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Sample records for abdominal aorta morphometric

  1. Effects of physical activity on blood pressure monitoring and morphometric parameters of the left ventricle and of the abdominal aorta in healthy elderly subjects.

    PubMed

    Macchi, Claudio; Lova, Raffaele Molino; Giannelli, Fabrizio; Papucci, Mario; Conti, Andrea A; Paternostro, Ferdinando; Contini, Massimo; Miniati, Benedetta; Gulisano, Massimo; Catini, Claudio

    2003-01-01

    To investigate the effects of physical activity not only on morphometric left ventricular parameters, but also on the abdominal aorta diameter and on blood pressure, we enrolled 100 healthy subjects, 50 males and 50 females, aged between 63 and 91 years (mean 73.3 +/- s.d. 7.7), each divided into two subgroups, sedentary and non sedentary, come to our observation for a diagnostic screening. For each subject an Echography was performed, by using an Acuson 128XP10 apparatus, equipped with a 2 MHz phased array probe, both for the study of the heart and for the study of the abdominal aorta. Then, all the subjects underwent 24 hours blood pressure monitoring by using a P6 Delmar apparatus in order to get mean systolic and diastolic blood pressure. Diastolic blood pressure was significantly related to physical activity (sedentary > non sedentary, P < 0.01), while systolic blood pressure was not; left ventricle and abdominal aorta diameters were both significantly related to sex (males > females, P < 0.001), but left ventricle diameter was significantly related to diastolic blood pressure (P < 0.01), while abdominal aorta diameter was significantly related to systolic blood pressure (P < 0.001). Our data suggest that physical activity might be strongly recommended to control blood pressure.

  2. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  3. A fibromatosis case mimicking abdominal aorta aneurysm.

    PubMed

    Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

    2013-01-01

    Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

  4. Spontaneous rupture of the abdominal aorta.

    PubMed Central

    Williams, T. G.

    1977-01-01

    Fatal spontaneous rupture of the lower abdominal aorta in a previously healthy 61-year-old woman is reported; the possibility that she had the Ehlers-Danlos syndrome is discussed. Images Fig. 1 PMID:870895

  5. Atrophic coarctation of the abdominal aorta.

    PubMed Central

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  6. Color Doppler ultrasonography of the abdominal aorta

    PubMed Central

    Battaglia, S.; Danesino, G.M.; Danesino, V.; Castellani, S.

    2010-01-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations. PMID:23396814

  7. Computed tomography of the postoperative abdominal aorta

    SciTech Connect

    Hilton, S.; Megibow, A.J.; Naidich, D.P.; Bosniak, M.A.

    1982-11-01

    Computed tomography (CT) of the abdomen was performed on 46 patients who had undergone graft replacement of abdominal aortic aneurysms. Twelve post-operative complications were found in nine patients. They included hemorrhage, infection, anastomotic pseudoaneurysms, major vessel occlusion, postoperative pancreatitis, and others. The varied apperance of the normal postoperative graft is also presented. It is concluded that CT is a rapid, sensitive, and noninvasive method for detecting or excluding postoperative complications of abdominal aortic surgery.

  8. Computed Tomographic Angiography of the Abdominal Aorta.

    PubMed

    Hansen, Neil J

    2016-01-01

    Computed tomographic (CT) angiography (CTA) has become the preferred imaging test of choice for various aortic conditions because of its excellent spatial resolution, rapid image acquisition, and its wide availability. CTA provides a robust tool for planning aortic interventions and diagnosing acute and chronic vascular diseases in the abdomen. CTA is the standard for imaging aneurysms before intervention and evaluating the aorta in the acute setting to assess traumatic injury, dissection, and aneurysm rupture. Knowledge of the imaging features of these disease processes, inflammatory vasculitides, and occlusive atherosclerotic disease is essential for guiding surgical and medical management of patients. PMID:26654390

  9. Rupture of retroperitoneal hydatid cyst into the abdominal aorta.

    PubMed

    Hadjiat, N; Graba, A; Mansouri, H

    1987-05-01

    We report the case of a retroperitoneal hydatid cyst ruptured into the infrarenal abdominal aorta. Initial treatment consisted of marsupialization of the cyst with patch angioplasty of the aorta. Formation of a false aneurysm led to reoperation for placement of an aortobifemoral bypass, but the patient died postoperatively. In spite of the exceptional character of this location, diagnosis should be suggested routinely in endemic areas when a retroperitoneal mass is discovered. Treatment should be either in situ prosthetic replacement or extra-anatomic exclusion bypass.

  10. Mechanical properties of rat thoracic and abdominal aortas.

    PubMed

    Assoul, N; Flaud, P; Chaouat, M; Letourneur, D; Bataille, I

    2008-07-19

    Mechanical properties of abdominal and thoracic arteries of 2mm in diameter were determined from adults Wistar rats. A tensile testing instrument was used to obtain stress/strain curves with arteries immersed in physiological buffer at 37 degrees C. A displacement was applied on all arteries with various frequencies (1-7.5Hz) and strains (5-60%). From each curve a Young modulus was obtained using a mathematical model based on a nonlinear soft tissue model. No influence of frequency on modulus was evidenced in the tested range. Abdominal aortas, which were found slightly thicker than thoracic aortas, were characterized by a higher modulus. Due to the interest of decellularized biological materials, we also used SDS/Triton treated arteries, and found that the chemical treatment increased modulus of thoracic arteries. Tensile tests were also performed on thoracic aortas in the longitudinal and transversal directions. Longitudinal moduli were found higher than transversal moduli and the difference could be related to the longitudinal orientation of collagen fibers. These data and mathematical model seem useful in the design of new vascular synthetic or biological prostheses for the field of tissue engineering.

  11. Essential Thrombocytosis-Associated Thromboembolism in the Abdominal Aorta

    PubMed Central

    Chong, Byung Kwon; Mun, Dana; Kang, Chae Hoon; Park, Chong-bin; Cho, Won Chul

    2016-01-01

    Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up. PMID:27734003

  12. An Abdominal Aorta Wall Extraction for Liver Cirrhosis Classification Using Ultrasonic Images

    NASA Astrophysics Data System (ADS)

    Hayashi, Takaya; Fujita, Yusuke; Mitani, Yoshihiro; Hamamoto, Yoshihiko; Segawa, Makoto; Terai, Shuji; Sakaida, Isao

    2011-06-01

    We propose a method to extract an abdominal aorta wall from an M-mode image. Furthermore, we propose the use of a Gaussian filter in order to improve image quality. The experimental results show that the Gaussian filter is effective in the abdominal aorta wall extraction.

  13. [The choice of surgical approach in the resection of abdominal aorta].

    PubMed

    Sukharev, I I; Levchuk, A Ia; Vlaĭkov, G G; Vikhliaev, S N

    1998-01-01

    The abdominal aorta aneurism (AAA) surgery experience in 110 patients was analysed. The topographic-anatomic investigations were conducted, a new surgical access to suprarenal and infrarenal AAA parts was proposed. PMID:9989069

  14. [Morphologic and morphometric analysis of atheromatous changes in the aorta in silibinin-treated cholesterin-fed rabbits].

    PubMed

    Schneider, F; Hídvégi, J; Bártfai, Z; Somogyi, A; Blázovics, A

    1990-07-01

    Authors studied the effect of Silibinin of antioxidative effect on cholesterin sclerosis of rabbits. Qualitative analysis of aorta sections, macroscopic and microscopic morphometric examination of aorta were the applied methods. Their results seem to show that Silibinin has a favourable influence on cholesterin sclerosis. According to their opinion only joint use of qualitative and quantitative macroscopic and microscopic methods can provide basis for really accurate judgment of any atheromatose change.

  15. Aberrant heartworm migration to the abdominal aorta and systemic arteriolitis in a dog presenting with vomiting and hemorrhagic diarrhea

    PubMed Central

    Grimes, Janet A.; Scott, Katherine D.; Edwards, John F.

    2016-01-01

    A 2-year-old Dachshund was presented for vomiting and diarrhea. Abdominal ultrasound revealed Dirofilaria immitis in the abdominal aorta and an avascular segment of small intestine. The dog was euthanized. Necropsy revealed D. immitis in the abdominal aorta and widespread necrotizing arteriolitis. This is a unique presentation of aberrant migration of D. immitis. PMID:26740703

  16. [Atypical angiographic appearances of aneurisms of the abdominal aorta (author's transl)].

    PubMed

    Chermet, J; Kieffer, E; Taboury, J; Monnier, J P; Chalut, J

    1976-10-01

    On the basis of 72 radio-surgical cases of abdominal aortic aneurism, the authors stress the value of atypical angiographic findings, which are ten in number. The presence of clot within the aneurism itself may explain a disparity between radiological and surgical findings. Failure to recognize these atypical signs is very serious, when the diagnosis of aneurism is not suspected clinically. Antero-posterior and, above all, lateral abdominal aortography is essential in the angiographic study of aneurisms of the abdominal aorta. Careful search for these 10 atypical signs should make it possible to avoid missing latent aneurisms. Lateral abdominal aortography is essential in order to determine the state of the abdominal collaterals of the aorta and, in particular, the superior mesenteric artery. PMID:1003379

  17. Morphometric analysis of hypertension-induced hypertrophy of rat thoracic aorta.

    PubMed Central

    Wiener, J.; Loud, A. V.; Giacomelli, F.; Anversa, P.

    1977-01-01

    The response of the intima-media of the thoracic aorta to 1 to 4 weeks of two-kidney renal hypertension in the rat has been analyzed by morphometric techniques at light and electron microscopic levels. The increased thickness of the aorta that ensues is the result of an increase in the size but not the number of smooth muscle cell layers. The volume fractions of intima occupied by endothelium (26%), internal elastic lamina (37%), and subendothelial space (37%) in normotensive animals are not significantly altered by the hypertension. The percent increases in muscle cross-sectional area is greatest (58 to 60%) in the two innermost layers (M1 and M2). M1 is composed of nearly equal compartments of smooth muscle cells and interstitial space that expand 69% and 50%, respectively, with hypertension. Analysis of the subcellular constituents of the M1 smooth muscle cells indicates that significant changes in absolute volume include increases of caveolae (45%), myofibrils (59%), mitochondria (81%), glycogen (163%), and rough endoplasmic reticulum (221%). Factors contributing to these alterations are discussed. Images Figure 1 Figure 2 PMID:888910

  18. Diagnosis of High Bifurcation of the Abdominal Aorta with Associated Vascular Variations: Case Report with Multidedector Computed Tomography

    PubMed Central

    Atalar, Mehmet Haydar; Salk, Ismail; Bozbiyik, Nisa; Cetin, Ali

    2015-01-01

    Summary Background Variations of the branches and bifurcation of the abdominal aorta and their relations with other abdominal structures and organs are important concerning abdominal and spinal surgery. Case Report In this report, authors present a high -positioned bifurcation of the abdominal aorta at the level of the L3 vertebral body and its associations with multiple variations of other abdominal arteries during contrast-enhanced multi-detector computed tomography (MDCT) examination of the abdomen. Conclusions We reported on a unique clinically and surgically significant case of variations of the abdominal aorta as related to the location and type of bifurcation. The awareness of the variations of the abdominal aorta is of great importance for surgeons in order to reduce complications during abdominal and spinal interventions, as well as for radiologists for precise interpretation of angiograms. PMID:26688701

  19. [Prognosis of operative treatment outcome in patients with abdominal aorta aneurism].

    PubMed

    Mazur, A P

    2008-06-01

    There was analyzed the risk of surgical intervention in patients, suffering abdominal aorta aneurism, using the risk indices POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) and GAS (Glasgow Aneurysm Score). The theoretically obtained indices were compared with the real indices and the availability of the indices for the practice were determined. The investigation was done in 122 consequent patients, suffering infrarenal abdominal aorta aneurism, to whom the abdominal aorta prosthesis was performed in 2005-2007 yrs. Lethality was 9.8% and complications rate--51.6%. The ROC curve analysis (the interrelationship curve of false-positive and true-positive results) and the analysis of square under the curve were performed for the indices availability analysis. The indices did not reveal high specificity for the lethality prognostication. PMID:18982723

  20. [Treatment of rupture of the infrarenal aneurysm of the abdominal aorta].

    PubMed

    Solaković, Emir; Vranić, Haris; Hadzimehmedagić, Amel

    2005-01-01

    One of the 15 most common cause of death in USA is rupture of the aneurism of the abdominal aorta. In 8-10% cases patients have no previous symptoms of aneurysm of the abdominal aorta, and they are coming to thr hospital with clinical picture of rupture This paperwork presents one such case. After assuming the data of basic lab. findings, clinical finding, and diagnostic procedures, an urgent operation was indicated. A resection of aneurismaticly changed infrarenal portion of abdominal aorta and its reconstruction with synthetic graft was done. In postoperative course we noticed cardiac decompensation followed by acute ischaemic attac of the left lower limb. It was solved by urgent disobliterative procedure--embolectomy in local anestesion. Patient was discharged after 21 day in good general condition. PMID:15997685

  1. [Conventional surgery versus endovascular surgery in a patient who undergoes an abdominal aorta aneurism. Nursing treatment].

    PubMed

    Espelosín Azpilicueta, M Dolores; Odériz Baquedano, M Arántzazu

    2006-06-01

    Patients diagnosed with an Abdominal Aorta Aneurism who undergo an operation using either conventional surgery or endovascular surgery require a series of different nursing treatment. The authors comparatively analyze nursing treatment applied to patients who have undergone an abdominal aorta aneurism according to the technique used; their study is retrospective, observational and comparative for all 61 patients who underwent an abdominal aorta aneurism in the Navarre Hospital in 2004. The authors describe both techniques, their advantages and inconveniences, and in a well-developed comparative manner, point out the differences in nursing treatment during post-operative care. Part of this study was presented in a poster format at the XVII National Congress on Vascular Nursing. PMID:16875361

  2. [Experience with the ovations stent graft system for totally percutaneous endovascular repair of the infrarenal portion of the abdominal aorta].

    PubMed

    Frantsevich, A M; Tsygankov, V N; Pokrovskiĭ, A V

    2015-01-01

    Presented in the article are clinical cases of successful totally percutaneous endovascular repair of the infrarenal portion of the abdominal aorta using the Ovation Prime ultra-low profile stent graft in high-surgical-risk patients, yielding good immediate and short-term results, thus demonstrating new possibilities in endovascular treatment of aneurysms of the infrarenal portion of the abdominal aorta. PMID:26673299

  3. [Mycotic aneurysm of the subrenal abdominal aorta: extra anatomical reconstruction in five patients].

    PubMed

    Denguir, R; Gharsallah, N; Khanfir, I; Ghedira, F; Kharroubi, M; Kalfat, T; Khayati, A; Abid, A

    2003-02-01

    Between 1988 and 2001, five patients with mycotic aneurysm of the abdominal aorta underwent surgery. Extra-anatomical reconstruction with axillo-bifemoral bypass grafting was performed in all patients. The hospital mortality rate was 20%. During the follow-up period two patients presented thrombosis of the axillo-bifemoral bypass, descending aorto-bifemoral bypass was performed in one. Extra-anatomic revascularization is a satisfactory procedure in the treatment of mycotic abdominal aortic aneurysm. The results are acceptable and the prognosis is mainly related to the underlying pathology and the severity of the infection. PMID:12616221

  4. Non-invasive ultrasonic measurement of the elastic properties of the human abdominal aorta.

    PubMed

    Imura, T; Yamamoto, K; Kanamori, K; Mikami, T; Yasuda, H

    1986-03-01

    A new echo tracking device linked to real time ultrasonic B mode equipment was developed to measure non-invasively the elastic properties of the human abdominal aorta. Pulsatile diameter change and mean diameter of the abdominal aorta were measured in 61 subjects with this ultrasonic device. Strain and pressure-strain elastic modulus Ep were calculated from pulsatile diameter change, diameter, and pulse pressure obtained by the auscultatory method. Strain significantly decreased with age; 0.076(0.024) (mean(SD)) in group 1 (20 young adults below the age of 35 years); 0.048(0.024) in group 2 (21 middle aged subjects between the ages of 35 and 60 years); and 0.030(0.010) in group 3 (20 elderly subjects over the age of 60 years). Ep values were 0.99(0.34) X 10(5), 1.55(0.68) X 10(5), and 3.80(2.05) X 10(5) N X m-2 in groups 1, 2, and 3 respectively. Ep in group 3 was significantly higher than in groups 1 and 2. The regression equation relating Ep to age was Ep = (-0.72 + 0.058 X age) X 10(5) N X m-2 (r = 0.73). The Ep value and its age related increase agreed with the findings in postmortem arteries. The elastic properties of the abdominal aorta could, therefore, be determined non-invasively by this ultrasonic method.

  5. Temporary Balloon Occlusion of the Abdominal Aorta in Treatment of Complex Acetabular Fracture

    PubMed Central

    Hao, Zhenhai; Zhou, Dongsheng; Wang, Fu; Li, Lianxin; He, Jiliang

    2016-01-01

    Background The aim of this study was to explore the efficacy of temporary balloon occlusion of the abdominal aorta assisting open reduction and internal fixation (ORIF) in the treatment of complex acetabular fracture. Material/Methods From August 2000 to October 2011, a total of 48 patients with complex acetabular fracture were enrolled in this study. Average operative time, intraoperative blood loss volume, blood transfusion volume, satisfactory reduction, and postoperative functional recovery rate were recorded and compared between the 2 groups. Results A significant difference was observed between the 2 groups in operative time (P=0.003). For intraoperative blood loss and blood transfusion, ORIF combined with temporary balloon occlusion of abdominal aorta techniques appeared to be superior to normal ORIF (blood loss: P=0.007; and blood transfusion: P=0.019, respectively). However, no differences were observed in postoperative blood loss or transfusion (P>0.05). Patients in group A showed better hip function than those in group B (group A: a good-to-excellent rate of 77.8%; group B: a good-to-excellent rate of 78.3%; P>0.05). With regard to the incidence of postoperative complications, there were no significant differences between the 2 groups (group A: 9/18; group B: 11/23; P=0.890). Conclusions In the treatment of complex acetabular fracture, temporary balloon occlusion of the abdominal aorta is a reliable technique to assist ORIF surgery to staunch the flow of blood. PMID:27367975

  6. [False aneurysms after prosthesis of the abdominal aorta and major arteries].

    PubMed

    Lytkin, M I; Peregudov, I G

    1980-04-01

    In 170 restorative operations performed by the authors false aneurisms made their appearance in 8 patients (4.7%) within 1 month--8 years after plasty. In 7 patients false aneurisms were formed in the area of anastomosis of the prosthesis with the femoral artery; in one patient there was an aneurism of the autovenous graft. Five patients with false aneurisms after rposthezing the abdominal aorta and main arteries were subjected to repeated reconstructive operations. The effect was good in four of them. PMID:7385571

  7. PET/CT imaging of abdominal aorta with intramural hematomas, penetrating ulcer, and saccular pseudoaneurysm.

    PubMed

    Nguyen, Vien X; Nguyen, Ba D

    2014-05-01

    Acute aortic syndromes, encompassing intramural hematoma, penetrating ulcer, and pseudoaneurysm, are best demonstrated by angiographic CT and magnetic resonance imaging. These imaging modalities provide an accurate evaluation and allow timely therapies of these frequently symptomatic lesions, thus reducing their morbidity and mortality. The inflammatory pathogenesis of these acute aortic syndromes may exhibit positive PET findings predictive of prognosis and outcomes of these vascular events. The authors present a case of PET/CT imaging showing asymptomatic intramural hematomas with penetrating ulcer and saccular pseudoaneurysm of the proximal abdominal aorta.

  8. The effect of age on the distensibility of the abdominal aorta of man.

    PubMed

    Newman, D L; Lallemand, R C

    1978-08-01

    The variation with age in distensibility and the dimensions of the abdominal aorta at the bifurcation have been measured in 43 fresh human cadavers. The age range was from birth to 69 years, both sexes being represented. Patients with vascular disease were excluded. Barium sulfate infused into the aorta through an iliac artery enabled the change in diameter to be measured from a roentgenogram with change in pressure. Incremental strain value could thus be calculated. Strain value increased from 0.02 at birth to a maximum at the end of the first decade of life and then decreased to less than 0.01 by the age of 70 years. Aortas in the age group of four to 11 years showed less stiffness with increasing pressure than at other ages. Variations of strain with age correlate with alterations in the ratio of aortic wall collagen to elastin in the young. An increase in the thickness of the wall and an atheroma, in response to prolonged hemodynamic stress, account for increased stiffness in the older age groups. Other age and disease factors may play a part, but further work is required in man to examine the role of relative wall thickness, elastic modulus and alteration in wall structure in determining the variation of aortic distensibility with age reported herein.

  9. Thrombosis of abdominal aorta in congenital afibrinogenemia: case report and review of literature.

    PubMed

    Sartori, M T; Teresa, S M; Milan, M; Marta, M; de Bon, E; Emiliano, D B; Fadin, M; Mariangela, F; Pesavento, R; Raffaele, P; Zanon, E; Ezio, Z

    2015-01-01

    Thrombotic events in congenital hypo-afibrinogenemia have been rarely reported, either in association or not with replacement therapy or thrombotic risk factors. We describe clinical findings and management of thrombosis of abdominal aorta with peripheral embolism in a patient with congenital afibrinogenemia. A review of arterial thrombosis in inherited hypo-afibrinogenemia was also performed. The patient with a severe bleeding history requiring prophylaxis with fibrinogen concentrates (FC) was admitted for ischaemia of the 4th right toe. An angio-CT of abdominal aorta showed a thrombosis from the origin of renal arteries to the carrefour with a distal floating part. No thrombotic risk factors were found; a previous traumatic lesion of aortic wall might have triggered the thrombus formation, whereas the role of FC prophylaxis remains uncertain. The patient was successfully treated with FC, enoxaparin followed by fondaparinux, and low-dose aspirin without bleeding or thrombosis recurrence. After 2 years, aortic thrombus was almost completely recovered. Sixteen hypo/afibrinogenemia patients with arterial thrombosis were found in Literature, showing that thrombosis often occurs at a young age, involves large vessels, its recurrence is not unusual, and therapeutic strategy is not defined yet. Our therapeutic approach was effective and also safe, but further studies are needed to improve the knowledge of pathogenesis and the anti-thrombotic management in this peculiar setting.

  10. Abdominal aorta anastomosis in rats and stable gastric pentadecapeptide BPC 157, prophylaxis and therapy.

    PubMed

    Hrelec, M; Klicek, R; Brcic, L; Brcic, I; Cvjetko, I; Seiwerth, S; Sikiric, P

    2009-12-01

    We focused on abdominal aorta, clamped and transected bellow renal arteries, and aortic termino-terminal anastomosis created in Albino male rats. We suggested stomach cytoprotection theory holding endothelium protection and peptidergic anti-ulcer cytoprotection therapy to improve management of abdominal aorta anastomosis and thrombus formation. The stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419) is a small anti-ulcer peptide efficient in inflammatory bowel disease trials (PL 14736) and various wound treatment, no toxicity reported. After 24 h following aortic termino-terminal anastomosis, we shown that BPC 157 (10 microg/kg) may also decrease formation of cloth after aortic termino-terminal anastomosis and preserved walking ability and muscle strength when given as a bath immediately after aortic anastomosis creation. This may be important since aortic termino-terminal anastomosis is normally presenting in rats with a formed cloth obstructing more than third of aortic lumen, severely impaired walking ability, painful screaming and weak muscle strength. Thereby, the effect of BPC 157 (10 microg/kg) was additionally studied at 24 h following aortic termino-terminal anastomosis. Given at the that point, intraperitoneally, within 3 minutes post-application interval the pentadecapeptide BPC 157 rapidly recovered the function of lower limbs and muscle strength while no cloth could be seen in those rats at the anastomosis site. PMID:20388960

  11. [Assessment of velocity of deformation of abdominal aorta wall with the help of the multivox working station].

    PubMed

    Sandrikov, V A; Fisenko, E P; Gavrilov, A V; Lozhkevich, A A; Platova, E N; Arkhipov, I V

    2013-01-01

    Most frequent cause of abnormalities of elastic properties of walls of abdominal aorta is development of atherosclerosis resulting in replacement of elastin by simpler fibrillar proteins and collagen. This subsequently leads to dilation of the aorta and formation of aneurism. Increase of collagen content in the aortic wall correlates with growth of aneurism dimensions. Main method of treatment of aneurisms is implantation of abdominal aortic prosthesis. Detailed preoperative assessment of functional state of the aortic wall is necessary in preoperative period but none of modern imaging instrumental methods including ultrasound study allows to realize this assessment. In this article we present first experience of assessment of aortic wall deformation velocity analyzing results of ultrasound study with the help of the Multivox working station in 36 patients 16 of whom were operated because of aneurism of abdominal aorta. PMID:24654437

  12. Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results

    SciTech Connect

    Lastovickova, Jarmila Peregrin, Jan H.

    2008-01-15

    Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months of mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.

  13. Seat belt injuries of the abdominal aorta in adults--case report and literature review.

    PubMed

    Freni, Luca; Barbetta, Iacopo; Mazzaccaro, Daniela; Settembrini, Alberto M; Dallatana, Raffaello; Tassinari, Luca; Settembrini, Piergiorgio G

    2013-02-01

    Blunt abdominal trauma with major vascular involvement is found to be rare. Although few series have been reported in the literature, the true incidence of blunt abdominal aortic injury is unknown. Different modalities of blunt trauma may occur among civilians with steering wheel and seat belt injury secondary to motor vehicle accident the most frequent. Mechanical forces produce variable patterns of injury; therefore, the onset of signs and symptoms can be different. Dissection and thrombosis of the abdominal aorta have been frequently described among seat-belted adult patients with major vascular involvement. The associated abdominal viscus and/or vertebral lesions must always be taken into account. Prompt diagnosis allows adequate surgical treatment. We present the case of a 66-year-old woman, restrained front passenger involved in a motor vehicle collision, who had small bowel transection, vertebral fractures, and aortic partial occlusion below inferior mesenteric artery with bilateral iliac artery involvement. Along with the case reported, the purpose of this study is to highlight and compare features and management of the previous cases described in the English literature.

  14. Effects of hindlimb unweighting on the mechanical and structure properties of the rat abdominal aorta

    NASA Technical Reports Server (NTRS)

    Papadopoulos, Anthony; Delp, Michael D.

    2003-01-01

    Previous studies have shown that hindlimb unweighting of rats, a model of microgravity, reduces evoked contractile tension of peripheral conduit arteries. It has been hypothesized that this diminished contractile tension is the result of alterations in the mechanical properties of these arteries (e.g., active and passive mechanics). Therefore, the purpose of this study was to determine whether the reduced contractile force of the abdominal aorta from 2-wk hindlimb-unweighted (HU) rats results from a mechanical function deficit resulting from structural vascular alterations or material property changes. Aortas were isolated from control (C) and HU rats, and vasoconstrictor responses to norepinephrine (10(-9)-10(-4) M) and AVP (10(-9)-10(-5) M) were tested in vitro. In a second series of tests, the active and passive Cauchy stress-stretch relations were determined by incrementally increasing the uniaxial displacement of the aortic rings. Maximal Cauchy stress in response to norepinephrine and AVP were less in aortic rings from HU rats. The active Cauchy stress-stretch response indicated that, although maximum stress was lower in aortas from HU rats (C, 8.1 +/- 0.2 kPa; HU, 7.0 +/- 0.4 kPa), it was achieved at a similar hoop stretch. There were also no differences in the passive Cauchy stress-stretch response or the gross vascular morphology (e.g., medial cross-sectional area: C, 0.30 +/- 0.02 mm(2); HU, 0.32 +/- 0.01 mm(2)) between groups and no differences in resting or basal vascular tone at the displacement that elicits peak developed tension between groups (resting tension: C, 1.71 +/- 0.06 g; HU, 1.78 +/- 0.14 g). These results indicate that HU does not alter the functional mechanical properties of conduit arteries. However, the significantly lower active Cauchy stress of aortas from HU rats demonstrates a true contractile deficit in these arteries.

  15. Hydatid cyst of the abdominal aorta and common iliac arteries complicated by a false aneurysm: a case report.

    PubMed

    Pulathan, Zerrin; Cay, Ali; Güven, Yaşar; Sarihan, Haluk

    2004-04-01

    The rupture of hydatid cysts into the abdominal aorta is an unusual and serious complication of the hydatid disease. The authors describe a case of a 12-year-old girl with hydatid disease presenting as a retroperitoneal mass invading the wall of the abdominal aortic bifurcation and complicated by a false aneurysm. Difficulties of preoperative diagnosis and operative management were discussed, and the literature was reviewed.

  16. [MORPHOMETRIC AND HISTOLOGICAL CHANGES OF TISSUES IN PATIENTS, WHO UNDERWENT OPERATIONS FOR POSTOPERATIVE ABDOMINAL HERNIAS].

    PubMed

    Brek, O O

    2015-05-01

    The impact of hernioplasty on postoperative morphometric and histological changes in tissues of patients, suffering postoperative abdominal hernias (POAH), was studied. For POAH 135 patients were operated, in 85 of them (the main group)--combined methods of hernial gate plasty in accordance to procedures proposed, and in 50 (control group)--classical methods of hernial gate were applied. The most favorable course of the wound process of the inflammatory, changes reduction and stabilization of the tissues reaction on implant already on the 7th postoperative day was noted after application of a sub lay method in original modification.

  17. Arterial hypertension and neurofibromatosis: renal artery stenosis and coarctation of abdominal aorta.

    PubMed Central

    Schürch, W.; Messerli, F. H.; Genest, J.; Lefebvre, R.; Roy, P.; Carter, P.; Rojo-Ortega, J. M.

    1975-01-01

    A 10-year-old girl had arterial hypertension, generalized neurofibromatosis, coarctation of the abdominal aorta and multiple stenoses at the origin of each renal artery. After resection of the stenotic areas and reimplantation of the renal arteries in the aorta, her arterial pressure decreased substantially. However, hypertension recurred and radiologic follow-up 4 1/2 years later showed distinct progression of the coarctation and renewed stenosis of all renal arteries at their origin. The stenotic areas showed eccentric intimal proliferation, frequently bulging into the lumen, with small nodular aggregates of smooth muscle cells and proliferation of fibrous tissue containing spindle-shaped nuclei in a palisading pattern. Hypertension associated with neurofibromatotic vascular disease has been described in 47 other patients in the literature. These patients have been young (mean age, 14 years) and predominantly male. In contrast to fibromuscular dysplasia, in which 95% of all stenoses are found in the distal two thirds of the renal arteries, in vascular neurofibromatosis more than 50% of the stenoses are found at the origin. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:810239

  18. Real-Time Intravascular Shear Stress in the Rabbit Abdominal Aorta

    PubMed Central

    Ai, Lisong; Yu, Hongyu; Dai, Wangde; Hale, Sharon L.; Kloner, Robert A.

    2012-01-01

    Fluid shear stress is intimately linked with the biological activities of vascular cells. A flexible microelectromechanical system (MEMS) sensor was developed to assess spatial- and temporal-varying components of intravascular shear stress (ISS) in the abdominal aorta of adult New Zealand white (NZW) rabbits. Real-time ISS (ISSreal-time) was analyzed in comparison with computational fluid dynamics (CFD) simulations for wall shear stress (WSS). Three-dimensional abdominal arterial geometry and mesh were created using the GAMBIT software. Simulation of arterial flow profiles was established by FLUENT. The Navier–Stokes equations were solved for non-Newtonian blood flow. The coaxial-wire-based MEMS sensor was deployed into the abdominal arteries of rabbits via a femoral artery cutdown. Based on the CFD analysis, the entrance length of the sensor on the coaxial wire (0.4 mm in diameter) was less than 10 mm. Three-dimensional fluoroscope and contrast dye allowed for visualization of the positions of the sensor and ratios of vessel to coaxial wire diameters. Doppler ultrasound provided the velocity profiles for the CFD boundary conditions. If the coaxial wire were positioned at the center of vessel, the CFD analysis revealed a mean ISS value of 31.1 with a systolic peak at 102.8 dyn · cm−2. The mean WSS was computed to be 10.1 dyn · cm−2 with a systolic peak at 33.2 dyn · cm−2, and the introduction of coaxial wire increased the mean WSS by 5.4 dyn · cm−2 and systolic peak by 18.0 dyn · cm−2. Experimentally, the mean ISS was 11.9 dyn · cm−2 with a systolic peak at 47.0 dyn · cm−2. The waveform of experimental ISS was similar to that of CFD solution with a 30.2% difference in mean and 8.9% in peak systolic shear stress. Despite the difference between CD and experimental results, the flexible coaxial-wire-based MEMS sensors provided a possibility to assess real-time ISS in the abdominal aorta of NZW rabbits. PMID:19527952

  19. β-adrenergic antagonists influence abdominal aorta contractility by mechanisms not involving β-adrenergic receptors.

    PubMed

    Hauzer, Willy; Bujok, Jolanta; Czerski, Albert; Rusiecka, Agnieszka; Pecka, Ewa; Gnus, Jan; Zawadzki, Wojciech; Witkiewicz, Wojciech

    2014-01-01

    β-adrenergic receptors (β-AR) are widely distributed in the cardiovascular system, where they considerably contribute to the control of its functions. β-blockers are commonly used in the treatment of disorders of the circulatory system. They act primarily by inhibiting cardiac β-receptors. However, there are also reports of pleiotropic action of β-blockers as well as of new compounds created to study β3 adrenergic receptors. The study aimed to investigate additional mechanisms of action of β-AR inhibitors in the rabbit abdominal aorta with emphasis on their action on α-adrenergic receptors and calcium influx. Responses to propranolol, betaxolol, metoprolol and SR59230A were evaluated in phenylephrine and PGF(2alpha) precontracted aortic rings. The effect of propranolol on the phenylephrine concentration-contraction curve was examined. Propranolol (≥ 10 μM) and SR59230A (≥ 0.1 μM) induced relaxations in phenylephrine-precontracted rings, while betaxolol and metoprolol had little effect. The β-AR inhibitors produced further contraction of tissues preincubated with PGF(2alpha), excluding SR59230A, which after initial contraction, elicited marked relaxation at a concentration above 1 ĕM. 100 μM of propranolol caused a significant rightward shift of the concentration-contraction curve to phenylephrine with no reduction in the maximum response. Incubation of aortic rings in phentolamine reduced the maximal contraction to propranolol; verapamil pretreatment by contrast enhanced contractile response. In conclusion, SR59230A and propranolol most probably act as α1-AR competitive antagonists in the presence of phenylephrine in rabbit abdominal aortic rings. After α-ARs blockade, propranolol exerts a weak relaxing activity connected with Ca2+ channel inactivation. SR59230A at a high concentration acts on the rabbit aorta by an additional mechanism needing further investigation.

  20. [The nearest and remote results in treatment aneurysms of the abdominal aorta and the main arteries].

    PubMed

    Cherviakov, Iu V; Staroverov, I N; Smurov, S Iu; Lavlinskiĭ, S N; Lonchakova, O M

    2011-01-01

    In the modern literature are taken widely up questions of medical tactics at an aneurysm of abdominal aorta (AA) depending on its sizes, presence of signs and presence of risk factors. The purpose of work was studying current aneurysm illnesses in various arterial parts, developments of optimum tactics of conducting patients and its influence on the remote results of operative treatment. Into research have entered 51 patient, suffering aneurism of an aorta, it branches and other main arteries. The nearest and remote results of dynamic supervision and operative treatment have been studied. The age of patients was within the limits of from 50 till 88 years, and has on the average made 71,8 ± 6,16. A parity men and women 8:1. Diameter AA changed from 3 up to 12 sm. Aneurysms combination met in an ascending part of an aorta, subclavian arteries, brachiochephalic trunk, carotid, iliofemoral, popliteal and limb arteries. All patients had accompanying cardial pathology. Patients have been divided into 2 groups. The first was made by 34 patients by whom resection AA has been made. Patients of the second group (17 patients) has been executed by dynamic supervision. The remote results are studied at 32 (62,7%) persons. Term of supervision has made from 6 till 168 months on the average. Postoperative lethal cases at scheduled operations were 4,7%, the general postoperative lethal cases were about - 11,7%. At the analysis of the remote results it is established, that the survival rate in a year has made 100 %, 5 years - 83,3% of patients. Average life expectancy in the given group of patients has made 76,4 ± 4 years, that there corresponds to data the WOHC for a healthy population. Dynamic supervision in both groups has shown progressing current of aneurysms combination in all arterial parts. Our data show perspectivity of surgical treatment aneurysms of an aorta and the main arteries except for patients with multistorey aneurysmosis arteries of legs in a combination to the

  1. [Non-standard method of reconstruction of the abdominal aorta for a giant aneurysm].

    PubMed

    Gaibov, A D; Baratov, A K; Sadriev, O N; Gaibova, Z V; Sharipov, Z R

    2016-01-01

    Abdominal aortic aneurysms are encountered predominantly in elderly patients suffering from severe concomitant diseases. Therefore, the rate of various complications associated with resection of aortic aneurysm amounts to 30%, with lethality in separate cohorts of patients reaching 43.7%. According the authors' opinion, in the development of intra- and postoperative complications of special importance is the duration of aortic clamping accompanied by severe haemodynamic alterations in coronary, cerebral and renal vessels. These changes are key moments in the development of fatal outcomes. In order to reduce the duration of aortic clamp the authors suggested a non-standard surgical technique of prosthetic repair of the abdominal aorta. Presented herein is a clinical case report illustrating this technique. The patient operated on according to this technique was discharged in a satisfactory condition with no serious postoperative complications. The proposed non-standard surgical technique makes it possible to reduce the duration of aortic cross-clamping in resection of an aneurysm by 10-12 minutes. PMID:27336353

  2. Endovascular Repair of an Actively Hemorrhaging Stab Wound Injury to the Abdominal Aorta

    SciTech Connect

    Hussain, Qasim; Maleux, Geert Heye, Sam; Fourneau, Inge

    2008-09-15

    Traumatic injury of the abdominal aorta is rare and potentially lethal (Yeh et al., J Vasc Surg 42(5):1007-1009, 2005; Chicos et al., Chirurgia (Bucur) 102(2):237-240, 2007) as it can result in major retroperitoneal hemorrhage, requiring an urgent open surgery. In case of concomitant bowel injury or other conditions of hostile abdomen, endovascular repair can be an alternative treatment. This case report deals with a 50-year-old man presenting at the emergency ward with three stab wounds: two in the abdomen and one in the chest. During explorative laparotomy, liver laceration and bowel perforation were repaired. One day later, abdominal CT-scan revealed an additional retroperitoneal hematoma associated with an aortic pseudoaneurysm, located anteriorly 3 cm above the aortic bifurcation. Because of the risk of graft infection, an endovascular repair of the aortic injury using a Gore excluder stent-graft was performed. Radiological and clinical follow-up revealed a gradual shrinkage of the pseudo-aneurysm and no sign of graft infection at two years' follow-up.

  3. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

    PubMed Central

    Michel, Jean-Baptiste; Martin-Ventura, José-Luis; Egido, Jesus; Sakalihasan, Natzi; Treska, Vladislav; Lindholt, Jes; Allaire, Eric; Thorsteinsdottir, Unnur; Cockerill, Gillian; Swedenborg, Jesper

    2011-01-01

    Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metalloproteinases and plasmin generation in progression of AAA have been demonstrated both in animal models and in clinical studies. In the present review, we highlight recent studies addressing the role of the haemoglobin-rich, intraluminal thrombus and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall. These events occur mainly at the intraluminal thrombus–circulating blood interface, and pathological mediators are conveyed outwards, where they promote matrix degradation of the arterial wall. In response, neo-angiogenesis, phagocytosis by mononuclear cells, and a shift from innate to adaptive immunity in the adventitia are observed. Abdominal aortic aneurysm thus represents an accessible spatiotemporal model of human atherothrombotic progression towards clinical events, the study of which should allow further understanding of its pathogenesis and the translation of pathogenic biological activities into diagnostic and therapeutic applications. PMID:21037321

  4. Optical pathology study of human abdominal aorta tissues using confocal micro resonance Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Liu, Cheng-hui; Boydston-White, Susie; Wang, Wubao; Sordillo, Laura A.; Shi, Lingyan; Weisberg, Arel; Tomaselli, Vincent P.; Sordillo, Peter P.; Alfano, Robert R.

    2016-03-01

    Resonance Raman (RR) spectroscopic technique has a high potential for label-free and in-situ detection of biomedical lesions in vivo. This study evaluates the ability of RR spectroscopy method as an optical histopathology tool to detect the atherosclerotic plaque states of abdominal aorta in vitro. This part demonstrates the RR spectral molecular fingerprint features from different sites of the atherosclerotic abdominal aortic wall tissues. Total 57 sites of five pieces aortic samples in intimal and adventitial wall from an autopsy specimen were examined using confocal micro Raman system of WITec 300R with excitation wavelength of 532nm. The preliminary RR spectral biomarkers of molecular fingerprints indicated that typical calcified atherosclerotic plaque (RR peak at 964cm-1) tissue; fibrolipid plaque (RR peaks at 1007, 1161, 1517 and 2888cm-1) tissue, lipid pool with the fatty precipitation cholesterol) with collagen type I (RR peaks at 864, 1452, 1658, 2888 and 2948cm-1) in the soft tissue were observed and investigated.

  5. A computational simulation of the effect of hybrid treatment for thoracoabdominal aortic aneurysm on the hemodynamics of abdominal aorta.

    PubMed

    Wen, Jun; Yuan, Ding; Wang, Qingyuan; Hu, Yao; Zhao, Jichun; Zheng, Tinghui; Fan, Yubo

    2016-01-01

    Hybrid visceral-renal debranching procedures with endovascular repair have been proposed as an appealing technique to treat conventional thoracoabdominal aortic aneurysm (TAAA). This approach, however, still remained controversial because of the non-physiological blood flow direction of its retrograde visceral revascularization (RVR) which is generally constructed from the aortic bifurcation or common iliac artery. The current study carried out the numerical simulation to investigate the effect of RVR on the hemodynamics of abdominal aorta. The results indicated that the inflow sites for the RVR have great impact on the hemodynamic performance. When RVR was from the distal aorta, the perfusion to visceral organs were adequate but the flow flux to the iliac artery significantly decreased and a complex disturbed flow field developed at the distal aorta, which endangered the aorta at high risk of aneurysm development. When RVR was from the right iliac artery, the abdominal aorta was not troubled with low WSS or disturbed flow, but the inadequate perfusion to the visceral organs reached up to 40% and low WSS and flow velocity predominated appeared at the right iliac artery and the grafts, which may result in the stenosis in grafts and aneurysm growth on the host iliac artery. PMID:27029949

  6. A computational simulation of the effect of hybrid treatment for thoracoabdominal aortic aneurysm on the hemodynamics of abdominal aorta

    PubMed Central

    Wen, Jun; Yuan, Ding; Wang, Qingyuan; Hu, Yao; Zhao, Jichun; Zheng, Tinghui; Fan, Yubo

    2016-01-01

    Hybrid visceral-renal debranching procedures with endovascular repair have been proposed as an appealing technique to treat conventional thoracoabdominal aortic aneurysm (TAAA). This approach, however, still remained controversial because of the non-physiological blood flow direction of its retrograde visceral revascularization (RVR) which is generally constructed from the aortic bifurcation or common iliac artery. The current study carried out the numerical simulation to investigate the effect of RVR on the hemodynamics of abdominal aorta. The results indicated that the inflow sites for the RVR have great impact on the hemodynamic performance. When RVR was from the distal aorta, the perfusion to visceral organs were adequate but the flow flux to the iliac artery significantly decreased and a complex disturbed flow field developed at the distal aorta, which endangered the aorta at high risk of aneurysm development. When RVR was from the right iliac artery, the abdominal aorta was not troubled with low WSS or disturbed flow, but the inadequate perfusion to the visceral organs reached up to 40% and low WSS and flow velocity predominated appeared at the right iliac artery and the grafts, which may result in the stenosis in grafts and aneurysm growth on the host iliac artery. PMID:27029949

  7. [Diameter decrement of abdominal aorta and redistribution of systemic blood flow in non-ambulant Duchenne muscular dystrophy patients].

    PubMed

    Shinoe, T; Kawai, M

    1996-10-01

    Cardiomyopathy is a major life-threatening complication in Duchenne muscular dystrophy (DMD). Cardiac output is always low in advanced stage patients. Impaired muscles presumably require extremely low circulation, while blood flow to brain and internal organs is probably maintained. Therefore, the redistribution of systemic circulation must be another important factor which determines whether or not the cardiomyopathy results in fatal heart failure. Although great efforts have been focused on the cardiac function, this problem has seldom attracted attentions. Assuming that diameter of blood vessels reflects blood flow, we measured the diameter of abdominal aorta on CT at four levels: 1) beginning of the abdominal aorta, 2) before and 3) after the branching of renal arteries, 4) before bifurcation of the common iliac arteries. Six bed-ridden DMD patients were compared with 10 ambulant patients suffering from other neurological and non-neurological diseases. We obtained following results. First, the diameter of abdominal aorta is significantly smaller in DMD patients. Second, the decrement is most prominent between before and after the branching of the renal arteries. These results clearly showed predilection of renointestinal circulation at the sacrifice of lower extremities. This narrowing of distal aorta was also observed in Kugelberg-Welander disease and understood as a sequelae of longstanding abolition of lower extremity functions. PMID:8997143

  8. [Non-invasive measurement of the elastic properties of the abdominal aorta and the analysis of aging change--changes of elasticity of the aorta by aging].

    PubMed

    Imura, T

    1985-09-01

    For the purpose of the non-invasive measurement of the elastic properties of human abdominal aorta, we developed high sensitive measurement system of small displacement of tissue. This system consists of phase locked echo tracking loop combined with conventional B-mode imaging. The sensitivity to displacement in the model experiment was in the order of micro meter. Pressure strain elastic modulus (Ep) and stiffness parameter (beta) of abdominal aorta were calculated by our equipment in 61 persons, which were subdivided into 3 age groups, the young group (20 persons less than 35 yrs.), the middle aged group (21 persons between 35 yrs. and 60 yrs.), and the old group (20 persons more than 60 yrs.). Ep in the young group was 0.99 +/- 0.34 X 10(6) dynes/cm2, the middle aged group 1.55 +/- 0.68 X 10(6) dynes/cm2, the old group 3.80 +/- 2.05 X 10(6) dynes/cm2. Beta in the young group was 9.3 +/- 3.3, the middle aged group 12.0 +/- 4.5, the old group 27.6 +/- 14.0. The values of Ep and beta in the old group were significantly different from those in the young group and the middle group. Moreover large deviation of the both values was showed within the old group. The influence of aging on the elastic properties of abdominal aorta was found with large individual variation in relation to the progression of the sclerotic change.

  9. Registration of Real-Time 3-D Ultrasound to Tomographic Images of the Abdominal Aorta.

    PubMed

    Brekken, Reidar; Iversen, Daniel Høyer; Tangen, Geir Arne; Dahl, Torbjørn

    2016-08-01

    The purpose of this study was to develop an image-based method for registration of real-time 3-D ultrasound to computed tomography (CT) of the abdominal aorta, targeting future use in ultrasound-guided endovascular intervention. We proposed a method in which a surface model of the aortic wall was segmented from CT, and the approximate initial location of this model relative to the ultrasound volume was manually indicated. The model was iteratively transformed to automatically optimize correspondence to the ultrasound data. Feasibility was studied using data from a silicon phantom and in vivo data from a volunteer with previously acquired CT. Through visual evaluation, the ultrasound and CT data were seen to correspond well after registration. Both aortic lumen and branching arteries were well aligned. The processing was done offline, and the registration took approximately 0.2 s per ultrasound volume. The results encourage further patient studies to investigate accuracy, robustness and clinical value of the approach. PMID:27156015

  10. [Primary mycotic aneurysm of the abdominal aorta from salmonella injection. A new case successfully operated upon (author's transl)].

    PubMed

    Jaillard, J; Carré, A; Marteau, D; Mizon, F; Warembourg, H

    1979-01-01

    A double aneurism, located in the abdominal aorta and left common iliac was found complicating a salmonella typhimurium infection which had been present for 7 months. A by-pass operation between the inaffected iliac arteries was followed by resection of the two aneurisms. Cultures taken from the walls of the aneurisms showed the presence of salmonella typhimurium. The authors stress the particular seriousness of the spontaneous evolution of such mycotic aneurisms. PMID:373564

  11. Low-dose Computed Tomography in a Pregnant Woman with a Ruptured Pseudoaneurysm of the Abdominal Aorta.

    PubMed

    Ramac, Jelena Popić; Vidjak, Vinko; Skegro, Dinko; Duić, Zeljko; Blasković, Darko; Erdelez, Lidija; Skopljanac-Macina, Andrija; Suknaić, Slaven; Slavica, Marko; Leder, Nikola Ivan

    2015-09-01

    Imaging the pregnant patient presents a unique challenge to radiologist due to the risk of radiation to the conceptus (embryo/fetus). A rare case of a successfully recognized and treated pseudoaneurysm (PA) of the abdominal aorta is to be presented. The pseudoaneurysm occurred in the third trimester and had a favorable outcome for the mother and the baby. Emergent abdominal ultrasound (US) is the first modality in diagnostic algorithm for the rupture of aortic aneurysm in a pregnant woman. It provides the most rapid diagnostic information, although intestinal gas and abdominal tenderness may limit its accuracy. To confirm the findings, magnetic resonance angiography (MRA) or CT angiography (CTA) can be used. In our case, the diagnosis was established using a color Doppler ultrasonography of the abdomen and was later confirmed by a low dose CT scan of the abdominal aorta. MRA in such cases have some disadvantages. At many health centers, the monitoring of patients with acute ruptures is more difficult in the MR suite than at the CT scanner. MRA angiographic images are also subject to degradation by multiple artifacts and the visualization of the distal vasculature is suboptimal and inferior to the one done by CTA. Due to fetal movements, a small quantity of fresh blood can be overlooked by MR. MRA is often not available on a 24-hours basis, and the time required for making a diagnosis can preclude the use of MRA in an unstable patient. For this reason, we used a low dose CTA protocol to confirm the diagnosis. Low dose scanning protocols in CT can obtain sufficient diagnostic information while reducing the risk of radiation. A particular focus is put on the outline of new concepts for dose management and optimization. We used new approaches based on tube current modulation. The birth was induced by an urgent Caesarean section followed by a resection of a pseudoaneurysm and a reconstruction of the aorta with an end-to-end vascular prosthesis. PMID:26898082

  12. Penetrating Atherosclerotic Ulcer of the Abdominal Aorta Involving the Celiac Trunk Origin and Superior Mesenteric Artery Occlusion: Endovascular Treatment

    SciTech Connect

    Ferro, Carlo; Rossi, Umberto G. Petrocelli, Francesco; Seitun, Sara; Robaldo, Alessandro; Mazzei, Raffaele

    2011-02-15

    We describe a case of endovascular treatment in a 64-year-old woman affected by a penetrating atherosclerotic ulcer (PAU) of the abdominal aorta with a 26-mm pseudoaneurysm involving the celiac trunk (CT) origin and with superior mesenteric artery (SMA) occlusion in the first 30 mm. The patient underwent stenting to treat the SMA occlusion and subsequent deployment of a custom-designed fenestrated endovascular stent-graft to treat the PAU involving the CT origin. Follow-up at 6 months after device placement demonstrated no complications, and there was complete thrombosis of the PAU and patency of the two branch vessels.

  13. [Clinical and immunological study of the relationship of the digestive system chronic diseases and atherosclerosis in the basin of the abdominal aorta in elderly patients].

    PubMed

    Dolgushina, A I; Shaposhnik, I I; Volchegorskiĭ, I A

    2014-01-01

    Paper describes clinical and immunological study about the relationship between chronic diseases of the digestive system and atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age. There were revealed the structural and clinical features of the gastrointestinal tract diseases, depending on the extent of atherosclerosis in the basin of the abdominal aorta. Evaluation of the immune status included the determination of lymphocyte subpopulation composition, the functional state of neutrophils and cytokine levels. It is found that the progression of atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age with chronic diseases of the digestive system was accompanied by the activation of pro-inflammatory mechanisms of the immune system and the accompanying intensification of oxidative stress.

  14. Gradient Echo MRI Characterization of Development of Atherosclerosis in the Abdominal Aorta in Watanabe Heritable Hyperlipidemic Rabbits

    SciTech Connect

    Wang, Yi-Xiang J. Kuribayashi, Hideto; Wagberg, Maria; Holmes, Andrew P.; Tessier, Jean J.; Waterton, John C.

    2006-08-15

    Purpose. The Watanabe Heritable Hyperlipidemic (WHHL) rabbit provides an important model of spontaneous atherosclerosis. With a strain of WHHL rabbits which do not develop abdominal aorta lumen stenosis even with advanced atherosclerosis, we studied the MRI-histology correlation, and the natural progression of atherosclerosis in the abdominal aorta. In addition, intra-reader segmentation repeatability and scan-rescan reproducibility were assessed. Methods. Two batches of female WHHL rabbits were used. The first batch of 6 rabbits was scanned at 20 weeks old. A second batch of 17 rabbits was scanned at 50 weeks old and then randomly divided into two subgroups: 8 were killed for histologic investigation; 9 were kept alive for follow-up, with repeat scanning a week later to assess scan-rescan reproducibility, and again at 73 weeks old to assess disease progression. MR images were acquired at 4.7 T using a chemical shift selective fat suppression gradient echo with a saturation band suppressing blood signal within the aortic lumen. Five slices per animal were acquired, centered around the renal artery region of the abdominal aorta, with in-plane resolution of 0.195 mm and slice thickness of 3 mm. Results. The coefficient of variation for intra-reader reproducibility for aortic wall thickness measurements was 2.5% for repeat segmentations of the same scans on the same day, but segmentations of these same scans made 8 months later showed a systematic change, suggesting that intra-reader bias as well as increased variability could compromise assessments made over time. Comparative analyses were therefore performed in one postprocessing session. The coefficient of variation for scan-rescan reproducibility for aortic wall thickness was 5.5% for nine pairs of scans acquired a week apart and segmented on the same day. Good MRI-histology correlation was obtained. The MRI-measured mean aortic wall thickness of animals at 20 weeks of age was 76% that of animals at 50 weeks of

  15. Low kV settings CT angiography (CTA) with low dose contrast medium volume protocol in the assessment of thoracic and abdominal aorta disease: a feasibility study

    PubMed Central

    Talei Franzesi, C; Fior, D; Bonaffini, P A; Minutolo, O; Sironi, S

    2015-01-01

    Objective: To assess the diagnostic quality of low dose (100 kV) CT angiography (CTA), by using ultra-low contrast medium volume (30 ml), for thoracic and abdominal aorta evaluation. Methods: 67 patients with thoracic or abdominal vascular disease underwent multidetector CT study using a 256 slice scanner, with low dose radiation protocol (automated tube current modulation, 100 kV) and low contrast medium volume (30 ml; 4 ml s−1). Density measurements were performed on ascending, arch, descending thoracic aorta, anonymous branch, abdominal aorta, and renal and common iliac arteries. Radiation dose exposure [dose–length product (DLP)] was calculated. A control group of 35 patients with thoracic or abdominal vascular disease were evaluated with standard CTA protocol (automated tube current modulation, 120 kV; contrast medium, 80 ml). Results: In all patients, we correctly visualized and evaluated main branches of the thoracic and abdominal aorta. No difference in density measurements was achieved between low tube voltage protocol (mean attenuation value of thoracic aorta, 304 HU; abdominal, 343 HU; renal arteries, 331 HU) and control group (mean attenuation value of thoracic aorta, 320 HU; abdominal, 339; renal arteries, 303 HU). Radiation dose exposure in low tube voltage protocol was significantly different between thoracic and abdominal low tube voltage studies (490 and 324 DLP, respectively) and the control group (thoracic DLP, 1032; abdomen, DLP 1078). Conclusion: Low-tube-voltage protocol may provide a diagnostic performance comparable with that of the standard protocol, decreasing radiation dose exposure and contrast material volume amount. Advances in knowledge: Low-tube-voltage-setting protocol combined with ultra-low contrast agent volume (30 ml), by using new multidetector-row CT scanners, represents a feasible diagnostic tool to significantly reduce the radiation dose delivered to patients and to preserve renal function

  16. [Mycotic aneurysms of the thoraco-abdominal part of the aorta].

    PubMed

    Ignashov, A M; Vasil'ev, S V; Usikov, V D; Gavrilenkov, V I; Semenov, D V; Bedrov, A Ia; Ivanov, A T; Kovalev, M G; Martynenko, G I; Petrova, E Iu; Peregoedov, E V; Kurkov, A A; Sidorov, A A

    2001-01-01

    Mycotoc aneurysms (MA)--a rare and extremely dangerous lesion of the aorta. CT, MRA and aortography were used to diagnose MA of the thoracoabdominal areas in 2 men of 64 and 67 years of age. The clinical picture included: fever with shivering with the temperature 38-39 degrees C and increasing pains in the inferiothoracic and lumbar areas of the spine. Hemoculture was positive in 1 patient only. The patients were operated on. Shunting of the aorta from the inferiothoracic to infrarenal segments was performed in one patient with the exclusion of the involved portion and resection of MA. Metalloosteosynthesis of the spine due to destruction of LI-LII and compression of the spine were performed in the second patient followed by analogous shunting of the aorta and visceral arteries with the resection of the aneurysm. To prevent infection of the prostheses the shunts were wrapped up with a piece of the greater omentum. One patient died two months later from recurrent sepsis. The other one is alive, within 28 months the shunts are patent, there are no signs of a reinfection. PMID:11837001

  17. Two anomalous cases of the hepato-mesenteric and the gastro-splenic trunks independently arising from the abdominal aorta.

    PubMed

    Hirai, Y; Yamaki, K; Saga, T; Hirata, T; Yoshida, M; Soejima, H; Kanazawa, T; Tanaka, K; Yoshizuka, M

    2000-01-01

    This report describes two arterial anomaly cases in the celiaco-mesenteric region, which were encountered in two Japanese male cadavers in the dissecting room at Kurume University School of Medicine in 1999. In these cases, the usual celiac trunks were not identified, and the hepato-mesenteric and the gastro-splenic trunks were independently arising from the abdominal aorta. Moreover, in the first case, the common hepatic artery passed ventral side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type V of Adachi's classification and the Type IV' of Morita's classification. In the second case, the common hepatic artery passed dorsal side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type VI of Adachi's classification and the Type IV' of Morita's classification. PMID:11059229

  18. [Endoprosthetic repair of the abdominal aorta in patients with infrarenal aneurysm and unfavourable anatomy of its proximal neck].

    PubMed

    Poliakov, R S; Abugov, S A; Puretskiĭ, M V; Saakian, Iu M; Charchian, É R; Poliakov, K V; Boltenkov, A V; Mardanian, G V; Karapetian, A Kh

    2015-01-01

    Analysed herein are immediate and remote results of endoprosthetic repair of the abdominal aorta in patients with unfavourable anatomy of its proximal neck. Group I (Study Group) was composed of 31 patients with unfavourable anatomy of the proximal neck, the control group (Group II) comprised a total of 52 patients with no unfavourable anatomical factors. The criteria of assessment were as follows: technical success, adequate position of the endograft, frequency of the development of various endoleaks, duration of the operation and hospital stay, lethality in the remote period, and necessity of secondary interventions. Technical success of endoprosthetic repair was achieved in 100% of patients in the both groups. An adequate position by the proximal end of the coated portion of the endograft was observed in 27 (87.1%) patients of Group I and in 51 (98.1%) patients of the control group (p=0.08). Secondary postdilatation of the endograft's body in the proximal neck was statistically more often performed in the study group of patients. The duration of the operation and hospital stay in the compared groups had no statistically significant differences. In the remote period, patients with unfavourable morphology of the proximal neck were found to develop type I-A endoleaks into the cavity of the aneurysm. By other evaluated criteria such as the total survival rate, secondary interventions, graft migration, type I-B, II and V endoleaks no statistically significant differences were revealed. It was concluded that endoprosthetic repair of the abdominal aorta in patients with unfavourable anatomy of the proximal neck of the aneurysm is associated with admissible immediate, short- and long-term outcomes. Longer follow up is required in order to more adequately asses the reliability of the obtained findings. PMID:26673297

  19. [Diagnosis and treatment of embolism and thrombosis of abdominal aorta and superior mesenteric artery].

    PubMed

    Matsubara, Kentaro; Obara, Hideaki; Kitagawa, Yuko

    2014-07-01

    Although acute aortic occlusion (AAO) and acute mesenteric ischemia (AMI) are relatively rare condition, it is very important to know clinical features and managements for these because a delay in diagnosis and appropriate interventions results in high morbidity and mortality. AAO can result from aortic saddle embolus, acute thrombosis of an atherosclerotic aorta, and so on. Superior mesenteric artery embolism and thrombosis are main cause of AMI. The purpose of this article is to review the pathophysiology, clinical presentation, diagnosis, and management of these diseases. The latest information in this article may help readers to promptly make the diagnosis and effectively manage it in a timely manner.

  20. Vasorelaxant activities of Danhong injection and their differential effects on the rat abdominal aorta and mesenteric artery.

    PubMed

    Su, Xianming; Zhi, Xiaowen; Cui, Ting; Zheng, Qiaowei; Wang, Shixiang; Cao, Yongxiao; Cui, Changcong; Feng, Weiyi

    2015-01-01

    Previous studies have found that Danhong injection (DHI), an extensively used herbal extract preparation in China, might be a powerful vasodilator. The aims of this study were to determine the vascular activity of DHI and its effects on arteries of different sizes. The results showed that DHI significantly inhibited rat-hindquarters and rabbit-ear vasoconstriction elicited by norepinephrine (NE) perfusion and markedly relaxed KCl-contracted and NE-contracted rat abdominal aortic and mesenteric artery rings. The endothelium made only a minor contribution to the vasorelaxant effect of DHI on artery segments. The vasorelaxant effect of DHI varied with the artery size, with larger arteries exhibiting a more sensitive and potent vasodilator response. DHI relaxed NE-induced vasoconstriction probably through inhibition of the intracellular Ca2+ release through the inositol triphosphate receptor system in the abdominal aorta and mesenteric artery, along with blockage of extracellular Ca2+ influx through the receptor-linked Ca2+ channels in the mesenteric artery. In addition, DHI completely relaxed KCl-induced contraction in both of the arteries, suggesting that inhibition of Ca2+ influx through voltage-gated Ca2+ channels is involved in the vasorelaxant effect of DHI. This elucidation of the vascular effects of DHI and the underlying mechanisms could lead to improved clinical applications.

  1. Biaxial mechanical properties of the human thoracic and abdominal aorta, common carotid, subclavian, renal and common iliac arteries.

    PubMed

    Kamenskiy, Alexey V; Dzenis, Yuris A; Kazmi, Syed A Jaffar; Pemberton, Mark A; Pipinos, Iraklis I; Phillips, Nick Y; Herber, Kyle; Woodford, Thomas; Bowen, Robert E; Lomneth, Carol S; MacTaggart, Jason N

    2014-11-01

    The biomechanics of large- and medium-sized arteries influence the pathophysiology of arterial disease and the response to therapeutic interventions. However, a comprehensive comparative analysis of human arterial biaxial mechanical properties has not yet been reported. Planar biaxial extension was used to establish the passive mechanical properties of human thoracic (TA, [Formula: see text]) and abdominal (AA, [Formula: see text]) aorta, common carotid (CCA, [Formula: see text]), subclavian (SA, [Formula: see text]), renal (RA, [Formula: see text]) and common iliac (CIA, [Formula: see text]) arteries from 11 deceased subjects ([Formula: see text] years old). Histological evaluation determined the structure of each specimen. Experimental data were used to determine constitutive parameters for a structurally motivated nonlinear anisotropic constitutive model. All arteries demonstrated appreciable anisotropy and large nonlinear deformations. Most CCA, SA, TA, AA and CIA specimens were stiffer longitudinally, while most RAs were stiffer circumferentially. A switch in anisotropy was occasionally demonstrated for all arteries. The CCA was the most compliant, least anisotropic and least frequently diseased of all arteries, while the CIA and AA were the stiffest and the most diseased. The severity of atherosclerosis correlated with age, but was not affected by laterality. Elastin fibers in the aorta, SA and CCA were uniformly and mostly circumferentially distributed throughout the media, while in the RA and CIA, elastin was primarily axially aligned and concentrated in the external elastic lamina. Constitutive modeling provided good fits to the experimental data for most arteries. Biomechanical and architectural features of major arteries differ depending on location and functional environment. A better understanding of localized arterial mechanical properties may support the development of site-specific treatment modalities for arterial disease.

  2. [Stagewise treatment of a giant false paraanastomotic aneurysm of the abdominal aorta].

    PubMed

    Ignatyev, I M; Volodyukhin, M Yu; Zanochkin, A V; Rafikov, A Yu; Khairullin, R N

    2016-01-01

    The article deals with a case report concerning successful stagewise treatment of a patient presenting with a giant false abdominal aortic paraanastomotic aneurysm having developed 2 months after an operation of linear prosthetic repair for a juxtarenal aneurysm with reimplantation of the left renal artery. The secondary operation was carried out 3 months after aortic reconstruction. The first stage consisted in performing endovascular prosthetic repair of the abdominal aortic paraanastomotic pseudoaneurysm by means of a bifurcated stent graft Endurant II (Medtronic), with the second stage being laparotomy with the removal of the retroperitoneal haematoma. The postoperative period turned out uneventful. The patient was discharged from hospital on the 8th day after the second operation. The patient was examined 2 months later, presenting no complaints and returning to his previous work. According to the findings of the check-up duplex scanning, the graft was patient, with no evidence of a paraanastomotic aneurysm. This is followed by discussion of the problems regarding the use of surgical and endovascular technologies in treatment of paraanastomotic aortic aneurysms. PMID:27336337

  3. Dissection of the Abdominal Aorta in Blunt Trauma: Management by Percutaneous Stent Placement

    SciTech Connect

    Vernhet, Helene; Marty-Ane, Charles-Henri; Lesnik, Alvian; Chircop, Regis; Serres-Cousine, Olivier; Picard, Eric; Mary, Henry; Senac, Jean Paul

    1997-11-15

    We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients were treated with Wallstents, one with a Palmaz stent. The occlusion of the false channel was obtained in all patients without any significant residual stenosis. No early or late complication was noted in any of the patients. The longest follow-up was 2 years.We conclude that stent placement is an efficient method for the treatment of noniatrogenic inframesenteric aortic dissections.

  4. Segmental and age differences in the elastin network, collagen, and smooth muscle phenotype in the tunica media of the porcine aorta.

    PubMed

    Tonar, Zbyněk; Kubíková, Tereza; Prior, Claudia; Demjén, Erna; Liška, Václav; Králíčková, Milena; Witter, Kirsti

    2015-09-01

    The porcine aorta is often used in studies on morphology, pathology, transplantation surgery, vascular and endovascular surgery, and biomechanics of the large arteries. Using quantitative histology and stereology, we estimated the area fraction of elastin, collagen, alpha-smooth muscle actin, vimentin, and desmin within the tunica media in 123 tissue samples collected from five segments (thoracic ascending aorta; aortic arch; thoracic descending aorta; suprarenal abdominal aorta; and infrarenal abdominal aorta) of porcine aortae from growing domestic pigs (n=25), ranging in age from 0 to 230 days. The descending thoracic aorta had the greatest elastin fraction, which decreased proximally toward the aortic arch as well as distally toward the abdominal aorta. Abdominal aortic segments had the highest fraction of actin, desmin, and vimentin positivity and all of these vascular smooth muscle markers were lower in the thoracic aortic segments. No quantitative differences were found when comparing the suprarenal abdominal segments with the infrarenal abdominal segments. The area fraction of actin within the media was comparable in all age groups and it was proportional to the postnatal growth. Thicker aortic segments had more elastin and collagen with fewer contractile cells. The collagen fraction decreased from ascending aorta and aortic arch toward the descending aorta. By revealing the variability of the quantitative composition of the porcine aorta, the results are suitable for planning experiments with the porcine aorta as a model, i.e. power test analyses and estimating the number of samples necessary to achieving a desirable level of precision. The complete primary morphometric data, in the form of continuous variables, are made publicly available for biomechanical modeling of site-dependent distensibility and compliance of the porcine aorta. PMID:26232584

  5. [Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].

    PubMed

    Konstantinov, B A; Bazylev, V V; Belov, Iu V; Kizyma, A G

    2008-01-01

    Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated. The multifactorial relative risk affecting hospital lethality is defined. The study includes 131 patients with generalized atherosclerosis, which have underwent myocardial revascularization at the first stage (the main group) and at the second stage have been operated on abdominal aorta and peripheral arteries. 1128 patients without peripheral arterial atherosclerosis have made the control group. They underwent only coronary shunting. All patients were treated from December of 1994 till June of 2006. Relying on the results of the study cumulative relative risk for unfavorable outcomes after revascularization is 1.8 times higher in patients from the main group than in patients from the control group, and the risk for primary complications is 2.03 times higher. Concomitant atherosclerotic arterial involvement among cardiosurgical patients is associated with high risk for stroke in postoperative period. In case of chronic renal failure risk factors are cumulated. In the main group lethality made 5% , which was higher as compared with the control group. Correlation of such risk factors as heart failure and renal failure (creatinine level more than 1.8 mg/dl) with lethality has been revealed among patients from the main group. Lethality risk raises in 5.30 times in the presence of heart failure in medical history, and raises in 13.15 times in case of initially elevated creatinine level. Age of patient didn't have any influence on lethality in early postoperative period.

  6. [Curriculum vitae aortae].

    PubMed

    Solberg, S

    1998-12-10

    The Greek word aorta means lifter. The vessel was so termed because Aristotle, who first described it, assumed that the heart was lifted by/hanging in aorta. Leonardo da Vinci described the detailed anatomy of aorta. During the 17th century our present understanding of the aorta and the circulation of blood took form due to the descriptions given by William Harvey. The first known operation for abdominal aortic aneurysm was performed in London in 1817 by Sir Astley Cooper who ligated the infrarenal aorta above the aneurysm. Puncture with needles and application of electricity were later tried in order to induce thromboses in the aneurysm. In 1948 Albert Einstein was operated with wrapping of his abdominal aneurysm with cellophane. In 1955 he suffered rupture and died after having refused operation. In 1951 the first successful operation for abdominal aortic aneurysm was performed in Paris by Charles Dubost. With slight modifications, the same operative technique is used today.

  7. Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study.

    PubMed

    Turgut, Ahmet Tuncay; Sönmez, Iclal; Cakıt, Burcu Duyur; Koşar, Pınar; Koşar, Uğur

    2008-06-01

    The goal of this cross-sectional observational study was to assess the possible impact of pineal gland calcification upon the intervertebral disc degeneration and abdominal aorta atherosclerosis in subjects with low back pain, and to investigate the course of these processes with aging. The study was carried out on 81 (66 women and 15 men) subjects: younger than 45 years (group X, n=22), 45-65 years of age (group Y, n=45), and older than 65 years (group Z, n=14). In addition to clinical data, computed tomography (CT) scan of the brain as well as X-ray and CT examination of the lumbar spine were recorded in this study. The degree of disc degeneration and calcification rates of aortic wall and pineal gland were independently determined by two radiologists. Both ratio of calcified pineal gland and density of pineal calcification increased progressively with aging. Also, both the degree of aortic wall calcification and disc degeneration score increased with advancing age. On CT scan, a positive correlation between degree of aortic wall calcification and disc degeneration score was found (r=0.306, p<0.01). Importantly, there was a positive association between calcification of the pineal gland and degenerative disc disease in X-ray or CT study (r=0.378 and r=0.295, p<0.005 and p<0.01, respectively), as well as between abdominal aorta atherosclerosis and pineal calcification (r=0.634, p<0.001). Our findings suggest that there is a significant interaction between pineal gland calcification and lumbar intervertebral disc degeneration and also abdominal aorta atherosclerosis. However, further studies with a larger subject cohorts are needed. PMID:18215511

  8. An anomalous case of the left gastric artery, the splenic artery and hepato-mesenteric trunk independently arising from the abdominal aorta.

    PubMed

    Saga, Tsuyoshi; Hirao, Takeshi; Kitashima, Sadaharu; Watanabe, Koh-Ichi; Nohno, Mariko; Araki, Yoshio; Kobayashi, Seiji; Yamaki, Koh-Ichi

    2005-01-01

    This report describes a rare case of an arterial anomaly in the celiaco-mesenteric region, encountered in a Japanese female cadaver for dissection at the gross anatomy laboratory of Kurume University School of Medicine in 2003. The usual celiac trunk was not identified, and the left gastric artery, the splenic artery and the hepato-mesenteric trunk independently arose from the abdominal aorta. Moreover, the hepatic artery arising from the hepato-mesenteric trunk ran behind the portal vein. The classification for this type of arterial anomaly is a Type II' of Morita's classification and Type II of Higashi and Hirai's classification, not belong to the Adachi's. PMID:16119612

  9. In vivo estimation of the contribution of elastin and collagen to the mechanical properties in the human abdominal aorta: effect of age and sex.

    PubMed

    Astrand, H; Stalhand, J; Karlsson, J; Karlsson, M; Sonesson, B; Länne, T

    2011-01-01

    The mechanical properties of the aorta affect cardiac function and are related to cardiovascular morbidity/mortality. This study was designed to evaluate the isotropic (mainly elastin, elastin(iso)) and anisotropic (mainly collagen, collagen(ani)) material parameters within the human aorta in vivo. Thirty healthy men and women in three different age categories (23-30, 41-54, and 67-72 yr) were included. A novel mechanical model was used to identify the mechanical properties and the strain field with aid of simultaneously recorded pressure and radius in the abdominal aorta. The magnitudes of the material parameters relating to both the stiffness of elastin(iso) and collagen(ani) were in agreement with earlier in vitro studies. The load-bearing fraction attributed to collagen(ani) oscillated from 10 to 30% between diastolic and systolic pressures during the cardiac cycle. With age, stiffness of elastin(iso) increased in men, despite the decrease in elastin content that has been found due to elastolysis. Furthermore, an increase in stiffness of collagen(ani) at high physiological pressure was found. This might be due to increased glycation, as well as changed isoforms of collagen in the aortic wall with age. A marked sex difference was observed, with a much less age-related effect, both on elastin(iso) and collagen(ani) stiffness in women. Possible factors of importance could be the effect of sex hormones, as well as differing collagen isoforms, between the sexes.

  10. [Ascending-to-abdominal Aorta Bypass under Percutaneous Cardiopulmonary Support for Lower Body Organ Malperfusion Secondary to Acute Type B Aortic Dissection; Report of a Case].

    PubMed

    Kemmochi, Reiko; Matsumoto, Mitsuaki; Kubo, Yoji; Oka, Takefumi; Yoshikawa, Masaki

    2016-05-01

    A 66-year-old man was admitted to our hospital because of uncomplicated Stanford B acute aortic dissection. Antihypertensive therapy was initially started; however, he suddenly experienced vomiting, diarrhea, anuria, and paraparesis on the fourteenth hospital day. Contrast-enhanced computed tomography (CECT) revealed expansion of the false lumen and severe stenosis of the true lumen at the distal aortic arch, which caused malperfusion syndrome of the lower body. Percutaneous cardiopulmonary support (PCPS) was immediately initiated to restore lower body organ perfusion, and an extra-anatomic ascending-to-abdominal aorta bypass was performed with a 16-mm Dacron graft. Postoperative CECT revealed expansion and good patency of both of the true lumen and the bypass graft. His symptoms improved except for the paraparesis; he was eventually able to ambulate using a crutch after postoperative rehabilitation. PMID:27220932

  11. An anomalous case of the hepato-spleno-mesenteric and the gastro-phrenic trunks independently arising from the abdominal aorta.

    PubMed

    Hirai, Y; Yamaki, K; Saga, T; Hirata, T; Yoshida, M; Soejima, H; Kanazawa, T; Araki, Y; Yoshizuka, M

    2000-01-01

    This report describes an arterial anomaly case in the celiaco-mesenteric region, which was encountered in a Japanese male cadaver in the dissecting room at Kurume University School of Medicine in 1999. In this case, the usual celiac trunk was not identified, and the hepato-spleno-mesenteric and the gastro-phrenic trunks were independently arising from the abdominal aorta. In addition, the common hepatic artery divided into the left hepatic, the right hepatic, and the gastroduodenal arteries simultaneously, then, the accessory gastric artery arose from the left hepatic artery. This type of arteral anomaly belongs to the Type III of Adachi's classification and the Type II of Morita's classification. PMID:10948660

  12. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  13. Exovascular application of epigallocatechin-3-O-gallate-releasing electrospun poly(L-lactide glycolic acid) fiber sheets to reduce intimal hyperplasia in injured abdominal aorta.

    PubMed

    Lee, Mi Hee; Kwon, Byeong-ju; Koo, Min-Ah; Jang, Eui Hwa; Seon, Gyeung Mi; Park, Jong-Chul

    2015-09-01

    Intimal hyperplasia is an excessive ingrowth of tissue resulting in chronic structural lesions commonly found at sites of atherosclerotic lesions, arterial angioplasty, vascular graft anastomoses, and other vascular abnormalities. Epigallocatechin-3-O-gallate (EGCG) was shown to elicit antioxidant, anti-proliferative, and anti-thrombogenic effects. In this study, we used an electrospinning technique to synthesize EGCG-eluting biodegradable poly(L-lactide glycolic acid) (PLGA) fiber sheets for local delivery of EGCG and investigated the effect of their exovascular application on intimal hyperplasia following balloon-induced abdominal aorta injury in a rabbit experimental model. The morphology of the composite sheets was characterized using scanning electron microscopy and Fourier transform-infrared spectroscopy. EGCG was loaded and dispersed into the PLGA-based electrospun fibers. The EGCG-loaded PLGA sheets exhibited sustained EGCG release following the initial 24 h of burst release in phosphate-buffered saline. In vivo studies demonstrated significant inhibition of intimal hyperplasia following the application of the EGCG-eluting electrospun PLGA fiber sheets, compared with vehicle PLGA controls. In conclusion, our results show that exovascular application of EGCG-eluting PLGA electrospun fiber sheets may provide a useful system for the effective local delivery of drugs for the prevention of intimal hyperplasia. PMID:26391656

  14. [Adventitial cyst of the aorta].

    PubMed

    Kitzis, M; Assens, P; Couffinhal, J C; Bourgeois, P; Weiss, A M; Remond, P; Andreassian, B

    1983-11-10

    The authors report a case of adventitial cyst of the abdominal aorta. This would seem to be the first time that a cyst has been reported in the literature with this localization. A 54 year old female patient was treated surgically for a suspected aneurysm of the abdominal aorta. Her antecedents included syphilis treated with bismuth. The condition began with a lumbago with no clearly defined etiology. An abdominal X-ray without preparation visualized a calcified abdominal tumor in a retroperitoneal position, apparently attached to the aorta. Arteriography showed that the tumor was excluded from the circulation. Surgical exploration of the aorta demonstrated a cystic tumor, which was resected. A review of the literature concerning the pathology of arterial cysts shows no previous cases of aortic cyst. On the other hand, references to identical anomalies of the iliac, femoral, popliteal and radial arteries provide grounds for discussion of the etiology of this aortic disease. The macroscopic data and histological studies suggest a phenomenon of cystic degeneration rather than a constitutional anomaly of the artery, or, in this particular case, an anomaly connected with syphilitic lesions.

  15. Lifetime, untreated isolated GH deficiency due to a GH-releasing hormone receptor mutation has beneficial consequences on bone status in older individuals, and does not influence their abdominal aorta calcification.

    PubMed

    Souza, Anita H O; Farias, Maria I T; Salvatori, Roberto; Silva, Gabriella M F; Santana, João A M; Pereira, Francisco A; de Paula, Francisco J A; Valença, Eugenia H O; Melo, Enaldo V; Barbosa, Rita A A; Pereira, Rossana M C; Gois-Junior, Miburge B; Aguiar-Oliveira, Manuel H

    2014-09-01

    The GH/IGF-I axis has essential roles in regulating bone and vascular status. The age-related decrease in GH secretion ("somatopause") may contribute to osteoporosis and atherosclerosis, commonly observed in the elderly. Adult-onset GH deficiency (GHD) has been reported to be associated with reduced bone mineral density (BMD), increased risk of fractures, and premature atherosclerosis. We have shown the young adult individuals with isolated GHD (IGHD) due to a homozygous for the c.57+1G>A GHRH receptor gene mutation have normal volumetric BMD (vBMD), and not develop premature atherosclerosis, despite adverse risk factor profile. However, the bone and vascular impact of lifetime GHD on the aging process remains unknown. We studied a group of ten older IGHD subjects (≥60 years) homozygous for the mutation, comparing them with 20 age- and gender-matched controls (CO). Areal BMD was measured, and vBMD was calculated at the lumbar spine and total hip. Vertebral fractures and abdominal aortic calcifications (expressed as calcium score) were also assessed. Areal BMD was lower in IGHD, but vBMD was similar in the two groups. The percent of fractured individuals was similar, but the mean number of fractures per individual was lower in IGHD than CO. Calcium score was similar in the two groups. A positive correlation was found between calcium score and number of fractures. Untreated lifetime IGHD has beneficial consequences on bone status and does not have a deleterious effect on abdominal aorta calcification. PMID:24272598

  16. [Acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult - 2014 AS SMC Guidelines on the classification and diagnosis of aortic diseases].

    PubMed

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít

    2015-01-01

    In addition to organovascular arterial ischemic diseases (cardiovascular, vasculovascular, neurovascular, extre-mitovascular, renovascular, genitovascular, bronchopulmovascular, mesenteriovascular, osteoarthromusculovascular, dermovascular, oculovascular, otovascular, stomatovascular etc.), aortic diseases contribute to the wide spectrum of arterial diseases: aortic aneurysms (AA), acute aortic syndromes (AAS) including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerosis, vasculitis as well as genetic diseases (e.g. Turner syndrome, Marfan syndrome, Ehlers-Danlos syndrome) and congenital abnormalities including the coarctation of the aorta (CoA). Similarly to other arterial diseases, aortic diseases may be diagnosed after a long period of subclinical development or they may have an acute presentation. Acute aortic syndrome is often the first sign of the disease, which needs rapid diagnosis and decisionmaking to reduce the extremely poor prognosis. Key clinical-etiology-anatomy-patophysiology (CEAP) diagnostic aspects of aortic diseases are discussed in this document (project Vessels).

  17. Multiple tuberculous aneurysms of the aorta.

    PubMed

    Pierret, Charles; Tourtier, Jean-Pierre; Grand, Bertrand; Boddaert, Guillaume; Laurian, Claude; de Kerangal, Xavier

    2011-06-01

    Tuberculous aneurysms of the aorta are quite rare, but are exceptional when found in multiple locations. We report the case of multiple tuberculous aortic aneurysms of the thoracic and abdominal aorta in a 19-year-old female discovered when she consulted for thrombocytopenic purpura. The treatment for both locations included prolonged antituberculous therapy and surgical resection with cryopreserved aortic allograft patch for the reconstruction.

  18. Comparison of Contrast-Enhanced Ultrasound and Computed Tomography in Classifying Endoleaks After Endovascular Treatment of Abdominal Aorta Aneurysms: Preliminary Experience

    SciTech Connect

    Carrafiello, Gianpaolo Lagana, Domenico; Recaldini, Chiara; Mangini, Monica; Bertolotti, Elena; Caronno, Roberto; Tozzi, Matteo; Piffaretti, Gabriele; Annibale Genovese, Eugenio; Fugazzola, Carlo

    2006-12-15

    The purpose of the study was to assess the effectiveness of contrast-enhanced ultrasonography (CEUS) in endoleak classification after endovascular treatment of an abdominal aortic aneurysm compared to computed tomography angiography (CTA). From May 2001 to April 2003, 10 patients with endoleaks already detected by CTA underwent CEUS with Sonovue (registered) to confirm the CTA classification or to reclassify the endoleak. In three conflicting cases, the patients were also studied with conventional angiography. CEUS confirmed the CTA classification in seven cases (type II endoleaks). Two CTA type III endoleaks were classified as type II using CEUS and one CTA type II endoleak was classified as type I by CEUS. Regarding the cases with discordant classification, conventional angiography confirmed the ultrasound classification. Additionally, CEUS documented the origin of type II endoleaks in all cases. After CEUS reclassification of endoleaks, a significant change in patient management occurred in three cases. CEUS allows a better attribution of the origin of the endoleak, as it shows the flow in real time. CEUS is more specific than CTA in endoleak classification and gives more accurate information in therapeutic planning.

  19. Leaking mycotic abdominal aortic aneurysm.

    PubMed

    Sing, T M; Young, N; O'Rourke, I C; Tomlinson, P

    1994-11-01

    A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes. PMID:7993259

  20. Hydatid cyst fistula into the aorta.

    PubMed

    Viver, E; Bianchi, L; Callejas, J M; Martorell, A

    1989-01-01

    A case is presented of fistula formation between a primary hydatid cyst and the abdominal aorta which we believe is the first in the world literature. The patient underwent surgery with a diagnosis of aneurysm of the coeliac trunk. During the operation the presence was discovered of a hydatid cyst opening into the aorta. It was dealt with by partial resection and closing of the communication. Three months later the patient was readmitted with a new bleeding episode which resulted in a fatal outcome.

  1. Robotic replacement of the descending aorta in human cadaver.

    PubMed

    Ishikawa, Norihiko; Sun, You Su; Nifong, L Wiley; Ohtake, Hiroshi; Watanabe, Go; Chitwood, W Randolph

    2006-09-01

    Robot-assisted replacement of the thoracic aorta was performed in a human cadaver. Temporary shunt bypass was established by inserting a left axillary artery catheter and directing it through the aortic arch toward the right femoral artery through the abdominal aorta. The technique utilized the da Vinci surgical system inserted through the 4-cm supramammary working port and two additional thoracoscopic ports. The working port allowed the introduction of an endoscope, endoscopic instruments, and artificial graft and suture materials. The aorta was dissected using the robotic instruments and was clamped with two transthoracic clamps. After transaction of the aorta, a 20-mm polytetrafluoroethylene graft was cut and an end-to-end anastomosis was then performed with running 3-0 Prolene sutures with robotic instruments. The robotic system provides superior optics and allows for enhanced dexterity. Minimally invasive robotic replacement of the descending aorta is an effective procedure and may add benefits for both surgeon and patients. PMID:16934102

  2. Cadaveric aorta implantation for aortic graft infection.

    PubMed

    Ali, Asad; Bahia, Sandeep S S; Ali, Tahir

    2016-01-01

    This case report describes a 73-year-old gentleman who underwent explantation of an infected prosthetic aorto-iliac graft and replacement with a cryopreserved thoracic and aorto-iliac allograft. The patient has been followed up a for more than a year after surgery and remains well. After elective tube graft repair of his abdominal aortic aneurysm (AAA) in 2003, he presented to our unit in 2012 in cardiac arrest as a result of a rupture of the distal graft suture line due to infection. After resuscitation he underwent aorto-bifemoral grafting using a cuff of the original aortic graft proximally. Distally the new graft was anastomosed to his common femoral arteries, with gentamicin beads left in situ. Post discharge the patient was kept under close surveillance with serial investigations including nuclear scanning, however it became apparent that his new graft was infected and that he would require aortic graft replacement, an operation with a mortality of at least 50%. The patient underwent the operation and findings confirmed a synthetic graft infection. This tube graft was explanted and a cryopreserved aorta was used to the refashion the abdominal aorta and its bifurcation. The operation required a return to theatre day one post operatively for a bleeding side branch, which was repaired. The patient went on to make a full recovery stepping down from the intensive therapy unit day 6 post operatively and went on to be discharged 32 days after his cryopreserved aorta implantation. PMID:27351624

  3. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  4. Abdominal tap

    MedlinePlus

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... abdominal cavity ( most often cancer of the ovaries ) Cirrhosis of the liver Damaged bowel Heart disease Infection ...

  5. Skeleton Graph Matching vs. Maximum Weight Cliques aorta registration techniques.

    PubMed

    Czajkowska, Joanna; Feinen, C; Grzegorzek, M; Raspe, M; Wickenhöfer, R

    2015-12-01

    Vascular diseases are one of the most challenging health problems in developed countries. Past as well as ongoing research activities often focus on efficient, robust and fast aorta segmentation, and registration techniques. According to this needs our study targets an abdominal aorta registration method. The investigated algorithms make it possible to efficiently segment and register abdominal aorta in pre- and post-operative Computed Tomography (CT) data. In more detail, a registration technique using the Path Similarity Skeleton Graph Matching (PSSGM), as well as Maximum Weight Cliques (MWCs) are employed to realise the matching based on Computed Tomography data. The presented approaches make it possible to match characteristic voxels belonging to the aorta from different Computed Tomography (CT) series. It is particularly useful in the assessment of the abdominal aortic aneurysm treatment by visualising the correspondence between the pre- and post-operative CT data. The registration results have been tested on the database of 18 contrast-enhanced CT series, where the cross-registration analysis has been performed producing 153 matching examples. All the registration results achieved with our system have been verified by an expert. The carried out analysis has highlighted the advantage of the MWCs technique over the PSSGM method. The verification phase proves the efficiency of the MWCs approach and encourages to further develop this methods.

  6. Mechanical properties of the aneurysmal aorta.

    PubMed

    MacSweeney, S T; Young, G; Greenhalgh, R M; Powell, J T

    1992-12-01

    The mechanical properties of the abdominal aorta were investigated non-invasively in 30 patients with aortic aneurysm and 11 with peripheral arterial disease. The distensibility of the aorta was measured using M-mode ultrasonography, permitting non-invasive assessment of the pressure--strain elastic modulus or aortic stiffness, Ep. The median Ep value increased from 4.0 N/cm2 in control subjects in their third decade of life (n = 10) to 10.4 N/cm2 in middle age (n = 11) to 14.0 N/cm2 in the elderly (n = 13). In the presence of a normal diameter, peripheral arterial disease with aortic atherosclerosis had little effect on aortic stiffness, median Ep being 16.0 N/cm2. Aneurysmal dilatation was associated with a significant increase in aortic stiffness, median Ep being 31.3 N/cm2 (P < 0.001). For aortas of normal diameter, Ep was at all ages dependent on mean arterial pressure. In patients with aortic aneurysms there was no clear relationship between Ep and mean arterial pressure or aortic diameter. Of the patients studied, 15 underwent aortic reconstruction; increasing aortic stiffness (log Ep) was associated with a decreased medial elastin content of the aortic biopsy (r = -0.63, P < 0.02). This study demonstrates the marked stiffness or inelasticity of dilated or aneurysmal vessels, part of which is attributable to the loss of elastin.

  7. Biomechanical and morphometric properties of the arterial wall referenced to the zero-stress state in experimental diabetes.

    PubMed

    Zhao, J; Lu, X; Zhuang, F; Gregersen, H

    2000-01-01

    Morphometric and passive biomechanical properties were studied in isolated segments of the thoracic and abdominal aorta, left common carotid artery, left femoral artery and the left pulmonary artery in 20 non-diabetic and 28 streptozotocin (STZ)-induced diabetic rats. The diabetic and non-diabetic rats were divided into groups living 1, 4, 8, and 12 weeks after the induction of diabetes (n = 7 for each diabetic group) or sham injection (n = 5 for each group). The mechanical test was performed as a distension experiment where the proximal end of the arterial segment was connected via a tube to the container used for applying pressures to the segment and the distal end was left free. The vessel diameter and length were obtained from digitized images of the arterial segments at pre-selected pressures and at no-load and zero-stress states. Circumferential and longitudinal stresses (force per area) and strains (deformation) were computed from the length, diameter and pressure data and from the zero-stress state data. The zero-stress state was obtained by cutting vessel rings radially causing the rings to open up into a sector. Diabetes was associated with pronounced morphometric changes, e.g., wall thickness. With respect to the biomechanical data, the opening angle increased and reached a plateau in 4 weeks after which it decreased again (p < 0.05). The opening angle was smallest in the thoracic aorta and largest in the pulmonary artery. Furthermore, it was found that the circumferential stiffness of the arteries studied increased with the duration of diabetes. In the longitudinal direction significant differences were found 8 weeks after injection of STZ in all arteries except the pulmonary artery. In the 12 weeks group, the femoral artery was stiffest in the circumferential direction whereas the thoracic aorta was stiffest in the longitudinal direction. The accumulated serum glucose level correlated with the arterial wall thickness and elastic modulus (correlation

  8. Tenascin C protects aorta from acute dissection in mice

    NASA Astrophysics Data System (ADS)

    Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

    2014-02-01

    Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGFβ signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

  9. Cannulation in the Diseased Aorta

    PubMed Central

    Khoynezhad, Ali; Plestis, Konstadinos A.

    2006-01-01

    The Seldinger technique is a method of femoral cannulation that has been used to establish cardiopulmonary bypass. Reports of cannulation of the ascending aorta for antegrade perfusion using the Seldinger method are anecdotal. To the best of our knowledge, the approach described herein for direct cannulation of the ascending aorta with use of the Seldinger technique for antegrade perfusion has not been previously described in the English-language medical literature. This method is helpful when the surgeon is treating a patient who has a calcified ascending aorta, complicated aortic dissection, calcified femoral vessels, or a diseased thoracoabdominal aorta. In such cases, retrograde perfusion has been associated with severe complications as a result of atheromatous embolization from the descending thoracic aorta. Herein, we describe our approach to cannulation for cardiopulmonary bypass, which entails insertion of an aortic cannula into the ascending aorta by means of the Seldinger technique. A soft-tip guidewire is inserted through an arterial entry catheter that has been used to puncture a hole in the wall of the vessel. Then the aortic cannula is introduced into the vessel, sliding along the guidewire. Guided by transesophageal echocardiography, the tip of the cannula is positioned carefully and is then advanced into the descending aorta. This positioning of the cannula decreases the chance of arterial embolization, thereby improving cerebral protection. If cannulation of the ascending aorta is not feasible, the transverse aortic arch or proximal descending aorta can be used. PMID:17041694

  10. [Coarctation of the aorta].

    PubMed

    Sekiguchi, Akihiko

    2004-07-01

    The surgical outcome of neonatal and infantile coarctation of the aorta has been improved dramatically in recent years. Not only the improvement of perioperative management based on the better understanding of the pathophysiology but the improvement of the surgical procedure made the successful outcome. There are still, however, several controversial aspects of surgical management: How to select surgical technique? How to fix the distal or transverse aortic arch hypoplasia? How to approach the intracardiac defect? How to protect spinal cord? Postoperative recoarctation in adult age will be mostly concerned in recent years. Surgeons have to aware all these short- and long-term problems when fixing this particular cardiac lesion. Now I want to discuss this not-unusual and relatively complex heart disease in this article.

  11. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues.

    PubMed

    Victorio, Jamaira A; Fontes, Milene T; Rossoni, Luciana V; Davel, Ana P

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  12. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues

    PubMed Central

    Victorio, Jamaira A.; Fontes, Milene T.; Rossoni, Luciana V.; Davel, Ana P.

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  13. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    PubMed

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  14. Monocytes, Macrophages and Other Inflammatory Mediators of Abdominal Aortic Aneurysm.

    PubMed

    Potteaux, Stephane; Tedgui, Alain

    2015-01-01

    Macrophages early invade the forming abdominal aortic aneurysm (AAA) and greatly contribute to its pathogenesis. Recent findings have shown that Ly-6C(high) and Ly-6C(low) monocytes are rapidly mobilized from the splenic reservoir in response to angiotensin II infusion and sequentially infiltrate the abdominal aorta. The first wave of Ly-6C(high) monocytes prevails in the aorta and promotes the accumulation of inflammatory macrophages, which most likely cause irreversible changes in the abdominal aorta. In this review, we discuss the current knowledge on the cellular mechanisms that initiate AAA in mice. We particularly focus on the role of monocyte and macrophage subsets during the early steps of the aneurysmal process. PMID:26306839

  15. [Retroperitoneal lymphocele: a rarely reported complication of abdominal aortic surgery. Apropos of a case].

    PubMed

    Paule, A M; Le Dreff, P; Nonent, M; Braesco, J; Le Guyader, J; Bellet, M

    1994-01-01

    The authors present a case of a retroperitoneal lymphocele following prosthetic reconstruction of the abdominal aorta followed by a discussion about the principal differential diagnosis of a retroperitoneal collection following surgery on abdominal aorta. To date, only ten cases have been reported in this post-operative; it is probably a more frequent complication; the radiologist must play a major role both in the detection and the treatment of such collections.

  16. Abdominal aortic rupture from an impaling osteophyte following blunt trauma.

    PubMed

    Vernon, Seth A; Murphy, William R C; Murphy, Todd W; Haan, James M

    2014-04-01

    Blunt injury of the abdominal aorta is highly fatal. We present an unusual case of an osteophyte impaling the abdominal aorta treated by endovascular repair. A 77-year-old man sustained a thoracolumbar fracture-dislocation with posterior aortic rupture between his celiac and superior mesenteric artery origins. His aortic injury was treated with a stent graft, excluding the celiac origin. He was dismissed on postoperative day 6. At 6 months, he had returned to most preinjury activities, and at 2-year follow-up, he continues to have good functional outcome. Endovascular repair may be successfully employed in select aortic injuries in hemodynamically stable patients.

  17. Coarctation of the Aorta (For Teens)

    MedlinePlus

    ... cases, doctors might do a procedure known as balloon dilation (also called balloon angioplasty ). For this procedure, a cardiologist inserts a ... the aorta. This specialized catheter has a deflated balloon inside. When the catheter is in the aorta, ...

  18. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  19. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  20. Quantification of abdominal aortic deformation after EVAR

    NASA Astrophysics Data System (ADS)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  1. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  2. Clear Depiction of Inflammatory Abdominal Aortic Aneurysm with Diffusion-Weighted Magnetic Resonance Imaging

    SciTech Connect

    Orta Kilickesmez, Kadriye; Kilickesmez, Ozgur

    2010-04-15

    We report the case of an inflammatory abdominal aortic aneurysm incidentally detected clearly with diffusion-weighted magnetic resonance imaging (DW-MRI) during the examination of a patient with myelofibrosis with myeloid metaplasia that later converted to acute myeloid leukemia. DW-MRI revealed a hyperintense halo surrounding the abdominal aorta with aneurysmatic dilatation, establishing the diagnosis.

  3. Abdominal coarctation in a hypertensive female collegiate basketball player.

    PubMed

    Sloan, B; Simons, S; Stromwall, A

    2004-10-01

    The purpose of the preparticipation examination is to identify health conditions that might adversely affect an athlete while participating in sport. Hypertension is the most common. This case report details a female basketball player found to be hypertensive, and complaining of fatigue, at her preparticipation physical examination. Presentation, diagnostics, treatment, and final outcome of coarctation involving the abdominal aorta are summarised.

  4. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  5. [Reducing the need in donor blood in reconstructive surgery of the aorta: using a Cell Saver apparatus].

    PubMed

    Mierbekov, E M; Ilialetdinov, I D

    2004-01-01

    The possibility of using a Cell Saver "Sequestra 1000" apparatus (Medtronics) for reducing the need for donor blood in reconstructive surgery for aortic aneurism was evaluated within the case study. Thirty-seven patients, who were made different reconstructive procedures on the ascending and abdominal aorta, were examined. Twelve patients with aneurism in the ascending aorta section (AAS) and with insufficiency of the aortal valve were made prosthesis of AAS and aortal valve under extracorporeal circulation (AEC). Twenty-five patients, who were operated on the abdominal aorta section, were resected aneurysm with linear prosthesis (9), aorto-hip bifurcational alloprosthesis (15) and branching of arterio-venous fistula (1). Five patients with aneurysm in the abdominal aorta, including 3 cases of aneurysm rupture, were operated on the emergency basis. The use of a Sequestra 1000 (Medtronics) apparatus based on the Cell Saver technology aorta reconstructions cut essentially the need in donor packed red blood cells at the intraoperative (3.6 times) and postoperative (2.8 times) stages. PMID:15573718

  6. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  7. Abdominal Aortic Disease Caused by Penetrating Atherosclerotic Ulcers

    PubMed Central

    Sato, Masataka; Imai, Akito; Sakamoto, Hiroaki; Sasaki, Akinobu; Watanabe, Yasunori; Jikuya,, Tomoaki

    2012-01-01

    Objective: Penetrating atherosclerotic ulcer (PAU) of the aorta is defined as an atherosclerotic lesion with ulceration of the aortic intima and media and rupture of the internal elastic lamina. PAU induced aortic dissection, aortic rupture, and secular aortic aneurysm and typically occurs in elderly hypertensive patients with severe atherosclerosis. Although it has been reported that atherosclerosis similarly occurs in the abdominal aorta, its natural history and treatment are still unclear. This study investigated the clinical features, natural history, and treatment of PAU of the abdominal aorta. Method:Between April 2006 and March 2009, 4 diagnoses of PAU in the abdominal aorta were made by computed tomography (CT) and magnetic resonance imaging (MRI). These 4 cases were analyzed along with 61 previously reported cases from the literature with diagnoses of PAU in the abdominal aorta, aortic rupture, and isolated abdominal aortic dissection over the past 15 years, giving a total of 65 cases. Results:The patients were men with an average age of 63.5 years. All 4 had hypertension, and 2 had concomitant coronary artery disease. Two patients were asymptomatic, and the other 2 were symptomatic and transmural rupture had occurred. All diagnoses were made by CT and MRI. All 4 patients underwent open surgery with a knitted Dacron graft, with no postoperative deaths. In the literature, 53% of cases were symptomatic, including pain (40%, n = 26), shock (4.6%, n = 3), and lower limb embolism (9.2%, n = 6). The remaining 40% of cases were asymptomatic (n = 26). Six patients were treated medically, while 58 patients underwent surgery, with 2 postoperative deaths. Conclusion:We suggest that surgical treatment (open surgery or endovascular stent grafting) should be performed to prevent an aortic catastrophe such as intramural hematoma, dissection, or rupture. (English translation of Jpn J Vasc Surg 2010; 19: 723-730.) PMID:23555480

  8. Monte Carlo simulation of aorta autofluorescence

    NASA Astrophysics Data System (ADS)

    Kuznetsova, A. A.; Pushkareva, A. E.

    2016-08-01

    Results of numerical simulation of autofluorescence of the aorta by the method of Monte Carlo are reported. Two states of the aorta, normal and with atherosclerotic lesions, are studied. A model of the studied tissue is developed on the basis of information about optical, morphological, and physico-chemical properties. It is shown that the data obtained by numerical Monte Carlo simulation are in good agreement with experimental results indicating adequacy of the developed model of the aorta autofluorescence.

  9. Genetic and Environmental Effects on the Abdominal Aortic Diameter Development

    PubMed Central

    Tarnoki, Adam Domonkos; Tarnoki, David Laszlo; Littvay, Levente; Garami, Zsolt; Karlinger, Kinga; Berczi, Viktor

    2016-01-01

    Background Configuration of the abdominal aorta is related to healthy aging and a variety of disorders. Objectives We aimed to assess heritable and environmental effects on the abdominal aortic diameter. Methods 114 adult (69 monozygotic, 45 same-sex dizygotic) twin pairs (mean age 43.6 ± 16.3 years) underwent abdominal ultrasound with Esaote MyLab 70X ultrasound machine to visualize the abdominal aorta below the level of the origin of the renal arteries and 1-3 cm above the bifurcation. Results Age- and sex-adjusted heritability of the abdominal aortic diameter below the level of the origin of the renal arteries was 40% [95% confidence interval (CI), 14 to 67%] and 55% above the aortic bifurcation (95% CI, 45 to 70%). None of the aortic diameters showed common environmental effects, but unshared environmental effects were responsible for 60% and 45% of the traits, respectively. Conclusions Our analysis documents the moderate heritability and its segment-specific difference of the abdominal aortic diameter. The moderate part of variance was explained by unshared environmental components, emphasizing the importance of lifestyle factors in primary prevention. Further studies in this field may guide future gene-mapping efforts and investigate specific lifestyle factors to prevent abdominal aortic dilatation and its complications. PMID:26559855

  10. Aorta-right atrial tunnel.

    PubMed

    Sai Krishna, Cheemalapati; Baruah, Dibya Kumar; Reddy, Gangireddy Venkateswara; Panigrahi, Nanda Kishore; Suman, Kalagara; Kumar, Palli Venkata Naresh

    2010-01-01

    Aorta-right atrial tunnel is a vascular channel that originates from one of the sinuses of Valsalva and terminates in either the superior vena cava or the right atrium. The tunnel is classified as anterior or posterior, depending upon its course in relation to the ascending aorta. An origin above the sinotubular ridge differentiates the tunnel from an aneurysm of the sinus of Valsalva, and the absence of myocardial branches differentiates it from a coronary-cameral fistula. Clinical presentation ranges from an asymptomatic precordial murmur to congestive heart failure. The embryologic background and pathogenesis of this lesion are attributable either to an aneurysmal dilation of the sinus nodal artery or to a congenital weakness of the aortic media. In either circumstance, progressive enlargement of the tunnel and ultimate rupture into the low-pressure right atrium could occur under the influence of the systemic pressure.The lesion is diagnosed by use of 2-dimensional echocardiography and cardiac catheterization. Computed tomographic angiography is an additional noninvasive diagnostic tool. The possibility of complications necessitates early therapy, even in asymptomatic patients or those with a hemodynamically insignificant shunt. Available treatments are catheter-based intervention, external ligation under controlled hypotension, or surgical closure with the patient under cardiopulmonary bypass.Herein, we discuss the cases of 2 patients who had this unusual anomaly. We highlight the outcome on follow-up imaging (patient 1) and the identification and safe reimplantation of the coronary artery (patient 2).

  11. Facts about Coarctation of the Aorta

    MedlinePlus

    ... and Tools Links to Other Websites Information For... Media Policy Makers ... the aorta is a birth defect in which a part of the aorta, the tube that carries oxygen-rich blood to the body, is narrower than usual. What is Coarctation of ...

  12. Treatment options for primary infected aorta.

    PubMed

    Taylor, Claire Fraser; Lennox, Andrew Ferris

    2007-03-01

    A 71-year-old man, with a history of anterior-perineal bowel resection for previous malignancy, presented with a septic picture and back pain. Investigations revealed a primary infected aorta. At laparotomy an ileocolic tumor was also discovered and resected. Blood cultures prior to the operation were positive for Escherichia coli, and Enterococcus faecium was cultured from the actual aorta. PMID:17349369

  13. [Practical method for morphometric reliefs].

    PubMed

    Loffredo Sampaolo, C; Sampaolo, G; Gagliardi, P E; Alfano, A

    1981-07-30

    This morphometric method consists in: - to photograph, during culture's period, with constant magnification, the organ rudiment explanted in vitro; - to place on the single images, in printing, a transparent squared reticle with size unit known; - to compute the size values of the considered image counting the number of reticle's squares comprised in the image. PMID:7295411

  14. [Abdominal multi-organ transplantation in dogs].

    PubMed

    Kumagae, T

    1988-07-01

    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  15. Thoracic aortic cannulation with antegrade perfusion for the procurement of abdominal organs.

    PubMed

    González Rodríguez, Francisco Javier; Fernández Pérez, Aquilino; Conde Freire, Rogelio; Martínez, Jorge; Pérez, Evaristo Varo; Bustamante Montalvo, Manuel

    2015-01-01

    The definitive acceptance of an organ as valid for transplant depends on the surgical team performing the multiorgan recovery; and unexpected difficulties can occur. The demographic characteristics of donors has changed, and some accepted donors can present difficulties in surgical technique and risky decisions on the validity of the retrieved organ or organs. An alternative method to the cannulation of the abdominal aorta is proposed when there is evidence of disease in the infrarenal aorta during the multiorgan procurement. The retrocardiac descending thoracic aorta is cannulated using an antegrade perfusion; this technique allows an increase in organ recovery.

  16. Influence of sympathetic stimulation on the mechanical properties of the aorta in humans.

    PubMed

    Sonesson, B; Vernersson, E; Hansen, F; Länne, T

    1997-02-01

    The mechanical properties of the aorta play a major role in the regulation of blood pressure and cardiac performance. The effect of sympathetic stimulation on the mechanical properties of the human abdominal aorta was studied in 19 healthy volunteers, divided into young (25 +/- 2 years) and elderly individuals (69 +/- 2 years) of both sexes. A non-invasive ultrasonic echo-tracking system for measurement of systolic/diastolic variation of aortic diameter in combination with intra-aortic pressure measurements was used to determine wall mechanics. The pressure-diameter (P-D) relationship and the distensibility indices, stiffness (beta) and pressure strain elastic modulus (Ep) of the abdominal aorta were obtained. Measurements were made at rest and during sympathetic stimulation induced by lower body negative pressure (LBNP). As a sign of sympathetic activation, the peripheral resistance increased by 74-96% (P < 0.001) during LBNP. However, the mechanical properties of the abdominal aorta remained unaltered, as estimated either from the P-D relationship or from the indices Ep and beta, both in the young (rest: Ep = 0.53 +/- 0.18, beta = 4.5 +/- 1.5; LBNP: Ep = 0.51 +/- 0.15, beta = 4.5 +/- 1.2, NS) and in the elderly (rest: Ep = 2.17 +/- 0.70, beta = 17.6 +/- 5.8; LBNP: Ep = 2.11 +/- 0.60, beta = 16.9 +/- 3.9, NS). In conclusion, this investigation shows that LBNP-induced sympathetic activation does not change aortic wall mechanics. Thus, sympathetic modulation of the aortic smooth muscle contractile activity seems to be unimportant in the blood pressure regulation.

  17. Morphometrics applied to medical entomology.

    PubMed

    Dujardin, Jean-Pierre

    2008-12-01

    Morphometrics underwent a revolution more than one decade ago. In the modern morphometrics, the estimate of size is now contained in a single variable reflecting variation in many directions, as many as there are landmarks under study, and shape is defined as their relative positions after correcting for size, position and orientation. With these informative data, and the corresponding software freely available to conduct complex analyses, significant biological and epidemiological features can be quantified more accurately. We discuss the evolutionary significance of the environmental impact on metric variability, mentioning the importance of concepts like genetic assimilation, genetic accommodation, and epigenetics. We provide examples of measuring the effect of selection on metric variation by comparing (unpublished) Qst values with corresponding (published) Fst. The primary needs of medical entomologists are to distinguish species, especially cryptic species, and to detect them where they are not expected. We explain how geometric morphometrics could apply to these questions, and where there are deficiencies preventing the approach from being utilized at its maximum potential. Medical entomologists in connection with control programs aim to identify isolated populations where the risk of reinfestation after treatment would be low ("biogeographical islands"). Identifying them can be obtained from estimating the number of migrants per generation. Direct assessment of movement remains the most valid approach, but it scores active movement only. Genetic methods estimating gene flow levels among interbreeding populations are commonly used, but gene flow does not necessarily mean the current flow of migrants. Methods using the morphometric variation are neither suited to evaluate gene flow, nor are they adapted to estimate the flow of migrants. They may provide, however, the information needed to create a preliminary map pointing to relevant areas where one could

  18. A novel approach for hybrid repair of type B aortic dissection associated with coarctation of the aorta.

    PubMed

    Li, Yu; Fan, Zhanming; Huang, Lianjun; Xue, Yuguo; Sun, Lizhong

    2014-05-01

    We report the case of an acute type B aortic dissection in association with an unknown isthmic coarctation in a 53-year-old man. An intimal tear was located just distal to the coarctation, and the intimal flap extended to the level of the renal arteries. Hybrid repair was performed successfully 4 months later, without deep hypothermic circulatory arrest. An extra-anatomic bypass connected the ascending aorta to the abdominal aorta. The coarctation was occluded using a ventricular septal defect occluder. The hybrid repair was safe and effective for the patient.

  19. Hemodynamic Influences on Abdominal Aortic Aneurysm Disease: Application of Biomechanics to Aneurysm Pathophysiology

    PubMed Central

    Dua, Monica M.; Dalman, Ronald L.

    2010-01-01

    “Atherosclerotic” abdominal aortic aneurysms (AAAs) occur with the greatest frequency in the distal aorta. The unique hemodynamic environment of this area predisposes it to site-specific degenerative changes. In this review, we summarize the differential hemodynamic influences present along the length of the abdominal aorta, and demonstrate how alterations in aortic flow and wall shear stress modify AAA progression in experimental models. Improved understanding of aortic hemodynamic risk profiles provides an opportunity to modify patient activity patterns to minimize risk of aneurysmal degeneration. PMID:20347049

  20. Human Aorta Is a Passive Pump

    NASA Astrophysics Data System (ADS)

    Pahlevan, Niema; Gharib, Morteza

    2012-11-01

    Impedance pump is a simple valveless pumping mechanism that operates based on the principles of wave propagation and reflection. It has been shown in a zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. Our aim in this study was to examine if the human aorta is a passive pump working like an impedance pump. A hydraulic model with different compliant models of artificial aorta was used for series of in-vitro experiments. The hydraulic model includes a piston pump that generates the waves. Our result indicates that wave propagation and reflection can create pumping mechanism in a compliant aorta. Similar to an impedance pump, the net flow and the flow direction depends on the frequency of the waves, compliance of the aorta, and the piston stroke.

  1. Measurement error in geometric morphometrics.

    PubMed

    Fruciano, Carmelo

    2016-06-01

    Geometric morphometrics-a set of methods for the statistical analysis of shape once saluted as a revolutionary advancement in the analysis of morphology -is now mature and routinely used in ecology and evolution. However, a factor often disregarded in empirical studies is the presence and the extent of measurement error. This is potentially a very serious issue because random measurement error can inflate the amount of variance and, since many statistical analyses are based on the amount of "explained" relative to "residual" variance, can result in loss of statistical power. On the other hand, systematic bias can affect statistical analyses by biasing the results (i.e. variation due to bias is incorporated in the analysis and treated as biologically-meaningful variation). Here, I briefly review common sources of error in geometric morphometrics. I then review the most commonly used methods to measure and account for both random and non-random measurement error, providing a worked example using a real dataset.

  2. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    NASA Astrophysics Data System (ADS)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  3. [Anomalies of the subrenal inferior vena cava in the surgery of non-specific and inflammatory abdominal aortic aneurysms].

    PubMed

    Gargiulo, M; Stella, A; Caputo, M; Brusori, S; Pedrini, L; Tarantini, S; Curti, T

    1993-01-01

    The sub-renal abnormalities of the lower vena cava (LVC) (left LVC, double LVC) are determined by a deterioration of the alteration process of supra-cardinal veins. Though they are rare, it is necessary to look for them during surgery of abdominal aorta in order to lower the risk of iatrogenic venous injuries. You will find below the description of six cases of sub-renal lower vena cava abnormality (3 double LVC, 3 left LVC) associated with an abdominal aorta aneurism (4 non specific aneurisms, 2 inflammations ones) as well as the diagnostic aspects and the technical issues they cause during the reconstruction of a non specific and inflammation aneurism of the abdominal aorta. PMID:8248315

  4. Estimation of prenatal aorta intima-media thickness in ultrasound examination

    NASA Astrophysics Data System (ADS)

    Veronese, Elisa; Poletti, Enea; Cosmi, Erich; Grisan, Enrico

    2012-03-01

    Prenatal events such as intrauterine growth restriction have been shown to be associated with an increased thickness of abdominal aorta in the fetus. Therefore the measurement of abdominal aortic intima-media thickness (aIMT) has been recently considered a sensitive marker of artherosclerosis risk. To date measure of aortic diameter and of aIMT has been performed manually on US fetal images, thus being susceptible to intra- and inter- operator variability. This work introduces an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from videos recorded during routine third trimester ultrasonographic fetal biometry. Firstly, in each frame, the algorithm locates and segments the region corresponding to aorta by means of an active contour driven by two different external forces: a static vector field convolution force and a dynamic pressure force. Then, in each frame, the mean diameter of the vessel is computed, to reconstruct the cardiac cycle: in fact, we expect the diameter to have a sinusoidal trend, according to the heart rate. From the obtained sinusoid, we identify the frames corresponding to the end diastole and to the end systole. Finally, in these frames we assess the aIMT. According to its definition, we consider as aIMT the distance between the leading edge of the blood-intima interface, and the leading edge of the media-adventitia interface on the far wall of the vessel. The correlation between end-diastole and end-systole aIMT automatic and manual measures is 0.90 and 0.84 respectively.

  5. [Surgical management of a dissecting aneurysm of the thoracic aorta in a patient with Marfan's syndrome - case report].

    PubMed

    Dinis Da Gama, A; Marcelino, João Luís; Damião, Angélica; Evangelista, Ana; Ministro, Augusto

    2011-01-01

    Marfan's Syndrome is a rare connective tissue disease whose surgical treatment presents several challenges. The existing criteria and recommendations on how and when to surgically approach this disease is almost exclusively confined to the root and ascending aorta, in contrast to the variability of indications on the involvement of the remaining segments of the thoracic and abdominal aorta, due to the multiplicity, morphology and topography of these involvements. This case report is related to a 39 year old woman with Marfan's syndrome, with a type B chronic dissection and a segmentar aneurysm of the proximal descending thoracic aorta with 6,1cm of maximum diameter. The clinical and imagiologic evaluation pointed out the absence of any disorder of the heart, root or ascending aorta. The patient underwent surgical management of the dissecting aneurysm through a transthoracic approach to the aneurysm, with fenestration of the distal aorta and exclusion of the aneurism and intercostal arteries. The efficacy and result of the procedure in addition to the rarity of the vascular pathology presented by the patient, even in the context of a Marfan, completely justify the presentation and disclosure of this clinical case. PMID:23560272

  6. Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review.

    PubMed

    Georgiadis, George S; Antoniou, George A; Georgakarakos, Efstratios I; Nikolopoulos, Evagelos S; Papanas, Nikolaos; Trellopoulos, George; Iatrou, Christos; Papadopoulou, Maria Z; Lazarides, Miltos K

    2013-10-01

    Little is known regarding the outcomes of endovascular and surgical treatment of penetrating ulcers in the abdominal aorta. The potential benefit of conservative management of asymptomatic disease is also debatable. A systematic review of the literature was undertaken to investigate these issues. PMID:23932417

  7. Aorta Atherosclerosis Lesion Analysis in Hyperlipidemic Mice

    PubMed Central

    Mohanta, Sarajo; Yin, Changjun; Weber, Christian; Hu, Desheng; Habenicht, Andreas JR

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease of large and medium-sized arteries. Apolipoprotein E-deficient (ApoE-/-) mice are used as experimental models to study human atherosclerosis. ApoE-/- mice are constitutively hyperlipidemic and develop intima plaques that resemble human plaques. Various issues including experimental design for lesion analysis, dietary conditions, isolation of the aorta, staining methods, morphometry, group size, age, the location within the arterial tree, and statistical analyses are important parameters that need to be addressed to obtain robust data. Here, we provide detailed methods to quantify aorta atherosclerosis. PMID:27366759

  8. Surgery for congenital diseases of the aorta.

    PubMed

    Cameron, Duke

    2015-02-01

    Congenital diseases of the aorta tend to be obstructive when they present early in life, and aneurysmal when they present later in life. The latter group also tends to be associated with connective tissue disorders and with repaired conotruncal lesions. The indications for intervention in the aneurysm group are still in evolution but are clearly age- and lesion-dependant. Disorders such as Loeys-Dietz syndrome and Turner syndrome may deserve aggressive prophylactic surgery, as well as Marfan syndrome to a lesser extent. The natural history of the dilated aorta after repair of congenital heart lesions is probably more benign than de novo aneurysms and therefore should be treated conservatively.

  9. Surgery for congenital diseases of the aorta.

    PubMed

    Cameron, Duke

    2015-02-01

    Congenital diseases of the aorta tend to be obstructive when they present early in life, and aneurysmal when they present later in life. The latter group also tends to be associated with connective tissue disorders and with repaired conotruncal lesions. The indications for intervention in the aneurysm group are still in evolution but are clearly age- and lesion-dependant. Disorders such as Loeys-Dietz syndrome and Turner syndrome may deserve aggressive prophylactic surgery, as well as Marfan syndrome to a lesser extent. The natural history of the dilated aorta after repair of congenital heart lesions is probably more benign than de novo aneurysms and therefore should be treated conservatively. PMID:25726075

  10. Arterial blood pressure regulation following aorta clamping and declamping during surgery.

    PubMed

    Ferrario, Manuela; Aletti, Federico; Toschi, Nicola; Canichella, Antonio; Coniglione, Filadelfo; Sabato, Elisabetta; Della Badia Giussi, Florencia; Dauri, Mario; Sabato, Alessandro F; Guerrisi, Maria; Cerutti, Sergio

    2011-01-01

    In this paper, we propose the use of black box models for the system identification of the cardiopulmonary baroreflex control of arterial resistance and of ventricular contractility and of arterial baroreflex control of heart rate (HR) from invasive, continuous measurements of arterial blood pressure (ABP) and central venous pressure (CVP), and non invasive, continuous recordings of ECG and respiration. Two crucial phases of the abdominal aortic aneurism (AAA) repair were investigated: the clamping and declamping of aorta. The objective of the present work is to evaluate and to test the ability to monitor baroreflex responses to clamping and declamping maneuvers preceding and following aneurism removal. PMID:22256303

  11. Functional chiral asymmetry in descending thoracic aorta.

    PubMed

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

    1990-12-01

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

  12. Retrograde replacement of the thoracic aorta.

    PubMed Central

    Cooley, D A

    1995-01-01

    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. PMID:7647599

  13. Modeling Blood Flow in the Aorta.

    ERIC Educational Resources Information Center

    McConnell, Colin J.; Carmichael, Jonathan B.; DeMont, M. Edwin

    1997-01-01

    Presents an exercise to demonstrate two fundamental concepts of fluid mechanics: the Reynolds number and the Principle of Continuity. The exercise demonstrates flow in a major blood vessel, such as the aorta, with and without a stenosis. Students observe the transition from laminar to turbulent flow as well as downstream persistence of turbulence.…

  14. Use of resuscitative endovascular balloon occlusion of the aorta in a patient with gastrointestinal bleeding

    PubMed Central

    Lee, Jungyoup; Kim, Kyuseok; Jo, You Hwan; Lee, Jae Hyuk; Kim, Joonghee; Chung, Heajin; Hwang, Ji Eun

    2016-01-01

    Resuscitative endovascular balloon occlusion of the aorta (REBOA) was developed for controlling intra-abdominal arterial bleeding before definitive bleeding control, and is commonly used in patients with ruptured abdominal aortic aneurysms. Although there is limited evidence for other uses of REBOA, we used REBOA in a patient with massive gastrointestinal bleeding. A 53-year-old man with hematochezia was admitted to our emergency department with an initial systolic blood pressure (SBP) of 83 mmHg. His SBP decreased to 40 mmHg in 10 minutes despite rapid fluid infusion. We decided to resuscitate the patient with REBOA in the emergency department and then move him to an intervention room after stabilization. After aortic occlusion, SBP abruptly increased from 57 to 108 mmHg, and the patient could be transferred to an intervention room. The patient was admitted to intensive care, but died of massive rebleeding 24 hours after admission to the emergency department. PMID:27752617

  15. Abdominal cerebrospinal fluid pseudocysts.

    PubMed

    Erşahin, Y; Mutluer, S; Tekeli, G

    1996-12-01

    Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.

  16. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  17. [Abdominal aortic aneurysm: an uncommon presentation].

    PubMed

    Taborda, Lúcia; Pereira, Laurinda; Amona, Eurides; Pinto, Erique Guedes; Rodrigues, Joaquim

    2011-01-01

    Most abdominal aortic aneurysms are asymptomatic, being accidentally found on physical examination or in routinely performed imaging studies. They only require surveillance (which is variable according to the aneurism size) and medical therapy in order to achieve risk factor reduction. However, in certain situations, according to the risk of aneurism rupture, elective surgery or endovascular procedure may be necessary. About 80% of the cases of aneurism rupture occur into the retroperitoneal space, with a high mortality rate. There are uncommon presentations of aneurism rupture as the aorto-caval fistula, which also require fast diagnosis and intervention. The authors present the case of a 71-year-old man, with the previous diagnosis of hypertension, acute myocardial infarction 2 months earlier (undergone primary Percutaneous Coronary Intervention) and tabagism, who was admitted at the emergency department with intense 24-hour-evolution epigastric pain. On physical examination, the Blood Pressure values measured at the lower limbs were about half the ones measured at the upper limbs and there was an abdominal pulsatile mass, with a high-intensity murmur. As the authors suspected aortic dissection, aneurysm, coarctation or thrombosis, it was done a Computed Tomography scanning with intravenous contrast, which revealed a ruptured abdominal aorta aneurysm with a mural thrombus. The doppler ultrasound confirmed the presence of a high debit aorto-caval fistula. The patient was immediately transferred to the Vascular Surgery. However he died 2 hours later, during surgery. PMID:22525642

  18. Endovascular management of lap belt-related abdominal aortic injury in a 9-year-old child.

    PubMed

    Papazoglou, Konstantinos O; Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T

    2015-02-01

    Blunt abdominal aortic trauma is a rare occurrence in children with only a few patients having been reported in the literature. Most such cases have been described in the context of lap belt injuries. We report a 9-year-old boy who suffered lap belt trauma to the abdomen during a high-speed road traffic accident resulting to the well-recognized pattern of blunt abdominal injury, that is, the triad of intestinal perforation, fractures of the lumbar spine, and abdominal aortic injury. The latter presented with lower limb ischemia due to dissection of the infrarenal aorta and right common iliac artery. Revascularization was achieved by endovascular means using 2 self-expanding stents in the infrarenal aorta and the right common iliac artery. This case is one of the few reports of lap belt-related acute traumatic abdominal aortic dissection in a young child and highlights the feasibility of endovascular management in the pediatric population. PMID:25463338

  19. Endovascular management of lap belt-related abdominal aortic injury in a 9-year-old child.

    PubMed

    Papazoglou, Konstantinos O; Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T

    2015-02-01

    Blunt abdominal aortic trauma is a rare occurrence in children with only a few patients having been reported in the literature. Most such cases have been described in the context of lap belt injuries. We report a 9-year-old boy who suffered lap belt trauma to the abdomen during a high-speed road traffic accident resulting to the well-recognized pattern of blunt abdominal injury, that is, the triad of intestinal perforation, fractures of the lumbar spine, and abdominal aortic injury. The latter presented with lower limb ischemia due to dissection of the infrarenal aorta and right common iliac artery. Revascularization was achieved by endovascular means using 2 self-expanding stents in the infrarenal aorta and the right common iliac artery. This case is one of the few reports of lap belt-related acute traumatic abdominal aortic dissection in a young child and highlights the feasibility of endovascular management in the pediatric population.

  20. Androgen Receptor (AR) Promotes Abdominal Aortic Aneurysm (AAA) Development via Modulating Inflammatory IL1α and TGFβ1 Expression

    PubMed Central

    Huang, Chiung-Kuei; Luo, Jie; Lai, Kuo-Pao; Wang, Ronghao; Pang, Haiyan; Chang, Eugene; Yan, Chen; Sparks, Janet; Lee, Soo Ok; Cho, Joshua; Chang, Chawnshang

    2015-01-01

    Gender difference is a risk factor for abdominal aortic aneurism formation yet the reason for male predominance remains unclear. Androgen and the androgen receptor influence the male gender difference, indicating that androgen receptor signaling may affect abdominal aortic aneurism development. Using angiotensin II induced abdominal aortic aneurism in apolipoprotein E null mouse models (82.4% abdominal aortic aneurism incidence), we found that mice lacking androgen receptor failed to develop abdominal aortic aneurism and aorta had dramatically reduced macrophages infiltration and intact elastic fibers. These findings suggested that androgen receptor expression in endothelial cells, macrophages or smooth muscle cells might play a role in abdominal aortic aneurism development. Selective knockout of androgen receptor in each of these cell types further demonstrated that mice lacking androgen receptor in macrophages (20% abdominal aortic aneurism incidence) or smooth muscle cells (12.5% abdominal aortic aneurism incidence), but not in endothelial cells (71.4% abdominal aortic aneurism incidence) had suppressed abdominal aortic aneurism development. Mechanism dissection showed that androgen receptor functioned through modulation of interleukin 1α and transforming growth factor β1 signals and by targeting androgen receptor with androgen receptor degradation enhancer ASC-J9® led to significant suppression of abdominal aortic aneurism development. These results demonstrate the underlying mechanism by which androgen receptor influences abdominal aortic aneurism development through interleukin 1α and transforming growth factor β1, and provides a potential new therapy to suppress/prevent abdominal aortic aneurism by targeting androgen receptor with ASC-J9®. PMID:26324502

  1. Membranous glomerulonephritis: a morphometric study.

    PubMed

    Paraskevakou, H; Kavantzas, N; Pavlopoulos, P M; Voudiklari, S; Zerefos, N; Papagalanis, N; Davaris, P

    2000-01-01

    Archival material from 45 renal biopsies with a diagnosis of idiopathic membranous glomerulonephritis (MGN) were studied by computer-aided image analysis in order to evaluate the prognostic significance of glomerular and interstitial morphometry in MGN. The control group consisted of thirty seven normal renal biopsy specimens. The surface area, the perimeter, the major axis length and the shape factor of renal glomeruli as well as the percentage of the interstitial fibrosis were measured. All the morphometric parameters related to the size of glomeruli had significantly higher values in the patient group (p = 0.000 for all the parameters). However, no significant difference of the glomerular size between different stages of MGN was observed. In contrast, the percentage of interstitial fibrosis increased as the MGN stage rose (median values: 10.3% in stage 1, 14.2% in stage II, 26.9% in stage III, 28.9% in stage IV and 34.2% in stage V, Kruskal-Wallis ANOVA H = 37.645, p = 0.000). In the multivariate analysis the percentage of interstitial fibrosis was the only independent prognostic factor (p = 0.013). Our findings suggest that, in membraneous glomerulonephritis, the interstitial fibrosis increases as the MGN stage progresses, while the size of renal glomeruli has increased at a very early stage of the disease. This fact may indicate that interstitial fibrosis, not glomerular lesions, is mainly responsible for the reduction of renal function. PMID:10729917

  2. [Abdominal ischemia and lesions of the pancreas].

    PubMed

    Myshanych, T V; Moskal', O M; Arkhiĭ, E Ĭ; Sozoniuk, O V

    2014-01-01

    The analysis of the results of 50 patients with diseases of coronary heart disease (25 pers.) And chronic pancreatitis (25 people) are submitted. Along with the standard test from these patients underwent Doppler-ultrasonography of abdominal aorta and its visceral branches. Conclusions: A characteristic feature of Doppler indices in AIC is to reduce Vps and Ved, and PI BbA, increase Vps, Ved, IR and PI after exercise in chBA, chC and BbA. At patients with CP with IHD feature is the increase in Ved and IR in the chC, and Ved and PI in BbA under act of loading Bleed a feature at CP with IHD must be taken into account for optimization of treatment of IHD at CP. PMID:25796868

  3. [Ultrasound of the large abdominal vessels].

    PubMed

    Oviedo-García, A A; Algaba-Montes, M; Segura-Grau, A; Rodríguez-Lorenzo, Á

    2016-01-01

    Ultrasound has recently become an indispensable tool for the family physician, whether exercised in primary care and emergency department; and likewise it has spread to many other specialties: internal medicine, critical care, neurology, pneumology, digestive, etc. and that ultrasound has proven to be a safe diagnostic tool and have great capacity. We firmly believe that ultrasound done to «bedside» the patient by the family doctor, can greatly complement the physical examination and greatly improve clinical effectiveness, allowing the browser an immediate view of the anatomy and physiology of certain structures. It is within this context is particularly relevant ultrasonography of the Aorta and large abdominal vessels, made by the family doctor or the emergency itself, which will develop along this chapter.

  4. Mechanical evaluation of decellularized porcine thoracic aorta

    PubMed Central

    Zou, Yu; Zhang, Yanhang

    2011-01-01

    Background Decellularized tissues are expected to have major cellular immunogenic components removed and in the mean time maintain similar mechanical strength and extracellular matrix (ECM) structure. However, the decellularization processes likely cause alterations of the ECM structure and thus influence the mechanical properties. In the present study, the effects of different decellularization protocols on the (passive) mechanical properties of the resulted porcine aortic ECM were evaluated. Methods Decellularization methods using anionic detergent (sodium dodecyl sulfate), enzymatic detergent (Trypsin), and non-ionic detergent (tert-octylphenylpolyoxyethylen (Triton X-100)) were adopted to obtain decellularized porcine aortic ECM. Histological studies and scanning electron microscopy were performed to confirm the removal of cells and to examine the structure of ECM. Biaxial tensile testing was used to characterize both the elastic and viscoelastic mechanical behaviors of decellularized ECM. Results All three decellularization protocols remove the cells effectively. The major ECM structure is preserved under SDS and Triton X-100 treatments. However, the structure of Trypsin treated ECM is severely disrupted. SDS and Triton X-100 decellularized ECM exhibits similar elastic properties as intact aorta tissues. Decellularized ECM shows less stress relaxation than intact aorta due to the removal of cells. Creep behavior is negligible for both decellularized ECM and intact aortas. Conclusion SDS and Triton X-100 decellularized ECM tissue appeared to maintain the critical mechanical and structural properties and might work as a potential material for further vascular tissue engineering. PMID:21571306

  5. Dissection of aorta: a pediatric case report.

    PubMed

    Serdaroğlu, Gül; Levent, Ertürk; Yurtsever, Serap; Calkavur, Tanzer; Yünten, Nilgün; Aydoğdu, Sema

    2002-01-01

    We present a 15-year-old boy who developed sudden walking disability and sensory loss. He could not stand up on his feet and had no feeling following a sudden fall while playing basketball. He had been referred to a local hospital with these symptoms. In his physical examination absence of deep tendon reflexes and sensory loss were noted. His arterial blood pressure was 210/160 mmHg. He was transferred to our hospital with these findings and diagnosis of Guillain-Barré syndrome and hypertensive encephalopathy. There was sudden onset of sensory loss, walking disability and history of trauma. In the following hours hematuria, back pain and lower extremity ischemia developed. We suspected spinal artery injury based on the findings. Dissection of descending aorta was established with the help of magnetic resonance imaging of spinal region and contrasted aortography. The patient went to surgery immediately. He was lost on the second day after operation because of malperfusion. We report this case because dissecting aorta is very rare in the pediatric age group. High index of suspicion and early aortography are needed to diagnose aorta dissection.

  6. The novel use of wooden spoons for control of massive intra-abdominal hemorrhage.

    PubMed

    Walter, Catherine Jane; Barker, Philip

    2010-03-01

    Massive intra-abdominal hemorrhage represents a challenging operative emergency. Temporary control of the aorta and inferior vena cava (IVC) using intra-luminal balloon occlusion, preemptive trans-thoracic clamping or infra-diaphragmatic clamping has been achieved with variable success. We report the use of wooden spoons with convex arches cut from their bases as a cheap and effective alternative. They can be used to compress the aorta or IVC against the vertebrae, giving vascular control while leaving good surgical access. This equipment requires minimal financial investment and only basic woodworking skills.

  7. Dynamic biaxial tissue properties of the human cadaver aorta.

    PubMed

    Shah, Chirag S; Hardy, Warren N; Mason, Matthew J; Yang, King H; Van Ee, Chris A; Morgan, Richard; Digges, Kennerly

    2006-11-01

    This study focuses on the biaxial mechanical properties of planar aorta tissue at strain rates likely to be experienced during automotive crashes. It also examines the structural response of the whole aorta to longitudinal tension. Twenty-six tissue-level tests were conducted using twelve thoracic aortas harvested from human cadavers. Cruciate samples were excised from the ascending, peri-isthmic, and descending regions. The samples were subjected to equibiaxial stretch at two nominal speed levels using a new biaxial tissue-testing device. Inertia-compensated loads were measured to facilitate calculation of true stress. High-speed videography and regional correlation analysis were used to track ink dots marked on the center of each sample to obtain strain. In a series of component-level tests, the response of the intact thoracic aorta to longitudinal stretch was obtained using seven aorta specimens. The aorta fails within the peri-isthmic region. The aorta fails in the transverse direction, and the intima fails before the media or adventitia. The aorta tissue exhibits nonlinear behavior. The aorta as complete structure can transect completely from 92 N axial load and 0.221 axial strain. Complete transection can be accompanied by intimal tears. These results have application to finite element modeling and the better understanding of traumatic rupture of the aorta. PMID:17311166

  8. Fourier Transform Infrared Spectroscopy to Quantify Collagen and Elastin in an In Vitro Model of Extracellular Matrix Degradation in Aorta

    PubMed Central

    Cheheltani, Rabee; McGoverin, Cushla M.; Rao, Jayashree; Vorp, David A.; Kiani, Mohammad F.; Pleshko, N.

    2014-01-01

    Extracellular matrix (ECM) is a key component and regulator of many biological tissues including aorta. Several aortic pathologies are associated with significant changes in the composition of the matrix, especially in the content, quality and type of aortic structural proteins, collagen and elastin. The purpose of this study was to develop an infrared spectroscopic methodology that is comparable to biochemical assays to quantify collagen and elastin in aorta. Enzymatically degraded porcine aorta samples were used as a model of ECM degradation in abdominal aortic aneurysm (AAA). After enzymatic treatment, Fourier transform infrared (FTIR) spectra of the aortic tissue were acquired by an infrared fiber optic probe (IFOP) and FTIR imaging spectroscopy (FT-IRIS). Collagen and elastin content were quantified biochemically and partial least squares (PLS) models were developed to predict collagen and elastin content in aorta based on FTIR spectra. PLS models developed from FT-IRIS spectra were able to predict elastin and collagen content of the samples with strong correlations (RMSE of validation = 8.4% and 11.1% of the range respectively), and IFOP spectra were successfully used to predict elastin content (RMSE = 11.3% of the range). The PLS regression coefficients from the FT-IRIS models were used to map collagen and elastin in tissue sections of degraded porcine aortic tissue as well as a human AAA biopsy tissue, creating a similar map of each component compared to histology. These results support further application of FTIR spectroscopic techniques for evaluation of AAA tissues. PMID:24761431

  9. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  10. Ultrasound Screening for Abdominal Aortic Aneurysm

    PubMed Central

    2006-01-01

    Executive Summary Objective The aim of this review was to assess the effectiveness of ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA). Clinical Need Abdominal aortic aneurysm is a localized abnormal dilatation of the aorta greater than 3 cm. In community surveys, the prevalence of AAA is reported to be between 2% and 5.4%. Abdominal aortic aneurysms are found in 4% to 8% of older men and in 0.5% to 1.5% of women aged 65 years and older. Abdominal aortic aneurysms are largely asymptomatic. If left untreated, the continuing extension and thinning of the vessel wall may eventually result in rupture of the AAA. Often rupture may occur without warning, causing acute pain. Rupture is always life threatening and requires emergency surgical repair of the ruptured aorta. The risk of death from ruptured AAA is 80% to 90%. Over one-half of all deaths attributed to a ruptured aneurysm take place before the patient reaches hospital. In comparison, the rate of death in people undergoing elective surgery is 5% to 7%; however, symptoms of AAA rarely occur before rupture. Given that ultrasound can reliably visualize the aorta in 99% of the population, and its sensitivity and specificity for diagnosing AAA approaches 100%, screening for aneurysms is worth considering as it may reduce the incidence of ruptured aneurysms and hence reduce unnecessary deaths caused by AAA-attributable mortality. Review Strategy The Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases to determine the effectiveness of ultrasound screening for abdominal aortic aneurysms. Case reports, letters, editorials, nonsystematic reviews, non-human studies, and comments were excluded. Questions asked: Is population-based AAA screening effective in improving health outcomes in asymptomatic populations? Is AAA screening acceptable to the population? Does this affect the

  11. [Abdominal compartment syndrome].

    PubMed

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  12. [Survival and complications in remote period of follow-up in patients with Marfan syndrome after correction of aneurism of the ascending aorta and aortic insufficiency].

    PubMed

    Cypiene, R; Grebelis, A; Semeniene, P; Nogiene, G

    2007-01-01

    Patients with Marfan syndrome (n=44) and ascending aorta aneurism combined with aortic insufficiency were followed up for 1 month - 16 years after graft repair of the ascending aorta aneurysm and replacement of aortic valve. Patients were divided into two groups: with dissecting aneurism (n=25) and chronic nondissecting aneurism (n=19). In remote postoperative period 11 patients had 13 complications (2 patients had 2 complications each - graft dysfunction and arterial thromboembolism). Repetitive surgery was carried out in 5 patients after 67.2 +/- 19.4 months because of expansion of dissection to the abdominal aorta, dysfunction of mitral valve prosthesis. In remote period of follow up 15 patients (34.1%) died. Causes of death were graft dysfunction, extension of aortic dissection, myocardial failure. Total survival was 80, 54 and 46% for 1 month, 10 and 15 years, respectively. PMID:18260913

  13. Monoparesis after graft replacement of non-ruptured abdominal aortic aneurysm.

    PubMed

    Matsuda, Hitoshi; Ogino, Hitoshi; Saito, Shunsuke; Sasaki, Hiroaki; Minatoya, Kenji; Kobayashi, Junjiro; Yagihara, Toshikatsu; Kitamura, Soichiro

    2006-10-01

    A 67-year-old man was admitted with a saccular aneurysm of the abdominal aorta. Preoperative CT revealed cylindrical calcification of the abdominal aorta and the patent internal iliac arteries (IIAs). At the elective surgery, a cylinder-shaped and severely calcified intimal layer was found, and the lumbar arteries were totally occluded. Hypotension caused by the loose iliac clamp due to severe calcification continued for 15 minutes and long-time cross clamp was necessary. Monoparesis of the left lower extremity and dysuria occurred postoperatively. Spinal MRI revealed small infarction at the Th10 level. Symptoms improved and he could walk with a cane and within a few months no uninary catheter support was needed. Thoracic spinal cord infarction after abdominal aortic aneurysm (AAA) surgery and a severely calcified abdominal aorta indicated the importance of the blood flow in the IIA as the significant source of spinal blood supply. To prevent spinal cord injury (SCI) which is rare but significant complication of AAA surgery, understanding of the spinal blood supply, quick surgery, and complete revascularization of pelvic arteries are important. PMID:17095985

  14. [Semeiotics of abdominal tuberculosis].

    PubMed

    Guseĭnov, G K; Ramazanova, A M; Guseĭnov, A G

    1984-01-01

    Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.

  15. Female gender attenuates cytokine and chemokine expression and leukocyte recruitment in experimental rodent abdominal aortic aneurysms.

    PubMed

    Sinha, Indranil; Cho, Brenda S; Roelofs, Karen J; Stanley, James C; Henke, Peter K; Upchurch, Gilbert R

    2006-11-01

    Female gender appears to be protective in the development of abdominal aortic aneurysms (AAAs). This study sought to identify gender differences in cytokine and chemokine expression in an experimental rodent AAA model. Male and female rodent aortas were perfused with either saline (control) or elastase to induce AAA formation. Aortic diameter was determined and aortic tissue was harvested on postperfusion days 4 and 7. Cytokine and chemokine gene expression was examined using focused gene arrays. Immunohistochemistry was used to quantify aortic leukocyte infiltration. Data were analyzed by Student's t-tests and ANOVA. Elastase-perfused female rodents developed significantly smaller aneurysms compared to males by day 7 (93 +/- 10% vs. 201 +/- 25%, P = 0.003). Elastase-perfused female aortas exhibited a fivefold decrease in expression of the BMP family and ligands of the TNF superfamily compared to males. In addition, the expression of members of the TGF beta and VEGF families were three to fourfold lower in female elastase-perfused aortas compared to males. Multiple members of the interleukin, CC chemokine receptor, and CC ligand families were detectable in only the male elastase-perfused aortas. Female elastase-perfused aortas demonstrated a corollary twofold lower neutrophil count (females: 17.5 +/- 1.1 PMN/HPF; males: 41 +/- 5.2 neutrophils/HPF, P = 0.01) and a 1.5-fold lower macrophage count (females: 12 +/- 1.1 macrophages/HPF; males: 17.5 +/- 1.1 macrophages/HPF, P = 0.003) compared to male elastase-perfused aortas. This study documents decreased expression of multiple cytokines and chemokines and diminished leukocyte trafficking in female rat aortas compared to male aortas following elastase perfusion. These genes may contribute to the gender disparity seen in AAA formation. PMID:17182958

  16. [Octreotide acetate for persistent cylothorax after descending aorta replacement].

    PubMed

    Naganuma, Hirokuni; Kawahito, Koji; Matsumura, Yoko; Nakamura, Ken; Haijima, Norimasa

    2010-12-01

    Cylothorax is one of a hazardous complication after thoracic aorta replacement. In this paper, we report effectiveness of octreotide acetate for postoperative persistent cylothorax. A 59-year-old female was referred to our hospital for chest pain. Previously she underwent arch reconstruction following aortic root replacement due to aortic dissection. Computed tomography (CT) revealed acute dissection on dissected descending aorta. Urgent descending aorta replacement was performed. After surgery, massive chylothoracic pleural fluid was drainaged. Although conventional medical treatment was not effective, drainage of chylothoracic pleural fluid significantly decreased after administration of octreotide acetate. Although mechanism has not been fully investigated, octreotide acetate was effective for persistent cylothorax after descending aorta replacement.

  17. [Early detection of abdominal aortic aneurysm in risk population].

    PubMed

    Enríquez-Vega, María Elizabeth; Solorio-Rosete, Hugo Francisco; Cossío-Zazueta, Alfonso; Bizueto-Rosas, Héctor; Cruz-Castillo, Juan Ernesto; Iturburu-Enríquez, Alessandra

    2015-01-01

    Introducción: aneurisma es el incremento del diámetro de una arteria > 50 %; los más frecuentes son los aneurismas de la aorta abdominal (AAA). La ecografía abdominal es el estudio de escrutinio para su diagnóstico. La detección oportuna del AAA en población de riesgo disminuye la morbimortalidad. El objetivo fue estimar la frecuencia de AAA en pacientes mayores de 65 años.Métodos: Se realizó un estudio transversal entre junio y octubre del 2012 en pacientes de ambos sexos mayores de 65 años que cubrieron los criterios de selección. Se les practicó ultrasonidoDoppler dúplex y se midió el diámetro anteroposterior de la aorta abdominal infrarrenal, se definió como AAA a una aorta abdominal con un diámetro mayor a 3 cm. Se empleó estadística descriptiva y regresión logística para factores de riesgo.Resultados: se incluyeron 144 pacientes, edad media (72.7 ± 6.7), el 95.1 % sexo masculino. El 13 % continuaban fumando. En 127 el diámetro de la aorta fue normal. Se detectaron 10 pacientes con AAA, todos del sexo masculino, el diámetro de los aneurismas identificados variaron de 3.2 a 7.11 cm, el diámetro promedio de 3 - 4 cm (n = 5). Solo el tabaquismo activo fue un factor predictivo significativo para AAA.Conclusión: Se demostró frecuencia significativa de AAA no detectada en masculinos mayores de 65 años, el tabaquismo fue el factor de riesgo más importante.

  18. Coarctation of the aorta: are genes relevant?

    PubMed

    Francis, Catherine M

    2016-08-01

    In a busy clinic, it is easy to overlook genetic aspects of congenital heart disease. The complexity of genetic influence on disease makes it difficult to provide clear, accurate advice about recurrence risks and genetics to individual patients. This is particularly true of coarctation of the aorta, which appears sporadic in the majority of cases. We will see that in fact, genetics can play an important role in coarctation. We will review the current state of knowledge about the genetics of coarctation, encompassing syndromic and non-syndromic presentations, and consider the implications for clinical practice. PMID:27243623

  19. Hydroelastic effects in the aorta bifurcation zone

    NASA Technical Reports Server (NTRS)

    Volmir, A. S.; Gersheyn, M. S.; Purinya, B. A.

    1980-01-01

    The mechanical behavior of the vessels and blood is mathematically analyzed at the point of aortic bifurcation using a homogeneous single layer channel as a model of the aorta. Allowance is made for the fact that the aortic intima is considerably less rigid than the other layers. For analysis of blood flow in the major arteries, the blood is treated as a viscous Newtonian fluid whose movements are described by Navier-Stokes equations and a continuity equation. Blood flow dynamics at the aortic bifurcation are discussed on the basis of the results.

  20. Current management of coarctation of the aorta

    PubMed Central

    Suradi, Hussam; Hijazi, Ziyad M.

    2015-01-01

    Coarctation of the aorta (C) is the sixth most common lesion in congenital heart disease and represents a spectrum of aortic narrowing that varies from a discrete entity to tubular hypoplasia. This condition was once thought to be a relatively simple lesion that would be “cured” upon repair of the narrowing, however, despite relief of the anatomical obstruction the subsequent risk of early morbidity and death persists. This review outlines the optimal management strategy of this disease from neonatal to adult life and provides insights to approach this straightforward but challenging condition. PMID:26779519

  1. 3D image analysis of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Subasic, Marko; Loncaric, Sven; Sorantin, Erich

    2002-05-01

    This paper presents a method for 3-D segmentation of abdominal aortic aneurysm from computed tomography angiography images. The proposed method is automatic and requires minimal user assistance. Segmentation is performed in two steps. First inner and then outer aortic border is segmented. Those two steps are different due to different image conditions on two aortic borders. Outputs of these two segmentations give a complete 3-D model of abdominal aorta. Such a 3-D model is used in measurements of aneurysm area. The deformable model is implemented using the level-set algorithm due to its ability to describe complex shapes in natural manner which frequently occur in pathology. In segmentation of outer aortic boundary we introduced some knowledge based preprocessing to enhance and reconstruct low contrast aortic boundary. The method has been implemented in IDL and C languages. Experiments have been performed using real patient CTA images and have shown good results.

  2. ENDOCOM : abdominal aortic aneurysm test bench for in vitro simulation.

    PubMed

    Mazeyrat, Johan; Romain, Olivier; Garda, Patrick; Lagrée, Pierre-Yves; Destrade, Michel; Karouia, Mourad; Leprince, Pascal

    2007-01-01

    An abdominal aortic aneurysm (AAA) is a dilatation of the aorta at the abdominal level, whose rupture is a life threatening complication. Recent treatment procedures of AAA consists in endovascular treatment with covered stent grafts. Despite improving design of these devices, this treatment is still associated with close to 25% of failure, due to persisting pressure into the excluded aneurysmal sac. The follow-up becomes thus crucial and demands frequent examinations (CT-scan, IRM) which are not so liable given the complications. In order to evaluate the post-operative period of an AAA treatment, we designed a communicative stent, comprising of an integrated pressure sensor. This paper presents the conception of a communicative sensor, the elaboration of a numerical model, and the development of an experimental testbench reproducing the aortic flux across an AAA and allowing the optimization and validation of the measurement principle. PMID:18002457

  3. Deficiency of endogenous acute phase serum amyloid A protects apoE−/− mice from angiotensin II-induced abdominal aortic aneurysm formation

    PubMed Central

    Webb, NR; De Beer, MC; Wroblewski, JM; Ji, A; Bailey, W; Shridas, P; Charnigo, RJ; Noffsinger, VP; Witta, J; Howatt, DA; Balakrishnan, A; Rateri, DL; Daugherty, A; De Beer, FC

    2016-01-01

    Objective Rupture of abdominal aortic aneurysm (AAA), a major cause of death in the aged population, is characterized by vascular inflammation and matrix degradation. Serum amyloid A (SAA), an acute phase reactant linked to inflammation and matrix metalloproteinase induction, correlates with aortic dimensions before aneurysm formation in humans. We investigated whether SAA deficiency in mice impacts AAA formation during angiotensin II (AngII) infusion. Approach and Results Plasma SAA increased ~60-fold in apoE−/− mice 24 hours after i.p. AngII injection (100 μg/kg; n = 4) and ~15-fold after chronic 28-day AngII infusion (1,000 ng/kg/min; n = 9). AAA incidence and severity after 28-day AngII infusion was significantly reduced in apoE−/− mice lacking both acute phase SAA isoforms (SAAKO; n = 20) compared to apoE−/− mice (SAAWT; n = 20) as assessed by in vivo ultrasound and ex vivo morphometric analyses, despite a significant increase in systolic blood pressure in SAAKO mice compared to SAAWT mice after AngII infusion. Atherosclerotic lesion area of the aortic arch was similar in SAAKO and SAAWT mice after 28-day AngII infusion. Immunostaining detected SAA in AAA tissues of AngII-infused SAAWT mice that co-localized with macrophages, elastin breaks, and enhanced matrix metalloproteinase (MMP) activity. MMP-2 activity was significantly lower in aortas of SAAKO mice compared to SAAWT mice after 10-day AngII infusion. Conclusion Lack of endogenous acute phase SAA protects against experimental AAA through a mechanism that may involve reduced MMP-2 activity. PMID:25745063

  4. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  5. Stent migration during transcatheter management of coarctation of aorta.

    PubMed

    Kannan, Bhava R J; Srinivasan, Muthusamy

    2012-02-15

    A 13-year-old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20-mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome.

  6. The association between abdominal body composition and vascular calcification.

    PubMed

    Jensky, Nicole E; Criqui, Michael H; Wright, C Michael; Wassel, Christina L; Alcaraz, John E; Allison, Matthew A

    2011-12-01

    Subclinical cardiovascular disease (CVD) may be associated with both adipose and skeletal muscle tissues in the abdomen. Accordingly, we examined whether subcutaneous, intermuscular, and visceral adipose tissue, as well as abdominal lean muscle, were associated with the presence and extent of vascular calcification in multiple vascular beds. Three hundred and ninety four patients (58.1% men) underwent electron beam computed tomography (EBCT) scans as part of routine health maintenance screening. The coronary and carotid calcium scores were analyzed at the time of the scan, whereas the other calcium scores, as well as the body composition analyses, were analyzed retrospectively. Mean age was 55.2 ± 11.1 years and BMI was 26.9 ± 4.2. The prevalence of any calcification in the carotids, coronaries, thoracic aorta, abdominal aorta, and iliacs was 30.1, 60.1, 39.8, 55.7, and 56.8%, respectively. Compared to those with calcification in different vascular beds, those without vascular calcification generally had significantly more lean muscle and less adipose tissue. In separate multivariable logistic models, a 1 s.d. increment in the ratio of abdominal and visceral fat to total area of each corresponding compartments was significantly associated with an increased odds for the presence of thoracic aortic calcium (odds ratio (OR) = 1.6, 1.5, respectively; P = 0.01 for both). Conversely, increases in abdominal lean muscle were associated with significantly decreased odds of thoracic aortic calcification (OR = 0.34; P ≤ 0.01). A similar pattern of associations existed among the other vascular beds. Also, the association between lean muscle and vascular calcification was independent of visceral adipose tissue. In conclusion, adipose tissue was positively and lean body mass inversely associated with prevalent aortic calcification. PMID:21475146

  7. Endovascular Treatment of a Ruptured Para-Anastomotic Aneurysm of the Abdominal Aorta

    SciTech Connect

    Sfyroeras, Giorgos S.; Lioupis, Christos Bessias, Nikolaos; Maras, Dimitris; Pomoni, Maria; Andrikopoulos, Vassilios

    2008-07-15

    We report a case of a ruptured para-anastomotic aortic aneurysm treated with implantation of a bifurcated stent-graft. A 72-year-old patient, who had undergone aortobifemoral bypass for aortoiliac occlusive disease 16 years ago, presented with a ruptured para-anastomotic aortic aneurysm. A bifurcated stent-graft was successfully deployed into the old bifurcated graft. This is the first report of a bifurcated stent-graft being placed through an 'end-to-side' anastomosed old aortobifemoral graft. Endovascular treatment of ruptured para-anastomotic aortic aneurysms can be accomplished successfully, avoiding open surgery which is associated with increased mortality and morbidity.

  8. A segmentation method for stentgrafts in the abdominal aorta from ECG-gated CTA data

    NASA Astrophysics Data System (ADS)

    Klein, Almar; Renema, W. KlaasJan; Oostveen, Luuk J.; Schultze Kool, Leo J.; Slump, Cornelis H.

    2008-03-01

    Endovascular aortic replacement (EVAR) is an established technique, which uses stentgrafts to treat aortic aneurysms in patients at risk of aneurysm rupture. The long-term durability of a stentgraft is affected by the stresses and hemodynamic forces applied to it, and may be reflected by the movements of the stentgraft itself during the cardiac cycle. A conventional CT scan (which results in a 3D volume) is not able to visualize these movements. However, applying ECG-gating does provide insight in the motion of the stentgraft caused by hemodynamic forces at different phases of the cardiac cycle. The amount of data obtained is a factor of ten larger compared to conventional CT, but the radiation dose is kept similar for patient safety. This causes the data to be noisy, and streak artifacts are more common. Algorithms for automatic stentgraft detection must be able to cope with this. Segmentation of the stentgraft is performed by examining slices perpendicular to the centreline. Regions with high CT-values exist at the locations where the metallic frame penetrates the slice. These regions are well suited for detection and sub-pixel localization. Spurious points can be removed by means of a clustering algorithm, leaving only points on the contour of the stent. We compare the performance of several different point detection methods and clustering algorithms. The position of the stent's centreline is calculated by fitting a circle through these points. The proposed method can detect several stentgraft types, and is robust against noise and streak artifacts.

  9. [Endovascular repair of abdominal aortic aneurysm in a patient with transplanted kidney].

    PubMed

    Khabazov, R I; Chupin, A V; Kolosov, R V; Deriabin, S V

    2016-01-01

    Endovascular repair of the abdominal aorta is a method of choice in pronounced concomitant pathology and high risk of open surgical treatment. The article deals with a clinical case report of successful surgical management of a patient with an infrarenal aortic aneurysm, transplanted kidney, chronic renal insufficiency, secondary diabetes mellitus, multifocal atherosclerosis with predominant involvement of coronary arteries and lower-limb arteries, in whom open surgical treatment was associated with high risk. Endoprosthetic repair of the abdominal aortic aneurysm was performed with a good postoperative outcome. PMID:27626264

  10. Enhanced production of the chemotactic cytokines interleukin-8 and monocyte chemoattractant protein-1 in human abdominal aortic aneurysms.

    PubMed Central

    Koch, A. E.; Kunkel, S. L.; Pearce, W. H.; Shah, M. R.; Parikh, D.; Evanoff, H. L.; Haines, G. K.; Burdick, M. D.; Strieter, R. M.

    1993-01-01

    Inflammatory leukocytes play a central role in the pathogenesis of human atherosclerotic disease, from early atherogenesis to the late stages of atherosclerosis, such as aneurysm formation. We have shown previously that human abdominal aortic aneurysms are characterized by the presence of numerous chronic inflammatory cells throughout the vessel wall (Am J Pathol 1990, 137: 1199-1213). The signals that attract lymphocytes and monocytes into the aortic wall in aneurysmal disease remain to be precisely defined. We have studied the production of the chemotactic cytokines interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) by aortic tissues obtained from 47 subjects. We compared the antigenic production of these cytokines by explants of: 1) human abdominal aneurysmal tissue, 2) occlusive (atherosclerotic) aortas, and 3) normal aortas. IL-8, which is chemotactic for neutrophils, lymphocytes, and endothelial cells was liberated in greater quantities by abdominal aortic aneurysms than by occlusive or normal aortas. Using immunohistochemistry, macrophages, and to a lesser degree endothelial cells, were found to be positive for the expression of antigenic IL-8. Similarly, MCP-1, a potent chemotactic cytokine for monocytes/macrophages, was released by explants from abdominal aortic aneurysms in greater quantities than by explants from occlusive or normal aortas. Using immunohistochemistry, the predominant MCP-1 antigen-positive cells were macrophages and to a lesser extent smooth muscle cells. Our results indicate that human abdominal aortic aneurysms produce IL-8 and MCP-1, both of which may serve to recruit additional inflammatory cells into the abdominal aortic wall, hence perpetuating the inflammatory reaction that may result in the pathology of vessel wall destruction and aortic aneurysm formation. Images Figure 2 Figure 3 Figure 4 Figure 5 PMID:8494046

  11. [Differential diagnosis of tumors of the gastrointestinal tract and retroperitoneal space from abdominal aortic aneurysms].

    PubMed

    Tsakadze, L O

    1981-01-01

    Aneurysm of the abdominal aorta is often erroneously identified as a gastrointestinal or retroperitoneal tumor of cyst. Out of 54 cases of this disease, 22 patients had undergone long-term examinations at various hospitals, oncological establishments included, while exploratory laparatomy had been carried out in 9 patients. The symptoms of aneurysm are described and compared with those of said tumors. Diagnostic procedures for identification of aneurysm and differentiation from gastrointestinal and retroperitoneal tumors and cysts are discussed.

  12. The coral reef aorta – a single centre experience in 70 patients

    PubMed Central

    Grotemeyer, Dirk; Pourhassan, Siamak; Rehbein, Hermann; Voiculescu, Adina; Reinecke, Petra; Sandmann, Wilhelm

    2007-01-01

    Coral reef aorta (CRA) is described as rock-hard calcifications in the visceral part of the aorta. These heavily calcified plaques grow into the lumen and can cause significant stenoses, which may lead to malperfusion of the lower limbs, visceral ischemia or hypertension due to renal ischemia. From January 1984 to February 2007, 70 patients (24 men, 46 women, mean age 59.5 years, range 14 to 81 years) underwent treatment in the Department of Vascular Surgery and Renal Transplantation, University Hospital, Heinrich-Heine-University (Düsseldorf, Germany) for CRA. The present study is based on a review of patients’ records and the prospective follow-up in the outpatient clinic. The most frequent finding was renovascular arterial hypertension (44.3%) causing headache, vertigo and visual symptoms. Intermittent claudication due to peripheral arterial occlusive disease was found in 28 patients (40.0%). Seventeen patients (24.3%) presented with chronic visceral ischemia causing diarrhea, weight loss and abdominal pain. Sixty-nine of the 70 patients (98.6%) underwent surgery; in 57 patients, aortic reconstruction was achieved with thromboendarterectomy, performed on an isolated suprarenal segment in six cases (8.7%), an infrarenal segment in 15 cases (21.7%), and the supra- and infrarenal aorta in 43 cases (62.3%). Eight patients (11.6%) died during or soon after surgery. Postoperative complications requiring corrective surgery occurred in 11 patients (15.9%). Almost one-third of the patients (n=19, 27.5%) returned for follow-up after a mean of 52.6 months (range six to 215 months). Of the 19 patients, there was significant clinical and diagnostic improvement in 16 patients (84.2%) and three patients (15.8%) were unchanged. Impairment was not observed. Despite the existing and improving surgical techniques for the treatment of CRA, its pathophysiological basis and genesis is not yet understood. PMID:22477301

  13. Can Severe Kyphoscoliosis Lead to Aorta Rupture?

    PubMed

    Kotopoulos, Constantinos; Karakasi, Maria Valeria; Kapetanakis, Stylianos; Pavlidis, Pavlos

    2016-09-01

    Neurofibromatosis type 1 is a polysystemic disease presenting with a multifaceted clinical picture. Clinical manifestations may present in the skin, as well as in the skeletal and cardiovascular system. The present study aims to describe and examine the case of a 46-year-old woman, who suffered from neurofibromatosis type 1 and died abruptly in the emergency room. The forensic examination attributed her death to traumatic rupture of the thoracic aorta resulting from an acute angulation that her vertebral column formed in the thoracic region (severe kyphosis). Outspread cutaneous neurofibromas, severe scoliosis, and osteoporosis (brittle bones) were observed during the autopsy. No atherosclerotic lesions were detected in the aortic lumen. To the authors' knowledge, no similar case has been reported throughout relevant literature. PMID:27323279

  14. Ultrasonographic identification of Dirofilaria immitis in the aorta and liver of a dog.

    PubMed

    Goggin, J M; Biller, D S; Rost, C M; DeBey, B M; Ludlow, C L

    1997-06-01

    A 5-year-old sexually intact male mixed-breed dog was evaluated because of suspected vena caval syndrome secondary to heartworm disease. On physical examination, the dog was thin, icteric, and weak and had tachycardia and a cardiac murmur. Serum biochemical and hematologic abnormalities included hyperbilirubinemia, high serum alkaline phosphatase and alanine transferase activities, hypoalbuminemia, leukocytosis, and normocytic normochromic anemia. Dirofilaria immitis microfilariae were seen in a blood smear. Echocardiography was used to confirm the diagnosis of vena caval syndrome. Multiple aberrant adult heartworms were evident ultrasonographically in the abdominal aorta and its branches and within hypoechoic nodules in the left caudal lobe of the liver. The dog's condition deteriorated despite supportive treatment and retrieval of 58 adult heartworms from the right side of the heart and vena cava, and the dog was euthanatized. At necropsy, adult heartworms were found in the aorta and inflammatory hepatic nodules. To our knowledge, ultrasonographic identification of heartworms within the systemic arterial system and liver of a dog has not been described previously.

  15. Novel pathways in the pathobiology of human abdominal aortic aneurysms

    PubMed Central

    Hinterseher, Irene; Erdman, Robert; Elmore, James R; Stahl, Elizabeth; Pahl, Matthew C; Derr, Kimberly; Golden, Alicia; Lillvis, John H; Cindric, Matthew C; Jackson, Kathryn; Bowen, William D; Schworer, Charles M; Chernousov, Michael A; Franklin, David P; Gray, John L; Garvin, Robert P; Gatalica, Zoran; Carey, David J; Tromp, Gerard; Kuivaniemi, Helena

    2012-01-01

    Objectives Abdominal aortic aneurysm (AAA), a dilatation of the infrarenal aorta, typically affects males > 65 years. The pathobiological mechanisms of human AAA are poorly understood. The goal of this study was to identify novel pathways involved in the development of AAAs. Methods A custom-designed “AAA-chip” was used to assay 43 of the differentially expressed genes identified in a previously published microarray study between AAA (n = 15) and control (n = 15) infrarenal abdominal aorta. Protein analyses were performed on selected genes. Results Altogether 38 of the 43 genes on the “AAA-chip” showed significantly different expression. Novel validated genes in AAA pathobiology included ADCY7, ARL4C, BLNK, FOSB, GATM, LYZ, MFGE8, PRUNE2, PTPRC, SMTN, TMODI and TPM2. These genes represent a wide range of biological functions, such as calcium signaling, development and differentiation, as well as cell adhesion not previously implicated in AAA pathobiology. Protein analyses for GATM, CD4, CXCR4, BLNK, PLEK, LYZ, FOSB, DUSP6, ITGA5 and PTPRC confirmed the mRNA findings. Conclusion The results provide new directions for future research into AAA pathogenesis to study the role of novel genes confirmed here. New treatments and diagnostic tools for AAA could potentially be identified by studying these novel pathways. PMID:22797469

  16. Computer-assisted diagnosis in CT angiography of abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    Fiebich, Martin; Tomiak, Myrosia M.; Engelmann, Roger M.; McGill, James; Hoffmann, Kenneth R.

    1997-04-01

    The purpose of this study was to develop methods for automatic 3D-segmentation and automatic quantification of vascular structures in CT angiographic studies, e.g., abdominal aortic aneurysms. Methods for segmentation were developed based on thresholding, maximum gradient, and second derivative techniques. All parameters for the segmentation are generated automatically, i.e. no user interaction is necessary for this process. Median filtering of all images is initially performed to reduce the image noise. The algorithm then automatically identifies the starting point inside the aorta for the volume growing. The segmentation of the vascular tree is achieved in two steps. First, only the aorta and small parts of branch vessels are segmented by using strong restrictions in the parameters for threshold and gradient. A description of the aorta is generated by fitting the detected outer border of the aorta with an ellipse. This description includes centerline, direction, contour, eccentricity, and area. In the second step, segmentation parameters are changed automatically for segmentation of branch vessels. A shaded surface display of the segmented structures is then generated. The segmentation of the aorta appears accurate, is fast, and the 3D display can be manipulated in real time. The quantitative description of the aorta is reliable giving reproducible information. Total CPU time for the segmentation and description is less than five minutes on a standard workstation. Time-consuming manual segmentation and parameterization of vascular structures are obviated, with 3D visualization and quantitative results available in minutes instead of hours. This technique for segmentation and description of the aorta and renal arteries shows the feasibility of computer assisted diagnosis in CT angiographic studies without user interaction. Besides the description, a rapid 3D view of the vessels is generated, often needed by the physician and normally only achievable by time

  17. Association between abdominal aortic plaque and coronary artery disease

    PubMed Central

    Li, Wei; Luo, Songyuan; Luo, Jianfang; Liu, Yuan; Huang, Wenhui; Chen, Jiyan

    2016-01-01

    Objective Currently, the association between abdominal aortic plaques and coronary artery disease (CAD) has not yet been clarified clearly. The purpose of this study was to determine the prevalence of abdominal aortic plaques by ultrasound imaging and to explore its association with CAD in patients undergoing coronary angiography. Methods Between October 2014 and June 2015, a prospective study was conducted in the Department of Cardiology at Guangdong General Hospital, Guangzhou, People’s Republic of China. Ultrasound scanning of the abdominal aortas was performed in 1,667 consecutive patients undergoing coronary angiography. Clinical characteristics and coronary profile were collected from the patients. Results Of the 1,667 study patients (male, 68.9%; mean age, 63±11 years) undergoing coronary angiography, 1,268 had CAD. Compared with 399 patients without CAD, 1,268 patients with CAD had higher prevalence of abdominal aortic plaques (37.3% vs 17%, P<0.001). In multivariate analysis, abdominal aortic plaques served as independent factors associated with the presence of CAD (odds ratio =2.08; 95% confidence interval =1.50–2.90; P<0.001). Of the 1,268 patients with CAD, the prevalence of abdominal aortic plaques was 27.0% (98/363) in patients with one-vessel disease, 35.0% (107/306) in patients with two-vessel disease, and 44.7% (268/599) in patients with three-vessel disease. Stepwise increases in the prevalence of abdominal aortic plaque was found depending on the number of stenotic coronary vessels (P<0.001; P-value for trend <0.001). In an ordinal logistic regression model, abdominal aortic plaques served as independent factors associated with the severity of CAD according to the number of stenotic coronary vessels (P<0.001). Conclusion The prevalence of abdominal aortic plaques was higher in patients with CAD than in those without CAD. Abdominal aortic plaque was an independent factor associated with the presence and severity of CAD. PMID:27279740

  18. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  19. [Abdominal actinomycosis: four cases].

    PubMed

    Ghannouchi Jaafoura, N; Kaabia, N; Khalifa, M; Ben Jazia, I; Hachfi, W; Braham, A; Letaief, A; Bahri, F

    2008-12-01

    The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.

  20. Classification of Tumor Histology via Morphometric Context *

    PubMed Central

    Chang, Hang; Borowsky, Alexander; Spellman, Paul; Parvin, Bahram

    2013-01-01

    Image-based classification of tissue histology, in terms of different components (e.g., normal signature, categories of aberrant signatures), provides a series of indices for tumor composition. Subsequently, aggregation of these indices in each whole slide image (WSI) from a large cohort can provide predictive models of clinical outcome. However, the performance of the existing techniques is hindered as a result of large technical and biological variations that are always present in a large cohort. In this paper, we propose two algorithms for classification of tissue histology based on robust representations of morphometric context, which are built upon nuclear level morphometric features at various locations and scales within the spatial pyramid matching (SPM) framework. These methods have been evaluated on two distinct datasets of different tumor types collected from The Cancer Genome Atlas (TCGA), and the experimental results indicate that our methods are (i) extensible to different tumor types; (ii) robust in the presence of wide technical and biological variations; (iii) invariant to different nuclear segmentation strategies; and (iv) scalable with varying training sample size. In addition, our experiments suggest that enforcing sparsity, during the construction of morphometric context, further improves the performance of the system. PMID:24319324

  1. [Endovascular repair for coarctation of the aorta in an adult].

    PubMed

    Hayashi, Jun; Abe, Kazuo; Hata, Masaki; Nagano, Naoko; Hamasaki, Azumi; Suzuki, Kenji

    2013-09-01

    A 27-year-old woman with Turner's syndrome who underwent successful endovascular treatment for coarctation of the aorta is presented. She was admitted to our hospital complaining of upper extremity hypertension. Computed tomography revealed discrete stenosis of the proximal descending aorta and developed collateral circulation. After endovascular repair with a balloon expandable stent, her transcoarctation gradient fell from 44 mmHg preoperatively to less than 10 mmHg. She was discharged with no complications on the 7th postoperative day. Coarctation of the aorta in an adult patient could be safely and effectively managed by endovascular treatment.

  2. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  3. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  4. Flow Cytometric Analysis of Immune Cells Within Murine Aorta.

    PubMed

    Gjurich, Breanne N; Taghavie-Moghadam, Parésa L; Galkina, Elena V

    2015-01-01

    The immune system plays a critical role in the modulation of atherogenesis at all stages of the disease. However, there are many technical difficulties when studying the immune system within murine aortas. Common techniques such as PCR and immunohistochemistry have answered many questions about the presence of immune cells and mediators of inflammation within the aorta yet many questions remain unanswered due to the limitations of these techniques. On the other hand, cumulatively the flow cytometry approach has propelled the immunology field forward but it has been challenging to apply this technique to aortic tissues. Here, we describe the methodology to isolate and characterize the immune cells within the murine aorta and provide examples of functional assays for aortic leukocytes using flow cytometry. The method involves the harvesting and enzymatic digestion of the aorta, extracellular and intracellular protein staining, and a subsequent flow cytometric analysis. PMID:26445788

  5. Endovascular management of recurrent adult coarctation of the aorta.

    PubMed

    Kpodonu, Jacques; Ramaiah, Venkatesh G; Rodriguez-Lopez, Julio A; Diethrich, Edward B

    2010-11-01

    Traditional open surgical repair has proven to be an effective treatment for the management of primary and recurrent coarctation of the thoracic aorta. Potential complications at short-term and long-term follow-up have included recurrent coarctation, hypertension, premature coronary artery disease, cerebrovascular disease, and anastomotic pseudoaneurysm. Endovascular repair of recurrent coarctation of the thoracic aorta offers a less invasive treatment approach in potential high-risk surgical patients.

  6. Critical decisions in trauma of the thoracic aorta.

    PubMed

    Degiannis, E; Boffard, K

    2002-05-01

    Trauma to the thoracic aorta is a significant injury with a high mortality. This mortality is partly due to the delayed recognition of the condition. The increase of motor vehicle accidents and the use of firearms worldwide has resulted in an increase of the incidence of trauma to the thoracic aorta. Certain new developments in diagnosis and management have resulted in traditional methods being questioned. This review analyses current literature and data which we attempt to evaluate.

  7. Palpation Simulator of Beating Aorta for Cardiovascular Surgery Training

    NASA Astrophysics Data System (ADS)

    Yamamoto, Yasuhiro; Nakao, Megumi; Kuroda, Tomohiro; Oyama, Hiroshi; Komori, Masaru; Matsuda, Tetsuya; Sakaguchi, Genichi; Komeda, Masashi; Takahashi, Takashi

    In field of cardiovascular surgeries, palpation of aorta plays important roles in decision of surgical site.This paper develops palpation simulator of aorta based on a finite element based physical model.The proposed model calculates soft tissue deformation according to the affection of inner pressure and the operation of a surgeon.The proposed method is implemented on a prototype with dual PHANToM device.Experimental results confirmed our model achieves real time simulation of the surgical palpation.

  8. Abdominal Pain, the Adolescent and Altered Brain Structure and Function

    PubMed Central

    Becerra, Lino; Heinz, Nicole; Ludwick, Allison; Rasooly, Tali; Wu, Rina; Johnson, Adriana; Schechter, Neil L.; Borsook, David; Nurko, Samuel

    2016-01-01

    Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology. Although relatively common in children, how this condition affects brain structure and function in a pediatric population remains unclear. Here, we investigate brain changes in adolescents with IBS and healthy controls. Imaging was performed with a Siemens 3 Tesla Trio Tim MRI scanner equipped with a 32-channel head coil. A high-resolution T1-weighted anatomical scan was acquired followed by a T2-weighted functional scan. We used a surface-based morphometric approach along with a seed-based resting-state functional connectivity (RS-FC) analysis to determine if groups differed in cortical thickness and whether areas showing structural differences also showed abnormal RS-FC patterns. Patients completed the Abdominal Pain Index and the GI Module of the Pediatric Quality of Life Inventory to assess abdominal pain severity and impact of GI symptoms on health-related quality of life (HRQOL). Disease duration and pain intensity were also assessed. Pediatric IBS patients, relative to controls, showed cortical thickening in the posterior cingulate (PCC), whereas cortical thinning in posterior parietal and prefrontal areas were found, including the dorsolateral prefrontal cortex (DLPFC). In patients, abdominal pain severity was related to cortical thickening in the intra-abdominal area of the primary somatosensory cortex (SI), whereas HRQOL was associated with insular cortical thinning. Disease severity measures correlated with cortical thickness in bilateral DLPFC and orbitofrontal cortex. Patients also showed reduced anti-correlations between PCC and DLPFC compared to controls, a finding that may reflect aberrant connectivity between default mode and cognitive control networks. We are the first to demonstrate concomitant structural and functional brain changes associated with abdominal pain severity, HRQOL related to GI-specific symptoms, and disease-specific measures in

  9. Abdominal Pain, the Adolescent and Altered Brain Structure and Function.

    PubMed

    Hubbard, Catherine S; Becerra, Lino; Heinz, Nicole; Ludwick, Allison; Rasooly, Tali; Wu, Rina; Johnson, Adriana; Schechter, Neil L; Borsook, David; Nurko, Samuel

    2016-01-01

    Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology. Although relatively common in children, how this condition affects brain structure and function in a pediatric population remains unclear. Here, we investigate brain changes in adolescents with IBS and healthy controls. Imaging was performed with a Siemens 3 Tesla Trio Tim MRI scanner equipped with a 32-channel head coil. A high-resolution T1-weighted anatomical scan was acquired followed by a T2-weighted functional scan. We used a surface-based morphometric approach along with a seed-based resting-state functional connectivity (RS-FC) analysis to determine if groups differed in cortical thickness and whether areas showing structural differences also showed abnormal RS-FC patterns. Patients completed the Abdominal Pain Index and the GI Module of the Pediatric Quality of Life Inventory to assess abdominal pain severity and impact of GI symptoms on health-related quality of life (HRQOL). Disease duration and pain intensity were also assessed. Pediatric IBS patients, relative to controls, showed cortical thickening in the posterior cingulate (PCC), whereas cortical thinning in posterior parietal and prefrontal areas were found, including the dorsolateral prefrontal cortex (DLPFC). In patients, abdominal pain severity was related to cortical thickening in the intra-abdominal area of the primary somatosensory cortex (SI), whereas HRQOL was associated with insular cortical thinning. Disease severity measures correlated with cortical thickness in bilateral DLPFC and orbitofrontal cortex. Patients also showed reduced anti-correlations between PCC and DLPFC compared to controls, a finding that may reflect aberrant connectivity between default mode and cognitive control networks. We are the first to demonstrate concomitant structural and functional brain changes associated with abdominal pain severity, HRQOL related to GI-specific symptoms, and disease-specific measures in

  10. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  11. Innovative chimney-graft technique for endovascular repair of a pararenal abdominal aortic aneurysm.

    PubMed

    Galiñanes, Edgar Luis; Hernandez-Vila, Eduardo A; Krajcer, Zvonimir

    2015-02-01

    After abdominal aortic aneurysm repair, progressive degeneration of the aneurysm can be challenging to treat. Multiple comorbidities and previous operations place such patients at high risk for repeat surgery. Endovascular repair is a possible alternative; however, challenging anatomy can push the limits of available technology. We describe the case of a 71-year-old man who presented with a 5.3-cm pararenal aneurysm 4 years after undergoing open abdominal aortic aneurysm repair. To avoid reoperation, we excluded the aneurysm by endovascular means, using visceral-artery stenting, a chimney-graft technique. Low-profile balloons on a monorail system enabled the rapid exchange of coronary wires via a buddy-wire technique. This novel approach facilitated stenting and simultaneous angioplasty of multiple visceral vessels and the abdominal aorta.

  12. Innovative Chimney-Graft Technique for Endovascular Repair of a Pararenal Abdominal Aortic Aneurysm

    PubMed Central

    Galiñanes, Edgar Luis; Hernandez-Vila, Eduardo A.

    2015-01-01

    After abdominal aortic aneurysm repair, progressive degeneration of the aneurysm can be challenging to treat. Multiple comorbidities and previous operations place such patients at high risk for repeat surgery. Endovascular repair is a possible alternative; however, challenging anatomy can push the limits of available technology. We describe the case of a 71-year-old man who presented with a 5.3-cm pararenal aneurysm 4 years after undergoing open abdominal aortic aneurysm repair. To avoid reoperation, we excluded the aneurysm by endovascular means, using visceral-artery stenting, a chimney-graft technique. Low-profile balloons on a monorail system enabled the rapid exchange of coronary wires via a buddy-wire technique. This novel approach facilitated stenting and simultaneous angioplasty of multiple visceral vessels and the abdominal aorta. PMID:25873796

  13. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  14. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  15. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  16. Biological, morphological and morphometric studies of Triatoma melanocephala Neiva & Pinto, 1923 (Hemiptera: Reduviidae: Triatominae).

    PubMed

    De Oliveira, Jader; Mendonça, Vagner J; De Araújo, Renato Freitas; Nascimento, Eliane Góes; Da Rosa, João Aristeu

    2015-09-04

    Triatoma melanocephala Neiva & Pinto is found in the Brazilian states of Bahia, Paraíba, Pernambuco, Rio Grande do Norte, and Sergipe. In addition to the species' specific description, eight other articles on this insect were found in the literature. In this study, data was obtained on the morphology, morphometry, and life cycle of T. melanocephala, since this vector is of epidemiological and taxonomic importance. The specimens studied were obtained from a colony that has been kept at the Triatomine Insectarium of the College of Pharmaceutical Sciences of São Paulo State University's in Brazil. The morphological studies were performed using scanning electron microscopy. These studies characterized the eggs, the external adult female genitalia, and the ninth ventral abdominal segments of male and female nymphs. The morphometric studies characterized the five nymphal instars and the adult stage by measuring the head, thorax, abdomen, antennae, and mouthparts parameters. The life cycle of T. melanocephala was developed starting by 15 couples in the fifth instar. They were fed on Swiss mice every two weeks and observed daily. During daily observation, minimum temperature, maximum temperature, and relative humidity of the laboratory were measured. The results of the biological, morphometric, and morphological studies have increased the knowledge available on T. melanocephala.

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

    PubMed

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

    2010-02-01

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

  18. Method for extracting the aorta from 3D CT images

    NASA Astrophysics Data System (ADS)

    Taeprasartsit, Pinyo; Higgins, William E.

    2007-03-01

    Bronchoscopic biopsy of the central-chest lymph nodes is vital in the staging of lung cancer. Three-dimensional multi-detector CT (MDCT) images provide vivid anatomical detail for planning bronchoscopy. Unfortunately, many lymph nodes are situated close to the aorta, and an inadvertent needle biopsy could puncture the aorta, causing serious harm. As an eventual aid for more complete planning of lymph-node biopsy, it is important to define the aorta. This paper proposes a method for extracting the aorta from a 3D MDCT chest image. The method has two main phases: (1) Off-line Model Construction, which provides a set of training cases for fitting new images, and (2) On-Line Aorta Construction, which is used for new incoming 3D MDCT images. Off-Line Model Construction is done once using several representative human MDCT images and consists of the following steps: construct a likelihood image, select control points of the medial axis of the aortic arch, and recompute the control points to obtain a constant-interval medial-axis model. On-Line Aorta Construction consists of the following operations: construct a likelihood image, perform global fitting of the precomputed models to the current case's likelihood image to find the best fitting model, perform local fitting to adjust the medial axis to local data variations, and employ a region recovery method to arrive at the complete constructed 3D aorta. The region recovery method consists of two steps: model-based and region-growing steps. This region growing method can recover regions outside the model coverage and non-circular tube structures. In our experiments, we used three models and achieved satisfactory results on twelve of thirteen test cases.

  19. A subpopulation of large granular von Willebrand Ag negative and CD105 positive endothelial cells, isolated from abdominal aortic aneurysms, overexpress ICAM-1 and Fas antigen.

    PubMed

    Páez, Araceli; Archundia, Abel; Méndez Cruz, René; Rodríguez, Emma; López Marure, Rebeca; Masso, Felipe; Aceves, José Luis; Flores, Leopoldo; Montaño, Luis F

    2002-01-01

    The aim of this work was to determine whether there is a pre-established basal condition of the endothelial cells isolated from aortic abdominal aneurysm that might augment immune effector mechanisms and thus provide us an insight into the possible causes of aneurysm rupture. Endothelial cells isolated from saccular aortic aneurysm fragments were analyzed by cytofluorometry for the expression of different immune response-related molecules. Our results showed that there is a subpopulation of granule-rich, CD105 positive and von Willebrand antigen negative endothelial cells that have an enhanced basal expression of ICAM-1, and Fas antigen, but, interestingly, no apoptotic bodies were detected. Control endothelial cells derived from healthy areas of the same abdominal aortas did not show such enhanced expression. We conclude that in the endothelium that lines abdominal aorta aneurysms there is, at least, one endothelial cell subpopulation with an apparent inhibition of programmed cell death and in a proinflammatory activation status.

  20. Right thoracotomy approach for repair of recurrent or complex coarctation of the aorta using an extra-anatomic ascending aorta to descending aorta bypass graft off-pump.

    PubMed

    Tabry, Imad F; Zachariah, Zachariah P

    2013-01-01

    A previously described but rarely used surgical technique for the repair of complex or recurrent coarctation of the aorta through a right thoracotomy approach is presented in detail. It has the advantages of being simple and avoiding left chest re-entry, median sternotomy and cardiopulmonary bypass altogether.

  1. The morphometrics of "masculinity" in human faces.

    PubMed

    Mitteroecker, Philipp; Windhager, Sonja; Müller, Gerd B; Schaefer, Katrin

    2015-01-01

    In studies of social inference and human mate preference, a wide but inconsistent array of tools for computing facial masculinity has been devised. Several of these approaches implicitly assumed that the individual expression of sexually dimorphic shape features, which we refer to as maleness, resembles facial shape features perceived as masculine. We outline a morphometric strategy for estimating separately the face shape patterns that underlie perceived masculinity and maleness, and for computing individual scores for these shape patterns. We further show how faces with different degrees of masculinity or maleness can be constructed in a geometric morphometric framework. In an application of these methods to a set of human facial photographs, we found that shape features typically perceived as masculine are wide faces with a wide inter-orbital distance, a wide nose, thin lips, and a large and massive lower face. The individual expressions of this combination of shape features--the masculinity shape scores--were the best predictor of rated masculinity among the compared methods (r = 0.5). The shape features perceived as masculine only partly resembled the average face shape difference between males and females (sexual dimorphism). Discriminant functions and Procrustes distances to the female mean shape were poor predictors of perceived masculinity.

  2. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway.

    PubMed

    Yan, Ya-Wei; Fan, Jun; Bai, Shu-Ling; Hou, Wei-Jian; Li, Xiang; Tong, Hao

    2016-01-01

    Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA). Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs) were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway. PMID:26918963

  3. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway

    PubMed Central

    Bai, Shu-Ling; Hou, Wei-Jian; Li, Xiang; Tong, Hao

    2016-01-01

    Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA). Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs) were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway. PMID:26918963

  4. Typology of abdominal arteries, with special reference to inferior phrenic arteries and their esophageal branches.

    PubMed

    Piao, D X; Ohtsuka, A; Murakami, T

    1998-08-01

    Origins and distribution of the human inferior phrenic arteries were studied by dissecting 68 Japanese adult cadavers. The inferior phrenic arteries were usually observed as paired (left and right) vessels. Their origins were summarized as follows: a) the aorta itself (85/138 cases, 61.6%), b) the ventro-visceral arteries (celiaco-mesenteric system of the aorta) including the celiac trunk (39/138 cases, 28.2%) and the left gastric artery (4/138 cases, 2.9%), and c) the latero-visceral arteries (adreno-renal system of the aorta) including the middle adrenal artery (4/138 cases, 2.9%) and the renal artery (6/138 cases, 4.3%). The left and right arteries occasionally originated in common trunk from the aorta, celiaco-mesenteric system or adreno-renal system (22/138 cases, 15.9%). A typological diagram explaining these variations is given. The inferior phrenic arteries, especially the left ones, sometimes issued visceral or esophageal branches. This fact indicates that the inferior phrenic arteries are homologous with the celiac trunk and mesenteric arteries. It is further discussed that the celiac trunk and mesenteric arteries are originally paired vessels, through introduction of our previous typological diagram of the abdominal arteries. PMID:9781269

  5. Spiral blood flow in aorta-renal bifurcation models.

    PubMed

    Javadzadegan, Ashkan; Simmons, Anne; Barber, Tracie

    2016-01-01

    The presence of a spiral arterial blood flow pattern in humans has been widely accepted. It is believed that this spiral component of the blood flow alters arterial haemodynamics in both positive and negative ways. The purpose of this study was to determine the effect of spiral flow on haemodynamic changes in aorta-renal bifurcations. In this regard, a computational fluid dynamics analysis of pulsatile blood flow was performed in two idealised models of aorta-renal bifurcations with and without flow diverter. The results show that the spirality effect causes a substantial variation in blood velocity distribution, while causing only slight changes in fluid shear stress patterns. The dominant observed effect of spiral flow is on turbulent kinetic energy and flow recirculation zones. As spiral flow intensity increases, the rate of turbulent kinetic energy production decreases, reducing the region of potential damage to red blood cells and endothelial cells. Furthermore, the recirculation zones which form on the cranial sides of the aorta and renal artery shrink in size in the presence of spirality effect; this may lower the rate of atherosclerosis development and progression in the aorta-renal bifurcation. These results indicate that the spiral nature of blood flow has atheroprotective effects in renal arteries and should be taken into consideration in analyses of the aorta and renal arteries. PMID:26414530

  6. Natural history of coarctation of the aorta

    PubMed Central

    Campbell, Maurice

    1970-01-01

    With the increasing number of subjects with coarctation of the aorta having operations, its natural history becomes more difficult to determine. The expectation of life has been calculated by two quite independent methods: (1) from 304 reported necropsies, and (2) from 22 deaths among 161 subjects followed for 716 patient-years. These were mostly patients rather than unselected school-children, but many were quite free from symptoms and were sent only because a murmur was heard on examination. Knowing how long they had been under observation, mortality rates could be calculated for each decade. They rise gradually but not very regularly, from 1.6 per cent in the first two decades to 6.7 per cent per annum in the sixth and later decades. The two methods give results in close agreement, closer than could be expected considering the relatively small numbers of patients and patient-years. The percentages of deaths at the end of each decade found by the two methods never differ by more than ±4 per cent and are often much closer. Of those surviving the serious hazards of the first one or two years, 25 per cent die before they reach 20, 50 per cent by 32, 75 per cent by 46, and 90 per cent by 58 years. The arithmetical mean of the ages of death is 34 years instead of 71 years as normally. These means, however, hide a very wide range, with standard deviations of at least ±15 per cent. For coarctation the median is 31 years and the mode is widely spread through the second to fifth decades rather than closely clustered round a point. This poor outlook makes an operative mortality in the region of 5 per cent a small price to pay for the greatly increased security afterwards. We do not yet know how much the risk of bacterial endocarditis or of intracranial haemorrhage will be reduced in the long run because there may be bicuspid aortic valves or intracranial berry aneurysms. The exact incidence of subacute bacterial endocarditis is uncertain, somewhere between 0.6 (from

  7. Novel Methodology for Characterizing Regional Variations in the Material Properties of Murine Aortas.

    PubMed

    Bersi, Matthew R; Bellini, Chiara; Di Achille, Paolo; Humphrey, Jay D; Genovese, Katia; Avril, Stéphane

    2016-07-01

    Many vascular disorders, including aortic aneurysms and dissections, are characterized by localized changes in wall composition and structure. Notwithstanding the importance of histopathologic changes that occur at the microstructural level, macroscopic manifestations ultimately dictate the mechanical functionality and structural integrity of the aortic wall. Understanding structure-function relationships locally is thus critical for gaining increased insight into conditions that render a vessel susceptible to disease or failure. Given the scarcity of human data, mouse models are increasingly useful in this regard. In this paper, we present a novel inverse characterization of regional, nonlinear, anisotropic properties of the murine aorta. Full-field biaxial data are collected using a panoramic-digital image correlation (p-DIC) system. An inverse method, based on the principle of virtual power (PVP), is used to estimate values of material parameters regionally for a microstructurally motivated constitutive relation. We validate our experimental-computational approach by comparing results to those from standard biaxial testing. The results for the nondiseased suprarenal abdominal aorta from apolipoprotein-E null mice reveal material heterogeneities, with significant differences between dorsal and ventral as well as between proximal and distal locations, which may arise in part due to differential perivascular support and localized branches. Overall results were validated for both a membrane and a thick-wall model that delineated medial and adventitial properties. Whereas full-field characterization can be useful in the study of normal arteries, we submit that it will be particularly useful for studying complex lesions such as aneurysms, which can now be pursued with confidence given the present validation. PMID:27210500

  8. [Traumatic rupture of the thoracic aorta].

    PubMed

    Glock, Y; Roux, D; Soula, P; Cerene, A; Fournial, G

    1996-01-01

    This is a retrospective analysis of 50 postraumatic aortic rupture (1968-1996, 39 males, mean age: 34.5). Group A is composed of 35 patients with an acute aortic rupture and a prompt diagnosis. Group B includes 13 patients with a chronic rupture. All patients from group A had a severe politraumatism with abdominal, cranial, extremities or hip fractures. Mediastinal thickening with or without hemothorax indicated an angiography or a transesophageal echocardiography lately. In group A, 36 patients have been operated on urgently (12-24 hours); cardiopulmonary bypass was performed on 20 patients; an aorto-aortical bypass was done in 27 cases and a direct suture in the remaining 9. In group B, cardiopulmonary bypass was performed on 9 patients; a aorto-aortical bypass was done in 11 cases and a direct suture in 2. Overall hospital mortality was 16%; 19% in group A and 7.6% in group B. Ischemic paraplejia appeared in 5 patients (10%), all from group A. No false aneurysm developed after 4.5 years of follow-up (3-135 months) in the 38 survivors. The usefulness of transesophageal echocardiography, the importance of medular protection and the utility of several interventionist radiologic techniques are discussed. PMID:9053930

  9. Modification of an endovascular stent graft for abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Moloye, Olajompo Busola

    Endovascular surgery is currently used to treat abdominal aortic aneurysms (AAA). A stent graft is deployed to exclude blood flow from the aneurysm sac. It is an effective procedure used in preventing aneurysm rupture, with reduced patient morbidity and mortality compared to open surgical repair. Migration and leakage around the device ("endoleak") due to poor sealing of the stent graft to the aorta have raised concerns about the long-term durability of endovascular repair. A preliminary study of cell migration and proliferation is presented as a prelude to a more extensive in vivo testing. A method to enhance the biological seal between the stent graft and the aorta is proposed to eliminate this problem. This can be achieved by impregnating the stent graft with 50/50 poly (DL-lactide co glycolic acid) (PLGA) and growth factors such as basic fibroblast growth factor (bFGF) or connective tissue growth factor (CTGF), at the proximal and distal ends. It is hypothesized that as PLGA degrades it will release the growth factors that will promote proliferation and migration of aortic smooth muscle cells to the coated site, leading to a natural seal between the aorta and the stent graft. In addition, growth factor release should promote smooth muscle cell (SMC) contraction that will help keep the stent graft in place at the proximal and distal ends. It is shown that a statistically significant effect of increased cell proliferation and migration is observed for CTGF release. Less of an effect is noted for bFGF or just the PLGA. The effect is estimated to be large enough to be clinically significant in a future animal study. The long term goal of this study is to reduce migration encounter after graft deployment and to reduce secondary interventions of EVAR especially for older patients who are unfit for open surgical treatment.

  10. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  11. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  12. Geometric morphometric footprint analysis of young women

    PubMed Central

    2013-01-01

    Background Most published attempts to quantify footprint shape are based on a small number of measurements. We applied geometric morphometric methods to study shape variation of the complete footprint outline in a sample of 83 adult women. Methods The outline of the footprint, including the toes, was represented by a comprehensive set of 85 landmarks and semilandmarks. Shape coordinates were computed by Generalized Procrustes Analysis. Results The first four principal components represented the major axes of variation in foot morphology: low-arched versus high-arched feet, long and narrow versus short and wide feet, the relative length of the hallux, and the relative length of the forefoot. These shape features varied across the measured individuals without any distinct clusters or discrete types of footprint shape. A high body mass index (BMI) was associated with wide and flat feet, and a high frequency of wearing high-heeled shoes was associated with a larger forefoot area of the footprint and a relatively long hallux. Larger feet had an increased length-to-width ratio of the footprint, a lower-arched foot, and longer toes relative to the remaining foot. Footprint shape differed on average between left and right feet, and the variability of footprint asymmetry increased with BMI. Conclusions Foot shape is affected by lifestyle factors even in a sample of young women (median age 23 years). Geometric morphometrics proved to be a powerful tool for the detailed analysis of footprint shape that is applicable in various scientific disciplines, including forensics, orthopedics, and footwear design. PMID:23886074

  13. Improving the Efficiency of Abdominal Aortic Aneurysm Wall Stress Computations

    PubMed Central

    Zelaya, Jaime E.; Goenezen, Sevan; Dargon, Phong T.; Azarbal, Amir-Farzin; Rugonyi, Sandra

    2014-01-01

    An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses. PMID:25007052

  14. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    PubMed

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress. PMID:25531554

  15. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    PubMed

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress.

  16. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  17. Endovascular covered stent treatment for descending aorta pseudoaneurysm following coarctation of the aorta repair in an infant.

    PubMed

    Takawira, Farirai F; Sinyangwe, Greenwood; Mooloo, Rene

    2010-12-01

    The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.

  18. Techniques of imaging of the aorta and its first order branches by endoscopic ultrasound (with videos)

    PubMed Central

    Sharma, Malay; Rai, Praveer; Mehta, Varun; Rameshbabu, C. S.

    2015-01-01

    Endoscopic ultrasonography (EUS) is a useful modality for imaging of the blood vessels of the mediastinum and abdomen. The aorta acts as an important home base during EUS imaging. The aorta and its branches are accessible by standard angiographic methods, but endosonography also provides a unique opportunity to evaluate the aorta and its branches. This article describes the techniques of imaging of different part of the aorta by EUS. PMID:26020043

  19. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  20. Peroxisome Proliferator-Activated Receptor γ Level Contributes to Structural Integrity and Component Production of Elastic Fibers in the Aorta.

    PubMed

    Tai, Haw-Chih; Tsai, Pei-Jane; Chen, Ju-Yi; Lai, Chao-Han; Wang, Kuan-Chieh; Teng, Shih-Hua; Lin, Shih-Chieh; Chang, Alice Y W; Jiang, Meei-Jyh; Li, Yi-Heng; Wu, Hua-Lin; Maeda, Nobuyo; Tsai, Yau-Sheng

    2016-06-01

    Loss of integrity and massive disruption of elastic fibers are key features of abdominal aortic aneurysm (AAA). Peroxisome proliferator-activated receptor γ (PPARγ) has been shown to attenuate AAA through inhibition of inflammation and proteolytic degradation. However, its involvement in elastogenesis during AAA remains unclear. PPARγ was highly expressed in human AAA within all vascular cells, including inflammatory cells and fibroblasts. In the aortas of transgenic mice expressing PPARγ at 25% normal levels (Pparg(C) (/-) mice), we observed the fragmentation of elastic fibers and reduced expression of vital elastic fiber components of elastin and fibulin-5. These were not observed in mice with 50% normal PPARγ expression (Pparg(+/-) mice). Infusion of a moderate dose of angiotensin II (500 ng/kg per minute) did not induce AAA but Pparg(+/-) aorta developed flattened elastic lamellae, whereas Pparg(C/-) aorta showed severe destruction of elastic fibers. After infusion of angiotensin II at 1000 ng/kg per minute, 73% of Pparg(C/-) mice developed atypical suprarenal aortic aneurysms: superior mesenteric arteries were dilated with extensive collagen deposition in adventitia and infiltrations of inflammatory cells. Although matrix metalloproteinase inhibition by doxycycline somewhat attenuated the dilation of aneurysm, it did not reduce the incidence nor elastic lamella deterioration in angiotensin II-infused Pparg(C/-) mice. Furthermore, PPARγ antagonism downregulated elastin and fibulin-5 in fibroblasts, but not in vascular smooth muscle cells. Chromatin immunoprecipitation assay demonstrated PPARγ binding in the genomic sequence of fibulin-5 in fibroblasts. Our results underscore the importance of PPARγ in AAA development though orchestrating proper elastogenesis and preserving elastic fiber integrity. PMID:27045031

  1. System and method for 3-D/3-D registration between non-contrast-enhanced CBCT and contrast-enhanced CT for abdominal aortic aneurysm stenting.

    PubMed

    Miao, Shun; Liao, Rui; Pfister, Marcus; Zhang, Li; Ordy, Vincent

    2013-01-01

    In this paper, we present an image guidance system for abdominal aortic aneurysm stenting, which brings pre-operative 3-D computed tomography (CT) into the operating room by registering it against intra-operative non-contrast-enhanced cone-beam CT (CBCT). Registration between CT and CBCT volumes is a challenging task due to two factors: the relatively low signal-to-noise ratio of the abdominal aorta in CBCT without contrast enhancement, and the drastically different field of view between the two image modalities. The proposed automatic registration method handles the first issue through a fast quasi-global search utilizing surrogate 2-D images, and solves the second problem by relying on neighboring dominant structures of the abdominal aorta (i.e. the spine) for initial coarse alignment, and using a confined and image-processed volume of interest around the abdominal aorta for fine registration. The proposed method is validated offline using 17 clinical datasets, and achieves 1.48 mm target registration error and 100% success rate in 2.83 s. The prototype system has been installed in hospitals for clinical trial and applied in around 30 clinical cases, with 100% success rate reported qualitatively. PMID:24505689

  2. Tyrphostin AG490 reduces NAPDH oxidase activity and expression in the aorta of hypercholesterolemic apolipoprotein E-deficient mice.

    PubMed

    Fenyo, Ioana M; Florea, Irina C; Raicu, Monica; Manea, Adrian

    2011-01-01

    Oxidative stress-induced vascular injury represents a major contributor to the pathoetiology of atherosclerosis. Elevated NADPH oxidase (Nox) activity promotes oxidative injury of the cardiovascular cells. Janus-tyrosine-kinase (Jak) family regulate various aspects of the atherosclerotic process e.g., inflammation, cellular growth, proliferation, and migration. Here, we investigated the potential of Jak2 inhibition to counteract Nox-dependent O(2)(•-) formation in atherogenesis in hypercholesterolemic apolipoprotein E-deficient (ApoE(-/-)) mice. Male ApoE(-/-) mice fed a high-fat, cholesterol-rich diet were treated for 5 weeks with either vehicle or tyrphostin AG490 (1 mg/kg), a specific Jak2 inhibitor. Lucigenin-enhanced-chemiluminescence assay, real-time PCR and Western blot analysis revealed that Nox-derived O(2)(•-) generation, Nox1, Nox2, and Nox4 mRNA and protein levels were significantly elevated in the aortas of ApoE(-/-) mice fed a high-fat diet compared to ApoE(-/-) mice fed a normal diet. Treatment with tyrphostin AG490 significantly reduced the up-regulated Nox activity, the expression of each Nox subtype, as well as the protein level of CD68, a macrophage-specific marker. Morphometric analysis showed a marked reduction of atherosclerotic lesions in the aorta of AG490-treated animals. These data provide new insights into the regulation of vascular Nox by tyrphostins in the cardiovascular system. Since Jak2 transduces the signals of various cardiovascular risk factors, pharmacological manipulation of this signaling pathway may represent a novel strategy to reduce oxidative stress in atherosclerosis. PMID:21457788

  3. [The abdominal drop flap].

    PubMed

    Bodin, F; Liverneaux, P; Seigle-Murandi, F; Facca, S; Bruant-Rodier, C; Dissaux, C; Chaput, B

    2015-08-01

    The skin between the mastectomy scar and the future infra-mammary fold may be managed in different ways in delayed breast reconstruction using a DIEP (deep inferior epigastric perforator). Conserving this skin and positioning the flap skin paddle in the middle of the breast usually highlights skin color disparity because of two visible transition zones. Resection of the entire skin under the scar may be more aesthetic but limits direct closure possibility in case of flap failure. In order to benefit from both aesthetic result and safe surgical method, we propose the abdominal drop flap. The inferior thoracic skin flap is detached from the thoracic wall beyond the future infra-mammary fold, preserved and pushed under the breast.

  4. Vein of Galen arteriovenous malformation mimicking coarctation of the aorta.

    PubMed

    Firdouse, Mohammed; Agarwal, Arnav; Mondal, Tapas

    2014-12-01

    Arteriovenous malformation of the vein of Galen is a rare congenital intracranial anomaly lacking a capillary bed and subsequent aneurysmal enlargement of the arterial and venous system, warranting careful management due to associated morbidity and mortality. Coarctations of aorta demonstrate similar neonatal echocardiographic signs to the vein of Galen arterial malformation (VGAM). We present a boy at 37 weeks of gestation whose initial ultrasound and echocardiographic investigations showed a dominant right ventricle and isthmal hypoplasia, suggestive of coarctation of aorta. Follow-up ultrasound and echocardiography revealed an arteriovenous malformation involving middle and posterior cerebral artery branches, eliminating coarctation of aorta. VGAM was confirmed by further ultrasound and angiographic investigation, which demonstrated a tangle of cerebral and choroidal arterial branches centrally feeding into an enlarged vein of Galen. The boy's hemodynamic and neurological statuses were confirmed to be stable despite increased venous pressure. Elective embolization at 7 months of age was complicated by a cerebrovascular accident, resulting in right hemiparesis despite no residual cardiac issues. This case demonstrates that rarely, arteriovenous malformations such as the vein of Galen malformations may be the primary cause of patients presenting with coarctation of aorta. The rarity of this condition and its guarded prognosis make our case of special interest to cardiologists and the perinatal care team.

  5. Cerebral ischaemia after repair of coarctation of the aorta.

    PubMed

    Gogou, Maria; Keivanidou, Anastasia; Giannopoulos, Andreas

    2015-04-01

    A 9-year-old boy, with a history of repair of severe coarctation of the aorta through balloon angioplasty 2 weeks ago, presented in the emergency paediatric department with symptoms consistent with transient cerebral ischaemia. MRI revealed an area of cerebral infarction in the right frontal lobe. Causes of cerebral ischaemia after aortic coarctation repair are briefly discussed.

  6. MORPHOMETRIC EVIDENCE FOR NUTRITIONAL STRESS IN ENGLISH SOLE

    EPA Science Inventory

    We present an application of the powerful thin plate spline method of morphometric analysis to demonstrate its utility for detecting environmental stress in an estuarine flatfish. Juvenile English sole (Pleuronectes vetulus) were captured from Yaquina Bay, Oregon, photographed w...

  7. Late diagnosis of Takayasu's arteritis with repeated attacks of heart failure and uncontrolled hypertension due to abdominal aortic thrombosis: case report and review of the literature.

    PubMed

    Wang, Huan; Lai, Baochun; Wu, Xiaoying; Han, Tao; Chen, Hui

    2015-01-01

    Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease affecting the aorta and its branches. To date, only one case involving abdominal aortic thrombosis due to TA has been reported. After bilateral artificial subclavian-iliac bypass, a case of abdominal aortic thrombosis due to TA received a delayed diagnosis in a 44-year-old Chinese male who experienced recurrent episodes of heart failure and uncontrolled hypertension with claudication of two extremities. Abdominal color Doppler sonography and computed tomography aortography (CTA) showed occlusion of the abdominal aorta and bilateral renal artery stenosis. After vascular bypass and during 1 year follow-up, his cardiac function improved and blood pressure was well controlled, with reduced serum creatinine. Postoperative CTA still showed abdominal aortic thrombosis resulting in arterial occlusion extending from the left renal artery initial segment level to the bilateral common iliac artery and the bifurcation of the renal artery, except for the vascular bypass. Abdominal aortic thrombosis due to TA is very rare and potentially life threatening, probably becoming an atherosclerosis risk factor. Doppler sonography and CTA results are important for diagnosis. Artificial vascular bypass can be used for TA in debilitated patients with diffuse aortic disease.

  8. Proximal clamping levels in abdominal aortic aneurysm surgery.

    PubMed Central

    Büket, S; Atay, Y; Islamoğlu, F; Yağdi, T; Posacioğlu, H; Alat, I; Cikirikçioğlu, M; Yüksel, M; Durmaz, I

    1999-01-01

    In the surgical treatment of abdominal aortic aneurysm, the single proximal cross-clamp can be placed at 3 alternative aortic levels: infrarenal, hiatal, and thoracic. We performed this retrospective study to evaluate the advantages and disadvantages of the 3 main aortic clamping locations. Eighty patients presented at our institution with abdominal aortic aneurysms from March 1993 through May 1998. Fifty of these patients had intact aneurysms and underwent elective surgery, and 30 had ruptured aneurysms that necessitated emergency surgery. Proximal aortic clamping was applied at the infrarenal level in 24 patients (22 from the intact aneurysm group, 2 from the ruptured group), at the hiatal level in 34 patients (22 intact, 12 ruptured), and at the thoracic level (descending aorta) via a limited left lateral thoracotomy in 22 patients (6 intact, 16 ruptured). Early mortality rates (within 30 days) were 4% (2 of 50 patients) among patients with intact aneurysms and 40% (12 of 30 patients) among those with ruptured aneurysms. In the 2 patients from the intact aneurysm group, proximal aortic clamps were applied at the hiatal level. In the ruptured aneurysm group, proximal aortic clamps were placed at the thoracic level in 10 patients, the infrarenal level in 1, and the hiatal level in 1. According to our study, the clinical status of the patient and the degree of operative urgency--as determined by the extent of the aneurysm--generally dictate the proximal clamp location. Patients who present with aneurysmal rupture or hypovolemic shock benefit from thoracic clamping, because it restores the blood pressure and allows time to replace the volume deficit. Infrarenal placement is advantageous in patients with intact aneurysms if there is sufficient space for the clamp between the renal arteries and the aortic aneurysm. In patients with juxtarenal aneurysms, hiatal clamping enables safe and easy anastomosis to the healthy aorta. Clamping at this level also helps prevent

  9. Biometrics, biomathematics and the morphometric synthesis.

    PubMed

    Bookstein, F L

    1996-03-01

    At the core of contemporary morphometrics--the quantitative study of biological shape variation--is a synthesis of two originally divergent methodological styles. One contributory tradition is the multivariate analysis of covariance matrices originally developed as biometrics and now dominant across a broad expanse of applied statistics. This approach, couched solely in the linear geometry of covariance structures, ignores biomathematical aspects of the original measurements. The other tributary emphasizes the direct visualization of changes in biological form. However, making objective the biological meaning of the features seen in those diagrams was always problematical; also, the representation of variation, as distinct from pairwise difference, proved infeasible. To combine these two variants of biomathematical modeling into a valid praxis for quantitative studies of biological shape was a goal earnestly sought though most of this century. That goal was finally achieved in the 1980s when techniques from mathematical statistics, multivariate biometrics, non-Euclidean geometry and computer graphics were combined in a coherent new system of tools for the complete regionalized quantitative analysis of landmark points together with the biomedical images in which they are seen. In this morphometric synthesis, correspondence of landmarks (biologically labeled geometric points, like "bridge of the nose") across specimens is taken as a biomathematical primitive. The shapes of configurations of landmarks are defined as equivalence classes with respect to the Euclidean similarity group and then represented as single points in David Kendall's shape space, a Riemannian manifold with Procrustes distance as metric. All conventional multivariate strategies carry over to the study of shape variation and covariation when shapes are interpreted in the tangent space to the shape manifold at an average shape. For biomathematical interpretation of such analyses, one needs a basis

  10. [Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].

    PubMed

    Nikul'nikov, P I; Liksunov, O V; Ratushniuk, A V; Lugovs'koĭ, E V; Kolesnikova, I M; Lytvynova, L M; Kostiuchenko, O P; Chernyshenko, T M; Hornyts'ka, O V; Platonova, T M

    2012-09-01

    Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.

  11. Numerical analysis of the hemodynamics of an abdominal aortic aneurysm repaired using the endovascular chimney technique.

    PubMed

    Ben Gur, Hila; Kosa, Gabor; Brand, Moshe

    2015-08-01

    This paper presents a numerical analysis of the hemodynamics in an abdominal aorta (AA) with an aneurysm repaired by a stent graft (SG) system using the chimney technique. Computational fluid dynamics (CFD) simulations were conducted in a model of an AA repaired with a chimney stent graft (CSG) inserted into a renal artery parallel to an aortic SG and a model of a healthy AA. Comparing the simulation results of these two cases suggests that the presence of the CSG in the AA causes changes in average wall shear stress (WSS), potentially damaging recirculation zones, and additional changes in flow patterns. PMID:26736427

  12. Snorkel/chimney and fenestrated endografts for complex abdominal aortic aneurysms.

    PubMed

    Ullery, B W; Lee, J T; Dalman, R L

    2015-10-01

    Complex endovascular aneurysm repair (EVAR) involves extension of the proximal aortic seal zone with preservation of branch vessel patency, thereby expanding the applicability of endografting from the infrarenal to the suprarenal aorta. Snorkel/chimney (Sn-EVAR) and fenestrated EVAR (f-EVAR) serve as the two most commonly utilized advanced endovascular techniques to combat hostile proximal neck anatomy. The purpose of this article is to describe the principles and evolution of these advanced endovascular strategies, technical considerations, and results of sn- and f-EVAR in the management of challenging neck anatomy in abdominal aortic aneurysm disease.

  13. Restoration of the pelvic circulation in patients with abdominal aortic aneurysms receiving aortobifemoral grafts.

    PubMed

    Cardia, G; Tumolo, R; Cafagna, L

    1998-04-01

    When operating on abdominal aortic aneurysms associated with stenoses or occlusions of iliac vessels, surgeons may face the problem of reestablishing circulation to pelvic or gluteal territories. A new technique consists of anastomosing a posterior opening in the body or one of the branches of a bifurcated graft, distally sutured to the femoral artery, to the distal aortic stump, which contains all the patent vessels arising from the end of the aorta, such as inferior mesenteric and lumbar arteries. This technique, successfully performed in two cases, has the advantages of avoiding closure of the distal aortic stump and a possible backflow leak and of ensuring adequate pelvic circulation. PMID:9576094

  14. An Aortic Tampon for Emergency Control of Ruptured Abdominal Aneurysm

    PubMed Central

    Heimbecker, R. O.

    1964-01-01

    Ruptured abdominal aneurysm has now become a common surgical emergency, frequently amenable to successful resection and cure. The final result is often marred, however, by the effects of renal, coronary or cerebral ischemia resulting from dangerous hypotension during transportation of the patient to a vascular centre. An aortic catheter has been developed which is passed by way of a brachial artery cut-down so that it rests in the abdominal aorta. The balloon at its tip is then filled with sodium diatrizoate (Hypaque) so that it completely obstructs the aortic lumen just above the level of the aneurysm. Accurate positioning of the balloon to carefully preserve renal blood flow is facilitated by fluoroscopic control. The use of this procedure in three patients has been very satisfactory, with a dramatic return of consciousness and of normal blood pressure, without the need for further blood replacement. Subsequent surgery with dissection of the aneurysm was aided by the presence of the palpable inflated balloon. ImagesFig. 1 PMID:14222672

  15. In vivo strain assessment of the abdominal aortic aneurysm.

    PubMed

    Satriano, Alessandro; Rivolo, Simone; Martufi, Giampaolo; Finol, Ender A; Di Martino, Elena S

    2015-01-21

    The only criteria currently used to inform surgical decision for abdominal aortic aneurysms are maximum diameter (>5.5 cm) and rate of growth, even though several studies have identified the need for more specific indicators of risk. Patient-specific biomechanical variables likely to affect rupture risk would be a valuable addition to the science of understanding rupture risk and prove to be a life saving benefit for patients. Local deformability of the aorta is related to the local mechanical properties of the wall and may provide indication on the state of weakening of the wall tissue. We propose a 3D image-based approach to compute aortic wall strain maps in vivo. The method is applicable to a variety of imaging modalities that provide sequential images at different phases in the cardiac cycle. We applied the method to a series of abdominal aneurysms imaged using cine-MRI obtaining strain maps at different phases in the cardiac cycle. These maps could be used to evaluate the distensibility of an aneurysm at baseline and at different follow-up times and provide an additional index to clinicians to facilitate decisions on the best course of action for a specific patient. PMID:25497379

  16. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  17. Studying avian encephalization with geometric morphometrics.

    PubMed

    Marugán-Lobón, Jesús; Watanabe, Akinobu; Kawabe, Soichiro

    2016-08-01

    Encephalization is a core concept in comparative neurobiology, aiming to quantify the neurological capacity of organisms. For measuring encephalization, many studies have employed relative brain sizes corrected for expected allometric scaling to body size. Here we highlight the utility of a multivariate geometric morphometric (GM) approach for visualizing and analyzing neuroanatomical shape variation associated with encephalization. GM readily allows the statistical evaluation of covariates, such as size, and many software tools exist for visualizing their effects on shape. Thus far, however, studies using GM have not attempted to translate the meaning of encephalization to shape data. As such, we tested the statistical relationship between size and encephalization quotients (EQs) to brain shape utilizing a broad interspecific sample of avian endocranial data. Although statistically significant, the analyses indicate that allometry accounts for <10% of total neuroanatomical shape variation. Notably, we find that EQs, despite being corrected for allometric scaling based on size, contain size-related neuroanatomical shape changes. In addition, much of what is traditionally considered encephalization comprises clade-specific trends in relative forebrain expansion, particularly driven by landbirds. EQs, therefore, fail to capture 90% of the total neuroanatomical variation after correcting for allometry and shared phylogenetic history. Moving forward, GM techniques provide crucial tools for investigating key drivers of this vast, largely unexplored aspect of avian brain morphology. PMID:27112986

  18. Geometric morphometrics of hominoid infraspinous fossa shape.

    PubMed

    Green, David J; Serrins, Jesse D; Seitelman, Brielle; Martiny, Amy R; Gunz, Philipp

    2015-01-01

    Recent discoveries of early hominin scapulae from Ethiopia (Dikika, Woranso-Mille) and South Africa (Malapa) have motivated new examinations of the relationship between scapular morphology and locomotor function. In particular, infraspinous fossa shape has been shown to significantly differ among hominoids. However, this region presents relatively few homologous landmarks, such that traditional distance and angle-based methods may oversimplify this three-dimensional structure. To more thoroughly assess infraspinous fossa shape variation as it relates to function among adult hominoid representatives, we considered two geometric morphometric (GM) approaches--one employing five homologous landmarks ("wireframe") and another with 83 sliding semilandmarks along the border of the infraspinous fossa. We identified several differences in infraspinous fossa shape with traditional approaches, particularly in superoinferior fossa breadth and scapular spine orientation. The wireframe analysis reliably captured the range of shape variation in the sample, which reflects the relatively straightforward geometry of the infraspinous fossa. Building on the traditional approach, the GM results highlighted how the orientation of the medial portion of the infraspinous fossa differed relative to both the axillary border and spine. These features distinguished Pan from Gorilla in a way that traditional analyses had not been able to discern. Relative to the wireframe method, the semilandmark approach further distinguished Pongo from Homo, highlighting aspects of infraspinous fossa morphology that may be associated with climbing behaviors in hominoid taxa. These results highlight the ways that GM methods can enhance our ability to evaluate complex aspects of shape for refining and testing hypotheses about functional morphology.

  19. Exploring Eucladoceros ecomorphology using geometric morphometrics.

    PubMed

    Curran, Sabrina C

    2015-01-01

    An increasingly common method for reconstructing paleoenvironmental parameters of hominin sites is ecological functional morphology (ecomorphology). This study provides a geometric morphometric study of cervid rearlimb morphology as it relates to phylogeny, size, and ecomorphology. These methods are then applied to an extinct Pleistocene cervid, Eucladoceros, which is found in some of the earliest hominin-occupied sites in Eurasia. Variation in cervid postcranial functional morphology associated with different habitats can be summarized as trade-offs between joint stability versus mobility and rapid movement versus power-generation. Cervids in open habitats emphasize limb stability to avoid joint dislocation during rapid flight from predators. Closed-adapted cervids require more joint mobility to rapidly switch directions in complex habitats. Two skeletal features (of the tibia and calcaneus) have significant phylogenetic signals, while two (the femur and third phalanx) do not. Additionally, morphology of two of these features (tibia and third phalanx) were correlated with body size. For the tibial analysis (but not the third phalanx) this correlation was ameliorated when phylogeny was taken into account. Eucladoceros specimens from France and Romania fall on the more open side of the habitat continuum, a result that is at odds with reconstructions of their diet as browsers, suggesting that they may have had a behavioral regime unlike any extant cervid.

  20. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  1. Preparation of Single Cell Suspensions from Mouse Aorta

    PubMed Central

    Hu, Desheng; Yin, Changjun; Mohanta, Sarajo K.; Weber, Christian; Habenicht, Andreas J. R.

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by lipid deposition, plaque formation, and immune cell infiltration. Innate and adaptive immune cells infiltrate the artery during development of the disease. Moreover, advanced disease leads to formation of artery tertiary lymphoid organs in the adventitia (Grabner et al., 2009; Hu et al., 2015). Various and diverse types of immune cells have been identified in the aorta adventitia vs atherosclerotic plaques (Elewa et al., 2016; Galkina et al., 2006; Lotzer et al., 2010; Mohanta et al., 2016; Mohanta et al., 2014; Moos et al., 2005; Srikakulapu et al., 2016; Zhao et al., 2004). There are conflicting reports on the number and subtypes of immune cells in the aorta depending on the age of the animals, the protocol that is used to obtain single cell suspensions, and the dietary conditions of the mice (Campbell et al., 2012; Clement et al., 2015; Galkina et al., 2006; Kyaw et al., 2012). The number of immune cells in the aorta differs as much as tenfold using different protocols (Butcher et al., 2012; Galkina et al., 2006; Gjurich et al., 2015; Grabner et al., 2009; Hu et al., 2015). These discrepant results call for a protocol that robustly documents bona fide aorta cells rather than those in the surrounding tissues or blood. Critical methodological hurdles include the removal of adjacent adipose tissue and small paraaortic lymph nodes lining the entire aortic tree that are not visible by the naked eye. A dissection microscope is therefore recommended. Moreover protocols of aorta preparations should ascertain that lymphocyte aggregates referred to as fat associated lymphoid clusters (FALCs) (Benezech et al., 2015; Elewa et al., 2015) that are often present at the border between the adipose tissue and the adventitia are removed before enzyme digestion. We propose - besides other approaches (Hu et al., 2015; Mohanta et al., 2014) - a combination of immunohistochemical staining and

  2. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  3. Fused Traditional and Geometric Morphometrics Demonstrate Pinniped Whisker Diversity

    PubMed Central

    Ginter, Carly C.; DeWitt, Thomas J.; Fish, Frank E.; Marshall, Christopher D.

    2012-01-01

    Vibrissae (whiskers) are important components of the mammalian tactile sensory system, and primarily function as detectors of vibrotactile information from the environment. Pinnipeds possess the largest vibrissae among mammals and their vibrissal hair shafts demonstrate a diversity of shapes. The vibrissae of most phocid seals exhibit a beaded morphology with repeating sequences of crests and troughs along their length. However, there are few detailed analyses of pinniped vibrissal morphology, and these are limited to a few species. Therefore, we comparatively characterized differences in vibrissal hair shaft morphologies among phocid species with a beaded profile, phocid species with a smooth profile, and otariids with a smooth profile using traditional and geometric morphometric methods. Traditional morphometric measurements (peak-to-peak distance, crest width, trough width and total length) were collected using digital photographs. Elliptic Fourier analysis (geometric morphometrics) was used to quantify the outlines of whole vibrissae. The traditional and geometric morphometric datasets were subsequently combined by mathematically scaling each to true rank, followed by a single eigendecomposition. Quadratic discriminant function analysis demonstrated that 79.3, 97.8 and 100% of individuals could be correctly classified to their species based on vibrissal shape variables in the traditional, geometric and combined morphometric analyses, respectively. Phocids with beaded vibrissae, phocids with smooth vibrissae, and otariids each occupied distinct morphospace in the geometric morphometric and combined data analyses. Otariids split into two groups in the geometric morphometric analysis and gray seals appeared intermediate between beaded- and smooth-whiskered species in the traditional and combined analyses. Vibrissal hair shafts modulate the transduction of environmental stimuli to the mechanoreceptors in the follicle-sinus complex (F-SC), which results in

  4. Influence of Tribulus terrestris extract on lipid profile and endothelial structure in developing atherosclerotic lesions in the aorta of rabbits on a high-cholesterol diet.

    PubMed

    Tuncer, M Altug; Yaymaci, Bengi; Sati, Leyla; Cayli, Sevil; Acar, Goksemin; Altug, Tuncay; Demir, Ramazan

    2009-01-01

    The aim of this study was to investigate the pleotropic effects of an extract of a traditional herb, Tribulus terrestris (TT), on the lipid profile and vascular endothelium of the abdominal aorta in New Zealand rabbits fed a cholesterol-rich diet. Eighteen rabbits were randomly divided into three groups (n=6 for each). One experimental group (EG-I) was given a cholesterol-rich diet, a second experimental group (EG-II) was treated with TT following a cholesterol-rich diet, and a control group (CG) was fed a standard diet. Blood samples were collected on day 0 and then at weeks 4 and 12 to determine total serum cholesterol (TC), high density lipid-cholesterol (HDL-C), low density lipid-cholesterol (LDL-C) and triglyceride (TG) levels. Tissues were collected from the abdominal aorta for immunohistochemistry and transmission and scanning electron microscopy. In EG-II, the serum lipid profile was significantly lower than that of EG-I at week 12 with a reduction of TC: 65%; LDL-C: 66%; HDL-C: 64%; TG: 55%. Ultrastructural analysis revealed that endothelial damage was more prominent in EG-I compared to EG-II. The ruptured endothelial linings and damaged cellular surfaces increased in EG-I compared to EG-II. Our data indicate that dietary intake of TT can significantly lower serum lipid profiles, decrease endothelial cellular surface damage and rupture and may partially repair the endothelial dysfunction resulting from hyperlipidemia.

  5. Hypoperfusion of the Adventitial Vasa Vasorum Develops an Abdominal Aortic Aneurysm

    PubMed Central

    Sasaki, Takeshi; Sano, Masaki; Yamamoto, Naoto; Saito, Takaaki; Inuzuka, Kazunori; Hayasaka, Takahiro; Goto-Inoue, Naoko; Sugiura, Yuki; Sato, Kohji; Kugo, Hirona; Moriyama, Tatsuya; Konno, Hiroyuki; Setou, Mitsutoshi; Unno, Naoki

    2015-01-01

    The aortic wall is perfused by the adventitial vasa vasorum (VV). Tissue hypoxia has previously been observed as a manifestation of enlarged abdominal aortic aneurysms (AAAs). We sought to determine whether hypoperfusion of the adventitial VV could develop AAAs. We created a novel animal model of adventitial VV hypoperfusion with a combination of a polyurethane catheter insertion and a suture ligation of the infrarenal abdominal aorta in rats. VV hypoperfusion caused tissue hypoxia and developed infrarenal AAA, which had similar morphological and pathological characteristics to human AAA. In human AAA tissue, the adventitial VV were stenotic in both small AAAs (30–49 mm in diameter) and in large AAAs (> 50 mm in diameter), with the sac tissue in these AAAs being ischemic and hypoxic. These results indicate that hypoperfusion of adventitial VV has critical effects on the development of infrarenal AAA. PMID:26308526

  6. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm.

    PubMed

    Li, Jiaze; Krishna, Smriti Murali; Golledge, Jonathan

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of functions, potentially relevant in AAA pathogenesis. Kallistatin has been reported to have inhibitory effects on tumor necrosis factor alpha (TNF-α) signaling induced oxidative stress and apoptosis. Kallistatin also inhibits vascular endothelial growth factor (VEGF) and Wnt canonical signaling, which promote inflammation, angiogenesis, and vascular remodeling in various pre-clinical experimental models. This review explores the potential protective role of kallistatin in AAA pathogenesis. PMID:27529213

  7. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm

    PubMed Central

    Li, Jiaze; Krishna, Smriti Murali; Golledge, Jonathan

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of functions, potentially relevant in AAA pathogenesis. Kallistatin has been reported to have inhibitory effects on tumor necrosis factor alpha (TNF-α) signaling induced oxidative stress and apoptosis. Kallistatin also inhibits vascular endothelial growth factor (VEGF) and Wnt canonical signaling, which promote inflammation, angiogenesis, and vascular remodeling in various pre-clinical experimental models. This review explores the potential protective role of kallistatin in AAA pathogenesis. PMID:27529213

  8. [ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR].

    PubMed

    Maĭstrenko, D N; Generalov, M I; Tarazov, P G; Zherebtsov, F K; Osovskikh, V V; Ivanov, A S; Oleshchuk, A N; Granov, D A

    2015-01-01

    The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group. PMID:26234059

  9. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  10. Abdominal ultrasonography, 2nd Ed

    SciTech Connect

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

  11. Elastic arteries in invertebrates: mechanics of the octopus aorta.

    PubMed

    Shadwick, R E; Gosline, J M

    1981-08-14

    The aorta of the octopus, Octopus dofleini, is a highly distensible, elastic tube. The circumferential elastic modulus increases with inflation in the physiological range from abut 10(4) to 10(5) newtons per square meter. Rubber-like fibers have been isolated, apparently for the first time, from the aorta of an invertebrate. These fibers have an elastic modulus, like elastin, of about 4 x 10(5) newtons per square meter and are present in sufficient quantity to account for the elastic properties of the intact vessel under physiological conditions. Thus the circulatory system of an invertebrate animal provides an "elastic reservoir" (much like that of the vertebrate system), which increases the efficiency of the circulation. PMID:7256277

  12. Thoracic aorta aneurysm successfully operated on during pregnancy

    PubMed Central

    Biskupski, Andrzej; Kuligowska, Ewelina; Listewnik, Mariusz; Brykczyński, Mirosław

    2014-01-01

    We present the case of an asymptomatic 26-year-old female patient with a huge thoracic aneurysm discovered at a routine echo screening. The patient had previously been operated on for coarctation of the aorta in childhood and also had diagnosed bicuspid aortic valve. The operation was carried out in extracorporeal circulation at the 22nd week of gestation without any complications. A few months later in the 38th week of pregnancy a baby girl was delivered by cesarean section with an Apgar score of 10. The patient is scheduled for implantation of a stent graft to the descending aorta, because the CT of the chest done a few months after delivery confirmed presence of a significant aneurysm located just below the left subclavian artery. PMID:26336442

  13. Baicalein protects against the development of angiotensin II-induced abdominal aortic aneurysms by blocking JNK and p38 MAPK signaling.

    PubMed

    Wang, Fang; Chen, Houzao; Yan, Yunfei; Liu, Yue; Zhang, Shuyang; Liu, Depei

    2016-09-01

    An abdominal aortic aneurysm (AAA) is a permanent, localized dilatation of the abdominal aorta. In western countries, the morbidity of AAA is approximately 8%. Currently, pharmacotherapies for AAA are limited. Here, we demonstrate that baicalein (BAI), the main component of the Chinese traditional drug "Huang Qin", attenuates the incidence and severity of AAA in Apoe (-/-) mice infused with angiotensin II (AngII). Mechanically, BAI treatment decreases AngII-induced reactive oxygen species (ROS) production in the aortic wall. Moreover, BAI inhibits inflammatory cell accumulation in the aortas of mice infused with AngII. It also inhibits AngII-induced activation of matrix metalloproteinase 2 (MMP-2) and MMP-9 to maintain elastin content in vivo. In addition, it blocks AngII cascade by downregulating angiotensin type 1 receptor (AT1R) and inhibiting mitogen-activated protein kinases (MAPKs). Taken together, our findings show that BAI is an effective agent for AAA prevention. PMID:27333787

  14. Laparoscopic resection of a paraganglioma located on the border of the thoracic and abdominal cavities using a transabdominal-transdiaphragmatic approach.

    PubMed

    Sunose, Yutaka; Hirai, Keitaro; Nakazawa, Seshiru; Yoshinari, Daisuke; Ogawa, Hiroomi; Tsukagoshi, Hiroshi; Takahashi, Norifumi; Yamazaki, Hodaka; Motegi, Yoko; Miyamae, Yohei; Igarashi, Takamichi; Takahashi, Kengo; Katoh, Ryuji; Tanaka, Kazumi; Takeyoshi, Izumi

    2015-05-01

    We treated a 64-year-old woman with high blood pressure. Catecholamine metabolite levels were elevated in the blood and urine. CT revealed a densely stained tumor on the right side of the descending aorta dorsal to the inferior vena cava. PET-CT revealed abnormal accumulation of (18) F-fluorodeoxyglucose, and (123) I-meta-iodo-benzylguanidine uptake was apparent on scintigraphy. The tumor was determined to be a paraganglioma located on the border between the thoracic and abdominal cavities, and laparoscopic tumorectomy was performed. The patient was placed in the left lateral position. The right lobe of the liver was turned over, and we cut the diaphragm to expose the front of the tumor. We resected the straight artery flowing in from the aorta and removed the tumor safely. Herein, we describe the removal of a paravertebral paraganglioma located in the border of the thoracic and abdominal cavities with a laparoscopic transabdominal-transdiaphragmatic approach.

  15. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  16. Ascending Aorta Elastography After Kawasaki Disease Compared to Systemic Hypertension.

    PubMed

    Nandlall, Ian; Maurice, Roch L; Fournier, Anne; Merouani, Aïcha; Dahdah, Nagib

    2015-10-01

    Kawasaki disease (KD) is a systemic vasculitis, classically affecting large- and medium-size arteries. The coronary arteries draw most of the clinical attention, whereas few studies have taken interest in the ascending aorta. Using a proprietary imaging-based mechanical biomarker (ImBioMark), we sought to determine aortic stiffness in KD compared to systemic hypertension (HTN) and healthy children. We evaluated parasternal long-axis views focused on the ascending aorta in 20 controls, 12 KD, and 8 HTN as a comparative clinical model of vascular stiffness. We calculated systolic and diastolic aortic wall strain with ImBioMark. Strain was tested for normality against height, systolic, and diastolic blood pressure in normal subjects. Strain from KD and HTN was normalized (Z score) accordingly. Z score comparisons were performed using nonparametric statistics. Age was similar between KD and HTN (9.1 ± 5.3 and 9.9 ± 5.3 years old; p = NS). Systolic and diastolic strain values were normally distributed against height, systolic blood pressure, and diastolic blood pressure in healthy subjects. HTN subjects had abnormal systolic and diastolic strain values (p < 0.0001). Whereas KD subjects had normal diastolic strain, systolic strain was significantly lower (p < 0.001), and systolic strain was intermediate between controls and HTN. There were no significant differences in aortic strain among KD, however, according to the presence of coronary artery aneurysms. Despite normal blood pressure, the ascending aorta in KD exhibits reduced strain during systole. This may reflect in situ rigidity of the aorta. The normal diastolic strain in KD may, in contrast, reflect normal peripheral vascular resistance. PMID:25921428

  17. [Resistant arterial hypertension and coarctation of the aorta].

    PubMed

    Martínez-Quintana, Efrén; Rossique-Delmas, Pilar; Rodríguez-González, Fayna

    2014-01-01

    Coarctation of the aorta accounts for around 5 percent of all congenital heart defects. Many of these patients develop arterial hypertension, and occasionally resistant arterial hypertension, despite adequate correction. This may lead to potentially fatal complications such as heart failure, aortic dissection, cerebrovascular events, or myocardial infarction. Therefore, a correct diagnosis must be made and an appropriate treatment started to reduce arterial hypertension, arteriosclerotic vascular disease, as well as the increased risk of cardiovascular morbidity and mortality.

  18. Morphometric Analysis of Auxin-Mediated Development

    NASA Astrophysics Data System (ADS)

    Lewis, Daniel

    Auxin controls many aspects of plant development through its effects on growth. Its distribution is controlled by specific tissue and organ level polar transport streams. The responses to environmental cues such as gravity light, nutrient availability are largely controlled by coordinated regulation of distinct auxin transport streams. Many plant responses to the environment involve changes in shape. Much can be learned about the underlying processes controlling plant form if the response is measured with sufficient resolution. Computer-aided analysis of digital images or 'machine vision' can be used to greatly increase the speed and consistency of data from a morphometric study of plant form. Advances in image acquisition and analysis pioneered at UW-Madison have allowed unprecedented resolution of the growth and gravitropism of Arabidopsis. A reverse genetic analysis was used to determine if the MDR-like ABC transporters influence auxin distribution important for plant development and the response to environmental cues in Arabidopsis. Mutations in MDR1 (At3g28860) reduce acropetal auxin transport in the root. This is correlated with deviation from the vertical axis. Mutations in MDR4 (At2g47000) reduce basipetal auxin transport in the root. This is correlated with hypergravitropism. It was theorized that reduced transport whithin the elongation zone is responsible for the increased curvature. Flavanols were found to regulate gravitropism upstream of MDR4. The mdr1 mdr4 double mutant showed additive but not synergistic phenotypes, suggesting that the two auxin transport streams are more independent than interdependent. MDR proteins seem to enhance auxin transport in situations where PIN-type effux alone is insufficient.

  19. Office-based ultrasound screening for abdominal aortic aneurysm

    PubMed Central

    Blois, Beau

    2012-01-01

    Abstract Objective To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). Design A prospective observational study. Consecutive patients were approached by nonphysician staff. Setting Rural family physician offices in Grand Forks and Revelstoke, BC. Participants The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. Main outcome measures A focused “quick screen,” which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (ie, a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Results Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Conclusion Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point

  20. Endovascular Repair of Contained Rupture of the Thoracic Aorta

    SciTech Connect

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

    2002-08-15

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

  1. [Noninvasive radiodiagnosis of aneurysms of the thoracic aorta].

    PubMed

    Todua, F I; Petsko, A R; Arablinskiĭ, A V; Kazanchian, P O; Nikitaev, N S; Sultanaliev, T A

    1990-05-01

    The paper is concerned with analysis of the results of X-ray investigation of 45 patients with aneurysms of the distal part of the arch and descending part of the thoracic aorta. Errors were made in 16 of 35 patients (35.6%) before admittance to hospital. X-ray investigation helped to establish correct diagnosis of aneurysm of the aorta in 42 of 45 patients (93.3%) on the basis of the detection of intense additional shadow formation in left pulmonary field, inseparable from the aortic shadow. The use of a new method of ultrasound diagnosis--duplex scanning--made it possible to establish the presence of aneurysm and to determine its sizes as well as to visualize the relation of the left subclavicular artery to aneurysm in 17 of 21 patients. CT-semiotics of aneurysms of the descending part of the thoracic aorta consisted in its dilatation over 3.5 cm, wall calcification, thrombosis of the cavity and change of the adjacent structures. Basing on the analysis of these signs correct diagnosis was established in 34 of 35 examinees (97.1%).

  2. Hemodynamics in an Aorta with Bicuspid and Trileaflet Valves

    NASA Astrophysics Data System (ADS)

    Gilmanov, Anvar; Sotiropoulos, Fotis

    2015-11-01

    Bicuspid aortic valve (BAV) is a congenital heart defect that has been associated with serious aortopathies, such as ascending aortic aneurysm, aortic stenosis, aortic regurgitation, infective endocarditis, aortic dissection, calcific aortic valve and dilatation of ascending aorta. Two main hypotheses - the genetic and the hemodynamic are discussed in literature to explain the development and progression of aortopathies in patients with BAV. In this study we seek to investigate the possible role of hemodynamic factors as causes of BAV-associated aortopathy. We employ the Curvilinear Immersed Boundary (CURVIB) method coupled with an efficient thin-shell finite element (TS-FE) formulation for tissues to carry out fluid-structure interaction simulations of a healthy tri-leaflet aortic valve (TAV) and a BAV placed in the same anatomic aorta. The computed results reveal major differences between the TAV and BAV flow patterns. These include: the dynamics of the aortic valve vortex ring formation and break up; the large scale flow patterns in the ascending aorta; and the shear stress magnitude on the aortic wall. The computed results are in qualitative agreement with in vivo Magnetic Resonance Imaging (MRI) data and suggest that the linkages between BAV aortopathy and hemodynamics deserve further investigation. This work is supported by the Lillehei Heart Institute at the University of Minnesota and the Minnesota Supercomputing Institute.

  3. Comparative hemodynamics in an aorta with bicuspid and trileaflet valves

    NASA Astrophysics Data System (ADS)

    Gilmanov, Anvar; Sotiropoulos, Fotis

    2016-04-01

    Bicuspid aortic valve (BAV) is a congenital heart defect that has been associated with serious aortopathies, such as aortic stenosis, aortic regurgitation, infective endocarditis, aortic dissection, calcific aortic valve and dilatation of ascending aorta. There are two main hypotheses to explain the increase prevalence of aortopathies in patients with BAV: the genetic and the hemodynamic. In this study, we seek to investigate the possible role of hemodynamic factors as causes of BAV-associated aortopathy. We employ the curvilinear immersed boundary method coupled with an efficient thin-shell finite-element formulation for tissues to carry out fluid-structure interaction simulations of a healthy trileaflet aortic valve (TAV) and a BAV placed in the same anatomic aorta. The computed results reveal major differences between the TAV and BAV flow patterns. These include: the dynamics of the aortic valve vortex ring formation and break up; the large-scale flow patterns in the ascending aorta; the shear stress magnitude, directions, and dynamics on the heart valve surfaces. The computed results are in qualitative agreement with in vivo magnetic resonance imaging data and suggest that the linkages between BAV aortopathy and hemodynamics deserve further investigation.

  4. Testing and quantifying phylogenetic signals and homoplasy in morphometric data.

    PubMed

    Klingenberg, Christian Peter; Gidaszewski, Nelly A

    2010-05-01

    The relationship between morphometrics and phylogenetic analysis has long been controversial. Here we propose an approach that is based on mapping morphometric traits onto phylogenies derived from other data and thus avoids the pitfalls encountered by previous studies. This method treats shape as a single, multidimensional character. We propose a test for the presence of a phylogenetic signal in morphometric data, which simulates the null hypothesis of the complete absence of phylogenetic structure by permutation of the shape data among the terminal taxa. We also propose 2 measures of the fit of morphometric data to the phylogeny that are direct extensions of the consistency index and retention index used in traditional cladistics. We apply these methods to a small study of the evolution of wing shape in the Drosophila melanogaster subgroup, for which a very strongly supported phylogeny is available. This case study reveals a significant phylogenetic signal and a relatively low degree of homoplasy. Despite the low homoplasy, the shortest tree computed from landmark data on wing shape is inconsistent with the well-supported phylogenetic tree from molecular data, underscoring that morphometric data may not provide reliable information for inferring phylogeny. PMID:20525633

  5. Morphometric analysis of llama (Lama glama) sperm head.

    PubMed

    Casaretto, C; Lombardo, D M; Giuliano, S; Gambarotta, M; Carretero, M I; Miragaya, M H

    2012-05-01

    Llama production in Argentina has increased, as the international interest in breeding this type of animals has grown in the last years. Considering the great polymorphism that llama spermatozoa present at evaluation using light microscopy, the aim of this study was to objectively evaluate llama sperm head morphometry using digital morphometric analysis. Five ejaculates from each of eight males were obtained to evaluate morphometric parameters of 8000 sperm heads stained with Tinción 15(®). The following average results were obtained for each parameter: size parameters: area 20.09 μm(2), length 6.60 μm, width 4.14 μm, equivalent circle diameter 5.06 μm, curve length 5.79 μm and curve width 3.48 μm; boundary parameters: perimeter 18.54 μm and convex perimeter 17.34 μm; and shape parameters: roundness 1.28 and elongation 1.59. Morphometric parameters of sperm head were compared between ejaculates of the same male and between males. Significant differences between ejaculates of the same male were found for all parameters evaluated (P < 0.01). Significant differences between males were found for all morphometric parameters (P < 0.01) except for curve length, curve width and perimeter. The differences detected would indicate that there is not a single morphometric pattern for Lama glama sperm head, because parameter values cannot be standardised.

  6. Experimental unsteady flow study in a patient-specific abdominal aortic aneurysm model

    NASA Astrophysics Data System (ADS)

    Stamatopoulos, Ch.; Mathioulakis, D. S.; Papaharilaou, Y.; Katsamouris, A.

    2011-06-01

    The velocity field in a patient-specific abdominal aneurysm model including the aorto-iliac bifurcation was measured by 2D PIV. Phase-averaged velocities obtained in 14 planes reveal details of the flow evolution during a cycle. The aneurysm expanding asymmetrically toward the anterior side of the aorta causes the generation of a vortex at its entrance, covering the entire aneurysm bulge progressively before flow peak. The fluid entering the aneurysm impinges on the left side of its distal end, following the axis of the upstream aorta segment, causing an increased flow rate in the left (compared to the right) common iliac artery. High shear stresses appear at the aneurysm inlet and outlet as well as along the posterior wall, varying proportionally to the flow rate. At the same regions, elevated flow disturbances are observed, being intensified at flow peak and during the deceleration phase. Low shear stresses are present in the recirculation region, being two orders of magnitude smaller than the previous ones. At flow peak and during the deceleration phase, a clockwise swirling motion (viewed from the inlet) is present in the aneurysm due to the out of plane curvature of the aorta.

  7. Serelaxin (recombinant human relaxin-2) prevents high glucose-induced endothelial dysfunction by ameliorating prostacyclin production in the mouse aorta.

    PubMed

    Ng, Hooi Hooi; Leo, Chen Huei; Parry, Laura J

    2016-05-01

    Diabetes-induced endothelial dysfunction is a critical initiating factor in the development of cardiovascular complications. Treatment with relaxin improves tumour necrosis factor α-induced endothelial dysfunction by enhancing endothelial nitric oxide synthase (eNOS) activity and restoring superoxide dismutase 1 protein in rat aortic rings ex vivo. It is, therefore, possible that relaxin treatment could alleviate endothelial dysfunction in diabetes. This study aimed to test the hypothesis that serelaxin (recombinant human relaxin-2) prevents high glucose-induced vascular dysfunction in the mouse aorta. Abdominal aortae were isolated from C57BL/6 male mice and incubated in M199 media for 3days with either normal glucose (5.5mM) or high glucose (30mM), and co-incubated with placebo (20mM sodium acetate) or 10nM serelaxin at 37°C in 5% CO2. Vascular function was analysed using wire-myography. High glucose significantly reduced the sensitivity to the endothelium-dependent agonist, acetylcholine (ACh) (pEC50; normal glucose=7.66±0.10 vs high glucose=7.29±0.10, n=11-12, P<0.05) and the contraction induced by NOS inhibitor, L-NAME (200μM) (normal glucose=59.9±8.3% vs high glucose=38.7±4.3%, n=6, P<0.05), but had no effect on the endothelium-independent agonist, sodium nitroprusside (SNP)-mediated relaxation. Treatment with serelaxin restored endothelial function (pEC50; 7.83±0.11, n=11) but not NO availability. The presence of the cyclooxygenase (COX) inhibitor, indomethacin (1μM) (pEC50; control=7.29±0.10 vs indo=7.74±0.18, n=6-12, P<0.05) and a superoxide dismutase mimetic, tempol (10μM) (pEC50; control=7.29±0.10 vs tempol=7.82±0.05, n=6-12, P<0.01) significantly improved sensitivity to ACh in high glucose treated aortae, but had no effect in serelaxin treated aortae. This suggests that high glucose incubation alters the superoxide and COX-sensitive pathway, which was normalized by co-incubation with serelaxin. Neither high glucose incubation nor serelaxin

  8. Both pelvic radiography and lateral abdominal radiography correlate well with coronary artery calcification measured by computed tomography in hemodialysis patients: A cross-sectional study.

    PubMed

    Hong, Daqing; Ruan, Yizhe; Pu, Lei; Zhong, Xiang; Zhang, Yuan; Zhang, Yue; Deng, Fei; Yang, Hongling; Li, Guisen; Wang, Li

    2016-07-01

    Introduction Lateral abdominal radiograph is suggested as an alternative to coronary artery computed tomography (CT) in evaluating vascular calcification. Simple scoring systems including pelvic radiograph scoring and abdominal scoring system were utilized to study their correlation with coronary artery calcification. Methods In 106 MHD patients, coronary artery CT, lateral abdominal, and pelvic radiograph were taken. The Agatston scoring system was applied to evaluate the degree of coronary artery calcification which was categorized according to Agatston coronary artery calcification score (CACS) ≥ 30, ≥100, ≥400, and ≥1000. Abdominal aortic calcification was scored by 4-scored and 24-scored systems. Pelvic artery calcification was scored by a 4-scored system. Sensitivities and specificities of abdominal aortic calcification scores and pelvic artery calcification scores to predict different categories of coronary artery calcification were analyzed. We studied the diagnostic capability of abdominal aorta calcification and pelvic artery calcification to predict different CACS categories by calculating likelihood ratios. Receiver operator characteristic curves were used to determine the area under the curve for each of these testing procedures. Findings The prevalence was 48(45.3%), 15 (14.2%), 11 (10.4%), 11 (10.4%), and 11 (10.4%) for CACs > 0, ≥30, ≥100, ≥400, and ≥1000, respectively. The degree of CACs was positively correlated with patient age, prevalence of diabetes, abdominal aorta scores, and pelvic calcification scores. The areas under the curves for different CACS by all X-ray scoring systems were above 0.70 except pelvic 4-scored system for diagnosing CACS ≥30, without significant difference (P > 0.05). Discussion Both lateral abdominal and pelvic plain radiographs were demonstrated as acceptable alternatives to CT in evaluating vascular calcification. PMID:26932162

  9. Conservative management of abdominal injuries

    PubMed Central

    Okuş, Ahmet; Sevinç, Barış; Ay, Serden; Arslan, Kemal; Karahan, Ömer; Eryılmaz, Mehmet Ali

    2013-01-01

    Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. PMID:25931868

  10. Dietary ecology of Murinae (Muridae, Rodentia): a geometric morphometric approach.

    PubMed

    Gómez Cano, Ana Rosa; Hernández Fernández, Manuel; Alvarez-Sierra, M Ángeles

    2013-01-01

    Murine rodents represent a highly diverse group, which displays great ecological versatility. In the present paper we analyse the relationship between dental morphology, on one hand, using geometric morphometrics based upon the outline of first upper molar and the dietary preference of extant murine genera, on the other. This ecomorphological study of extant murine rodents demonstrates that dietary groups can be distinguished with the use of a quantitative geometric morphometric approach based on first upper molar outline. A discriminant analysis of the geometric morphometric variables of the first upper molars enables us to infer the dietary preferences of extinct murine genera from the Iberian Peninsula. Most of the extinct genera were omnivore; only Stephanomys showed a pattern of dental morphology alike that of the herbivore genera. PMID:24236090

  11. Dietary Ecology of Murinae (Muridae, Rodentia): A Geometric Morphometric Approach

    PubMed Central

    Gómez Cano, Ana Rosa; Hernández Fernández, Manuel; Álvarez-Sierra, M. Ángeles

    2013-01-01

    Murine rodents represent a highly diverse group, which displays great ecological versatility. In the present paper we analyse the relationship between dental morphology, on one hand, using geometric morphometrics based upon the outline of first upper molar and the dietary preference of extant murine genera, on the other. This ecomorphological study of extant murine rodents demonstrates that dietary groups can be distinguished with the use of a quantitative geometric morphometric approach based on first upper molar outline. A discriminant analysis of the geometric morphometric variables of the first upper molars enables us to infer the dietary preferences of extinct murine genera from the Iberian Peninsula. Most of the extinct genera were omnivore; only Stephanomys showed a pattern of dental morphology alike that of the herbivore genera. PMID:24236090

  12. Dietary ecology of Murinae (Muridae, Rodentia): a geometric morphometric approach.

    PubMed

    Gómez Cano, Ana Rosa; Hernández Fernández, Manuel; Alvarez-Sierra, M Ángeles

    2013-01-01

    Murine rodents represent a highly diverse group, which displays great ecological versatility. In the present paper we analyse the relationship between dental morphology, on one hand, using geometric morphometrics based upon the outline of first upper molar and the dietary preference of extant murine genera, on the other. This ecomorphological study of extant murine rodents demonstrates that dietary groups can be distinguished with the use of a quantitative geometric morphometric approach based on first upper molar outline. A discriminant analysis of the geometric morphometric variables of the first upper molars enables us to infer the dietary preferences of extinct murine genera from the Iberian Peninsula. Most of the extinct genera were omnivore; only Stephanomys showed a pattern of dental morphology alike that of the herbivore genera.

  13. [Clinical peculiarities of atherosclerosis of peripheral arteries in patients with abdominal aortic calcification].

    PubMed

    Mel'nikov, M V; Zelinskiĭ, V A

    2016-01-01

    The authors analysed clinical peculiarities of atherosclerosis of peripheral arteries (hereinafter referred to as APA) in patients presenting with abdominal aortic calcification (AAC). In order to determine the incidence rate of AAC in the population of patients with APA we analysed medical records of a total of 1,800 patients. The study itself included a total of 193 patients with APA further subdivided into two groups: 108 patients with AAC (Study Group) and 85 patients without AAC. Beside general clinical examination all patients were subjected to transthoracic echocardiography, duplex scanning of the aorta and lower-limb arteries, extended lipidogram and coagulogram. AAC was verified by means of computed tomography. It was determined that in one third of cases AAC was combined with abdominal aortic calcification, with APA on the background of AAC having certain peculiarities, i.e., high incidence of multisegmental lesions (68%) with predominant localization of the process in the aortoiliac and femoropopliteal segments (43%); frequent involvement of the terminal portion of the aorta and pelvic arteries. Patients with AAC also were noted to have a series of peculiarities in the indices of lipid metabolism, as well as signs of procoagulant syndrome and alterations of the structural and functional characteristics of the myocardium. It was stated that peculiarities of APA on the background of AAC should be taken into consideration while working out the program of diagnosis, treatment (including surgical), and rehabilitation of patients. PMID:27626248

  14. Does Lower Limb Exercise Worsen Renal Artery Hemodynamics in Patients with Abdominal Aortic Aneurysm?

    PubMed Central

    Zhang, Nan; Xu, Zaipin; Deng, Xiaoyan; Liu, Ming; Liu, Xiao

    2015-01-01

    Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS), increased the oscillatory shear index (OSI) and increased the relative residence time (RRT). EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients. PMID:25946196

  15. Management of small asymptomatic abdominal aortic aneurysms – a review

    PubMed Central

    Silaghi, H; Branchereau, A; Malikov, S; Andercou, Aurel

    2007-01-01

    The approach for abdominal aortic aneurysms (AAAs) larger than 55 mm is well defined due to the risk of rupture being higher than 10% per year, and a 30-day perioperative mortality rate between 2.5% and 5%. However, the approach for small asymptomatic AAAs is less well defined. There are different definitions given to describe a small AAA. The one the authors accepted and applied is “a localized, permanent and irreversible dilation of the aorta of at least 50% in relation to the normal adjacent infrarenal or suprarenal aorta, with a maximum diameter between 30–55 mm”. The investigators of the largest study on small AAAs (United Kingdom Small Aneurysm Trial [UK-SAT]) concluded, in brief, that ultrasound monitoring is the most appropriate solution because the results do not support a policy of surgical restoration for AAAs with a diameter of between 40 mm and 55 mm. The aim of the present review article is to highlight several challenges that could change the limits or create a more flexible deciding factor in the management of AAAs. There are multiple factors that influence surgical decision-making, and the limit on aneurysm diameter that indicates surgery should depend on the patient’s age, life expectancy, general status, associated diseases, diameter in relation to body mass, risk factors, sex, anxiety and compliance during the follow-up period. Monitoring is an acceptable alternative for AAAs between 40 mm and 55 mm, and is probably the best solution for high-risk patients. Surgery is the most reasonable solution for patients who are at moderate risk, have a significant life expectancy, are less than 70 to 75 years of age, and/or have aortic aneurysms larger than 50 mm. PMID:22477326

  16. Abdominal aortic grafting for spontaneous infrarenal abdominal aortic dissection.

    PubMed

    Iwasaki, Hiroto; Shibuya, Takashi; Shintani, Takashi; Uenaka, Hisazumi; Suehiro, Shigefumi; Satoh, Hisashi

    2010-02-01

    This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at the median sacral artery, indicating that the false lumen had progressed and compressed the true lumen. A direct approach involving grafting appears to be an effective procedure for resolving mesenteric and lower extremity hypoperfusion due to aortic dissection with a dilated false channel, even during the acute period. PMID:19879731

  17. Elevated expression of runt-related transcription factors in human abdominal aortic aneurysm.

    PubMed

    Dubis, J; Litwin, M; Michalowska, D; Zuk, N; Szczepanska-Buda, A; Grendziak, R; Baczynska, D; Barc, P; Witkiewicz, W

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease of unknown etiology. AAA is caused by segmental weakening of the aortic walls and progressive aortic dilation leading to the eventual rupture of the aorta, accompanied by intense inflammation. Additionally, studies have indicated a close relationship between the pathogenesis and progression of AAA and cellular immune responses in aneurysm wall tissue. The Runt-related genes (RUNX) encode multifunctional mediators of the of intracellular signal transduction pathways in vascular remodeling, endothelial function, immune response and inflammation. The aim of this study was to evaluate the expression level of RUNX regulatory genes in AAA tissues and to assess the correlations between them. The study was performed on AAA wall-tissue samples obtained from patients with AAA during open aneurysm repair and normal aortic tissues collected from healthy organ donors. There are no proven clinical management strategies or pharmaco-therapeutics to prevent AAA progression once an AAA has been detected. Moreover, so far no biomarkers have been established to indicate the disease status of AAA. Hence, understanding the pathogenesis of AAA has recently become an increasing priority in basic and translational vascular research. We identified significantly higher mRNA and protein level of all of three Runt-related genes in aneurysmal aorta compared to a normal aorta. Increased expression of RUNX2 was demonstrated for the first time in abdominal aortic aneurysm tissue. Additionally, relationships between the activity of RUNX genes in the pathological tissue were identified. The results of elevated expression of RUNX genes and their relationships in the AAA tissues suggest the involvement of conserved Runt-related genes in the pathophysiology of AAA development. PMID:27358138

  18. [The results of treatment of the patients with the rupture of abdominal aortic aneurysms in multifield hospital].

    PubMed

    Mosiagin, V B; Ryl'kov, V F; Moiseev, A A; Karpatskiĭ, I V

    2013-01-01

    The rupture of infrarenal segment of aorta is the severe pathology in spite of modem diagnostics and the operation. This case is accompanied by negative results of treatment (lethality consists of 56,3%). The article presents the experience of treatment of 157 patients with the rupture of infrarenal segment of aorta in conditions of multifield hospital (Municipal hospital No 26). The authors highlighted the postoperative complications, their influence on negative outcome. It was shown, that the main reasons of negative outcome of such patients with abdominal aortic aneurism, complicated by the rupture, were an advanced age of patients, who had the complex of concomitant diseases and postoperative complications such as nosocomial pneumonia, cardiac problems and multiple organ failure due to massive acute hemorrhage. PMID:24640754

  19. False aneurysm on distal part of coarctation of the aorta in a parous Turner syndrome patient.

    PubMed

    Oi, Keiji; Yoshida, Tetsuya; Takeshita, Masashi; Tsuruta, Goro

    2013-09-01

    False aneurysm associated with untreated coarctation of the aorta (CoA) is an uncommon vascular complication. We present a 41-year-old woman with mosaic Turner syndrome who had CoA complicated with a small false aneurysm on descending aorta just distal to the coarctation. The patient had not been diagnosed with Turner syndrome despite several physical characteristics of the syndrome because she had histories of natural childbirth. The false aneurysm was resected with the coarctation through a thoracotomy and proximal aorta was directly anastomosed to distal aorta. Endovascular therapy has become preferred method in recent years in treatment for coarctation of the aorta. However, careful consideration should be given to the irregularities on the aorta with the coarctation for diagnosis of false aneurysm.

  20. Abdominal actinomycosis mimicking acute appendicitis.

    PubMed

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  1. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  2. A case of aorta-right atrial tunnel presented with an asymptomatic murmur.

    PubMed

    Kim, Kyoung-Nyoun; Cho, Kyoung-Im; Kim, Jae-Joon; Kang, Ji-Hoon; Goo, Ja-Jun; Lee, Ja-Young; Kim, Seong-Man

    2013-09-01

    Aorta-right atrial tunnel is a rare and distinct congenital anomaly. It is a vascular channel that originates from one of the sinuses of Valsalva with a tortuous course anterior or posterior to the ascending aorta, and terminates either in the superior vena cava or in the right atrium (RA). We report a 42-year-old female briefly with aorta-right atrial tunnel in which the left coronary artery arose from the tunnel and terminated into the RA.

  3. Coarctation of the aorta associated with agenesis of left common carotid artery and left subclavian artery

    PubMed Central

    Yang, Yang; Ding, Shiao; Xu, Gaojun; Liu, Hao

    2016-01-01

    We describe the case of a 10-year-old boy with coarctation of the aorta complicated by innominate artery stenosis and agenesis of left common carotid artery and left subclavian artery. The patient was treated with an interposition graft between the ascending and descending aorta. The right subclavian was revascularized with another graft from the interposition graft to the distal right subclavian. This is a rare case of the combination of coarctation of the aorta and other vascular malformations. PMID:27162694

  4. A case of aorta-right atrial tunnel presented with an asymptomatic murmur.

    PubMed

    Kim, Kyoung-Nyoun; Cho, Kyoung-Im; Kim, Jae-Joon; Kang, Ji-Hoon; Goo, Ja-Jun; Lee, Ja-Young; Kim, Seong-Man

    2013-09-01

    Aorta-right atrial tunnel is a rare and distinct congenital anomaly. It is a vascular channel that originates from one of the sinuses of Valsalva with a tortuous course anterior or posterior to the ascending aorta, and terminates either in the superior vena cava or in the right atrium (RA). We report a 42-year-old female briefly with aorta-right atrial tunnel in which the left coronary artery arose from the tunnel and terminated into the RA. PMID:24174967

  5. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  6. Recurrent abdominal pain during childhood.

    PubMed Central

    Scott, R. B.

    1994-01-01

    Recurrent abdominal pain is a common presenting complaint among children. A thorough history and physical examination and limited laboratory investigation should enable a physician to make a positive diagnosis of "functional" recurrent abdominal pain in 90% to 95% of cases; an organic cause is identified in only 5% to 10%. The care and thoroughness of the history and physical examination establish the physician's credibility; explaining the clinical basis for the diagnosis and educating the child and parents on what is known about the condition reassures the parents. PMID:8199511

  7. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  8. Radiological management of abdominal abscess.

    PubMed Central

    Mac Erlean, D P; Gibney, R G

    1983-01-01

    Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID:6842496

  9. Laparoscopic excision of intra-abdominal paragonimiasis.

    PubMed

    Kim, Jun-Young; Kang, Chang-Moo; Choi, Gi-Hong; Yang, Woo-Ick; Sim, Seo-Bo; Kwon, Ji-Eun; Kim, Kyung-Sik; Choi, Jin-Sub; Lee, Woo-Jung; Kim, Byong-Ro

    2007-12-01

    Lung fluke, Paragonimus westermani of Paragonimus species usually are accompanied by a persistent cough, hemoptysis, and chest pain. Extrapulmonary paragonimiasis caused by ectopic parasites in aberrant locations such as the abdominal wall, abdominal organs, and brain has been reported and the most commonly involved extrapulmonary organ is the brain. We present a case of 56-year-old male patient with intra-abdominal paragonimiasis who underwent laparoscopic excision of abdominal granuloma caused by parasite infection. An intra-abdominal mass associated with eosinophilia might be related to parasite infection. A laparoscopic approach is the most appropriate treatment modality in such benign abdominal pathology.

  10. Differences in the performance of PCL-based vascular grafts as abdominal aorta substitutes in healthy and diabetic rats.

    PubMed

    Wang, Zhihong; Zheng, Wenting; Wu, Yifan; Wang, Jianing; Zhang, Xiuyuan; Wang, Kai; Zhao, Qiang; Kong, Deling; Ke, Tingyu; Li, Chen

    2016-10-20

    Great progress has been made in the field of vascular tissue engineering, with some artificial vascular grafts already exhibiting promising outcomes in animal models. However, these studies were mostly conducted using healthy animals, which are not representative of actual clinical demands. Indeed, patients who require artificial vascular graft implantation are often accompanied by other comorbidities, such as hyperlipidaemia, hypertension and diabetes which should also be taken into consideration when assessing the potential of vascular grafts that are intended for clinical applications. In the present study, we established a rat model with type 2 diabetes (T2D) for performance evaluation of an electrospun PCL vascular graft. Our data showed that rats with T2D had elevated incidents of adverse event rates, including exacerbated platelet adhesion, inflammation, early calcification and impaired regeneration compared to the non-diabetic controls. Thus, we report that T2D exacerbates the regeneration process after in vivo implantation of vascular grafts. More advanced grafts are in demand for clinical use in patients with clinical complications such as T2D. PMID:27537499

  11. [Polyethylene terephtalate (Dacron) prostheses as arterial substitutes. Value of commercial grafts as abdominal aorta substitutes in the dog (author's transl)].

    PubMed

    Guidoin, R; Levaillant, P A; Marois, M; Gosselin, C; Martin, L; Rouleau, C; Garneau, P; Noel, H P; Blais, P

    1980-01-01

    Most of the presently available Dacron fabric grafts are either woven or knitted; some are velours. Whereas the various configurations and textures can be easily recognized and classified with respect to morphology, structure, porosity and fabric tenacity, it is also necessary to establish their post-implantation healing characteristics. Canine models have been used to investigate the healing characteristics of 18 types of prostheses over implantation periods from one to six months using techniques of scanning electron microscopy and conventional light microscopy. Velours exhibit superiar tissue ingrowth but the internal tissue lining does seldom embeds all of the fibres. Complete neoendothelialization is not achieved; the process appears more closely linked to haemodynamic factors such as shear forces acting postfacto on blood deposits as opposed to graft porosity facilitating ingrowth. More meaningful criteria of performance must be found to allow a closer matching between the available products and the individual clinical needs of each situation. PMID:6450812

  12. Iodixanol vs iopamidol in intravenous DSA of the abdominal aorta and lower extremity arteries: a comparative phase-III trial.

    PubMed

    Fischbach, R; Landwehr, P; Lackner, K; Nossen, J O; Heindel, W; Berg, K J; Eichhorn, G; Jacobsen, T F

    1996-01-01

    Iodixanol (Visipaque, 320 mgI/ml) was compared with iopamidol (Solutrast, 370 mgI/ml) in a double-blind, randomized, parallel group, intravenous DSA phase-III trial for evaluation of safety and efficacy. A total of 117 patients received iodixanol (n = 60) or iopamidol (n = 57). Diagnostic efficacy was evaluated using categoric and visual analogue scales. Discomfort and adverse events were recorded. A total of 39 patients collected urine up to 72 h after the examination for analysis. Diagnostic efficacy and radiographic density were similar in both groups. Discomfort was milder with iodixanol. The difference between the frequency of adverse events between both groups (iodixanol = 7, iopamidol = 2) was without statistical significance. Creatinine clearance was slightly more affected by iodixanol, whereas the increase in renal excretion of N-acetyl-beta-glucosaminidase (NAG) in the first 24-h collection period after the examination was significantly higher (p < 0.01) with iopamidol. Iodixanol was of equal diagnostic efficacy compared with iopamidol despite its reduced iodine content. Both contrast media are well suited for IV DSA.

  13. Direct aortic transcatheter valve implantation in a porcelain aorta.

    PubMed

    Bruschi, Giuseppe; Botta, Luca; De Marco, Federico; Colombo, Paola; Klugmann, Silvio; Martinelli, Luigi

    2014-10-01

    Transcatheter aortic valve implantation has been designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is generally performed retrogradely with vascular access. However, in certain patients, this access is either not possible or deemed to carry a high risk of vascular injury. We report our experience of a direct aortic approach in a 78-year old man with severe aortic stenosis, excluded from standard aortic valve replacement due to a porcelain aorta, and affected by severe aortic, iliac-femoral, and subclavian arteriopathy, rendering the transfemoral or subclavian approach unemployable.

  14. Pericardial fat flap for mycotic aneurysm of the thoracic aorta.

    PubMed

    Nakamura, Yoshitsugu; Kawatani, Yohei; Ito, Yujiro; Hori, Takaki

    2016-07-01

    Standard treatment for mycotic aneurysm of thoracic aorta is complete debridement with replacement of the aneurysm with a homograft or Dacron graft. However, contamination from surrounding tissues may occur after the graft replacement. Transposition of the viable, well-vascularized tissues should be used to fill surrounding dead space and isolate the graft to prevent reinfection. Although the omentum is regarded as the best tissue, it is not always available for use. We describe here a new alternative technique for such situations, that is, the use of a pericardial fat flap for patients with a mycotic descending thoracic aortic aneurysm. PMID:27059067

  15. Crack cocaine causing fatal vasoconstriction of the aorta.

    PubMed

    Williams, Joanne; Wasserberger, Jonathan

    2006-08-01

    Cocaine is the most powerful central nervous stimulant found in nature. All forms of cocaine cause tachycardia and vasoconstriction. A smokable, rapidly reacting form of cocaine base, "crack," is highly addictive. Smoking crack introduces a high concentration of cocaine into the bloodstream, rendering it especially dangerous. We report a case that visually demonstrates severe aortic vasoconstriction from the suprarenal aorta and extending to both femoral arteries and beyond, resulting in renal failure and fatal bowel ischemia after a 5-day binge of crack cocaine.

  16. Effect of telmisartan on the expression of adiponectin receptors and nicotinamide adenine dinucleotide phosphate oxidase in the heart and aorta in type 2 diabetic rats

    PubMed Central

    2012-01-01

    Background Diabetic cardiovascular disease is associated with decreased adiponectin and increased oxidative stress. This study investigated the effect of telmisartan on the expression of adiponectin receptor 2 (adipoR2) and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunits in the heart and the expression of adiponectin receptor 1 (adipoR1) in aorta in type 2 diabetic rats. Methods Type 2 diabetes was induced by high-fat and high-sugar diet and intraperitoneal injection of a low dose of streptozotocin (STZ). Heart function, adipoR2, p22phox, NOX4, glucose transporter 4(GLUT4), monocyte chemoattractant protein-1(MCP-1) and connective tissue growth factor (CTGF)in the heart, and adipoR1, MCP-1 and nuclear factor kappa B (NF-κB) in aorta were analyzed in controls and diabetic rats treated with or without telmisartan (5mg/kg/d) by gavage for 12 weeks. Results Heart function, plasma and myocardial adiponectin levels, the expression of myocardial adipoR2 and GLUT4 were significantly decreased in diabetic rats (P <0.05). The expression of myocardial p22phox, NOX4, MCP-1, and CTGF was significantly increased in diabetic rats (P <0.05). The expression of adipoR1 was decreased and the expression of MCP-1 and NF-κB was increased in the abdominal aorta in diabetic rats (P <0.05). Telmisartan treatment significantly attenuated these changes in diabetic rats (P <0.05). Conclusions Our results suggest that telmisartan upregulates the expression of myocardial adiponectin, its receptor 2 and GLUT4. Simultaneously, it downregulates the expression of myocardial p22phox, NOX4, MCP-1, and CTGF, contributing so to the improvement of heart function in diabetic rats. Telmisartan also induces a protective role on the vascular system by upregulating the expression of adipoR1 and downregulating the expression of MCP-1 and NF-κB in the abdominal aorta in diabetic rats. PMID:22873349

  17. Catchment delineation and morphometric analysis using geographical information system.

    PubMed

    Kumar, Manoj; Kumar, Rohitashw; Singh, P K; Singh, Manjeet; Yadav, K K; Mittal, H K

    2015-01-01

    The geographical information system (GIS) has emerged as an efficient tool in delineation of drainage patterns of watershed planning and management. The morphometric parameters of basins can address linear, areal and relief aspects. The study deals with the integrated watershed management of Baliya micro-watersheds, located in the Udaipur district of Rajasthan, India. Morphometric analysis in hydrological investigation is an important aspect and it is inevitable in the development and management of drainage basins. The determination of linear, areal and relief parameters indicate fairly good significance. The low value of the bifurcation ratio of 4.19 revealed that the drainage pattern has not been distorted by structural disturbance. The high value of the elongation ratio (0.68) compared to the circulatory ratio (0.27) indicates an elongated shape of the watershed. The high value of drainage density (5.39 km/km(2)) and stream frequency (12.32) shows that the region has impermeable subsoil material under poor vegetative cover with a low relief factor. The morphometric parameters of relief ratio (0.041) and relative relief (0.99%) show that the watershed can be treated using GIS techniques to determine the morphometric presence of dendritic drainage pattern, with a view to selecting the soil and water conservation measures and water harvesting.

  18. Morphometric Evaluation of Hypotriploid and Triploid Populations of Meloidogyne arenaria

    PubMed Central

    Hirschmann, Hedwig; Rammah, Abdallah

    1993-01-01

    A morphometric comparison of seven hypotriploid populations with five pooled triploid populations of Meloidogyne arenaria was made using standard descriptive statistics, stepwise discriminant analysis (SDA), and cluster analysis. Six morphometric characters of females, 14 of second-stage juveniles (J2), and 18 of males were measured for each population. Useful differentiating characters included: body length in J2; stylet length in females and J2; stylet-knob dimensions in females and males; dorsal esophageal gland orifice distance in all three life stages; esophagus-length ratio in males and J2; excretory pore position in J2; and spicule length in males. SDA and cluster analysis showed that in each life stage, the hypotriploid populations were set off to varying degrees from the triploid populations. In addition, the relationships among populations differed when different life stages were compared. No consistent relationships could be detected among the populations, when morphometric data of the present study and morphological findings of the same populations in a parallel study were considered. Morphometric differences were not sufficient to propose any of the hypotriploid populations as new species. PMID:19279751

  19. Diffuse thalamic degeneration in fatal familial insomnia. A morphometric study.

    PubMed

    Macchi, G; Rossi, G; Abbamondi, A L; Giaccone, G; Mancia, D; Tagliavini, F; Bugiani, O

    1997-10-10

    A morphometric investigation disclosed most thalamic nuclei severely degenerated in two patients with fatal familial insomnia. Associative and motor nuclei lost 90% neurons, and limbic-paralimbic, intralaminar and reticular nuclei lost 60%. These findings point to the disorganization of most thalamic circuits as a condition necessary for the sleep-wake rhythm being affected.

  20. Sodium metabisulfite-induced changes on testes, spermatogenesis and epididymal morphometric values in adult rats

    PubMed Central

    Shekarforoush, Shahnaz; Ebrahimi, Zahra; Hoseini, Maryam

    2015-01-01

    Background: Sulphites are widely used as a preservative and antioxidant additives in the food and pharmaceutical industries. Many types of biological and toxicological effects of sulphites in multiple organs of mammals have been shown in previous studies. Objective: The aim of this study was to investigate the effects of sodium metabisulfite (SMB) on testicular function and morphometric values of epididymis in adult male Wistar rats. Materials and Methods: A total of 32 rats were randomly divided into four groups. The experimental groups received SMB at doses of 10 mg/kg (S10), 100mg/kg (S100), and 260 mg/kg (S260) while an equal volume of normal saline was administered to the control group via gavage. The rats were anaesthetized after 28 days and the left testis with the head of epididimis was excised following abdominal incision for histological observation using hematoxylin and eosin staining. Serum samples were collected for assay of testosterone level. The initial epididymis was analyzed for motility, morphology, and the number of sperms. Result: The results of this study showed that normal morphology, count, and motility of sperms and testosterone level were decreased in the SMB treated groups. In comparison with the control group, SMB resulted in a lower total number of spermatogonia, primary spermatocyte, spermatids, and Leydig cells. Conclusion: It is suggested that SMB decreases the sperm production and has the potential to affect the fertility adversely in male rats. PMID:27141536

  1. Adipocyte morphometric evaluation and angiogenesis in the omentum transposed to the breast: a preliminary study

    PubMed Central

    Costa, Sirlei Santos; Blotta, Rosa Maria; Meurer, Luise; Edelweiss, Maria Isabel Albano

    2011-01-01

    OBJECTIVE: The purpose of this study was to describe the probable mechanism of the volume increase of laparoscopically harvested omentum flaps used to treat breast deformities. METHODS: A histological analysis of omentum samples was performed to study the volume increase of laparoscopically harvested omentum flaps. Samples were harvested immediately after the transposition of the omentum from the abdominal cavity to the breast region and during the second surgical procedure for breast symmetrization of eight patients submitted to the transposition of the omentum flap. Changes in the morphometric measurements of the adipocytes (perimeter, diameter, and area), microvascular density (as measured by the CD31 endothelial marker), and immunohistochemical expression of VEGF were documented. RESULTS: The increases in adipocyte size and microvascular density were statistically significant (P ≤ 0.012). The expression levels of VEGF were lower in the second set of samples when compared to the first set, but the differences were not statistically significant (P < 0.093). CONCLUSION: These results demonstrate an increase in cellular volume as measured by adipocyte perimeter, diameter, and area. Moreover, the increase in the number of vessels in the second set of samples suggests that neoangiogenesis was stimulated by the initial increase in VEGF expression levels observed in the first set of samples. The increase in VEGF expression in the flap may have been caused by adipocyte hypertrophy resulting from neoangiogenesis. PMID:21484051

  2. Pulse wave imaging in normal, hypertensive and aneurysmal human aortas in vivo: a feasibility study

    NASA Astrophysics Data System (ADS)

    Li, Ronny X.; Luo, Jianwen; Balaram, Sandhya K.; Chaudhry, Farooq A.; Shahmirzadi, Danial; Konofagou, Elisa E.

    2013-07-01

    Arterial stiffness is a well-established biomarker for cardiovascular risk, especially in the case of hypertension. The progressive stages of an abdominal aortic aneurysm (AAA) have also been associated with varying arterial stiffness. Pulse wave imaging (PWI) is a noninvasive, ultrasound imaging-based technique that uses the pulse wave-induced arterial wall motion to map the propagation of the pulse wave and measure the regional pulse wave velocity (PWV) as an index of arterial stiffness. In this study, the clinical feasibility of PWI was evaluated in normal, hypertensive, and aneurysmal human aortas. Radiofrequency-based speckle tracking was used to estimate the pulse wave-induced displacements in the abdominal aortic walls of normal (N = 15, mean age 32.5 ± 10.2 years), hypertensive (N = 13, mean age 60.8 ± 15.8 years), and aneurysmal (N = 5, mean age 71.6 ± 11.8 years) human subjects. Linear regression of the spatio-temporal variation of the displacement waveform in the anterior aortic wall over a single cardiac cycle yielded the slope as the PWV and the coefficient of determination r2 as an approximate measure of the pulse wave propagation uniformity. The aortic PWV measurements in all normal, hypertensive, and AAA subjects were 6.03 ± 1.68, 6.69 ± 2.80, and 10.54 ± 6.52 m s-1, respectively. There was no significant difference (p = 0.15) between the PWVs of the normal and hypertensive subjects while the PWVs of the AAA subjects were significantly higher (p < 0.001) compared to those of the other two groups. Also, the average r2 in the AAA subjects was significantly lower (p < 0.001) than that in the normal and hypertensive subjects. These preliminary results suggest that the regional PWV and the pulse wave propagation uniformity (r2) obtained using PWI, in addition to the PWI images and spatio-temporal maps that provide qualitative visualization of the pulse wave, may potentially provide valuable information for the clinical characterization of aneurysms

  3. Endovascular Repair of Traumatic Rupture of the Thoracic Aorta: Single-Center Experience

    SciTech Connect

    Saratzis, Nikolaos A. Saratzis, Athanasios N.; Melas, Nikolaos; Ginis, Georgios; Lioupis, Athanasios; Lykopoulos, Dimitrios; Lazaridis, John; Dimitrios, Kiskinis

    2007-06-15

    Purpose. Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. Methods. Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. Results. Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. Conclusions. This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising.

  4. Performance assessment of Pulse Wave Imaging using conventional ultrasound in canine aortas ex vivo and normal human arteries in vivo

    PubMed Central

    Li, Ronny X.; Qaqish, William; Konofagou, Elisa. E.

    2015-01-01

    The propagation behavior of the arterial pulse wave may provide valuable diagnostic information for cardiovascular pathology. Pulse Wave Imaging (PWI) is a noninvasive, ultrasound imaging-based technique capable of mapping multiple wall motion waveforms along a short arterial segment over a single cardiac cycle, allowing for the regional pulse wave velocity (PWV) and propagation uniformity to be evaluated. The purpose of this study was to improve the clinical utility of PWI using a conventional ultrasound system. The tradeoff between PWI spatial and temporal resolution was evaluated using an ex vivo canine aorta (n = 2) setup to assess the effects of varying image acquisition and signal processing parameters on the measurement of the PWV and the pulse wave propagation uniformity r2. PWI was also performed on the carotid arteries and abdominal aortas of 10 healthy volunteers (24.8 ± 3.3 y.o.) to determine the waveform tracking feature that would yield the most precise PWV measurements and highest r2 values in vivo. The ex vivo results indicated that the highest precision for measuring PWVs ~ 2.5 – 3.5 m/s was achieved using 24–48 scan lines within a 38 mm image plane width (i.e. 0.63 – 1.26 lines/mm). The in vivo results indicated that tracking the 50% upstroke of the waveform would consistently yield the most precise PWV measurements and minimize the error in the propagation uniformity measurement. Such findings may help establish the optimal image acquisition and signal processing parameters that may improve the reliability of PWI as a clinical measurement tool. PMID:26640603

  5. Pharmacological Inhibitor of Notch Signaling Stabilizes the Progression of Small Abdominal Aortic Aneurysm in a Mouse Model

    PubMed Central

    Cheng, Jeeyun; Koenig, Sara N.; Kuivaniemi, Helena S.; Garg, Vidu; Hans, Chetan P.

    2014-01-01

    Background The progression of abdominal aortic aneurysm (AAA) involves a sustained influx of proinflammatory macrophages, which exacerbate tissue injury by releasing cytokines, chemokines, and matrix metalloproteinases. Previously, we showed that Notch deficiency reduces the development of AAA in the angiotensin II–induced mouse model by preventing infiltration of macrophages. Here, we examined whether Notch inhibition in this mouse model prevents progression of small AAA and whether these effects are associated with altered macrophage differentiation. Methods and Results Treatment with pharmacological Notch inhibitor (DAPT [N‐(N‐[3,5‐difluorophenacetyl]‐L‐alanyl)‐S‐phenylglycine t‐butyl ester]) at day 3 or 8 of angiotensin II infusion arrested the progression of AAA in Apoe−/− mice, as demonstrated by a decreased luminal diameter and aortic width. The abdominal aortas of Apoe−/− mice treated with DAPT showed decreased expression of matrix metalloproteinases and presence of elastin precursors including tropoelastin and hyaluronic acid. Marginal adventitial thickening observed in the aorta of DAPT‐treated Apoe−/− mice was not associated with increased macrophage content, as observed in the mice treated with angiotensin II alone. Instead, DAPT‐treated abdominal aortas showed increased expression of Cd206‐positive M2 macrophages and decreased expression of Il12‐positive M1 macrophages. Notch1 deficiency promoted M2 differentiation of macrophages by upregulating transforming growth factor β2 in bone marrow–derived macrophages at basal levels and in response to IL4. Protein expression of transforming growth factor β2 and its downstream effector pSmad2 also increased in DAPT‐treated Apoe−/− mice, indicating a potential link between Notch and transforming growth factor β2 signaling in the M2 differentiation of macrophages. Conclusions Pharmacological inhibitor of Notch signaling prevents the progression of AAA by macrophage

  6. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  7. Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

    NASA Astrophysics Data System (ADS)

    Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

    2007-03-01

    Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

  8. [Wall elasticity of the ascending aorta in ischemic heart disease].

    PubMed

    Alessandri, N; Franzin, S; Sulpizii, L; Cecchetti, F; Rondoni, G; Martarelli, L; Anaclerio, M; Campa, P P

    1995-03-01

    M-mode echocardiography was used to examine in male subjects the physical properties of the ascending aorta, 3 cm above the valvular plane. Subjects were divided into three groups based on age, lifestyle and presence or absence of vascular disease: Group A (10 recruited military young men, age 20.87 +/- 0.834 years) in good health; Group B (14 senior competitive athletes, age 49.92 +/- 8.17 years); Group C (10 patients with effort-angina, age 53.1 +/- 11.18 years). We observed that: the inner diastolic diameter of the ascending aorta was different between Group A and B (p < 0.001) and between Group A and C (p < 0.001), and it increased with aging (r = 0.7) whereas no relationship to body surface was seen (r = 0.3); the elasticity-stiffness parameters (aortic wall distensibility, aortic wall stress, wall stiffness index, wall elasticity index and modulus) of major vessels in senior athletes (Group B), were not different (p > 0.05) from military young men (Group A), although they were significantly lower (p < 0.001) in Group C patients; wall elasticity was lower in Group C patients (versus both Group A and B). Altered compliance might be the consequence of vessel structural changes and may contribute to reduce blood flow to the coronary arteries. Our data suggest that sports activity has beneficial effects; physical characteristics of great vessels do not show age-related changes.

  9. Automatic segmentation of the aorta and the adjoining vessels

    NASA Astrophysics Data System (ADS)

    Stutzmann, Tobias; Hesser, Jürgen; Völker, Wolfram; Dobhan, Matthias

    2010-03-01

    Diseases of the cardiovascular system are one of the main causes of death in the Western world. Especially the aorta and its main descending vessels are of high importance for diagnosis and treatment. Today, minimally invasive interventions are becoming increasingly popular due to their advantages like cost effectiveness and minimized risk for the patient. The training of such interventions, which require much of coordination skills, can be trained by task training systems, which are operation simualtion units. These systems require a data model that can be reconstructed from given patient data sets. In this paper, we present a method that allows to segment and classify aorta, carotides, and ostium (including coronary arteries) in one run, fully automatic and highly robust. The system tolerates changes in topology, streak artifacts in CT caused by calcification and inhomogeneous distribution of contrast agent. Both CT and MRI-Images can be processed. The underlying algorithm is based on a combination of Vesselness Enhancement Diffusion, Region Growing, and the Level Set Method. The system showed good results on all 15 real patient data sets whereby the deviation was smaller than two voxels.

  10. Volumetric lattice Boltzmann simulation for blood flow in aorta arteries

    NASA Astrophysics Data System (ADS)

    Deep, Debanjan; Yu, Huidan (Whitney); Teague, Shawn

    2012-11-01

    Complicated moving boundaries pose a major challenge in computational fluid dynamics for complex flows, especially in the biomechanics of both blood flow in the cardiovascular system and air flow in the respiratory system where the compliant nature of the vessels can have significant effects on the flow rate and wall shear stress. We develop a computation approach to treat arbitrarily moving boundaries using a volumetric representation of lattice Boltzmann method, which distributes fluid particles inside lattice cells. A volumetric bounce-back procedure is applied in the streaming step while momentum exchange between the fluid and moving solid boundary are accounted for in the collision sub-step. Additional boundary-induced migration is introduced to conserve fluid mass as the boundary moves across fluid cells. The volumetric LBM (VLBM) is used to simulate blood flow in both normal and dilated aorta arteries. We first compare flow structure and pressure distribution in steady state with results from Navier-Stokes based solver and good agreements are achieved. Then we focus on wall stress within the aorta for different heart pumping condition and present quantitative measurement of wall shear and normal stress.

  11. Coarctation of the aorta: Management from infancy to adulthood.

    PubMed

    Torok, Rachel D; Campbell, Michael J; Fleming, Gregory A; Hill, Kevin D

    2015-11-26

    Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

  12. Coarctation of the aorta: Management from infancy to adulthood

    PubMed Central

    Torok, Rachel D; Campbell, Michael J; Fleming, Gregory A; Hill, Kevin D

    2015-01-01

    Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient’s anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults. PMID:26635924

  13. Laceration of the thoracic aorta from a .22 lr bullet.

    PubMed

    Karger, B; Teige, K; Brinkmann, B

    1997-01-01

    A gunshot wound (.22 long rifle) to the chest including perforation of the aorta ascendens is presented. The small wound tract in soft tissue was characteristic for this type of ammunition and did not show any special peculiarities. However, arterial injury was not restricted to two small perforations, as expected in the light of previous wound ballistic findings. Three large longitudinal ruptures (3.0-4.5 cm in length and two of them independent of the perforations) additionally occurred, which led to rapid exsanguination. This extraordinary extent of vascular injury can be explained by perforation of the artery during the ventricular ejection phase, which causes a considerable dilation of the aorta analogous to a windkessel. The pre-existing dilation enables intraluminal temporary cavitation to have an "explosive" effect despite the high elastic tolerance to the vessel wall. The importance of tissue characteristics in gunshot wounds in general and the possible role of temporary cavitation inside the vessel in vascular gunshot wound production in particular are stressed.

  14. Open Surgery for Giant Bilateral Internal Iliac Artery Aneurysms with Compression of Neighboring Abdominal Structures: A Case Report

    PubMed Central

    Tomioka, Hideyuki; Katahira, Seiichiro; Hoshino, Takeshi; Hanzawa, Kazuhiko

    2015-01-01

    We describe a patient with successfully treated giant bilateral internal iliac artery aneurysms that were associated with acute renal failure secondary to bilateral hydronephrosis, lumbosacral plexopathy, and ileus. After hemodialysis for 1 month, the patient underwent graft replacement of the abdominal aorta and iliac arteries, including complete obliteration of the internal iliac artery branches, reconstruction of the inferior mesenteric artery, and ureterolysis. Weaning from hemodialysis was achieved and postoperative renal function improved. Although the patient had serious preoperative co-morbidities, emergency traditional open surgery should be the gold standard for securely releasing compression of the neighboring organs instead of endovascular treatment. PMID:26421081

  15. [Anesthesia and recovery of infrarenal abdominal aortic aneurysm surgery].

    PubMed

    Beye, S A; Kane, O; Tchikangoua, T N; Ndiaye, A; Dieng, P A; Ciss, G; Ba, P S; Ndiaye, M

    2009-01-01

    The aim of this study was to evaluate the anaesthetic assumption of responsibility of the surgery of the aneurism of under renal abdominal aorta. It was a retrospective study over two years (April 2005 - April 2007). Seven patients were operated, the mean age was 69,4 years. An operational pre evaluation was carried out among all patients including/understanding an interrogation, a clinical examination and a clinical assessment. All the patients profited from a general anaesthesia with controlled ventilation. Arterial hypertension (5 cases) was the independent factor of risk followed by the nicotinism (2 cases) with a patient at the stage of obstructive chronic broncho-pneumonopathy (BPCO). A patient was allowed in a table of rupture with acute abdominal pain and a cardiovascular collapse. Electrocardioscopic anomalies were noted among three patients with type of: HVD+ HBAG; HVG; HAG. A patient presented a hypertrophy cardiopathy with deterioration of the function of the VG and an important pulmonary arterial hypertension. A tensionnelle fall was found among three patients after induction with the midazolam. The aortic time of clampage varied between 20 and 120 mn with an average of 57, 6 mn. The incidents at the time of the clampage were: a bradycardia, a hypertensive push and a hypotension. No incident was observed at the time of the declampage. The blood losses per operational were estimated on average at 1000 ml and the numbers of transfusion by patient was on average of 4 pockets. The post operative issue was simple among 5 patients. A surgical recovery was necessary in front of a case of thrombosis of prosthesis. An oligoanurie, an acute respiratory insufficiency was found at the patient admitted in a table of rupture. The intermediate duration of stay threw 11 days. The maintenance of a homodynamic stability per and post operational remainder a good strategy to prevent the operational complications post. PMID:19666389

  16. Abdominal cocoon secondary to disseminated tuberculosis

    PubMed Central

    Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

    2014-01-01

    Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. PMID:25239980

  17. Obstruction of the Aorta and Left Pulmonary Artery After Gianturco Coil Occlusion of Patent Ductus Arteriosus

    SciTech Connect

    Kuo, H.-Cg; Ko, Sheung-Fat; Wu, Yu-Tsun; Huang, Chien-Fu; Chien, Shao-Ju; Tiao, Mao-Meng; Liang, Chi-Di

    2005-01-15

    We report an unusual case of simultaneous obstruction of the left pulmonary artery and descending thoracic aorta after Gianturco coil occlusion in a 15-month-old boy. The diagnosis was made by echocardiography and cardiac angiography. At surgery, thrombi coating on the protruded parts of the Gianturco coil in the pulmonary artery and aorta were found.

  18. Extraanatomic reconstruction for isolated thoracic aorta coarctation in an adult patient.

    PubMed

    Lee, Seung Hyun; Kim, Jae Bum; Park, Nam Hee; Keum, Dong Yoon; Choi, Sea Young

    2012-10-01

    A 42-year-old male patient with no medical history except hypertension presented with intermittent chest pain radiating to the left shoulder. From coronary computed tomography, a coarctation of proximal descending thoracic aorta was found demonstrating near aortic occlusion. From various available surgical options for this condition, we chose extraanatomic bypass from the left subclavian artery to the descending aorta.

  19. Pressure-volume characteristics of aortas of harbor and Weddell seals.

    PubMed

    Rhode, E A; Elsner, R; Peterson, T M; Campbell, K B; Spangler, W

    1986-07-01

    The mechanical properties of the radially enlarged proximal segment of the aorta of diving marine mammals was studied on 15 excised aortas of harbor seals and five aortas of Weddell seals. This was done by recording static pressure-volume relationships for the whole thoracic aorta, the aortic bulb, and the descending thoracic aorta and passive length-tension measurements of aortic strips. Aortic bulb volume distensibility was found to be much greater than that of the descending thoracic aorta or of an equivalent aortic segment of terrestrial mammals. The consequences were that the total potential energy and volume that may be stored within the aortic bulb is very large, with a capacity for storage of the stroke work of more than two normal heart beats and a volume of more than three times normal stroke volume. The aortic bulb has an average radius and wall thickness twice that of the descending aorta, but at any level of distension the wall stress (g/cm2) is the same throughout. The static mechanical properties of aortic strips from the bulb and descending thoracic aortas were not markedly different, so that the differences in the pressure-volume relationships are explained by differences in geometry of the two sections. The expanded aortic bulb functions through energy and volume storage actions and through uncoupling actions to maintain arterial pressures and stroke volume at near predive levels during a dive.

  20. Surgical management of a ballistic trauma of the right ventricle and descending thoracic aorta.

    PubMed

    Carrières, Caroline; Georg, Yannick; Khelifa, Ismail; Koskas, Fabien

    2014-07-01

    Ballistic injuries of the descending aorta are uncommon and of extremely severe prognosis. We report the case of a 55-year-old man treated for such a thoracic trauma that combined wounds of the heart and descending thoracic aorta. A combination of conventional surgical and endovascular approaches enabled successful treatment.

  1. Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

    PubMed Central

    Bhimarao; Bhat, Venkataramana; Gowda, Puttanna VN

    2015-01-01

    Background The high incidence of IUGR and its low recognition lead to increasing perinatal morbidity and mortality for which prediction of IUGR with timely management decisions is of paramount importance. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR. Aim To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation. Materials and Methods The prospective study was conducted over a period of one year on 50 clinically suspected IUGR pregnancies who were evaluated with 3.5 MHz frequency ultrasound scanner by a single sonologist. BPD, HC, AC and FL along with TCD were measured for assessing the sonological gestational age. Two morphometric ratios- TCD/AC and HC/AC were calculated. Estimated fetal weight was calculated for all these pregnancies and its percentile was determined. Statistical Methods The TCD/AC and HC/AC ratios were correlated with advancing gestational age to know if these were related to GA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC and HC/AC ratios in evaluating IUGR fetuses were calculated. Results In the present study, linear relation of TCD and HC in IUGR fetuses with gestation was noted. The sensitivity, specificity, PPV, NPV & DA were 88%, 93.5%, 77.1%, 96.3% & 92.4% respectively for TCD/AC ratio versus 84%, 92%, 72.4%, 95.8% & 90.4% respectively for HC/AC ratio in predicting IUGR. Conclusion Both ratios were gestational age independent and can be used in detecting IUGR with good diagnostic accuracy. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC ratio in predicting asymmetric IUGR. PMID:26557588

  2. Morphometric assessment of uplifting coral reef sequences, Sumba Island, Indonesia

    NASA Astrophysics Data System (ADS)

    Nexer, Maëlle; Authemayou, Christine; Schildgen, Taylor; Hantoro, Wayhoe; Molliex, Stephane; Delcaillau, Bernard; Pedoja, Kevin; Husson, Laurent; Regard, Vincent

    2015-04-01

    Rates and patterns of vertical ground motions constitute a basic framework for understanding the kinematics of the deforming lithosphere. Calibrating morphometric indices with landscape maturity and tectonic deformation requires comparisons with regions of known uplift history. The ability to derive uplift histories from marine or reefal terrace analysis in coastal zones therefore makes such settings ideal for testing morpho-tectonic analysis techniques. To explore the relationships between uplift rates and landscape morphology, we studied a 300-km-long coastal stretch affected by slow to moderate uplift rates, varying laterally from ≈0.02 to ≈0.6 mm/yr. We exploited the systematic spatial variation in rock uplift rates recorded in well-dated sequences of coral reef terraces of Sumba Island to assess the manner and degree to which the eight morphometric indices selected for this study can be correlated with tectonic forcing. The uniform equatorial climate and lithology (most of the bedrock is composed of Quaternary reefal limestones) across the study area allow us to evaluate which morphometric indices best reflect the spatial variations in Pleistocene coastal uplift rates. Morphometric indices extracted from digital elevation models include residual relief, incision, stream length index, ksn, hypsometric integral, drainage area, mean relief, and shape factor. We calculated and extracted these indices at three scales: across the whole island, from grouped sequences of coral reef terraces undergoing comparable uplift rates and individual catchments draining mainly the coral reef zones located in the northern part of Sumba Island. We find that SL, hypsometric integral, mean relief and shape factor of catchments positively correlate with uplift rates, whereas incision, residual relief, and ksn do not. Interestingly enough, we find that only the areas that are uplifting at a rate faster than 0.3 mm/yr can yield the extreme values for these indices, implying in turn

  3. Protective effect of zingerone on increased vascular contractility in diabetic rat aorta.

    PubMed

    Ghareib, Salah A; El-Bassossy, Hany M; Elberry, Ahmed A; Azhar, Ahmad; Watson, Malcolm L; Banjar, Zainy M; Alahdal, Abdulrahman M

    2016-06-01

    The aim of the present study was to investigate the effect and possible mechanism of action of zingerone, the main constituent of ginger, on vascular reactivity in isolated aorta from diabetic rats. The results show that incubation of aortae with zingerone alleviates the exaggerated vasoconstriction of diabetic aortae to phenylephrine, as well as the impaired relaxatory response to acetylcholine in a concentration-dependent manner. Furthermore, Zingerone directly relax phenylephrine-precontracted aortae. The vasorelaxatory response is significantly attenuated by the nitric oxide synthase inhibitor Nω-nitro-l-arginine methyl ester hydrochloride and the guanylate cyclase inhibitor methylene blue but no effect of either the potassium channels blocker tetraethylammonium chloride, or the cyclooxygenase inhibitor indomethacin was observed. Zingerone had no effect on advanced glycation end product formation as well. In conclusion, zingerone ameliorates enhanced vascular contraction in diabetic aortae which may be mediated by its vasodilator effect through NO- and guanylate cyclase stimulation. PMID:27020549

  4. Prostaglandin receptor EP4 in abdominal aortic aneurysms.

    PubMed

    Cao, Richard Y; St Amand, Tim; Li, XinZhi; Yoon, Sung-Hee; Wang, Carol P; Song, Hui; Maruyama, Takayuki; Brown, Peter M; Zelt, David T; Funk, Colin D

    2012-07-01

    Abdominal aortic aneurysm (AAA) pathogenesis is distinguished by vessel wall inflammation. Cyclooxygenase (COX)-2 and microsomal prostaglandin E synthase-1, key components of the most well-characterized inflammatory prostaglandin pathway, contribute to AAA development in the 28-day angiotensin II infusion model in mice. In this study, we used this model to examine the role of the prostaglandin E receptor subtype 4 (EP4) and genetic knockdown of COX-2 expression (70% to 90%) in AAA pathogenesis. The administration of the prostaglandin receptor EP4 antagonist AE3-208 (10 mg/kg per day) to apolipoprotein E (apoE)-deficient mice led to active drug plasma concentrations and reduced AAA incidence and severity compared with control apoE-deficient mice (P < 0.01), whereas COX-2 genetic knockdown/apoE-deficient mice displayed only a minor, nonsignificant decrease in incidence of AAA. EP4 receptor protein was present in human and mouse AAA, as observed by using Western blot analysis. Aortas from AE3-208-treated mice displayed evidence of a reduced inflammatory phenotype compared with controls. Atherosclerotic lesion size at the aortic root was similar between all groups. In conclusion, the prostaglandin E(2)-EP4 signaling pathway plays a role in the AAA inflammatory process. Blocking the EP4 receptor pharmacologically reduces both the incidence and severity of AAA in the angiotensin II mouse model, potentially via attenuation of cytokine/chemokine synthesis and the reduction of matrix metalloproteinase activities.

  5. Possible Dual Role of Decorin in Abdominal Aortic Aneurysm

    PubMed Central

    Ueda, Koshiro; Yoshimura, Koichi; Yamashita, Osamu; Harada, Takasuke; Morikage, Noriyasu; Hamano, Kimikazu

    2015-01-01

    Abdominal aortic aneurysm (AAA) is characterized by chronic inflammation, which leads to pathological remodeling of the extracellular matrix. Decorin, a small leucine-rich repeat proteoglycan, has been suggested to regulate inflammation and stabilize the extracellular matrix. Therefore, the present study investigated the role of decorin in the pathogenesis of AAA. Decorin was localized in the aortic adventitia under normal conditions in both mice and humans. AAA was induced in mice using CaCl2 treatment. Initially, decorin protein levels decreased, but as AAA progressed decorin levels increased in all layers. Local administration of exogenous decorin prevented the development of CaCl2-induced AAA. However, decorin was highly expressed in the degenerative lesions of human AAA walls, and this expression positively correlated with matrix metalloproteinase (MMP)-9 expression. In cell culture experiments, the addition of decorin inhibited secretion of MMP-9 in vascular smooth muscle cells, but had the opposite effect in macrophages. The results suggest that decorin plays a dual role in AAA. Adventitial decorin in normal aorta may protect against the development of AAA, but macrophages expressing decorin in AAA walls may facilitate the progression of AAA by up-regulating MMP-9 secretion. PMID:25781946

  6. Distribution of Wall Stress in Abdominal Aortic Aneurysm (AAA)

    NASA Astrophysics Data System (ADS)

    Lasheras, Juan

    2005-11-01

    Abdominal aortic aneurysm (AAA) rupture is believed to occur when the mechanical stress acting on the wall exceeds the strength of the wall tissue. Therefore, knowledge of the AAA wall stress distribution could be useful in assessing its risk of rupture. In our research, a finite element analysis was used to determine the wall stresses both in idealized models and in a real clinical model in which the aorta was considered isotropic with nonlinear material properties and was loaded with a given pressure. In the idealized models, both maximum diameter and asymmetry were found to have substantial influence on the distribution of the wall stress. The thrombus inside the AAA was also found to help protecting the walls from high stresses. Using CT scans of the AAA, the actual geometry of the aneurysm was reconstructed and we found that wall tension increases on the flatter surface (typically corresponds to the posterior surface) and at the inflection points of the bulge. In addition to the static analysis, we also performed simulations of the effect of unsteady pressure wave propagation inside the aneurysm.

  7. 3D image analysis of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Subasic, Marko; Loncaric, Sven; Sorantin, Erich

    2001-07-01

    In this paper we propose a technique for 3-D segmentation of abdominal aortic aneurysm (AAA) from computed tomography angiography (CTA) images. Output data (3-D model) form the proposed method can be used for measurement of aortic shape and dimensions. Knowledge of aortic shape and size is very important in planning of minimally invasive procedure that is for selection of appropriate stent graft device for treatment of AAA. The technique is based on a 3-D deformable model and utilizes the level-set algorithm for implementation of the method. The method performs 3-D segmentation of CTA images and extracts a 3-D model of aortic wall. Once the 3-D model of aortic wall is available it is easy to perform all required measurements for appropriate stent graft selection. The method proposed in this paper uses the level-set algorithm for deformable models, instead of the classical snake algorithm. The main advantage of the level set algorithm is that it enables easy segmentation of complex structures, surpassing most of the drawbacks of the classical approach. We have extended the deformable model to incorporate the a priori knowledge about the shape of the AAA. This helps direct the evolution of the deformable model to correctly segment the aorta. The algorithm has been implemented in IDL and C languages. Experiments have been performed using real patient CTA images and have shown good results.

  8. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  9. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated.

  10. Congenital lateral abdominal wall hernia.

    PubMed

    Montes-Tapia, Fernando; Cura-Esquivel, Idalia; Gutiérrez, Susana; Rodríguez-Balderrama, Isaías; de la O-Cavazos, Manuel

    2016-08-01

    Congenital abdominal wall defects that are located outside of the anterior wall are extremely rare and difficult to classify because there are no well accepted guidelines. There are two regions outside of the anterior wall: the flank or lateral wall; and the lumbar region. We report the case of a patient with an oval 3 cm-diameter hernia defect located above the anterior axillary line, which affects all layers of the muscular wall. An anorectal malformation consisting of a recto-vestibular fistula was also identified, and chest X-ray showed dextrocardia. The suggested treatment is repair of the defect before 1 year of age. Given that the anomalies described may accompany lateral abdominal wall hernia, it is important to diagnose and treat the associated defects.

  11. [Abdominal cystic tumor revealing lymphangioleiomyomatosis].

    PubMed

    Barbier, L; Ebbo, M; Andrac-Meyer, L; Schneilitz, N; Le Treut, Y-P; Reynaud-Gaubert, M; Hardwigsen, J

    2009-02-01

    We report the case of a 39 year-old woman with many years of intermittent abdominal pain who was found to have cystic masses evocative of cystic lymphangioma involving the posterior mediastinal and retroperitoneum. Worsening abdominal pain led to a recommendation for laparoscopic unroofing and decompression of the cysts. During the postoperative period, hemorrhagic shock required reintervention with excision of the tumoral mass. Pathologic examination revealed lymphangioleiomyomatosis (LAM). On the 15th postoperative day, the patient developed a chylopneumothorax which required prolonged chest tube drainage. The presence of multiple polycystic lesions in the pulmonary parenchyma supported the diagnosis of diffuse LAM with primary extrapulmonary presentation. This diagnosis should be considered preoperatively since it modifies the treatment: a complete excision of the cystic lesions seems to be necessary in order to prevent bleeding and lymphatic extravasation.

  12. [Morpho-Functional Changes of Thoracic Aorta in Atherosclerosis: Multiplane Transesophageal Ultrasound Study

    PubMed

    Vrublevskiĭ, A. V.; Boshchenko, A. A.; Karpov, R. S.

    2001-01-01

    AIM: To elucidate possibilities of multiplane transesophageal ultrasound for assessment of localization and structure of atherosclerotic plaques in the thoracic aorta as well as relationship between changes of elastic-tonic properties, processes of aortic wall remodeling, stage of aortic atheromatosis, and coronary atherosclerosis. MATERIAL: Patients with chronic ischemic heart disease and atherosclerosis of thoracic aorta (n=120), healthy volunteers (n=11, all men, mean age 51-/+8 years). METHODS: Multiplane transesophageal ultrasound with subsequent calculation of parameters of elasticity and stiffness. The classification of C. Pitsavos et al. (1997) was used for grading aortic atheromatosis. RESULTS. Atherosclerotic plaques were found in 109 patients (91%) and 69 patients (58%) had pronounced (stage 3-5) atheromatosis of thoracic aorta. The plaques were most frequently (87%) localized in descending aorta. Calcinated hyperdense plaques, soft plaques with low density, soft plaques with heterogeneous density prevailed in ascending aorta, aortic arch, and descending aorta, respectively. Sensitivity and specificity of thoracic atherosclerosis as predictor of atherosclerotic lesions in coronary vessels were 90 and 65%, respectively. Pronounced diffuse atherosclerosis of thoracic aorta decreased its elastic-tonic properties as evidenced by significant lowering of parameters of elasticity and increase of stiffness index. This process was associated with remodeling of thoracic aorta (progressive passive dilatation, thickening of its wall and lowering of amplitude of systolic excursion). Atheromatosis stage correlated inversely with systolic excursion and parameters of elasticity and directly with stiffness index, intima-media thickness, systolic and diastolic diameters of the aorta. There was also a direct correlation between stage of aortic atheromatosis and age and total score of coronary artery involvement. CONCLUSION: Multiplane transesophageal echocardiography is a

  13. Automated quantitative 3D analysis of aorta size, morphology, and mural calcification distributions

    PubMed Central

    Kurugol, Sila; Come, Carolyn E.; Diaz, Alejandro A.; Ross, James C.; Kinney, Greg L.; Black-Shinn, Jennifer L.; Hokanson, John E.; Budoff, Matthew J.; Washko, George R.; San Jose Estepar, Raul

    2015-01-01

    Purpose: The purpose of this work is to develop a fully automated pipeline to compute aorta morphology and calcification measures in large cohorts of CT scans that can be used to investigate the potential of these measures as imaging biomarkers of cardiovascular disease. Methods: The first step of the automated pipeline is aorta segmentation. The algorithm the authors propose first detects an initial aorta boundary by exploiting cross-sectional circularity of aorta in axial slices and aortic arch in reformatted oblique slices. This boundary is then refined by a 3D level-set segmentation that evolves the boundary to the location of nearby edges. The authors then detect the aortic calcifications with thresholding and filter out the false positive regions due to nearby high intensity structures based on their anatomical location. The authors extract the centerline and oblique cross sections of the segmented aortas and compute the aorta morphology and calcification measures of the first 2500 subjects from COPDGene study. These measures include volume and number of calcified plaques and measures of vessel morphology such as average cross-sectional area, tortuosity, and arch width. Results: The authors computed the agreement between the algorithm and expert segmentations on 45 CT scans and obtained a closest point mean error of 0.62 ± 0.09 mm and a Dice coefficient of 0.92 ± 0.01. The calcification detection algorithm resulted in an improved true positive detection rate of 0.96 compared to previous work. The measurements of aorta size agreed with the measurements reported in previous work. The initial results showed associations of aorta morphology with calcification and with aging. These results may indicate aorta stiffening and unwrapping with calcification and aging. Conclusions: The authors have developed an objective tool to assess aorta morphology and aortic calcium plaques on CT scans that may be used to provide information about the presence of cardiovascular

  14. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  15. Postprandial abdominal pain owing to isolated enteric duplication cyst in the superior mesenteric artery root: sonographic and magnetic resonance imaging features.

    PubMed

    Ko, Sheung-Fat; Ng, Shu-Hang; Huang, Fu-Chen; Sung, Ming-Tse; Hsieh, Chie-Song

    2011-04-01

    A 7-year-old girl presented to the emergency department with postprandial abdominal pain. An abdominal sonogram revealed a retroperitoneal septated cystic lesion. Magnetic resonance imaging showed a septated cystic lesion in the superior mesenteric artery (SMA) root with a vessel originating from the proximal SMA supplying the cyst wall and a deformed adjacent aortic contour. A laparotomy was performed and confirmed the presence of an isolated enteric duplication cyst with its own blood supply from the SMA and marked perilesional adhesions to the duodenal loop and aorta. Histopathologic study was consistent with a duplication. To our knowledge, this is the first report of isolated enteric duplication cyst in the superior mesenteric root with perilesional adhesion leading to postprandial abdominal pain, which was successfully relieved after surgery.

  16. Blood flow and coherent vortices in the normal and aneurysmatic aortas: a fluid dynamical approach to intra-luminal thrombus formation

    PubMed Central

    Biasetti, Jacopo; Hussain, Fazle; Gasser, T. Christian

    2011-01-01

    Abdominal aortic aneurysms (AAAs) are frequently characterized by the development of an intra-luminal thrombus (ILT), which is known to have multiple biochemical and biomechanical implications. Development of the ILT is not well understood, and shear–stress-triggered activation of platelets could be the first step in its evolution. Vortical structures (VSs) in the flow affect platelet dynamics, which motivated the present study of a possible correlation between VS and ILT formation in AAAs. VSs educed by the λ2-method using computational fluid dynamics simulations of the backward-facing step problem, normal aorta, fusiform AAA and saccular AAA were investigated. Patient-specific luminal geometries were reconstructed from computed tomography scans, and Newtonian and Carreau–Yasuda models were used to capture salient rheological features of blood flow. Particularly in complex flow domains, results depended on the constitutive model. VSs developed all along the normal aorta, showing that a clear correlation between VSs and high wall shear stress (WSS) existed, and that VSs started to break up during late systole. In contrast, in the fusiform AAA, large VSs developed at sites of tortuous geometry and high WSS, occupying the entire lumen, and lasting over the entire cardiac cycle. Downward motion of VSs in the AAA was in the range of a few centimetres per cardiac cycle, and with a VS burst at that location, the release (from VSs) of shear-stress-activated platelets and their deposition to the wall was within the lower part of the diseased artery, i.e. where the thickest ILT layer is typically observed. In the saccular AAA, only one VS was found near the healthy portion of the aorta, while in the aneurysmatic bulge, no VSs occurred. We present a fluid-dynamics-motivated mechanism for platelet activation, convection and deposition in AAAs that has the potential of improving our current understanding of the pathophysiology of fluid-driven ILT growth. PMID:21471188

  17. Blood flow and coherent vortices in the normal and aneurysmatic aortas: a fluid dynamical approach to intra-luminal thrombus formation.

    PubMed

    Biasetti, Jacopo; Hussain, Fazle; Gasser, T Christian

    2011-10-01

    Abdominal aortic aneurysms (AAAs) are frequently characterized by the development of an intra-luminal thrombus (ILT), which is known to have multiple biochemical and biomechanical implications. Development of the ILT is not well understood, and shear-stress-triggered activation of platelets could be the first step in its evolution. Vortical structures (VSs) in the flow affect platelet dynamics, which motivated the present study of a possible correlation between VS and ILT formation in AAAs. VSs educed by the λ(2)-method using computational fluid dynamics simulations of the backward-facing step problem, normal aorta, fusiform AAA and saccular AAA were investigated. Patient-specific luminal geometries were reconstructed from computed tomography scans, and Newtonian and Carreau-Yasuda models were used to capture salient rheological features of blood flow. Particularly in complex flow domains, results depended on the constitutive model. VSs developed all along the normal aorta, showing that a clear correlation between VSs and high wall shear stress (WSS) existed, and that VSs started to break up during late systole. In contrast, in the fusiform AAA, large VSs developed at sites of tortuous geometry and high WSS, occupying the entire lumen, and lasting over the entire cardiac cycle. Downward motion of VSs in the AAA was in the range of a few centimetres per cardiac cycle, and with a VS burst at that location, the release (from VSs) of shear-stress-activated platelets and their deposition to the wall was within the lower part of the diseased artery, i.e. where the thickest ILT layer is typically observed. In the saccular AAA, only one VS was found near the healthy portion of the aorta, while in the aneurysmatic bulge, no VSs occurred. We present a fluid-dynamics-motivated mechanism for platelet activation, convection and deposition in AAAs that has the potential of improving our current understanding of the pathophysiology of fluid-driven ILT growth.

  18. The relationship between wall tension, lamellar thickness, and intercellular junctions in the fetal and adult aorta: its relevance to the pathology of dissecting aneurysm.

    PubMed

    Berry, C L; Sosa-Melgarejo, J A; Greenwald, S E

    1993-01-01

    It is known that the distribution of stress and strain in the vessel wall is not uniform. We believe that this explains the location of the plane of dissection in dissecting aneurysms of large elastic arteries. We have investigated the effects of non-uniformity of stress and strain on the thickness of each elastic lamella and on the distribution of intercellular junctions in the media of developing and adult rats, to seek evidence to support this hypothesis. Intercellular junctions were identified by transmission electron microscopy of whole wall sections. A morphometric study of elastic tissue distribution was made on an image analysis computer. Differences were analysed using one-way analysis of variance. There are between six and eight elastic lamellae in the aorta of rats. In the fetus, only the internal elastic lamella is complete; the others were not fully formed by term. In the adult, the inner five elastic lamellae were thicker than the remaining two or three, and smooth muscle cells in the thicker lamellar units had more cell-cell contacts of all types examined. These data support the concept of a difference in stress-resisting properties of the aortic wall on the junctions between the inner two-thirds and the outer third of the media. The findings indicate that, as proposed in theoretical models the innermost lamellae support the high tension. In the adult aorta, the structure is modified to enhance the capacity to resist stress in the internal two-thirds of the media.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8433211

  19. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  20. Transperitoneal repair of a juxtarenal abdominal aortic aneurysm and co-existent horseshoe kidney with division of the renal isthmus.

    PubMed

    Hajibandeh, Shahin; Hajibandeh, Shahab; Johnpulle, Michelle; Perricone, Vittorio

    2015-01-01

    The co-existence of abdominal aortic aneurysm (AAA) and horseshoe kidney (HSK) is rare. We report a 67-year-old man with an expanding juxtarenal AAA associated with a HSK. The aneurysm had a severely angulated neck and contained a significant amount of mural thrombus. The isthmus of HSK closely lied over the aneurysm, making its exposure extremely difficult. The aneurysm was successfully repaired using transperitoneal approach with division of the renal isthmus and without any need for the renal artery reconstruction. Despite the potential complications, particularly renal insufficiency, associated with division of the renal isthmus and suprarenal cross-clamping of the abdominal aorta, in our case, post-operative period was uneventful and the patient's recovery was satisfactory. PMID:26511935

  1. Iatrogenic dissection of the descending aorta: Conservative or endovascular treatment?

    PubMed Central

    Baikoussis, Nikolaos G.; Argiriou, Michalis; Kratimenos, Theodoros; Karameri, Vasiliki; Dedeilias, Panagiotis

    2016-01-01

    Transcatheter aortic valve implantation (TAVI) is without any doubt a standard technique and the treatment of choice of severe aortic valve stenosis (AVS) in very high-operative risk patients. However, a number of complications may occur and has been described. Improper valve position, valve migration, paravalvular regurgitation, conduction disturbances, stroke and aortic dissection have been succeeded despite the perfection of the technique. For anyone of the complications above described, a solution may be invented. We present an interesting case of an 81-year-old woman with severe AVS treated through TAVI due to very high operative risk. This female, 12 days later presented with thoracic pain and shortness of breath and through the computed tomography of the chest performed was diagnosed a dissection of the descending aorta. She successfully underwent on thoracic endovascular aortic repair. In this report, we refer the bibliographic data and we discuss the treatment options in these cases. PMID:27397470

  2. Coarctation of the aorta and post-stenotic aneurysm formation.

    PubMed Central

    Mitchell, I M; Pollock, J C

    1990-01-01

    Despite earlier angiography, post-stenotic aneurysm of the aorta was an unexpected finding at operation in two patients with coarctation. One aneurysm was found in an intercostal artery in a 19 year old man and the other was a false aneurysm just distal to the coarctation site in a 7 year old boy. These aneurysms are fragile, apt to rupture, and difficult to diagnose preoperatively. Though local factors such as jet streams and bacterial endocarditis may influence their formation there must be an underlying generalised weakness in the arterial wall. A coarctation should not be regarded as an isolated arterial abnormality because it may be a feature of a more generalised disease. Because of the risk of rupture, which may not be prevented by antihypertensive treatment, operation should not be delayed in any age group. PMID:2245114

  3. Ayahuasca Alters Structural Parameters of the Rat Aorta.

    PubMed

    Pitol, Dimitrius L; Siéssere, Selma; Dos Santos, Rafael G; Rosa, Maria L N M; Hallak, Jaime E C; Scalize, Priscilla H; Pereira, Bruno F; Iyomasa, Melina M; Semprini, Marisa; Riba, Jordi; Regalo, Simone C H

    2015-07-01

    Ayahuasca is a hallucinogenic brew traditionally used by Northwestern Amazonian indigenous groups for therapeutic purposes. It is prepared by the decoction of Banisteriopsis caapi with the leaves of Psychotria viridis. Banisteriopsis caapi contains β-carbolines that are inhibitors of monoamine oxidase and P. viris is rich in dimethyltryptamine, a 5-HT(1A/2A/2C) agonist. Acute ayahuasca administration produces moderate cardiovascular effects in healthy volunteers, but information regarding long-term use is lacking. This study investigated the effects of ayahuasca (2-4 mL/kg) in the rat aorta after acute and chronic (14 days) administration. Ayahuasca caused flattening and stretching of vascular smooth muscle cells and changes in the arrangement and distribution of collagen and elastic fibers. Chronic treatment with the higher dose significantly increased media thickness and the ratio of media thickness to lumen diameter. More research is needed on the cardiovascular function of long-term ayahuasca consumers.

  4. [Perioperative management of abdominal aortic balloon occlusion in patients complicated with placenta percteta: a case report].

    PubMed

    Zeng, Hong; Wang, Yan; Wang, Yang; Guo, Xiang-yang

    2015-12-18

    When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta previa and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery (9 F sheath ), subarachnoid anesthesia had been established. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Immediately after the baby was delivered, following which there was massive haemorrhage and general anaesthesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disappeared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta, who were at high

  5. On growth measurements of abdominal aortic aneurysms using maximally inscribed spheres.

    PubMed

    Gharahi, H; Zambrano, B A; Lim, C; Choi, J; Lee, W; Baek, S

    2015-07-01

    The maximum diameter, total volume of the abdominal aorta, and its growth rate are usually regarded as key factors for making a decision on the therapeutic operation time for an abdominal aortic aneurysm (AAA) patient. There is, however, a debate on what is the best standard method to measure the diameter. Currently, two dominant methods for measuring the maximum diameter are used. One is measured on the planes perpendicular to the aneurism's central line (orthogonal diameter) and the other one is measured on the axial planes (axial diameter). In this paper, another method called 'inscribed-spherical diameter' is proposed to measure the diameter. The main idea is to find the diameter of the largest sphere that fits within the aorta. An algorithm is employed to establish a centerline for the AAA geometries obtained from a set of longitudinal scans obtained from South Korea. This centerline, besides being the base of the inscribed spherical method, is used for the determination of orthogonal and axial diameter. The growth rate parameters are calculated in different diameters and the total volume and the correlations between them are studied. Furthermore, an exponential growth pattern is sought for the maximum diameters over time to examine a nonlinear growth pattern of AAA expansion both globally and locally. The results present the similarities and discrepancies of these three methods. We report the shortcomings and the advantages of each method and its performance in the quantification of expansion rates. While the orthogonal diameter measurement has an ability of capturing a realistic diameter, it fluctuated. On the other hand, the inscribed sphere diameter method tends to underestimate the diameter measurement but the growth rate can be bounded in a narrow region for aiding prediction capability. Moreover, expansion rate parameters derived from this measurement exhibit good correlation with each other and with growth rate of volume. In conclusion, although the

  6. Mycotic Abdominal Aneurysm Caused by Campylobacter Fetus: A Case Report for Surgical Management

    PubMed Central

    Noda, Yukihiro; Sawada, Ko-ichiro; Yoshida, Syu-hei; Nishida, Satoru; Yamamoto, Shinichiro; Otake, Yuji; Watanabe, Go

    2011-01-01

    We report a rare case of mycotic abdominal aortic aneurysm associated with Campylobacter fetus. A 72-year-old male admitted to the hospital because of pain in the right lower quadrant with pyrexia. The enhanced abdominal computed tomography (CT) examination showed abdominal aortic aneurysm (AAA) measuring 50 mm in maximum diameter and a high-density area of soft tissue density from the right lateral wall to the anterior wall of the aorta. However, since the patient showed no significant signs of defervescence after antibiotics administration, so we performed emergency surgery on the patient based on the diagnosis of impending rupture of mycotic AAA. The aneurysm was resected in situ reconstruction using a bifurcated albumin-coated knitted Dacron graft was performed. The cultures of blood and aneurysmal wall grew Campylobacter fetus, allowing early diagnosis and appropriate surgical management in this case, and the patient is making satisfactory progress. This is the fifth report of mycotic AAA characterizing culture positive for Campylobacter fetus in blood and tissue culture of the aortic aneurysm wall. PMID:23555431

  7. Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation

    SciTech Connect

    Van de Velde, Joris; Wouters, Johan; Vercauteren, Tom; De Gersem, Werner; Duprez, Fréderic; De Neve, Wilfried; Van Hoof, Tom

    2015-07-01

    Purpose: The purpose of this study was to determine the effects of atlas selection based on different morphometric parameters, on the accuracy of automatic brachial plexus (BP) segmentation for radiation therapy planning. The segmentation accuracy was measured by comparing all of the generated automatic segmentations with anatomically validated gold standard atlases developed using cadavers. Methods and Materials: Twelve cadaver computed tomography (CT) atlases (3 males, 9 females; mean age: 73 years) were included in the study. One atlas was selected to serve as a patient, and the other 11 atlases were registered separately onto this “patient” using deformable image registration. This procedure was repeated for every atlas as a patient. Next, the Dice and Jaccard similarity indices and inclusion index were calculated for every registered BP with the original gold standard BP. In parallel, differences in several morphometric parameters that may influence the BP segmentation accuracy were measured for the different atlases. Specific brachial plexus-related CT-visible bony points were used to define the morphometric parameters. Subsequently, correlations between the similarity indices and morphometric parameters were calculated. Results: A clear negative correlation between difference in protraction-retraction distance and the similarity indices was observed (mean Pearson correlation coefficient = −0.546). All of the other investigated Pearson correlation coefficients were weak. Conclusions: Differences in the shoulder protraction-retraction position between the atlas and the patient during planning CT influence the BP autosegmentation accuracy. A greater difference in the protraction-retraction distance between the atlas and the patient reduces the accuracy of the BP automatic segmentation result.

  8. Landmark-based Morphometric and Meristic Analysis of Serranidae

    PubMed Central

    Lim, Sang Gu; Jeong, Min Hwan; Kim, Bong Seok; Lee, Tae Ho; Gil, Hyun Woo; Park, In-Seok

    2016-01-01

    The landmark-based morphometric and meristic analysis of the kelp grouper (Epinephelus bruneus), red spotted grouper (E. akaara) and seven-banded grouper (E. septemfasciatus) were performed to compare the differentiation of overall body shape and structure. The measurements of the morphometric dimensions were observed in 25 parts (truss dimension: 16 parts; head part dimension: 9 parts) of 38 morphometric dimensions and also meristic differences observed in 3 parts (dorsal fin, anal fin and caudal fin) of 6 meristic counts (P < 0.05). Observed morphometric characteristics primarily involved in truss and head part dimension, kelp grouper have larger values in caudal part of truss dimension, kelp grouper, red spotted grouper and seven-banded grouper have similar values in pectoral part of truss dimension, in addition to, results of head part dimension showed that red spotted grouper have smaller values in overall dimensions (P < 0.05). As meristic characteristics, kelp grouper have more number of anal fin rays than other fish, red spotted grouper have more number of dorsal soft rays than other fish, and seven spotted grouper have more number of anal soft rays, and caudal fin rays than other fish (P < 0.05). Photographed under the x-ray, kelp grouper have the most curved vertebral column and largest swim bladder than other fishes (P < 0.05). Our results of this study confirmed that 3 subfamily fishes adequately can distinguish with external body shape, and we hope that the results of our study could be used to identify in Serranidae family as taxonomical parameters.

  9. Landmark-based Morphometric and Meristic Analysis of Serranidae

    PubMed Central

    Lim, Sang Gu; Jeong, Min Hwan; Kim, Bong Seok; Lee, Tae Ho; Gil, Hyun Woo; Park, In-Seok

    2016-01-01

    The landmark-based morphometric and meristic analysis of the kelp grouper (Epinephelus bruneus), red spotted grouper (E. akaara) and seven-banded grouper (E. septemfasciatus) were performed to compare the differentiation of overall body shape and structure. The measurements of the morphometric dimensions were observed in 25 parts (truss dimension: 16 parts; head part dimension: 9 parts) of 38 morphometric dimensions and also meristic differences observed in 3 parts (dorsal fin, anal fin and caudal fin) of 6 meristic counts (P < 0.05). Observed morphometric characteristics primarily involved in truss and head part dimension, kelp grouper have larger values in caudal part of truss dimension, kelp grouper, red spotted grouper and seven-banded grouper have similar values in pectoral part of truss dimension, in addition to, results of head part dimension showed that red spotted grouper have smaller values in overall dimensions (P < 0.05). As meristic characteristics, kelp grouper have more number of anal fin rays than other fish, red spotted grouper have more number of dorsal soft rays than other fish, and seven spotted grouper have more number of anal soft rays, and caudal fin rays than other fish (P < 0.05). Photographed under the x-ray, kelp grouper have the most curved vertebral column and largest swim bladder than other fishes (P < 0.05). Our results of this study confirmed that 3 subfamily fishes adequately can distinguish with external body shape, and we hope that the results of our study could be used to identify in Serranidae family as taxonomical parameters. PMID:27660823

  10. Landmark-based Morphometric and Meristic Analysis of Serranidae.

    PubMed

    Lim, Sang Gu; Jeong, Min Hwan; Kim, Bong Seok; Lee, Tae Ho; Gil, Hyun Woo; Park, In-Seok

    2016-06-01

    The landmark-based morphometric and meristic analysis of the kelp grouper (Epinephelus bruneus), red spotted grouper (E. akaara) and seven-banded grouper (E. septemfasciatus) were performed to compare the differentiation of overall body shape and structure. The measurements of the morphometric dimensions were observed in 25 parts (truss dimension: 16 parts; head part dimension: 9 parts) of 38 morphometric dimensions and also meristic differences observed in 3 parts (dorsal fin, anal fin and caudal fin) of 6 meristic counts (P < 0.05). Observed morphometric characteristics primarily involved in truss and head part dimension, kelp grouper have larger values in caudal part of truss dimension, kelp grouper, red spotted grouper and seven-banded grouper have similar values in pectoral part of truss dimension, in addition to, results of head part dimension showed that red spotted grouper have smaller values in overall dimensions (P < 0.05). As meristic characteristics, kelp grouper have more number of anal fin rays than other fish, red spotted grouper have more number of dorsal soft rays than other fish, and seven spotted grouper have more number of anal soft rays, and caudal fin rays than other fish (P < 0.05). Photographed under the x-ray, kelp grouper have the most curved vertebral column and largest swim bladder than other fishes (P < 0.05). Our results of this study confirmed that 3 subfamily fishes adequately can distinguish with external body shape, and we hope that the results of our study could be used to identify in Serranidae family as taxonomical parameters. PMID:27660823

  11. A system for automatic aorta sections measurements on chest CT

    NASA Astrophysics Data System (ADS)

    Pfeffer, Yitzchak; Mayer, Arnaldo; Zholkover, Adi; Konen, Eli

    2016-03-01

    A new method is proposed for caliber measurement of the ascending aorta (AA) and descending aorta (DA). A key component of the method is the automatic detection of the carina, as an anatomical landmark around which an axial volume of interest (VOI) can be defined to observe the aortic caliber. For each slice in the VOI, a linear profile line connecting the AA with the DA is found by pattern matching on the underlying intensity profile. Next, the aortic center position is found using Hough transform on the best linear segment candidate. Finally, region growing around the center provides an accurate segmentation and caliber measurement. We evaluated the algorithm on 113 sequential chest CT scans, slice thickness of 0.75 - 3.75mm, 90 with contrast agent injected. The algorithm success rates were computed as the percentage of scans in which the center of the AA was found. Automated measurements of AA caliber were compared with independent measurements of two experienced chest radiologists, comparing the absolute difference between the two radiologists with the absolute difference between the algorithm and each of the radiologists. The measurement stability was demonstrated by computing the STD of the absolute difference between the radiologists, and between the algorithm and the radiologists. Results: Success rates of 93% and 74% were achieved, for contrast injected cases and non-contrast cases, respectively. These results indicate that the algorithm can be robust in large variability of image quality, such as the cases in a realworld clinical setting. The average absolute difference between the algorithm and the radiologists was 1.85mm, lower than the average absolute difference between the radiologists, which was 2.1mm. The STD of the absolute difference between the algorithm and the radiologists was 1.5mm vs 1.6mm between the two radiologists. These results demonstrate the clinical relevance of the algorithm measurements.

  12. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales

    PubMed Central

    Barnard, Edward Benjamin Graham; Morrison, Jonathan James; Madureira, Ricardo Mondoni; Lendrum, Robbie; Fragoso-Iñiguez, Marisol; Edwards, Antoinette; Lecky, Fiona; Bouamra, Omar; Lawrence, Thomas; Jansen, Jan Olaf

    2015-01-01

    Introduction Non-compressible torso haemorrhage (NCTH) carries a high mortality in trauma as many patients exsanguinate prior to definitive haemorrhage control. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct that has the potential to bridge patients to definitive haemostasis. However, the proportion of trauma patients in whom REBOA may be utilised is unknown. Methods We conducted a population based analysis of 2012–2013 Trauma Audit and Research Network (TARN) data. We identified the number of patients in whom REBOA may have been utilised, defined by an Abbreviated Injury Scale score ≥3 to abdominal solid organs, abdominal or pelvic vasculature, pelvic fracture with ring disruption or proximal traumatic lower limb amputation, together with a systolic blood pressure <90 mm Hg. Patients with non-compressible haemorrhage in the mediastinum, axilla, face or neck were excluded. Results During 2012–2013, 72 677 adult trauma patients admitted to hospitals in England and Wales were identified. 397 patients had an indication(s) and no contraindications for REBOA with evidence of haemorrhagic shock: 69% men, median age 43 years and median Injury Severity Score 32. Overall mortality was 32%. Major trauma centres (MTCs) received the highest concentration of potential REBOA patients, and would be anticipated to receive a patient in whom REBOA may be utilised every 95 days, increasing to every 46 days in the 10 MTCs with the highest attendance of this injury type. Conclusions This TARN database analysis has identified a small group of severely injured, resource intensive patients with a highly lethal injury that is theoretically amenable to REBOA. The highest density of these patients is seen at MTCs, and as such a planned evaluation of REBOA should be further considered in these hospitals. PMID:26598631

  13. Statolith Morphometrics Can Discriminate among Taxa of Cubozoan Jellyfishes.

    PubMed

    Mooney, Christopher J; Kingsford, Michael J

    2016-01-01

    Identification of potentially harmful cubomedusae is difficult due to their gelatinous nature. The only hard structure of medusae, the statolith, has the potential to provide robust measurements for morphometric analysis. Traditional morphometric length to width ratios (L: W) and modern morphometric Elliptical Fourier Analysis (EFA) were applied to proximal, oral and lateral statolith faces of 12 cubozoan species. EFA outperformed L: W as L: W did not account for the curvature of the statolith. Best discrimination was achieved with Canonical Discriminant Analysis (CDA) when analysing proximal + oral + lateral statolith faces in combination. Normalised Elliptical Fourier (NEF) coefficients classified 98% of samples to their correct species and 94% to family group. Statolith shape agreed with currently accepted cubozoan taxonomy. This has potential to assist in identifying levels of risk and stock structure of populations in areas where box jellyfish envenomations are a concern as the severity of envenomation is family dependent. We have only studied 12 (27%) of the 45 currently accepted cubomedusae, but analyses demonstrated that statolith shape is an effective taxonomic discriminator within the Class. PMID:27192408

  14. Statolith Morphometrics Can Discriminate among Taxa of Cubozoan Jellyfishes.

    PubMed

    Mooney, Christopher J; Kingsford, Michael J

    2016-01-01

    Identification of potentially harmful cubomedusae is difficult due to their gelatinous nature. The only hard structure of medusae, the statolith, has the potential to provide robust measurements for morphometric analysis. Traditional morphometric length to width ratios (L: W) and modern morphometric Elliptical Fourier Analysis (EFA) were applied to proximal, oral and lateral statolith faces of 12 cubozoan species. EFA outperformed L: W as L: W did not account for the curvature of the statolith. Best discrimination was achieved with Canonical Discriminant Analysis (CDA) when analysing proximal + oral + lateral statolith faces in combination. Normalised Elliptical Fourier (NEF) coefficients classified 98% of samples to their correct species and 94% to family group. Statolith shape agreed with currently accepted cubozoan taxonomy. This has potential to assist in identifying levels of risk and stock structure of populations in areas where box jellyfish envenomations are a concern as the severity of envenomation is family dependent. We have only studied 12 (27%) of the 45 currently accepted cubomedusae, but analyses demonstrated that statolith shape is an effective taxonomic discriminator within the Class.

  15. Statolith Morphometrics Can Discriminate among Taxa of Cubozoan Jellyfishes

    PubMed Central

    Kingsford, Michael J.

    2016-01-01

    Identification of potentially harmful cubomedusae is difficult due to their gelatinous nature. The only hard structure of medusae, the statolith, has the potential to provide robust measurements for morphometric analysis. Traditional morphometric length to width ratios (L: W) and modern morphometric Elliptical Fourier Analysis (EFA) were applied to proximal, oral and lateral statolith faces of 12 cubozoan species. EFA outperformed L: W as L: W did not account for the curvature of the statolith. Best discrimination was achieved with Canonical Discriminant Analysis (CDA) when analysing proximal + oral + lateral statolith faces in combination. Normalised Elliptical Fourier (NEF) coefficients classified 98% of samples to their correct species and 94% to family group. Statolith shape agreed with currently accepted cubozoan taxonomy. This has potential to assist in identifying levels of risk and stock structure of populations in areas where box jellyfish envenomations are a concern as the severity of envenomation is family dependent. We have only studied 12 (27%) of the 45 currently accepted cubomedusae, but analyses demonstrated that statolith shape is an effective taxonomic discriminator within the Class. PMID:27192408

  16. Morphometric growth relationships of the immature human mandible and tongue.

    PubMed

    Hutchinson, Erin F; Kieser, Jules A; Kramer, Beverley

    2014-06-01

    The masticatory apparatus is a highly adaptive musculoskeletal complex comprising several relatively independent structural components, which assist in functions including feeding and breathing. We hypothesized that the tongue is elemental in the maintenance of normal ontogeny of the mandible and in its post-natal growth and development, and tested this using a morphometric approach. We assessed tongue and mandibular measurements in 174 (97 male) human cadavers. Landmark lingual and mandibular data were gathered individuals aged between 20 gestational weeks and 3 yr postnatal. In this analysis, geometric morphometrics assisted in visualizing the morphometrical growth changes in the mandible and tongue. A linear correlation in conjunction with principal component analysis further visualized the growth relationship between these structures. We found that the growth of the tongue and mandible were intrinsically linked in size and shape between 20 gestational weeks and 24 months postnatal. However, the mandible continued to change in shape and size into the 3rd yr of life, whereas the tongue only increased in size over this same period of time. These findings provide valuable insights into the allometric growth relationship between these structures, potentially assisting the clinician in predicting the behaviour of these structures in the assessment of malocclusions.

  17. Chronic progressive nephropathy: functional, morphological, and morphometrical studies.

    PubMed

    Fiori, Mariana C; Ossani, Georgina P; Lago, Néstor R; Amorena, Carlos; Monserrat, Alberto J

    2010-01-01

    Some aspects of the functional, morphological, and morphometrical characteristics of chronic progressive nephropathy occurring in 18- to 26-month-old male rats and in 3-month-old control rats were studied. Rats with chronic progressive nephropathy were proteinuric and showed a slight increase in serum creatinine and no changes in blood pressure. The morphological changes were studied by light microscopy, high-resolution light microscopy, and electron microscopy. They showed focal and segmental or global glomerulosclerosis, the three types of atrophic tubules ("classic," "thyroid-like," and "endocrine") described by Nadasdy et al, as well as interstitial fibrosis with mononuclear cell infiltrates. On certain occasions, small vessels showed hyalinosis. Glomerular morphometrical studies showed a biphasic pattern in the glomeruli progressing toward obsolescence. Vascular morphometrical studies showed significant increase in media wall thickness and media cross-sectional area in the 18- to 26-month-old rats. These results support the hypothesis that changes in the vascular system are not of utmost importance in the pathogenesis of chronic progressive nephropathy, and that glomerular sequential changes seem to be of paramount significance in the progression of the disease. PMID:20113276

  18. A Hemodynamic Predict of an Intra-Aorta Pump Application in Vitro Using Numerical Analysis

    NASA Astrophysics Data System (ADS)

    Gao, Bin; Chen, Ningning; Chang, Yu

    The Intra-Aorta Pump is a novel LVAD assisting the native heart without percutaneous drive-lines. The Intra-Aorta Pump is emplaced between the radix aortae and the aortic arch to draw-off the blood from the left ventricle to the aorta. To predict the change of pressure drop and blood flow along with the change of pump speed, a nonlinear model has been made based on the structure and speed of the Intra-Aorta Pump. To do this, a nonlinear electric circuit for the Intra-Aorta Pump has been developed. The model includes two speed dependent current sources and flow dependent resistant to simulate the relationship between the pressure drop of the Intra-Aorta Pump and the flow through the pump along with the change of pump speed. The pressure drop and blood flow is derived by solving differential equations with variable coefficients. The parameters of the model are determined by experiment, and the results of the experiment show that these parameters change along with the change of the pump speed distinctness. The accuracy of the model is tested experimentally on a test loop. The comparison of the prediction data derived from the model with the experimental data shows that the error is lest than 15%. The experimental results showed that the model can predict the change of pressure drop and blood flow accurately.

  19. Rat aorta as a pharmacological tool for in vitro and in vivo studies.

    PubMed

    Rameshrad, Maryam; Babaei, Hossein; Azarmi, Yadollah; Fouladia, Daniel Fadaei

    2016-01-15

    Rat aorta assay provides a low cost and rapid platform, especially for preclinical in vivo models. The signaling pathways of the analog on the vessels could be evaluated separately on the endothelium or smooth muscle cells by rings of the rat aorta in vitro. The rat aorta is used for angiogenesis modeling to integrate the benefits of the both in vivo and in vitro models. These explain the importance and usage of rat aorta in researches. Furthermore, about 4503 articles have been published with the key word "rat aorta" in title or abstract from 1955 until the end of 2013 in Medline. In this review, these articles were organized into two main categories: in vivo and in vitro studies. The in vitro section focused on the rat aorta model, as a tool for evaluate the mechanism of vasodilation, vasoconstriction and angiogenesis. In the in vivo section, the most important usage of this tissue was evaluated. Also, the vasotonic signaling pathways in the vessel are explained briefly and some rat aorta applications in vitro and in vivo have been discussed.

  20. Arterial wall metabolism in experimental hypertension of coarctation of the aorta of short duration

    PubMed Central

    Hollander, William; Kramsch, Dieter M.; Farmelant, Melvin; Madoff, Irving M.

    1968-01-01

    Coarctation of the mid-thoracic aorata was surgically produced in mongrel dogs which were sacrificed from 4-12 wk after the operation. As compared to the findings in control animals, the sodium, chloride, and water content of the hypetensive portion of the coarcted thoracic aorta was significantly elevated, whereas the electrolyte and water content of the relatively normotensive portion of the coarcted aorta was normal. The sodium, potassium, and water content of the pulmonary artery, skeletal muscle, and cardiac muscle of the coarcted dog was not altered. These observations suggest that an elevated arterial pressure may influence the electrolyte and water composition of the arteries. The arterial pressure also may influence the content and synthesis of acid mucopolysaccharides (MPS) in the arteries since the content of sulfated MPS and the incorporation of injected radiosulfate into sulfated MPS were significantly increased in the hypertensive portion of the coarcted thoracic aorta but were significantly reduced in the relatively normotensive (“hypotensive”) portion of the coarcted aorta. The observed increase in MPS may have been a factor directly responsible for the increase in the sodium content of the hypertensive aorta since MPS can act as polyelectrolytes and bind cations. Although the arterial pressure may influence certain metabolic functions in the arteries, it did not appear to have a direct effect on the arterial lipids since the lipid content of the hypertensive and of the relatively normotensive portions of the coarcted aorta were comparable to the values found in the normal aorta. Images PMID:5645864

  1. Saccular aneurysm formation of the descending aorta associated with aortic coarctation in an infant.

    PubMed

    Ozyuksel, Arda; Canturk, Emir; Dindar, Aygun; Akcevin, Atif

    2014-01-01

    Aneurysm of the descending aorta associated with CoA is an extremely rare congenital abnormality. In this report, we present a 16 months old female patient in whom cardiac catheterization had been performed which had revealed a segment of coarctation and saccular aneurysm in the descending aorta. The patient was operated and a 3x2 centimeters aneurysm which embraces the coarcted segment in descending aorta was resected. In summary, we present a case of saccular aortic aneurysm distal to aortic coarctation in an infant without any history of intervention or vascular inflammatory disease. Our case report seems to be the youngest patient in literature with this pathology.

  2. Repair of acute dissection of the ascending aorta associated with aortic coarctation.

    PubMed Central

    Tesler, U F; Tomasco, B

    1996-01-01

    A 54-year-old man with coarctation of the thoracic aorta and acute dissection of the ascending aorta ruptured into the pericardium underwent emergency repair of the dissection by means of replacement of the ascending aorta and the aortic valve. Correction of the aortic coarctation was performed 4 months later. The authors examine the special problems encountered in the treatment of this infrequent clinical emergency, which include decisions on the optimal sequence and timing of repair, on the best surgical exposure, and on the technique and adequacy of circulatory support (especially the choice of the arterial cannulation site. Images PMID:8792549

  3. Asymptomatic mycotic aneurysm of ascending aorta after heart transplantation: a case report.

    PubMed

    Behzadnia, N; Ahmadi, Z H; Mandegar, M H; Salehi, F; Sharif-Kashani, B; Pourabdollah, M; Ansari-Aval, Z; Kianfar, A-A; Mirhosseini, S M; Eiji, M

    2015-01-01

    Mycotic pseudoaneurysm and aneurysm of the ascending aorta is a very rare and potentially fatal complication of heart transplantation. It usually presents with fever, chest pain, dyspnea, or constitutional symptoms. Most reports in the literature are about mycotic pseudoaneurysm, but mycotic aneurysm is rarer. Herein we report a 39-year-old man in who had an asymptomatic mycotic aneurysm of the ascending aorta developed late (1 year) after orthotopic heart transplantation. There was no history of previous mediastinitis or any other important infection. He underwent an uneventful replacement of the ascending aorta.

  4. Huge dissected ascending aorta associated with pseudo aneurysm and aortic coarctation feridoun.

    PubMed

    Sabzi, Feridoun; Khosravi, Donya

    2015-07-01

    We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE) confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer. The rarity of the report is an association of the chronic dissection with huge pseudoaneurysm and coarctation. The patient underwent staged repair of an aneurysm and coarctation and had an uneventful postoperative recovery period. PMID:26520633

  5. High-quality conforming hexahedral meshes of patient-specific abdominal aortic aneurysms including their intraluminal thrombi.

    PubMed

    Tarjuelo-Gutierrez, J; Rodriguez-Vila, B; Pierce, D M; Fastl, T E; Verbrugghe, P; Fourneau, I; Maleux, G; Herijgers, P; Holzapfel, G A; Gomez, E J

    2014-02-01

    In order to perform finite element (FE) analyses of patient-specific abdominal aortic aneurysms, geometries derived from medical images must be meshed with suitable elements. We propose a semi-automatic method for generating conforming hexahedral meshes directly from contours segmented from medical images. Magnetic resonance images are generated using a protocol developed to give the abdominal aorta high contrast against the surrounding soft tissue. These data allow us to distinguish between the different structures of interest. We build novel quadrilateral meshes for each surface of the sectioned geometry and generate conforming hexahedral meshes by combining the quadrilateral meshes. The three-layered morphology of both the arterial wall and thrombus is incorporated using parameters determined from experiments. We demonstrate the quality of our patient-specific meshes using the element Scaled Jacobian. The method efficiently generates high-quality elements suitable for FE analysis, even in the bifurcation region of the aorta into the iliac arteries. For example, hexahedral meshes of up to 125,000 elements are generated in less than 130 s, with 94.8 % of elements well suited for FE analysis. We provide novel input for simulations by independently meshing both the arterial wall and intraluminal thrombus of the aneurysm, and their respective layered morphologies.

  6. Endovascular abdominal aortic aneurysm repair

    PubMed Central

    Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D

    2007-01-01

    The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique. PMID:17267674

  7. [Dirofilaria in the abdominal cavity].

    PubMed

    Révész, Erzsébet; Markovics, Gabriella; Darabos, Zoltán; Tóth, Ildikó; Fok, Eva

    2008-10-01

    Number of cases of filariasis have been recently reported in the Hungarian medical literature, most of them caused by Dirofilaria repens . Dirofilaria repens is a mosquito-transmitted filarioid worm in the subcutaneous tissue of dogs and cats. Human infection manifests as either subcutaneous nodules or lung parenchymal disease, which may even be asymptomatic. The authors report a human Dirofilaria repens infection of the abdominal cavity in a 61-year-old man,who underwent laparotomy for acute abdomen. Intraoperatively, local peritonitis was detected caused by a white nemathhelminth, measured 8 cm in size. Histocytology confirmed that the infection was caused by Dirofilaria repens.

  8. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  9. Treatment of neonatal abdominal cysts.

    PubMed

    Dénes, J; Lukäcs, F V; Léb, J; Bognár, M

    1974-01-01

    Intraperitoneal or retroperitoneal cystic structures in the newborn appear with a variable clinical picture and in the case of intra-abdominal cysts, surgery is performed mostly on an emergency basis. In such cases the exact preoperative diagnosis is difficult and is seldom made. With early laparotomy, extensive small bowel resection can usually be avoided. Retroperitoneal lesions are mostly of renal origin; in such cases, preoperative diagnosis is easy, being based on specific examinations. In the year 1973, 5 newborns with an intraperitoneal or retroperitoneal cyst have been treated surgically. In this series, one infant died after resection of 90% of the small bowel.

  10. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.

  11. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS].

    PubMed

    Grubnik, V V; Parfentyeva, N D; Parfentyev, R S

    2015-07-01

    In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini. PMID:26591212

  12. Diagnosis of Intra-Abdominal Extralobar Pulmonary Sequestration by means of Ultrasound in a Neonate

    PubMed Central

    Pires, Claudio Rodrigues; Czapkowski, Adriano; Zanforlin Filho, Sebastião Marques

    2013-01-01

    Pulmonary sequestration is a congenital abnormality consisting of a mass of pulmonary tissue that presents an abnormal connection with the tracheobronchial tree, with a blood supply coming from an anomalous artery derived from the systemic circulation. Extralobar pulmonary sequestration is characterized by having pleural coverings that are independent of the normal lungs, with vascular supply usually coming from the aorta or from one of its branches. This diagnosis can be suspected prenatally if an abdominal mass, generally below the diaphragm, is seen. Here, we present a case of a neonate on the second day of life, with ultrasonography showing extralobar pulmonary sequestration located above the left adrenal gland that prenatally simulated a neuroblastoma. PMID:23762717

  13. Trans-radial Carotid Artery Stenting in a Patient with Abdominal Aortic Occlusion

    PubMed Central

    Ha, Jin Heon; Kim, Hoon; Park, Ik Seong

    2016-01-01

    We report transradial access (TRA) for emergency carotid artery stenting (CAS) as a useful alternative when the femoral artery cannot be accessed. A 63-year-old man arrived at our emergency room 30 minutes after left hemiplegia and loss of consciousness. Brain computed tomography (CT) anigograpy showed occlusion of the right interntal carotid artery (ICA) and CT perfusion revealed delayed time-to-peak in the territory of the middle cerebral artery. For, endovascular treatment, trans-femoral access (TFA) was attempted but failed due to occlusion of the abdominal aorta. So, we changed access route via radial artery and confirmed proximal ICA dissection. CAS was attempted via TRA and it was successfully performed. Final angiography showed recanalization of ICA and patient was clinically improved. PMID:27790405

  14. Abdominal pain and hematuria: duodenal perforation from ingested foreign body causing ureteral obstruction and hydronephrosis.

    PubMed

    Kolbe, Nina; Sisson, Kathleen; Albaran, Renato

    2016-01-01

    Foreign body (FB) ingestion is a relatively common reason for visits to the emergency room. If the FB is symptomatic or damaging to the patient, either endoscopic or surgical intervention should ensue. We present a case of abdominal pain and hematuria beginning ∼24 h after an incidental FB ingestion. Initial CT imaging defined a linear opacity perforating through the posterior duodenal wall abutting the ureter causing inflammation and hydronephrosis. After two unsuccessful endoscopic attempts at retrieval, we were able to identify the object with the aid of intraoperative fluoroscopy and surgically remove the FB. The patient recovered uneventfully and was discharged home. Posterior duodenal perforation by an FB may not manifest with obvious localized or systemic symptoms unless the perforation involves surrounding structures such as the aorta, vena cava or ureter. In such cases, surgical intervention is required for FB removal. PMID:26903557

  15. Abdominal pain and hematuria: duodenal perforation from ingested foreign body causing ureteral obstruction and hydronephrosis

    PubMed Central

    Kolbe, Nina; Sisson, Kathleen; Albaran, Renato

    2016-01-01

    Foreign body (FB) ingestion is a relatively common reason for visits to the emergency room. If the FB is symptomatic or damaging to the patient, either endoscopic or surgical intervention should ensue. We present a case of abdominal pain and hematuria beginning ∼24 h after an incidental FB ingestion. Initial CT imaging defined a linear opacity perforating through the posterior duodenal wall abutting the ureter causing inflammation and hydronephrosis. After two unsuccessful endoscopic attempts at retrieval, we were able to identify the object with the aid of intraoperative fluoroscopy and surgically remove the FB. The patient recovered uneventfully and was discharged home. Posterior duodenal perforation by an FB may not manifest with obvious localized or systemic symptoms unless the perforation involves surrounding structures such as the aorta, vena cava or ureter. In such cases, surgical intervention is required for FB removal. PMID:26903557

  16. Abdominal aortic occlusion and vascular compromise secondary to acute gastric dilatation in a patient with bulimia.

    PubMed

    Elsharif, M; Doulias, T; Aljundi, W; Balchandra, S

    2014-11-01

    Acute gastric dilation is a rare but recognised complication in patients with bulimia and anorexia following binge episodes owing to decreased bowel motility. We present a rare case of acute gastric dilation secondary to bulimia in an otherwise healthy 18-year-old female patient that resulted in compression and complete occlusion of the abdominal aorta, leading to acute mesenteric and bilateral lower limb ischaemia. This resolved immediately following a laparotomy and gastric decompression. Management of these patients is very challenging owing to the lack of a successful precedent. To our knowledge, such a catastrophic complication has only ever been reported once in the literature and the outcome was fatal. Our case is of additional importance as it offers a successful management strategy for these patients.

  17. Abdominal arteries recognition in x-ray using a structural model

    NASA Astrophysics Data System (ADS)

    Nempont, Olivier; Florent, Raoul

    2010-03-01

    The automatic recognition of vascular trees is a challenging task, required for roadmapping or advanced visualization. For instance, during an endovascular aneurysm repair (EVAR), the recognition of abdominal arteries in angiograms can be used to select the appropriate stent graft. This choice is based on a reduced set of arteries (aorta, renal arteries, iliac arteries) whose relative positions are quite stable. We propose in this article a recognition process based on a structural model. The centerlines of the target vessels are represented by a set of control points whose relative positions are constrained. To find their position in an angiogram, we enhance the target vessels and extract a set of possible positions for each control point. Then, a constraint propagation algorithm based on the model prunes those sets of candidates, removing inconsistent ones. We present preliminary results on 5 cases, illustrating the potential of this approach and especially its ability to handle the high variability of the target vessels.

  18. Periadventitial adipose-derived stem cell treatment halts elastase-induced abdominal aortic aneurysm progression

    PubMed Central

    Blose, Kory J; Ennis, Terri L; Arif, Batool; Weinbaum, Justin S; Curci, John A; Vorp, David A

    2014-01-01

    Aim Demonstrate that periadventitial delivery of adipose-derived mesenchymal stem cells (ADMSCs) slows aneurysm progression in an established murine elastase-perfusion model of abdominal aortic aneurysm (AAA). Materials & methods AAAs were induced in C57BL/6 mice using porcine elastase. During elastase perfusion, a delivery device consisting of a subcutaneous port, tubing and porous scaffold was implanted. Five days after elastase perfusion, 100,000 ADMSCs were delivered through the port to the aorta. After sacrifice at day 14, analyzed metrics included aortic diameter and structure of aortic elastin. Results ADMSC treated aneurysms had a smaller diameter and less fragmented elastin versus saline controls. Conclusion Periadventitial stem cell delivery prevented the expansion of an established aneurysm between days 5 and 14 after elastase perfusion. PMID:25431910

  19. [Endovascular management of an infectious and ruptured abdominal aortic aneurysm. Clinical report].

    PubMed

    Amorim, Pedro; Sousa, Gonçalo; Vieira, João; C E Sousa, Lourenço; Ribeiro, Karla; Sobrinho, Gonçalo; Vieira, Teresa; Meireles, Nuno; Albino, Pereira

    2014-01-01

    Infectious aneurysms are about 1-3% of all aneurysms of the infrarenal aorta. Its treatment is challenging and the best strategy is far from consensual. The authors report a case of a HIV + patient with multiple other co-morbidities, which was seen in the emergency department with fever and left back pain. These symptoms would prove to be in relation to a ruptured infectious aneurysm of the abdominal aorta. Facing this situation it was decided to select an endovascular technique with implantation of an aorto uni - iliac stent graft with a right-left femoro-femoral cross-over using a 8 mm PTFE graft and exclusion of the left common iliac . The patient didn't have any complication from the situation or the procedure, but died 18 months postoperatively because of a pneumonia caused by Pneumocystis jiroveci. Although it is not the ideal solution for the treatment of infectious elective aneurysms, we believe that endovascular treatment seems to be a viable option and should be taken into account in a subgroup of patients that for their co-morbidities are not good candidates for conventional surgery and for those in rupture, either as a bridge or as a final solution. PMID:25596398

  20. Decellularized aortic homografts for aortic valve and aorta ascendens replacement†

    PubMed Central

    Tudorache, Igor; Horke, Alexander; Cebotari, Serghei; Sarikouch, Samir; Boethig, Dietmar; Breymann, Thomas; Beerbaum, Philipp; Bertram, Harald; Westhoff-Bleck, Mechthild; Theodoridis, Karolina; Bobylev, Dmitry; Cheptanaru, Eduard; Ciubotaru, Anatol; Haverich, Axel

    2016-01-01

    OBJECTIVES The choice of valve prosthesis for aortic valve replacement (AVR) in young patients is challenging. Decellularized pulmonary homografts (DPHs) have shown excellent results in pulmonary position. Here, we report our early clinical results using decellularized aortic valve homografts (DAHs) for AVR in children and mainly young adults. METHODS This prospective observational study included all 69 patients (44 males) operated from February 2008 to September 2015, with a mean age of 19.7 ± 14.6 years (range 0.2–65.3 years). In 18 patients, a long DAH was used for simultaneous replacement of a dilated ascending aorta as an extended aortic root replacement (EARR). Four patients received simultaneous pulmonary valve replacement with DPH. RESULTS Thirty-nine patients (57%) had a total of 62 previous operations. The mean aortic cross-clamp time in isolated cases was 129 ± 41 min. There was 1 conduit-unrelated death. The mean DAH diameter was 22.4 ± 3.7 mm (range, 10–29 mm), the average peak gradient was 14 ± 15 mmHg and the mean aortic regurgitation grade (0.5 = trace, 1 = mild) was 0.6 ± 0.5. The mean effective orifice area (EOA) of 25 mm diameter DAH was 3.07 ± 0.7 cm2. DAH annulus z-values were 1.1 ± 1.1 at implantation and 0.7 ± 1.3 at the last follow-up. The last mean left ventricle ejection fraction and left ventricle end diastolic volume index was 63 ± 7% and 78 ± 16 ml/m2 body surface area, respectively. To date, no dilatation has been observed at any level of the graft during follow-up; however, the observational time is short (140.4 years in total, mean 2.0 ± 1.8 years, maximum 7.6 years). One small DAH (10 mm at implantation) had to be explanted due to subvalvular stenosis and developing regurgitation after 4.5 years and was replaced with a 17 mm DAH without complication. No calcification of the explanted graft was noticed intraoperatively and after histological analysis, which revealed extensive recellularization without inflammation

  1. Uncluttered single-image visualization of the abdominal aortic vessel tree: Method and evaluation

    SciTech Connect

    Won, Joong-Ho; Rosenberg, Jarrett; Rubin, Geoffrey D.; Napel, Sandy

    2009-11-15

    Purpose: The authors develop a method to visualize the abdominal aorta and its branches, obtained by CT or MR angiography, in a single 2D stylistic image without overlap among branches. Methods: The abdominal aortic vasculature is modeled as an articulated object whose underlying topology is a rooted tree. The inputs to the algorithm are the 3D centerlines of the abdominal aorta, its branches, and their associated diameter information. The visualization problem is formulated as an optimization problem that finds a spatial configuration of the bounding boxes of the centerlines most similar to the projection of the input into a given viewing direction (e.g., anteroposterior), while not introducing intersections among the boxes. The optimization algorithm minimizes a score function regarding the overlap of the bounding boxes and the deviation from the input. The output of the algorithm is used to produce a stylistic visualization, made of the 2D centerlines modulated by the associated diameter information, on a plane. The authors performed a preliminary evaluation by asking three radiologists to label 366 arterial branches from the 30 visualizations of five cases produced by the method. Each of the five patients was presented in six different variant images, selected from ten variants with the three lowest and three highest scores. For each label, they assigned confidence and distortion ratings (low/medium/high). They studied the association between the quantitative metrics measured from the visualization and the subjective ratings by the radiologists. Results: All resulting visualizations were free from branch overlaps. Labeling accuracies of the three readers were 93.4%, 94.5%, and 95.4%, respectively. For the total of 1098 samples, the distortion ratings were low: 77.39%, medium: 10.48%, and high: 12.12%. The confidence ratings were low: 5.56%, medium: 16.50%, and high: 77.94%. The association study shows that the proposed quantitative metrics can predict a reader

  2. Advanced techniques in abdominal surgery.

    PubMed Central

    Monson, J R

    1993-01-01

    Almost every abdominal organ is now amenable to laparoscopic surgery. Laparoscopic appendicectomy is a routine procedure which also permits identification of other conditions initially confused with an inflamed appendix. However, assessment of appendiceal inflammation is more difficult. Almost all colonic procedures can be performed laparoscopically, at least partly, though resection for colonic cancer is still controversial. For simple patch repair of perforated duodenal ulcers laparoscopy is ideal, and inguinal groin hernia can be repaired satisfactorily with a patch of synthetic mesh. Many upper abdominal procedures, however, still take more time than the open operations. These techniques reduce postoperative pain and the incidence of wound infections and allow a much earlier return to normal activity compared with open surgery. They have also brought new disciplines: surgeons must learn different hand-eye coordination, meticulous haemostasis is needed to maintain picture quality, and delivery of specimens may be problematic. The widespread introduction of laparoscopic techniques has emphasised the need for adequate training (operations that were straight-forward open procedures may require considerable laparoscopic expertise) and has raised questions about trainee surgeons acquiring adequate experience of open procedures. Images FIG 9 p1347-a p1347-b p1349-a p1350-a p1350-b PMID:8257893

  3. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  4. Abdominal Aortic Aneurysms Targeted by Functionalized Polysaccharide Microparticles: a new Tool for SPECT Imaging

    PubMed Central

    Bonnard, Thomas; Yang, Gonord; Petiet, Anne; Ollivier, Véronique; Haddad, Oualid; Arnaud, Denis; Louedec, Liliane; Bachelet-Violette, Laure; Derkaoui, Sidi Mohammed; Letourneur, Didier; Chauvierre, Cedric; Le Visage, Catherine

    2014-01-01

    Aneurysm diagnostic is nowadays limited by the lack of technology that enables early detection and rupture risk prediction. New non invasive tools for molecular imaging are still required. In the present study, we present an innovative SPECT diagnostic tool for abdominal aortic aneurysm (AAA) produced from injectable polysaccharide microparticles radiolabeled with technetium 99m (99mTc) and functionalized with fucoidan, a sulfated polysaccharide with the ability to target P-Selectin. P-Selectin is a cell adhesion molecule expressed on activated endothelial cells and platelets which can be found in the thrombus of aneurysms, as well as in other vascular pathologies. Microparticles with a maximum hydrodynamic diameter of 4 µm were obtained by crosslinking the polysaccharides dextran and pullulan. They were functionalized with fucoidan. In vitro interactions with human activated platelets were assessed by flow cytometry that demonstrated a specific affinity of fucoidan functionalized microparticles for P-Selectin expressed by activated platelets. For in vivo AAA imaging, microparticles were radiolabeled with 99mTc and intravenously injected into healthy and AAA rats obtained by elastase perfusion through the aorta wall. Animals were scanned by SPECT imaging. A strong contrast enhancement located in the abdominal aorta of AAA rats was obtained, while no signal was obtained in healthy rats or in AAA rats after injection of non-functionalized control microparticles. Histological studies revealed that functionalized radiolabeled polysaccharide microparticles were localized in the AAA wall, in the same location where P-Selectin was expressed. These microparticles therefore constitute a promising SPECT imaging tool for AAA and potentially for other vascular diseases characterized by P-Selectin expression. Future work will focus on validating the efficiency of the microparticles to diagnose these other pathologies and the different stages of AAA. Incorporation of a

  5. Morphometric analysis of the Marmara Sea river basins, Turkey

    NASA Astrophysics Data System (ADS)

    Elbaşı, Emre; Ozdemir, Hasan

    2014-05-01

    The drainage basin, the fundamental unit of the fluvial landscape, has been focus of research aimed at understanding the geometric characteristics of the master channel and its tributary network. This geometry is referred to as the basin morphometry and is nicely reviewed by Abrahams (1984). A great amount of research has focused on geometric characteristic of drainage basins, including the topology of the stream networks, and quantitative description of drainage texture, pattern, shape, and relief characteristics. Evaluation of morphometric parameters necessitates the analysis of various drainage parameters such as ordering of the various streams, measurement of basin area and perimeter, length of drainage channels, drainage density (Dd), stream frequency (Fs), bifurcation ratio (Rb), texture ratio (T), basin relief (Bh), Ruggedness number (Rn), time of concentration (Tc), hypsometric curve and integral (Hc and Hi) (Horton, 1932, Schumn, 1956, Strahler, 1957; Verstappen 1983; Keller and Pinter, 2002; Ozdemir and Bird, 2009). These morphometric parameters have generally been used to predict flood peaks, to assess sediment yield, and to estimate erosion rates in the basins. River basins of the Marmara Sea, has an area of approximately 40,000 sqkm, are the most important basins in Turkey based on their dense populations, industry and transportation systems. The primary aim of this study is to determine and analyse of morphometric characteristics of the Marmara Sea river basins using 10 m resolution Digital Elevation Model (DEM) and to evaluate of the results. For these purposes, digital 10 m contour maps scaled 1:25000 and geological maps scaled 1:100000 were used as the main data sources in the study. 10 m resolution DEM data were created using the contour maps and then drainage networks and their watersheds were extracted using D8 pour point model. Finally, linear, areal and relief morphometries were applied to the river basins using Geographic Information Systems

  6. Relapsing polychondritis: bone marrow and circular fibrous nodules in the aorta.

    PubMed Central

    Wilson, G E; Hasleton, P S; Manns, J J; Marks, J S

    1990-01-01

    A case is reported of extensive aortic calcification, bone formation, and haemopoietic tissue in a woman with relapsing polychondritis. An additional feature was 'clock face' nodules of collagen in the aorta. Images PMID:1700671

  7. Characterizing Floral Symmetry in the Core Goodeniaceae with Geometric Morphometrics

    PubMed Central

    Gardner, Andrew G.; Fitz Gerald, Jonathan N.; Menz, John; Shepherd, Kelly A.; Howarth, Dianella G.; Jabaily, Rachel S.

    2016-01-01

    Core Goodeniaceae is a clade of ~330 species primarily distributed in Australia. Considerable variation in flower morphology exists within this group and we aim to use geometric morphometrics to characterize this variation across the two major subclades: Scaevola sensu lato (s.l.) and Goodenia s.l., the latter of which was hypothesized to exhibit greater variability in floral symmetry form. We test the hypothesis that floral morphological variation can be adequately characterized by our morphometric approach, and that discrete groups of floral symmetry morphologies exist, which broadly correlate with subjectively determined groups. From 335 images of 44 species in the Core Goodeniaceae, two principal components were computed that describe >98% of variation in all datasets. Increasing values of PC1 ventralize the dorsal petals (increasing the angle between them), whereas increasing values of PC2 primarily ventralize the lateral petals (decreasing the angle between them). Manipulation of these two morphological “axes” alone was sufficient to recreate any of the general floral symmetry patterns in the Core Goodeniaceae. Goodenia s.l. exhibits greater variance than Scaevola s.l. in PC1 and PC2, and has a significantly lower mean value for PC1. Clustering clearly separates fan-flowers (with dorsal petals at least 120° separated) from the others, whereas the distinction between pseudo-radial and bilabiate clusters is less clear and may form a continuum rather than two distinct groups. Transitioning from the average fan-flower to the average non-fan-flower is described almost exclusively by PC1, whereas PC2 partially describes the transition between bilabiate and pseudo-radial morphologies. Our geometric morphometric method accurately models Core Goodeniaceae floral symmetry diversity. PMID:27148960

  8. Morphometric examination of straight, tapered titanium stems: a retrieval study.

    PubMed

    Böhm, G; Lintner, F; Auterith, A; Lester, D K; Zweymüller, K A

    2001-12-01

    Cementless straight, tapered rectangular cross section titanium stems have been used by the senior author since 1979. Thirty-four stems retrieved postmortem, after between 10 days and 15.2 years in situ, were studied morphometrically and histologically. Nineteen stems were first generation (1979-1986), with an incomplete sagittal taper and a mean surface roughness of 1 microm (Ra 1.23 +/- 0.3 microm); 15 stems were second generation after 1986, with a full biplane taper and a mean surface roughness of 4 microm (Ra 4.14 +/- 0.36 microm). Implant surface bony coverage was determined morphometrically in 10 segments of the stems, and expressed as a bone implant contact index. Histologically, there were no differences between implants with different levels of roughness. Morphometrically, the first-generation stems showed significant differences in coverage (distal > proximal); second-generation stems had a more uniform pattern. Stems retrieved early after arthroplasty had a mean bone implant contact index of 10%. The mean bone implant contact index showed attainment of maximum coverage by 5 years after arthroplasty, without additional apposition or loss thereafter. Patients younger than 65 years at arthroplasty had similar bone implant contact indices to patients 65 years or older; coverage in the six patients 80 years of age at retrieval did not differ from the rates in the other patients. Morphometry was able to provide objective evidence of design change effects. No differences in coverage were found in terms of times in situ, patient age at arthroplasty and at retrieval, and degree of stem surface roughness. PMID:11764342

  9. Morphometric Wing Characters as a Tool for Mosquito Identification.

    PubMed

    Wilke, André Barretto Bruno; Christe, Rafael de Oliveira; Multini, Laura Cristina; Vidal, Paloma Oliveira; Wilk-da-Silva, Ramon; de Carvalho, Gabriela Cristina; Marrelli, Mauro Toledo

    2016-01-01

    Mosquitoes are responsible for the transmission of important infectious diseases, causing millions of deaths every year and endangering approximately 3 billion people around the world. As such, precise identification of mosquito species is crucial for an understanding of epidemiological patterns of disease transmission. Currently, the most common method of mosquito identification relies on morphological taxonomic keys, which do not always distinguish cryptic species. However, wing geometric morphometrics is a promising tool for the identification of vector mosquitoes, sibling and cryptic species included. This study therefore sought to accurately identify mosquito species from the three most epidemiologically important mosquito genera using wing morphometrics. Twelve mosquito species from three epidemiologically important genera (Aedes, Anopheles and Culex) were collected and identified by taxonomic keys. Next, the right wing of each adult female mosquito was removed and photographed, and the coordinates of eighteen digitized landmarks at the intersections of wing veins were collected. The allometric influence was assessed, and canonical variate analysis and thin-plate splines were used for species identification. Cross-validated reclassification tests were performed for each individual, and a Neighbor Joining tree was constructed to illustrate species segregation patterns. The analyses were carried out and the graphs plotted with TpsUtil 1.29, TpsRelw 1.39, MorphoJ 1.02 and Past 2.17c. Canonical variate analysis for Aedes, Anopheles and Culex genera showed three clear clusters in morphospace, correctly distinguishing the three mosquito genera, and pairwise cross-validated reclassification resulted in at least 99% accuracy; subgenera were also identified correctly with a mean accuracy of 96%, and in 88 of the 132 possible comparisons, species were identified with 100% accuracy after the data was subjected to reclassification. Our results showed that Aedes, Culex

  10. Morphometric Wing Characters as a Tool for Mosquito Identification

    PubMed Central

    Christe, Rafael de Oliveira; Multini, Laura Cristina; Vidal, Paloma Oliveira; Wilk-da-Silva, Ramon; de Carvalho, Gabriela Cristina; Marrelli, Mauro Toledo

    2016-01-01

    Mosquitoes are responsible for the transmission of important infectious diseases, causing millions of deaths every year and endangering approximately 3 billion people around the world. As such, precise identification of mosquito species is crucial for an understanding of epidemiological patterns of disease transmission. Currently, the most common method of mosquito identification relies on morphological taxonomic keys, which do not always distinguish cryptic species. However, wing geometric morphometrics is a promising tool for the identification of vector mosquitoes, sibling and cryptic species included. This study therefore sought to accurately identify mosquito species from the three most epidemiologically important mosquito genera using wing morphometrics. Twelve mosquito species from three epidemiologically important genera (Aedes, Anopheles and Culex) were collected and identified by taxonomic keys. Next, the right wing of each adult female mosquito was removed and photographed, and the coordinates of eighteen digitized landmarks at the intersections of wing veins were collected. The allometric influence was assessed, and canonical variate analysis and thin-plate splines were used for species identification. Cross-validated reclassification tests were performed for each individual, and a Neighbor Joining tree was constructed to illustrate species segregation patterns. The analyses were carried out and the graphs plotted with TpsUtil 1.29, TpsRelw 1.39, MorphoJ 1.02 and Past 2.17c. Canonical variate analysis for Aedes, Anopheles and Culex genera showed three clear clusters in morphospace, correctly distinguishing the three mosquito genera, and pairwise cross-validated reclassification resulted in at least 99% accuracy; subgenera were also identified correctly with a mean accuracy of 96%, and in 88 of the 132 possible comparisons, species were identified with 100% accuracy after the data was subjected to reclassification. Our results showed that Aedes, Culex

  11. Ascending aorta-right pulmonary artery anastomosis: Waterston's operation

    PubMed Central

    Alvarez-Díaz, F.; Brito, J. M.; Cordovilla, G.; De León, J. Pérez; Sanchez, P. A.; Bordiú, C. M.

    1973-01-01

    The results of 180 cases of congenital heart disease with diminished pulmonary flow operated upon with Waterston's technique are presented. It is considered that Waterston's operation is to be preferred in children under 2 years of age and in older children who have had a previous thrombotic or insufficient Blalock operation and in whom total correction is not indicated. The problem of pseudotruncus with hypoplastic pulmonary arteries is discussed. The convenience of the Waterston operation in these cases, and the importance of creating an anastomosis at the pulmonary bifurcation and as far back as possible in the aorta, is emphasized. The need to perform this technique in the correct way is stressed. This will avoid the kinking and pulling of the right pulmonary artery, which are causes of preferential blood flow to the right lung, as we have demonstrated experimentally. The possible complications caused by such a technical failure are discussed. The necessity for previous angiocardiographic study, in order properly to repair the defect during total correction, is also considered. Images PMID:4731106

  12. Metformin restores endothelial function in aorta of diabetic rats

    PubMed Central

    Sena, Cristina M; Matafome, Paulo; Louro, Teresa; Nunes, Elsa; Fernandes, Rosa; Seiça, Raquel M

    2011-01-01

    BACKGROUND AND PURPOSE The effects of metformin, an antidiabetic agent that improves insulin sensitivity, on endothelial function have not been fully elucidated. This study was designed to assess the effect of metformin on impaired endothelial function, oxidative stress, inflammation and advanced glycation end products formation in type 2 diabetes mellitus. EXPERIMENTAL APPROACH Goto-Kakizaki (GK) rats, an animal model of nonobese type 2 diabetes, fed with normal and high-fat diet during 4 months were treated with metformin for 4 weeks before evaluation. Systemic oxidative stress, endothelial function, insulin resistance, nitric oxide (NO) bioavailability, glycation and vascular oxidative stress were determined in the aortic rings of the different groups. A pro-inflammatory biomarker the chemokine CCL2 (monocyte chemoattractant protein-1) was also evaluated. KEY RESULTS High-fat fed GK rats with hyperlipidaemia showed increased vascular and systemic oxidative stress and impaired endothelial-dependent vasodilatation. Metformin treatment significantly improved glycation, oxidative stress, CCL2 levels, NO bioavailability and insulin resistance and normalized endothelial function in aorta. CONCLUSION AND IMPLICATIONS Metformin restores endothelial function and significantly improves NO bioavailability, glycation and oxidative stress in normal and high-fat fed GK rats. This supports the concept of the central role of metformin as a first-line therapeutic to treat diabetic patients in order to protect against endothelial dysfunction associated with type 2 diabetes mellitus. PMID:21250975

  13. Phorbol ester and spontaneous activity in SHR aorta

    SciTech Connect

    Moisey, D.M.; Cox, R.H.

    1986-03-01

    Thoracic aortas (TA) were excised from 6-week old SHR and WKY. 2mm rings were mounted isometrically at optimum preload. Spontaneous rhythmical activity developed in TA from SHR and had a frequency of 3-4/min with varying periods of quiescence between bursts of activity. The spontaneous activity often produced an increase in tension development which was associated with increased frequency of oscillations. Verapamil (10/sup -7/ M) or Ca/sup + +/-free solution added during the contractile phase resulted in an immediate loss of tension and spontaneous activity. Addition of ouabain (10/sup -4/ M) during the contractile phase of spontaneous activity, increased the frequency of oscillations which appeared to fuse into a tetanus. Spontaneous rhythmical activity was infrequently observed in TA from WKY. However, addition of phorbol 12-myristate-13 acetate (TPA), frequently induced spontaneous rhythmic oscillations associated with tension development in TA from WKY. TPA contracted the SHR TA and increased the frequency of oscillations. SHR TA were more sensitive to TPA than WKY. This study demonstrates (1) spontaneous rhythmical activity, independent of agonist stimulation in TA from 6-week old SHR and (2) TPA induced spontaneous oscillatory activity. The mechanism underlying the spontaneous oscillatory activity may involve membrane coupling events and Na-pump difference between SHR and WKY.

  14. Phosphoinositide metabolism and metabolism-contraction coupling in rabbit aorta

    SciTech Connect

    Coburn, R.F.; Baron, C.; Papadopoulos, M.T. )

    1988-12-01

    The authors tested a hypothesis that metabolism-contraction coupling in vascular smooth muscle is controlled by the rate of delivery of energy to ATP-dependent reactions in the inositol phospholipid transduction system that generate second messengers exerting control on smooth muscle force. Rabbit aorta was contracted by norepinephrine (NOR) under conditions of normoxia and hypoxia, and changes in inositol phospholipid pool sizes and metabolic flux rates (J{sub F}) were determined. J{sub F} was determined by labeling free cytosolic myo-inositol by incubation of unstimulated muscle with myo-({sup 3}H)inositol and then measuring rates of incorporation of this isotope into inositol phospholipids and inositol phosphates when the muscle was activated by NOR. J{sub F} measured during maintenance of NOR-induced force was markedly inhibited during hypoxia to 40-50% of that determined during normoxia; rates of increases in inositol phosphate radioactivities were similarly depressed during NOR activation under hypoxia. The hypoxia-induced decrease in J{sub F} was associated with four- to fivefold increase in phosphatidylinositol 4-phosphate (PIP) total pool size, suggesting PIP kinase was inhibited and rate limiting. These data suggest that activation of inositol phospholipid metabolism, which generates inositol 1,4,5-trisphosphate (IP{sub 3}) and diacylglycerol, is blunted under conditions where aerobic energy production is inhibited. Data are consistent with rate-limiting effects of decreased ATP delivery, or decreased phosphate potential, on PIP kinase and reactions that control resynthesis of phosphatidylinositol.

  15. Fluid Dynamics of Coarctation of the Aorta and Effect of Bicuspid Aortic Valve

    PubMed Central

    Keshavarz-Motamed, Zahra; Garcia, Julio; Kadem, Lyes

    2013-01-01

    Up to 80% of patients with coarctation of the aorta (COA) have a bicuspid aortic valve (BAV). Patients with COA and BAV have elevated risks of aortic complications despite successful surgical repair. The development of such complications involves the interplay between the mechanical forces applied on the artery and the biological processes occurring at the cellular level. The focus of this study is on hemodynamic modifications induced in the aorta in the presence of a COA and a BAV. For this purpose, numerical investigations and magnetic resonance imaging measurements were conducted with different configurations: (1) normal: normal aorta and normal aortic valve; (2) isolated COA: aorta with COA (75% reduction by area) and normal aortic valve; (3) complex COA: aorta with the same severity of COA (75% reduction by area) and BAV. The results show that the coexistence of COA and BAV significantly alters blood flow in the aorta with a significant increase in the maximal velocity, secondary flow, pressure loss, time-averaged wall shear stress and oscillatory shear index downstream of the COA. These findings can contribute to a better understanding of why patients with complex COA have adverse outcome even following a successful surgery. PMID:24015239

  16. Effect of coarctation of the aorta and bicuspid aortic valve on flow dynamics and turbulence in the aorta using particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Keshavarz-Motamed, Zahra; Garcia, Julio; Gaillard, Emmanuel; Maftoon, Nima; Di Labbio, Giuseppe; Cloutier, Guy; Kadem, Lyes

    2014-03-01

    Blood flow in the aorta has been of particular interest from both fluid dynamics and physiology perspectives. Coarctation of the aorta (COA) is a congenital heart disease corresponding to a severe narrowing in the aortic arch. Up to 85 % of patients with COA have a pathological aortic valve, leading to a narrowing at the valve level. The aim of the present work was to advance the state of understanding of flow through a COA to investigate how narrowing in the aorta (COA) affects the characteristics of the velocity field and, in particular, turbulence development. For this purpose, particle image velocimetry measurements were conducted at physiological flow and pressure conditions, with three different aorta configurations: (1) normal case: normal aorta + normal aortic valve; (2) isolated COA: COA (with 75 % reduction in aortic cross-sectional area) + normal aortic valve and (3) complex COA: COA (with 75 % reduction in aortic cross-sectional area) + pathological aortic valve. Viscous shear stress (VSS), representing the physical shear stress, Reynolds shear stress (RSS), representing the turbulent shear stress, and turbulent kinetic energy (TKE), representing the intensity of fluctuations in the fluid flow environment, were calculated for all cases. Results show that, compared with a healthy aorta, the instantaneous velocity streamlines and vortices were deeply changed in the presence of the COA. The normal aorta did not display any regions of elevated VSS, RSS and TKE at any moment of the cardiac cycle. The magnitudes of these parameters were elevated for both isolated COA and complex COA, with their maximum values mainly being located inside the eccentric jet downstream of the COA. However, the presence of a pathologic aortic valve, in complex COA, amplifies VSS (e.g., average absolute peak value in the entire aorta for a total flow of 5 L/min: complex COA: = 36 N/m2; isolated COA = 19 N/m2), RSS (e.g., average peak value in the entire aorta for a total flow of 5

  17. Puerperal endometritis after abdominal twin delivery.

    PubMed

    Suonio, S; Huttunen, M

    1994-04-01

    The infectious complications of 122 consecutive abdominal twin deliveries over the period 1984-1989 were analyzed in a prospective clinical study, comparing them with 761 singleton abdominal deliveries over the period 1984-1986. The incidence of endometritis was nearly three-fold after twin deliveries and the incidence of abdominal wound infections nearly two-fold compared with singleton abdominal pregnancies (13.1/4.7% and 5.6/3.0%). The risk of amnionitis was increased ten-fold, 6 hours after rupture of the membranes in abdominal twin delivery, but no connection was found between amnionitis and endometritis, as in singleton abdominal deliveries. Multiple regression analysis indicated only two risk factors as regards puerperal endometritis after abdominal twin delivery: age under 25 years (odds ratio 6.9, 95% confidence limits 1.9-24.8), an association also seen in singleton abdominal deliveries, and a period of more than 6 hours from rupture of membranes to delivery (odds ratio 7.8, 95% confidence limits 2.1-28.5). Multiple pregnancy appears to be associated with an increased risk of endometritis. The etiological factors remain unknown, but a large placental bed and/or immunological factors may be implicated. PMID:8160537

  18. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    PubMed

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  19. Abdominal tuberculosis of the gastrointestinal tract: Revisited

    PubMed Central

    Debi, Uma; Ravisankar, Vasudevan; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sharma, Arun Kumar

    2014-01-01

    Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease. PMID:25356043

  20. Morphometricity as a measure of the neuroanatomical signature of a trait.

    PubMed

    Sabuncu, Mert R; Ge, Tian; Holmes, Avram J; Smoller, Jordan W; Buckner, Randy L; Fischl, Bruce

    2016-09-27

    Complex physiological and behavioral traits, including neurological and psychiatric disorders, often associate with distributed anatomical variation. This paper introduces a global metric, called morphometricity, as a measure of the anatomical signature of different traits. Morphometricity is defined as the proportion of phenotypic variation that can be explained by macroscopic brain morphology. We estimate morphometricity via a linear mixed-effects model that uses an anatomical similarity matrix computed based on measurements derived from structural brain MRI scans. We examined over 3,800 unique MRI scans from nine large-scale studies to estimate the morphometricity of a range of phenotypes, including clinical diagnoses such as Alzheimer's disease, and nonclinical traits such as measures of cognition. Our results demonstrate that morphometricity can provide novel insights about the neuroanatomical correlates of a diverse set of traits, revealing associations that might not be detectable through traditional statistical techniques.

  1. Morphometricity as a measure of the neuroanatomical signature of a trait.

    PubMed

    Sabuncu, Mert R; Ge, Tian; Holmes, Avram J; Smoller, Jordan W; Buckner, Randy L; Fischl, Bruce

    2016-09-27

    Complex physiological and behavioral traits, including neurological and psychiatric disorders, often associate with distributed anatomical variation. This paper introduces a global metric, called morphometricity, as a measure of the anatomical signature of different traits. Morphometricity is defined as the proportion of phenotypic variation that can be explained by macroscopic brain morphology. We estimate morphometricity via a linear mixed-effects model that uses an anatomical similarity matrix computed based on measurements derived from structural brain MRI scans. We examined over 3,800 unique MRI scans from nine large-scale studies to estimate the morphometricity of a range of phenotypes, including clinical diagnoses such as Alzheimer's disease, and nonclinical traits such as measures of cognition. Our results demonstrate that morphometricity can provide novel insights about the neuroanatomical correlates of a diverse set of traits, revealing associations that might not be detectable through traditional statistical techniques. PMID:27613854

  2. Morphometricity as a measure of the neuroanatomical signature of a trait

    PubMed Central

    Sabuncu, Mert R.; Ge, Tian; Holmes, Avram J.; Smoller, Jordan W.; Buckner, Randy L.; Fischl, Bruce

    2016-01-01

    Complex physiological and behavioral traits, including neurological and psychiatric disorders, often associate with distributed anatomical variation. This paper introduces a global metric, called morphometricity, as a measure of the anatomical signature of different traits. Morphometricity is defined as the proportion of phenotypic variation that can be explained by macroscopic brain morphology. We estimate morphometricity via a linear mixed-effects model that uses an anatomical similarity matrix computed based on measurements derived from structural brain MRI scans. We examined over 3,800 unique MRI scans from nine large-scale studies to estimate the morphometricity of a range of phenotypes, including clinical diagnoses such as Alzheimer’s disease, and nonclinical traits such as measures of cognition. Our results demonstrate that morphometricity can provide novel insights about the neuroanatomical correlates of a diverse set of traits, revealing associations that might not be detectable through traditional statistical techniques. PMID:27613854

  3. Surgical Repair of Abdominal Aortic and Renal Artery Aneurysms in Takayasu's Arteritis.

    PubMed

    Wetstein, Paul J; Clark, Margaret E; Cafasso, Danielle E; Golarz, Scott R; Ayubi, Farhan S; Kellicut, Dwight C

    2016-01-01

    Takayasu's arteritis is a large vessel vasculitis that can be a challenging diagnosis to make and has a varied clinical presentation. Management largely depends on affected vessel disease severity and individual patient considerations. The diagnosis must be considered in a young patient with large vessel aneurysms. We present a case of a 30 year-old woman of Pacific Islander descent who presented to the Tripler Army medical Center Vascular Surgery Department in Honolulu, Hawai'i seeking repair of her abdominal aortic and renal artery aneurysms prior to conception. A 30 year-old Pacific Islander woman with a history of a saccular abdominal aortic aneurysm and renal artery aneurysms presented to our clinic seeking vascular surgery consultation prior to a planned pregnancy. She had a renal artery stent placed at an outside institution for hypertension. She met the diagnosis of Takayasu's arteritis by Sharma's criteria. Physical exam was significant for a palpable, pulsatile, abdominal mass and CT angiography revealed a saccular irregular-appearing infra-renal abdominal aortic aneurysm, extending to the aortic bifurcation, with a maximum diameter of 3.3 cm. A right renal artery aneurysm was also identified proximally, contiguous with the aorta, with a maximal transverse diameter of 1.7 cm. The patient underwent a supraceliac bypass to the right renal artery with a 7 mm Dacron graft, as well as excision of the right renal artery aneurysm. The abdominal aortic aneurysm was replaced using a Hemashield Dacron bifurcated 14 mm x 7 mm bypass graft. Intraoperative measurements of the renal artery aneurysm were 1.5 x 1.5 cm and the saccular appearing distal abdominal aortic aneurysm measured 3.6 x 3.3 cm. The patient was discharged from the hospital 7 days post-operatively. At 1-year follow up, CT scan of the abdominal aorta revealed the repair was without any evidence of aneurysm formation, anastomotic pseudoaneurysm formation, or areas of stenosis. She has remained

  4. CORRELATED MORPHOMETRIC AND BIOCHEMICAL STUDIES ON THE LIVER CELL

    PubMed Central

    Stäubli, Willy; Hess, Robert; Weibel, Ewald R.

    1969-01-01

    The changes occurring in rat hepatocytes during a 5 day period of treatment with phenobarbital were determined by morphometric and biochemical methods, particular attention being paid to the endoplasmic reticulum. The hepatocytic cytoplasm played an overwhelming part in the liver hypertrophy, while the hepatocytic nuclei contributed to only a moderate extent. The endoplasmic reticulum accounted for more than half of the increase in cytoplasmic volume. The increase in the volume and number of hepatocytic nuclei in the course of phenobarbital treatment was associated with changes in the ploidy pattern. Until the 2nd day of treatment both the rough-surfaced endoplasmic reticulum (RER) and the smooth-surfaced endoplasmic reticulum (SER) participated in the increase in volume and surface of the whole endoplasmic reticulum (ER). Subsequently, the values for RER fell again to control levels, whereas those for SER continued to increase, with the result that by the 5th day of treatment the SER constituted the dominant cytoplasmic element. The specific volume of mitochondria and microbodies (peroxisomes) remained constant throughout the duration of the experiment, while that of the dense bodies increased. The specific number of mitochondria and microbodies displayed a significant increase, associated with a decrease in their mean volume. The phenobarbital-induced increase in the phospholipid and cytochrome P-450 content of the microsomes, as well as in the activities of microsomal reduced nicotinamide-adenine dinucleotide phosphate-cytochrome c reductase and N-demethylase, was correlated with the morphometric data on the endoplasmic reticulum. PMID:4306789

  5. Morphometric analysis of cerebral ventricular system from MR images

    NASA Astrophysics Data System (ADS)

    Aziz, Aamer; Hu, QingMao; Nowinski, Wieslaw L.

    2004-04-01

    Cerebrospinal fluid filled ventricular system is an essential part of brain. The volume, shape and size of this ventricular system remain more or less constant and various pathologies directly or indirectly affect them. Morphometric analysis of cerebral ventricular system is important for evaluating changes due to growth, aging, intrinsic and extrinsic pathologies. Previous quantification efforts using ex vivo techniques suffered considerable error due to deformation of slices during sectioning, and numerous other factors. In vivo studies using air or contrast media also introduce volumetric changes in the ventricles thus giving erroneous quantitative information. Imaging of ventricular anatomy avoids these problems and allows repetitive studies following progression of ventricular system changes due to disease or natural processes. We have developed a methodology for automated extraction of ventricular system from MR neuroimages. Once extracted, landmarks are located on the surface of ventricular system automatically. These landmarks are then used for calculation of the ventricular shape, volume and size. A total of 20 brain ventricular systems were analyzed. The morphometric dimensions of the ventricles are presented in this paper. This study forms an initial basis for more advanced work on ventricular segmentation and morphometry.

  6. Morphometric approach to pulp fibroblast development in tooth germ.

    PubMed

    Căruntu, Irina-Draga; Săvinescu, Sergiu Daniel; Amălinei, Cornelia

    2014-01-01

    This paper builds a morphometric framework for the analysis of dental pulp fibroblast evolution during tooth development. We investigated 15 tooth germs (cases) organized, by histological criteria, in three groups corresponding to cap, early bell, and late bell stages, respectively. Each group comprised five cases. The morphometric description used the following parameters: area (A), perimeter (P)--automatically extracted by a color segmentation technique, and form factor (FF)--calculated as 4πA/P (2). The designed framework operated at inter- and intragroup levels. The intergroup analysis quantified the differences between groups, in the sense of a relative distance (RD) adequately defined by mean-value scaling. We showed that the stage of early bell is approximately 5 times closer to late bell than to cap. The quantification procedure required concomitant information about A, P parameters (as P versus A dependences, or FF values), whereas the procedure failed for A or P separately used. The intragroup analysis quantified the similarity of the cases belonging to the same stage. We proved that, unlike the intergroup tests, the individual exploitation of all three descriptors A, P, and FF is effective, yielding highly compatible results. Within any group, most cases presented RDs less than 10% from the group mean value, regardless of the descriptor type.

  7. Morphometric Approach to Pulp Fibroblast Development in Tooth Germ

    PubMed Central

    Căruntu, Irina-Draga; Săvinescu, Sergiu Daniel; Amălinei, Cornelia

    2014-01-01

    This paper builds a morphometric framework for the analysis of dental pulp fibroblast evolution during tooth development. We investigated 15 tooth germs (cases) organized, by histological criteria, in three groups corresponding to cap, early bell, and late bell stages, respectively. Each group comprised five cases. The morphometric description used the following parameters: area (A), perimeter (P)—automatically extracted by a color segmentation technique, and form factor (FF)—calculated as 4πA/P2. The designed framework operated at inter- and intragroup levels. The intergroup analysis quantified the differences between groups, in the sense of a relative distance (RD) adequately defined by mean-value scaling. We showed that the stage of early bell is approximately 5 times closer to late bell than to cap. The quantification procedure required concomitant information about A, P parameters (as P versus A dependences, or FF values), whereas the procedure failed for A or P separately used. The intragroup analysis quantified the similarity of the cases belonging to the same stage. We proved that, unlike the intergroup tests, the individual exploitation of all three descriptors A, P, and FF is effective, yielding highly compatible results. Within any group, most cases presented RDs less than 10% from the group mean value, regardless of the descriptor type. PMID:25057501

  8. Time-related morphometric studies of neurofilaments in brain contusions.

    PubMed

    Kobek, M; Jankowski, Z; Szala, J; Gąszczyk-Ożarowski, Z; Pałasz, A; Skowronek, R

    2016-01-01

    In forensic pathology age determination of injuries is of key importance. The purpose of the study was to analyze morphometrically changes in neurofilaments following the brain contusion and relate them to the length of the time of survival. To do this, the authors analyzed specimens of brains collected during medicolegal autopsies. According to the available literature, no such study involving material from deceased humans was conducted. The researched material was divided into nine subgroups (10 cases each) according to the time of death of persons: immediately at the crime site, 12 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days and 7 days after head trauma. Neurofilaments were immunohistochemically stained and evaluated quantitatively using the Met-Ilo computer application. The initial results were then analyzed statistically with the one way analysis of variance (ANOVA) and the least significant difference (LSD) tests. It was calculated that there are significant differences in numbers and area fractions of neurofilaments within 7 days after head trauma. It must be concluded that morphometric analysis of neurofilaments is a promising method but further studies are required. PMID:27179221

  9. Morphometrical variations of the carpal bones in thoroughbreds and ponies.

    PubMed

    Abdunnabi, A H; Ahmed, Y A; Philip, C J; Davies, H M S

    2012-04-01

    There is scant morphological data for equine carpal bones despite the frequent pathology in Thoroughbreds (TB). This study aimed to identify morphological and morphometrical variations and similarities in carpal bones between and within TB and Ponies (Po). Carpal bones from nine TB and 13 Po were prepared by boiling and drying. Lateromedial width, dorsopalmar depth, proximodistal height, relative density and volume of each bone were measured. Normalized measurements of the radial (Cr) and third (C3) carpal bones were significantly different in all dimensions, and there were significant variations in relative sizes of articular facets of the ulnar (Cu), C3 and fourth (C4) carpal bones between the groups. Bilaterally, the proportionate volume of the intermediate carpal bone (Ci) was significantly greater in Po while that of Cu and C4 were significantly greater in TB. Relative density of most bones was greater in Po. The palmar tuberosity of the proximal surface of Ci and palmar tubercle on the palmar surface of Cu were more prominent and relatively larger in TB. In the second carpal bone (C2), the distal extent of the proximal articular surface on the palmar surface was greater in Po. The inconsistent first carpal bone (C1) was relatively larger in Po. Morphometrical similarities and differences in carpal bones between TB and Po indicate potential effects of selection for body size or fast exercise.

  10. Predictive models of insulin resistance derived from simple morphometric and biochemical indices related to obesity and the metabolic syndrome in baboons

    PubMed Central

    Chavez, Alberto O; Gastaldelli, Amalia; Guardado-Mendoza, Rodolfo; Lopez-Alvarenga, Juan C; Leland, M Michelle; Tejero, M Elizabeth; Sorice, GianPio; Casiraghi, Francesca; Davalli, Alberto; Bastarrachea, Raúl A; Comuzzie, Anthony G; DeFronzo, Ralph A; Folli, Franco

    2009-01-01

    Background Non-human primates are valuable models for the study of insulin resistance and human obesity. In baboons, insulin sensitivity levels can be evaluated directly with the euglycemic clamp and is highly predicted by adiposity, metabolic markers of obesity and impaired glucose metabolism (i.e. percent body fat by DXA and HbA1c). However, a simple method to screen and identify obese insulin resistant baboons for inclusion in interventional studies is not available. Methods We studied a population of twenty baboons with the euglycemic clamp technique to characterize a population of obese nondiabetic, insulin resistant baboons, and used a multivariate linear regression analysis (adjusted for gender) to test different predictive models of insulin sensitivity (insulin-stimulated glucose uptake = Rd) using abdominal circumference and fasting plasma insulin. Alternatively, we tested in a separate baboon population (n = 159), a simpler model based on body weight and fasting plasma glucose to predict the whole-body insulin sensitivity (Rd/SSPI) derived from the clamp. Results In the first model, abdominal circumference explained 59% of total insulin mediated glucose uptake (Rd). A second model, which included fasting plasma insulin (log transformed) and abdominal circumference, explained 64% of Rd. Finally, the model using body weight and fasting plasma glucose explained 51% of Rd/SSPI. Interestingly, we found that percent body fat was directly correlated with the adipocyte insulin resistance index (r = 0.755, p < 0.0001). Conclusion In baboons, simple morphometric measurements of adiposity/obesity, (i.e. abdominal circumference), plus baseline markers of glucose/lipid metabolism, (i.e. fasting plasma glucose and insulin) provide a feasible method to screen and identify overweight/obese insulin resistant baboons for inclusion in interventional studies aimed to study human obesity, insulin resistance and type 2 diabetes mellitus. PMID:19389241

  11. [Ultrasound screening of abdominal aortic aneurysm: Lessons from Vesale 2013].

    PubMed

    Laroche, J P; Becker, F; Baud, J M; Miserey, G; Jaussent, A; Picot, M C; Bura-Rivière, A; Quéré, I

    2015-12-01

    Although aneurysm of the abdominal infra-renal aorta (AAA) meets criteria warranting B mode ultrasound screening, the advantages of mass screening versus selective targeted opportunistic screening remain a subject of debate. In France, the French Society of Vascular Medicine (SFMV) and the Health Authority (HAS) published recommendations for targeted opportunistic screening in 2006 and 2013 respectively. The SFMV held a mainstream communication day on November 21, 2013 in France involving participants from metropolitan France and overseas departments that led to a proposal for free AAA ultrasound screening: the Vesalius operation. Being a consumer operation, the selection criteria were limited to age (men and women between 60 and 75 years); the age limit was lowered to 50 years in case of direct family history of AAA. More than 7000 people (as many women as men) were screened in 83 centers with a 1.70% prevalence of AAA in the age-based target population (3.12% for men, 0.27% for women). The median diameter of detected AAA was 33 mm (range 20 to 74 mm). The prevalence of AAA was 1.7% in this population. Vesalius data are consistent with those of the literature both in terms of prevalence and for cardiovascular risk factors with the important role of smoking. Lessons from Vesalius to take into consideration are: screening is warranted in men 60 years and over, especially smokers, and in female smokers. Screening beyond 75 years should be discussed. Given the importance of screening, the SFMV set up a year of national screening for AAA (Vesalius operation 2014/2015) in order to increase public and physician awareness about AAA detection, therapeutic management, and monitoring. AAA is a serious, common, disease that kills 6000 people each year. The goal of screening is cost-effective reduction in the death toll. PMID:26371387

  12. [Ultrasound screening of abdominal aortic aneurysm: Lessons from Vesale 2013].

    PubMed

    Laroche, J P; Becker, F; Baud, J M; Miserey, G; Jaussent, A; Picot, M C; Bura-Rivière, A; Quéré, I

    2015-12-01

    Although aneurysm of the abdominal infra-renal aorta (AAA) meets criteria warranting B mode ultrasound screening, the advantages of mass screening versus selective targeted opportunistic screening remain a subject of debate. In France, the French Society of Vascular Medicine (SFMV) and the Health Authority (HAS) published recommendations for targeted opportunistic screening in 2006 and 2013 respectively. The SFMV held a mainstream communication day on November 21, 2013 in France involving participants from metropolitan France and overseas departments that led to a proposal for free AAA ultrasound screening: the Vesalius operation. Being a consumer operation, the selection criteria were limited to age (men and women between 60 and 75 years); the age limit was lowered to 50 years in case of direct family history of AAA. More than 7000 people (as many women as men) were screened in 83 centers with a 1.70% prevalence of AAA in the age-based target population (3.12% for men, 0.27% for women). The median diameter of detected AAA was 33 mm (range 20 to 74 mm). The prevalence of AAA was 1.7% in this population. Vesalius data are consistent with those of the literature both in terms of prevalence and for cardiovascular risk factors with the important role of smoking. Lessons from Vesalius to take into consideration are: screening is warranted in men 60 years and over, especially smokers, and in female smokers. Screening beyond 75 years should be discussed. Given the importance of screening, the SFMV set up a year of national screening for AAA (Vesalius operation 2014/2015) in order to increase public and physician awareness about AAA detection, therapeutic management, and monitoring. AAA is a serious, common, disease that kills 6000 people each year. The goal of screening is cost-effective reduction in the death toll.

  13. Age-dependent ascending aorta mechanics assessed through multiphase CT.

    PubMed

    Martin, Caitlin; Sun, Wei; Primiano, Charles; McKay, Raymond; Elefteriades, John

    2013-12-01

    Quantification of the age- and gender-specific in vivo mechanical characteristics of the ascending aorta (AA) will allow for identification of abnormalities aside from changes brought on by aging alone. Multiphase clinical CT scans of 45 male patients between the ages of 30 and 79 years were analyzed to assess age-dependent in vivo AA characteristics. The three-dimensional AA geometry for each patient was reconstructed from the CT scans for 9-10 phases throughout the cardiac cycle. The AA circumference was measured during each phase and was used to determine the corresponding diameter, circumferential strain, and wall tension at each phase. The pressure-strain modulus was also determined for each patient. The mean diastolic AA diameter was significantly smaller among young (42.6 ± 5.2 years) at 29.9 ± 2.8 mm than old patients (69.0 ± 5.2 years) at 33.2 ± 3.2 mm. The circumferential AA strain from end-diastole to peak-systole decreased from 0.092 ± 0.03 in young to 0.056 ± 0.03 in old patients. The pressure-strain modulus increased two-fold from 68.4 ± 30.5 kPa in young to 162.0 ± 93.5 kPa in old patients, and the systolic AA wall tension increased from 268.5 ± 31.3 kPa in young to 304.9 ± 49.2 kPa in old patients. The AA dilates and stiffens with aging which increases the vessel wall tension, likely predisposing aneurysm and dissection.

  14. Determinants of mechanical properties in the developing ovine thoracic aorta.

    PubMed

    Wells, S M; Langille, B L; Lee, J M; Adamson, S L

    1999-10-01

    We previously reported changes in mechanical properties and collagen cross-linking of the ovine thoracic aorta during perinatal development and postnatal maturation, and we now report changes in biochemical composition (elastin, collagen, and DNA contents per mg wet wt) over the same developmental intervals. A comparison of results from the present and previous studies has yielded novel and important observations concerning the relationship between aortic mechanics and composition during maturation. Developmental changes in aortic incremental elastic modulus at low tensile stress (E(low)) closely followed changes in relative elastin content (i.e., per mg wet wt). An 89% increase in E(low) during the perinatal period was associated with a 69% increase in relative elastin content, whereas neither variable changed during postnatal life. Incremental elastic modulus at high tensile stress (E(high)) did not change during the perinatal period but increased 88% during postnatal life. This pattern closely paralleled changes in collagen cross-linking index, which did not change perinatally but almost doubled postnatally. In contrast, relative collagen content (per mg wet wt) increased only slightly from fetal to adult life, a trend that was unrelated to aortic mechanics. Substantial, progressive decreases in measures of wall viscosity (pressure wave attenuation coefficient and viscoelastic phase angle) from fetal to adult life followed the pattern observed for relative DNA (smooth muscle cell) content (per mg wet wt). Our findings suggest that accumulation of elastin per milligram wet weight contributes most to developmental changes in E(low), change in collagen cross-linking is the primary determinant of developmental changes in E(high), and cell accumulation contributes most to developmental changes in wall viscosity.

  15. Endovascular Stenting for Unsuccessful Angioplasty of the Aorta in Aortoarteritis

    SciTech Connect

    Tyagi, Sanjay; Kaul, Upkar A.; Arora, Ramesh

    1999-11-15

    Purpose: The efficacy and safety of endovascular stent implantation to correct dissection or a suboptimal result after percutaneous transluminal angioplasty (PTA) was evaluated in patients suffering from aortic stenosis due to aortoarteritis. Methods: Twelve children and young adults [aged (mean {+-} SD) 18.2 {+-} 8.7 years] underwent stent implantation after PTA of the aorta, seven for obstructive dissection, four for ineffective balloon dilatation, and one for recurrent restenosis. Nine patients underwent implantation of self-expandable stents and three received balloon-expandable Palmaz stents. Results: Stent implantation could be successfully performed in all 12 patients. After stent implantation, the peak systolic pressure gradient decreased from 91 {+-} 33.5 mmHg to 12.4 {+-} 12.5 mmHg (p < 0.001). The diameter of the stenosed segment increased from 4.6 {+-} 0.8 mm to 11.1 {+-} 1.9 mm (p < 0.001). The dissection was completely covered in all seven patients with dissection. Except for epigastric pain with vomiting in one patient, there was no complication. On follow-up, over 12-57 months (mean 26.8 {+-} 10.8 months), 11 patients (91.6%) had marked improvement in their blood pressure. Patients with congestive heart failure and claudication also showed improvement. Repeat catheterization in five patients, between 6-30 months (mean 16.8 {+-} 9.1 months) after stent implantation, showed sustained improvement in four and a fusiform, long segment, intrastent restenosis after 30 months in one child. The stenosis was safely redilated. Conclusion: Endovascular aortic stent implantation is safe and provides good immediate relief in patients with unsatisfactory results after balloon angioplasty. Improvement is sustained in most patients on intermediate-term follow-up.

  16. Reproducibility of aortic pulsatility measurements from ECG-gated abdominal CTA in patients with abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    Manduca, Armando; Fletcher, Joel G.; Wentz, Robert J.; Shields, Raymond C.; Vrtiska, Terri J.; Siddiki, Hassan; Nielson, Theresa

    2009-02-01

    Purpose: ECG-gated abdominal CT angiography with reconstruction of multiple, temporally overlapping CT angiography datasets has been proposed for measuring aortic pulsatility. The purpose of this work is to develop algorithms to segment the aorta from surrounding structures from CTA datasets across cardiac phases, calculate registered centerlines and measurements of regional aortic pulsatility in patients with AAA, and to assess the reproducibility of these measurements. Methods: ECG-gated CTA was performed with a temporal resolution of 165 ms, reconstructed to 1 mm slices ranging at 14 cardiac phase points. Data sets were obtained from 17 patients on which two such scans were performed 6 to 12 months apart. Automated segmentation, centerline generation, and registration of centerlines between phases was performed, followed by calculation of cross-sectional areas and regional and local pulsatility. Results: Pulsatility calculations for the supraceliac region were very reproducible between earlier and later scans of the same patient, with average differences less than 1% for pulsatility values ranging from 2% to 13%. Local radial pulsatilities were also reproducible to within ~1%. Aneurysm volume changes between scans can also be quantified. Conclusion: Automated segmentation, centerline generation, and registration of temporally resolved CTA datasets permit measurements of regional changes in cross-sectional area over the course of the cardiac cycle (i.e., regional aortic pulsatility). These measurements are reproducible between scans 6-12 months apart, with differences in aortic areas reflecting both aneurysm remodeling and changes in blood pressure. Regional pulsatilities ranged from 2 to 13% but were reproducible at the 1% level.

  17. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. PMID:23868677

  18. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure.

  19. The Benefits of Internal Thoracic Artery Catheterization in Patients With Chronic Abdominal Aortic Occlusion

    SciTech Connect

    Ilic, Nikola Davidovic, Lazar; Koncar, Igor; Dragas, Marko; Markovic, Miroslav; Colic, Momcilo; Cinara, Ilijas

    2011-04-15

    Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography.

  20. Adipocyte in vascular wall can induce the rupture of abdominal aortic aneurysm

    PubMed Central

    Kugo, Hirona; Zaima, Nobuhiro; Tanaka, Hiroki; Mouri, Youhei; Yanagimoto, Kenichi; Hayamizu, Kohsuke; Hashimoto, Keisuke; Sasaki, Takeshi; Sano, Masaki; Yata, Tatsuro; Urano, Tetsumei; Setou, Mitsutoshi; Unno, Naoki; Moriyama, Tatsuya

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular disease involving the gradual dilation of the abdominal aorta. It has been reported that development of AAA is associated with inflammation of the vascular wall; however, the mechanism of AAA rupture is not fully understood. In this study, we investigated the mechanism underlying AAA rupture using a hypoperfusion-induced animal model. We found that the administration of triolein increased the AAA rupture rate in the animal model and that the number of adipocytes was increased in ruptured vascular walls compared to non-ruptured walls. In the ruptured group, macrophage infiltration and the protein levels of matrix metalloproteinases 2 and 9 were increased in the areas around adipocytes, while collagen-positive areas were decreased in the areas with adipocytes compared to those without adipocytes. The administration of fish oil, which suppresses adipocyte hypertrophy, decreased the number and size of adipocytes, as well as decreased the risk of AAA rupture ratio by 0.23 compared to the triolein administered group. In human AAA samples, the amount of triglyceride in the adventitia was correlated with the diameter of the AAA. These results suggest that AAA rupture is related to the abnormal appearance of adipocytes in the vascular wall. PMID:27499372

  1. Adipocyte in vascular wall can induce the rupture of abdominal aortic aneurysm.

    PubMed

    Kugo, Hirona; Zaima, Nobuhiro; Tanaka, Hiroki; Mouri, Youhei; Yanagimoto, Kenichi; Hayamizu, Kohsuke; Hashimoto, Keisuke; Sasaki, Takeshi; Sano, Masaki; Yata, Tatsuro; Urano, Tetsumei; Setou, Mitsutoshi; Unno, Naoki; Moriyama, Tatsuya

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular disease involving the gradual dilation of the abdominal aorta. It has been reported that development of AAA is associated with inflammation of the vascular wall; however, the mechanism of AAA rupture is not fully understood. In this study, we investigated the mechanism underlying AAA rupture using a hypoperfusion-induced animal model. We found that the administration of triolein increased the AAA rupture rate in the animal model and that the number of adipocytes was increased in ruptured vascular walls compared to non-ruptured walls. In the ruptured group, macrophage infiltration and the protein levels of matrix metalloproteinases 2 and 9 were increased in the areas around adipocytes, while collagen-positive areas were decreased in the areas with adipocytes compared to those without adipocytes. The administration of fish oil, which suppresses adipocyte hypertrophy, decreased the number and size of adipocytes, as well as decreased the risk of AAA rupture ratio by 0.23 compared to the triolein administered group. In human AAA samples, the amount of triglyceride in the adventitia was correlated with the diameter of the AAA. These results suggest that AAA rupture is related to the abnormal appearance of adipocytes in the vascular wall. PMID:27499372

  2. Therapeutic Prospect of Adipose-Derived Stromal Cells for the Treatment of Abdominal Aortic Aneurysm.

    PubMed

    Parvizi, Mojtaba; Harmsen, Martin C

    2015-07-01

    Aneurysm refers to the dilation of the vessel wall for more than 50%. Abdominal aortic aneurysm (AAA) refers to the dilation and weakening of all three layers of the abdominal aorta, which mostly occur infrarenally. The population aged above 50 years is at risk of AAA development, while a familiar history doubles the risk. Progression of AAA can cause immanent rupture of the vascular wall and has a high mortality and morbidity risk. They are additional risk factors for AAA development such as gender, smoking, and dyslipidemia. In general, pathological features of AAA include inflammation, degradation of the extracellular matrix (ECM), and smooth muscle cell apoptosis. The main pathophysiology of AAA development is still unknown. Besides available treatment modalities for large AAA, which associate with a high mortality risk, effective, alternative, and safer treatments are required, preferably already at an early stage of AAA. For the last decades, tissue engineering and regenerative medicine showed promising potential therapeutic effects for various (cardiovascular) diseases, including AAA. Adipose tissue-derived stromal cells (ADSC) are a candidate source of stem cells for regenerative medicine. ADSC are isolated from adipose tissue with low risk and are easily cultured and expanded while maintaining their multipotency. In addition, due to their differentiation capacity and trophic factor production, ADSC serve an important role in tissue engineering and regenerative medicine modalities. In this review, we will highlight the main pathobiology of AAA and introduce ADSC as a new promising therapeutic source for small AAA.

  3. Flow topology in patient-specific abdominal aortic aneurysms during rest and exercise

    NASA Astrophysics Data System (ADS)

    Arzani, Amirhossein; Shadden, Shawn

    2012-11-01

    Abdominal aortic aneurysm (AAA) is a permanent, localized widening of the abdominal aorta. Flow in AAA is dominated by recirculation, transitional turbulence and low wall shear stress. Image-based CFD has recently enabled high resolution flow data in patient-specific AAA. This study aims to characterize transport in different AAAs, and understand flow topology changes from rest to exercise, which has been a hypothesized therapy due to potential acute changes in flow. Velocity data in 6 patients with different AAA morphology were obtained using image-based CFD under rest and exercise conditions. Finite-time Lyapunov exponent (FTLE) fields were computed from integration of the velocity data to identify dominant Lagrangian coherent structures. The flow topology was compared between rest and exercise conditions. For all patients, the systolic inflow jet resulted in coherent vortex formation. The evolution of this vortex varied greatly between patients and was a major determinant of transport inside the AAA during diastole. During exercise, previously observed stagnant regions were either replaced with undisturbed flow, regions of uniform high mixing, or persisted relatively unchanged. A mix norm measure provided a quantitative assessment of mixing. This work was supported by the National Institutes of Health, grant number 5R21HL108272.

  4. Evolution of the wall shear stresses during the progressive enlargement of symmetric abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    Salsac, A.-V.; Sparks, S. R.; Chomaz, J.-M.; Lasheras, J. C.

    2006-08-01

    The changes in the evolution of the spatial and temporal distribution of the wall shear stresses (WSS) and gradients of wall shear stresses (GWSS) at different stages of the enlargement of an abdominal aortic aneurysm (AAA) are important in understanding the aetiology and progression of this vascular disease since they affect the wall structural integrity, primarily via the changes induced on the shape, functions and metabolism of the endothelial cells. Particle image velocimetry (PIV) measurements were performed in in vitro aneurysm models, while changing their geometric parameters systematically. It has been shown that, even at the very early stages of the disease, i.e. increase in the diameter ≤ 50%, the flow separates from the wall and a large vortex ring, usually followed by internal shear layers, is created. These lead to the generation of WSS that drastically differ in mean and fluctuating components from the healthy vessel. Inside the AAA, the mean WSS becomes negative along most of the aneurysmal wall and the magnitude of the WSS can be as low as 26% of the value in a healthy abdominal aorta.

  5. Fluid Characteristics in Abdominal Aortic Aneurysms (AAAs) and Its Correlation to Thrombus Formation

    NASA Astrophysics Data System (ADS)

    Tang, Rubing; Bar-Yoseph, Pinhas Z.; Lasheras, Juan

    2008-11-01

    It has been observed that most large Abdominal Aortic Aneurysms (AAAs) develop an intraluminal thrombus as they progressively enlarge. Previous studies have suggested that the build up of the thrombus may be associated with the altered hemodynamic patterns that arise inside the AAA. We have performed a parametrical computational study of the flow patterns inside enlarging AAA to investigate the possible mechanism controlling the thrombus formation. Pulsatile blood flows were simulated in idealized models of fusiform aneurysms with different dilatation ratios and the effects of shear-activated platelet accumulation and platelet/wall interaction were evaluated based on the calculated flow fields. The platelet activation level (PAL) was determined by computing the integral over time of flow shear stresses exerted over the platelets as they are transported throughout the aneurysm. Our results have shown that the values of PAL in AAAs are in fact smaller than the maximum value obtained in a healthy abdominal aorta. However, we show that the transportation of blood cells towards the wall and the formation of stagnation points on the aneurysm's wall play more significant roles in thrombus formation than PAL.

  6. Chronic Contained Rupture of an Abdominal Aortic Aneurysm: From Diagnosis to Endovascular Resolution

    SciTech Connect

    Gandini, Roberto Chiocchi, Marcello; Maresca, Luciano; Pipitone, Vincenzo; Messina, Massimo; Simonetti, Giovanni

    2008-07-15

    A male patient, 69 years old, presented with fever, leucocytosis, and persistent low back pain; he also had an abdominal aortic aneurysm (AAA), as previously diagnosed by Doppler UltraSound (US), and was admitted to our hospital. On multislice computed tomography (msCT), a large abdominal mass having no definite border and involving the aorta and both of the psoas muscles was seen. This mass involved the forth-lumbar vertebra with lysis, thus simulating AAA rupture into a paraspinal collection; it was initially considered a paraspinal abscess. After magnetic resonance imaging examination and culture of the fluid aspirated from the mass, no infective organisms were found; therefore, a diagnosisof chronically contained AAA rupture was made, and an aortic endoprosthesis was subsequently implanted. The patient was discharged with decreased lumbar pain. At 12-month follow-up, no evidence of leakage was observed. To our knowledge, this is the first case of endoprosthesis implantation in a patient, who was a poor candidate for surgical intervention due to renal failure, leucocytosis and high fever, having a chronically contained AAA ruptured simulatingspodilodiscitis abscess. Appropriate diagnosis and therapy resolved potentially crippling pathology and avoided surgical graft-related complications.

  7. Flow dynamics in anatomical models of abdominal aortic aneurysms: computational analysis of pulsatile flow.

    PubMed

    Finol, Ender A; Amon, Cristina H

    2003-01-01

    Blood flow in human arteries is dominated by time-dependent transport phenomena. In particular, in the abdominal segment of the aorta under a patient's average resting conditions, blood exhibits laminar flow patterns that are influenced by secondary flows induced by adjacent branches and in irregular vessel geometries. The flow dynamics becomes more complex when there is a pathological condition that causes changes in the normal structural composition of the vessel wall, for example, in the presence of an aneurysm. An aneurysm is an irreversible dilation of a blood vessel accompanied by weakening of the vessel wall. This work examines the importance of hemodynamics in the characterization of pulsatile blood flow patterns in individual Abdominal Aortic Aneurysm (AAA) models. These patient-specific computational models have been developed for the numerical simulation of the momentum transport equations utilizing the Finite Element Method (FEM) for the spatial and temporal discretization. We characterize pulsatile flow dynamics in AAAs for average resting conditions by means of identifying regions of disturbed flow and quantifying the disturbance by evaluating wall pressure and wall shear stresses at the aneurysm wall. PMID:14515766

  8. Case report: Open replacement of incomplete semi-circular traumatic ruptures of the ascending and descending aorta.

    PubMed

    Mytsyk, Miroslawa; Grapow, Martin T R; Shahinian, Jasmin; Maurer, Markus; Gurke, Lorenz; Eckstein, Friedrich S

    2016-01-01

    An incomplete traumatic rupture of the ascending aorta is a rare but life-threatening condition. Hence, the assessment of the extent of the injury prior to therapy is crucial. We report a case of a 50-year-old male with traumatic aortic rupture who underwent emergency surgery after the evaluation of computed tomography scan (CT-scan). The surgical treatment involved replacement of the ascending aorta and stent implantation in descending aorta due to its covered rupture. PMID:27422556

  9. Sand mining and morphometric dynamics along Ologe Lagoon

    NASA Astrophysics Data System (ADS)

    Thaddeus, D.; Odunuga, S.

    2015-04-01

    The study focuses on the sand mining activities and morphometric dynamics of Ologe Lagoon, in Lagos, Nigeria. It determines the sand mining activities and morphometric dynamics of Ologe Lagoon catchment area, the quantity of sand mined per unit time, and the extent of environmental degradation due to the continuous sand mining activities. Topographic maps of the 1985 and 2013 Ikonos satellite imagery were used to identify the morphometric dynamics of the area. Two hypotheses were generated to determine if there are significant differences between the means of the sampled population that lost properties due to flooding, and to determine if there was a correlation between building subsidence and loss of property; it was tested using Analysis of Variance (ANOVA) with a correlation coefficient at 0.05 α significance level. The results of geometric measurement of the Ologe Lagoon between the two years interval show that perimeter width and circularity of the basin had reduced and shrunk, while the form factor remains the same at 0.15 km2. The basin elongation increased significantly by 0.01 km2, thus, increasing the rate at which water will be supplied to the lagoon. The ration of the form factor of 0.69/0.5 is close to the unity value R1, which shows a higher peak runoff; the values of the circularity ratio of 3.94/3.13 indicates circularity. This shows that the basin is circular time. The impact of the geometry indicates the development of mud flats and sandy bars, particularly at the lower portion of the lagoon; there is also modification of sediment deposition. The anthropogenic activity of sand mining causes destruction of the riparian forest around the lagoon. There is no significant difference in the means of sampled respondents regarding loss properties due to flooding, while there is a correlation between building subsidence and loss of life. It is recommended that a road map should be developed and implemented by the relevant agency of the government to guide

  10. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  11. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture. PMID:24298780

  12. Isolate abdominal bronchogenic cyst: a case report.

    PubMed

    Cetinkurşun, S; Oztürk, H; Celasun, B; Sakarya, M T; Sürer, I

    1997-04-01

    Isolated abdominal bronchogenic cysts are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of other vital structures. The authors report on a 20-month-old girl who had an abdominal bronchogenic cyst and presented with a history of recurrent urinary tract infections. The evaluation and treatment of this patient is presented as well as a review of the ten previously reported cases. A literature review showed only four cases in the pediatric age group. Excision is recommended to establish diagnosis and alleviate any symptoms. Abdominal bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal masses.

  13. Apolipoprotein E-knockout mice on high-fat diet show autoimmune injury on kidney and aorta

    SciTech Connect

    Wang, Yuehai; Lu, Huixia; Huang, Ziyang; Lin, Huili; Lei, Zhenmin; Tang, Mengxiong; Gao, Fei; Dong, Mei; Li, Rongda; Lin, Ling

    2014-07-18

    Highlights: • Titers of ANA and anti-dsDNA antibodies were similar in ApoE{sup −/−} and Fas{sup −/−} mice. • The spleen weights and glomerular areas were similar in ApoE{sup −/−} and Fas{sup −/−} mice. • Expressions of IgG and C3 in glomeruli were similar in ApoE{sup −/−} and Fas{sup −/−} mice. • IgG, C3 and macrophage infiltration in aortic plaques were found in ApoE{sup −/−} mice. - Abstract: Background: Apolipoprotein E-knockout (ApoE{sup −/−}) mice is a classic model of atherosclerosis. We have found that ApoE{sup −/−} mice showed splenomegaly, higher titers of serum anti-nuclear antibody (ANA) and anti-dsDNA antibody compared with C57B6/L (B6) mice. However, whether ApoE{sup −/−} mice show autoimmune injury remains unclear. Methods and results: Six females and six males in each group, ApoE{sup −/−}, Fas{sup −/−} and B6 mice, were used in this study. The titers of serum ANA, anti-dsDNA antibody and creatinine and urine protein were measured by ELISA after 4 months of high-fat diet. The spleen weight and the glomerular area were determined. The expressions of IgG, C3 and macrophage in kidney and atherosclerotic plaque were detected by immunostaining followed by morphometric analysis. Similar to the characteristics of Fas{sup −/−} mice, a model of systemic lupus erythematosus (SLE), ApoE{sup −/−} mice, especially female, displayed significant increases of spleen weight and glomerular area when compared to B6 mice. Also, elevated titers of serum ANA, anti-dsDNA antibody and creatinine and urine protein. Moreover, the expressions of IgG, C3 and macrophage in glomeruli and aortic plaques were found in ApoE{sup −/−} mice. In addition, the IgG and C3 expressions in glomeruli and plaques significantly increased (or a trend of increase) in female ApoE{sup −/−} mice compared with males. Conclusions: Apolipoprotein E-knockout mice on high-fat diet show autoimmune injury on kidney and aorta.

  14. Platelet accumulation and turnover on de-endothelialized aortae in rats.

    PubMed Central

    Winocour, P. D.; Kinlough-Rathbone, R. L.; Richardson, M.; Mustard, J. F.

    1989-01-01

    Previous studies indicate that the subendothelium of rabbit aortae de-endothelialized with a balloon catheter rapidly becomes covered with a monolayer of platelets; after 60 min few additional platelets accumulate and although most platelets are lost from the injured surface by 4 days, there is a substantial delay before re-endothelialization. We examined the dynamics of platelet accumulation on rat aortae de-endothelialized with a balloon catheter to determine if the response to this type of injury is similar to rabbit aortae. When 51Cr-platelets were injected prior to aortic de-endothelialization, 25,500 +/- 2,750 platelets/mm2 accumulated on rat subendothelium in the first 15 min. After 60 and 92 h, fewer platelets remained on the surface (13,740 +/- 2,400 and 5,020 +/- 1,330 platelets/mm2, respectively). When 51Cr-platelets were injected into rats 30 min after injury, platelet accumulation in a 30-min period was 8,610 +/- 1,230 platelets/mm2. By 4 days rat aortae did not accumulate newly injected platelets significantly in a 30-min period, but in a 24-h period 20,600 +/- 3,490 platelets/mm2 accumulated. Morphologically, the non-endothelialized areas of rat aortae were almost completely covered with platelets 4 days after injury. Fourteen days after injury, rat aortae did not accumulate newly injected platelets and, morphologically, no platelets were present on the surface which was almost re-endothelialized. Thus, in rats, as with rabbits, platelets rapidly accumulate on de-endothelialized aortae and the ability to attract newly introduced platelets is considerably reduced shortly after injury. In contrast to rabbits, however, de-endothelialized aortae in rats remain attractive to new platelets up to 4 days following injury, but less so than at the time of injury. Also, in contrast to rabbits, 14 days after injury to rat aortae the surface is almost completely re-endothelialized. Thus, there are species differences in platelet interactions with de

  15. Regional flood susceptibility analysis in mountainous areas through the use of morphometric and land cover indicators

    NASA Astrophysics Data System (ADS)

    Rogelis, M. C.; Werner, M.

    2013-12-01

    A classification of susceptibility to flooding of 106 mountain watersheds was carried out in Bogotá (Colombia) through the use of an index composed of a morphometric indicator and a land cover indicator. Susceptibility was considered to increase with flashiness and the possibility of debris flows. Morphological variables recognised in literature to significantly influence flashiness and occurrence of debris flows were used to construct the morphometric indicator by applying principal component analysis. Subsequently, this indicator was compared with the results of debris flow propagation to assess its capacity in indentifying the morphological conditions of a watershed that make it able to transport debris flows. Propagation of debris flows was carried out using the Modified Single Flow Direction algorithm, following identification of source areas by applying thresholds identified in the slope-area curve of the watersheds. Results show that the morphometric variables can be grouped in four categories: size, shape, hypsometry and energy, with energy being the component that best explains the capability of a watershed to transport debris flows. However, the morphometric indicator was found to not sufficiently explain the records of past floods in the study area. Combining the morphometric indicator with land cover indicators improved the agreement, showing that even if morphometric parameters identify a high disposition to the occurrence of debris flow, improving land cover can reduce the susceptibility. On the contrary, if good morphometric conditions are present but deterioration of the land cover in the watershed takes place then the susceptibility to debris flow events increases.

  16. Effects of freezing on white perch Morone americana (Gmelin, 1789): Implications for multivariate morphometrics

    USGS Publications Warehouse

    Kocovsky, Patrick

    2015-01-01

    This study tested the hypothesis that duration of freezing differentially affects whole-body morphometrics of a derived teleost. Whole-body morphometrics are frequently analyzed to test hypotheses of different species, or stocks within a species, of fishes. Specimens used for morphometric analyses are typically fixed or preserved prior to analysis, yet little research has been done on how fixation or preservation methods or duration of preservation of specimens might affect outcomes of multivariate statistical analyses of differences in shape. To determine whether whole-body morphometrics changed as a result of freezing, 23 whole-body morphometrics of age-1 white perch (Morone americana) from western Lake Erie (n = 211) were analyzed immediately after capture, after being held on ice overnight, and after freezing for 100 or 200 days. Discriminant function analysis revealed that all four groups differed significantly from one another (P < 0.0001). The first canonical axis reflected long-axis morphometrics, where there was a clear pattern of positive translation along this axis with duration of preservation. Re-classification analysis demonstrated fish were typically assigned to their original preservation class except for fish frozen 100 days, which assigned mostly to frozen 200 days. Morphometric comparisons using frozen fish must be done on fish frozen for identical periods of time to avoid biases related to the length of time they were frozen. Similar experiments should be conducted on other species and also using formalin- and alcohol-preserved specimens.

  17. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  18. Polydimethylsiloxane embedded mouse aorta ex vivo perfusion model: proof-of-concept study focusing on atherosclerosis.

    PubMed

    Wang, Xueya; Wolf, Marc P; Keel, Rahel Bänziger; Lehner, Roman; Hunziker, Patrick R

    2012-07-01

    Existing mouse artery ex vivo perfusion models have utilized arteries such as carotid, uterine, and mesenteric arteries, but not the aorta. However, the aorta is the principal vessel analyzed for atherosclerosis studies in vivo. We have devised a mouse aorta ex vivo perfusion model that can bridge this gap. Aortas from apoE((-/-)) mice are embedded in a transparent, gas-permeable, and elastic polymer matrix [polydimethylsiloxane (PDMS)] and artificially perfused with cell culture medium under cell culture conditions. After 24 h of artificial ex vivo perfusion, no evidence of cellular apoptosis is detected. Utilizing a standard confocal microscope, it is possible to image specific receptor targeting of cells in atherosclerotic plaques during 24 h. Imaging motion artifacts are minimal due to the polymer matrix embedding. Re-embedding of the aorta enables tissue sectioning and immuno-histochemical analysis. The ex vivo data are validated by comparison with in vivo experiments. This model can save animal lives via production of multiple endpoints in a single experiment, is easy to apply, and enables straightforward comparability with pre-existing atherosclerosis in vivo data. It is suited to investigate atherosclerotic disease in particular and vascular biology in general.

  19. Effects of canrenone on aorta and right ventricle of the rat.

    PubMed

    Cargnelli, G; Trevisi, L; Debetto, P; Luciani, S; Bova, S

    2001-05-01

    Canrenone is a major active metabolite of spironolactone and, in addition to the antimineralocorticoid effect, shares with the parent compound the action as a partial agonist with respect to ouabain on the Na+-K+ ATPase. We have investigated whether canrenone, through its action on Na+-K+ ATPase, reverses rat aorta contractions induced by ouabain and has vasorelaxant properties unrelated to its interaction with ouabain. Contractile responses of endothelium-deprived aorta to 1 mM ouabain, 0.1 microM phenylephrine, 10 microM serotonin, and 60 mM K+ were relaxed by canrenone (50-250 microM), with maximum inhibitions of 85.3%, 55.3%, 56.7%, and 64.2%, respectively. Canrenone shifted to the right the concentration-response curve for Ca2+ in depolarized aorta and did not affect the response to 10 mM caffeine. In rat right ventricular strips driven at 0.1 Hz, canrenone exerted negative inotropic effect. The relaxation of ouabain-induced contraction may be due, at least in part, to an interaction between canrenone and ouabain on the Na+-K+ ATPase. Inhibition of calcium entry through calcium channels either in aorta or ventricles is the most parsimonious hypothesis of mechanism underlying the effect of canrenone on contractile responses of rat aorta to agonists and high K+ and the negative inotropic effect on ventricular strips. PMID:11336105

  20. Composition of proteoglycans in the aortas of copper-deficient rats

    SciTech Connect

    Radhakrishnamurthy, B.; Ruiz, H.; Dalferes, E.R. Jr.; Klevay, L.M. ); Berenson, G. )

    1989-01-01

    Copper deficiency adversely affects the extracellular matrix of the arterial wall, leading to cardiovascular lesions. To study the lesions resulting from copper deficiency, the composition of proteoglycans from aortas of copper-deficient rats was compared with proteoglycans of aortas from copper-supplemented rats. Copper deficiency in rats was verified by copper levels in adrenal glands (mean {plus minus} SE, 0.37 {plus minus} 0.07 vs 1.03 {plus minus} 0.17 {mu}g/g wet wt in supplemented rats). Total uronate in the aortas from copper-deficient rats was 25% greater than in aortas from copper-supplemented rats, and the proteoglycans from copper-deficient rat aortas were of greater molecular size. Among the glycosaminoglycans the concentration ({mu}g/mg tissue) of isomeric chondroitin sulfates, particularly dermatan sulfate, was greater in copper-deficient animals than in copper-supplemented animals. These observations are similar to earlier findings in experimental atherosclerosis and to a response of cardiovascular connective tissue to injury.

  1. Polydimethylsiloxane embedded mouse aorta ex vivo perfusion model: proof-of-concept study focusing on atherosclerosis

    NASA Astrophysics Data System (ADS)

    Wang, Xueya; Wolf, Marc P.; Keel, Rahel Bänziger; Lehner, Roman; Hunziker, Patrick R.

    2012-07-01

    Existing mouse artery ex vivo perfusion models have utilized arteries such as carotid, uterine, and mesenteric arteries, but not the aorta. However, the aorta is the principal vessel analyzed for atherosclerosis studies in vivo. We have devised a mouse aorta ex vivo perfusion model that can bridge this gap. Aortas from apoE(-/-) mice are embedded in a transparent, gas-permeable, and elastic polymer matrix [polydimethylsiloxane (PDMS)] and artificially perfused with cell culture medium under cell culture conditions. After 24 h of artificial ex vivo perfusion, no evidence of cellular apoptosis is detected. Utilizing a standard confocal microscope, it is possible to image specific receptor targeting of cells in atherosclerotic plaques during 24 h. Imaging motion artifacts are minimal due to the polymer matrix embedding. Re-embedding of the aorta enables tissue sectioning and immuno-histochemical analysis. The ex vivo data are validated by comparison with in vivo experiments. This model can save animal lives via production of multiple endpoints in a single experiment, is easy to apply, and enables straightforward comparability with pre-existing atherosclerosis in vivo data. It is suited to investigate atherosclerotic disease in particular and vascular biology in general.

  2. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  3. Automation of Morphometric Measurements for Planetary Surface Analysis and Cartography

    NASA Astrophysics Data System (ADS)

    Kokhanov, A. A.; Bystrov, A. Y.; Kreslavsky, M. A.; Matveev, E. V.; Karachevtseva, I. P.

    2016-06-01

    For automation of measurements of morphometric parameters of surface relief various tools were developed and integrated into GIS. We have created a tool, which calculates statistical characteristics of the surface: interquartile range of heights, and slopes, as well as second derivatives of height fields as measures of topographic roughness. Other tools were created for morphological studies of craters. One of them allows automatic placing of topographic profiles through the geometric center of a crater. Another tool was developed for calculation of small crater depths and shape estimation, using C++ programming language. Additionally, we have prepared tool for calculating volumes of relief features from DTM rasters. The created software modules and models will be available in a new developed web-GIS system, operating in distributed cloud environment.

  4. Morphometric analysis of a fresh simple crater on the Moon.

    NASA Astrophysics Data System (ADS)

    Vivaldi, V.; Ninfo, A.; Massironi, M.; Martellato, E.; Cremonese, G.

    In this research we are proposing an innovative method to determine and quantify the morphology of a simple fresh impact crater. Linné is a well preserved impact crater of 2.2 km in diameter, located at 27.7oN 11.8oE, near the western edge of Mare Serenitatis on the Moon. The crater was photographed by the Lunar Orbiter and the Apollo space missions. Its particular morphology may place Linné as the most striking example of small fresh simple crater. Morphometric analysis, conducted on recent high resolution DTM from LROC (NASA), quantitatively confirmed the pristine morphology of the crater, revealing a clear inner layering which highlight a sequence of lava emplacement events.

  5. Geometric morphometric analysis of mandibular shape diversity in Pan.

    PubMed

    Robinson, Chris

    2012-07-01

    The aim of this research is to determine whether geometric morphometric (GM) techniques can provide insights into how the shape of the mandibular corpus differs between bonobos and chimpanzees and to explore the potential implications of those results for our understanding of hominin evolution. We focused on this region of the mandible because of the relative frequency with which it has been recovered in the hominin fossil record. In addition, no previous study had explored in-depth three-dimensional (3D) mandibular corpus shape differences between adults of the two Pan species using geometric morphometrics. GM methods enable researchers to quantitatively analyze and visualize 3D shape changes in skeletal elements and provide an important compliment to traditional two-dimensional analyses. Eighteen mandibular landmarks were collected using a Microscribe 3DX portable digitizer. Specimen configurations were superimposed using Generalized Procrustes analysis and the projections of the fitted coordinates to tangent space were analyzed using multivariate statistics. The size-adjusted corpus shapes of Pan paniscus and Pan troglodytes could be assigned to species with approximately 93% accuracy and the Procrustes distance between the two species was significant. Analyses of the residuals from a multivariate linear regression of the data on centroid size suggested that much of the shape difference between the species is size-related. Chimpanzee subspecies and a small sample of Australopithecus specimens could be correctly identified to taxon, at best, only 75% of the time, although the Procrustes distances between these taxa were significant. The shape of the mandibular symphysis was identified as especially useful in differentiating Pan species from one another. This suggests that this region of the mandible has the potential to be informative for taxonomic analyses of fossil hominoids, including hominins. The results also have implications for phylogenetic hypotheses of

  6. The Application of Morphometric Indices for Neotectonic Study of Iran

    NASA Astrophysics Data System (ADS)

    Zamani, Ahmad; Hadavi, Fatemeh

    2010-05-01

    The application of morphometric indices for neotectonic studies in large scale, is leading to obtain of accurate results. Indices that used in this study were such as: asymmetry factor, stream-gradient index, drainage density, elongation ratio, and relief ratio. In this research, the whole of Iran was studied that from geographical position side it is placed in northern latitude of 25 up to 39 degree and eastern longitude of 44 up to 63 degree. This study was unique from the point of aim and work scale in Iran, and review of literature showed that most of applied indices in this research have been used only in Hydrogeology course in the world. This study at first, started with digitizing the topographic maps and creates DEM in the scale of 1/250000 and the limit's definition for 660 subsidiary drainage basin and the selection of 900 stream from diverse kinds of orders. Indices, calculated in the base of DEM with regarding to special definition of them. All of these stages have done with using of some software such as: Arc View GIS, Arc Map and Maple. With the aim of analyzing crude data; mentioned indices were implied for preparing contour maps. Investigating of findings and their correlation with the trend of tectonic liniments, revealed that morphometric indices in neotectonic studies of region (with the aim of detection of relative intensity of tectonic processes and comparison of tectonically potential in large scale) had some advantages like applicability and high pace. There was Relative correlation between linear trends of anomaly with trends of tectonic liniments, and also correlation maps and charts with the natural geographic map in the whole scale of country. These observations showed the influence of fault's operation on formation of morphologic landscapes. Therefore it's clear; negative and positive anomalies that obtained for each index, distinguished relative intensity of tectonic activity in the different regions of Iran.

  7. Quantitative morphometric analysis for the tectonic characterisation of northern Tunisia.

    NASA Astrophysics Data System (ADS)

    Camafort, Miquel; Pérez-Peña, José Vicente; Booth-Rea, Guillermo; Ranero, César R.; Gràcia, Eulàlia; Azañón, José Miguel; Melki, Fetheddine; Ouadday, Mohamed

    2016-04-01

    Northern Tunisia is characterized by low deformation rates and low to moderate seismicity. Although instrumental seismicity reaches maximum magnitudes of Mw 5.5, some historical earthquakes have occurred with catastrophic consequences in this region. Aiming to improve our knowledge of active tectonics in Tunisia, we carried out both a quantitative morphometric analysis and field study in the north-western region. We applied different morphometric tools, like river profiles, knickpoint analysis, hypsometric curves and integrals and drainage pattern anomalies in order to differentiate between zones with high or low recent tectonic activity. This analysis helps identifying uplift and subsidence zones, which we relate to fault activity. Several active faults in a sparse distribution were identified. A selected sector was studied with a field campaign to test the results obtained with the quantitative analysis. During the fieldwork we identified geological evidence of recent activity and a considerable seismogenic potential along El Alia-Teboursouk (ETF) and Dkhila (DF) faults. The ETF fault could be responsible of one of the most devastating historical earthquakes in northern Tunisia that destroyed Utique in 412 A.D. Geological evidence include fluvial terraces folded by faults, striated and cracked pebbles, clastic dikes, sand volcanoes, coseismic cracks, etc. Although not reflected in the instrumental seismicity, our results support an important seismic hazard, evidenced by the several active tectonic structures identified and the two seismogenic faults described. After obtaining the current active tectonic framework of Tunisia we discuss our results within the western Mediterranean trying to contribute to the understanding of the western Mediterranean tectonic context. With our results, we suggest that the main reason explaining the sparse and scarce seismicity of the area in contrast with the adjacent parts of the Nubia-Eurasia boundary is due to its extended

  8. Genetics Home Reference: abdominal wall defect

    MedlinePlus

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

  9. Understanding noninguinal abdominal hernias in the athlete.

    PubMed

    Cabry, Robert J; Thorell, Erik; Heck, Keith; Hong, Eugene; Berkson, David

    2014-01-01

    Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play. PMID:24614421

  10. Magnetic Surgical Instruments for Robotic Abdominal Surgery.

    PubMed

    Leong, Florence; Garbin, Nicolo; Natali, Christian Di; Mohammadi, Alireza; Thiruchelvam, Dhan; Oetomo, Denny; Valdastri, Pietro

    2016-01-01

    This review looks at the implementation of magnetic-based approaches in surgical instruments for abdominal surgeries. As abdominal surgical techniques advance toward minimizing surgical trauma, surgical instruments are enhanced to support such an objective through the exploration of magnetic-based systems. With this design approach, surgical devices are given the capabilities to be fully inserted intraabdominally to achieve access to all abdominal quadrants, without the conventional rigid link connection with the external unit. The variety of intraabdominal surgical devices are anchored, guided, and actuated by external units, with power and torque transmitted across the abdominal wall through magnetic linkage. This addresses many constraints encountered by conventional laparoscopic tools, such as loss of triangulation, fulcrum effect, and loss/lack of dexterity for surgical tasks. Design requirements of clinical considerations to aid the successful development of magnetic surgical instruments, are also discussed.

  11. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    PubMed

    Stagnitti, Franco

    2009-01-01

    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  12. Late iliac artery aneurysms and occlusive disease after aortic tube grafts for abdominal aortic aneurysm repair. A 35-year experience.

    PubMed Central

    Calcagno, D; Hallett, J W; Ballard, D J; Naessens, J M; Cherry, K J; Gloviczki, P; Pairolero, P C

    1991-01-01

    Controversy continues over whether patients treated with straight Dacron aortic tube grafts for an abdominal aortic aneurysm remain at significant risk for subsequent development of iliac aneurysm or occlusive disease. To address this issue, the authors performed a population-based analysis of 432 patients who had an abdominal aortic aneurysm diagnosed between 1951 and 1984. Aneurysm repair was performed eventually in 206 patients (48%). To ascertain differences in late development of graft-related complications, iliac aneurysms, and arterial occlusions, the authors compared all tube-graft patients with similar numbers of bifurcated-graft patients matched for age and year of operation. In the tube-graft group, no subsequent clinically evident or autopsy-proven iliac aneurysms or iliac occlusive disease were noted. Over a mean follow-up of 6 years (range, 4 to 18 years), new aortic aneurysms occurred in the proximal aorta in both tube and bifurcated-graft patients (5.0% and 2.5%, respectively). In contrast the cumulative incidence of graft-related complications was higher with a bifurcated prosthesis (12.8%) compared with a straight graft (5.0%) (p = 0.15). These problems generally occurred 5 to 15 years postoperatively and emphasize the need for long-term graft surveillance. The authors conclude that straight tube-grafts for repair of abdominal aortic aneurysms provide excellent late patency with minimal risk of subsequent iliac aneurysm development. PMID:1835832

  13. Management of abdominal contusion in polytraumatized children.

    PubMed

    Canarelli, J P; Boboyono, J M; Ricard, J; Doidy, L; Collet, L M; Postel, J P

    1991-01-01

    Management of abdominal contusion in polytraumatized children is based on the conservative treatment of spleen and liver lesions when it is possible. Ultrasonography and CTScan can give a good evaluation of splenic, liver, pancreas or kidney lesions. In some cases, if the haemodynamic conditions are good, a non-operative treatment may be proposed. We report our experience of conservative management of intra abdominal lesions in children, about 91 cases in ten years. PMID:1869385

  14. Abdominal Aortic Aneurysmectomy in Renal Transplant Patients

    PubMed Central

    Jebara, Victor A.; Fabiani, Jean-Noël; Moulonguet-Deloris, L.; Acar, Christophe; Debauchez, Mathieu; Chachques, J.C.; Glotz, Denis; Duboust, Alain; Langanay, Thierry; Carpentier, Alain

    1990-01-01

    Because renal transplantation is allowing an increased number of patients to survive for prolonged periods, abdominal aortic aneurysms can be expected to occur with growing frequency in these patients. Surgical management of such cases involves the provision of allograft protection. To date, the literature contains 15 reports of abdominal aortic aneurysms in renal allograft recipients. We describe a 16th case and discuss the management of these patients. (Texas Heart Institute Journal 1990;17:240-4) Images PMID:15227179

  15. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death. PMID:27695177

  16. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as

  17. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  18. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death.

  19. [Late primary abdominal pregnancy. Case report].

    PubMed

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  20. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  1. Thoracic endovascular aortic repair of a severely angulated aorta using a double-wire technique

    PubMed Central

    Kawatani, Yohei; Nakamura, Yoshitsugu; Hayashi, Yujiro; Taneichi, Tetsuyoshi; Ito, Yujiro; Kurobe, Hirotsugu; Suda, Yuji; Hori, Takaki

    2016-01-01

    When endovascular treatment is performed, angulation of the access route for a device can make the operative procedure difficult. We encountered a case in which we successfully completed thoracic endovascular aortic repair (TEVAR) in a patient with severely angulated aorta by applying ‘double-wire technique’. The patient was an 80-year-old woman. An aneurysm with a 71-mm diameter was observed in the descending aorta. We performed TEVAR. Device delivery could not be achieved by a conventional procedure using one guide wire since the peripheral aorta was severely angulated. Therefore, in addition to a guide wire for main body, a stiff wire and a stiff sheath were introduced to straighten the angulation. The device was successfully introduced and TEVAR was completed. We used the Relay Plus® that facilitates tracking through the angulation. The device has a dual structure consisting of a hard sheath and a flexible sheath. We performed TEVAR successfully. PMID:27421301

  2. Geodesic Distance Algorithm for Extracting the Ascending Aorta from 3D CT Images.

    PubMed

    Jang, Yeonggul; Jung, Ho Yub; Hong, Youngtaek; Cho, Iksung; Shim, Hackjoon; Chang, Hyuk-Jae

    2016-01-01

    This paper presents a method for the automatic 3D segmentation of the ascending aorta from coronary computed tomography angiography (CCTA). The segmentation is performed in three steps. First, the initial seed points are selected by minimizing a newly proposed energy function across the Hough circles. Second, the ascending aorta is segmented by geodesic distance transformation. Third, the seed points are effectively transferred through the next axial slice by a novel transfer function. Experiments are performed using a database composed of 10 patients' CCTA images. For the experiment, the ground truths are annotated manually on the axial image slices by a medical expert. A comparative evaluation with state-of-the-art commercial aorta segmentation algorithms shows that our approach is computationally more efficient and accurate under the DSC (Dice Similarity Coefficient) measurements. PMID:26904151

  3. Alteration of time-resolved autofluorescence properties of rat aorta, induced by diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Uherek, M.; Uličná, O.; Vančová, O.; Muchová, J.; Ďuračková, Z.; Šikurová, L.; Chorvát, D.

    2016-10-01

    Changes in autofluorescence properties of isolated rat aorta, induced by diabetes mellitus, were detected using time-resolved fluorescence spectroscopy with pulsed ultraviolet (UV) laser excitation. We demonstrated that time-resolved spectroscopy was able to detect changes in aorta tissues related to diabetes and unambiguously discriminate diabetic (τ 1 0.63  ±  0.05 ns, τ 2 3.66  ±  0.10 ns) samples from the control (τ 1 0.76  ±  0.03 ns, τ 2 4.48  ±  0.15 ns) group. We also report changes in the ratio of relative amplitudes of the two lifetime component in aorta tissue during diabetes, most likely related to the pseudohypoxic state with altered NADH homeostasis.

  4. Prenatal diagnosis of left ventricular diverticulum and coarctation of the aorta.

    PubMed

    Hunter, L E; Pushparajah, K; Miller, O; Anderson, D; Simpson, J M

    2016-02-01

    Congenital left ventricular diverticulum (LVD) is a rare abnormality of the myocardium which has been detected previously in the fetus. Lesions have been reported from as early as 12 weeks' gestation but are more commonly detected in the mid-second trimester. Fetal presentation of LVD ranges from an abnormal four-chamber view of the heart, arrhythmia or isolated pericardial effusion to fetal hydrops with associated heart failure. Here, we describe the prenatal diagnosis of an infant with LVD originating from the left ventricular outflow tract associated with coarctation of the aorta. The diagnosis was confirmed postnatally by two-dimensional echocardiography and cardiac magnetic resonance imaging. We hypothesize that the lesion compromised antegrade flow into the transverse aortic arch, which may have contributed to underdevelopment of the aortic arch and subsequently the development of coarctation of the aorta. This is a unique case of LVD and coarctation of the aorta. PMID:26376444

  5. Endovascular stent for coarctation of the aorta in a child and review of the literature.

    PubMed

    Cheng, Hsu-Ting; Lin, Ming-Chih; Jan, Sheng-Ling; Fu, Yun-Ching

    2011-08-01

    An 11-year-old, 35-kg boy underwent balloon angioplasty twice, at the ages of 4 years and 10 years, with only limited effect. He was admitted for another cardiac catheterization because of chest pain and breathlessness on exercise. Aortography revealed severe discrete coarctation of the aorta, with the narrowest diameter of 6mm. The pressures of the ascending aorta and descending aorta were 115/72mmHg and 93/66mmHg, respectively. After implantation of a 16-mm-diameter stent, the systolic pressure gradient decreased from 22mmHg to 0mmHg. Annual follow-up for 6 years showed normal blood pressure, no exercise intolerance, and no recoarctation.

  6. Rupture of the thoracic aorta associated with experimental Angiostrongylus vasorum infection in a dog.

    PubMed

    Mozzer, L R; Lima, W S

    2012-05-01

    This note describes the sudden death of a dog by the rupture of the thoracic aorta caused by the presence of Angiostrongylus vasorum. A female mongrel canine with a history of weight loss and exhaustion died two hours after clinical examination. At necropsy, performed one hour after death, showed the presence of clotted blood in the thoracic cavity. Haemothorax was diagnosed. The thoracic aorta wall was thin, congested and an abnormal hole in the wall was detected approximately 0.5 cm from the entrance to the diaphragm. From clotted blood collected from the thoracic cavity, 224 first stage larvae (L1) and 15 adults of Angiostrongylus vasorum were recovered alive. Also, from a blood clot found in the aorta, four adult females and 47 L1 larvae were recovered alive. Possibly, this parasite was responsible for the aortic rupture and death of the animal.

  7. [Surgical Repair of Coarctation of the Aorta in an Adult;Report of a Case].

    PubMed

    Hara, Masanori; Kawasaki, Muneyasu; Tokuhiro, Keiichi; Niitsu, Katsushi; Katayanagi, Tomoyuki; Watanabe, Yoshinori

    2015-06-01

    We present a case of 30-year-old man with successful bypass grafting for coarctation of the aorta. Hypertension was identified during a health examination. Blood pressure difference between the upper and lower limbs was about 60 mmHg. Computed tomography( CT) revealed stenosis of the distal aortic arch and development of collateral arteries. The pressure gradient across the coarctation by catheterization was 56 mmHg. After left thoracotomy through the 4th intercostal space, a bypass graft using a 14-mm woven Dacron graft was placed between the left subclavian artery and descending aorta without the use of extracorporeal circulation. Postoperative course was satisfactory, with minimal pressure difference between the upper and lower extremities. The patient was discharged 16 days postoperatively. As of 7 years later, he remains asymptomatic, and CT has revealed no marked changes of the aorta or bypass graft. PMID:26066879

  8. Optical coherence tomography assessment of vessel wall degradation in aneurysmatic thoracic aortas

    NASA Astrophysics Data System (ADS)

    Real, Eusebio; Eguizabal, Alma; Pontón, Alejandro; Val-Bernal, J. Fernando; Mayorga, Marta; Revuelta, José M.; López-Higuera, José; Conde, Olga M.

    2013-06-01

    Optical coherence tomographic images of ascending thoracic human aortas from aneurysms exhibit disorders on the smooth muscle cell structure of the media layer of the aortic vessel as well as elastin degradation. Ex-vivo measurements of human samples provide results that correlate with pathologist diagnosis in aneurysmatic and control aortas. The observed disorders are studied as possible hallmarks for aneurysm diagnosis. To this end, the backscattering profile along the vessel thickness has been evaluated by fitting its decay against two different models, a third order polynomial fitting and an exponential fitting. The discontinuities present on the vessel wall on aneurysmatic aortas are slightly better identified with the exponential approach. Aneurysmatic aortic walls present uneven reflectivity decay when compared with healthy vessels. The fitting error has revealed as the most favorable indicator for aneurysm diagnosis as it provides a measure of how uniform is the decay along the vessel thickness.

  9. Numerical investigation of mass transport through patient-specific deformed aortae.

    PubMed

    Chen, Jie; Gutmark, Ephraim; Mylavarapu, Goutham; Backeljauw, Philippe F; Gutmark-Little, Iris

    2014-01-22

    Blood flow in human arteries has been investigated using computational fluid dynamics tools. This paper considers flow modeling through three aorta models reconstructed from cross-sectional magnetic resonance scans of female patients. One has the normal control configuration, the second has elongation of the transverse aorta, and the third has tortuosity of the aorta with stenosis. The objective of this study is to determine the impact of aortic abnormal geometries on the wall shear stress (WSS), luminal surface low-density lipoproteins (LDLs) concentration, and oxygen flux along the arterial wall. The results show that the curvature of the aortic arch and the stenosis have significant effects on the blood flow, and in turn, the mass transport. The location of hypoxia areas can be predicted well by ignoring the effect of hemoglobin on the oxygen transport. However, this simplification indeed alters the absolute value of Sherwood number on the wall. PMID:24210472

  10. FSI analysis of the blood flow and geometrical characteristics in the thoracic aorta

    NASA Astrophysics Data System (ADS)

    Suito, Hiroshi; Takizawa, Kenji; Huynh, Viet Q. H.; Sze, Daniel; Ueda, Takuya

    2014-10-01

    We present a fluid-structure interaction (FSI) analysis of the blood flow and geometrical characteristics in the thoracic aorta. The FSI is handled with the sequentially-coupled arterial FSI technique. The fluid mechanics equations are solved with the ST-VMS method, which is the variational multiscale version of the deforming-spatial-domain/stabilized space-time (DSD/SST) method. We focus on the relationship between the centerline geometry of the aorta and the flow field, which influences the wall shear stress distribution. The centerlines of the aorta models we use in our analysis are extracted from the CT scans, and we assume a constant diameter. Torsion-free model geometries are generated by projecting the original centerline to its averaged plane of curvature. The flow fields for the original and projected geometries are compared to examine the influence of the torsion.

  11. Ascending aorta of hooded seals with particular emphasis on its vasa vasorum.

    PubMed

    Blix, Arnoldus Schytte; Kuttner, Samuel; Messelt, Edward B

    2016-07-01

    The pressure-volume relationship in the ascending aorta ("windkessel") of the hooded seal was determined and the morphology of its vasa vasorum described in some detail. We found that the ascending aorta has a high compliance and can easily accommodate the entire stroke volume when the peripheral vascular resistance becomes much increased and maintain perfusion pressure during the much extended diastole and thereby reduce cardiac stroke work during diving. We also found that the 3- to 5-mm thick wall of the ascending aorta had a very elaborate vasa vasorum interna with a hitherto undescribed vascular structure that penetrates the entire vascular wall. If similar structures with similar importance for the nutrition of the wall of the vessel are found in humans, important implications for the understanding of pathological conditions, such as aneurisms, may be indicated. PMID:27122367

  12. Fatty streak formation occurs in human fetal aortas and is greatly enhanced by maternal hypercholesterolemia. Intimal accumulation of low density lipoprotein and its oxidation precede monocyte recruitment into early atherosclerotic lesions.

    PubMed Central

    Napoli, C; D'Armiento, F P; Mancini, F P; Postiglione, A; Witztum, J L; Palumbo, G; Palinski, W

    1997-01-01

    To determine whether oxidized LDL enhances atherogenesis by promoting monocyte recruitment into the vascular intima, we investigated whether LDL accumulation and oxidation precede intimal accumulation of monocytes in human fetal aortas (from spontaneous abortions and premature newborns who died within 12 h; fetal age 6.2+/-1.3 mo). For this purpose, a systematic assessment of fatty streak formation was carried out in fetal aortas from normocholesterolemic mothers (n = 22), hypercholesterolemic mothers (n = 33), and mothers who were hypercholesterolemic only during pregnancy (n = 27). Fetal plasma cholesterol levels showed a strong inverse correlation with fetal age (R = -0.88, P < 0.0001). In fetuses younger than 6 mo, fetal plasma cholesterol levels correlated with maternal ones (R = 0.86, P = 0.001), whereas in older fetuses no such correlation existed. Fetal aortas from hypercholesterolemic mothers and mothers with temporary hypercholesterolemia contained significantly more and larger lesions (758,651+/-87,449 and 451,255+/-37,448 micron2 per section, respectively; mean+/-SD) than aortas from normocholesterolemic mothers (61,862+/-9,555 micron2; P < 0.00005). Serial sections of the arch, thoracic, and abdominal aortas were immunostained for recognized markers of atherosclerosis: macrophages, apo B, and two different oxidation-specific epitopes (malondialdehyde- and 4-hydroxynonenal-lysine). Of the atherogenic sites that showed positive immunostaining for at least one of these markers, 58.6% were established lesions containing both macrophage/foam cells and oxidized LDL (OxLDL). 17.3% of all sites contained only native LDL, and 13.3% contained only OxLDL without monocyte/ macrophages. In contrast, only 4.3% of sites contained isolated monocytes in the absence of native or oxidized LDL. In addition, 6.3% of sites contained LDL and macrophages but few oxidation-specific epitopes. These results demonstrate that LDL oxidation and formation of fatty streaks occurs

  13. Genes and Abdominal Aortic Aneurysm

    PubMed Central

    Hinterseher, Irene; Tromp, Gerard; Kuivaniemi, Helena

    2010-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease with a strong genetic component. Since first candidate gene studies were published 20 years ago, nearly 100 genetic association studies using single nucleotide polymorphisms (SNPs) in biologically relevant genes have been reported on AAA. The studies investigated SNPs in genes of the extracellular matrix, the cardiovascular system, the immune system, and signaling pathways. Very few studies were large enough to draw firm conclusions and very few results could be replicated in another sample set. The more recent unbiased approaches are family-based DNA linkage studies and genome-wide genetic association studies, which have the potential of identifying the genetic basis for AAA, if appropriately powered and well-characterized large AAA cohorts are used. SNPs associated with AAA have already been identified in these large multicenter studies. One significant association was of a variant in a gene called CNTN3 which is located on chromosome 3p12.3. Two follow-up studies, however, could not replicate the association. Two other SNPs, which are located on chromosome 9p21 and 9q33 were replicated in other samples. The two genes with the strongest supporting evidence of contribution to the genetic risk for AAA are the CDKN2BAS gene, also known as ANRIL, which encodes an antisense RNA that regulates expression of the cyclin-dependent kinase inhibitors CDKN2A and CDKN2B, and DAB2IP, which encodes an inhibitor of cell growth and survival. Functional studies are now needed to establish the mechanisms by which these genes contribute to AAA pathogenesis. PMID:21146954

  14. New device for saphenous vein-to-aorta proximal anastomosis without side-clamping

    PubMed Central

    Tappainer, Ernesto

    2007-01-01

    Background Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy. Methods We developed a simple object that helps to perform a manual proximal anastomosis without the need to clamp the side of the aorta. This device is a steel bar which blocks the aortic hole and simultaneously it provides a slit to receive the needle. Through the slit comes out a thin, sharp, straight, but also well directed and predictable jet of blood which could be easily controlled during the suture. Results The function of the object is quite different from other devices. Nothing is deployed in the aorta. The object is only placed on the aorta with the small appendage slipped into the hole. The main advantage of the device is that while manipulation of the aorta is avoided no foreign bodies are incorporated in the suture and – most importantly – the aortic intima is not touched at all. The main drawback of the device is the blood jet coming from the slit so that the blood pressure has to be lowered by vasodilators during the anastomosis. Moreover, the suture has to change direction and the needle has to enter the aortic wall first to slip out through the slit. Conclusion The object was named "Slit Device" and is not a routine instrument. It would be only an alternative to other anastomotic devices with the same surgical indications. In the case of ascending aortic disease and saphenous vein grafting, the Slit Device avoids aortic clamping thereby preventing atheroembolism and also avoiding the need for hypothermic circulatory arrest in patients with unclampable aorta. PMID:17480222

  15. Age-related decrease in 15-lipoxygenase contributes to reduced vasorelaxation in rabbit aorta.

    PubMed

    Tang, Xin; Aggarwal, Nitin; Holmes, Blythe B; Kuhn, Hartmut; Campbell, William B

    2008-02-01

    Rabbit 15-lipoxygenase-1 (15-LO-1) oxygenates arachidonic acid (AA) into 15-hydroperoxyeicosatetraenoic acid, which is then converted to the vasodilatory 15-hydroxy-11,12-epoxyeicosatrienoic acid (HEETA) and 11,12,15-trihydroxyeicosatrienoic acid (THETA). We studied the age-dependent expression of the 15-LO-1 in rabbit aorta and its effects on the synthesis of THETA, HEETA, and vasoactivity. Aortas of 1-wk-old rabbits express greater amounts of 15-LO-1 mRNA and protein compared with aortas of 4-, 8-, or 16-wk-old rabbits. The synthesis of THETA and HEETA in the rabbit aorta was also reduced with age. THETA synthesis was maximal in 1-wk-old aortas but decreased in aortas of 4- (42%), 8- (4%), and 16-wk-old (1%) rabbits. Similarly, THETA and HEETA synthesis decreased with age in mesenteric arteries from 1-, 4-, 8-, and 16-wk-old rabbits. The maximum vasorelaxation response to acetylcholine (10(-6) M) in the presence of indomethacin and nitro-l-arginine decreased in the order of 1 wk (64.5 +/- 6.9%), 4 wk (52.6 +/- 8.9%), 8 wk (53.0 +/- 9.4%), and 16 wk (33.3 +/- 6.6%). Similarly, the maximum relaxation to AA (3 x 10(-4) M) decreased with age in the order of 1 wk (60.4 +/- 8.9%), 4 wk (56.3 +/- 5.8%), 8 wk (41.8 +/- 12.3%), and 16 wk (28.9 +/- 1.6%). In contrast, the vasorelaxation to sodium nitroprusside was not significantly altered by age. These data indicate that aortic 15-LO-1 expression and activity are downregulated with aging in rabbits. This decrease is paralleled by the reduced synthesis of vasoactive THETA and HEETA and aortic relaxations to acetylcholine and AA. PMID:18055513

  16. Ovariectomy Increases the Participation of Hyperpolarizing Mechanisms in the Relaxation of Rat Aorta

    PubMed Central

    Sagredo, Ana; del Campo, Lara; Martorell, Aina; Navarro, Rocío; Martín, María C.; Blanco-Rivero, Javier; Ferrer, Mercedes

    2013-01-01

    This study examines the downstream NO release pathway and the contribution of different vasodilator mediators in the acetylcholine-induced response in rat aorta 5-months after the loss of ovarian function. Aortic segments from ovariectomized and control female Sprague-Dawley rats were used to measure: the levels of superoxide anion, the superoxide dismutases (SODs) activity, the cGMP formation, the cGMP-dependent protein kinase (PKG) activity and the involvement of NO, cGMP, hydrogen peroxide and hyperpolarizing mechanisms in the ACh-induced relaxation. The results showed that ovariectomy did not alter ACh-induced relaxation; incubation with L-NAME, a NO synthase inhibitor, decreased the ACh-induced response to a lesser extent in aorta from ovariectomized than from control rats, while ODQ, a guanylate cyclase inhibitor, decreased that response to a similar extent; the blockade of hyperpolarizing mechanisms, by precontracting arteries with KCl, decreased the ACh-induced response to a greater extent in aortas from ovariectomized than those from control rats; catalase, that decomposes hydrogen peroxide, decreased the ACh-induced response only in aorta from ovariectomized rats. In addition, ovariectomy increased superoxide anion levels and SODs activity, decreased cGMP formation and increased PKG activity. Despite the increased superoxide anion and decreased cGMP in aorta from ovariectomized rats, ACh-induced relaxation is maintained by the existence of hyperpolarizing mechanisms in which hydrogen peroxide participates. The greater contribution of hydrogen peroxide in ACh-induced relaxation is due to increased SOD activity, in an attempt to compensate for increased superoxide anion formation. Increased PKG activity could represent a redundant mechanism to ensure vasodilator function in the aorta of ovariectomized rats. PMID:24058477

  17. Thoracic aorta aneurysm open repair in heart transplant recipient; the anesthesiologist's perspective

    PubMed Central

    Monaco, Fabrizio; Oriani, Alessandro; De Luca, Monica; Bignami, Elena; Sala, Alessandra; Chiesa, Roberto; Melissano, Germano; Zangrillo, Alberto

    2016-01-01

    Many years following transplantation, heart transplant recipients may require noncardiac major surgeries. Anesthesia in such patients may be challenging due to physiological and pharmacological problems regarding allograft denervation and difficult immunosuppressive management. Massive hemorrhage, hypoperfusion, renal, respiratory failure, and infections are some of the most frequent complications related to thoracic aorta aneurysm repair. Understanding how to optimize hemodynamic and infectious risks may have a substantial impact on the outcome. This case report aims at discussing risk stratification and anesthetic management of a 54-year-old heart transplant female recipient, affected by Marfan syndrome, undergoing thoracic aorta aneurysm repair. PMID:26750703

  18. [Evaluation of the invasion of esophageal cancer to the aorta by cine-MR imaging].

    PubMed

    Kawahara, I; Nishimura, H; Uchida, M; Ueda, H; Fujimoto, K; Meno, S; Hayabuchi, N; Fujita, H

    1993-01-25

    We examined the usefulness of cine-MR imaging for evaluation of the invasion of esophageal cancer to the aorta in 12 cases. We used the technique of field echo pulse sequence. When the low intensity stripe was recognized between the tumor and the wall of aorta, we interpreted it as negative finding of the direct tumor invasion. By using this criteria, 11 of the 12 cases (92%) of the esophageal cancer for aortic wall invasion were correctly diagnosed as compared with 75% correct diagnosis by conventional MR imaging.

  19. Clampless and Sutureless Hybrid Technique for Aortic Arch Debranching on a Porcelain Aorta.

    PubMed

    Poletto, Giorgio L; Musto, Liam; Civilini, Efrem; Giorgetti, PierLuigi

    2016-06-01

    An innovative hybrid approach to the supraaortic vessels in a porcelain aorta and severe fibrotic tissue reaction at the neck is described. The technique is demonstrated in an 80-year-old woman with previous several carotid operations but still experiencing recurrent transient ischemic attacks. Clinical success was achieved at midterm follow-up, demonstrating the efficacy of hybrid treatment for this high-risk patient. Novel prosthetic vascular grafts that can be applied without cross-clamping may also provide a solution to approaching a porcelain aorta and difficult anatomies. PMID:27211961

  20. Intramural Hematoma of the Thoracic Aorta as a Form of Aortic Dissection

    SciTech Connect

    Juszkat, Robert Pukacki, Fryderyk; Oszkinis, Grzegorz; Zarzecka, Anna; Majewski, Waclaw

    2007-09-15

    Intramural hematoma (IMH) of the thoracic aorta is a complication with unknown etiology and a poorly predictable prognosis. There is also considerable controversy about the management and prognosis of IMH as well as the treatment. We present two cases of endovascular treatment of IMH with stent-graft placement. On the basis of references, we discuss risks of progression of the given pathology and possible complications. Despite the lack of uniform opinion about the management of this disorder, we present our observations of and experiences with endovascular treatment of IMH of the thoracic aorta.

  1. Protective effect of angulated aorta for saving coronary artery during endovascular repair for ascending aortic pseudoaneurysm

    PubMed Central

    Kim, Myeong Gun; Oh, Pyung Chun; Jeon, Yang Bin; Lee, Ji Yeon; Shin, Eak Kyun

    2016-01-01

    Ascending aortic pseudoaneurysm is a rare complication after cardiothoracic surgery and the open surgical repair for this complication is challenging. We report on a patient who developed an ascending aortic pseudoaneurysm after aortic valve replacement (AVR), which was treated successfully with endovascular therapy. Our case showed that angulation of the ascending aorta is one of factors for consideration in application of endovascular therapy and endovascular therapy might be an option for management of ascending aortic pathology in patients with high surgical risk, particularly patients with a severely angulated proximal ascending aorta.

  2. Repair of coarctation of the aorta in children with Turner syndrome.

    PubMed

    Brandt, B; Heintz, S E; Rose, E F; Ehrenhaft, J L; Clark, E B

    1984-01-01

    Increased risk of perioperative hemorrhage has been described in patients with Turner syndrome and coarctation of the aorta. We have operated on 11 patients with Turner syndrome and coarctation of the aorta, two of whom developed bleeding. One patient died. End-to-end anastomosis was performed in all patients. Histologic studies of resected specimens did not reveal any abnormalities. The risk of bleeding was not related to age at the time of repair or postoperative hypertension. Although no specific abnormality has been identified in these patients, the risk of serious hemorrhage appears increased.

  3. Protective effect of angulated aorta for saving coronary artery during endovascular repair for ascending aortic pseudoaneurysm

    PubMed Central

    Kim, Myeong Gun; Oh, Pyung Chun; Jeon, Yang Bin; Lee, Ji Yeon; Shin, Eak Kyun

    2016-01-01

    Ascending aortic pseudoaneurysm is a rare complication after cardiothoracic surgery and the open surgical repair for this complication is challenging. We report on a patient who developed an ascending aortic pseudoaneurysm after aortic valve replacement (AVR), which was treated successfully with endovascular therapy. Our case showed that angulation of the ascending aorta is one of factors for consideration in application of endovascular therapy and endovascular therapy might be an option for management of ascending aortic pathology in patients with high surgical risk, particularly patients with a severely angulated proximal ascending aorta. PMID:27621896

  4. Pathologic Features of Lone Aortic Mobile Thrombus in the Ascending Aorta.

    PubMed

    Endo, Hidehito; Ishii, Hikaru; Tsuchiya, Hiroshi; Takahashi, Yu; Shimoyamada, Hiroaki; Isomura, Aya; Nakajima, Masanori; Hirano, Teruyuki; Ohkura, Yasuo; Kubota, Hiroshi

    2016-10-01

    This report describes the case of a 79-year-old man with aortic mobile thrombus in the ascending aorta, followed by a discussion of the pathologic basis of aortic mobile thrombus formation. The patient underwent replacement of the ascending aorta. Macroscopic examination revealed an aortic wall ulcer with cholesterol-rich atherosclerotic plaque under the aortic mobile thrombus. Microscopic examination showed plaque rupture. These findings are very similar to those of plaque rupture in the coronary artery. We speculate that plaque rupture of localized aortic atherosclerosis is one of the causes of aortic mobile thrombus. PMID:27645970

  5. Thoracic aorta aneurysm open repair in heart transplant recipient; the anesthesiologist's perspective.

    PubMed

    Monaco, Fabrizio; Oriani, Alessandro; De Luca, Monica; Bignami, Elena; Sala, Alessandra; Chiesa, Roberto; Melissano, Germano; Zangrillo, Alberto

    2016-01-01

    Many years following transplantation, heart transplant recipients may require noncardiac major surgeries. Anesthesia in such patients may be challenging due to physiological and pharmacological problems regarding allograft denervation and difficult immunosuppressive management. Massive hemorrhage, hypoperfusion, renal, respiratory failure, and infections are some of the most frequent complications related to thoracic aorta aneurysm repair. Understanding how to optimize hemodynamic and infectious risks may have a substantial impact on the outcome. This case report aims at discussing risk stratification and anesthetic management of a 54-year-old heart transplant female recipient, affected by Marfan syndrome, undergoing thoracic aorta aneurysm repair.

  6. Redescription of Xiphinema americanum Cobb, 1913 with Comments on Its Morphometric Variations.

    PubMed

    Lamberti, F; Golden, A M

    1984-04-01

    Xiphinema americanum is redescribed and illustrated from material collected from Arlington Cemetery, near Cobb's type locality (Falls Church, Virginia), Morphometric data showing variations within this species are given for three additional populations.

  7. Morphometric and preliminary genetic characteristics of Branchinecta orientalis populations from Iran (Crustacea: Anostraca).

    PubMed

    Atashbar, Behroz; Agh, Naser; Manaffar, Ramin; Stappen, Gilbert Van; Mohamadyari, Ali; Mertens, Johan; Beladjal, Lynda

    2016-01-01

    Branchinecta orientalis is a fairy shrimp endemic to the Palearctic region, from Mongolia to Spain. The patchy nature of its habitat is thought to result in a high degree of subdivision among populations, potentially promoting speciation. We combined morphometric characteristics with molecular phylogeny of cytochrome c oxidase I (COI) to test whether B. orientalis could be a species complex and whether there is any correlation between the genetic variation, morphometric characteristics and geographical variables. We studied six populations from Iran based on the comparison of morphometric and molecular datasets, we confirmed that the Aigher Goli (AIG) population is biometrically well separated from the Akh Gol, Hassar, Rashakan, Khaslou and Garagojanlou populations in northwestern Iran. The relatively high genetic divergence in the AIG from the other populations and its congruence with morphometric data were observed in B. orientalis populations. However, as these results were generated using a small sample size and on a limited sampling range, they should be considered as preliminary. PMID:27394849

  8. Aorta segmentation with a 3D level set approach and quantification of aortic calcifications in non-contrast chest CT.

    PubMed

    Kurugol, Sila; San Jose Estepar, Raul; Ross, James; Washko, George R

    2012-01-01

    Automatic aorta segmentation in thoracic computed tomography (CT) scans is important for aortic calcification quantification and to guide the segmentation of other central vessels. We propose an aorta segmentation algorithm consisting of an initial boundary detection step followed by 3D level set segmentation for refinement. Our algorithm exploits aortic cross-sectional circularity: we first detect aorta boundaries with a circular Hough transform on axial slices to detect ascending and descending aorta regions, and we apply the Hough transform on oblique slices to detect the aortic arch. The centers and radii of circles detected by Hough transform are fitted to smooth cubic spline functions using least-squares fitting. From these center and radius spline functions, we reconstruct an initial aorta surface using the Frenet frame. This reconstructed tubular surface is further refined with 3D level set evolutions. The level set framework we employ optimizes a functional that depends on both edge strength and smoothness terms and evolves the surface to the position of nearby edge location corresponding to the aorta wall. After aorta segmentation, we first detect the aortic calcifications with thresholding applied to the segmented aorta region. We then filter out the false positive regions due to nearby high intensity structures. We tested the algorithm on 45 CT scans and obtained a closest point mean error of 0.52 ± 0.10 mm between the manually and automatically segmented surfaces. The true positive detection rate of calcification algorithm was 0.96 over all CT scans. PMID:23366394

  9. Combined Two-Photon Luminescence Microscopy and OCT for Macrophage Detection in the Hypercholesterolemic Rabbit Aorta Using Plasmonic Gold Nanorose

    PubMed Central

    Wang, Tianyi; Mancuso, J. Jacob; Kazmi, S.M. Shams; Dwelle, Jordan; Sapozhnikova, Veronika; Willsey, Brian; Ma, Li L.; Qiu, Jinze; Li, Xiankai; Dunn, Andrew K.; Johnston, Keith P.; Feldman, Marc D.; Milner, Thomas E.

    2013-01-01

    Background and Objectives The macrophage is an important early cellular marker related to risk of future rupture of atherosclerotic plaques. Two-channel two-photon luminescence (TPL) microscopy combined with optical coherence tomography (OCT) was used to detect, and further characterize the distribution of aorta-based macrophages using plasmonic gold nanorose as an imaging contrast agent. Study Design/Materials and Methods Nanorose uptake by macrophages was identified by TPL microscopy in macrophage cell culture. Ex vivo aorta segments (8 × 8 × 2 mm3) rich in macrophages from a rabbit model of aorta inflammation were imaged by TPL microscopy in combination with OCT. Aorta histological sections (5 µm in thickness) were also imaged by TPL microscopy. Results Merged two-channel TPL images showed the lateral and depth distribution of nanorose-loaded macrophages (confirmed by RAM-11 stain) and other aorta components (e.g., elastin fiber and lipid droplet), suggesting that nanorose-loaded macrophages are diffusively distributed and mostly detected superficially within 20 µm from the luminal surface of the aorta. Moreover, OCT images depicted detailed surface structure of the diseased aorta. Conclusions Results suggest that TPL microscopy combined with OCT can simultaneously reveal macrophage distribution with respect to aorta surface structure, which has the potential to detect vulnerable plaques and monitor plaque-based macrophages overtime during cardiovascular interventions. PMID:22246984

  10. Morphometric Identification of Queens, Workers and Intermediates in In Vitro Reared Honey Bees (Apis mellifera).

    PubMed

    De Souza, Daiana A; Wang, Ying; Kaftanoglu, Osman; De Jong, David; Amdam, Gro V; Gonçalves, Lionel S; Francoy, Tiago M

    2015-01-01

    In vitro rearing is an important and useful tool for honey bee (Apis mellifera L.) studies. However, it often results in intercastes between queens and workers, which are normally are not seen in hive-reared bees, except when larvae older than three days are grafted for queen rearing. Morphological classification (queen versus worker or intercastes) of bees produced by this method can be subjective and generally depends on size differences. Here, we propose an alternative method for caste classification of female honey bees reared in vitro, based on weight at emergence, ovariole number, spermatheca size and size and shape, and features of the head, mandible and basitarsus. Morphological measurements were made with both traditional morphometric and geometric morphometrics techniques. The classifications were performed by principal component analysis, using naturally developed queens and workers as controls. First, the analysis included all the characters. Subsequently, a new analysis was made without the information about ovariole number and spermatheca size. Geometric morphometrics was less dependent on ovariole number and spermatheca information for caste and intercaste identification. This is useful, since acquiring information concerning these reproductive structures requires time-consuming dissection and they are not accessible when abdomens have been removed for molecular assays or in dried specimens. Additionally, geometric morphometrics divided intercastes into more discrete phenotype subsets. We conclude that morphometric geometrics are superior to traditional morphometrics techniques for identification and classification of honey bee castes and intermediates.

  11. Morphometric Identification of Queens, Workers and Intermediates in In Vitro Reared Honey Bees (Apis mellifera)

    PubMed Central

    A. De Souza, Daiana; Wang, Ying; Kaftanoglu, Osman; De Jong, David; V. Amdam, Gro; S. Gonçalves, Lionel; M. Francoy, Tiago

    2015-01-01

    In vitro rearing is an important and useful tool for honey bee (Apis mellifera L.) studies. However, it often results in intercastes between queens and workers, which are normally are not seen in hive-reared bees, except when larvae older than three days are grafted for queen rearing. Morphological classification (queen versus worker or intercastes) of bees produced by this method can be subjective and generally depends on size differences. Here, we propose an alternative method for caste classification of female honey bees reared in vitro, based on weight at emergence, ovariole number, spermatheca size and size and shape, and features of the head, mandible and basitarsus. Morphological measurements were made with both traditional morphometric and geometric morphometrics techniques. The classifications were performed by principal component analysis, using naturally developed queens and workers as controls. First, the analysis included all the characters. Subsequently, a new analysis was made without the information about ovariole number and spermatheca size. Geometric morphometrics was less dependent on ovariole number and spermatheca information for caste and intercaste identification. This is useful, since acquiring information concerning these reproductive structures requires time-consuming dissection and they are not accessible when abdomens have been removed for molecular assays or in dried specimens. Additionally, geometric morphometrics divided intercastes into more discrete phenotype subsets. We conclude that morphometric geometrics are superior to traditional morphometrics techniques for identification and classification of honey bee castes and intermediates. PMID:25894528

  12. Morphometric analysis of sinkholes in a karst coastal area

    NASA Astrophysics Data System (ADS)

    Basso, A.; Bruno, E.; Parise, M.; Pepe, M.

    2012-04-01

    Salento, the southern portion of Apulia region (SE Italy) is a narrow and elongated peninsula in carbonate rocks, with prevailing low coastlines, locally interrupted by high rock cliffs. The long stretches of low coasts are marked by typical karst landforms consisting of collapse sinkholes. These are locally designated with the dialectal term "spunnulate" (deriving from the verb "spunnare", which means to break, to sink; PARISE et al., 2003). As observed in many other karst coastal settings worldwide (FORTH et al., 1999), development of sinkholes may be particularly severe along the coast, where both natural and anthropogenic processes contribute to accelerate the dissolution of carbonate rocks and subsidence processes, influencing the coastline evolution. Following a previous study, where the main features of sinkholes at Torre Castiglione (Taranto province) were investigated and described, and a preliminary susceptibility map produced (BRUNO et al., 2008), in the present paper we perform a detailed morphometric analysis on the sample of identified sinkholes. The main morphometric parameters generally used for sinkhole characterization have been considered in this study: shape of the sinkhole, azimuth and length of major and minimum axes, depth, elongation ratio, distance from the shorelines. Each of them is described, both as individual parameter and in conjunction with the others, in the attempt to identify the main factors controlling development of sinkholes in the area, and their evolution as well. As regards this latter aspect, beside simple morphometry of the sample of sinkholes at Torre Castiglione, we also focused our attention on the likely relationships existing between distribution and shape of the sinkholes and the tectonic discontinuities. The role played by discontinuities in controlling both distribution and evolution of sinkholes has been pointed out by several authors (WHITE & WHITE, 1987; DENIZMAN, 2003; FLOREA, 2005). To investigate the matter

  13. [Effect of patients' preoperative condition on the outcome of the surgical repair of the infrarenal abdominal aortic aneurism].

    PubMed

    Kipiani, K B; Ubilava, P K

    2006-07-01

    During the past decades there is an evidence of the increase in the number of patients with the aneurism of the infrarenal abdominal aorta (IRAAA). As a rule, there is an increased operative risk among these patients due to presence of concomitant diseases. The aim of this study was to investigate effect of patients' preoperative condition on the outcome after the surgical repair of the IRAAA. We studied 78 patients with IRAAA, who underwent elective surgery during 1982-2006. Age ranged from 30 to 84 with the main age of 64. Concomitant diseases were detected in 99% of patients. Postoperative complications occurred in 55% and in 14% there was a lethal outcome. The effect of patients' preoperative condition on the postoperative course was investigated. The role of the thorough preoperational evaluation in an effort to reduce complications in the postoperative course was emphasized. PMID:16905839

  14. Uterine perforation and migration of an intrauterine contraceptive device in a 24-year-old patient seeking care for abdominal pain

    PubMed Central

    Barber, Michelle; Chalifour, Daryl S.; Anderson, Maria R.

    2011-01-01

    Objective The purpose of this case report is to describe the case of a 24-year-old woman complaining of diffuse abdominal pain following insertion of an intrauterine contraceptive device (IUC). Methods A 24-year-old woman, 8 weeks postpartum, sought chiropractic care for intermittent stabbing pain in her left upper quadrant that had been present for a week. She returned 1 week later with no resolution of her complaint. She then recalled that, at her 6-week gynecological examination, she had undergone insertion of an IUC and that the abdominal pain had begun a week later. She was advised to return to her gynecologist. Subsequent evaluation by the gynecologist revealed that the IUC had perforated her uterus and had migrated to the upper left quadrant of her abdomen, where it was found anterior to the L1-2 vertebral bodies, lying in contact with the anterior surface of the abdominal aorta. To our knowledge, this is the only report of this type of presentation in a chiropractic office. Results The initial intervention with this patient included chiropractic adjustment and myofascial release. At her subsequent visit, with no resolution of her complaint, she was referred back to her gynecologist for additional evaluation. Because the IUC had perforated her uterus, she underwent emergency laparoscopic surgery. The surgery was successful, and she recovered fully. Conclusion Chiropractic physicians should consider uterine perforation by IUC in the differential diagnosis of a female patient of childbearing age seeking care for abdominal pain. PMID:22014868

  15. Protective effect of soybeans as protein source in the diet against cadmium-aorta redox and morphological alteration

    SciTech Connect

    Pérez Díaz, Matías F.F.; Acosta, Mariano; Mohamed, Fabián H.; Ferramola, Mariana L.; Oliveros, Liliana B.; Gimenez, María S.

    2013-11-01

    We investigated the effects of cadmium exposition on thoracic aorta redox status and morphology, and the putative protective effect of soybeans in the diet. Male Wistar rats were separated into 6 groups: 3 fed with a diet containing casein and 3 containing soybeans, as protein source. Within each protein group, one was given tap water (control) and the other two tap water containing 15 and 100 ppm of Cd{sup 2+}, respectively, for two months. In rats fed with casein diet, 15 ppm of Cd induced an increase of thiobarbituric acid-reactive substances (TBARS), and of the catalase (CAT) and glutathione peroxidase (GPx) activities, which were even higher with 100 ppm of Cd{sup 2+}, in aorta. Also, 100 ppm Cd{sup 2+} exposure increased superoxide dismutase (CuZnSOD) activity; CAT, GPX, SOD, Nrf2 and metallothioneine II mRNA expressions and CAT, GPx and NOX-2 protein levels, compared with control. Aorta endothelial and cytoplasmic alterations were observed. However, with the soybeans diet, 15 and 100 ppm of Cd{sup 2+} did not modify TBARS levels; CAT, GPX and Nrf2 mRNA expressions; CAT, GPx and NOX-2 protein; and the aorta morphology, compared with control. The soybean diet attenuates the redox changes and protects against morphological alterations induced, in a dose-dependent way, by Cd in aorta. - Highlights: • Under casein diet, 100 ppm Cd{sup 2+} in drinking water induces oxidative stress in aorta. • Under casein diet, 100 ppm Cd{sup 2+} increases Nrf2, MT II and NOX2 expressions in aorta. • Under casein diet, 100 ppm Cd{sup 2+} induces morphological changes in rat aorta. • The soybean diet attenuates the redox changes induced by Cd in rat aorta. • The soybean diet attenuates morphological alterations induced by Cd in rat aorta.

  16. Cell-Activation by Shear Stresses in Abdominal Aortic Aneurysms (AAA)

    NASA Astrophysics Data System (ADS)

    Salsac, Anne-Virginie; Sparks, Steven; Chomaz, Jean-Marc; Lasheras, Juan C.

    2003-11-01

    Increasing experimental evidence indicates that low and oscillatory shear stresses promote proliferative, thrombotic, adhesive and inflammatory-mediated degenerative conditions throughout the wall of the aorta. These degenerative conditions have been shown to be involved in the pathogenesis of AAAs, a permanent, localized dilatation of the abdominal aorta. The purpose of this study is to measure both the magnitude and the duration of the shear stresses acting on both the arterial walls and on the blood cells inside AAAs, and to characterize their changes as the AAA enlarges. We conducted a parametric in-vitro study of the pulsatile blood flow in elastic models of AAAs while systematically varying the blood flow parameters, and the geometry of the aneurysm's bulging. The instantaneous flow characteristic inside the AAA was measured using DPIV at a sampling rate of 15 Hertz. A "cell-activation parameter" defined as the integral of the product of the magnitude of the shear stress and the time during which the stress acts was computed along each of the blood cell pathlines. The Lagrangian tracking of the blood cells shows that a large majority of them are subjected first to very high level of shear-induced "cell-activation" while later on they are entrained in regions of stasis where their residence time can increase up to several cardiac cycles. This cell-activation followed by the entrainment in low shear regions creates the optimal cell-adhesive and inflammatory-mediated degenerative conditions that are postulated to play an important role in the etiology and progressive enlargement of AAAs.

  17. Quantification of the migration and deformation of abdominal aortic aneurysm stent grafts

    NASA Astrophysics Data System (ADS)

    Mattes, Julian; Steingruber, Iris; Netzer, Michael; Fritscher, Karl; Kopf, Helmut; Jaschke, Werner; Schubert, Rainer

    2006-03-01

    The endovascular repair of an abdominal aortic aneurysm is a minimal invasive therapy which has been established during the past 15 years. A stent-graft is placed inside the aorta in order to cover the weakened regions of its wall. During a time interval of one or more years the stent-graft can migrate and deform with the risk of the occlusion of one of its limbs or of the rupture of the aneurysm. In this work we developed several strategies to quantify the migration and deformation in order to assess the risk coming with these movements and especially to characterize appearing complications by them. We calculated the rigid movement of the stent-graft and the aorta relative to the spinal canal. For this purpose, firstly, we rigidly registered the spinal canals, extracted for the different points in time, in order to establish a fixed reference system. All objects have been segmented first and surface points have been determined before applying a rigid and non-rigid point set registration algorithm. The change in the residual error after registration of the stent-graft with an increasing number of degrees of freedom indicates the amount of change in the stent-graft's morphology. We investigated a sample of 9. Two cases could be clearly distinguished by the quantified parameters: a high global migration and a strong reduction of the residual error after non-rigid registration. In both cases, strong complications have been detected by the examination of clinical experts but only by means of the images acquired one year later.

  18. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  19. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  20. Methods of Patient Warming during Abdominal Surgery

    PubMed Central

    Shao, Li; Zheng, Hong; Jia, Feng-Ju; Wang, Hui-Qin; Liu, Li; Sun, Qi; An, Meng-Ying; Zhang, Xiu-Hua; Wen, Hao

    2012-01-01

    Background Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. Methods Patients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients’ nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. Results When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. Discussion The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed. PMID:22808045