-optic probes in rats subjected to acute unilateral ureteral obstruction (AUUO). In parallel, regional blood flow measurements were obtained by MRI to investigate the relationship between regional blood flow and tissue oxygen tension. The abundance of transport proteins was determined by immunoblotting. In the obstructed kidney, AUUO caused a prompt decrease in medullary tissue P(O(2)) to 60% of baseline level whereas cortical tissue P(O(2)) was unchanged. By contrast, tissue P(O(2)) slightly increased in the non-obstructed kidney. These changes developed during the first 30 min after AUUO and persisted for the 3 h observation period. Medullary blood flow declined 1.5-2 h after induction of AUUO to 61% of baseline level in the obstructed kidney. By contrast, cortical blood flow increased to 108% of baseline level in the non-obstructed kidney. Finally, the abundance of phosphorylated aquaporin 2 decreased significantly in the obstructed kidney medulla, but increased in the obstructed kidney cortex. The Na(+)/K(+)-ATPase abundance increased in the obstructed kidney medulla whereas the Na(+)/K(+)/2Cl(-) co-transporter abundance remained unchanged in the obstructed kidney. In conclusion, measurements of regional blood flow reflect tissue P(O(2)) changes during AUUO suggesting that reduced regional blood flow is a predictor of local hypoxia. Furthermore, the abundance of major transport protein is independent of tissue P(O(2)). PMID:19749109

Jensen, Anja M; Nørregaard, Rikke; Topcu, Sukru Oguzkan; Frøkiaer, Jørgen; Pedersen, Michael



The unjustified classification of kidney donors as patients with CKD: critique and recommendations.  


Unilateral nephrectomy for kidney donation results in loss of about 30% of baseline GFR, leaving some donors with GFR <60 ml/min per 1.73 m(2), the threshold for the diagnosis CKD. This has resulted in insurability problems for some donors. This article reviews the definition of CKD, risks associated with CKD, and large follow-up studies on the vital status and risk of ESRD in kidney donors. It also provides evidence that kidney donors, despite having reduced GFR, are not at increased risk for CKD-associated morbidity and mortality. Epidemiologic studies, most with follow-up <10 years, have shown an association between GFR <60 ml/min per 1.73 m(2) and higher mortality and progression to ESRD. Low GFR in the absence of any other markers for kidney disease, however, conveys attenuated or minimal risk. Of note, studies of long-term kidney donor outcomes (6-45 years) have not shown excess mortality or ESRD. The limitation of the collective evidence is that the increased risks associated with GFR <60 ml/min per 1.73 m(2) were demonstrated in much larger cohorts than those reported for kidney donor outcomes, but donor outcome studies have substantially longer follow-up. On the basis of current findings, kidney donors with low GFR and no other signs of kidney disease should not be classified as having CKD. This is definitely not the reward they deserve, and, more important, the implications of reduced GFR in donors are not associated with unfavorable outcomes. PMID:23813555

Matas, Arthur J; Ibrahim, Hassan N



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

SciTech Connect

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

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



Non-healing ulcer on the foot: early onset unilateral Mali-type acroangiodermatitis.  


Acroangiodermatitis (pseudo-Kaposi's sarcoma, AAD) is a benign vascular dermatosis that resembles Kaposi's sarcoma clinically and histopathologically (1). Four types have been defined: the Stewart-Bluefarb type accompanying chronic arteriovenous malformations, the Mali type accompanying stasis dermatitis, a type accompanying the first gestation, and a type accompanying arteriovenous shunts in patients with chronic kidney failure (3). Although AAD development is associated with chronic venous failure, less frequently AAD can develop as a complication of extremity paralysis, hemodialysis, post-traumatic arteriovenous fistula, amputated extremities, and vascular malformations (e.g., Klippel-Trénaunay syndrome). Pseudo-Kaposi's sarcoma can be histopathologically and clinically confused with malignant diseases such as Kaposi's sarcoma (1, 4). A 22-year-old male was referred to our outpatient clinic with a complaint of a non-healing wound on the distal phalanx of the left first toe. The patient was referred to various centers for 2 years and stated that he had received infection treatments but that his complaints did not disappear. An AAD diagnosis was established for the patient based on clinical and histopathologic evidence. Because he had early-onset disease and it was unilateral, the diagnosis was delayed. In addition, due to the rare occurrence of the disease, we histopathologically diagnosed this patient as having acroangiodermatitis. PMID:23836359

Ozkaya, Dilek B?y?k; Su, Ozlem; Onsun, Nahide; Ulusal, Hande; Demirkesen, Cuyan



Video-assisted thoracic surgery (VATS) right upper lobectomy  

PubMed Central

Video-assisted thoracic surgery (VATS) plays supplementary role to the open surgery in the thoracic surgery. As the clinical education and VATS procedure developed, more patients are willing to take VATS surgery than open surgery if the condition permits. With the help of proficiency and HD thoracoscopic instruments, nearly all open surgery can be done, theoretically, in VATS either. In addition the better accessibility to the operative video and academic meeting greatly propel the prevalence of VATS surgery. Here I present a VATS right upper lobectomy case to communicating operative techniques.

Song, Xiaoyun; Xiao, Ning; Yu, Daping



Late failure after endovascular repair of descending thoracic aneurysms.  


Although endovascular repair of descending thoracic aneurysm has been increasingly utilized as a minimally invasive alternative to open repair, the availability of late results remains quite limited, and what exists does not yet completely reflect the rapid evolution of devices, refinement in delivery systems and maturation of both institutional and general learning curves. Durability of endografts in the thoracic aorta continues to be defined as more long-term data emerge from the major device regulatory trials. This review describes the currently available published long-term results and describes some of the anecdotally reported modes of late failure associated with the technique. PMID:19573746

Chaer, Rabih A; Makaroun, Michel S



Video-assisted thoracic surgery (VATS) right upper lobectomy.  


Video-assisted thoracic surgery (VATS) plays supplementary role to the open surgery in the thoracic surgery. As the clinical education and VATS procedure developed, more patients are willing to take VATS surgery than open surgery if the condition permits. With the help of proficiency and HD thoracoscopic instruments, nearly all open surgery can be done, theoretically, in VATS either. In addition the better accessibility to the operative video and academic meeting greatly propel the prevalence of VATS surgery. Here I present a VATS right upper lobectomy case to communicating operative techniques. PMID:24040538

Song, Xiaoyun; Xiao, Ning; Yu, Daping; Liu, Zhidong



Posterior spinal arthrodesis for adolescent idiopathic scoliosis using pedicle screw instrumentation: does a bilateral or unilateral screw technique affect surgical outcome?  


We reviewed 212 consecutive patients with adolescent idiopathic scoliosis who underwent posterior spinal arthrodesis using all pedicle screw instrumentation in terms of clinical, radiological and Scoliosis Research Society (SRS)-22 outcomes. In Group 1 (51 patients), the correction was performed over two rods using bilateral segmental pedicle screws. In Group 2 (161 patients), the correction was performed over one rod using unilateral segmental pedicle screws with the second() rod providing stability of the construct through two-level screw fixation at proximal and distal ends. The mean age at surgery was 14.8 years in both groups. Comparison between groups showed no significant differences with regard to age and Risser grade at surgery, pre- and post-operative scoliosis angle, coronal Cobb correction, length of hospital stay and SRS scores. Correction of upper thoracic curves was significantly better in Group 1 (p = 0.02). Increased surgical time and intra-operative blood loss was recorded in Group 1 (p < 0.001 and p = 0.04, respectively). The implant cost was reduced by mean 35% in Group 2 due to the lesser number of pedicle screws. Unilateral and bilateral pedicle screw techniques have both achieved excellent deformity correction in adolescent patients with idiopathic scoliosis, which was maintained at two-year follow-up. This has been associated with high patient satisfaction and low complication rates. PMID:23188910

Tsirikos, A I; Subramanian, A S



Plasticity of kidney cells: Role in kidney remodeling and scarring  

Microsoft Academic Search

Plasticity of kidney cells: Role in kidney remodeling and scarring. The progression of renal scarring and the associated loss of function remains one of the main challenges in nephrology. Until recently, the glomerular and tubulointerstitial scarring processes were thought to involve primarily interactions between infiltrating inflammatory cells and resident renal cells culminating in loss of renal cells and their replacement

A. Meguid El Nahas



[Kidney diseases: new issues].  


Chronic kidney disease (CKD) affects two to four million people in France and most of them are not aware of their disease. CKD is a major, independent risk factor of cardiovascular mortality and morbidity; the cardiovascular risk increases with the severity of renal failure. Evaluation of renal function (GFR) relies on MDRD and CKD-EPI equations. The French CKD-REIN cohort with more than 3000 patients followed for 5 years, will hopefully provide substantial advances in the knowledge of CKD epidemiology, of risk factors and mechanisms of CKD progression and medical practices. Improving CKD screening based on blood pressure, proteinuria (microalbuminuria in diabetic patients) and serum creatinine, is a national duty in high risk patients (with diabetes, hypertension and cardiovascular diseases). A major research goal is to identify new therapeutic targets and biomarkers, in order to treat kidney diseases before the occurrence of renal insufficiency, to halt their progression and to decrease cardiovascular risk. Careful therapeutic education of patients is required to successfully implement established guidelines, appropriate diets and new therapeutic strategies. PMID:22244724

Ronco, Pierre



Kidney paired donation.  


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

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



Genetic kidney diseases  

PubMed Central

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

Hildebrandt, Friedhelm



Thoracic endovascular aortic repair with visceral arteries intermittent clamp technique for descending thoracic aortic aneurysm with shaggy aorta.  


Aortic repair for severely atheromatous aneurysm remains a challenge. We used an intermittent clamp technique for all visceral arteries during thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm with a "shaggy aorta" to prevent systemic thromboembolism. In addition, we applied an extracorporeal circulation circuit to trap the thrombi during the endovascular repair. Postoperatively, no embolic complications were seen, and microscopic examination showed trapped plaques on the filter. We conclude that this technique is an option for preventing thromboembolism in aortic aneurysm repair in the context of a shaggy aorta when substantial concern of distal diffuse atheromatous emboli is raised based on clinical history or clear evidence on imaging. PMID:23777895

Igarashi, Takashi; Takase, Shinya; Satokawa, Hirono; Misawa, Yukitoki; Wakamatsu, Hiroki; Yokoyama, Hitoshi



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

PubMed Central

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

Offiah, C E; Twigg, S



9 CFR 310.12 - Sternum to be split; abdominal and thoracic viscera to be removed.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Sternum to be split; abdominal and thoracic viscera to be removed... § 310.12 Sternum to be split; abdominal and thoracic viscera to be removed...of each carcass shall be split and the abdominal and thoracic viscera shall be...



9 CFR 310.12 - Sternum to be split; abdominal and thoracic viscera to be removed.  

Code of Federal Regulations, 2010 CFR

...2009-01-01 false Sternum to be split; abdominal and thoracic viscera to be removed... § 310.12 Sternum to be split; abdominal and thoracic viscera to be removed...of each carcass shall be split and the abdominal and thoracic viscera shall be...



A novel approach toward pedicle screw placement in the thoracic spine  

Microsoft Academic Search

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

John Thalgott; Mark Kabins; James Giuffre



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

Microsoft Academic Search

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

Roberto S. Martins; Mario G. Siqueira



Review Endovascular versus open repair for descending thoracic aortic rupture: institutional experience and meta-analysis  

Microsoft Academic Search

Summary Rupture of thoracic aneurysm, acute type B dissection, blunt thoracic trauma, and penetrating aortic ulcer can present with a similar clinical profile of thoracic aortic rupture. We report a meta-analysis of comparative studies evaluating endoluminal graft versus open repair of these lesions as well as the early experience from our institution. We searched the following databases for reports of

Eleftherios Sarantis Xenos; David J. Minion; Daniel L. Davenport; Omar Hamdallah; Nick N. Abedi; Ehab E. Sorial; Eric D. Endean



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

Microsoft Academic Search

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

Hongkai Wang; Jing Bai; Yonghong Zhang



Kidney scintigraphy after ACE inhibition in the diagnosis of renovascular hypertension  

SciTech Connect

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

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



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


Suppression of the renin-angiotensin system (RAS) by angiotensin converting enzyme (ACE) inhibition may induce renal failure in patients with bilateral renal artery stenosis. Recent scintigraphic studies with the glomerular tracer technetium-99m-diethylenetriaminepenta-acetate (99m-Tc DTPA) indicate that in patients with unilateral renal artery stenosis, glomerular filtration rate (GFR) may be markedly reduced in the affected kidney after inhibition of ACE. This finding reflects the important role of the RAS in maintaining GFR (by increasing postglomerular resistance) in states of low renal perfusion pressure. Preliminary observations suggest that this scintigraphic test might be useful in the detection of renovascular hypertension. PMID:3915923

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


Radiological kidney size in childhood  

Microsoft Academic Search

Kidney length (KL), renal area and renal parenchymal area were measured on i. v. urograms of 255 children without apparent kidney disease age 0 to 14 years. These parameters were compared with age, body height, body surface area and the distance between the 1st and 4th lumbar vertebral body. In addition, renal parenchymal thickness was determined at the upper and

B. Klare; B. Geiselhardt; H. Wesch; K. Schärer; H. Immich; E. Willich



Autosomal recessive polycystic kidney disease  

Microsoft Academic Search

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

K. Zerres



Uromodulin and Chronic Kidney Disease  

Microsoft Academic Search

Uromodulin (Tamm-Horsfall protein) is produced in the kidney by cells of the thick ascending limb and distal tubule. Recent genetic studies suggest a role of uromodulin in chronic kidney disease. Mutations in the UMOD gene cause uromodulin storage disease. They code for amino acid substitutions that lead to misfolding of the molecule and its retention in the endoplasmic reticulum. Single

Karl Lhotta



Chronic Rejection in Kidney Transplants  

Microsoft Academic Search

Advances in surgical techniques and immunosuppressive therapy have made kidney transplantation routine in most countries; the incidence of chronic rejection, however, has remained relatively unchanged over the years [1]. There was expectation that the introduction of cyclosporine (CsA) would reduce chronic rejection of kidney allografts, however, data have been presented to show that this may not be true [2]. Tacrolimus

Rahul M. Jindal; Sundaram Hariharan



Genetics of Chronic Kidney Disease  

Microsoft Academic Search

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

Conall M. O’Seaghdha; Caroline S. Fox



Epidemiology of Acute Kidney Injury  

Microsoft Academic Search

Different definitions for acute kidney injury (AKI) once posed an important impediment to research. The RIFLE consensus classification was the first universally accepted definition for AKI, and has facilitated a much better understanding of the epidemiology of this condition. The RIFLE classification was adapted by a broad platform of world societies, the Acute Kidney Injury Network group, as the preferred

Eric A. J. Hoste; John A. Kellum; Nevin M. Katz; Mitchell H. Rosner; Michael Haase; Claudio Ronco



Thoracic Dust Exposures on Longwall and Continuous Mining Sections  

Microsoft Academic Search

Past data on the prevalence of symptoms of chronic bronchitis and decreases in pulmonary function indicate a potential problem due to deposition of coal mine dust in the bronchial airways. Difficulty with dust control in certain jobs indicates that chronic bronchitis may continue to be a problem.Compliance with the respirable dust standard does not equally limit the thoracic dust exposure

J. Drew Potts; Michael A. McCawley; Robert A. Jankowski



Primary thoracoplasty and pedicle screw instrumentation in thoracic idiopathic scoliosis  

Microsoft Academic Search

Thoracoplasty in combination with spine fusion is an established method to address the rib cage deformity in idiopathic scoliosis. Most reports about thoracoplasty and scoliosis correction focused on Harrington or CD instrumentation. We report a retrospective analysis of 21 consecutive patients, who were treated with pedicle screw instrumentation for idiopathic thoracic scoliosis and concomitant thoracoplasty. Minimal follow up was 24

Kan Min; Beat Waelchli; Frederik Hahn



The Efficacy of Scalene Injection in Thoracic Outlet Syndrome  

PubMed Central

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

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



Multimodality serial follow-up of thoracic aortic aneurysms  

Microsoft Academic Search

We identified 520 diagnostic imaging tests (MRI, CT, ECHO) performed in 205 patients (79 female 126 male) (age 20–94, mean 63.9) being followed at Yale-New Haven hospital for progression in size of their thoracic aortas. Estimated growth rates did not differ significantly across imaging modalities.

John A. Rizzo; Umer Darr; Michael Fischer; Kevin M. Johnson; John K. Finkle; Richard J. Gusberg; Gary S. Kopf; Thomas A. Abbott; Ivan P. Shevchenko; John A. Elefteriades



Vulnerability of long thoracic nerve: An anatomic study  

Microsoft Academic Search

The anatomic course of 40 long thoracic nerves was studied in relation to anatomic landmarks and reference lines, that is, the axillary lines and first 2 ribs. After its supraclavicular course, the nerve passes beneath the clavicle within the axillary sheath and then emerges from the axillary sheath. As it passes inferiorly and posteriorly from the point of emergence to

Nabil A Ebraheim; Jike Lu; Brian Porshinsky; Brace E Heck; Richard A Yeasting



Synaptic processes in thoracic ?-motoneurons evoked by segmental afferent stimulation  

Microsoft Academic Search

Synaptic processes in various functional groups of thoracic motoneurons (Th9-Th11) evoked by stimulation of segmental nerves were investigated in anesthetized and decerebrate cats. No reciprocal relations were found between these groups of motoneurons. Only excitatory mono- and polysynaptic responses were recorded in the motoneurons of the principal intercostal nerve following stimulation of the homonymous nerve. Activation of the afferents of

N. N. Preobrazhenskii; A. P. Gokin; I. S. Bezhenary



The wide spectrum of the asphyxiating thoracic dysplasia  

Microsoft Academic Search

Seven cases of A. T. D. are presented. Radiological findings were extraordinarily diverse. The prognosis of the disease is difficult for each individual case, because of the frequent pulmonary complications and cystic renal lesions are not always directly related to the severity of the bone changes. The authors believe that the term “thoracic-pelvic-phalangeal dysplasia” proposed by Langer, is the most

H. Cortina; J. Beltran; R. Olague; L. Ceres; A. Alonso; A. Lanuza



[Bevacizumab in thoracic oncology: results and practical aspects].  


Bevacizumab (Avastin(®)) is the first antiangiogenic therapy approved in non-small cell lung cancer (NSCLC). It is also currently the only agent in this family approved in NSCLC. This review focuses on results of clinical trials assessing bevacizumab in thoracic oncology. It also provides to clinicians practical advices for its prescription. PMID:23597632

Dansin, É; Cousin, S; Lauridant, G; Mennecier, B



Sternum lifting technique for thoracoscopic internal thoracic artery harvest  

Microsoft Academic Search

We employed the Laparolift and Laparofan (Origin Medsystems Inc., CA, USA) and developed a sternum lifting technique to create a sufficient intra-pleural space between the heart and the sternum in which the left internal thoracic artery (ITA) in situ graft could be thoracoscopically mobilized. Between June and December 2004, this technique was applied to 12 consecutive patients (eight men, four

Toshiya Ohtsuka; Mikio Ninomiya; Taisei Maemura


Sternum lifting technique for thoracoscopic internal thoracic artery harvest  

Microsoft Academic Search

We employed the Laparolift and Laparofan (Origin Medsystems Inc., CA, USA) and developed a sternum lifting technique to create a sufficient intra-pleural space between the heart and the sternum in which the left internal thoracic artery (ITA) in situ graft could be thoracoscopically mobilized. Between June and December 2004, this technique was applied to 12 consecutive patients (eight men, four

Toshiya Ohtsuka; Mikio Ninomiya; Taisei Maemura



A case of pediatric thoracic SCIWORA following minor trauma  

Microsoft Academic Search

Case report: A case of spinal cord injury without radiological abnormality (SCIWORA) at the thoracic level is reported. A 14-year-old girl fell backwards from a low chair and hit her back on the floor. It left her bent forward markedly. After taking a nap, she found herself unable to walk. Neurological examination revealed flaccid paraparesis, hypalgesia below the L-1 level,

Satoshi Yamaguchi; Kazutoshi Hida; Minoru Akino; Shunsuke Yano; Hisatoshi Saito; Yoshinobu Iwasaki



Surgery of tumours in the thoracic portion of the trachea  

PubMed Central

We have operated on nine patients suffering from benign or malignant tumours in the thoracic portion of the trachea. The main clinical symptom was difficulty in breathing, accompanied in the majority of cases by attacks of asphyxia, cough with mucous phlegm, and haemoptysis. The following operations were performed: circular resection of the trachea with end-to-end anastomosis, thoracic tracheotomy with enucleation of the tumour, fenestral resection with auto-alloplasty of the ensuing defect, piecemeal removal of the tumour through the lumen of the trachea, and intrathoracic tracheotomy with biopsy of the tumour. All patients were discharged after the operation. When giving an anaesthetic during an operation on the thoracic portion of the trachea it is expedient to introduce a tube into the left main bronchus from the right pleural cavity and to exclude the right lung from ventilation. These measures ensure convenience of manipulation of the trachea, unhampered by the presence of a tube. End-to-end anastomosis is the best way to restore the thoracic portion of the trachea after circular resection. The problem of replacing large fenestral defects of the trachea can be solved by auto-alloplasty with thick Marlex, preliminarily overgrown with connective tissue.

Perelman, Mikhail; Korolyova, Natalia



Cellular and molecular mechanisms of thoracic aortic aneurysms  

Microsoft Academic Search

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

Ismail El-Hamamsy; Magdi H. Yacoub



Human hepatocyte growth factor levels in patients undergoing thoracic operations  

Microsoft Academic Search

Human hepatocyte growth factor (hHGF) is the most potent mitogen identified for alveolar type II cells, and may have other important functions in the repair of the alveolar epithelium and compensatory lung growth. A study was conducted to evaluate the changes of serum hHGF levels in patients who underwent thoracic surgical procedures. The patients comprised 17 males and 14 females

E. Dikmen; M. Kara; U. Kisa; C. Atinkaya; S. Han; U. Sakinci



Etiology, pathogenesis and management of thoracic aortic aneurysm  

Microsoft Academic Search

Given the growing proportion of elderly people in Western societies and the increasing prevalence of chronic hypertension, the management of aneurysmal aortic disease is an ever growing challenge. Although degenerative changes in the aortic wall are common to thoracic aortic aneurysm (TAA) and to various types of dissection in general, TAA can result from specific heritable disorders of connective tissues.

Hüseyin Ince; Christoph A Nienaber



Neurology and the kidney  

PubMed Central

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

Burn, D; Bates, D



Unilateral parathyroidectomy: the value of the localizing scan.  


Surgery for correction of primary hyperparathyroidism utilizing a standard bilateral neck exploration has a success rate of approximately 90 to 95%. With the inception of pre-operative localization studies that were 90% accurate in localizing the diseased gland, the concept arose that a unilateral exploration could be as successful as a bilateral exploration. Bilateral exploration of the neck for hyperparathyroidism exposes the patient to a greater potential of morbidity for hypoparathyroidism and recurrent laryngeal nerve injury. It is our feeling based on personal experience that unilateral parathyroidectomy in selective cases can be as successful as the bilateral operation and be more cost effective, saving over $1,100 (U.S.) per case. PMID:8230383

Petti, G H; Chonkich, G D; Morgan, J W



Unilateral Stance Strategies of Athletes With ACL Deficiency  

PubMed Central

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.

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



Angiotensin-converting enzyme inhibitor-induced unilateral tongue angioedema.  


Angioedema is a frequently reported side effect of angiotensin-converting enzyme inhibitors. The literature suggests that immunosuppressed transplant patients are at an increased risk for this adverse condition. A 62-year-old African American man presented with acute unilateral angioedema attributed to angiotensin-converting enzyme inhibitor initiation. A PubMed literature search regarding unilateral angioedema produced only 3 reported cases confirming an uncommon presentation of an otherwise common adverse drug event. The cases raised questions regarding evidence-based management of drug-induced angioedema, effectiveness of current medical management regimens and the potential of other treatment options. Our objective was to review the presentation, diagnosis and acute management of a common adverse drug effect based on an uncommon patient presentation. PMID:22986608

Kuhlen, James Lee; Forcucci, Jessica



Offspring of patients treated for unilateral Wilms' tumor in childhood  

SciTech Connect

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

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



Leg Length Discrepancy in Unilateral Congenital Clubfoot Following Surgical Treatment  

PubMed Central

Length discrepancy secondary to limb hypoplasia has been described as an associated finding in patients with unilateral clubfoot. In this manuscript we bring attention to limb length discrepancy as a result of surgical treatment in unilateral clubfoot. Three patients who underwent extensive posterior, medial and lateral release were noted to have an average discrepancy in foot height of 2.1 centimeters (range, 2.0-2.3 centimeters). A decrease in foot height in addition to baseline limb hypoplasia may lead to a significant discrepancy that may justify surgical treatment. In this manuscript we point out that length discrepancy in such cases may not be adequately quantified on standard anteroposterior scanograms. Standing lateral foot radiographs will document loss in foot height as a possible factor in length discrepancy in surgically treated clubfoot patients.

Noonan, Kenneth J; Meyers, Alex M; Kayes, Kosmas



Computed tomography of partial unilateral agenesis of the pectoralis muscles.  


The most common congenitally absent muscles are the pectoralis major and minor. Absence is usually incomplete. This anomaly is often one component of a syndrome associated with other hand (Poland syndrome) and thoracic anomalies. Computed tomography can identify partial absence of the pectoralis muscle and exactly define the altered anatomy. A patient with myasthenia gravis and isolated partial agenesis of the pectoralis muscle is presented. PMID:3989055

Demos, T C; Johnson, C; Love, L; Posniak, H


Silent Intravascular Lymphoma Initially Manifesting as a Unilateral Adrenal Incidentaloma  

PubMed Central

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

Takahashi, Yoshiko; Iida, Keiji; Hino, Yasuhisa; Ohara, Takeshi; Kurahashi, Toshifumi; Tashiro, Takashi; Chihara, Kazuo



Comparison of maximal unilateral versus bilateral voluntary contraction force  

Microsoft Academic Search

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

Boris Matkowski; Alain Martin; Romuald Lepers


Nasopharyngeal amyloidosis: an unusual cause of unilateral hearing loss  

PubMed Central

Amyloidosis is typically a systemic depositional disease, diagnosed on clinical symptoms and signs in conjunction with histopathology. When occurring on a localized basis in the head and neck, the lesion is most commonly observed in the larynx. Primary localized nasal amyloidosis however is an uncommon finding, with 25 reported cases in the literature to date. We present the case of a young woman presenting with primary localized nasal amyloidosis secondary to the curious symptoms of unilateral hearing loss.

Mirza, A.H.; El-Shunnar, Suliman; Sama, Anshul



Unilateral Multiple Primary Tumours in an Atomic-bomb Survivor  

Microsoft Academic Search

We report here a case of an atomic-bomb survivor with sequential, unilateral, multiple-organ primary tumours after exposure to direct external radiation. This 67-year-old woman was 8 years old when she was exposed to radiation from the atomic bomb. At the time of the explosion, she was in an open area, but hiding behind a tree, which shielded her left side.

M. Morishita; A. Ohtsuru; M. Nakashima; S. Yamashita



Perioperative outcomes after unilateral and bilateral total knee arthroplasty  

PubMed Central

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

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