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Sample records for cava superior caso

  1. Leiomyosarcoma of the superior vena cava.

    PubMed

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.

  2. Leiomyosarcoma of the superior vena cava.

    PubMed

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts. PMID:25087805

  3. Inferior Vena Cava Filter from Left-Sided Superior Vena Cava

    SciTech Connect

    Nair, Sujit Ettles, Duncan; Robinson, Graham; Scott, Paul

    2008-07-15

    We describe the unusual case of a 71-year-old male with a history of deep vein thrombosis and recurrent multiple pulmonary embolism (PE) despite adequate anticoagulation. Computed tomography (CT) and brachiocephalic venography revealed a left-sided superior vena cava. We describe successful placement of an inferior vena cava filter via a left-sided superior vena cava.

  4. [Cardiac resynchronization through a persistent left superior vena cava].

    PubMed

    Moriña-Vázquez, P; Barba-Pichardo, R; Venegas Gamero, J; Herrera Carranza, M

    2006-12-01

    Cardiac resynchronization therapy is effective in the treatment of patients with severe heart failure and intraventricular dysynchrony. However, we are sometimes faced with the unexpected presence of a persistent left superior vena cava. We report the case of a patient with dilated cardiomyopathy and left ventricular dysynchrony in which we implanted a resynchronization pacemaker exclusively through a persistent left superior vena cava that did not communicate with the right vena cava. PMID:17194405

  5. Congenital Absence of Superior Vena Cava with no Manifestation of Superior Vena Cava Syndrome

    PubMed Central

    Park, Chan Soon; Kim, Jeong Jae

    2016-01-01

    Total absence of superior vena cava (SVC) is a very rare anomaly, and the patient usually suffers from SVC syndrome or conduction disturbances. We report an asymptomatic 27 year-old male, with complete absence of SVC. Transthoracic echocardiography and computed tomography demonstrated the absence of SVC and other congenital cardiac anomalies, but the presence of prominent collateral vessels that allow a sufficient venous return.

  6. Left Atrial Drainage of a Persistent Left Superior Vena Cava.

    PubMed

    Yousaf, Muhammad; Malak, Sharp F

    2008-01-01

    Although the most common form of the persistent left superior vena cava anomaly is usually clinically silent and often discovered incidentally, the risk of developing cyanosis, heart failure, and embolic cerebrovascular events is high among cases where the anomaly causes a right to left shunt. A rare case of persistent left superior vena cava draining into the left atrium through the superior left pulmonary vein is presented with a discussion of the embryology, morphologic forms, and clinical significance of the persistent left superior vena cava.

  7. [Superior vena cava syndrome--surgical solution--case report].

    PubMed

    Galie, N; Vasile, R; Savu, C; Petreanu, C; Grigorie, V; Tabacu, E

    2010-01-01

    The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.

  8. Superior vena cava syndrome: A radiation oncologist's perspective.

    PubMed

    Talapatra, Kaustav; Panda, Soumadip; Goyle, Sandeep; Bhadra, Kallol; Mistry, Rajesh

    2016-01-01

    Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava. It can occur due to both benign and malignant causes with the latter being the predominant. There is a paradigm shift in the approach to manage this condition. It is no longer considered a medical emergency and histological diagnosis is necessary before treatment. This article reviews the causes, symptoms, pathophysiology, and overall management policy which have changed over decades. PMID:27461602

  9. [Malignant mediastinal lesions with invasion to the superior vena cava].

    PubMed

    Kitada, M; Kubo, Y; Hirata, S; Yatsuyanagi, E; Nosaka, T; Sugimoto, S; Moriyama, H; Koshigo, S; Muraki, S; Sasajima, T

    1995-11-01

    Four patients underwent resection of mediastinal malignant tumors with invasion to the superior vena cava. Two patients had invasive thymoma, one seminoma, and one metastatic mediastinal lymph nodes of unknown origin. Prior to resection of the tumor, an ePTFE graft was anastomosed between the innominate vein and the right atrium to maintain the venous drainage from the brain and the upper extremities. In two patients, the superior vena cava was reconstructed by patch angioplasty after the tumor with a part of the vena cava was safely resected. One patient died of acute respiratory failure, but the other three are alive and well without any evidence of graft obstruction. This safe and useful method in order to prevent cerebral congestion during and after resection of the tumor.

  10. [Superior Cava Venous syndrome as presentation of neoplasic disease].

    PubMed

    Pérez Maure, M; Subils, G; Peresin Paz, R; Cazaux, A; Cambursano, V H; Cortés, J R

    2013-01-01

    Superior Cava Venous Syndrome (SVCS) encompasses a constellation of signs and symptoms resulting from partial or complete obstruction of blood flow through the superior vena cava (SVC) to the right atrium. Thrombosis can be caused by intrinsic (primary) or extrinsic compression (with or without secondary thrombosis). The causes of SVCS can be grouped according to their etiology in non-neoplastic and neoplastic. The causes malignant correspond to 65-90% of them, thrombosis and nonmalignant conditions are another causes. The presentation may be acute, clinically characterized by dyspnea and a characteristic triad (facial, neck and arms edema, cyanosis and collateral circulation). Early detection improves prognosis and is based on clinical data and imaging studies. We describe 8 cases where the SVCS was the first manifestation of neoplastic diseases. Patients were predominantly of middle-aged, male, without association with consumption of tobacco and lymphoma was most frequent diagnosis.

  11. Superior vena cava reconstruction using bovine jugular vein conduit.

    PubMed

    Lü, Wei Dong; Yu, Feng Lei; Wu, Zhong Shi

    2007-11-01

    The glutaraldehyde-treated bovine jugular vein conduit (BJVC) is a xenograft conduit initially used for right ventricular outflow tract reconstruction and has never been used for reconstruction of superior vena cava (SVC). In September 2003, a patient with SVC obstruction underwent SVC reconstruction using BJVC. He has been alive for 42 months and free from signs and symptoms of SVC obstruction except that metastasis was found in the vertebrae. The radionuclide venography showed the graft tube was patent and only slight stenosis was found in the proximal anastomosis. The initial result supports BJVC as an acceptable alternative for SVC reconstruction. PMID:17768061

  12. Anesthetic management of superior vena cava syndrome due to anterior mediastinal mass

    PubMed Central

    Chaudhary, Kapil; Gupta, Anshu; Wadhawan, Sonia; Jain, Divya; Bhadoria, Poonam

    2012-01-01

    Anesthetic management of superior vena cava syndrome carries a possible risk of life-threatening complications such as cardiovascular collapse and complete airway obstruction during anesthesia. Superior vena cava syndrome results from the enlargement of a mediastinal mass and consequent compression of mediastinal structures resulting in impaired blood flow from superior vena cava to the right atrium and venous congestion of face and upper extremity. We report the successful anesthetic management of a 42-year-old man with superior vena cava syndrome posted for cervical lymph node biopsy. PMID:22557753

  13. Type A aortic dissection presenting as superior vena cava syndrome.

    PubMed

    Raja, Faisal S; Islam, Ali; Khan, Mustafa; Abbasi, Iram

    2013-01-01

    A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Past medical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin. A clinical diagnosis of acute superior vena cava (SVC) syndrome was made. Portable chest radiograph showed a widened superior mediastinum. Computed tomography scan of the thorax demonstrated a large type A aortic dissection almost completely effacing the SVC. Acute type A aortic dissection (AD) is an emergency requiring prompt diagnosis and treatment. Patients typically present with acute onset of chest and/or back pain, classically described as "ripping" or "tearing." SVC syndrome is rarely, if ever, mentioned as a presentation, as it is usually due to more chronic conditions. This case illustrates a rare incidence of type A AD actually presenting as SVC syndrome.

  14. [Primary Cardiac Angiosarcoma with Superior Vena Cava Syndrome].

    PubMed

    Shimada, Naohiro; Shiomi, Daisuke; Kaki, Nobuaki; Kiyama, Hiroshi

    2016-05-01

    Primary cardiac angiosarcoma is rare and its prognosis very poor. A 34-year-old woman complained of facial edema and dyspnea. Echocardiography, chest computed tomography scan and chest magnetic resonance imaging showed a huge tumor arising in the right atrium. Surgical excision of the tumor was performed for the purpose of relieving superior vena cava syndrome and making diagnosis of the tumor. The right atrial wall, including the tumor, was resected and reconstructed with Gore Tex patch under cardiopulmonary bypass. The tumor was diagnosed as angiosarcoma. Doxorubicin hydrochloride/ifosfamide were used to treat postoperative cardiac recurrence and lung metastasis. These drugs were effective to a certain degree, but she died of brain metastasis of the tumor in the 14th postoperative month. PMID:27220927

  15. Superior Vena Cava Syndrome. From the Bronchus to the Vessel

    PubMed Central

    Schmidt, B.; Borges, A. C.; Doerffel, W.; Baumann, G.; Romaniuk, P.

    1997-01-01

    This paper addresses the diagnosis and management of superior vena cava syndrome (SVCS) due to malignant intrathoracic tumours. Diagnosis of SVCS is usually established by bedside examination. Chest X-ray and computed tomography may be helpful, but the cavography remains the “gold-standard”. Other imaging techniques (MRI, nuclear flow studies) are more of scientific interest. Bronchoscopy helps to evaluate the risk of pulmonary complications and endoscopic procedures often lead to histological findings. In the treatment of malignant SVCS surgery, radiotherapy, and chemotherapy have been successfully used. The placement of a vascular stent might be an additional or alternative possibility. There are no conclusive indication criteria and no conclusive regimen concerning post-stenting anticoagulation. From all reported results and published papers we draw the conclusion that the immediate effects of stent implantation and the long-term results of tumour-specific therapy are complementary to one another. The stent dilates the local venous stenosis while tumour-specific therapy has a general effect on the vascular and respiratory situation in a multi-therapy concept. PMID:18493457

  16. [Catheter in the superior vena cava for hemodialysis as a last resort in superior hemithorax].

    PubMed

    Restrepo Valencia, C A; Buritica Barragán, C M; Arango, A

    2010-01-01

    We report four patients with chronic kidney disease undergoing haemodialysis therapy, which had exhausted conventional venous access (internal jugular, subclavian) and non-conventional access (axillary, innominate) in the upper hemithorax for haemodialysis. This was primarily due to thrombosis of these veins caused by previous catheterisation. These patients did not qualify for peritoneal dialysis. Using the technique recommended by Archundia et al., 4 indwelling catheters were implanted directly in the superior vena cava in each of the patients with subsequent subcutaneous tunneling. The catheters operated correctly and are currently permeable after being used for an average of 19 months.

  17. Bilateral agenesis of the superior vena cava associated with congenital hydrothorax.

    PubMed

    Römer, S; Opgen-Rhein, B; Chaoui, R; Scheer, I; Czernik, C; Obladen, M

    2006-11-01

    Agenesis of the superior vena cava is a rare anomaly that is generally asymptomatic in the neonate. We report a male neonate with bilateral (total) agenesis of the superior vena cava with obstructed thoracic duct and subsequent congenital hydrothorax, anomalies that were detected by prenatal ultrasound at 25 weeks' gestation. The cardiac anomaly was confirmed by postnatal magnetic resonance angiography. The chylothorax disappeared with conservative therapy.

  18. [Superior vena cava syndrome after pacemaker implantation. Increased risk with DDD-systems? Case report].

    PubMed

    Minale, C; Splittgerber, F H; Niehage, D

    1992-04-01

    Superior vena cava syndrome due to transvenous pacing leads is a rare event. Local infection as well as multiple leads are important predisposing factors. The case of a patient with superior caval syndrome after multiple complicated permanent pacemaker insertions is presented. Medical treatment was unsuccessful. At operation a fibrous narrowing of the vena cava superior was found. The two leads (DDD-pacemaker) were left in place. A Goretex patch was used for enlargement of the anterior wall of the vein. Postoperatively, the patient remained free of symptoms and the vein was patent angiographically. In case of failure of medical management surgical correction should be attempted without delay. PMID:1604927

  19. Superior vena cava clamping for brachiocephalic vein cannulation during heart surgery.

    PubMed

    Kuralay, Erkan

    2009-08-01

    A new central venous catheterization during open heart surgery is seldom required. Clamping of superior vena cava (SVC) causes adequate brachiocephalic vein distension which facilitates vein puncture. In our experience, approximately 20 s is enough for adequate brachiocephalic vein distension. I usually prefer subclavian vein puncture by supraclavicular approach. By this approach, average superior vein clamping time is about 45 s. PMID:19339273

  20. Radical resection of the superior vena cava using the Contegra bovine jugular vein conduit.

    PubMed

    Belcher, Elizabeth; Dusmet, Michael; Petrou, Mario

    2010-02-01

    Radical resection of the superior vena cava poses a challenge for the cardiothoracic surgeon. The Contegra graft (Medtronic Inc, Minneapolis, MN), a biologic conduit comprising the valved segment of the bovine jugular vein, is established as a right ventricular to pulmonary artery conduit for right ventricular outflow tract repair in the pediatric population. We describe the use of the Contegra graft to facilitate radical resection and reconstruction of the superior vena cava in 2 patients, with demonstrable patency of grafts at 12 months and 7 months postoperatively. PMID:20103366

  1. Intracranial hemorrhage due to intracranial hypertension caused by the superior vena cava syndrome.

    PubMed

    Bartek, Jiri; Abedi-Valugerdi, Golbarg; Liska, Jan; Nyström, Harriet; Andresen, Morten; Mathiesen, Tiit

    2013-07-01

    We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have an intracranial hemorrhage secondary to a superior vena cava syndrome. The condition appears to be caused by a reversible transient rise in intracranial pressure, as a result of compression of the venous return from the brain. Treatment consisted of surgery for the aortic pseudoaneurysm, which led to normalization of the intracranial pressure and resorption of the intracranial hemorrhage.

  2. Surgical repair of coronary sinus orifice atresia with persistent left superior vena cava in heterotaxia.

    PubMed

    Takabayashi, Shin; Shimpo, Hideto; Yokoyama, Kazuto

    2007-05-01

    A 6-month-old boy was diagnosed with coronary sinus orifice atresia, double-outlet right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and moderate common atrioventricular valve regurgitation associated with heterotaxy syndrome. Cardiac venous flow drained through a persistent left superior vena cava. We decided to perform coronary sinus orifice unroofing through the right atrium under a guide using a bougie. The persistent left superior vena cava was divided. Bidirectional Glenn anastomosis and edge-to-edge common atrioventricular valve repair were concomitantly performed. After a 1-year follow-up period, the patient is alive and well without any ischemic event.

  3. Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings

    SciTech Connect

    Dursun, Memduh Sarvar, Sadik; Cekrezi, Bledi; Kaba, Erkan; Bakir, Baris; Toker, Alper

    2008-07-15

    Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

  4. Persistent Left Superior Vena Cava: A Rare Case with Clinical Significance

    PubMed Central

    Kumar, Raj; Yadav, Sankalp; Verma, Deepak

    2016-01-01

    Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly (incidence of 0.3-0.5% of the general population) which being mostly asymptomatic in its presentation, is usually detected incidentally. There are many practical clinical implications associated with it including arrhythmias. We report a rare case of PLSVC with absent Right Superior Vena Cava (RSVC) (isolated PLSVC), in a 55-year-old lady who had complete heart block followed by sepsis and was diagnosed to have this condition during the permanent cardiac pacemaker implantation and central venous catheter insertion showing an abnormal path of the catheter/pacing leads. The authors also give an insight into its clinical relevance. PMID:27437282

  5. Radiation-induced leiomyosarcoma of the great vessels presenting as superior vena cava syndrome

    SciTech Connect

    Weiss, K.S.; Zidar, B.L.; Wang, S.; Magovern, G.J. Sr.; Raju, R.N.; Lupetin, A.R.; Shackney, S.E.; Simon, S.R.; Singh, M.; Pugh, R.P.

    1987-09-15

    A patient with a pleomorphic intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presented clinically with a superior vena cava syndrome. A latent period of 29 years elapsed between receiving orthovoltage radiation to the neck and right side of chest to treat recurrent ganglioneuroblastoma, and the appearance of a leiomyosarcoma and subsequent recurrences. The patient underwent partial resection of the tumor, received adjunct chemotherapy, and was shown to be free of disease by clinical tests and by magnetic resonance imaging (MRI) 17 months after completion of chemotherapy. The criteria for the diagnosis of radiation-induced sarcomas are reviewed in relation to the present case. The critical role of magnetic resonance imaging in both the diagnosis and continued follow-up of the patient is described. This would appear to be the first reported case of radiation-induced intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presenting as a superior vena cava syndrome.

  6. Radiofrequency Guide Wire Recanalization of Venous Occlusions in Patients with Malignant Superior Vena Cava Syndrome

    SciTech Connect

    Davis, Robert M.; David, Elizabeth; Pugash, Robyn A.; Annamalai, Ganesan

    2012-06-15

    Fibrotic central venous occlusions in patients with thoracic malignancy and prior radiotherapy can be impassable with standard catheters and wires, including the trailing or stiff end of a hydrophilic wire. We report two patients with superior vena cava syndrome in whom we successfully utilized a radiofrequency guide wire (PowerWire, Baylis Medical, Montreal, Quebec, Canada) to perforate through the occlusion and recanalize the occluded segment to alleviate symptoms.

  7. Acute superior vena cava syndrome after rupture of Kommerell's diverticulum: a case report.

    PubMed

    Suarez, Alison E; Slivka, Rachael

    2013-03-01

    Kommerell's diverticulum, a rare congenital aortic anomaly, is dilatation at the region in which an aberrant subclavian artery branches from either a left-sided or right-sided thoracic aorta. We report a rare case of acute superior vena cava syndrome that developed in a young healthy male patient who presented to the emergency department in imminent respiratory arrest after rupture of this diverticulum.

  8. [Maze procedure in a case of dextrocardia with atrial septal defect and persistent left superior vena cava].

    PubMed

    Muraoka, Arata; Kawada, Masaaki; Misawa, Yoshio

    2014-08-01

    A 52-year-old man was diagnosed with dextrocardia at the age of 1 year and was asymptomatic until 1 year before admission. He was transferred to our hospital for management of atrial fibrillation. A transthoracic echocardiogram showed dextrocardia with atrial septal defect;moderate tricuspid valve regurgitation; and a large, persistent left superior vena cava. A cardiac catheterization study revealed that pulmonary flow/systemic flow (Qp/Qs) was 3.6 and that pulmonary vascular resistance was 2.5 Wood U·m². Intracardiac repair with tricuspid annuloplasty and a maze procedure was scheduled. When establishing cardiopulmonary bypass, venous drainage was initially obtained from the inferior vena cava and the left superior vena cava, and the small superior vena cava was then directly cannulated after opening the right atrium. The patient's postoperative course was uneventful, and serial electrocardiograms have demonstrated maintenance of normal sinus rhythm for 3.5 years after the operation.

  9. [Duplication of the superior vena cava and other malformations discovered at insertion of a port-a-cath].

    PubMed

    Hammerer, V; Jeung, M; Mennecier, B; Demian, M; Pauli, G; Quoix, E

    2005-09-01

    We report a clinical case of a persistent left superior vena cava discovered in a 50-year-old female patient when a port-a-cath was inserted. This already seldom malformation was associated with an arteria lusoria and polysplenia with left inferior vena cava with hemiazygos continuation, right-sided stomach, short pancreas, preduodenal portal vein and intestinal malrotation, but without any cardiac abnormalities.

  10. [Duplication of the superior vena cava and other malformations discovered at insertion of a port-a-cath].

    PubMed

    Hammerer, V; Jeung, M; Mennecier, B; Demian, M; Pauli, G; Quoix, E

    2005-09-01

    We report a clinical case of a persistent left superior vena cava discovered in a 50-year-old female patient when a port-a-cath was inserted. This already seldom malformation was associated with an arteria lusoria and polysplenia with left inferior vena cava with hemiazygos continuation, right-sided stomach, short pancreas, preduodenal portal vein and intestinal malrotation, but without any cardiac abnormalities. PMID:16208194

  11. Azygos Tip Placement for Hemodialysis Catheters in Patients with Superior Vena Cava Occlusion

    SciTech Connect

    Wong, Jeffrey J.; Kinney, Thomas B.

    2006-02-15

    Chronic central venous access is necessary for numerous life-saving therapies. Repeated access is complicated by thrombosis and occlusion of the major veins, such as the superior vena cava (SVC), which then require novel vascular approaches if therapy is to be continued. We present two cases of catheterization of the azygos system in the presence of an SVC obstruction. We conclude that the azygos vein may be used for long-term vascular access when other conduits are unavailable and that imaging studies such as magnetic resonance venography, contrast-enhanced computed tomography or conventional venography can be employed prior to the procedure to aid with planning and prevent unforeseen complications.

  12. Invasive Thymoma Protruding into the Superior Vena Cava through the Thymic Vein

    PubMed Central

    Yoshimura, Takashi; Matsubara, Yoshito; Yasuhara, Yumiko; Terada, Yasuji

    2015-01-01

    We report a rare case of protrusion of an invasive thymoma with intraluminal growth through the thymic vein into the superior vena cava (SVC) without direct invasion of the vessel walls. The tumor and left brachiocephalic vein were resected, and the tumor in the SVC was removed with temporal bypass of the right brachiocephalic vein and right auricle. Histopathological finding showed that the thymoma had protruded via a thymic vein. During resection of a thymoma, a detailed examination of thymic vein is necessary to ensure that no tumor tissue remains in the vessels. PMID:26299398

  13. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    SciTech Connect

    Sofue, Keitaro Takeuchi, Yoshito Arai, Yasuaki; Sugimura, Kazuro

    2013-02-15

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  14. Giant Right Coronary Artery Aneurysm Associated with a Fistula Draining into the Superior Vena Cava

    PubMed Central

    Dolapoglu, Ahmet

    2016-01-01

    Giant coronary artery aneurysm associated with a coronary–cameral fistula is an uncommon condition. Such aneurysms are usually associated with other cardiac diseases, such as coronary atherosclerosis, and therefore might augment myocardial ischemia in adults. The main indications for surgical intervention are severe coexisting coronary artery disease, evidence of embolization, and aneurysmal enlargement or rupture. We describe a large right coronary artery aneurysm and a coronary–cameral fistula that drained into the superior vena cava. The surgical repair was successful. PMID:27547153

  15. Superior Vena Cava Stent Migration into the Pulmonary Artery Causing Fatal Pulmonary Infarction

    SciTech Connect

    Anand, Girija Lewanski, Conrad R.; Cowman, Steven A.; Jackson, James E.

    2011-02-15

    Migration of superior vena cava (SVC) stents is a well-recognised complication of their deployment, and numerous strategies exist for their retrieval. To our knowledge, only three cases of migration of an SVC stent to the pulmonary vasculature have previously been reported. None of these patients developed complications that resulted in death. We report a case of SVC stent migration to the pulmonary vasculature with delayed pulmonary artery thrombosis and death from pulmonary infarction. We conclude that early retrieval of migrated stents should be performed to decrease the risk of serious complications.

  16. Permanent Pacemaker-Induced Superior Vena Cava Syndrome: Successful Treatment by Endovascular Stent

    SciTech Connect

    Lanciego, Carlos Rodriguez, Mario; Rodriguez, Adela; Carbonell, Miguel A.; Garcia, Lorenzo Garcia

    2003-11-15

    The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later.

  17. Extrinsic compression of superior vena cava: an analysis of 41 patients

    SciTech Connect

    Kanji, A.M.; Chao, J.H.; Liebner, E.J.; Lobo, P.; Thakrar, H.V.

    1980-02-01

    A retrospective analysis was made of 41 patients with extrinsic compression of the superior vena cava who were treated at the University of Illinois Hospital, Mercy Hospital and Columbus Hospital between 1967 and 1977. Small cell carcinoma was the predominant histological variety. The mode of presentation (acute versus subacute) was found to be an important prognostic factor: 47% of patients with acute presentation responded to treatment compared to 79% of patients with subacute onset. Chemotherapy given concomitantly with radiotherapy did not produce better results than radiotherapy alone.

  18. Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation

    SciTech Connect

    Sauter, Alexander; Triller, Juergen; Schmidt, Felix; Kickuth, Ralph

    2008-07-15

    Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

  19. Endovascular Treatment of Malignant Superior Vena Cava Syndrome: Results and Predictive Factors of Clinical Efficacy

    SciTech Connect

    Fagedet, Dorothee; Thony, Frederic; Timsit, Jean-Francois; Rodiere, Mathieu; Monnin-Bares, Valerie; Ferretti, Gilbert R.; Vesin, Aurelien; Moro-Sibilot, Denis

    2013-02-15

    To demonstrate the effectiveness of endovascular treatment (EVT) with self-expandable bare stents for malignant superior vena cava syndrome (SVCS) and to analyze predictive factors of EVT efficacy. Retrospective review of the 164 patients with malignant SVCS treated with EVT in our hospital from August 1992 to December 2007 and followed until February 2009. Endovascular treatment includes angioplasty before and after stent placement. We used self-expandable bare stents. We studied results of this treatment and looked for predictive factors of clinical efficacy, recurrence, and complications by statistical analysis. Endovascular treatment was clinically successful in 95% of cases, with an acceptable rate of early mortality (2.4%). Thrombosis of the superior vena cava was the only independent factor for EVT failure. The use of stents over 16 mm in diameter was a predictive factor for complications (P = 0.008). Twenty-one complications (12.8%) occurred during the follow-up period. Relapse occurred in 36 patients (21.9%), with effective restenting in 75% of cases. Recurrence of SVCS was significantly increased in cases of occlusion (P = 0.01), initial associated thrombosis (P = 0.006), or use of steel stents (P = 0.004). Long-term anticoagulant therapy did not influence the risk of recurrence or complications. In malignancy, EVT with self-expandable bare stents is an effective SVCS therapy. These results prompt us to propose treatment with stents earlier in the clinical course of patients with SVCS and to avoid dilatation greater than 16 mm.

  20. Giant saccular superior vena cava aneurysm-a rare and difficult clinical case.

    PubMed

    Janczak, Dariusz; Skiba, Jacek; Gemel, Marek; Mak, Marek; Ziomek, Agnieszka; Malinowski, Maciej; Dorobisz, Tadeusz; Lesniak, Michal; Janczak, Dawid; Chabowski, Mariusz

    2016-03-01

    A superior vena cava (SVC) aneurysm is an extremely rare case of vascular malformation in the chest cavity. This is a report of a case of a 57-year-old woman with a saccular SVC aneurysm which was 8 cm wide. The chest computed tomography (CT) scan confirmed a giant 75 mm × 79 mm × 81 mm mass containing the contrast medium from SVC, constricting the right lung parenchyma, narrowing the right innominate vein, in contact with the anterolateral chest cavity wall, and adjoining the superior mediastinum. Under general anesthesia and employing the median sternotomy approach, using a cardiopulmonary bypass (CPB), the venous aneurysm was successfully resected. The postoperative period was uneventful. Radical surgical resection using a sternotomy and a CPB is recommended. PMID:27076981

  1. Giant saccular superior vena cava aneurysm—a rare and difficult clinical case

    PubMed Central

    Janczak, Dariusz; Skiba, Jacek; Gemel, Marek; Mak, Marek; Ziomek, Agnieszka; Malinowski, Maciej; Dorobisz, Tadeusz; Lesniak, Michal; Janczak, Dawid

    2016-01-01

    A superior vena cava (SVC) aneurysm is an extremely rare case of vascular malformation in the chest cavity. This is a report of a case of a 57-year-old woman with a saccular SVC aneurysm which was 8 cm wide. The chest computed tomography (CT) scan confirmed a giant 75 mm × 79 mm × 81 mm mass containing the contrast medium from SVC, constricting the right lung parenchyma, narrowing the right innominate vein, in contact with the anterolateral chest cavity wall, and adjoining the superior mediastinum. Under general anesthesia and employing the median sternotomy approach, using a cardiopulmonary bypass (CPB), the venous aneurysm was successfully resected. The postoperative period was uneventful. Radical surgical resection using a sternotomy and a CPB is recommended. PMID:27076981

  2. Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.

    PubMed

    Wan, Chingping; Oren, Jess W; Szymkiewicz, Steven J

    2013-09-01

    Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest. This report describes the first case of successful defibrillation therapy delivered by the wearable cardioverter defibrillator to a patient with dextrocardia and persistent left superior vena cava during a ventricular tachycardia arrest.

  3. Hypoxia caused by persistent left superior vena cava connecting to the left atrium a rare clinical entity.

    PubMed

    Freeman, Andrew M; Fenster, Brett E; Weinberger, Howard D; Buckner, J Kern; Lynch, David

    2012-01-01

    We relate the case of a 40-year-old man with a history of premature birth and dextroposition of the heart who presented for an evaluation of persistent hypoxia. An unrevealing pulmonary evaluation and agitated-saline echocardiogram led to cardiac magnetic resonance imaging. This revealed a very unusual finding: a persistent left superior vena cava with insertion into the left atrium and a small connecting vein between the right and left superior venae cavae. The implications, embryology, and pathogenesis of this rare condition are discussed.

  4. Placement of a Retrievable Guenther Tulip Filter in the Superior Vena Cava for Upper Extremity Deep Venous Thrombosis

    SciTech Connect

    Nadkarni, Sanjay; Macdonald, Sumaira; Cleveland, Trevor J.; Gaines, Peter A.

    2002-12-15

    A retrievable Guenther Tulip caval filter(William Cook, Europe) was successfully placed and retrieved in the superior vena cava for upper extremity deep venous thrombosis in a 56-year-old woman. Bilateral subclavian and internal jugular venous thromboses thought secondary to placement of multiple central venous catheters were present. There have been reports of the use of permanent Greenfield filters and a single case report of a temporary filter in the superior vena cava. As far as we are aware this is the first reported placement and successful retrieval of a filter in these circumstances.

  5. Management of superior vena cava obstruction syndrome due to thrombosis of a Contegra conduit used to re-establish the innominate vein-to-right atrium continuity.

    PubMed

    Xu, Gang; Alexiou, Christos; Tofeig, Magdi; Spyt, Tomasz J

    2007-08-01

    Following intraoperative superior vena cava injury, venous drainage of the head, neck and upper extremities can be re-established with bovine jugular vein (Contegra) conduits. Inadequate anticoagulation, however, may lead to conduit thrombosis and superior vena cava obstruction syndrome. This can be successfully treated with percutaneous dilatation and stenting of the failed conduit. PMID:17669924

  6. Surgical treatment of an invasive thymoma extending into the superior vena cava and right atrium

    PubMed Central

    2014-01-01

    Although invasive thymoma commonly infiltrates neighbouring mediastinal structures, its extension into the superior vena cava (SVC) and consequent SVC occlusion are rare. In such cases, the urgent removal of the thymoma and radical resection of the infiltrated SVC representreasonable options, since induction therapy is time-consuming and useless for symptom resolution. A case of invasive thymoma extending into the SVC and right atrium (RA) with SVC syndrome is reported. The patient underwent a combined resection of the invasive tumor and SVC under cardiopulmonary bypass (CPB), and the SVC and bilateral brachiocephalic vein (BCV) were reconstructed with an autologous pericardial ‘Y’ conduit. After 40 months of follow-up, the patient showed a patent graft and no tumor recurrence. PMID:24400724

  7. Primary Pulmonary Ewing’s Sarcoma: Rare Cause of Superior Vena Cava Syndrome in Children

    PubMed Central

    Atwal, Swapndeep Singh; Garga, Umesh Chandra

    2014-01-01

    Ewing’s sarcoma is a common malignant bone tumour presenting in children and young adults. Rarely extra- skeletal soft tissues and visceral organs can also be the site of origin of Ewing’s sarcoma. Primary pulmonary Ewing’s sarcoma is an extremely rare malignancy which occurs in the paediatric population. We report an unusual case of primary pulmonary Ewing’s sarcoma in a nine year old girl who presented with features of superior vena cava syndrome in the emergency department. The diagnosis was confirmed pathologically both by light microscopy and immunohistochemistry. The patient was put on chemotherapy and surgery was planned but the patient expired within three days of starting chemotherapy. PMID:25302247

  8. Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters.

    PubMed

    Cui, Jie; Kawai, Tasuo; Irani, Zubin

    2015-01-01

    Indwelling central venous catheters have been reported to increase the risk of superior venous cava (SVC) syndrome. This case report describes the development of acute SVC syndrome in a 28-year-old woman with end-stage renal disease implanted with a left-side hemodialysis reliable outflow graft and a right-side double lumen hemodialysis catheter via internal jugular veins. Her symptoms were not alleviated after catheter removal and systemic anticoagulation therapy. She was eventually treated with catheter-directed thrombolysis and a predischarge computer tomographic venogram on postthrombolytic procedure day 7 showed patent central veins and patient remained asymptomatic. This case demonstrates that catheter-directed thrombolysis can be safely employed to treat refractory catheter-induced acute SVC syndrome in end-stage renal disease patients.

  9. [Sinus histiocytosis with massive lymphadenopathy with complete occlusion of the superior and inferior vena cava].

    PubMed

    Runde, J; Ebbecke, H; Kurlemann, G; Frosch, M; Schuierer, G

    1997-01-01

    Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare disease of the lymph nodes, still of unknown origin. We are reporting the case of a 16 year old boy with SHML which occurred in 1983. Investigations showed a massive lymphadenopathy of the mediastinal and abdominal nodes, causing displacement and compression of surrounding tissue. The patient further developed a blockage of the vena cava superior and inferior, leading to numerous collateral circulation routes in the upper and lower extremities. The etiology of the venous blockage is still disputed. It is possible that they are the result of compression of the major veins. Alternatively, the cause could lie in the disruption of the coagulation system. Finally and more likely, the problem could be the result of fibrosis developing through the healing process.

  10. Bilateral Breast Enlargement: An Unusual Presentation of Superior Vena Cava Obstruction in a Hemodialysis Patient with Fibrosing Mediastinitis

    SciTech Connect

    Goo, Dong Erk Kim, Yong Jae; Choi, Deuk Lin; Kwon, Kui Hyang; Yang, Seung Boo

    2011-02-15

    A 67-year-old woman with end-stage renal disease presented with profound edema of both breasts. The presence of a patent hemodialysis basilic transposition fistula and superior vena cava obstruction (SVC), due to fibrosing mediastinitis, was demonstrated by the use of fistulography. Endovascular treatment with a balloon and stent caused immediate resolution of the breast edema.

  11. Dramatic response of follicular thyroid carcinoma with superior vena cava syndrome and tracheal obstruction to external-beam radiotherapy

    SciTech Connect

    Wilford, M.R.; Chertow, B.S.; Lepanto, P.B.; Leidy, J.W. Jr. )

    1991-06-01

    We report a patient with follicular thyroid carcinoma progressing to superior vena cava (SVC) syndrome and tracheal obstruction despite multiple doses of radioactive iodine therapy but subsequently responding dramatically to external-beam radiotherapy (RT). Although RT is not considered to be the treatment of choice for follicular carcinoma, RT in our patient produced unequivocal improvement of SVC syndrome and tracheal obstruction.

  12. Role of cardiac output and the autonomic nervous system in the antinatriuretic response to acute constriction of the thoracic superior vena cava.

    NASA Technical Reports Server (NTRS)

    Schrier, R. W.; Humphreys, M. H.; Ufferman, R. C.

    1971-01-01

    Study of the differential characteristics of hepatic congestion and decreased cardiac output in terms of potential afferent stimuli in the antinatriuretic effect of acute thoracic inferior vena cava (TIVC) constriction. An attempt is made to see if the autonomic nervous system is involved in the antinatriuretic effect of acute TIVC or thoracic superior vena cava constriction.

  13. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma.

    PubMed

    Santra, Avradip; Nandi, Saumen; Mondal, Saibal; Chakraborty, Subhankar

    2016-07-01

    Superior vena cava (SVC) syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient. PMID:27365560

  14. Superior Vena Cava Obstruction in Hemodialysis Patients: Symptoms, Clinical Presentation and Outcomes Compared to Other Etiologies.

    PubMed

    Siegel, Yoel; Kuker, Russ

    2016-08-01

    The incidence of superior vena cava (SVC) obstruction associated with non-malignant diseases is on the rise, and a large percentage of these patients are on hemodialysis (HD). The objective was to characterize the presentation, symptoms and outcomes of HD patients with SVC obstruction identified on computerized tomography (CT) compared to patients with other etiologies such as neoplasm. A search was performed through the PACS system using key words to identify patients with SVC obstruction. The CT scans and charts were reviewed for degree of obstruction, signs, symptoms and outcomes. Thirty-six patients were included in the study. Thirteen were on HD and of these, five had symptoms associated with SVC obstruction and one had concordant findings on physical exam. In comparison, thirteen patients with a chest neoplasm had symptoms and four had concordant findings on physical exam. On follow up, 31% of the HD patients died and of these 60% were symptomatic and died within 2 years. 29% of lung cancer patients died within 16 months. The majority of the HD patients had complete SVC obstruction (85%) as opposed to those with a chest neoplasm who mostly had partial SVC occlusion (67%). In conclusion, patients on HD with SVC obstruction are less often symptomatic than those with a neoplasm. However, these HD patients had a death rate similar to the patients with cancer. This risk seems to increase in those who are symptomatic. Diagnosis of SVC obstruction by CT in HD patients may help identify those with less favorable prognosis.

  15. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

    PubMed Central

    Santra, Avradip; Nandi, Saumen; Mondal, Saibal; Chakraborty, Subhankar

    2016-01-01

    Superior vena cava (SVC) syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient. PMID:27365560

  16. [Syndrome of vena cava superior in the injured persons with traumatic instability of a sternocostal skeleton as a consequence of polytrauma].

    PubMed

    Sheĭko, V D; Panasenko, S I

    2013-06-01

    There were analyzed 8 clinical observations of treatment of syndrome of vena cava superior in the injured persons in traumatic instability of a sternocostal skeleton. Peculiarities of course of traumatic process, concerning the trauma severity objective prove, were established.

  17. Macro-reentrant atrial tachycardia conducting through a left superior vena cava after catheter ablation in a patient with paroxysmal atrial fibrillation.

    PubMed

    Kurotobi, Toshiya; Kino, Naoto; Tonomura, Daisuke; Shimada, Yoshihisa

    2015-01-01

    A left superior vena cava can be a cause of cardiac rhythm or conduction abnormalities, and can also be the arrhythmogenic source of atrial fibrillation (AF) with connections to the coronary sinus and left atrium. In the present study, we report a case with a macro re-entrant atrial tachycardia that coursed through the left superior vena cava after a previous AF ablation, which successfully ablated paroxysmal AF.

  18. Persistent left superior vena cava, absence of the innominate vein, and upper sinus venosus defect : a rare anomaly detected using bubbles.

    PubMed

    Akpinar, I; Sayin, M R; Karabag, T; Dogan, S M; Sen, S T; Gudul, N E; Aydin, M

    2013-05-01

    Superior vena cava anomalies are rare malformations that are typically seen with other congenital cardiac defects. Although a persistent left superior vena cava is the most common anomaly of the systemic venous return in the thorax, its combination with an upper sinus venosus defect and absence of the innominate vein is extremely rare. Here, we report a patient diagnosed with these anomalies based on a bubble study and confirmed with magnetic resonance imaging.

  19. Renal transplantation with venous drainage through the superior mesenteric vein in cases of thrombosis of the inferior vena cava.

    PubMed

    Aguirrezabalaga, Javier; Novas, Serafín; Veiga, Francisco; Chantada, Venancio; Rey, Ignacio; Gonzalez, Marcelino; Gomez, Manuel

    2002-08-15

    Renal transplantation usually is performed by placing the graft in the iliac fossa, anastomosing the renal vein to the iliac vein or, when this is not possible, to the vena cava. When vascular complications occur, particularly on the venous side, the position of the graft may have to be changed. This report describes orthotopic renal grafts and positioning of the organ with anastomosis to the splenic vessels. Venous drainage was established directly into the mesenteric-portal territory, with two cases to the portal vein and one to the inferior mesenteric vein. A new technique for the venous drainage of the renal graft is shown. We have used this model in two cases of infrarenal inferior vena cava thrombosis. The kidney was located in a retroperitoneal position, with venous drainage to the superior mesenteric vein through an orifice in the posterior peritoneum.

  20. Resection of the sidewall of superior vena cava using video-assisted thoracic surgery mechanical suture technique

    PubMed Central

    Xu, Xin; Qiu, Yuan; Pan, Hui; Mo, Lili; Chen, Hanzhang

    2016-01-01

    Lung cancer invading the superior vena cava (SVC) is a locally advanced condition, for which poor prognosis is expected with conservative treatment alone. Surgical resection of the lesion can rapidly relieve the symptoms and significantly improve survival for some patients. Replacement, repair and partial resection of SVC via thoracotomy were generally accepted and used in the past. As the rapid development of minimally invasive techniques and devices, partial resection and repair of SVC are feasible via video-assisted thoracic surgery (VATS). However, few studies have reported the VATS surgical techniques. In this study, we reported the crucial techniques of partial resection of SVC via VATS. PMID:27076960

  1. ICD Leads Extraction and Clearing of Access Way in a Patient With Superior Vena Cava Syndrome: Building A Tunnel.

    PubMed

    Kiuchi, Márcio Galindo; Andrade, Ricardo Luiz Lima; da Silva, Gustavo Ramalho; Souto, Hanry Barros; Chen, Shaojie; Villacorta Junior, Humberto

    2015-09-01

    Central vein disease is defined as at least 50% narrowing up to total occlusion of central veins of the thorax including superior vena cava, brachiocephalic, subclavian, and internal jugular vein. Thrombosis due to intravascular leads occurs in approximately 30% to 45% of patients early or late after implantation of a pacemaker by transvenous access.In this case, we report a male patient, 65-years old, hypertensive, type 2 diabetic, with atherosclerotic disease, coronary artery disease, underwent coronary artery bypass surgery in the past 10 years, having already experienced an acute myocardial infarction, bearer automatic implantable cardioverter defibrillator for 8 years after an episode of aborted sudden death due to ischemic cardiomyopathy, presenting left superior vena cava syndrome. The use of clopidogrel and rivaroxaban for over a year had no benefit on symptoms improvement.After atrial and ventricular leads extraction, a new shock lead was positioned in the right ventricle using active fixation and a new atrial lead was positioned in the right atrium, passing inside of the stents. Two days after the procedure the patient was asymptomatic and was discharged. PMID:26402803

  2. Intra-atrial rerouting and maze procedure for an adult patient in cor triatriatum, persistent left superior vena cava, and atrial fibrillation.

    PubMed

    Sughimoto, Koichi; Matsuo, Kozo; Ohba, Masanao

    2012-06-01

    A combination of cor triatriatum and persistent left superior vena cava without communication to the coronary sinus is uncommon. A 62-year-old male with this diagnosis in conjunction with atrial fibrillation underwent successful intracardiac repair done with a unique method. After a maze procedure and enlargement of the route from the pulmonary veins to the mitral valve, a GoreTex graft was used to reroute the left superior vena cava into the right atrium and to close two thirds of the circumference of the patient's atrial septal defect; the rest of the defect was closed with another GoreTex patch.

  3. Treatment of a coronary artery to superior vena cava fistula resulting from early closure of a Possis Perma-Flow graft.

    PubMed

    Graham, M M; Kells, C M; Sullivan, J; O'Neill, B J

    1999-06-01

    The Perma-Flow graft used in bypass surgery achieves more complete revascularization when paucity of native conduits exists. We report a coronary artery to superior vena cava fistula as a complication of this graft, leading to severe right heart failure. The fistula was successfully occluded percutaneously, improving the patient's clinical situation.

  4. Demonstration of collateral pathways in superior vena cava syndrome by means of radionuclide venography

    SciTech Connect

    Kida, T.

    1985-03-01

    Radionuclide venography was used to study lesions producing obstruction in the superior vena caval system. This procedure is a simple and safe diagnostic method; it offers precise information regarding the site and degree of venous obstruction and the extent of the collaterals. It is useful not only in diagnosis, but also in radiotherapy planning and follow-up evaluation.

  5. Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.

    PubMed

    Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

    2014-04-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases.

  6. Coronary sinus orifice atresia and persistent left superior vena cava. A report of two cases, one associated with atypical coronary artery thrombosis.

    PubMed Central

    Gerlis, L M; Gibbs, J L; Williams, G J; Thomas, G D

    1984-01-01

    Fourteen previously reported cases of atresia of the coronary sinus ostium, in which the coronary venous flow entered the right atrium by a persistent left superior vena cava, the innominate vein, and the right superior vena cava, are reviewed and two new cases reported. The first new case was in a 43 year old woman with atypical chest pains in whom investigations for suspected ischaemic heart disease, including coronary arteriography, yielded normal results. She died suddenly from massive myocardial infarction due to extensive old thrombotic occlusion of a major coronary artery without any appreciable underlying disease of the vessel wall. Exercise testing is considered to be advisable in symptomatic patients with normal coronary angiograms and attention to the venous phase might be informative. The second new case occurred in a child with an atrial septal defect and complete transposition of the great arteries, who died aged 1 month. Images PMID:6508965

  7. Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava-right atrium junction.

    PubMed

    Kitamura, Takeshi; Fukamizu, Seiji; Arai, Ken; Hojo, Rintaro; Aoyama, Yuya; Komiyama, Kota; Sakurada, Harumizu; Hiraoka, Masayasu

    2016-01-01

    We performed catheter ablation to septal superior vena cava (SVC)-right atrium (RA) junction rapid firing in a 57-year-old man with paroxysmal atrial fibrillation. He later experienced transient sinus node dysfunction resulting from injury to the sinus node artery (SNA), which branched only from the proximal region of the left circumflex artery. The direction of the SNA should be considered during catheter ablation at the septal SVC-RA junction, especially if the sinus node is supplied by only one SNA from the right coronary artery or the left circumflex artery.

  8. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    SciTech Connect

    Erol, Ilknur Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

    2006-06-15

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.

  9. Hemopericardium After Superior Vena Cava Stenting for Malignant SVC Obstruction: The Importance of Contrast-Enhanced CT in the Assessment of Postprocedural Collapse

    SciTech Connect

    Brant, Jonathan; Peebles, Charles; Kalra, Paul; Odurny, Allan

    2001-09-15

    We report the complication of hemopericardium following superior vena cava (SVC) stenting with an uncovered Wallstent in a patient with malignant SVC obstruction. The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain. The possible complications of SVC stenting, including hemopericardium, pulmonary embolism, mediastinal hematoma, and pulmonary edema from increased venous return resulting from improved hemodynamics, ensure a wide differential diagnosis in the post procedural collapsed patient and this case emphasizes the important role of contrast-enhanced CT in the peri-resuscitation assessment of these patients.

  10. Role of bilateral inferior petrosal sinus sampling (BIPSS) in the diagnosis of Cushing's disease in a patient with double superior vena cava.

    PubMed

    Tashi, Sonam; Ng, Keng Sin

    2015-08-01

    Cushing's syndrome is known to have a wide spectrum of clinical presentation with debilitating consequences and morbidity if not diagnosed and treated in time. Sometimes the diagnosis of Cushing's syndrome can be challenging to the endocrinologist, especially when the usual battery of biochemical tests and advanced cross-sectional imaging is negative or inconclusive. We described a case in which the use of bilateral inferior petrosal sinus sampling (BIPSS) was conclusive albeit being technically challenging (due to a rare incidental finding of double superior vena cava) and invasive in nature.

  11. Left-sided high-flow arteriovenous hemodialysis fistula combined with a persistent left superior vena cava causing coronary sinus dilatation.

    PubMed

    Wolf, Michael; Scott, Benjamin

    2013-01-01

    We present an interesting case illustrating the possible hemodynamic consequences when a left-sided arteriovenous hemodialysis fistula is combined with the congenital anomaly of a persistent left superior vena cava (PLSVC). Our case illustrates the importance of an echocardiographic examination with attention to the coronary sinus (CS) caliber-raising suspicion of a PLSVC-in the assessment for the hemodialysis access in end-stage renal disease patients. The causes and symptoms of CS dilatation, as well as the literature on PLSVC, are also discussed in detail.

  12. The relationship between cerebral and somatic oxygenation and superior and inferior vena cava flow, arterial oxygenation and pressure in infants during cardiopulmonary bypass.

    PubMed

    White, M C; Edgell, D; Li, J; Wang, J; Holtby, H

    2009-03-01

    We investigated blood flow and regional oxygenation (rSO(2)) during cardiopulmonary bypass (CPB). Twenty infants (mean (SD) age 5 (3) months, weight 5.4 (1.6) kg) were prospectively studied. Total CPB and superior vena cava (SVC) flow were measured using Transonic Bypass Flowmeters, inferior vena cava (IVC) flow derived arithmetically and rSO(2) measured using Near Infra-Red Spectroscopy. Mean SVC flow was 51.3 (14.8) ml.kg(-1).min(-1) and mean IVC flow 62.5 (19.0) ml.kg(-1).min(-1). Mean cerebral rSO(2) was 71 (11)% and somatic rSO(2) 55 (13)%. Cerebral and somatic rSO(2) showed no correlation with SVC and IVC flow. Cerebral rSO(2) showed a positive correlation with P(a)co(2), mean arterial pressure (MAP) and haematocrit (p < 0.0001). Somatic rSO(2) showed a positive correlation with MAP and haematocrit (p = 0.01, p = 0.02). In conclusion, the distribution of blood flow during CPB varies. The most important factor affecting this is P(a)CO(2). Cerebral and somatic oxygenation are unaffected by flow but significantly influenced by MAP, haematocrit and P(a)CO(2). PMID:19302636

  13. Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report

    PubMed Central

    Tunc, Mehtap; Sazak, Hilal; Karlilar, Bulent; Ulus, Fatma; Tastepe, Irfan

    2015-01-01

    Introduction: Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS. Case Presentation: We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications. Conclusions: Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS. PMID:26082848

  14. Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma.

    PubMed

    Bunkar, Moti lal; Takhar, Rajendra Prasad; Arya, Savita

    2015-01-01

    Invasive pulmonary aspergillosis (IPA) is a disease of immunocompromised patients, but its prevalence is increasing in immunocompetent persons. Patients usually present with non-specific symptoms, sometimes consistent with bronchopneumonia. We discuss the case of a 19-year-old boy who presented with constitutional respiratory symptoms along with signs of obstruction of the superior and inferior vena cava. A chest radiograph was suggestive of a thoracic mass raising suspicion of bronchogenic carcinoma/ benign mass, sarcoidosis and tuberculosis, but a diagnosis of invasive aspergillosis was established. The patient showed excellent clinico-radiological improvement with administration of voriconazole. Invasive pulmonary aspergillosis may also present with atypical findings and should be considered in differentials when investigating a case even if the patient does not have a risk factor. PMID:26506978

  15. Near-Infrared Spectroscopy Monitoring, Superior Vena Cava Flow, and Neurodevelopmental Outcome at 2 years in a Cohort of Very Low-Birth-Weight Infants.

    PubMed

    Cerbo, Rosa Maria; Orcesi, Simona; Scudeller, Luigia; Borellini, Martina; Croci, Carolina; Ravelli, Claudia; Masa, Giulia; Paolillo, Piermichele; Manzoni, Paolo; Balottin, Umberto; Stronati, Mauro

    2016-09-01

    Objective We aimed at assessing the association between superior vena cava flow (SVCf), regional (cerebral) tissue oxygen saturation (rSO2), and cerebral fractional oxygen extraction (CFOE) during the first 48 hours of life and 2-years neurodevelopmental outcome of very low-birth-weight infants (VLBW). Methods We prospectively studied 60 VLBW infants admitted to our neonatal intensive care unit; rSO2 was continuously monitored with near-infrared spectroscopy during the first 48 hours of life, SVCf was measured at 4 to 6, 12, 24, and 48 hours, and CFOE was calculated. Neurodevelopmental outcome was assessed at 24 months corrected age. Results The mean gestational age at birth was 27.9 weeks (standard deviation: 2.4); 8 infants died in the first 3 months of life, 6 were lost to follow-up, 46 survived and were followed up. At 24 months, 6 (13%) and 7 (15.2%) infants developed minor and major sequelae, respectively. Infants who died had higher CFOE (p < 0.001) and lower SVCf (p < 0.001) than infants surviving with sequelae. In turn, these had higher SVCf between 24 and 48 hours than those without sequelae (p < 0.001). Conclusion SVCf, rSO2, and CFOE patterns in the first days of life suggest cerebral hyperperfusion, related to loss of autoregulation and/or use of inotropic drugs, as a potential mechanism of cerebral injury. PMID:27603543

  16. Defibrillation lead placement using a transthoracic transatrial approach in a case without transvenous access due to lack of the right superior vena cava.

    PubMed

    Otsuka, Yosuke; Okamura, Hideo; Sato, Syunsuke; Nakajima, Ikutaro; Ishibashi, Kohei; Miyamoto, Kouji; Noda, Takashi; Aiba, Takeshi; Kamakura, Shiro; Kobayashi, Junjiro; Yasuda, Satoshi; Ogawa, Hisao; Kusano, Kengo

    2015-06-01

    A 65-year-old woman with a history of syncope was diagnosed with hypertrophic cardiomyopathy. She had previously undergone mastectomy of the left breast owing to breast cancer. Holter electrocardiogram (ECG) and monitor ECG revealed sick sinus syndrome (Type II) and non-sustained ventricular tachycardia. Sustained ventricular tachycardia and ventricular fibrillation were induced in an electrophysiological study. Although the patient was eligible for treatment with a dual chamber implantable cardioverter defibrillator (ICD), venography revealed lack of the right superior vena cava (R-SVC). Lead placement from the left subclavian vein would have increased the risk of lymphedema owing to the patient׳s mastectomy history. Consequently, the defibrillation lead was placed in the right ventricle by direct puncture of the right auricle through the tricuspid valve. The atrial lead was sutured to the atrial wall, and the postoperative course was unremarkable. Defibrillation lead placement using a transthoracic transatrial approach can be an alternative method in cases where a transvenous approach for lead placement is not feasible.

  17. Prosthetic graft interposition of the brachiocephalic veins or superior vena cava combined with resection of malignant tumours: graft patency and risk factors for graft occlusion

    PubMed Central

    Lee, Geun Dong; Choi, Se Hoon; Kim, Yong-Hee; Kim, Dong Kwan; Park, Seung-Il

    2016-01-01

    Background We aimed to assess graft patency in patients undergoing prosthetic graft interposition of the brachiocephalic veins (BCVs) or the superior vena cava (SVC) combined with resection of malignant tumours. Methods A retrospective analysis was conducted on 16 patients who underwent prosthetic graft interposition of the BCVs or the SVC between 1998 and 2012. Results Among a total of 20 grafts in 16 patients (unilateral graft interposition in 12, bilateral graft interposition in 4), 8 grafts were occluded in 8 patients. Overall graft patency rate was 64.6%, 42.4% at the 2- and 5-year follow-up. Graft patency rate of the left BCV was significantly lower than that of the right BCV or the SVC (2-year patency, 38.1% vs. 81.8%, P=0.024). In univariate analysis, the superior anastomosis site [left BCV vs. right BCV; hazard ratio (HR) =2.312; 95% confidence interval (CI), 1.015–5.265; P=0.046], the inferior anastomosis site (right atrial appendage vs. SVC; HR =2.409; 95% CI, 1.124–5.161; P=0.024), and interruption of warfarin (HR =5.015; 95% CI, 1.106–22.734; P=0.037) were significant risk factors for graft occlusion. Graft occlusive symptoms were identified in 4 patients who underwent unilateral graft interposition. Conclusions Prosthetic graft interposition between the left BCV and the right atrial appendage resulted in a significant rate of graft occlusion. Prosthetic graft interposition of the bilateral BCVs and long-term warfarin therapy may be necessary to prevent graft occlusive symptoms. PMID:26904213

  18. Follow-up Results of 71 Patients Undergoing Metallic Stent Placement for the Treatment of a Malignant Obstruction of the Superior Vena Cava

    SciTech Connect

    Nagata, Takeshi Makutani, Shiro; Uchida, Hideo; Kichikawa, Kimihiko; Maeda, Munehiro; Yoshioka, Tetsuya; Anai, Hiroshi; Sakaguchi, Hiroshi; Yoshimura, Hitoshi

    2007-09-15

    Purpose. To retrospectively clarify the utility of metallic stent placement for the treatment of the malignant obstruction of the superior vena cava (SVC) in 71 patients with VC syndrome (SVCS) on the basis of long-term follow-up data. Materials and Methods. Seventy-one patients underwent stent placement and were followed until death. The applicability of the spiral Z-stent (S-Z-stent) mainly used the initial and follow-up results, stent placement for bilateral BCV obstruction and the value of concurrent anticancer therapy were studied. Results. The technical success rate was 100%, the initial clinical success rate was 87% (62/71), the primary clinical patency rate was 88% (57/65), and the secondary clinical patency rate was 95% (62/65). The obstruction rate of the stent was 12% (8/65), and an additional stent was useful for relief of recurrent SVCS. Survival of 57 patients in whom there was no recurrence of SVCS until death ranged from 1 week to 29 months (mean, 5.4 months and the S-Z-stent appeared to be suitable for the treatment of the malignant obstruction of SVC. Unilateral stent placement was effective for relief of SVCS with bilateral BCV obstruction. Patients who received concurrent anticancer therapy survived 2 months longer than those who did not. Conclusion. Stent placement is an effective treatment for SVCS. Further, the utility of S-Z-stent for SVCS, an additional stent for recurrence, unilateral stent for patients with bilateral BCV obstruction, and anticancer therapy after stent placement were verified.

  19. [Outcome of Resection of Inferior Vena Cava Superior to the Renal Vein in Renal Cell Carcinoma with Vena Caval Tumor Thrombus].

    PubMed

    Kashima, Soki; Narita, Shintaro; Saito, Mitsuru; Takahashi, Makoto; Maita, Shinya; Tsuruta, Hiroshi; Numakura, Kazuyuki; Maeno, Atsushi; Inoue, Takamitsu; Tsuchiya, Norihiko; Satoh, Shigeru; Yamamoto, Hiroshi; Yamamoto, Yuzo; Habuchi, Tomonori

    2016-06-01

    Surgical management with radical nephrectomy and thrombectomy has often been performed in renal cell carcinoma (RCC) with tumor thrombus infiltrating the inferior vena cava (IVC). We retrospectively reviewed the outcomes of IVC resection without venous reconstruction in patients with RCC and IVC thrombus at our institution. Eight patients with right RCC underwent radical nephrectomy and IVC resection superior to the level of the renal vein without venous reconstruction from August 2005 to February 2015. Thoracotomy, liver mobilization, and extracorporeal circulation were performed based on the IVC thrombus level. We assessed surgical outcomes, perioperative complications, and survival. At presentation, four patients had level IIIa IVC thrombus, three had level IIIb IVC thrombus, and one had level IV IVC thrombus. Perioperative imaging showed that three of the four patients who underwent neoadjuvant molecular targeting therapy achieved down-staging of the tumor thrombus level. The median operative time was 406 min, and the median estimated blood loss was 3,135 ml. With regard to IVC resectionassociated perioperative complications, one patient needed extracorporeal circulation with IVC ligation and Pringle maneuver owing to low blood pressure. Another patient underwent temporary hemodialysis for 8 days after surgery. There were no perioperative deaths, and none of the patients required permanent hemodialysis. Three patients survived the mean observation period of 25 months, including one patient with no recurrence. Three patients achieved long-term survival of more than 2 years. IVC resection without venous reconstruction may be a feasible option for patients with RCC and IVC tumor thrombus. Further study is needed to determine the most appropriate candidates for this procedure. PMID:27452491

  20. Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report

    PubMed Central

    2014-01-01

    Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection. PMID:25110520

  1. An unusual constellation of congenital malformations in a single patient including partial anomalous pulmonary venous return, persistent left superior vena cava, aberrant pulmonary fissure, anomalous aortic arch, tracheal diverticulum and annular pancreas

    PubMed Central

    Lapa, T; Vedelago, J; Kim, H; Patrick, E

    2014-01-01

    We report a case of a male patient with a constellation of rare congenital anomalies consisting of: partial anomalous pulmonary venous return (PAPVR), persistent left superior vena cava, ‘bovine arch’ aortic branching, tracheal diverticulum, aberrant lung fissure anatomy and an annular pancreas. He had presented with a history of worsening dyspnoea. To the best of our knowledge, this is the first reported case of a single patient with such a vast constellation of anomalies. The radiological evaluations, epidemiology, embryology and clinical features of the anomalies are discussed. It is important for radiologists to be aware of each of these anomalies as distinct entities; detection of a single anomaly should alert to the possibility that further anatomic aberrancies may be present. PMID:25362184

  2. An unusual constellation of congenital malformations in a single patient including partial anomalous pulmonary venous return, persistent left superior vena cava, aberrant pulmonary fissure, anomalous aortic arch, tracheal diverticulum and annular pancreas.

    PubMed

    Lapa, T; Vedelago, J; Kim, H; Patrick, E

    2014-10-31

    We report a case of a male patient with a constellation of rare congenital anomalies consisting of: partial anomalous pulmonary venous return (PAPVR), persistent left superior vena cava, 'bovine arch' aortic branching, tracheal diverticulum, aberrant lung fissure anatomy and an annular pancreas. He had presented with a history of worsening dyspnoea. To the best of our knowledge, this is the first reported case of a single patient with such a vast constellation of anomalies. The radiological evaluations, epidemiology, embryology and clinical features of the anomalies are discussed. It is important for radiologists to be aware of each of these anomalies as distinct entities; detection of a single anomaly should alert to the possibility that further anatomic aberrancies may be present.

  3. [UNMODIFIED DIAMETER V. PORTA. IN 79-YEAR-OLD PATIENT WITH CONGESTIVE HEART FAILURE AND SEVERE PULMONARY HYPERTENSION IN THE SETTING OF COMPLEX CONGENITAL HEART DISEASE--PATENT FORAMEN OVALE AT THE CONFLUENCE OF THE LEFT PULMONARY VEINS INTO THE V. CAVA SUPERIOR AND MIXED (HCV) LIVER CIRRHOSIS].

    PubMed

    Alexandrova, A A; Kolos, I P; Dupik, N V; Lazebnik, L B

    2015-01-01

    The clinical observation and analysis of the reasons for late diagnosis of congenital heart disease is presented. A feature of this observation is diagnosed complex congenital heart defect with shunting of blood in elderly woman with the second disease--chronic viral hepatitis C and cirrhosis of the liver. Long-term compensation circulation and lack of pulmonary fibrosis in our patient with patent foramen ovale was due to the presence of a second malformation--confluence of the left pulmonary veins in vena cava superior that apparently contributed to the constant lung tissue haemooxygenation.

  4. Vena cava filter insertion and the general surgery armamentarium: a 13-year experience.

    PubMed

    Sing, Ronald F; Nguyen, Phuong H; Christmas, A Britton; Jacobs, David G; Heniford, B Todd

    2010-07-01

    The prevention of pulmonary emboli has a long surgical history. Through the development of percutaneous technologies, vena cava filters (VCFs) are now commonly inserted by interventional radiologists. This study reviews our experience with VCFs inserted by general surgeons. We retrospectively reviewed data from our VCF performance improvement database, which is a prospective collection of the VCF experience of the Department of General Surgery from February 1996 to May 2009. Demographics, procedural information, and complications were recorded. Eight hundred fifty-five VCFs were inserted in 853 patients. The mean age was 42.0 years (range, 14 to 90 years). One hundred ninety-seven VCFs were placed in the operating room, and 658 were placed in the intensive care unit. Twelve VCFs were intentionally inserted in a suprarenal position, and four were placed in the superior vena cava. Two patients received both superior vena cava and inferior vena cava filters. Complications included deep vein thrombosis at the insertion site (n=16), vena cava thrombosis (n=9), post-VCF pulmonary embolism (n=2), and a ventricle perforation requiring operative repair (n=1). No deaths were attributed to the presence of a VCF. Overall insertion success was 99.8 per cent. In two patients, an inferior VCF could not be placed as a result of inferior vena cava occlusion with no safe "landing zone" for deployment. The placement of VCFs is a vital skill in the general surgery armamentarium. Our experience demonstrates that general surgeons can safely insert VCFs with minimal perioperative complications.

  5. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava.

    PubMed

    Charlagorla, Pradeepkumar; Breinholt, John P

    2016-01-01

    Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  6. Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

    SciTech Connect

    Carnevale, Francisco Cesar Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

    2010-06-15

    We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

  7. Nutcracker syndrome in a patient with a history of inferior vena cava ligation.

    PubMed

    Peker, Ahmet; Yagmurlu, Aydin; Ekim, Mesiha; Gokcora, Haluk; Fitoz, Suat

    2011-09-01

    We report the case of a child with clinical and radiological signs of nutcracker syndrome who had a history of inferior vena cava ligation during a previous surgery. He was referred for evaluation of abdominal pain and hematuria. Entrapment of the left renal vein between the superior mesenteric artery and the aorta with aneurysmal dilatation was detected on Doppler ultrasonography. Magnetic resonance angiography revealed paravertebral and epidural collateral vessels.

  8. [The vena cava--reflections on nomenclature].

    PubMed

    Kaiser, E

    1984-01-01

    In the course of standardization of anatomical nomenclature old nomenclatures are retained although their sense is not clear. One example is the term " Hohl "- Vene (= "hollow" vein). During the time of ancient medicine the names artery/vein signified a hollow structure and later the meaning was limited to vessels. At that time two names existed for the inferior vena cava: vena magna (the "big" vein) and vena cava (the "hollow" vein). Later authors thought that the name vena cava was an error of translation. But the history of medicine demonstrates a clear coherence between the words "hollow space" and "spirit". Therefore the name " Hohl "- Vene indicates that people supposed the animal spirit being in the hollow part of the blood circulation. PMID:6721176

  9. Transapical closure of paraprosthetic mitral leak in a patient with inferior vena cava interruption and azygos continuation.

    PubMed

    Mega, Simona; Patti, Giuseppe; Carminati, Mario; Sedati, Pietro; D'Ambrosio, Andrea; Di Sciascio, Germano

    2015-01-01

    Para-valvular leaks represent a relevant post-operative complication of cardiac valve replacement, often causing heart failure or severe hemolysis. We report a case of a 72 year-old woman with aortic and mitral mechanical prostheses who developed hemolytic anemia because of a para-prosthetic mitral leak. Chest tomography in such patient unexpectedly documented inferior vena cava interruption with azygos continuation into superior vena cava. Given the high surgical risk, the venous anomaly and the presence of the aortic valve prosthesis, transcatheter leak closure via antero-lateral mini-thoracotomy and transapical approach was performed.

  10. Spanish sparkling wines (Cavas) as inhibitors of in vitro human low-density lipoprotein oxidation.

    PubMed

    Satué-Gracia, M T; Andrés-Lacueva, C; Lamuela-Raventós, R M; Frankel, E N

    1999-06-01

    Forty-seven dealcoholized sparkling wines (cava) from the Penedès area in Spain were tested for their antioxidant activity in a low-density lipoprotein system. The effect of different quality-related parameters, such as harvest year or grape variety, was investigated. Twenty-two phenolic compounds were separated by high-performance liquid chromatography and identified by comparing their retention time and their ultraviolet spectra with those of pure standards. When tested at the same total phenol concentration, the antioxidant activity of these white sparkling wines was found to be similar to that reported for red wines. This activity was positively correlated with the total phenolic content, trans-caffeic acid, coumaric acid, protocatechuic acid, and quercetin 3-glucuronide. The wines made of the classic cava wine coupage had superior antioxidant activity compared to those of other cultivars.

  11. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    PubMed Central

    Charlagorla, Pradeepkumar; Breinholt, John P.

    2016-01-01

    Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly. PMID:27212858

  12. Local colloid trapping in the liver in the inferior vena cava syndrome

    SciTech Connect

    Lin, M.S.; Fletcher, J.W.; Donati, R.M.

    1981-04-01

    Local radioactive areas in the liver were observed as a result of superficial cavoportal shunting of radiocolloids in two patients with the inferior vena cava syndrome. In one patient a paraumbilical and/or a recanalized umbilical vein was apparently involved in the hepatopetal shunting. In the other patient a superficial anastomosis other than the paraumbilical vein shunted colloid to the liver. Relatively discrete areas of increased radioactivity, single or multiple, were seen in the left lobe. Virtually all reported instances of hepatopetal shunting of radioparticles in a superior or an inferior vena cava syndrome have demonstrated similar findings. Various hepatopetal collateral pathways in infrarenal caval obstruction are considered, and factors that could affect liver scan findings in the infrarenal obstruction are discussed.

  13. Total laparoscopic retrieval of inferior vena cava filter

    PubMed Central

    Benrashid, Ehsan; Adkar, Shaunak Sanjay; Bennett, Kyla Megan; Zani, Sabino

    2015-01-01

    While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach. PMID:27489697

  14. In Vitro Studies of Temporary Vena Cava Filters

    SciTech Connect

    Lorch, Heike; Zwaan, Martin; Kulke, Christian; Weiss, Hans-Dieter

    1998-03-15

    Purpose: To evaluate the clot trapping capacity of different temporary vena cava filters in a vena cava model. Methods: A vena cava flow model was built using PVC tubing, a hemodialysis membrane and a pulsatile pump. Blood was imitated by a Dextran 40 solution. Five different temporary vena cava filters and two prototypes were tested using human thrombi. The mechanism of clot capture was observed. Results: Decreasing rank order according to decreasing percentage of clots captured for the 21-mm diameter vena cava model was Cook (C) > Angiocor (A) > Cordis (CD) > Antheor (TF-6) > DIL for thrombi with a diameter of 3 mm and A > C > CD > TF-6 > DIL for 5-mm thrombi. In a cava with diameter of 28 mm, decreasing rank order was C > CD = A > TF-6 > DIL and C > CD = A > DIL > TF-6 for 3- and 5-mm thrombi, respectively. Two new prototypes, the TF-8 and TF-10 filters, achieved better results than the TF-6 filter and were in most conditions comparable to the A and CD filters. In most cases, thrombi were trapped between filter and cava wall. Conclusion: The vena cava flow model demonstrates significant differences in rates of clot capture (range 22%-98%) depending on cava diameter, thrombus size, and filter type.

  15. 21 CFR 870.3260 - Vena cava clip.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vena cava clip. 870.3260 Section 870.3260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3260 Vena cava clip. (a) Identification. A...

  16. 21 CFR 870.3260 - Vena cava clip.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vena cava clip. 870.3260 Section 870.3260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3260 Vena cava clip. (a) Identification. A...

  17. Anatomic Variant of Liver, Gall Bladder and Inferior Vena Cava.

    PubMed

    Sontakke, Yogesh Ashok; Gladwin, V; Chand, Parkash

    2016-07-01

    The morphology and relations of liver, gall bladder and inferior vena cava are cardinal. Their anatomical variations may be a reason for the adverse surgical outcome. During routine anatomy dissection of an abdomen, we noticed a variant liver, gall bladder and inferior vena cava in a 63-year-old male cadaver. In the specimen, a retrohepatic segment of inferior vena cava was found to be intrahepatic. On dissection, it was observed that inferior vena cava was covered entirely by a liver tissue on its dorsal aspect. In the same specimen, the gall bladder had undulated inferior surface. On dissection of the gall bladder, numerous mucosal folds were present in the interior. A band of fibrous tissue was found, which was extending from the right side of the gall bladder to the falciform ligament. Hence, preoperative scanning of congenital variations of the liver, gall bladder and inferior vena cava may be compassionate in planning safe surgeries and interventional abdominal procedures. PMID:27630832

  18. Anatomic Variant of Liver, Gall Bladder and Inferior Vena Cava

    PubMed Central

    Gladwin, V.; Chand, Parkash

    2016-01-01

    The morphology and relations of liver, gall bladder and inferior vena cava are cardinal. Their anatomical variations may be a reason for the adverse surgical outcome. During routine anatomy dissection of an abdomen, we noticed a variant liver, gall bladder and inferior vena cava in a 63-year-old male cadaver. In the specimen, a retrohepatic segment of inferior vena cava was found to be intrahepatic. On dissection, it was observed that inferior vena cava was covered entirely by a liver tissue on its dorsal aspect. In the same specimen, the gall bladder had undulated inferior surface. On dissection of the gall bladder, numerous mucosal folds were present in the interior. A band of fibrous tissue was found, which was extending from the right side of the gall bladder to the falciform ligament. Hence, preoperative scanning of congenital variations of the liver, gall bladder and inferior vena cava may be compassionate in planning safe surgeries and interventional abdominal procedures. PMID:27630832

  19. Mesoaortic entrapment of a left inferior vena cava.

    PubMed

    Gupta, Ashish; Naik, Nitish; Gulati, Gurpreet Singh

    2010-02-01

    A persistent left inferior vena cava (IVC) is a rare anomaly, with a reported incidence of only 0.2-0.5%. When present, it courses between the superior mesenteric artery and the aorta to continue as the right IVC, similar to the course of a left renal vein (LRV). This anomaly is usually asymptomatic, but there may be vague abdominal complaints if the IVC is compressed in the mesoaortic angle. Although symptomatic compression of the LRV (anterior nutcracker syndrome) is well recognized, there has been only one report in the literature of a similar compression of a persistent left IVC. Because of its rarity, this anomaly may be missed or mistaken for other conditions on imaging. An accurate diagnosis is crucial as the presence of this anomaly may have implications for surgical treatment of aortic lesions or placement of an IVC filter. Magnetic resonance angiography and, more recently, multidetector computed tomography scan, can provide an exquisite three-dimensional demonstration of vascular abnormalities.

  20. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    SciTech Connect

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating

  1. Suprarenal symplastic leiomyoma of the inferior vena cava.

    PubMed

    Kepenekci, Ilknur; Demirkan, Arda; Sözener, Ulas; Cakmak, Atil; Demirer, Seher; Alaçayir, Iskender; Ekinci, Cemil

    2009-01-01

    We report on a case of a leiomyoma in the inferior vena cava that appeared in the image to be located in the adrenal gland. En bloc excision of the tumor with the right adrenal gland and the involved segment of the vena cava was carried out. Histopathological work-up of the tumor revealed smooth muscle fibers and marked nuclear pleomorphism consistent with symplastic leiomyoma. This case report presents a distinct histological variant of the rarely seen primary smooth muscle tumor of the inferior vena cava.

  2. Leiomyosarcoma of the inferior vena cava: a case report.

    PubMed

    Nascif, Rafael Lemos; Antón, Ana Graziela Santana; Fernandes, Gabriel Lacerda; Dantas, George Caldas; Gomes, Vinícius de Araújo; Natal, Marcelo Ricardo Canuto

    2014-01-01

    The authors report a case of a 48 year-old female patient with moderate abdominal pain and bulging in the abdomen. Physical examination demonstrated the presence of a palpable abdominal mass. Computed tomography showed a heterogeneously enhancing retroperitoneal mass in close contact with the inferior vena cava. En bloc resection of the mass and of the attached vena cava segment was performed. Histological analysis revealed leiomyosarcoma.

  3. Troubleshooting OptEase inferior vena cava filter retrieval.

    PubMed

    Nakashima, Masaya; Kobayashi, Hideaki; Kobayashi, Masayoshi

    2016-01-01

    For treatment of deep vein thrombosis and prevention of pulmonary thromboembolism, a retrievable inferior vena cava filter is commonly utilized as an effective bridge to anticoagulation. However, we have experienced difficulties in retrieving inferior vena cava filters. Endovascular retrieval assisted by disposable biopsy forceps is an appropriate approach because it provides a less-invasive low-cost way to remove a migrated filter. We suggest this troubleshooting technique to deal with filter hook migration into the caval wall.

  4. The North Atlantic Oscillation affects the quality of Cava (Spanish sparkling wine).

    PubMed

    Real, Raimundo; Báez, José Carlos

    2013-05-01

    This study explores the possible effects of the North Atlantic Oscillation (NAO) on the quality of Spanish Cava. We found a significant negative relationship between the mean NAO for the months of March through August of each year between 1970 and 2008 and the probability of obtaining a top quality Cava. The NAO is associated with temperature and rainfall variations in the Cava region, which affect vine physiological processes during grape maturity. The probability of obtaining a top quality Cava was highest when the mean value of the NAO was negative, which causes the mean temperature in the Cava area to decrease, with positive consequences on Cava quality. Although the overall discrimination capacity and explanatory power of the model were low, 80% of clearly favorable years were classified correctly as corresponding to top quality Cava, and 70% of clearly unfavorable years were classified correctly as non top quality Cava.

  5. Entrapment of J-tip guidewires by Venatech and stainless-steel Greenfield vena cava filters during central venous catheter placement: percutaneous management in four patients.

    PubMed

    Andrews, R T; Geschwind, J F; Savader, S J; Venbrux, A C

    1998-01-01

    We present four patients in whom bedside placement of a central venous catheter was complicated by entrapment of a J-tip guidewire by a previously placed vena cava (VC) filter. Two Venatech filters were fragmented and displaced into the superior VC or brachiocephalic vein during attempted withdrawal of the entrapped wire. Two stainless-steel Greenfield filters remained in place and intact. Fluoroscopically guided extraction of both wires entrapped by Greenfield filters was successfully performed in the angiography suite.

  6. Trimodality Therapy for an Advanced Thymic Carcinoma With Both Aorta and Vena Cava Invasion.

    PubMed

    Momozane, Tohru; Inoue, Masayoshi; Shintani, Yasushi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Shirakawa, Yukitoshi; Kuratani, Toru; Sawa, Yoshiki; Okumura, Meinoshin

    2016-08-01

    A case of locally advanced thymic carcinoma that was successfully resected with the great vessels after chemoradiation therapy is reported. A 57-year-old man with Masaoka stage III thymic carcinoma received two cycles of cisplatin/docetaxel and 60 Gy irradiation. The response was stable disease with 19% size reduction, and a radical resection with the ascending aorta and superior vena cava with the patient under circulatory arrest with the use of cardiopulmonary bypass was performed. The postoperative course was uneventful, and the patient has been free of disease for 28 months. Trimodality therapy with use of a cardiovascular surgical procedure might be a valuable option in locally advanced thymic carcinoma. PMID:27449450

  7. Effect of Dieckol, a Component of Ecklonia cava, on the Promotion of Hair Growth

    PubMed Central

    Kang, Jung-Il; Kim, Sang-Cheol; Kim, Min-Kyoung; Boo, Hye-Jin; Jeon, You-Jin; Koh, Young-Sang; Yoo, Eun-Sook; Kang, Sung-Myung; Kang, Hee-Kyoung

    2012-01-01

    This study was conducted to evaluate the effect of Ecklonia cava, a marine alga native to Jeju Island in Korea, on the promotion of hair growth. When vibrissa follicles were cultured in the presence of E. cava enzymatic extract (which contains more than 35% of dieckol) for 21 days, E. cava enzymatic extract increased hair-fiber length. In addition, after topical application of the 0.5% E. cava enzymatic extract onto the back of C57BL/6 mice, anagen progression of the hair-shaft was induced. The treatment with E. cava enzymatic extract resulted in the proliferation of immortalized vibrissa dermal papilla cells (DPC). Especially, dieckol, among the isolated compounds from the E. cava enzymatic extract, showed activity that increased the proliferation of DPC. When NIH3T3 fibroblasts were treated with the E. cava enzymatic extract and the isolated compounds from the E. cava enzymatic extract, the E. cava enzymatic extract increased the proliferation of NIH3T3 fibroblasts, but the isolated compounds such as eckol, dieckol, phloroglucinol and triphlorethol-A did not affect the proliferation of NIH3T3 fibroblasts. On the other hand, the E. cava enzymatic extract and dieckol significantly inhibited 5α-reductase activity. These results suggest that dieckol from E. cava can stimulate hair growth by the proliferation of DPC and/or the inhibition of 5α-reductase activity. PMID:22754373

  8. Asymptomatic Lumbar Vertebral Erosion from Inferior Vena Cava Filter Perforation

    SciTech Connect

    Fang, Wayne Hieb, Robert A.; Olson, Eric; Carrera, Guillermo F.

    2007-06-15

    In 2002, a 24-year-old female trauma patient underwent prophylactic inferior vena cava filter placement. Recurrent bouts of renal stones prompted serial CT imaging in 2004. In this brief report, we describe erosion and ossification of the L3 vertebral body by a Greenfield filter strut.

  9. Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis.

    PubMed

    Haddad, Raad A; Saadaldin, Mazin; Kumar, Binay; Bachuwa, Ghassan

    2015-01-01

    Inferior vena cava agenesis (IVCA) is a rare congenital anomaly that can be asymptomatic or present with vague, nonspecific symptoms, such as abdominal or lower back pain, or deep vein thrombosis (DVT). Here, we present a 55-year-old male who came with painless swelling and redness of his left lower limb. On examination, swelling and redness were noted extending from the left foot to the upper thigh; it was also warm compared to his right lower limb. Venous Doppler ultrasound was done which showed DVT extending up to the common femoral vein. Subsequently, computed-tomography (CT) of the chest and abdomen was done to exclude malignancy or venous flow obstruction; it revealed congenital absence (agenesis) of the infrarenal inferior vena cava (IVC). PMID:26788400

  10. Penetrating injuries of the abdominal inferior vena cava.

    PubMed Central

    Degiannis, E.; Velmahos, G. C.; Levy, R. D.; Souter, I.; Benn, C. A.; Saadia, R.

    1996-01-01

    This is a retrospective study of 74 patients with penetrating injuries of the abdominal inferior vena cava; the cause of injury was gunshot in 91% and stabbing in 9%. Of the patients, 77% underwent lateral venorrhaphy, 5% underwent infrarenal ligation of the inferior vena cava (IVC), and 18% died perioperatively before any caval repair could be carried out. There was an overall perioperative mortality of 39%. Persistent shock, the site of the venous injury, particularly in the retrohepatic position, and the number of associated vascular injuries were directly related to mortality. Irrespective of the improvements in resuscitation and the various operative methods available, penetrating trauma of the abdominal IVC remains a life-threatening injury. PMID:8943628

  11. Atrioventricular nodal reentrant tachycardia ablation and inferior vena cava agenesis.

    PubMed

    Galand, Vincent; Pavin, Dominique; Behar, Nathalie; Mabo, Philippe; Martins, Raphaël P

    2016-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. PMID:27633734

  12. Modeling Flow Past a Tilted Vena Cava Filter

    SciTech Connect

    Singer, M A; Wang, S L

    2009-06-29

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  13. [Mitral surgery by superior biatrial septotomy].

    PubMed

    Saade, A; Delepine, G; Lemaitre, C; Baehrel, B

    1995-01-01

    The superior biatrial septotomy approach consists of two semicircular right atrial and septal incisions joined at the superior end of the interatrial septum and extended across the dome of the left atrium, allowing exposure of the mitral valve by reflecting the ventricular side using stay sutures. From 1991 to 1993, 81 patients underwent mitral valve surgery by this technic. Mitral valve operation was combined with other cardiac procedures in 30 patients (37%) and was performed as a second operation in 21 patients (25.9%). Duration of cardiopulmonary bypass and aortic occlusion was not significantly different from that of patients operated via a conventional left atrial approach. The five hospital deaths (6.2%) were not related to this operative approach. Only 2 patients (3.3%) with preoperative in sinus rythm were discharged in atrial fibrillation after operation. In one patient (1.6%), atrioventricular block appeared at late follow-up. There were no cases of bleeding, atrioventricular nodal dysfunction or intra-atrial shunting related to the approach. This approach provides excellent exposure of the mitral valve even in unfavorable situations such as a small left atrium, dense adhesions from previous procedures or a previously implanted aortic prosthesis, without damage to various cardiac structures due to excessive traction. No retractor or vena cava repair are required. These data support a wide application of the superior biatrial septotomy approach in mitral valve surgery.

  14. Experimental investigation of the effects of inserting a bovine venous valve in the inferior vena cava of Fontan circulation

    NASA Astrophysics Data System (ADS)

    Santhanakrishnan, Arvind; Johnson, Jacob; Kotz, Monica; Tang, Elaine; Khiabani, Reza; Yoganathan, Ajit; Maher, Kevin

    2012-11-01

    The Fontan procedure is a palliative surgery performed on patients with single ventricle (SV) congenital heart defects. The SV is used for systemic circulation and the venous return from the inferior vena cava (IVC) and superior vena cava (SVC) is routed to the pulmonary arteries (PA), resulting in a total cavopulmonary connection (TCPC). Hepatic venous hypertension is commonly manifested in the Fontan circulation, leading to long-term complications including liver congestion and cirrhosis. Respiratory intrathoracic pressure changes affect the venous return from the IVC to the PA. Using a physical model of an idealized TCPC, we examine placement of a unidirectional bovine venous valve within the IVC as a method of alleviating hepatic venous hypertension. A piston pump is used to provide pulsatility in the internal flow through the TCPC, while intrathoracic pressure fluctuations are imposed on the external walls of the model using a pair of linear actuators. When implanted in the extrathoracic position, the hepatic venous pressure is lowered from baseline condition. The effects of changing caval flow distribution and intrathoracic pressure on TCPC hemodynamics will be examined.

  15. A Giant Mesenteric Desmoid Tumor Revealed by Acute Pulmonary Embolism due to Compression of the Inferior Vena Cava

    PubMed Central

    Palladino, Elisa; Nsenda, Joseph; Siboni, Renaud; Lechner, Christian

    2014-01-01

    Patient: Male, 69 Final Diagnosis: Mesenteric desmoid tumor Symptoms: — Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Intra-abdominal fibromatosis is a benign rare tumor of fibrous origin with a significant potential for local invasion and no ability to metastasize, but it can recur. The etiology of desmoid tumors is unknown. It is often associated with conditions such as familial adenomatous polyposis and Gardner syndrome. Case Report: We report the case of a 69-year-old man who presented to our hospital with an acute pulmonary embolism. The patient had a past history of colic surgery for a polyp with a high-grade dysplasia. Pulmonary angiography showed partial occlusion of the right superior lobe artery and partial occlusion of the middle lobe artery. The patient was given thrombolytic therapy. Abdominal computerized tomography revealed a mesenterial giant mass with compression of the inferior vena cava (IVC). A biopsy of the mass, confirming aggressive fibromatosis. A laparotomy was performed, which revealed a massive growth occupying the abdomen and attached to the previous ileocolic anastomosis. One day after surgery, his condition deteriorated. Conclusions: This report underlines the potential of imaging investigations of abdomen and vena cava if pulmonary embolism is suspected, especially when there is no evidence of peripheral venous thrombosis or other predisposing factors. Unfortunately, data on the surgical management of desmoid tumor is scarce. Therefore, the standard of treatment is a surgical resection for resectable tumors. PMID:25180474

  16. Congenital atresia of the inferior vena cava and antithrombin III deficiency in a young adult: compounding risk factors for deep vein thrombosis.

    PubMed

    Muscianese, Laura; Seese, Ronald R; Graham, William; Williams, James H

    2015-01-01

    Atresia, or absence, of the inferior vena cava (AIVC) is a rare, usually fortuitous finding on advanced imaging that predisposes patients to deep venous thrombosis (DVT). In young adults who lack predisposing risk factors but nonetheless develop extensive or bilateral DVTs, AIVC should be considered. We describe a case of a previously healthy 17-year-old male patient who developed an extensive renal vein thrombus due to the absence of the superior portion of his IVC compounded with previously undiagnosed antithrombin III deficiency. We discuss the diagnosis and management of this complicated condition.

  17. Deep venous thrombosis in a young woman with hypoplastic inferior vena cava.

    PubMed

    Lavens, Matthias; Moors, Boudewijn; Thomis, Sarah

    2014-05-01

    We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis.

  18. Enhancement of Human Hair Growth Using Ecklonia cava Polyphenols

    PubMed Central

    Shin, Hyoseung; Cho, A-Ri; Kim, Dong Young; Munkhbayer, Semchin; Choi, Soon-Jin; Jang, Sunhyae; Kim, Seong Ho; Shin, Hyeon-Cheol

    2016-01-01

    Background Ecklonia cava is a brown alga that contains various compounds, including carotenoids, fucoidans, and phlorotannins. E. cava polyphenols (ECPs) are known to increase fibroblast survival. The human dermal papilla cell (hDPC) has the properties of mesenchymal-origin fibroblasts. Objective This study aims to investigate the effect of ECPs on human hair growth promotion in vitro and ex vivo. Methods MTT assays were conducted to examine the effect of ECPs on hDPC proliferation. Hair growth was measured using ex-vivo hair follicle cultures. Real-time polymerase chain reaction was performed to evaluate the mRNA expression of various growth factors in ECP-treated hDPCs. Results Treatment with 10 µg/ml purified polyphenols from E. cava (PPE) enhanced the proliferation of hDPCs 30.3% more than in the negative control (p<0.001). Furthermore, 0.1 µg/ml PPE extended the human hair shaft 30.8% longer than the negative control over 9 days (p<0.05). Insulin-like growth factor-1 (IGF-1) mRNA expression increased 3.2-fold in hDPCs following treatment with 6 µg/ml PPE (p<0.05). Vascular endothelial growth factor (VEGF) mRNA expression was also increased 2.0-fold by 3 µg/ml PPE (p<0.05). Treatment with 10 µg/ml PPE reduced oxidative stress in hDPCs (p<0.05). Conclusion These results suggest that PPE could enhance human hair growth. This can be explained by hDPC proliferation coupled with increases in growth factors such as IGF-1 and VEGF. Reducing oxidative stress is also thought to help increase hDPCs. These favorable results suggest that PPE is a promising therapeutic candidate for hair loss. PMID:26848214

  19. [Vena cava agenesia presented as incarcerated groin hernia].

    PubMed

    Safir-Hansen, Kristina; Achiam, Michael Patrick

    2014-12-15

    The case describes a 45-year-old man with a rare finding of vena cava agenesia presented as incarcerated groin hernia. From childhood the patient had developed dilatation of subcutaneous veins with establishment of aneurismal dilatation in the lower right side of the abdomen and groin. The patient was submitted with severe abdominal pain in the lower right side. The case describes the difficulties of an initially incorrect radiological diagnosis of incarcerated groin hernia and the discrepancy of the clinical findings. The case stresses the importance of a thorough evaluation of each patient. PMID:25497657

  20. Inferior Vena Cava Duplication: Incidental Case in a Young Woman.

    PubMed

    Coco, Danilo; Cecchini, Sara; Leanza, Silvana; Viola, Massimo; Ricci, Stefano; Campagnacci, Roberto

    2016-01-01

    A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures. PMID:27217964

  1. Leiomyosarcoma of the Inferior Vena Cava With Kidney Invasion.

    PubMed

    Brewer, Katherine; Attalla, Kyrollis; Husain, Fatima; Tsao, Che-Kai; Badani, Ketan K; Sfakianos, John P

    2016-11-01

    Primary leiomyosarcomas of the inferior vena cava (IVC) are rare tumors associated with poor prognosis, and surgical resection with the goal of obtaining negative margins is the gold standard for initial treatment. Tumor characteristics of both extraluminal extension into renal parenchyma and intraluminal extension of the subdiaphragmatic IVC are even less common. The prognosis of vascular leiomyosarcomas is determined by the location and the size of the tumor, as these factors determine the risk of local recurrence and metastasis. We present a case of a 30-year old female incidentally found to have a 14 cm right renal mass and IVC thrombus. PMID:27679758

  2. Left Inferior Vena Cava and Right Retroaortic Renal Vein

    PubMed Central

    Nania, Alberto; Capilli, Fabio; Longo, Eugenia

    2016-01-01

    Nowadays, incidental anatomical variants are frequent findings, due to the widespread diffusion of cross-sectional imaging. This case report illustrates a fairly uncommon anatomical variant, that is, the copresence of left inferior vena cava and retroaortic right renal vein reported in a 46-year-old lady, undergoing a staging CT for breast cancer. Although the patient was asymptomatic, the authors highlight potential risks related to the above-mentioned condition and the importance of correct identification and diagnosis of the findings. PMID:26955497

  3. Ultrasonographic findings in a cow with ascites due to thrombosis of the caudal vena cava.

    PubMed

    Braun, U; Schefer, U; Gerber, D; Föhn, J

    1992-01-01

    This case report describes a three-year-old Swiss Braunvieh cow with ascites due to thrombosis of the caudal vena cava. Ultrasonography verified the ascites and revealed dilatation of the abdominal portion of the caudal vena cava (4.8 cm). It was presumed that the caudal vena cava was occluded by a thrombus or by perivenous compression cranial to the dilatation. Post mortem findings included: a massive accumulation of fluid in the abdominal cavity; a 15 cm long thrombus in the subphrenic region of the caudal vena cava; multiple pulmonary abscesses; severe thrombosis of the pulmonary vasculature; hepatic congestion; oedematous abomasal folds; and severe thrombophlebitis of the left jugular vein and both udder veins, due to poor intravenous injection technique. Ascites caused by thrombosis of the caudal vena cava is rare because collateral routes of venous return, including the udder veins, are usually established. It was therefore concluded that the ascites was attributable to bilateral thrombosis of the udder veins.

  4. Bedside insertion of inferior vena cava filters by a medical intensivist: preliminary results.

    PubMed

    Haley, Michael; Christmas, Britton; Sing, Ronald F

    2009-01-01

    The development of percutaneous techniques has allowed vena cava filters to be safely placed at the bedside. Such procedures appear uniquely suited for critically ill patients as they avoid the inherent risks associated with transportation. We report a "medical intensivist's" experience with the placement of 13 percutaneous vena cava filters. Vena cava filters were successfully placed in 12 of 13 patients as confirmed by postplacement venacavograms; 1 placement attempt was aborted because of a completely occluded inferior vena cava. These results suggest that with appropriate training and supervision, medical intensivists can safely insert vena cava filters in the intensive care unit setting. Such a practice appears safe, reduces patient risk associated with intrahospital transport, and may promote cost containment.

  5. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    SciTech Connect

    Iliescu, Bogdan; Haskal, Ziv J.

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  6. [Emphysematous cystitis with air bubbles in the vena cava].

    PubMed

    Yokokawa, Ryusei; Tsuka, Harutoshi; Muranaka, Koji

    2014-01-01

    A 76-year-old diabetic woman was referred to our hospital with an episode of high fever and sub-abdominal pain. Computed tomography (CT) of the pelvis revealed gas accumulation within the lumen and wall of the bladder and CT of the abdomen demonstrated bubbles in the inferior vena cava. She recovered by urinary drainage and antibiotic therapy. Urinary culture revealed Escherichia coli. CT after the therapy didn't demonstrate gas accumulation of the bladder and bubbles in the inferior vena cava. Emphysematous urinary tract infections (UTIs) have the high fatality rate, it seems to be a possibility that venous bubbles with emphysematous UTIs contribute to the high fatality rate such as air embolisms. It was suspected that bacterial injury of the bladder wall and high vesical pressure caused by urinary outlet obstruction such as neurogenic bladder lead gas translocation into the venous system. Six previous cases of emphysematous UTIs (three emphysematous cystitis cases and three emphysematous pyelonephritis cases) with venous bubbles have been reported to this day. Our case is seems to be the fourth case report that venous bubbles with emphysematous cystitis was demonstrated.

  7. Pictorial Superiority Effect

    ERIC Educational Resources Information Center

    Nelson, Douglas L.; And Others

    1976-01-01

    Pictures generally show superior recognition relative to their verbal labels. This experiment was designed to link this pictorial superiority effect to sensory or meaning codes associated with the two types of symbols. (Editor)

  8. Failure properties of vena cava tissue due to deep penetration during filter insertion.

    PubMed

    Hernández, Q; Peña, E

    2016-08-01

    In this work, we use an in-vitro mechanical test to explore the resistance of biaxially stretched vena cava tissue against deep perforation and a methodology which integrates experimental and numerical modeling to identify constitutive fracture properties of the vena cava. Six sheep vena cava were harvested just after killing, and cyclic uniaxial tension tests in longitudinal and circumferential directions and biaxial deep penetration tests were performed. After that, we use a nonlinear finite element model to simulate in vitro penetration of the cava tissue in order to fit the fracture properties under penetration of the vena cava by defining a cohesive fracture zone. An iterative process was developed in order to fit the fracture properties of the vena cava using the previously obtained experimental results. The proposed solutions were obtained with fracture energy of 0.22 or 0.33 N/mm. In comparison with the experimental data, the simulation using [Formula: see text], [Formula: see text], and [Formula: see text] parameters ([Formula: see text]) is in good agreement with results from penetration experiments of cava tissue. It is noticeable that the parameter estimation process of the fracture behavior is more accurate than the estimation process of the elastic behavior for the toe region of the curve.

  9. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography.

    PubMed

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; Zu, Mao-Heng

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS in a 61-year old Chinese woman. This is the first IVCLMS case confirmed by catheter suction biopsy during digital subtraction angiography. PMID:25232438

  10. Pheochromocytoma with inferior vena cava thrombosis: An unusual association

    PubMed Central

    Kota, Sunil K.; Kota, Siva K.; Jammula, Sruti; Meher, Lalit K.; Modi, Kirtikumar D.

    2012-01-01

    Pheochromocytomas have been described in association with vascular abnormalities like renal artery stenosis. A 48-year-old man was admitted to our hospital with the complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and hypertension. For last several days, he was having a dull aching abdominal pain. Abdominal computed tomography (CT) revealed the presence of a left adrenal pheochromocytoma. An inferior vena cava (IVC) venogram via the right jugular vein demonstrated occlusion of the IVC inferior to the right atrium. Surgical removal of pheochromocytoma was done, followed by anticoagulant treatment for IVC thrombosis, initially with subcutaneous low molecular weight heparin, and then with oral warfarin, resulting in restoration of patency. To the best of our knowledge, the occurrence of pheochromocytoma in IVC thrombosis has not been reported so far from India. Possible mechanisms of such an involvement are discussed. PMID:22629039

  11. Infrahepatic inferior vena cava agenesis with bilateral renal vein thrombosis.

    PubMed

    Skeik, Nedaa; Wickstrom, Kelly K; Schumacher, Clark W; Sullivan, Timothy M

    2013-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and are estimated to be present in 0.07-8.7% of the general population. IVC agenesis (IVCA) is found in approximately 5% of cases of unprovoked lower extremity deep vein thrombosis in patients <30 years of age. Renal vein thrombosis (RVT) is an extremely rare and unusual presentation of IVCA. We report a unique case of a 23-year-old previously healthy man presenting with infrahepatic IVCA-induced bilateral RVT with azygos and hemiazygos continuation. To our knowledge, this is the third reported case in the literature of IVCA-induced RVT and the first to affect the bilateral renal veins in the absence of any other thrombogenic risk factors or any lower extremity venous complications. We also present a literature review of IVCA-induced vein thrombosis and highlight the lack of literature to manage this condition.

  12. Indications, Management, and Complications of Temporary Inferior Vena Cava Filters

    SciTech Connect

    Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen

    1998-11-15

    Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters. Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis. Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis. Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

  13. Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters

    SciTech Connect

    Yamagami, Takuji Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko

    2010-02-15

    The purpose of this study was to examine the incidence of new or recurrent venous thromboembolism (VTE) after retrieval of inferior vena cava (IVC) filters and risk factors associated with such recurrence. Between March 2001 and September 2008, at our institution, implanted retrievable vena cava filters were retrieved in 76 patients. The incidence of new or recurrent VTE after retrieval was reviewed and numerous variables were analyzed to assess risk factors for redevelopment of VTE after filter retrieval. In 5 (6.6%) of the 76 patients, redevelopment or worsening of VTE was seen after retrieval of the filter. Three patients (4.0%) had recurrent deep venous thrombosis (DVT) in the lower extremities and 2 (2.6%) had development of pulmonary embolism, resulting in death. Although there was no significant difference in the incidence of new or recurrent VTE related to any risk factor investigated, a tendency for development of VTE after filter retrieval was higher in patients in whom DVT in the lower extremities had been so severe during filter implantation that interventional radiological therapies in addition to traditional anticoagulation therapies were required (40% in patients with recurrent VTE vs. 23% in those without VTE; p = 0.5866 according to Fisher's exact probability test) and in patients in whom DVT remained at the time of filter retrieval (60% in patients with recurrent VTE vs. 37% in those without VTE; p = 0.3637). In conclusion, new or recurrent VTE was rare after retrieval of IVC filters but was most likely to occur in patients who had severe DVT during filter implantation and/or in patients with a DVT that remained at the time of filter retrieval. We must point out that the fatality rate from PE after filter removal was high (2.6%).

  14. [Calcified bullet thrombus of the inferior vena cava and left renal vein in an adult].

    PubMed

    Leclerc, A; Lapébie, F-X; Thuillier, F; Lacroix, P

    2016-07-01

    Calcifications are rarely located within the inferior vena cava and the renal veins. The etiology is poorly understood and the prognosis is uncertain. We report a case in a 55-year-old man. PMID:27344300

  15. A Critical Review of Available Retrievable Inferior Vena Cava Filters and Future Directions.

    PubMed

    Montgomery, Jennifer P; Kaufman, John A

    2016-06-01

    Inferior vena cava filters have been placed in patients for decades for protection against pulmonary embolism. The widespread use of filters has dramatically increased owing at least in part to the approval of retrievable vena cava filters. Retrievable filters have the potential to protect against pulmonary embolism and then be retrieved once no longer needed to avoid potential long-term complications. There are several retrievable vena cava filters available for use. This article discusses the different filter designs as well as the published data on these available filters. When selecting a filter for use, it is important to consider the potential short-term complications and the filters' window for retrieval. Understanding potential long-term complications is also critical, as these devices are approved for permanent placement and many filters are not retrieved. Finally, this article will address research into new designs that may be the future of vena cava filtration.

  16. Superior mesenteric artery syndrome.

    PubMed Central

    Ahmed, A. R.; Taylor, I.

    1997-01-01

    Superior mesenteric artery syndrome is a rare and controversial form of upper intestinal obstruction in which the third part of the duodenum is compressed by the overlying superior mesenteric artery. Any disease process decreasing the angle between the superior mesenteric artery and the abdominal aorta can result in the external compression of the duodenum and subsequent intestinal obstruction. The aetiology, presentation, investigation and management of this unusual condition are discussed. PMID:9497945

  17. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    PubMed Central

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-01-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas. PMID:8655416

  18. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    PubMed

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  19. Multidetector row computed tomography and ultrasound characteristics of caudal vena cava duplication in dogs.

    PubMed

    Bertolini, Giovanna; Diana, Alessia; Cipone, Mario; Drigo, Michele; Caldin, Marco

    2014-01-01

    Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P < 0.0001). Breeds with increased risk for duplicated caudal vena cava were Yorkshire Terrier (odds ratio [OR] = 6.41), Poodle (OR = 7.46), West Highland White Terrier (OR = 6.33), and Maltese (OR = 3.87). Presence of a duplicated caudal vena cava was significantly associated with presence of extrahepatic portosystemic shunt(s) (P < 0.004). While uncommon in dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses.

  20. Amebic Liver abscess Complicated by Inferior Vena Cava Thrombosis: A Case Report.

    PubMed

    Ray, S; Khanra, D; Saha, M; Talukdar, A

    2012-10-01

    Amebic liver abscess is the most common extraintestinal manifestation of infection with Entamoeba histolytica. It is a common disease, especially in endemic areas, but it is a rare cause of inferior vena cava (IVC) obstruction, with only a few cases appearing in the literature. The authors describe a case of amebic liver abscess in a patient who developed a rare vascular complication of inferior vena cava thrombosis. The case responded to conservative treatment and radiological intervention.

  1. [Retroperitoneal hematoma revealing a tumor of the inferior vena cava: about a case].

    PubMed

    Lakhdar, Karim; Malki, Sidi Mohamed; Er-Raji, Ihssane; Derkaoui, Ali; Shimi, Abdelkrim; Khatouf, Mohamed

    2016-01-01

    Tumors of the inferior vena cava are rare, their most common histology is represented by leiomyosarcoma. They have few specific clinical features, however, the literature does not report hemorrhagic manifestations. Preoperative diagnosis is based on tomodensitometry and magnetic resonance imaging (MRI); it is confirmed by histology. We report a case with retroperitoneal hematoma revealing a tumor of the inferior vena cava. The diagnosis was made on the basis of clinical and radiological findings. PMID:27642432

  2. Haematogenous tumour growth in the inferior vena cava in a patient with a nonseminomatous testicular tumour.

    PubMed

    Ham, S J; Schraffordt Koops, H; Sleijfer, D T; Freling, N M; Molenaar, W M

    1991-08-01

    The case history is reported of a patient with an invasion of the inferior vena cava by metastases of a non-seminomatous testicular tumour. He was treated with combination chemotherapy, followed by laparotomy and resection of residual tumour tissue. Fourteen months after this operation he is in good health. For every retroperitoneal lymph node dissection it is necessary to be on the look-out for invasion of the vena cava, because of the risk of a sudden pulmonary embolism.

  3. [Symptomatology and treatment of malformations of the inferior vena cava (author's transl)].

    PubMed

    Sachweh, D; Horsch, S; Janssen, W

    1979-05-01

    A review of the embryology, pathophysiology semiotics and surgical treatment of malformations of the inferior vena cava is given based on 3 clinical histories. The cases consisted of a typical membrane occlusion, an atresia of the infrarenal segment and of a hitherto not described combination of several malformations of the inferior vena cava: membrane occlusion, aplasia of the infrarenal segment of the vena cava inferior and multiple aneurysms of the iliac vein. The symptomatology of malformations of the vena cava inferior depends on the compensation by the collateral or the persisting embryonic veins, respectively, and on the localization and the degree of the obliteration. The varying hemodynamic reactions are described. The following surgical methods for the treatment of inferior vena cava occlusions in the hepatic segment are available: The so called conservative interventions for the creation of collaterals, the direct or indirect recanalization and the bypass operation. Congenital infrarenal atresias of the vena cava are corrected by homologous or prosthetic interposition. The venous replacement with a bovine heterograft presented here, has not yet been described in the literature.

  4. Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma with Inferior Vena Cava and Right Atrial Tumors

    SciTech Connect

    Chern, M. C. Chuang, V. P. Cheng, T. Lin, Z. H. Lin, Y. M.

    2008-07-15

    Advanced hepatocelluar carcinoma (HCC) with invasion of venous systems usually indicates not only a poor prognosis but also a contraindication for transcatheter arterial chemoembolization (TACE). This study evaluated the feasibility of TACE for advanced HCC with inferior vena cava (IVC) and right atrium (RA) tumors and, also, to search for the ideal embolization particle size. Twenty-six patients who had HCC invasion into the IVC included five patients with coexistent RA tumors that were treated with TACE. The chemoembolization method was cisplatin, doxorubicin, and mitomycin C mixed with Lipiodol and Ivalon. The selection of Ivalon particles was divided into two groups based on their size: (A) >180 {mu}m, N = 9; and (B) 47-180 {mu}m, N = 17. The overall response rate was 53.8% (14/26). Based on the response to TACE, the median survival period of the entire group was 4.2 months (range, 1.5 to 76.7 months). The median survival period of the 14 responders was 13.5 months (1.5-76.7 months), and that of the 12 nonresponders, 3.3 months (2.1 to 24.3 months) (p < 0.002). Comparing the two Ivalon particle sizes, the response rate was 12.5% (1/9 patients) for group A and 76.5% for group B (13/17 patients) (p < 0.02). No serious complication was observed post-chemoembolization. In conclusion, TACE is a safe and effective treatment for advanced HCC with IVC and RA tumors, and small Ivalon particles (47-180 {mu}m) are superior to large ones (>180 {mu}m).

  5. Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt.

    PubMed

    Yamagami, Takuji; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

    2013-01-01

    Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed. PMID:23986855

  6. Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient

    SciTech Connect

    Veerapong, Jula; Wahlgren, Carl Magnus; Jolly, Neeraj; Bassiouny, Hisham

    2008-07-15

    The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

  7. The curious case of the disappearing IVC: A case report and review of the aetiology of Inferior Vena Cava Agenesis

    PubMed Central

    Paddock, Michael; Robson, Nicola

    2014-01-01

    We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth. PMID:24967034

  8. Compression of the Inferior Vena Cava in Bowel Obstruction

    PubMed Central

    Cina, Alessandro; Zamparelli, Roberto; Venturino, Sara

    2013-01-01

    Introduction. We investigated whether (a) the inferior vena cava (IVC) is compressed in bowel obstruction and (b) some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT) examinations were collected retrospectively. Group O (N = 69) scans were positive for bowel obstruction, group C (N = 50) scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD) were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14), the area of which increased gradually from 1.9 (confluence of the iliac veins) to 3.1 cm2/m2 of BSA (confluence of the hepatic veins) with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17). Along its course, IVC section area increased from 1.3 to 2.5 cm2/m2. At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression. PMID:24151603

  9. Inferior vena cava filter migration: updated review and case presentation.

    PubMed

    Janjua, Muhammad; Omran, Fatema M; Kastoon, Tony; Alshami, Mahmood; Abbas, Amr E

    2009-11-01

    We report a case of inferior vena cava filter migration to the right ventricle resulting in ventricular tachycardia and elevated troponin. The patient was taken to the cardiac catheterization laboratory and under fluoroscopy the filter was found to be in the right ventricle. Later in the day the filter was removed surgically with the aid of cardiopulmonary bypass. This case, as well as the other 27 reported cases of filter migration, were reviewed. It was noticed that newer retrievable filters made of nitinol, phynox and elgioly have a significantly higher percentage of filter migration into the right ventricle as compared to the old stainless steel and titanium-based Greenfield filters. Similarly, there were also higher percentages of complications and mortality associated with the newer retrievable filters migrating to the right ventricle. Filter migration to the right ventricle as opposed to the right atrium increased over the past 10 years, which has resulted in more serious symptoms, ventricular arrhythmias, deaths and higher rates of surgical removal.

  10. Evaluation of Retrievability of the Gunther Tulip Vena Cava Filter

    SciTech Connect

    Yamagami, Takuji Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

    2007-04-15

    Purpose. To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF). Methods. Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval. Results. Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 {+-} 4.2 days. In the 5 filters that were filled to a height of {>=} 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure. Conclusion. GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods.

  11. Sonographic findings of superior mesenteric artery syndrome causing massive gastric dilatation in a young healthy girl.

    PubMed

    Abu-Zidan, F M; Hefny, A F; Saadeldinn, Y A; El-Ashaal, Y I

    2010-11-01

    Acute gastric dilatation due to superior mesenteric artery syndrome in healthy individuals is extremely rare. A 17-year-old girl who complained of epigastric pain for two days following excessive eating was admitted to our hospital. She was nauseated but was unable to vomit. Succussion splash was positive. Bedside ultrasonography revealed a hyperactive duodenum, a distended stomach compressing on the inferior vena cava and a narrowed angle between the superior mesenteric artery (SMA) and the aorta. Abdominal computed tomography imaging confirmed the above findings. The angle between the aorta and SMA was only eight degrees. Gastrograffin follow-through showed complete obstruction of the third part of the duodenum. 3,500 ml of fluid was immediately drained through the nasogastric tube. Another gastrograffin study conducted five days later showed normal results. Bedside ultrasonography thus proved to be useful for both the diagnosis and management of superior mesenteric artery syndrome. PMID:21140106

  12. Unusual Case of Parkes Weber Syndrome with Aneurysm of the Left Common Iliac Vein and Thrombus in Inferior Vena Cava.

    PubMed

    Banzic, Igor; Brankovic, Milos; Koncar, Igor; Ilic, Nikola; Davidovic, Lazar

    2015-10-01

    We report an unusual case of aneurysm of the left common iliac vein and thrombus formation in inferior vena cava associated with Parkes Weber syndrome (PWS). In addition to many already known clinical signs which determine PWS, common iliac vein aneurysm formation together with inferior vena cava thrombus present a new clinical feature and new challenges in treatment strategy of these patients. PMID:26122423

  13. Factors involved in the antinatriuretic effects of acute constriction of the thoracic and abdominal inferior vena cava.

    NASA Technical Reports Server (NTRS)

    Schrier, R. W.; Humphreys, M. H.

    1971-01-01

    Study of the antinatriuretic effect of acute thoracic inferior vena cava (TIVC) constriction in the absence of alterations in renal perfusion pressure. A comparison is made of the effects of equivalent degrees of TIVC and abdominal inferior vena cava constriction on arterial pressure, renal hemodynamics, and electrolyte excretion.

  14. Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism

    SciTech Connect

    Jha, V. M.; Lee-Llacer, J.; Williams, J.; Ubaissi, H.; Gutierrez, G.

    2010-08-15

    Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a retrospective study of patients with acute PE treated with full anticoagulation admitted to a single academic medical center. Information abstracted from patient charts included presence or absence of right heart strain and of deep-vein thrombosis, and whether or not an IVC filter was placed. The endpoint was in-hospital mortality. Over 2.75 years, we found that 248 patients were diagnosed with acute PE, with an in-hospital mortality rate of 4.4%. The prevalence of adjunctive IVC filter placement was 13.3% (33 of 248), and the prevalence of documented right heart strain was 27.0% (67 of 248). In-hospital mortality was 10.2% in the non-filter-treated group (5 of 49), whereas there were no deaths in the filter-treated group (0 of 18); however, the difference was not statistically significant (P = 0.37). Both the presence of deep-vein thrombosis and of right heart strain increased the likelihood that an adjunctive IVC filter was placed (P < 0.0001 and P < 0.001, respectively). At our institution, patients were treated with IVC filters in addition to anticoagulation in 13.3% of cases of acute PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

  15. Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails

    PubMed Central

    Serrano, Fátima; Torres, Rita; Borges, Augusta

    2013-01-01

    The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy. PMID:23781361

  16. Deep venous thrombosis caused by congenital absence of inferior vena cava, combined with hyperhomocysteinemia.

    PubMed

    Yun, Sang Seob; Kim, Ji Il; Kim, Kee Hwan; Sung, Gi Young; Lee, Do Sang; Kim, Jeong Soo; Moon, In Sung; Lim, Keun Woo; Koh, Young Bok

    2004-01-01

    We present a case of suprarenal and infrarenal absence of the inferior vena cava, combined with hyperhomocysteinemia in a 39-year-old woman who presented with symptoms of deep venous thrombosis. The patient also had a homozygous mutation of C677T methylenetetrahydrofolate reductase. Deep vein thrombosis has a multifactorial etiology involving both genetic and acquired factors. Absence of the inferior vena cava is a rare congenital anomaly, but recently it was confirmed as an important risk factor for the development of deep vein thrombosis, especially in young persons. Hypercoagulability due to hyperhomocysteinemia with a tendency toward venous stasis, mediated by congenital absence of the inferior vena cava is thought to have caused deep vein thrombosis in our patient. To our knowledge, this association has not yet been reported. The clinical features and prognosis of the entity are discussed. PMID:15043024

  17. [Remote results of implantation of cava filters: analysis of errors and complications].

    PubMed

    Zatevakhin, I I; Shipovsky, V N; Barzaeva, M A

    2015-01-01

    The authors carried out comparative assessment of efficacy of cava filters (CF) for prevention of pulmonary artery thromboembolism in patients presenting with iliofemoral thrombosis with flotation of thrombi, as well as analysed complications in the remote postimplantation period. A total of 266 patients were examined within the terms from 1 month to 10 years after CF implantation. Depending on the type of the implanted device, all patients were subdivided into 3 groups: group 1 (n=65) consisted of patients with one-level CF, group 2 (n=112) comprised those with "sandglass" and "shuttle" type two-level cava filters, and group 3 (n=89) was composed of patients with the implanted CF "TrapEase" and "OptEase". In the remote period relapsed PATE was revealed in 5.2% of cases. Embolism in the CF was noted in 9.3% of cases, with the incidence rate of this complication not depending on the type of the implanted device. However, total occlusion of the inferior vena cava after embolism was observed 2 times more often in patients of the 2nd and 3rd group. In the first group recanalization of the intrafilter space occurred in one third of cases. Chronic occlusion of the inferior vena cava was revealed in 13.9% of cases, most frequently in group 2. Total occlusion of the inferior vena cava with the development of inferior vena cava syndrome was diagnosed in 24.1% of patients with thrombotic lesion below the level of renal veins confluence. This complication was associated with both characteristics of CF and technical errors of implantation, and was also encountered more frequently in group 2. PMID:26035565

  18. Design Optimization of Vena Cava Filters: An application to dual filtration devices

    SciTech Connect

    Singer, M A; Wang, S L; Diachin, D P

    2009-12-03

    Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

  19. Imaging of the vena cava in the intensive care unit prior to vena cava filter insertion: carbon dioxide as an alternative to iodinated contrast.

    PubMed

    Schmelzer, Thomas M; Christmas, A Britton; Jacobs, David G; Heniford, B Todd; Sing, Ronald F

    2008-02-01

    This study evaluates the safety and effectiveness of carbon dioxide (CO2) as a contrast agent in patients in the intensive care unit undergoing vena cava filter (VCF) insertion. We prospectively evaluated patients in the intensive care unit undergoing bedside VCF insertion using CO2 cavagraphy. Blood pressure, pulse rate, mixed venous oxygen saturation, and intracranial pressure were monitored before, during, and after the CO2 injection. Fifty patients in the intensive care unit (mean age 48.2 +/- 16.5 years) were included in the study. Five patients had decreases in blood pressure, which resolved without intervention. Two patients required iodinated contrast as a result of inadequate CO2 imaging. All patients had successful insertion of VCF. The use of CO2 as a contrast agent is a safe and highly effective alternative for vena cava imaging and can be considered the first-line contrast agent for all critically ill patients requiring VCF placement.

  20. Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter

    SciTech Connect

    Ahmad, Iftikhar; Yeddula, Kalpana; Wicky, Stephan; Kalva, Sanjeeva P.

    2010-04-15

    The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001-2008, 598 (34.8%) had follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean age at filter placement was 64 years. The medical diseases included cancer in 64, trauma in 15, stroke in 12, and others in 20. The frequency of filter thrombus on CT and asymptomatic filter thrombus on CT was calculated. The frequency of pulmonary embolism (PE) in patients with filter thrombus was calculated. The frequency of thrombus progression or regression (on CT, available in 56) was calculated. The effect of anticoagulation on filter thrombus regression/progression was evaluated using the Fisher exact test by comparing the group of patients who received anticoagulants versus those who did not. A P-value of <0.05 was considered significant. The overall frequency of filter thrombus was 18.6%. Total occlusion of the IVC filter was seen in 12 of 598 (2%). The filter thrombus was asymptomatic in 110 (18.3%). Filter thrombus was detected after a median of 35 days (range, 0-2082) following filter placement. Thrombus extended above the filter in 4 (3.6%); IVC thrombus below the filter was seen in 35(31.5%). Thrombus in the filter occluded <25% of the filter volume in 58 (52.3%), 25-50% in 21 (18.9%), and 50-75% in 20 (18%). Total IVC occlusion was seen in 12 (10.8%). Eighty-three patients received anticoagulation. Sixteen patients developed symptoms of PE. PE was confirmed on CT in 3 of 15 (2.7%). On follow-up, filter thrombus regressed completely in 19 (33.9%) after a median of 6 months. Filter thrombus decreased in size in 13 (23.2%) and it progressed without IVC occlusion in 7 (12.6%). In one (1.7%), filter thrombus progressed to IVC occlusion. Filter thrombus remained stable in 16 (28.6%). There was no

  1. Cranial vena cava syndrome secondary to cryptococcal mediastinal granuloma in a cat

    PubMed Central

    Letendre, Jo-Annie; Boysen, Søren

    2015-01-01

    The successful management of cranial vena cava syndrome with suspected secondary chylothorax due to mediastinal cryptococcal granuloma in a 4-year-old male domestic shorthair cat is described. Treatment included long-term antifungal medication, short-term corticosteroids, intermittent thoracocentesis, rutin, octreotide, and enalapril. PMID:25829555

  2. Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty

    SciTech Connect

    Athreya, S.; Mathias, N.; Rogers, P.; Edwards, R.

    2009-07-15

    Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

  3. Procedural and Indwelling Complications with Inferior Vena Cava Filters: Frequency, Etiology, and Management

    PubMed Central

    Milovanovic, Lazar; Kennedy, Sean A.; Midia, Mehran

    2015-01-01

    Inferior vena cava (IVC) filters are commonly used in select high-risk patients for the prevention of pulmonary embolism. Potentially serious complications can arise from the use of IVC filters, including thrombosis of the filter itself and filter fragment embolization. This article discusses the utility of IVC filters and reviews the management of two cases of filter-related complications. PMID:25762846

  4. Thrombosis of the cranial vena cava in a cow with bronchopneumonia and traumatic reticuloperitonitis

    PubMed Central

    Gerspach, Christian; Wirz, Mirjam; Schweizer-Knubben, Gabriela; Braun, Ueli

    2011-01-01

    This paper reports the clinical findings, surgical and medical management, and necropsy of a 6-year-old cow with thrombosis of the cranial vena cava and thrombo-embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy. PMID:22547845

  5. Acute Traumatic Renal Artery to Inferior Vena Cava Fistula Treated with a Covered Stent

    SciTech Connect

    Tam, J.; Kossman, T.; Lyon, S.

    2006-12-15

    A 34-year-old man presented within hours of suffering a penetrating stab wound and was diagnosed with a right renal artery to inferior vena cava fistula. Initial attempts at excluding the fistula with a balloon were unsuccessful. He was subsequently treated with a covered stent inserted into the right renal artery which successfully excluded the fistula.

  6. Lake Superior, Duluth, MN

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This view shows the west end of Lake Superior and Duluth, MN (47.0N, 91.0W). Portions of Minnesota, Michigan and Ontario, Canada are in the scene. The Duluth metropolitan area is at the west end of the lake. The discoloration plume in the water at Duluth is the result of tailings from the iron ore smelters that process the iron ore from the nearby open pit mines seen near the upper left corner of the photo.

  7. Three-Dimensional Rotational Angiography of the Inferior Vena Cava as an Adjunct to Inferior Vena Cava Filter Retrieval

    SciTech Connect

    Bozlar, Ugur; Edmunds, J. Stewart; Turba, Ulku C.; Hartwell, Gary D.; Housseini, Ahmed M.; Hagspiel, Klaus D.

    2009-01-15

    The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection of filter arms or legs beyond the caval lumen, thrombus burden within the filter and IVC, and orientation of the filter within IVC. Skin and effective radiation doses were calculated. Statistical analysis was performed using paired Student t test and nonparametric McNemar's test. Standard anteroposterior cavography detected 49 filter arms or legs projecting beyond the caval lumen in 25 patients. Three-dimensional CV demonstrated 89 filter arms or legs projecting beyond the caval lumen in 28 patients. Twenty-two patients had additional filter arms or legs projecting beyond the caval lumen detected on 3-D CV that were not detected on sCV (p < 0.001). Filter apex tilt detection differed significantly (p < 0.001) between sCV and 3-D CV, with 3-D CV being more accurate. The filter apex abutted the IVC wall in 10 patients (33%) on 3-D CV, but this was diagnosed in only 3 patients (10%) with sCV. Thrombus was detected in 8 patients (27%), 1 thrombus of which was seen only on 3-D CV, and treatment was changed in this patient because of thrombus size. Mean effective radiation doses for 3-D CV were approximately two times higher than for sCV (1.68 vs. 0.86 mSv), whereas skin doses were three times lower (12.87 vs. 35.86 mGy). Compared with sCV, performing 3-D CV before optional IVC filter retrieval has the potential to improve assessment of filter arms or legs projecting beyond the caval lumen, filter orientation, and thrombus burden.

  8. [Agenesis of the infrarenal inferior vena cava with thrombosis of the renal vein in a fetus: a case report].

    PubMed

    Raposo Rodríguez, L; Recio Rodríguez, M; Alvarez Moreno, E; López Azorín, M

    2012-01-01

    Agenesis of the inferior vena cava, especially of the infrarenal segment, is exceptional. This condition is thought to result from thrombosis during gestation rather than from a true congenital malformation. Agenesis of the inferior vena cava can be associated with renal vein thrombosis, which in turn is related to suprarenal hemorrhage in the fetus. We present a case of agenesis of the inferior vena cava with preservation of the hepatic segment, thrombosis of the left renal vein, and secondary bilateral suprarenal hemorrhage diagnosed prenatally using sonography and magnetic resonance imaging.

  9. Lake Superior revisited 1984

    USGS Publications Warehouse

    MacCallum, Wayne R.; Selgeby, James H.

    1987-01-01

    The Lake Superior fish community has changed substantially since the early 1960s, when control of the sea lamprey (Petromyzon marinus) became effective. Self-reproducing stocks of lake trout (Salvelinus namaycush) have been reestablished in many inshore areas, although they have not yet reached pre-sea lamprey abundance; offshore lake trout are probably at or near pre-sea lamprey abundance. Stocks of lake whitefish (Coregonus clupeaformis) appear to have fully recovered; commercial catches are at or above historical levels. Lake herring (Coregonus artedii) are recovering rapidly in U.S. waters and are abundant in western Canadian waters. The population of rainbow smelt (Osmerus mordax), which declined in the 1970s, is recovering. Pacific salmon (Oncorhynchus) are becoming more abundant as a result of increased stocking in U.S. waters and are reproducing in most suitable tributaries; they have become significant in anglers' creels.

  10. Inferior vena cava stenosis-induced sinusoidal obstructive syndrome after living donor liver transplantation

    PubMed Central

    Orgoi, Sergelen; Sandag, Erdene; Namkhai, Ulzii-Orshikh; Badarch, Bat-Ireedui; Batsuuri, Batsaikhan

    2016-01-01

    The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft. The underlying causes of SOS are complex pathologic entity with multifactorial etiology. It is likely that its multifactorial etiology includes a decrease of hepatic venous outflow that is caused by graft liver infection and inferior vena cava stenosis.

  11. Inferior vena cava stenosis-induced sinusoidal obstructive syndrome after living donor liver transplantation.

    PubMed

    Bat-Erdene, Batsaikhan; Orgoi, Sergelen; Sandag, Erdene; Namkhai, Ulzii-Orshikh; Badarch, Bat-Ireedui; Batsuuri, Batsaikhan

    2016-08-01

    The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft. The underlying causes of SOS are complex pathologic entity with multifactorial etiology. It is likely that its multifactorial etiology includes a decrease of hepatic venous outflow that is caused by graft liver infection and inferior vena cava stenosis. PMID:27621751

  12. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    SciTech Connect

    Abdel-Aal, Ahmed Kamel Saddekni, Souheil; Hamed, Maysoon Farouk; Fitzpatrick, Farley

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  13. Duplication of Inferior Vena Cava with Associated Anomalies: A Rare Case Report.

    PubMed

    Shaha, Pramod; Garg, Ashish; Sahoo, Kulamani; Kothari, Nupoor; Garg, Pooja

    2016-03-01

    Duplication of inferior vena cava is an uncommon abnormality and is important in daily today practice for vascular surgeons, radiologist and urologist especially during retroperitoneal surgeries and treatment of thromboembolic disease. Radiologically, Duplicated IVC can be mistaken for lymphadenopathy or left pyeloureteric dilatation. Crossed fused kidney with a single ureter defy the embryological theory of ureteric bud crossing the opposite side and induce nephron formation associated anomaly of Duplication of inferior vena cava and malrotation of gut are not reported in a same patient. On meticulous search of literature no such combination of abnormalities has been reported. In this case report we bring forward this rare type of combination of three congenital malformations that is Duplication of IVC, crossed fused kidney and malrotation of gut.

  14. Inferior vena cava stenosis-induced sinusoidal obstructive syndrome after living donor liver transplantation

    PubMed Central

    Orgoi, Sergelen; Sandag, Erdene; Namkhai, Ulzii-Orshikh; Badarch, Bat-Ireedui; Batsuuri, Batsaikhan

    2016-01-01

    The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft. The underlying causes of SOS are complex pathologic entity with multifactorial etiology. It is likely that its multifactorial etiology includes a decrease of hepatic venous outflow that is caused by graft liver infection and inferior vena cava stenosis. PMID:27621751

  15. Extra-Adrenal Retroperitoneal Paraganglioma with Extensive Duodenal Invasion and Inferior Vena Cava Tumor Thrombus.

    PubMed

    Sadamori, Hiroshi; Monden, Kazuteru; Hioki, Masayoshi; Yoshimoto, Masashi; Ueki, Toru; Hyodo, Tsuyoshi; Omonishi, Kunihiro; Kioka, Yukio; Kuriyama, Mitsuhito; Ohno, Satoshi; Sakaguchi, Kohsaku; Matsuda, Tadakazu; Takakura, Norihisa

    2016-08-01

    We report a case of extra-adrenal retroperitoneal paraganglioma (RP) with extensive duodenal invasion and tumor thromboses both in the right testicular vein and in the inferior vena cava (IVC). Because there was rigid adherence between the RP and the abdominal aorta, pancreatoduodenectomy with replacement of the IVC and aorta was performed for complete surgical resection. In the present case, both the mode of progression of the RP and the surgical approach were extremely rare. PMID:26921027

  16. Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

    SciTech Connect

    Brountzos, Elias N.; Kaufman, John A. Lakin, Paul L.

    2004-01-15

    Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach.

  17. Technical Error During Deployment Leads to Vena Cava Filter Migration and Massive Pulmonary Embolism

    SciTech Connect

    Fotiadis, Nikolas I. Sabharwal, Tarun; Dourado, Renato; Fikrat, Shabbo; Adam, Andreas

    2008-07-15

    The Guenther Tulip vena cava filter is a safe, effective, well-established device for pulmonary embolism prophylaxis. We report a patient in whom there was migration of the filter to the right atrium, 2 weeks after insertion, caused by a technical error during deployment. An attempt to retrieve the filter percutaneously failed, necessitating removal at open-heart surgery. The potential causes of migration are described and the lessons learned from this unusual case are outlined.

  18. Inferior Vena Cava Filter-Related Thrombus/Deep Vein Thrombosis: Data and Management.

    PubMed

    Andreoli, Jessica M; Thornburg, Bartley G; Hickey, Ryan M

    2016-06-01

    Recurrent deep venous thrombosis and inferior vena cava (IVC) thrombosis are well-described complications following IVC filter placement. IVC thrombosis ranges in severity of clinical presentation, but can lead to significant morbidity and mortality with incidence rates depending on patient population and type of filter used. Endovascular therapies such as catheter-directed thrombolysis, mechanical thrombectomy, balloon venoplasty, and stenting are safe and effective in restoration of venous patency. PMID:27247478

  19. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    PubMed

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  20. Safety and Efficacy of the Gunther Tulip Retrievable Vena Cava Filter: Midterm Outcomes

    SciTech Connect

    Hoffer, Eric K. Mueller, Rebecca J.; Luciano, Marcus R.; Lee, Nicole N.; Michaels, Anne T.; Gemery, John M.

    2013-08-01

    PurposeTo evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.MethodsA retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59 % were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86 % of patients; 14 % were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.ResultsMean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3 %). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4 %). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8 %) at a mean of 731 days revealed a single (0.3 %) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5 %), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4 %) at a mean 757 days.ConclusionThe Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters.

  1. First evidence that Ecklonia cava-derived dieckol attenuates MCF-7 human breast carcinoma cell migration.

    PubMed

    Kim, Eun-Kyung; Tang, Yujiao; Kim, Yon-Suk; Hwang, Jin-Woo; Choi, Eun-Ju; Lee, Ji-Hyeok; Lee, Seung-Hong; Jeon, You-Jin; Park, Pyo-Jam

    2015-04-01

    We investigated the effect of Ecklonia cava (E. cava)-derived dieckol on movement behavior and the expression of migration-related genes in MCF-7 human breast cancer cell. Phlorotannins (e.g., dieckol, 6,6'-biecko, and 2,7″-phloroglucinol-6,6'-bieckol) were purified from E. cava by using centrifugal partition chromatography. Among the phlorotannins, we found that dieckol inhibited breast cancer cell the most and was selected for further study. Radius™-well was used to assess cell migration, and dieckol (1-100 µM) was found to suppress breast cancer cell movement. Metastasis-related gene expressions were evaluated by RT-PCR and Western blot analysis. In addition, dieckol inhibited the expression of migration-related genes such as matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF). On the other hand, it stimulated the expression of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2. These results suggest that dieckol exerts anti-breast cancer activity via the regulation of the expressions of metastasis-related genes, and this is the first report on the anti-breast cancer effect of dieckol. PMID:25830682

  2. Comparison of superior vena caval and inferior vena caval access using a radioisotope technique during normal perfusion and cardiopulmonary resuscitation

    SciTech Connect

    Dalsey, W.C.; Barsan, W.G.; Joyce, S.M.; Hedges, J.R.; Lukes, S.J.; Doan, L.A.

    1984-10-01

    Recent studies of thoracic pressure changes during external cardiopulmonary resuscitation (CPR) suggest that there may be a significant difference in the rate of delivery of intravenous drugs when they are administered through the extrathoracic inferior vena cava (IVC) rather than the intrathoracic superior vena cava (SVC). Comparison of delivery of a radionuclide given using superior and inferior vena caval access sites was made during normal blood flow and during CPR. Mean times from injection to peak emission count in each ventricle were determined. There were no significant differences between mean peak times for SVC or IVC routes during normal flow or CPR. When peak times were corrected for variations in cardiac output, there were no significant differences between IVC and SVC peak times during normal flow. During CPR, however, mean left ventricular peak time, when corrected for cardiac output, was significantly shorter (P less than .05) when the SVC route was used. The mean time for the counts to reach half the ventricular peak was statistically shorter (P less than .05) in both ventricles with the SVC route during the low flow of CPR. This suggests that during CPR, increased drug dispersion may occur when drugs are infused by the IVC route and thus may modify the anticipated effect of the drug bolus. These results suggest that during CPR, both the cardiac output and the choice of venous access are important variables for drug delivery.

  3. A massive retroperitoneal neuroblastoma with stenosis of the inferior vena cava in a 5-month-old boy

    PubMed Central

    Li, Jui-Ting; Dai, Yang-Hong; Kuo, Shih-Ming

    2014-01-01

    Neuroblastoma is the second most common retroperitoneal tumour in children after Wilms’ tumour. When it originates in the retroperitoneum, neuroblastoma usually presents as an abdominal mass with clinical manifestations of nausea, vomiting and weight loss. Imaging studies of this tumour demonstrate a heterogeneous mass with an irregular capsule and visible calcifications. Encasement and compression of the abdominal vessels, especially the inferior vena cava, are often observed. However, stenosis of the inferior vena cava has never been reported to be associated with this tumour. Here, we present a case of a 5-month-old boy with a right retroperitoneal tumour with extensive encasement of the inferior vena cava and significant narrowing of its distal part between the venous bifurcation and the tumour capsule. To our knowledge, this is the first case of neuroblastoma with this manifestation in a child. PMID:24671327

  4. Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses.

    PubMed

    Gonzalez-Pinto, I M; Tryphonopoulos, P; Avison, D L; Nishida, S; Tekin, A; Santiago, S; Tzakis, A G

    2013-06-01

    Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors. PMID:23769047

  5. On-and offshore tephrostratigraphy and -chronology of the southern Central American Volcanic Arc (CAVA)

    NASA Astrophysics Data System (ADS)

    Schindlbeck, J. C.; Kutterolf, S.; Hemming, S. R.; Wang, K. L.

    2015-12-01

    Including the recently drilled CRISP sites (IODP Exp. 334&344) the deep sea drilling programs have produced 69 drill holes at 29 Sites during 9 Legs at the Central American convergent margin, where the Cocos plate subducts beneath the Caribbean plate. The CAVA produced numerous plinian eruptions in the past. Although abundant in the marine sediments, information and data regarding large late Cenozoic explosive eruptions from Costa Rica, Nicaragua, Honduras, El Salvador, and Guatemala remain very sparse and discontinuous on land. We have established a tephrostratigraphy from recent through Miocene times from the unique archive of ODP/IODP sites offshore Central America in which we identify tephra source regions by geochemical fingerprinting using major and trace element glass shard compositions. Here we present first order correlations of ­~500 tephra layers between multiple holes at a single site as well as between multiple sites. We identified ashes supporting Costa Rican (~130), Nicaraguan (17) and Guatemalan (27) sources as well as ~150 tephra layers from the Galápagos hotspot. Within our marine record we also identified well-known marker beds such as the Los Chocoyos tephra from Atitlán Caldera in Guatemala and the Tiribi Tuff from Costa Rica but also correlations to 15 distinct deposits from known Costa Rican and Nicaraguan eruptions within the last 4.1 Ma. These correlations, together with new radiometric age dates, provide the base for an improved tephrochronostratigraphy in this region. Finally, the new marine record of explosive volcanism offshore southern CAVA provides insights into the eruptive history of long-living volcanic complexes (e.g., Barva, Costa Rica) and into the distribution and frequency of large explosive eruptions from the Galápagos hotspot. The integrated approach of Ar/Ar age dating, correlations with on land deposits from CAVA, biostratigraphic ages and sediment accumulation rates improved the age models for the drilling sites.

  6. Hypotension in the Right Lateral Position Secondary to Inferior Vena Cava Abnormality.

    PubMed

    Hutton, Meredith J H; Swamy, Ganesh; Shinkaruk, Kelly; Duttchen, Kaylene

    2015-09-15

    Surgical positioning is accompanied by numerous anesthetic considerations, particularly its potential effects on the cardiovascular, respiratory, and nervous systems. Clinical studies have shown that lateral positioning does not affect hemodynamics; however, with the addition of trunk flexion, there is a decrease in cardiac output, which may be secondary to caval compression. In this report, we describe a unique case of hypotension that arose in a patient positioned only in the right lateral decubitus position with flexion and that was exacerbated by an abnormally narrow inferior vena cava. PMID:26361387

  7. Inferior vena cava stent grafting closure of a high-flow portacaval shunt.

    PubMed

    Alhaizaey, Abdullah; Ghanekar, Anand; Oreopoulos, George

    2016-01-01

    Portacaval (PC) shunts can be of congenital or acquired types. Acquired PC shunts are usually created in patients with end-stage liver disease to manage complications associated with portal hypertension or may be part of selected adult-adult living donor liver transplantation procedures to decrease the chance of the small-for-size syndrome. The main potential complication of these acquired high-flow PC shunts is early hepatic encephalopathy. We present a case of a high-flow acquired PC shunt after liver transplantation that was complicated by uncontrolled encephalopathy. This was treated by endovascular inferior vena cava stent grafting for shunt closure. PMID:26946901

  8. The Typical Presentation Spectrum of Deep Vein Thrombosis Associated with Inferior Vena Cava Malformations

    PubMed Central

    El Lakis, Mustapha A.; Chamieh, Jad

    2016-01-01

    Congenital malformations of the inferior vena cava (IVC) are rare and underreported. They can be a risk factor for deep venous thrombosis (DVT) as a result of inadequate venous drainage of the lower extremities through collateral circulation. The significant number of cases reported in the literature highlights their importance, warranting investigating their existence in younger individuals with idiopathic DVT of the lower extremities and pelvic veins. In this systematic review, we depict the typical presentation of IVC malformations, their management, and the management of their associated DVT. PMID:27478635

  9. Unprovoked deep venous thrombosis in a young adult associated with membranous obstruction of inferior vena cava.

    PubMed

    Epperla, Narendranath; Usoltseva, Natalia

    2014-01-01

    Unprovoked deep venous thrombosis (DVT) in young adults is an unusual phenomenon, but it is associated with significant morbidity. Developmental anomalies of the inferior vena cava (IVC) should be considered as a possible aetiological factor, and appropriate investigations should be performed to determine the conclusive diagnosis and necessary treatment plan. We report a case of spontaneous thrombosis of the IVC and bilateral iliac venous system in a young man, associated with membranous obstruction of the IVC. He was diagnosed using several different investigational techniques, and successfully treated with mechanical thrombectomy, thrombolysis therapy and anticoagulation.

  10. Severe low back pain as the initial symptom of venous thrombosis of the inferior vena cava

    PubMed Central

    Tabatabai, Mohsen Abdul Wahab; Butros, Victor Mikhaeel; Mahdi, Shihab Ahmed; Ahmad, Mohammad Javad

    2014-01-01

    A 45-year-old previously well male truck driver presented to the emergency department with severe low back pain; lumbosacral X-ray was normal and he was given analgaesics and discharged. The following day, he presented to the emergency department again, his pain had not responded to the analgaesics; this time he also presented with massive bilateral swelling of lower limbs and left testicle that started 3 h earlier. The pain was severe, dull and interfered with the patient's ability to walk. An urgent workup revealed extensive thrombosis of the inferior vena cava. PMID:25155491

  11. Residual Inferior Vena Cava Thrombus Detected by Transesophageal Echocardiography After Resection of a Malignant Adrenal Mass.

    PubMed

    Burbano, Nelson H; Vlah, Claudene; Argalious, Maged

    2015-10-15

    A 43-year-old woman with a history of the Cushing syndrome secondary to adrenocortical carcinoma presented to the operating room for right adrenalectomy, hepatectomy, nephrectomy, and inferior vena cava (IVC) thrombectomy. Initial intraoperative transesophageal echocardiogram (TEE) confirmed the presence of an IVC tumor below the hepatic veins. Total vascular exclusion of the liver was necessary to perform the operation. A repeat TEE showed a residual thrombus within the IVC prompting an additional cavotomy to successfully remove the entire mass. The remainder of the procedure finalized uneventfully. The case highlights the importance of TEE monitoring for noncardiac surgery with thrombotic involvement of the IVC. PMID:26466307

  12. [Bilateral renal vein thrombosis and acute renal failure due to inferior vena cava filter thrombosis. Report of one case].

    PubMed

    Vega, Jorge; Díaz, Rienzi

    2014-11-01

    Bilateral renal vein thrombosis is an unusual etiology of acute renal failure and usually is associated with nephrotic syndrome. We report a 77-year-old man, consulting in the emergency room for anuria that appeared 24 hours after a syncope. The patient was carrier of an inferior vena cava filter prophylactically installed 17 months earlier and was not receiving anticoagulation. Serum creatinine on admission was 5.45 mg/dl and blood urea nitrogen was 54 mg/dl. Computed tomography and Doppler ultrasonography showed an extensive thrombosis of inferior vena cava and both renal veins. Heparin therapy was started with a rapid recovery of renal function and diuresis.

  13. [Intraluminal dilation of inferior vena cava stenosis after repair of the scimitar syndrome in an adult patient].

    PubMed

    Benito Bartolomé, Fernando; González García, Ana; Oliver Ruiz, José M

    2002-02-01

    A 39 year-old woman diagnosed with anomalous drainage of middle and lower right pulmonary veins to the inferior vena cava was corrected surgically by means of baffle with patch up to the left atrium. Early after the operation the patient related intolerance to small efforts and an episode of syncope. The cardiac catheterization demonstrated the presence of a severe stenosis in the inferior vena cava, in its union with the right atrium, that was successfully treated by means of intraluminal percutaneous dilation with a catheter of Inoue. After the procedure the gradient decreased and she improved tolerance to effort, which persisted 10 months later.

  14. Compression of the Inferior Vena Cava by the Right Iliac Artery: A Rare Variant of May-Thurner Syndrome

    SciTech Connect

    Fretz, V.; Binkert, C. A.

    2010-10-15

    May-Thurner syndrome is known as compression of the left common iliac vein by the right common iliac artery. We describe a case of an atypical compression of the inferior vena cava by the right common iliac artery secondary to a high aortic bifurcation. Despite an extensive collateral network, there was a significant venous gradient between the iliac veins and the inferior vena cava above the compression. After stenting the venous pressure gradient disappeared. Follow-up 4 months later revealed a good clinical response with a patent stent.

  15. Intravenous leiomyomatosis with inferior vena cava or intracardiac extension and concurrent bilateral multiple pulmonary nodules

    PubMed Central

    Zhang, Guorui; Yu, Xin; Lang, Jinghe

    2016-01-01

    Abstract Background: Intravenous leiomyomatosis is a special type of uterine leiomyoma and features formation and growth of benign leiomyoma tissue within vascular wall. Benign metastatic leiomyoma refers to benign leiomyoma metastasizing to extra-uterine sites, dominantly lung. Solitary or multiple small nodules in the lung can be seen in image scans. Methods: We report 2 cases of intravenous leiomyomatosis with inferior vena cava or intracardiac extension and concurrent multiple nodules in bilateral lungs. Results: Case 1 was a 40-year-old woman with a large mass in pelvic cavity, masses in heart chambers, and disseminates pulmonary nodules detected at preoperative image scans. Masses in pelvic cavity and heart were resected in a 2-stage surgery. Histology examination confirmed the diagnosis of intravenous leiomyomatosis. Pulmonary nodules stayed stable during follow-up. Case 2 was a 37-year-old woman with 3 times of uterine-related surgeries. A pelvic mass appeared again and filling defect was observed in left ovarian vein, right renal vein, right common iliac vein, and inferior vena cava. Tumors in pelvic cavity and within vessels were removed in a 1-stage surgery. Histology examination confirmed the diagnosis of intravenous leiomyomatosis. Pulmonary nodules remained stable during follow-up. Conclusion: The incidence of benign metastatic leiomyoma in patients with intravenous leiomyomatosis might be relatively high. Metastasis of intravenous leiomyomatosis lesions was a possible source of benign metastatic leiomyoma in these cases. PMID:27583911

  16. Right Double Inferior Vena Cava (IVC) with Preaortic Iliac Confluence - Case Report and Review of Literature.

    PubMed

    Babu, C S Ramesh; Lalwani, Rekha; Kumar, Indra

    2014-02-01

    Anomalies of the inferior vena cava (IVC) are uncommon and most of them remain asymptomatic. Though rare, anomalies of IVC can lead to severe hemorrhagic complications especially during aortoiliac surgery. Prior knowledge of these variations facilitates proper interpretation of radiological images and safe performance of interventional procedures and surgeries. During routine anatomical dissection of abdomen in a female cadaver we observed the presence of right sided duplication of IVC. Both IVCs were present on the right side of abdominal aorta, one ventral and the other more dorsal in position and named ventral right IVC and dorsal right IVC. The ventrally and medially placed IVC, which appeared to be the main IVC was formed by the union of two common iliac veins in front of the right common iliac artery (Preaortic iliac confluence-"Marsupial Cava"). The right external iliac vein continued as the more dorsally and laterally placed dorsal right IVC. The right internal iliac vein after receiving a transverse anastomotic vein from the external iliac continued as the right common iliac vein. This transverse anastomosis was present behind the right common iliac artery. The narrower dorsal right IVC joined the wider ventral right IVC just below the level of renal veins to form a single IVC. The abdominal aorta presented a convexity to the left.

  17. Inferior Vena Cava Resection and Reconstruction for Tumoral Recurrence after Right Nephrectomy.

    PubMed

    Botianu, Pv-H; Chirtes, R; Marcu, C; Kosza, H; Stoian, M; Brusnic, O; Botianu, Amv; Dobre, A

    2016-01-01

    We report a 60 years old patient who was admitted for a local recurrence after a right nephrectomy performed 2 years ago (papillary renal carcinoma with areas of sarcomatoid differentiation - pT3a). CT scan showed a retroperitoneal mass with invasion of the inferior vena cava. We performed a complete en-bloque excision of the tumor with the infrarenal portion of the inferior vena cava and lympha-denectomy. The vascular reconstruction was performed by the interposition of a 20 mm diameter Dacron prosthesis. The postoperative course was complicated due to an episode of digestive bleeding (duodenal ulcer) which stopped after conservative treatment (antisecretory and hemostatics, including rFVIIa), but eventually favourable. At 6 months follow-up the patient presents no sign of tumoral relapse and a functional vascular prosthesis. The case is interesting due to the rarity of the surgical procedure and the indication. The surgical approach of the retroperitoneal tumors with vascular involvement is possible in centers with adequate technical endownment and human expertise. PMID:27604673

  18. Pancreatic and multiorgan resection with inferior vena cava reconstruction for retroperitoneal leiomyosarcoma

    PubMed Central

    Stauffer, John A; Fakhre, G Peter; Dougherty, Marjorie K; Nakhleh, Raouf E; Maples, William J; Nguyen, Justin H

    2009-01-01

    Background Inferior vena cava (IVC) leiomyosarcoma is a rare tumor of smooth muscle origin. It is often large by the time of diagnosis and may involve adjacent organs. A margin-free resection may be curative, but the resection must involve the tumor en bloc with the affected segment of vena cava and locally involved organs. IVC resection often requires vascular reconstruction, which can be done with prosthetic graft. Case presentation We describe a 39-year-old man with an IVC leiomyosarcoma that involved the adrenal gland, distal pancreas, and blood supply to the spleen and left kidney. Tumor excision involved en bloc resection of all involved organs with reimplantation of the right renal vein and reconstruction of the IVC with a polytetrafluoroethylene graft. The patient recovered without renal insufficiency, graft infection, or other complications. Follow-up abdominal imaging at 1 year showed a patent IVC graft and no locally recurrent tumor. Prosthetic graft provides a sufficient diameter and length for replacement conduit in extensive resection of IVC leiomyosarcoma. Conclusion To our knowledge, this is the first case of resection of an IVC sarcoma with prosthetic graft reconstruction in combination with pancreatic resection. Aggressive surgical resection including vascular reconstruction is warranted for select IVC tumors to achieve a potentially curative outcome. PMID:19126222

  19. CT of inferior vena cava filters: normal presentations and potential complications.

    PubMed

    Georgiou, Nicholas A; Katz, Douglas S; Ganson, George; Eng, Kaitlin; Hon, Man

    2015-12-01

    With massive pulmonary embolism (PE) being the first or second leading cause of unexpected death in adults, protection against PE is critical in appropriately selected patients. The use of inferior vena cava (IVC) filters has increased over the years, paralleling the increased detection of deep venous thrombosis (DVT) and PE by improved and more available imaging techniques. The use of IVC filters has become very common as an alternative and/or as a supplement to anticoagulation, and these filters are often seen on routine abdominal CT, including in the emergency setting; therefore, knowledge of the normal spectrum of findings of IVC filters by the radiologist on CT is critical. Additionally, CT can be used specifically to identify complications related to IVC filters, and CT may alternatively demonstrate IVC filter-related problems which are not specifically anticipated clinically. With multiple available IVC filters on the US market, and even more available outside of the USA, it is important for the emergency and the general radiologist to recognize the different models and various appearances and positioning on CT, as well as their potential complications. These complications may be related to venous access, but also include thrombosis related to the filter, filter migration and penetration, and problems associated with filter deployment. With the increasing number of inferior vena cava filters placed and their duration within patients increasing over time, it is critical for emergency and other radiologists to be aware of these findings on CT.

  20. Modeling Flow Past a TrapEase Inferior Vena Cava Filter

    NASA Astrophysics Data System (ADS)

    Singer, Michael; Henshaw, William; Wang, Stephen

    2008-11-01

    This study uses three-dimensional computational fluid dynamics to evaluate the efficacy of the TrapEase inferior vena cava (IVC) filter. Hemodynamics of the unoccluded and partially occluded filter are examined, and the clinical implications are assessed. The IVC, which is the primary vein that drains the legs, is modeled as a straight pipe, and a geometrically accurate model of the filter is constructed using computer aided design. Blood is modeled as a homogeneous, incompressible, Newtonian fluid, and the method of overset grids is used to solve the Navier-Stokes equations. Results are corroborated with in-vitro studies. Flow around the unoccluded filter demonstrates minimal disruption, but spherical clots in the downstream trapping position lead to regions of stagnant and recirculating flow that may promote further clotting. The volume of stagnant flow and the peak wall shear stress increase with clot volume. For clots trapped in the upstream trapping position, flow is disrupted along the cava wall downstream of the clot and within the filter. The shape and location of trapped clots also effect the peak wall shear stress and may impact the efficacy of the filter.

  1. Development of a fluid resuscitation protocol using inferior vena cava and lung ultrasound.

    PubMed

    Lee, Christopher W C; Kory, Pierre D; Arntfield, Robert T

    2016-02-01

    Appropriate fluid resuscitation has been a major focus of critical care medicine since its inception. Currently, the most accurate method to guide fluid administration decisions uses "dynamic" measures that estimate the change in cardiac output that would occur in response to a fluid bolus. Unfortunately, their use remains limited due to required technical expertise, costly equipment, or applicability in only a subset of patients. Alternatively, point-of-care ultrasound (POCUS) has become widely used as a tool to help clinicians prescribe fluid therapy. Common POCUS applications that serve as guides to fluid administration rely on assessments of the inferior vena cava to estimate preload and lung ultrasound to identify the early presence of extravascular lung water and avoid fluid overresuscitation. Although application of these POCUS measures has multiple limitations that are commonly misunderstood, current evidence suggests that they can be used in combination to sort patients among 3 fluid management categories: (1) fluid resuscitate, (2) fluid test, and (3) fluid restrict. This article reviews the pertinent literature describing the use of inferior vena cava and lung ultrasound for fluid responsiveness and presents an evidence-informed algorithm using these measures to guide fluid resuscitation decisions in the critically ill. PMID:26475100

  2. Effectiveness of Inferior Vena Cava Filters without Anticoagulation Therapy for Prophylaxis of Recurrent Pulmonary Embolism

    PubMed Central

    Zektser, Miri; Bartal, Carmi; Zeller, Lior; Nevzorov, Roman; Jotkowitz, Alan; Stavi, Vered; Romanyuk, Vitaly; Chudakov, Gregory; Barski, Leonid

    2016-01-01

    Objective The optimal treatment of deep vein thrombosis (DVT) is anticoagulation therapy. Inferior vena cava filter (IVC) placement is another option for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis. This is used mostly in patients with a contraindication to anticoagulant therapy. The purpose of the present study was to compare the two options. Methods A retrospective cohort study of two groups of patients with DVT: patients who received an IVC filter and did not receive anticoagulation due to contraindications; and patients with DVT and similar burden of comorbidity treated with anticoagulation without IVC insertion. To adjust for a potential misbalance in baseline characteristics between the two groups, we performed matching for age, gender, and Charlson’s index, which is used to compute the burden of comorbid conditions. The primary outcome was an occurrence of a PE. Results We studied 1,742 patients hospitalized with the diagnosis of DVT in our hospital;93 patients from this population received IVC filters. Charlson’s score index was significantly higher in the IVC filter group compared with the anticoagulation group. After matching of the groups of patients according to Charlson’s score index there were no significant differences in primary outcomes. Conclusion Inferior vena cava filter without anticoagulation may be an alternative option for prevention of PE in patients with contraindications to anticoagulant therapy. PMID:27487310

  3. Measurement of streaming potentials of mammalian blood vessels, aorta and vena cava, in vivo.

    PubMed

    Sawyer, P N; Himmelfarb, E; Lustrin, I; Ziskind, H

    1966-09-01

    Attempts to measure streaming potentials in large rabbit blood vessels in vivo have been carried out. Streaming potentials, V(89), were measured by the introduction of microelectrodes through the wall of the blood vessel at separations greater than 1 cm. The outputs from these electrodes fed through calomel cells were amplified and recorded directly by using an Electronics for Medicine photorecorder (White Plains, N. Y.). "Effective streaming currents" were determined by running the output through a low impedence galvanometer while simultaneously measuring the resistance of the circuit V(8) were, therefore, calculated from two measurements and compared. Flow through vessels studied was measured using two different electromagnetic flowmeters. The results indicate that V(8) present in both aorta and vena cava are of the order of 5 to 10 mv. By using the Helmholtz-Smoluchowski equation into which flow was reintegrated, the numbers yield zeta potentials approximating 0.1 to 0.4 v in both aorta and vena cava. This number approaches the apparent upper limit for zeta (actually "interfacial potentials") potentials in biological systems. The measured "i.f." potential is considered as the interreaction of several physical and metabolic factors operating at the blood intimal interface. The polarity of the potential suggests that the interface is negative with respect to the blood flowing through the vessel. Interfacial potential and related V(8) are discussed in terms of their possible importance as a mechanism for maintaining vascular homeostasis in the living animal. PMID:5970567

  4. CT of inferior vena cava filters: normal presentations and potential complications.

    PubMed

    Georgiou, Nicholas A; Katz, Douglas S; Ganson, George; Eng, Kaitlin; Hon, Man

    2015-12-01

    With massive pulmonary embolism (PE) being the first or second leading cause of unexpected death in adults, protection against PE is critical in appropriately selected patients. The use of inferior vena cava (IVC) filters has increased over the years, paralleling the increased detection of deep venous thrombosis (DVT) and PE by improved and more available imaging techniques. The use of IVC filters has become very common as an alternative and/or as a supplement to anticoagulation, and these filters are often seen on routine abdominal CT, including in the emergency setting; therefore, knowledge of the normal spectrum of findings of IVC filters by the radiologist on CT is critical. Additionally, CT can be used specifically to identify complications related to IVC filters, and CT may alternatively demonstrate IVC filter-related problems which are not specifically anticipated clinically. With multiple available IVC filters on the US market, and even more available outside of the USA, it is important for the emergency and the general radiologist to recognize the different models and various appearances and positioning on CT, as well as their potential complications. These complications may be related to venous access, but also include thrombosis related to the filter, filter migration and penetration, and problems associated with filter deployment. With the increasing number of inferior vena cava filters placed and their duration within patients increasing over time, it is critical for emergency and other radiologists to be aware of these findings on CT. PMID:26183040

  5. Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter

    SciTech Connect

    Mahrer, Arie; Zippel, Douglas; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Simon, Daniel; Rimon, Uri

    2008-07-15

    The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured trauma patients (mean injury severity score 33.5). The filters were inserted within 1 to 6 (mean 2) days of injury. Thirty-seven patients were referred for filter removal (32 with Optease and 5 with Gunther-Tulip). The indwelling time was 7 to 22 (mean 13) days. All patients underwent inferior vena cavography prior to filter removal. There were no insertion-related complications and all filters were successfully deployed. Forty-three (54%) of the 80 patients were not referred for filter removal, as these patients continued to have contraindications to anticoagulation. Thirty-seven patients (46%) were referred for filter removal. In eight of them (22%) a large thrombus was seen within the filters and they were left in place, all with the Optease device. The other 29 filters (36%) were removed uneventfully.We conclude that the relatively high prevalence of intrafilter thrombi with the Optease filter may be explained by either spontaneous thrombus formation or captured emboli.

  6. [Suprarenal leiomyoma of the vena cava. A rare differential adrenal gland tumor diagnosis].

    PubMed

    Friedrich, M G; Witte, A; Hautmann, S H; Saeger, W

    2002-11-01

    Leiomyomas are benign tumors that can arise in the smooth muscle and can appear practically everywhere; hence, they must be taken into consideration as a rare possibility in the differential diagnosis of numerous tumors. While leiomyomas of the peripheral vessels are a relatively common finding, they are rarely found in the central vessels. Only a few cases of leiomyomas in the vena cava are known. In contrast to malignant leiomyosarcomas, leiomyomas usually grow towards the lumen. We report on the rare case of a leiomyoma in the inferior vena cava that appeared in the image to be located in the adrenal gland. Therefore, transperitoneal extirpation of the site was undertaken. It was only during surgery that a tumor emanating from the vessel wall became apparent. Thus, after an initial laparoscopic approach it became necessary to change to open resection of the tumor with cavotomy and resection of the vessel wall. The histopathological work-up revealed a benign leiomyoma and further imaging diagnostics gave no indication for the presence of metastases.

  7. Preparative isolation and purification of phlorotannins from Ecklonia cava using centrifugal partition chromatography by one-step.

    PubMed

    Lee, Ji-Hyeok; Ko, Ju-Young; Oh, Jae-Young; Kim, Chul-Young; Lee, Hee-Ju; Kim, Jaeil; Jeon, You-Jin

    2014-09-01

    Various bioactive phlorotannins of Ecklonia cava (e.g., dieckol, eckol, 6,6-bieckol, phloroglucinol, phloroeckol, and phlorofucofuroeckol-A) are reported. However, their isolation and purification are not easy. Centrifugal partition chromatography (CPC) can be used to efficiently purify the various bioactive-compounds efficiently from E. cava. Phlorotannins are successfully isolated from the ethyl acetate (EtOAc) fraction of E. cava by CPC with a two-phase solvent system comprising n-hexane:EtOAc:methanol:water (2:7:3:7, v/v) solution. The dieckol (fraction I, 40.2mg), phlorofucofuroeckol-A (fraction III, 31.1mg), and fraction II (34.1mg) with 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are isolated from the crude extract (500 mg) by a one-step CPC system. The purities of the isolated dieckol and phlorofucofuroeckol-A are ⩾90% according to high performance liquid chromatography (HPLC) and electrospray ionization multi stage tandem mass spectrometry analyses. The purified 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are collected from fraction II by recycle-HPLC. Thus, the CPC system is useful for easy and simple isolation of phlorotannins from E. cava.

  8. Azygos Vein Dialysis Catheter Placement Using the Translumbar Approach in a Patient with Inferior Vena Cava Occlusion

    SciTech Connect

    Jaber, Mohammad R.; Thomson, Matthew J.; Smith, Douglas C.

    2008-07-15

    We describe percutaneous, translumbar placement of a 14-Fr dialysis catheter into an ascending lumbar vein to achieve tip position in an enlarged azygos vein. The patient had thrombosis of all traditional vascular sites, as well as the inferior vena cava. This catheter functioned well for 7 months before fatal catheter-related infection developed.

  9. Catheter-directed thrombolysis for double inferior vena cava with deep venous thrombosis: A case report and literature review.

    PubMed

    Wang, Xiaodong; Chen, Zhengxin; Cai, Qianrong

    2014-08-01

    Double inferior vena cava (DIVC) with deep venous thrombosis (DVT) is rare, and there is only one reported case of DIVC with DVT treated by catheter-directed thrombolysis. We report a case of a 32-year-old man with an extensive venous clot involving the infrarenal segment of a double IVC who received filter implantation and catheter-directed thrombolysis.

  10. 75 FR 28542 - Superior Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... orient the new Superior Resource Advisory Committee members on their roles and responsibilities. DATES... of the roles and responsibilities of the Superior Resource Advisory Committee members; Election of... Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice...

  11. Studies on Budd-chiari syndrome complicated with hepatocellular carcinoma: most patients without inferior vena cava obstruction

    PubMed Central

    Dang, Xiaowei; Li, Luhao; Li, Suxin; Wang, Yafei; Li, Hai; Xu, Shaokai; Xu, Peiqin

    2015-01-01

    Background: To investigate the characteristics of Budd-Chiari syndrome (B-CS) types, rate of HCC complicated by different types of B-CS and values of CTA in diagnosis of B-CS and HCC complicated by B-CS. Material and Methods: 494 patients with B-CS were analyzed retrospectively. All patients underwent CTA, which was used to assess the accuracy of diagnosing B-CS and the rate of HCC complicated by various kinds of B-CS. Digital subtraction angiography (DSA) and pathological examination were used as gold standard. Results: Among 494 patients diagnosed by DSA, there were 21 (4.3%) cases of inferior vena cava type, 80 (16.2%) cases of hepatic vein type and 393 (79.6%) cases of hepatic vein combined with inferior vena cava complex type. The accuracy of diagnosing B-CS by CTA was 86.6% (428/494), in which the accuracy of diagnosing inferior vena cava type was 85.7% (18/21), 83.8% (67/80) for hepatic vein type and 87.3% (343/393) for complex type. The rate of HCC complicated by B-CS was 12.8% (63/494), among which inferior vena cava type was 4.8% (1/21), hepatic vein type was 11.3% (9/80) and complex type was 13.5% (53/393). There were no statistic differences between these three types (P=0.459). The accuracy of diagnosing HCC by CTA was 82.5% (52/63). Conclusion: B-CS in patients from China’s Yellow River basin is mainly hepatic vein combined with inferior vena cava complex type, which is more likely to be complicated by HCC. CTA plays an important role in diagnosing B-CS and HCC complicated by B-CS. PMID:26309561

  12. OptEase and TrapEase Vena Cava Filters: A Single-Center Experience in 258 Patients

    SciTech Connect

    Onat, Levent Ganiyusufoglu, Ali Kursat; Mutlu, Ayhan; Sirvanci, Mustafa; Duran, Cihan; Ulusoy, Onur Levent; Hamzaoglu, Azmi

    2009-09-15

    We aimed to evaluate the efficacy and safety of the OptEase and TrapEase (both from Cordis, Roden, Netherlands) vena cava filters in the prevention of pulmonary embolism (PE). Between May 2004 and December 2008, OptEase (permanent/retrievable; n = 228) or TrapEase (permanent; n = 30) vena cava filters were placed in 258 patients (160 female and 98 male; mean age 62 years [range 22 to 97]). Indications were as follows: prophylaxis for PE (n = 239), contraindication for anticoagulation in the presence of PE or DVT (n = 10), and development of PE or DVT despite anticoagulation (n = 9). Medical records were retrospectively reviewed for indications, clinical results, and procedure-related complications during placement and retrieval. Clinical PE did not develop in any of the patients. However, radiologic signs of segmental PE were seen in 6 of 66 patients with follow-up imaging data. Migration or fracture of the filter or cava perforation was not seen in any of the patients. Except for a single case of asymptomatic total cava thrombosis, no thrombotic occlusion was observed. One hundred forty-one patients were scheduled to undergo filter removal; however, 17 of them were not suitable for such based on venography evaluation. Removal was attempted in 124 patients and was successful in 115 of these (mean duration of retention 11 days [range 4 to 23]). Nine filters could not be removed. Permanent/retrievable vena cava filters are safe and effective devices for PE prophylaxis and for the management of venous thromboembolism by providing the option to be left in place.

  13. Identifying Intellectually Superior Black Children.

    ERIC Educational Resources Information Center

    Ryan, Judith S.

    1983-01-01

    The effectiveness of several methods used to identify intellectually superior black children was evaluated. Findings suggest that less commonly used identification methods, such as parents' opinion and the Leiter International Performance Scale, may point out these children more accurately than do traditional measures. (Author/PP)

  14. Hypoplasia of the inferior vena cava in a young man presenting with extensive deep venous thrombosis.

    PubMed

    Alderman, Bryony Eloise Pfyffer; de Boisanger, James; Bottomley, Thomas

    2015-01-01

    We present a case of a 34-year-old man with extensive deep venous thrombosis (DVT) who was found to have multiple abnormalities of venous anatomy, notably hypoplasia of the inferior vena cava with azygous continuation. DVT has an annual incidence of around 1 in 1000 people in the UK. Many cases will have readily identifiable risk factors, such as underlying malignancy, immobility or thrombophilia, but at times, these might not be so straightforward and unexpected contributing factors may be found. Although relatively uncommon in the general population, congenital venous abnormalities have been found at higher incidence in young adults presenting with spontaneous DVT and should therefore remain a consideration when classical risk factors are absent.

  15. Inferior Vena Cava Filtration in the Management of Venous Thromboembolism: Filtering the Data

    PubMed Central

    Molvar, Christopher

    2012-01-01

    Venous thromboembolism (VTE) is a common cause of morbidity and mortality. This is especially true for hospitalized patients. Pulmonary embolism (PE) is the leading preventable cause of in-hospital mortality. The preferred method of both treatment and prophylaxis for VTE is anticoagulation. However, in a subset of patients, anticoagulation therapy is contraindicated or ineffective, and these patients often receive an inferior vena cava (IVC) filter. The sole purpose of an IVC filter is prevention of clinically significant PE. IVC filter usage has increased every year, most recently due to the availability of retrievable devices and a relaxation of thresholds for placement. Much of this recent growth has occurred in the trauma patient population given the high potential for VTE and frequent contraindication to anticoagulation. Retrievable filters, which strive to offer the benefits of permanent filters without time-sensitive complications, come with a new set of challenges including methods for filter follow-up and retrieval. PMID:23997414

  16. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    PubMed Central

    Koppisetty, Shalini; Smith, Alton G.; Dhillon, Ravneet K.

    2015-01-01

    Inferior vena cava atresia (IVCA) is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT), found in approximately 5% of cases of unprovoked lower extremity (LE) DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging. PMID:26640723

  17. Extensive Thrombosis of the Inferior Vena Cava and Left Renal Vein in a Neonate.

    PubMed

    Kdous, Moez; Khlifi, Oussema; Brahem, Marwene; Khrouf, Mohamed; Amari, Sarah; Ferchiou, Monia; Zhioua, Fethi

    2015-01-01

    Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child.

  18. A Dedicated Inferior Vena Cava Filter Service Line: How to Optimize Your Practice.

    PubMed

    Karp, Jennifer K; Desai, Kush R; Salem, Riad; Ryu, Robert K; Lewandowski, Robert J

    2016-06-01

    Despite the increased placement of retrievable inferior vena cava filters (rIVCFs), efforts to remove these devices are not commensurate. The majority of rIVCFs are left in place beyond their indicated usage, and often are retained permanently. With a growing understanding of the clinical issues associated with these devices, the United States Food and Drug Administration (FDA) has prompted clinicians to remove rIVCF when they are no longer indicated. However, major obstacles exist to filter retrieval, chief among them being poor clinical follow-up. The establishment of a dedicated IVC filter service line, or clinic, has been shown to improve filter retrieval rates. Usage of particular devices, specifically permanent versus retrievable filters, is enhanced by prospective physician consultation. In this article, the rationale behind a dedicated IVC filter service line is presented as well as described the structure and activities of the authors' IVC filter clinic; supporting data will also be provided when appropriate.

  19. Renal Failure Secondary to Thrombotic Complications of Suprarenal Inferior Vena Cava Filter in Cancer Patients

    SciTech Connect

    Marcy, Pierre-Yves; Magne, Nicolas; Frenay, Marc; Bruneton, Jean-Noel

    2001-07-15

    Purpose: To evaluate renal function before and after suprarenal inferior vena cava (IVC) filter placement.Methods: We describe, in a personal series of 13 consecutive cases (all of them stage IV cancer patients, one LGM filter, one Antheor filter, 11 Greenfield filters) in our institution, two cases of fatal renal vein thrombosis after placement of a suprarenal filter. Evaluation of renal function was based on serum urea (in mmol/L; normal 3.30-6.60), serum creatinine (in {mu}mol/L; normal <115.1), and calculation of serum creatinine clearance. Results and conclusion: This study suggests that in advanced-stage cancer patients who have a single functional kidney, renal functional insufficiency, or previous renal vein thrombosis, IVC filter placement above the renal veins may not be appropriate. Suprarenal filter placement should be performed only after analysis of predicted survival, after detailed discussions with the patient, and most importantly after renal function evaluation.

  20. Multiorgan resection with inferior vena cava reconstruction for hepatic alveolar echinococcosis

    PubMed Central

    Li, Wei; Wu, Hong

    2016-01-01

    Abstract Alveolar echinococcosis (AE) is a life-threatening parasitic disease characterized by its tumor-like growth. Radical operation is deemed the curable method for AE treatment if R0-resection is achievable. We present a 26-year-old AE patient with AE lesions invading the right lobe of the liver, the inferior vena cava, inferior lobe of right lung, the right hemidiaphragm, and the right kidney. On the basis of precise preoperative and intraoperative evaluations, a radical surgery that removed the huge lesion en bloc was performed successfully with skillful surgical techniques. This patient had an uneventful postoperative recovery and a good prognosis. Multiorgan resection is justified and unavoidable in selected patients when AE lesions invade different organs and the main vascular structures. PMID:27281076

  1. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    PubMed

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii.

  2. Adult liver transplantation in the congenital absence of inferior vena cava.

    PubMed

    Angelico, R; Stonelake, S; Perera, D S; Mirza, D F; Russell, S; Muiesan, P; Perera, M T P R

    2015-10-01

    Whereas congenital absence of inferior vena cava observed in paediatric population more often than not, as an isolated or syndromic variety, this is seldom encountered in adult liver transplant recipients. There appear few sporadic reports in the literature on experience of such anomaly in adults. Given the rarity of situation, surprising encounters of such anomalies may pose challenge to the unprepared transplant surgeon and unfavourable outcomes may even have resulted in under-reportage of this condition. In this brief report we document our recent experience with two such cases and this is supplemented with extensive reference to the literature on classification of such anomalies with the endeavour to document implications of such in the adult liver transplant setting. PMID:26278662

  3. Marine algae-mediated synthesis of gold nanoparticles using a novel Ecklonia cava.

    PubMed

    Venkatesan, Jayachandran; Manivasagan, Panchanathan; Kim, Se-Kwon; Kirthi, Arivarasan Vishnu; Marimuthu, Sampath; Rahuman, Abdul Abdul

    2014-08-01

    In the present study, we report rapid biological synthesis of gold nanoparticles (Au NPs) using a novel marine brown alga Ecklonia cava (Family: Lessoniaceae) by the reduction of chloroauric acid. The formation of Au NPs reaction was complete within 1 min at 80 °C and physiochemically characterized with different analytical techniques. FTIR spectroscopy revealed that Au NPs were functionalized with biomolecules that have primary amine group, hydroxyl group and other stabilizing functional groups. X-ray diffraction pattern showed high purity and face-centered cubic structure of Au NPs. Microscopy results showed that these Au NPs are formed with shapes like spherical and triangular with an average size of 30 ± 0.25 nm. Synthesized Au NPs showed good antimicrobial and biocompatibility with human keratinocyte cell line. Thus, physiochemical characteristic results suggest that Au NPs will have promising biomedical applications in different area such as drug delivery, tissue engineering, biosensor, etc.

  4. Endometrial Stromal Sarcoma Metastatic from the Uterus to the Inferior Vena Cava and Right Atrium

    PubMed Central

    Nghiem, William; Aziz, Salim; Rahbar, Rodeen; Banks, Whitney; Venbrux, Anthony; Sarin, Shawn

    2015-01-01

    Endometrial stromal sarcoma metastases usually occur within the pelvis and rarely involve the great vessels or the heart. We present the case of a 55-year-old woman who was referred for endovascular therapy to treat presumed thrombosis of the inferior vena cava. The suspected thrombus was recalcitrant to endovascular removal with use of an AngioVac venous drainage device. Results of an intraprocedural transvenous biopsy revealed the mass to be the intravascular extension of an endometrial stromal sarcoma. The patient underwent surgical excision of the tumor, and, shortly thereafter, a hysterectomy and salpingo-oophorectomy. This complex case highlights both the rarity of malignancy masquerading as caval thrombus and the importance of multispecialty collaboration. PMID:26664311

  5. Klippel-Trenaunay and Sturge-Weber syndromes with renal hemangioma and double inferior vena cava.

    PubMed

    Schofield, D; Zaatari, G S; Gay, B B

    1986-08-01

    We describe a 3 1/2-year-old boy with the Klippel-Trenaunay and Sturge-Weber syndromes. The child had congenital superficial capillary hemangiomas, congenital glaucoma and mild hydrocephalus. During the first year of life he experienced intermittent hematuria. When he was 3 years old he presented with seizures and left hemihypertrophy first was noted. Several months later radiological examination of a large abdominal mass demonstrated its origin to be in the right kidney. Radical nephrectomy documented the presence of renal hemangioma with complicating perirenal hematoma. A double inferior vena cava was another unexpected surgical finding that complicated the course of this patient. All of these unusual features in these rare syndromes with their clinical, pathogenetic and therapeutic implications are discussed. The differential diagnosis of renal masses in these syndromes also is presented. PMID:3016342

  6. Cava-suprarenal line: new position for sonographic imaging of left adrenal gland.

    PubMed

    Krebs, C A; Eisenberg, R L; Ratcliff, S; Jouppi, L

    1986-09-01

    Because of overlying attenuating structures, sonographic imaging of the left adrenal gland is often difficult, especially in obese or pediatric patients. In a series of 50 consecutive patients, the left adrenal glands were examined in both the conventional right posterior oblique (RPO) position and using the new cava-suprarenal line (CSL) position. The CSL position permitted identification of the left adrenal gland in 90% of the patients; in contrast, the gland could be demonstrated in only 60% of the patients using the conventional RPO position. With the CSL position, the left adrenal gland could be imaged in half the time required with the conventional RPO position. The improved ability to demonstrate the left adrenal gland as well as the reduction in the required scanning time was particularly marked in obese and pediatric patients.

  7. Long-Term Safety and Effectiveness of the 'OptEase' Vena Cava Filter

    SciTech Connect

    Kalva, Sanjeeva P.; Marentis, Theodore C.; Yeddula, Kalpana; Somarouthu, Bhanusupriya; Wicky, Stephan; Stecker, Michael S.

    2011-04-15

    Purpose: To assess the long-term safety and effectiveness of the OptEase inferior vena cava (IVC) filter. Materials and Methods: In this Institutional Review Board-approved, retrospective study, we reviewed data of 71 patients who received an OptEase filter at our institution from 2002 to 2007. Thirty-nine (55%) patients had symptoms of venous thromboembolism before filter placement. The indications for filter included contraindication to anticoagulation in 31 (44%) patients, prophylaxis against pulmonary embolism (PE) in 29 (41%) patients, and failure of anticoagulation in 11 (15%) patients. Procedure-related complications, such as symptomatic post-filter PE, deep venous thrombosis (DVT), IVC occlusion, and incidental imaging-evident filter-related complications, were recorded. Safety was assessed by the occurrence of filter-related complications during placement and follow-up. Effectiveness was assessed by the occurrence of post-filter PE. Results: Sixty-five (92%) filters were placed under fluoroscopy, and 6 (8%) were placed using intravascular ultrasound guidance. Seventy (99%) filters were placed successfully. Seven (10%) filters were placed in the suprarenal cava. Retrieval was attempted in 14 (20%) patients, and 12 filters were successfully retrieved. Clinical follow-up was available for 20 {+-} 21 months. Symptoms of postfilter PE and DVT occurred in 15% (n = 11) and 10% (n = 7) patients, respectively. None of these patients had computed tomography (CT)-proven PE, and only one had ultrasound-proven new DVT. One patient had symptomatic IVC occlusion. Follow-up abdominal CT in 20 patients showed thrombus in the filter in two of them. There were no instances of filter migration, filter tilt, or caval wall penetration. Conclusion: The OptEase filter appears to have an acceptable long-term safety profile. The filter was effective against PE.

  8. Use of noncontrast computed tomography of the inferior vena cava for real-time imaging guidance for the placement of inferior vena cava filters.

    PubMed

    Winkler, Michael A; Majmudar, Palak M; Landwehr, Kevin P; Hobbs, Stephen B; Saha, Sibu P

    2015-03-01

    Appropriate placement of an inferior vena cava (IVC) filter necessitates imaging of the renal veins because when an IVC filter is deployed its tip should be at or below the inferior aspect of the inferiormost renal vein. Traditionally, imaging during placement of IVC filters has been with conventional cavography and fluoroscopy. Recently, intravascular ultrasound has been used for the same purpose but with additional expense. Morbidly obese patients often exceed the weight limit of fluoroscopy tables. In addition, short obese patients are at risk of falling from narrow fluoroscopy tables. For such patients, computed tomography (CT) guidance is a viable alternative to conventional fluoroscopic guidance. IVC placement was performed in the CT suite for two obese patients who exceeded the weight limits of the available fluoroscopy tables. In one case, a Vena-Tech filter (Braun Medical, Melsungen, Germany) was placed using CT fluoroscopy. In the second case, a Recovery (Bard, Murray Hill, NJ) filter was placed using intermittent limited z-axis scanning. In the first case, the filter was placed below the level of the renal veins and above the confluence of the iliac veins, which is acceptable placement. In the second case, with refinement of technique, the filter tip was placed less than 1 cm below the inferiormost renal vein, which is considered optimal placement. CT of the IVC precisely images the renal veins and can characterize their number and their confluence with the IVC. CT guidance is a viable alternative to fluoroscopic guidance for the placement of IVC filters in morbidly obese patients. PMID:25780332

  9. The letter height superiority illusion.

    PubMed

    New, Boris; Doré-Mazars, Karine; Cavézian, Céline; Pallier, Christophe; Barra, Julien

    2016-02-01

    Letters are identified better when they are embedded within words rather than within pseudowords, a phenomenon known as the word superiority effect (Reicher in Journal of Experimental Psychology, 81, 275-280, 1969). This effect is, inter alia, accounted for by the interactive-activation model (McClelland & Rumelhart in Psychological Review, 88, 375-407, 1981) through feedback from word to letter nodes. In this study, we investigated whether overactivation of features could lead to perceptual bias, wherein letters would be perceived as being taller than pseudoletters, or words would be perceived as being taller than pseudowords. In two experiments, we investigated the effects of letter and lexical status on the perception of size. Participants who had to compare the heights of letters and pseudoletters, or of words and pseudowords, indeed perceived the former stimuli as being taller than the latter. Possible alternative interpretations of this height superiority effect for letters and words are discussed. PMID:26370216

  10. Writing superiority in cued recall.

    PubMed

    Fueller, Carina; Loescher, Jens; Indefrey, Peter

    2013-01-01

    In list learning paradigms with free recall, written recall has been found to be less susceptible to intrusions of related concepts than spoken recall when the list items had been visually presented. This effect has been ascribed to the use of stored orthographic representations from the study phase during written recall (Kellogg, 2001). In other memory retrieval paradigms, by contrast, either better recall for modality-congruent items or an input-independent writing superiority effect have been found (Grabowski, 2005). In a series of four experiments using a paired associate learning paradigm we tested (a) whether output modality effects on verbal recall can be replicated in a paradigm that does not involve the rejection of semantically related intrusion words, (b) whether a possible superior performance for written recall was due to a slower response onset for writing as compared to speaking in immediate recall, and (c) whether the performance in paired associate word recall was correlated with performance in an additional episodic memory recall task. We observed better written recall in the first half of the recall phase, irrespective of the modality in which the material was presented upon encoding. An explanation for this effect based on longer response latencies for writing and hence more time for memory retrieval could be ruled out by showing that the effect persisted in delayed response versions of the task. Although there was some evidence that stored additional episodic information may contribute to the successful retrieval of associate words, this evidence was only found in the immediate response experiments and hence is most likely independent from the observed output modality effect. In sum, our results from a paired associate learning paradigm suggest that superior performance for written vs. spoken recall cannot be (solely) explained in terms of additional access to stored orthographic representations from the encoding phase. Our findings rather

  11. You see what you know … gas bubbles in the inferior vena cava, an unusual presentation of necrotizing soft tissue infection.

    PubMed

    Winter, Thomas C; Rudolf, Lou; Sommers, Daniel N

    2015-06-01

    Gas detected within the systemic circulation as an unexpected finding is a very rare phenomenon. A case of multiple bubbles within the inferior vena cava detected incidentally during a sonogram requested to assess for portal vein thrombosis is presented. These were eventually determined to be sequelae of a fatal, clinically silent necrotizing soft tissue infection. The differential diagnosis for gas within the inferior vena cava is reviewed, and teaching points that may help future patients are presented.

  12. Superior sulcus tumors (Pancoast tumors).

    PubMed

    Marulli, Giuseppe; Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-06-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach.

  13. Superior sulcus tumors (Pancoast tumors).

    PubMed

    Marulli, Giuseppe; Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-06-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach. PMID:27429965

  14. Superior sulcus tumors (Pancoast tumors)

    PubMed Central

    Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-01-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner’s syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach. PMID:27429965

  15. Modified Senning Procedure for Correction of Atrioventricular Discordance With Total Anomalous Pulmonary Venous Return, Atrial Situs Inversus, Dextrocardia, and Bilateral Superior Venae Cavae.

    PubMed

    Sebastian, Vinod A; Guleserian, Kristine J; Juraszek, Amy; Kane, Colin; Hamzeh, Rabih; Forbess, Joseph M

    2015-10-01

    The Senning and Mustard baffles remain important techniques for the treatment of congenitally corrected transposition (cc-TGA), isolated ventricular inversion, and D-transposition of the great arteries with delayed presentation. We describe the treatment of an 8-month old infant with atrioventricular discordance, ventriculoarterial concordance, and dextrocardia with atrial situs inversus. A modified Senning procedure was performed through the "left-sided" atrium. Modifications of the Senning and Mustard baffles remain important tools in the treatment of rare conditions like isolated ventricular inversion.

  16. [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

  17. Deep venous thrombosis caused by congenital inferior vena cava agenesis and heterozygous factor V Leiden mutation – a case report

    PubMed Central

    Vasco, Pablo Guisado; López, Angel Ruedas; Piñeiro, María Laiño; Rivera, José Ignacio Gallego

    2009-01-01

    The unusual clinical presentation, importance of imaging techniques and role of low molecular weight heparin are described for an initial treatment of thrombosis in inferior vena cava agenesis associated with heterozygous factor V Leiden. The patient, a 36-year-old woman, presented to the emergency room with sudden onset of back pain, swelling of the legs and thighs, and claudication while walking. Abdominal ultrasonography was immediately ordered. Anomalies in vascular blood flow were detected. Computed tomography was performed, and initially showed a complete absence of the infrarenal segment of inferior vena cava caudally to the origin of both renal veins. Treatment with enoxaparin (1 mg/kg twice per day) was started. The patient was discharged and returned to her activities of daily living two weeks after admission. This vascular abnormality is mostly incidentally diagnosed in adults and only a few cases are described as being associated with thrombophilia. PMID:22477517

  18. Fractured inferior vena cava filter strut presenting as a penetrating foreign body in the right ventricle: report of a case.

    PubMed

    Kumar, S Prathap; Mahtabifard, Ali; Young, J Nilas

    2008-01-01

    Migration of a fractured strut of an inferior vena cava (IVC) filter to the heart is a rare complication. We report the case of a 40-year-old woman who had this complication eight months after infrarenal IVC filter placement. She presented with chest pain. The broken arm of the IVC filter had migrated to the heart and penetrated the free wall of the right ventricle. It was removed successfully by cardiac surgery without the aid of cardiopulmonary bypass.

  19. Renal Artery Stump to Inferior Vena Cava Fistula: Unusual Clinical Presentation and Transcatheter Embolization with the Amplatzer Vascular Plug

    SciTech Connect

    Taneja, Manish; Lath, Narayan Soo, Tan Bien; Hiong, Tay Kiang; Htoo, Maung Myint; Richard, Lo; Fui, Alexander Chung Yaw

    2008-07-15

    Fistulous communication between the renal artery stump and inferior vena cava following nephrectomy is rare. We describe the case of a 52-year-old man with a fistula detected on investigation for hemolytic anemia in the postoperative period. The patient had had a nephrectomy performed 2 weeks prior to presentation for blunt abdominal trauma. The fistula was successfully occluded percutaneously using an Amplatzer vascular plug. The patient recovered completely and was discharged 2 weeks later.

  20. The Arthroscopic Superior Capsular Reconstruction.

    PubMed

    Adams, Christopher R; Denard, Patrick J; Brady, Paul C; Hartzler, Robert U; Burkhart, Stephen S

    2016-01-01

    In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative. In this article, we describe our technique for the SCR. PMID:27552457

  1. Polyphenol-Rich Fraction of Ecklonia cava Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed Mice

    PubMed Central

    Park, Eun-Young; Choi, Hojung; Yoon, Ji-Young; Lee, In-Young; Seo, Youngwan; Moon, Hong-Seop; Hwang, Jong-Hee; Jun, Hee-Sook

    2015-01-01

    Ecklonia cava (E. cava; CA) is an edible brown alga with beneficial effects in diabetes via regulation of various metabolic processes such as lipogenesis, lipolysis, inflammation, and the antioxidant defense system in liver and adipose tissue. We investigated the effect of the polyphenol-rich fraction of E. cava produced from Gijang (G-CA) on nonalcoholic fatty liver disease (NAFLD) in high-fat diet (HFD)-fed mice. C57BL6 mice were fed a HFD for six weeks and then the HFD group was administered 300 mg/kg of G-CA extracts by oral intubation for 10 weeks. Body weight, fat mass, and serum biochemical parameters were reduced by G-CA extract treatment. MRI/MRS analysis showed that liver fat and liver volume in HFD-induced obese mice were reduced by G-CA extract treatment. Further, we analyzed hepatic gene expression related to inflammation and lipid metabolism. The mRNA expression levels of inflammatory cytokines and hepatic lipogenesis-related genes were decreased in G-CA-treated HFD mice. The mRNA expression levels of cholesterol 7 alpha-hydroxylase 1 (CYP7A1), the key enzyme in bile acid synthesis, were dramatically increased by G-CA treatment in HFD mice. We suggest that G-CA treatment ameliorated hepatic steatosis by inhibiting inflammation and improving lipid metabolism. PMID:26569269

  2. Polyphenol-Rich Fraction of Ecklonia cava Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed Mice.

    PubMed

    Park, Eun-Young; Choi, Hojung; Yoon, Ji-Young; Lee, In-Young; Seo, Youngwan; Moon, Hong-Seop; Hwang, Jong-Hee; Jun, Hee-Sook

    2015-11-12

    Ecklonia cava (E. cava; CA) is an edible brown alga with beneficial effects in diabetes via regulation of various metabolic processes such as lipogenesis, lipolysis, inflammation, and the antioxidant defense system in liver and adipose tissue. We investigated the effect of the polyphenol-rich fraction of E. cava produced from Gijang (G-CA) on nonalcoholic fatty liver disease (NAFLD) in high-fat diet (HFD)-fed mice. C57BL6 mice were fed a HFD for six weeks and then the HFD group was administered 300 mg/kg of G-CA extracts by oral intubation for 10 weeks. Body weight, fat mass, and serum biochemical parameters were reduced by G-CA extract treatment. MRI/MRS analysis showed that liver fat and liver volume in HFD-induced obese mice were reduced by G-CA extract treatment. Further, we analyzed hepatic gene expression related to inflammation and lipid metabolism. The mRNA expression levels of inflammatory cytokines and hepatic lipogenesis-related genes were decreased in G-CA-treated HFD mice. The mRNA expression levels of cholesterol 7 alpha-hydroxylase 1 (CYP7A1), the key enzyme in bile acid synthesis, were dramatically increased by G-CA treatment in HFD mice. We suggest that G-CA treatment ameliorated hepatic steatosis by inhibiting inflammation and improving lipid metabolism.

  3. INTERDEPENDENT SUPERIORITY AND INFERIORITY FEELINGS

    PubMed Central

    Ingham, Harrington V.

    1949-01-01

    It is postulated that in neurotic persons who have unrealistic feelings of superiority and inferiority the two are interdependent. This is a departure from the concept of previous observers that either one or the other is primary and its opposite is overcompensation. The author postulates considerable parallelism, with equal importance for each. He submits that the neurotic person forms two logic-resistant compartments for the two opposed self-estimates and that treatment which makes inroads of logic upon one compartment, simultaneously does so upon the other. Two examples are briefly reported. The neurotic benefits sought in exaggeration of capability are the same as those sought in insistence upon inferiority: Presumption of superiority at once bids for approbation and delivers the subject from the need to prove himself worthy of it in dreaded competition; exaggeration of incapability baits sympathy and makes competition unnecessary because failure is conceded. Some of the characteristics of abnormal self-estimates that distinguish them from normal are: Preoccupation with self, resistance to logical explanation of personality problems, inconsistency in reasons for beliefs in adequacy on the one hand and inadequacy on the other, unreality, rationalization of faults, and difficulty and vacillation in the selection of adequate goals. PMID:15390573

  4. 76 FR 11193 - Superior Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Superior Resource Advisory Committee will meet in Duluth, Minnesota. The...

  5. 75 FR 65296 - Superior Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Superior Resource Advisory Committee will meet in Duluth, Minnesota. The...

  6. First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept

    SciTech Connect

    Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H.; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M.; Borm, Paul J. A.; Jacob, Augustinus L.; Bilecen, Deniz

    2009-05-15

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  7. Management of Primitive Neuroectodermal Tumor of the Kidney with Inferior Vena Cava Thrombus

    PubMed Central

    Gupta, Sahil; Majumder, Kaustav; Chahal, Anurag; Saini, Ashish K.; Gupta, Arjun

    2016-01-01

    Primitive neuroectodermal tumors (PNET) are an aggressive group of small round cell tumors usually arising in the nervous system and affecting children. They have a tendency for local invasion, distant spread and formation of tumor thrombi. The kidney is a rare primary location for these tumors. Outcomes are frequently poor due to late diagnosis (Wilms tumor is a more common tumor in this population) and early spread. Immunohistochemistry is invaluable in making the diagnosis of PNET. We report a case of a primary renal PNET with extensive tumor thrombus into the inferior vena cava, and lung metastasis in a pediatric patient, and its successful management. Our 14-year-old patient with renal PNET was managed with radical nephrectomy, thrombectomy and chemotherapy and remains disease free to date. The diagnosis of renal PNETs should be considered in young adult patients who present with aggressive renal masses at initial presentations. Despite its aggressive nature, good outcomes can be achieved by a multimodality therapeutic strategy. PMID:26989372

  8. Histology of Tissue Adherent to OptEase Inferior Vena Cava Filters Regarding Indwelling Time

    SciTech Connect

    Rimon, Uri Volkov, Alexander; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Khaitovich, Boris; Abu-Salah, Kamel; Zissin, Rivka; Simon, Daniel; Konen, Eli

    2009-01-15

    The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism. Cavography was performed both before and after filter removal to evaluate the presence of thrombi or wall damage. Filters were retrieved with the snare and sheath method. All material adherents to the filters were examined histologically.The mean indwelling time of the filters was 24.9 days (range, 6-69 days). Red tissue fragments were seen on all the filters, consistent microscopically with clots and fibrin. On five filters (18%; mean indwelling time, 45.4 days) white tissue consistent with vascular intima was found. All postprocedure cavographies were normal. We conclude that most material adherent to the retrieved filters is thrombi, while vascular intima can be found in the minority of filters with a longer indwelling time.

  9. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    SciTech Connect

    Pellerin, O.; Barral, F. G.; Lions, C.; Novelli, L.; Beregi, J. P.; Sapoval, M.

    2008-09-15

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 {+-} 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.

  10. Computational Simulations of Inferior Vena Cava (IVC) Filter Placement and Hemodynamics in Patient-Specific Geometries

    NASA Astrophysics Data System (ADS)

    Aycock, Kenneth; Sastry, Shankar; Kim, Jibum; Shontz, Suzanne; Campbell, Robert; Manning, Keefe; Lynch, Frank; Craven, Brent

    2013-11-01

    A computational methodology for simulating inferior vena cava (IVC) filter placement and IVC hemodynamics was developed and tested on two patient-specific IVC geometries: a left-sided IVC, and an IVC with a retroaortic left renal vein. Virtual IVC filter placement was performed with finite element analysis (FEA) using non-linear material models and contact modeling, yielding maximum vein displacements of approximately 10% of the IVC diameters. Blood flow was then simulated using computational fluid dynamics (CFD) with four cases for each patient IVC: 1) an IVC only, 2) an IVC with a placed filter, 3) an IVC with a placed filter and a model embolus, all at resting flow conditions, and 4) an IVC with a placed filter and a model embolus at exercise flow conditions. Significant hemodynamic differences were observed between the two patient IVCs, with the development of a right-sided jet (all cases) and a larger stagnation region (cases 3-4) in the left-sided IVC. These results support further investigation of the effects of IVC filter placement on a patient-specific basis.

  11. Congenital agenesis of inferior vena cava: a rare cause of unprovoked deep venous thrombosis.

    PubMed

    Parsa, Pouria; Lane, John S; Barleben, Andrew R; Owens, Erik L; Bandyk, Dennis

    2015-07-01

    Congenital anomalies of the inferior vena cava (IVC), although rare, are a risk factor for lower limb deep venous thrombosis (DVT). A 19-year-old male presented with a left flank and groin pain caused by iliofemoral venous thrombosis. Vascular imaging by computed tomography (CT) scanning and venography demonstrated agenesis of the IVC. Catheter-directed thrombolysis via a popliteal vein was attempted but did not alter the patency of the common femoral vein outflow collaterals into the retroperitoneal azygous venous system. The patient was anticoagulated using systemic heparin infusion and clinical symptoms resolved within 5 days. He was transitioned to oral Coumadin anticoagulation, and follow-up venous duplex testing demonstrated no infrainguinal DVT and phasic venous flow with respiration in the femoral vein indicating patent collateral veins. Anomalies of the IVC are present in 0.3-0.5% of otherwise healthy individuals. Agenesis of the IVC has an incidence of 0.0005-1% in the general population but is found in almost 5% of patients <30 years of age with unprovoked lower limb DVT. In adults, IVC agenesis anomaly can cause diagnostic problems in the paravertebral area because of the tumor-like appearance of the azygous venous collaterals on noncontrast CT imaging. In young adults presenting with unprovoked lower limb DVT, the presence of an IVC anomaly should be considered and evaluated for by venous duplex testing and if necessary CT venography.

  12. Assessment of Snared-Loop Technique When Standard Retrieval of Inferior Vena Cava Filters Fails

    SciTech Connect

    Doody, Orla Noe, Geertje; Given, Mark F.; Foley, Peter T.; Lyon, Stuart M.

    2009-01-15

    Purpose To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. Methods A retrospective review of all Cook Guenther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. Results The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range, 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. Conclusion The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.

  13. On determining the characteristics of a Greenfield Inferior Vena Cava Filter using CFD

    NASA Astrophysics Data System (ADS)

    Swaminathan, Tirumani; Hu, Howard; Patel, Aalpen

    2004-11-01

    In those patients with deep venous thrombosis (DVT) or those at a high risk for DVT, and who have contraindications to or are unresponsive to anticoagulation therapy, vena cava filters are often used to prevent recurrent pulmonary emboli. Ideally, the filter should be efficacious while being non-thrombogenic and non-impeding to the blood flow. In reality, the filter has to establish a balance between clot capture efficiency and flow impedance before and after clot capture. The development and use of numerical tools to study the characteristics of filters and its application to the case of a Greenfield filter has been presented here. A detailed model resolving the flow field around the filter to a fine detail is described. The thrombogenecity of the filter in un-occluded flows is determined by analyzing plots of shear stresses and velocity fields. To evaluate a filter's clot capturing efficacy, a Thin Wire Model (TWM) has been developed and used in conjunction with a moving finite element scheme to study the probability of clot capturing for the Greenfield filter.

  14. Disintegration of the 'waterfall phenomenon' in the inferior vena cava due to right heart failure.

    PubMed

    Kira, S; Dambara, T; Mieno, T; Tamaki, S; Natori, H

    1996-03-01

    The concept of the waterfall phenomenon in Zone 2 in the pulmonary vasculature is well known from West's lung model. It is believed that the flow through this zone is determined by the pressure difference between the pulmonary artery and alveoli, and the left atrial pressure is not transmissible to the alveolar capillaries. However, it is impossible to see whether alveolar capillaries are really displaying the waterfall phenomenon or not. In this review, the interrelation between the flow and geometry of the alveolar capillaries in the waterfall phenomenon is analyzed based on physiological studies using a model system and isolated lung lobe experiments. Further, extending the concept to the analysis of ventilatory changes of the inferior vena cava (IVC) configuration, it is ascertained that the waterfall phenomenon normally occurs in the IVC during inspiration just before it enters the thorax and the waterfall phenomenon in the IVC disintegrates with elevation of the central venous pressure. Because these configurations of the IVC in normal and abnormal conditions are visible with ultrasonography, the technique is very useful as a noninvasive approach to diagnose right heart failure.

  15. Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma

    PubMed Central

    Psutka, Sarah P.

    2015-01-01

    The diagnosis of renal cell carcinoma is accompanied by intravascular tumor thrombus in up to 10% of cases, of which nearly one-third of patients also have concurrent metastatic disease. Surgical resection in the form of radical nephrectomy and caval thrombectomy represents the only option to obtain local control of the disease and is associated with durable oncologic control in approximately half of these patients. The objective of this clinical review is to outline the preoperative evaluation for, and operative management of patients with locally advanced renal cell carcinoma with venous tumor thrombi involving the inferior vena cava. Cornerstones of the management of these complex patients include obtaining high-quality imaging to characterize the renal mass and tumor thrombus preoperatively, with further intraoperative real-time evaluation using transesophageal echocardiography, careful surgical planning, and a multidisciplinary approach. Operative management of patients with high-level caval thrombi should be undertaken in high-volume centers by surgical teams with capacity for bypass and invasive intraoperative monitoring. In patients with metastatic disease at presentation, cytoreductive nephrectomy and tumor thrombectomy may be safely performed with simultaneous metastasectomy if possible. In the absence of level one evidence, neoadjuvant targeted therapy should continue to be viewed as experimental and should be employed under the auspices of a clinical trial. However, in patients with significant risk factors for postoperative complications and mortality, and especially in those with metastatic disease, consultation with medical oncology and frontline targeted therapy may be considered. PMID:26445601

  16. Adrenal cortical carcinoma with extension into the inferior vena cava – case report and literature review

    PubMed Central

    2014-01-01

    Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with an incidence rate of 1 to 2 per million person-years. ACC most commonly arises sporadically, but may be associated with familial tumour syndromes. Clinical symptoms are mainly related to an excess of steroid hormones. We present an unusual case of adrenocortical carcinoma in a 27-year-old male who complained of non specific mass-effect related symptoms of slowly growing intensity differing from others described in literature because of the patient’s age and the sudden deterioration of the clinical course. The tumour was resected with the left kidney with an extension into the inferior vena cava. Histological examination revealed morphological features characteristic of an adrenal cortical tumour. The immunohistochemical results (positive reactions for vimentin, CD56, inhibin, melan A, synaptophysin, bcl-2, calretinin) confirmed the diagnosis. According to the most widely used modified Weiss criteria and the Van Slooten system, a diagnosis of adrenal cortical carcinoma was strongly confirmed. The postoperative condition was poor. Reoperation was conducted, including abdominal aorta thrombectomy and aortic prosthesis implantation. The patient died two days after the second operation. Autopsy revealed a metastatic tumour in the left lung and morphological symptoms of acute circulatory collapse due to a massive haemorrhage into the abdominal cavity, which was the direct cause of death. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1602226377106882. PMID:24602387

  17. Complex Adaptive System of Systems (CASoS) Engineering Applications. Version 1.0.

    SciTech Connect

    Linebarger, John Michael; Maffitt, S. Louise; Glass, Robert John, Jr.; Beyeler, Walter Eugene; Brown, Theresa Jean; Ames, Arlo Leroy

    2011-10-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to highly-saturated interdependencies and allied vulnerabilities to cascades in associated systems. The Phoenix initiative approaches this high-impact problem space as engineers, devising interventions (problem solutions) that influence CASoS to achieve specific aspirations. CASoS embody the world's biggest problems and greatest opportunities: applications to real world problems are the driving force of our effort. We are developing engineering theory and practice together to create a discipline that is grounded in reality, extends our understanding of how CASoS behave, and allows us to better control those behaviors. Through application to real-world problems, Phoenix is evolving CASoS Engineering principles while growing a community of practice and the CASoS engineers to populate it.

  18. Phoenix : Complex Adaptive System of Systems (CASoS) engineering version 1.0.

    SciTech Connect

    Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph; Conrad, Stephen Hamilton; Kelic, Andjelka; Starks, Shirley J.; Beyeler, Walter Eugene; Brodsky, Nancy S.; Verzi, Stephen J.; Brown, Theresa Jean; Glass, Robert John, Jr.; Sunderland, Daniel J.; Mitchell, Michael David; Ames, Arlo Leroy; Maffitt, S. Louise; Finley, Patrick D.; Russell, Eric Dean; Zagonel, Aldo A.; Reedy, Geoffrey E.; Mitchell, Roger A.; Corbet, Thomas Frank, Jr.; Linebarger, John Michael

    2011-08-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline of CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.

  19. Complex Adaptive Systems of Systems (CASoS) engineering and foundations for global design.

    SciTech Connect

    Brodsky, Nancy S.; Finley, Patrick D.; Beyeler, Walter Eugene; Brown, Theresa Jean; Linebarger, John Michael; Moore, Thomas W.; Glass, Robert John, Jr.; Maffitt, S. Louise; Mitchell, Michael David; Ames, Arlo Leroy

    2012-01-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which must be recognized and reckoned with to design a secure future for the nation and the world. Design within CASoS requires the fostering of a new discipline, CASoS Engineering, and the building of capability to support it. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Using a wide range of applications, Phoenix has begun building both theoretical foundations and capability for: the integration of Applications to continuously build common understanding and capability; a Framework for defining problems, designing and testing solutions, and actualizing these solutions within the CASoS of interest; and an engineering Environment required for 'the doing' of CASoS Engineering. In a secondary objective, we applied CASoS Engineering principles to begin to build a foundation for design in context of Global CASoS

  20. Indications, applications, and outcomes of inferior vena cava filters for venous thromboembolism in Japanese patients.

    PubMed

    Yamashita, Yugo; Unoki, Takashi; Takagi, Daisuke; Hamatani, Yasuhiro; Ishii, Mitsuru; Iguchi, Moritake; Ogawa, Hisashi; Masunaga, Nobutoyo; Wada, Hiromichi; Hasegawa, Koji; Abe, Mitsuru; Akao, Masaharu

    2016-07-01

    A recent multicenter registry study of venous thromboembolism (VTE) patients in Japan demonstrated a high prevalence of inferior vena cava (IVC) filter placement. However, data regarding indications, applications, and outcomes of IVC filters in Japanese patients are quite limited. This study was an observational, single-center, retrospective cohort study of all consecutive patients with acute VTE treated between March 2006 and February 2014. Data extracted included patient demographics, indications, applications, and complications of IVC filters, as well as VTE recurrence and death. A total of 257 consecutive patients were analyzed. Seventy-eight patients (30 %) received IVC filters. The proportions of IVC filter placement were 26 % for deep-vein thrombosis (DVT) alone, 10 % for pulmonary embolism (PE) alone, and 46 % for both DVT and PE. There was no significant difference in patient demographics between the IVC filter group and no-IVC filter group. Stated indications for filter placement were 24 cases (30 %) of DVT in intrapelvic veins, 16 cases (20 %) of DVT in proximal veins, and 11 cases (14 %) of contraindication to anticoagulant therapy. In the IVC filter group, cases of class I indication (guidelines: JCS 75:1258-1281, 2009) numbered only 6 (8 %). Many of the retrievable IVC filters were not removed and placed permanently and the retrieval rate was 42 %. We found complications of IVC filters in 8 cases (10 %). IVC filter placement was significantly associated with a better survival rate and a higher incidence of DVT recurrence during a mean observation period of 541 days. Our research suggests the frequent use of IVC filters for VTE treatment, combined with a low retrieval rate. Most of the stated indications of IVC filter placement for VTE in Japanese patients were cases of DVT in intrapelvic veins or proximal veins, not cases of contraindication to anticoagulant therapy.

  1. Medical literature, vena cava filters and evidence of efficacy. A descriptive review.

    PubMed

    Girard, Philippe; Meyer, Guy; Parent, Florence; Mismetti, Patrick

    2014-04-01

    Up to 15% of all patients with venous thromboembolism (VTE) receive an inferior vena cava filter, and prophylactic placements are increasing. To determine whether current use of filters is based on robust evidence, a global review of the recent (2001-2012) literature on filters was undertaken. The MEDLINE database was searched for articles related to filters appearing during the period 2001-2012, updating a prior search of literature from 1975-2001. All retrieved articles were analysed, classified into predetermined categories and compared to the prior analysis; randomised and large (>100 patients with a filter) comparative non-randomised clinical studies were read in full. The 651 articles, vs 568 in the period 1975-2000, consisted mainly of retrospective series (37.8%), case reports (31.7%), reviews (14.7%, vs 6.7%, p<0.001), animal and/or in vitro studies (7.5%, vs 12.9%, p=0.002), and prospective series or trials (4.9%, vs 7.4%, p=0.07). Of 4 new randomised trials (RCT), none were designed to test the efficacy of the device; to date, only one RCT has attempted to ascertain efficacy, occurring during the period 1975-2000. Eleven large non-randomised studies compared clinical outcomes of patients with and without filters, in VTE patients (n=5) or prophylactic indications (n=6); two studies found statistically significant relationships between filter use and lower mortality rates, though none could demonstrate a causal relationship. Hence, the plethoric literature on filters parallels growing experience with these devices, but still fails to provide reliable evidence that filter use improves relevant clinical outcomes. No indication for filter placement is based on appropriate scientific evidence.

  2. Successful Kidney Transplantation in Children With a Compromised Inferior Vena Cava

    PubMed Central

    Shishido, Seiichiro; Kawamura, Takeshi; Hamasaki, Yuko; Takahashi, Yusuke; Itabashi, Yoshihiro; Muramatsu, Masaki; Satoh, Hiroyuki; Aikawa, Atsushi

    2016-01-01

    Background Children with a compromised inferior vena cava (IVC) were previously considered unsuitable for kidney transplantation because of the technical difficulties and the increased risk of graft thrombosis secondary to inadequate renal venous outflow. Methods We conducted a retrospective study of 11 transplants in 9 patients with end-stage renal disease and thrombosed IVCs who received adult kidney allografts between 2000 and 2015. The mean age at transplantation was 7.5 ± 3.5 years. A pretransplant diagnosis of the IVC thrombosis was made in 7 patients by magnetic resonance imaging and computerized tomography, whereas there were 2 instances of intraoperative discovery of the IVC thrombosis. Results In the early cases, a kidney was placed intraperitoneally at the right iliac fossa with a venous anastomosis to the patent segment of the suprarenal IVC. After 2008, however, 6 adult-sized kidneys were subsequently placed in the left orthotopic position. Venous drainage was attained to the infrahepatic IVC (n = 3), left native renal vein (n = 2), and ascending lumbar vein (n = 1). Moreover, a venous bypass was created between the graft and the splenic vein in 2 children who showed high return pressure after the vessel was declamped. The mean glomerular filtration rate of the functioning 8 grafts 1 year posttransplant was 73.4 ± 20.4 mL/min per 1.73 m2. Of note, 6 of the grafts have been functioning well, with a mean follow-up of 66 months. Both 1- and 5-year graft survival were 81.8%. Conclusions Transplantation into the left orthotopic position and the revascularization methods are an effective set of surgical techniques that could potentially be adopted as safe and reliable transplant approaches in children with IVC thrombosis. PMID:27500272

  3. Winogradskyella eckloniae sp. nov., a marine bacterium isolated from the brown alga Ecklonia cava.

    PubMed

    Kim, Ji-Young; Park, So-Hyun; Seo, Ga-Young; Kim, Young-Ju; Oh, Duck-Chul

    2015-09-01

    A novel bacterial strain, designated EC29(T), was isolated from the brown alga Ecklonia cava collected on Jeju Island, Republic of Korea. Cells of strain EC29(T) were Gram-stain-negative, aerobic, rod-shaped and motile by gliding. Growth was observed at 10-30 °C (optimum, 20-25 °C), at pH 6.0-9.5 (optimum, pH 7.5) and in the presence of 1-5% (w/v) NaCl. Phylogenetic analyses based on the 16S rRNA gene sequence revealed that the strain belonged to the genus Winogradskyella. Strain EC29(T) exhibited the highest 16S rRNA gene sequence similarities, of 96.5-97.8%, to the type strains of Winogradskyella pulchriflava EM106(T), Winogradskyella echinorum KMM 6211(T) and Winogradskyella ulvae KMM 6390(T). Strain EC29(T) exhibited < 27% DNA-DNA relatedness with Winogradskyella pulchriflava EM106(T) and Winogradskyella echinorum KMM 6211(T). The predominant fatty acids of strain EC29(T) were iso-C15 : 0, iso-C15 : 1 G, C15 : 0, iso-C17 : 0 3-OH, iso-C15 : 0 3-OH and anteiso-C15 : 0. The DNA G+C content was 31.1 mol% and the major respiratory quinone was menaquinone-6 (MK-6). Based on a polyphasic study, strain EC29(T) is considered to represent a novel species of the genus Winogradskyella, for which the name Winogradskyella eckloniae sp. nov. is proposed. The type strain is EC29(T) ( = KCTC 32172(T) = JCM 18703(T)). PMID:25979633

  4. Flavobacterium jejuensis sp. nov., isolated from marine brown alga Ecklonia cava.

    PubMed

    Park, So-Hyun; Kim, Ji-Young; Kim, Young-Ju; Heo, Moon-Soo

    2015-11-01

    A bacterial strain, designated EC11(T) was isolated from brown alga Ecklonia cava collected from Jeju Island, Korea. EC11(T) was identified as a Gram-negative, rod-shaped and yellow-pigmented bacterial strain. The strain EC11(T) grew over a temperature range of 10 °C to 30 °C (optimally at 25 °C), and a pH range of 6.0-10.5 (optimally at pH 7.5). Phylogenetic analysis based on 16S rRNA gene sequences showed that strain EC11(T) belongs to the genus Flavobacterium. Strain EC11(T) shared close similarity with Flavobacterium jumunjinense HME7102(T) (96.4%), Flavobacterium dongtanense LW30(T) (95.8%), Flavobacterium haoranii LQY-7(T) (95.3%), and Flavobacterium urocaniciphilum (95.1%). The major fatty acids (> 5%) were iso-C17:0 3-OH (22.4%), iso-C15:0 3-OH (19.0%), C15:0 (12.4%), summed feature 3 (comprising C16:1 ω7c/ C16:1 ω6c; 9.78%), iso-C15:1 G (9.6%), and iso-C16:0 3-OH (9.0%). The DNA G+C content was 28.1 mol% and the strain contained MK-6 as the predominant menaquinone. The major polar lipids were phosphatidylethanolamine, two unknown aminolipids and three unknown polar lipids. Based on phenotypic, chemotaxonomic and phylogenetic analysis, strain EC11T represents a novel species of the Flavobacterium genus, for which the name Flavobacterium jejuensis sp. nov. is proposed. The type strain of F. jejuensis is EC11(T) (=KCTC 42149(T) = JCM 30735(T)). PMID:26502959

  5. Living donor liver transplantation with replacement of vena cava for Echinococcus alveolaris: A case report☆

    PubMed Central

    Mamedov, Ruslan; Novruzov, Namig; Baskiran, Adil; Yetisir, Fahri; Unal, Bulent; Aydın, Cemalettın; Bayramov, Nuru; Kayaalp, Cuneyt; Yilmaz, Sezai

    2014-01-01

    INTRODUCTION There is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can’t be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver. PRESENTATION OF CASE Here we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done. DISCUSSION Curative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft. CONCLUSION Although living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver. PMID:24584043

  6. Polymer-Based Reconstruction of the Inferior Vena Cava in Rat: Stem Cells or RGD Peptide?

    PubMed Central

    Pontailler, Margaux; Illangakoon, Eranka; Williams, Gareth R.; Marijon, Camille; Bellamy, Valérie; Balvay, Daniel; Autret, Gwenhael; Vanneaux, Valérie; Larghero, Jérôme; Planat-Benard, Valérie; Perier, Marie-Cécile; Bruneval, Patrick; Menasché, Philippe

    2015-01-01

    As part of a program targeted at developing a resorbable valved tube for replacement of the right ventricular outflow tract, we compared three biopolymers (polyurethane [PU], polyhydroxyalkanoate (the poly(3-hydroxybutyrate-co-3-hydroxyvalerate-co-4-hydroxyvalerate) [PHBVV]), and polydioxanone [PDO]) and two biofunctionalization techniques (using adipose-derived stem cells [ADSCs] or the arginine-glycine-aspartate [RGD] peptide) in a rat model of partial inferior vena cava (IVC) replacement. Fifty-three Wistar rats first underwent partial replacement of the IVC with an acellular electrospun PDO, PU, or PHBVV patch, and 31 nude rats subsequently underwent the same procedure using a PDO patch biofunctionalized either by ADSC or RGD. Results were assessed both in vitro (proliferation and survival of ADSC seeded onto the different materials) and in vivo by magnetic resonance imaging (MRI), histology, immunohistochemistry [against markers of vascular cells (von Willebrand factor [vWF], smooth muscle actin [SMA]), and macrophages ([ED1 and ED2] immunostaining)], and enzyme-linked immunosorbent assay (ELISA; for the expression of various cytokines and inducible NO synthase). PDO showed the best in vitro properties. Six weeks after implantation, MRI did not detect significant luminal changes in any group. All biopolymers were evenly lined by vWF-positive cells, but only PDO and PHBVV showed a continuous layer of SMA-positive cells at 3 months. PU patches resulted in a marked granulomatous inflammatory reaction. The ADSC and RGD biofunctionalization yielded similar outcomes. These data confirm the good biocompatibility of PDO and support the concept that appropriately peptide-functionalized polymers may be successfully substituted for cell-loaded materials. PMID:25611092

  7. Laparoscopic radical nephrectomy with inferior vena cava thrombectomy: highlight of key surgical steps

    PubMed Central

    Sim, A.; Todenhöfer, T.; Mischinger, J.; Fahmy, O.; Boettge, J.; Rausch, S.; Bier, S.; Aufderklamm, S.; Stenzl, A.; Gakis, G.; Schwentner, C.

    2016-01-01

    ABSTRACT Objective: Vascular involvement in the form of renal vein (RV) or inferior vena cava (IVC) thrombus can be seen in 4-10% of patients presented with RCC. In patients without presence of metastasis, surgical treatment in the form of radical nephrectomy remains the treatment of choice with 5-year survival rates of 45-70%. Open surgery is still the first treatment option of choice at the moment for RCC patients with IVC thrombus. Materials and Methods: In our study, we are reporting a case of patient with RCC and level I IVC thrombus treated with laparoscopy. Our patient is a 72 years old man with underlying co-morbidity of hypertension and chronic kidney disease (CKD) presented with right-sided RCC. The CT scan done showed a large right renal upper pole tumor measuring 8.4x5.2cm with level I IVC thrombus (Figure-1). There were no regional lymphadenopathy and the staging scans were negative. Results: The operative time was 124 minutes and blood loss was minimal. The patient was progressed to diet on POD 1 with bowel movement on POD 2. There was no significant change in the pre and post-operative glomerular filtration rate (GFR). The surgical drain was removed on POD2. The patient was discharged well on POD 5. There were no perioperative complications. The pathology was pT3bN0M0 Fuhrman grade II clear cell RCC. Conclusions: As a conclusion, laparoscopic radical nephrectomy and IVC thrombectomy is a complex and technically demanding surgery. With advancement of surgical skills as well as technology, more cases of minimally invasive laparoscopic radical nephrectomy and IVC thrombectomy can performed to improve the perioperative outcomes of carefully selected patients in a high volume center. PMID:27564306

  8. Thrombectomy and surgical reconstruction for extensive iliocaval thrombosis in a patient with agenesis of the retrohepatic vena cava and atresia of the left renal vein.

    PubMed

    La Spada, Michele; Stilo, Francesco; Carella, Giuseppe; Salomone, Ignazio; Benedetto, Filippo; De Caridi, Giovanni; Spinelli, Francesco

    2011-08-01

    In 80% of the patients presenting with deep-venous thrombosis (DVT), a risk factor can be identified. An absent or hypoplastic infrarenal vena cava is a rare risk factor for DVT in young adults. In these cases, the prevalence of congenital anomalies of the inferior vena cava (IVC) is estimated at 0.5% of the general population, up to 5% in young people. The association with coagulopathy increases the risk of DVT. We report a case of a young man who presented with a massive caval and iliofemoral-popliteal thrombosis in presence of the agenesis of retrohepatic inferior vena cava and atresia of the left renal vein. Open thrombectomy and caval reconstruction with a polytetrafluoroethylene graft were performed. Surgical option with vein reconstruction was preferred to prevent new episodes of thrombosis and the risk of acute renal failure.

  9. Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

    SciTech Connect

    Saettele, Megan R.; Morelli, John N.; Chesis, Paul; Wible, Brandt C.

    2013-12-15

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.

  10. Acute Kidney Injury Associated with Renal Cell Carcinoma Complicated by Renal Vein and Inferior Vena Cava Involvement.

    PubMed

    Sugase, Taro; Akimoto, Tetsu; Kubo, Taro; Imai, Toshimi; Otani-Takei, Naoko; Miki, Takuya; Takeda, Shin-Ichi; Nukui, Akinori; Muto, Shigeaki; Morita, Tatsuo; Nagata, Daisuke

    2016-01-01

    Acute kidney injury (AKI) is caused by diverse pathologies, although it may occasionally result from concurrent renal efflux disturbances. We herein describe a case of AKI in a patient complicated by renal cell carcinoma (RCC) with renal vein and inferior vena cava (IVC) involvement. A neoplastic thrombus which disrupted the blood flow in the renal vein appeared to play a role in the rapid decline in the renal function. Such a scenario has rarely been mentioned in the previous literature describing the cases of RCC complicated by AKI. Concerns regarding the diagnostic and therapeutic strategies for RCC are also discussed. PMID:27580548

  11. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    PubMed Central

    Lin, ShaoChun; Li, XueHua; Feng, ShiTing; Peng, ZhenPeng; Huang, SiYun; Li, ZiPing

    2014-01-01

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement. PMID:25246826

  12. Congenital anomaly of the inferior vena cava and factor V Leiden mutation predisposing to deep vein thrombosis.

    PubMed

    Lamparello, Brooke M; Erickson, Cameron R; Kulthia, Arun; Virparia, Vasudev; Thet, Zeyar

    2014-01-01

    A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT) in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC) segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis.

  13. Catheter-Directed Thrombolysis of Inferior Vena Cava Thrombosis in a 13-Day-Old Neonate and Review of Literature

    SciTech Connect

    Khan, Jawad U.; Takemoto, Clifford M.; Casella, James F.; Streiff, Michael B.; Nwankwo, Ikechi J.; Kim, Hyun S.

    2008-07-15

    Complete inferior vena cava thrombosis (IVC) in neonates is uncommon, but may cause significant morbidity. A 13-day-old neonate suffered IVC thrombosis secondary to antithrombin III deficiency, possibly contributed to by a mutation in the methyl tetrahydrofolate reductase gene. Catheter-directed thrombolysis (CDT) with recombinant tissue plasminogen activator (rt-PA, Alteplase) was used successfully to treat extensive venous thrombosis in this neonate without complications. We also review the literature on CDT for treatment of IVC thrombosis in critically ill neonates and infants.

  14. Nickel hypersensitivity in patients with inferior vena cava filters: case report and literature and MAUDE database review.

    PubMed

    Morshedi, Maud M; Kinney, Thomas B

    2014-08-01

    Placement of a prophylactic retrievable inferior vena cava (IVC) filter was requested in a 73-year-old woman with nickel hypersensitivity resulting in a clinical dilemma. Given that all retrievable filters contain nickel, the published literature and the Manufacturer and User Facility Device Experience (MAUDE) database were reviewed; no documented case of IVC filter placement in a patient with nickel hypersensitivity or reported hypersensitivity reaction in a patient after IVC filter placement could be identified. This article presents the uneventful course of the case described and a review of the literature and recommendations on use of nickel-containing devices in patients with nickel hypersensitivity.

  15. Congenital anomaly of the inferior vena cava and factor V Leiden mutation predisposing to deep vein thrombosis

    PubMed Central

    Lamparello, Brooke M; Erickson, Cameron R; Kulthia, Arun; Virparia, Vasudev; Thet, Zeyar

    2014-01-01

    A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT) in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC) segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis. PMID:25395858

  16. The role for prophylaxis inferior vena cava filters in patients undergoing bariatric surgery: replacing anecdote with evidence.

    PubMed

    Shamian, Ben; Chamberlain, Ronald S

    2012-12-01

    The number of patients choosing surgical alternatives for weight reduction continues to increase. Despite common thromboembolic preventive methods, which include perioperative subcutaneous heparin injections, early mobilization, and sequential compression devices, postoperative deep vein thrombosis/pulmonary embolism remains a devastating complication after bariatric surgery. The role prophylactic inferior vena cava (IVC) filters may play in bariatric surgery remains controversial, and this article aims to address the risks and benefits of prophylactic IVC filters in high-risk bariatric patients and suggest an evidence-based algorithm for their use.

  17. [THE CHOICE OF SURGICAL TREATMENT METHOD FOR THE DEEP VEINS THROMBOSIS IN SYSTEM OF VENA CAVA INFERIOR].

    PubMed

    Rusyn, V I; Korsak, V V; Popovych, Ya M; Boyko, S O

    2015-05-01

    There were analyzed the results of examination and treatment of 455 patients, suffering deep veins thrombosis in a system of vena cava inferior, of whom 175 (38.5%) were operated on. Inclusion of ultrasound duplex scanning, roentgencontrast phlebography, multispiral computer tomography with intravenous contrasting, radionuclide phleboscintigraphy into complex of clinic-instrumental examination of the patients gives possibility to estimate the disorders of the main trunk and collateral venous blood flow in the deep veins thrombosis, as well as to substantiate indications and choice of the operative treatment method.

  18. Can the Right Kidney be Salvaged in the Surgical Management of Leiomyosarcoma of the Inferior Vena Cava-a Rare Case Report.

    PubMed

    Chakrabarti, Suvadip; Agarwal, Deepak; Desai, Sanjay M; Mehta, Dharmendra Y

    2016-09-01

    Primary leiomyosarcoma is rare malignant tumour arising from the smooth muscles and can appear at any site where smooth muscle is present. It is more common in the peripheral vessels and has predilection for the female sex. We here report a rare case of leiomyosarcoma involving the segment I & II of inferior vena cava with extension into the renal veins in a 70 year old male patient. Midline transperitoneal approach was taken to excise the tumour along with the vessel wall with anastomosis between the right renal vein and the infrarenal inferior vena cava with a reversed great saphenous vein graft thereby salvaging the right kidney. PMID:27651700

  19. Sonographic assessment of the inferior vena cava/aorta index measured with the transducer placed in the anterior median line and right anterior axillary line – a comparison

    PubMed Central

    Łoś, Magdalena; Szmygel, Łukasz; Kosiak, Wojciech

    2014-01-01

    The aim of the study was to compare the values of the sonographic inferior vena cava/ aorta index obtained with the transducer placed in the median line and right anterior axillary line. Material and methods The study enrolled 45 volunteers, including 33 women, aged 22.5 ± 1.26 with a negative history of circulatory and renal diseases. The study consisted in a sonographic assessment and measurement of the inferior vena cava and aorta by placing the transducer in the anterior median line and right anterior axillary line. The value of the inferior vena cava/aorta index was obtained by calculating the ratio of the diameters of the inferior vena cava and aorta. The diameter measurements were taken by placing the ultrasound transducer in the anterior median line and right anterior axillary line. Two examiners performed the measurement three times and used convex probes of 3.5–5 MHz. Additionally, the subjects’ weight, height and arterial blood pressure were taken. Results Following a statistical analysis with the use of STATISTICA software, the following values of the inferior vena cava/aorta index were obtained: in the anterior median line – 1.43 ± 0.21, and in the right anterior axillary line – 1.285 ± 0.19. There was no statistically significant difference between the measurements obtained by the two examiners (p = 0.17). A strong correlation was noted between the inferior vena cava/ aorta indices calculated in both sites of transducer placement, which was irrespective of the examiners (the correlation coefficient: r = 0.61 and r = 0.71). The study indicate that the inferior vena cava/aorta index measured in the right anterior axillary line is a simple and reproducible method for determining the body fluid status; the examinations conducted in both sites may be used interchangeably. Further studies are needed to determine reference values for the inferior vena cava/aorta index measured in the right anterior axillary line. PMID:26674356

  20. Rehearsal Characteristics of "Superior" Band Directors

    ERIC Educational Resources Information Center

    Juchniewicz, Jay; Kelly, Steven N.; Acklin, Amy I.

    2014-01-01

    The purpose of this study was to investigate the rehearsal characteristics of "superior" middle and high school band directors. A total of 131 respondents from Florida, Kentucky, and North Carolina who received a "superior" rating for 4 out of the past 5 years, completed an open-ended essay question online asking them to…

  1. STATUS OF MYSIS RELICTA IN LAKE SUPERIOR

    EPA Science Inventory

    The status of different components of the lower food web is reported for Lake Superior. Results are preliminary summaries from the Binational collaboration in 2005, which measured the lower food web at the request of the Lake Superior Fisheries Technical Committee and Lake Superi...

  2. Biaxial Mechanical Properties of the Inferior Vena Cava in C57BL/6 and CB-17 SCID/bg Mice

    PubMed Central

    Lee, Y.U.; Naito, Y.; Kurobe, H.; Breuer, C.K.; Humphrey, J.D.

    2013-01-01

    Multiple murine models have proven useful in studying the natural history of neovessel development in the tissue engineering of vascular grafts. Nevertheless, to better understand longitudinal changes in the biomechanics of such neovessels, we must first quantify native tissue structure and properties. In this paper, we present the first biaxial mechanical data for, and nonlinear constitutive modeling of, the inferior vena cava from two models used in tissue engineering: wild-type C57BL/6 and immunodeficient CB-17 SCID/bg mice. Results show that inferior vena cava from the latter are significantly stiffer in the circumferential direction, both materially (as assessed by a stored energy function) and structurally (as assessed by the compliance), despite a lower intramural content of fibrillar collagen and similar wall thickness. Quantifying the natural history of neovessel development in different hosts could lead to increased insight into the mechanisms by which cells fashion and maintain extracellular matrix in order to match best the host stiffness while ensuring sufficient vascular integrity. PMID:23859752

  3. Gunther Tulip Inferior Vena Cava Filter Placement During Treatment for Deep Venous Thrombosis of the Lower Extremity

    SciTech Connect

    Yamagami, Takuji Kato, Takeharu; Iida, Shigeharu; Hirota, Tatsuya; Nishimura, Tsunehiko

    2005-05-15

    Purpose. To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity. Methods. We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology. Results. Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 {+-} 8.3 days (mean {+-} SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment. Conclusion. The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary.

  4. Superior vena caval pressure elevation causes pleural effusion formation in sheep.

    PubMed

    Allen, S J; Laine, G A; Drake, R E; Gabel, J C

    1988-09-01

    The effect of superior vena caval pressure (SVCP) elevation on the formation of pleural effusions (PE) was studied in sheep. Through a right thoracotomy, a Silastic cuff was placed around the superior vena cava. Catheters for monitoring SVCP and pulmonary artery pressure (PAP) were also placed. After a 1- to 3-wk recovery period, we measured the SVCP, PAP, cardiac output, and plasma protein concentration (Cp). We then elevated the SVCP to various levels from base line [5.3 +/- 2.6 (SD) mmHg] to 33 mmHg. The cardiac output, PAP, and Cp were remeasured 1-2 h and 24 h after SVCP elevation. At the end of the 24-h period, the animals were killed. The PE volume and pleural fluid protein concentration (Cpl) were measured, and the Cpl/Cp was calculated. PE generally did not occur until the SVCP was elevated above 15 mmHg. To study the effect of the thoracotomy on the subsequent pleural effusion, we studied six additional sheep in which we did not perform a thoracotomy. In these animals, the SVCP was elevated to between 5 and 28 mmHg for 24 h by use of a 16-Fr balloon catheter placed via a left external jugular vein and a right carotid-external jugular shunt. We found that the PE volume, for a given SVCP elevation, was similar to that present in sheep that received a thoracotomy. For all sheep the volume of PE was related to SVCP by the equation PE (ml) = 0.24e0.26SVCP, r = 0.85. In the sheep without a thoracotomy, Cpl/Cp rose with increasing volume of PE. Our data demonstrate that elevation of SVCP greater than 15 mmHg for 24 h results in the formation of PE. The rise in Cpl/Cp with PE volume suggests that filtration through the pleural vessels is not the major contributor to PE formation. PMID:3414816

  5. Physiologic Effect of Stent Therapy for Inferior Vena Cava Obstruction Due to Malignant Liver Tumor

    SciTech Connect

    Kishi, Kazushi Sonomura, Tetsuo; Fujimoto, Hisashi; Kimura, Masashi; Yamada, Katsuya; Sato, Morio; Juri, Masanobu

    2006-02-15

    Purpose. To understand systemic the influence of stent therapy for inferior vena cava (IVC) obstruction due to advanced liver tumor. Methods. Seven patients with symptomatic IVC obstruction due to advanced primary (n 4) or secondary (n = 3) liver tumor were subjected to stent therapy. Enrollment criteria included high IVC pressure over 15 mmHg and the presence of edema and ascites. Z-stents were deployed using coaxial sheath technique via femoral venous puncture. Physiologic and hematobiochemical parameters were analyzed. Results. All procedures were successful, and the stents remained patent until patient death. Promptly after stent placement, the IVC flow recovered, and the venous blood pressure in the IVC below the obstruction level showed a significant decrease from 20.8 {+-} 1.2 mmHg (mean {+-} SE) to 10.7 {+-} 0.7 mmHg (p < 0.01). Transient mild increase of right atrial pressure was observed in 1 patient. During the following week prominent diuresis was observed in all patients. Mean urine output volume in the 3 days before the stent therapy was 0.81 {+-} 0.09 l/day compared with 2.1 {+-} 0.2 l/day (p < 0.01) in the 3 days after. The edema and ascites decreased in all patients. The caval pressure change correlated well (r > 0.6) with the urine volume increase, and with the decreased volume of edema and ascites. The urine volume increase correlated well with the decrement of edema, but not with that of ascites. Improvements for various durations in the levels of blood urea nitrogen, serum creatinine, lactate dehydrogenase, fibrinogen, and platelet count were found (p < 0.05). These hematobiochemical changes were well correlated with each other and with the decrement of ascites. Two patients showed a low blood sodium level of 128.5 mEq/l after intensive natriuresis, and one of them died on day 21 with hepatic failure, which was interpreted as maladaptation aggravation. The mean survival time was 94.1 {+-} 34.1 days (mean {+-} SD), ranging from 21 to 140 days

  6. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    SciTech Connect

    Uberoi, Raman Tapping, Charles Ross; Chalmers, Nicholas; Allgar, Victoria

    2013-12-15

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter

  7. 'Recovery{sup TM}' Vena Cava Filter: Experience in 96 Patients

    SciTech Connect

    Kalva, Sanjeeva P. Athanasoulis, Christos A.; Fan, C.-M.; Curvelo, Marcio; Geller, Stuart C.; Greenfield, Alan J.; Waltman, Arthur C.; Wicky, Stephan

    2006-08-15

    The purpose of the study was to assess the clinical safety and efficacy of the 'Recovery{sup TM}' (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a 'Recovery{sup TM}' IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and procedure-related complications during placement and retrieval were evaluated. Follow-up computed tomography (CT) examinations of the abdomen and chest were evaluated for filter-related complications and pulmonary embolism (PE), respectively. 'Recovery' filters were placed in 96 patients (72 males and 24 females; age range: 16-87 years; mean: 46 years). Twenty-four patients presented with PE, 13 with deep vein thrombosis (DVT) and 2 with both PE and DVT. The remaining 57 patients had no symptoms of thromboembolism. Indications for filter placement included contraindication to anticoagulation (n = 27), complication of anticoagulation (n = 3), failure of anticoagulation (n = 5), and prophylaxis (n = 61). The device was successfully deployed in the infrarenal (n = 95) or suprarenal (n = 1) IVC through a femoral vein approach. Retrieval was attempted in 11 patients after a mean period of 117 days (range: 24-426). The filter was successfully removed in nine patients (82%). Failure of retrieval was due to technical difficulty (n = 1) and the presence of thrombus in the filter (n = 1). One of the nine patients who had the filter removed developed IVC thrombus after retrieval and another had an intimal tear of the IVC. Follow-up abdominal CT (n = 40) at a mean of 80 days (range: 1-513) showed penetration of the IVC by the filter arms in 11, of which 3 had fracture of filter components. In one patient, a broken arm migrated into the pancreas. Asymmetric deployment of the filter legs was seen in 12 patients and thrombus within the filter in 2 patients. No filter migration or caval occlusion was encountered. Follow-up chest

  8. Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience

    SciTech Connect

    Ha, Thuong G. Van Chien, Andy S.; Funaki, Brian S.; Lorenz, Jonathan; Piano, Giancarlo; Shen, Maxine; Leef, Jeffrey

    2008-03-15

    The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonary embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In

  9. Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome

    SciTech Connect

    Mert, Murat Saltik, Levent; Gunay, Ilhan

    2004-08-15

    An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

  10. [A Case of Long-Term Survival of a Patient with Liver Metastasis of Colon Cancer and Suspected Inferior Vena Cava Invasion].

    PubMed

    Otani, Takahiro; Kameyama, Hitoshi; Kaneko, Kazuhiro; Sato, Tomoi; Suzuki, Susumu; Okada, Takayuki; Aono, Takashi; Muto, Ichiro; Hasegawa, Masaki; Sakata, Jun; Kobayashi, Takashi; Minagawa, Masahiro; Kosugi, Shin-ichi; Kurosaki, Isao; Wakai, Toshifumi

    2015-11-01

    A 58-year-old woman was diagnosed with a sigmoid colon cancer and synchronous liver metastasis. Because an obstruction of the sigmoid colon was identified, the patient underwent sigmoidectomy. Computed tomography(CT)findings suggested possible vena cava and hepatic vein invasion. Therefore, the decision was made to offer systemic chemotherapy. The patient underwent 6 courses of chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin (mFOLFOX6). After 4 courses of chemotherapy, CT scans showed a significant reduction of the liver metastasis (reduction rate of 5 0%; a partial response) and demonstrated improved exclusion of the inferior vena cava and hepatic vein. After 6 courses of chemotherapy, we performed right trisegmentectomy of the liver and resection of the inferior vena cava and diaphragm. Postoperative pathological findings revealed negative margins, and no invasion of the inferior vena cava. The pathological response grade of the tumor after chemotherapy was determined to be Grade 2. Adjuvant chemotherapy was not performed because of the patient 's poor performance status. The patient was alive with no recurrence 8 years after resection of the liver metastasis. PMID:26805305

  11. Superior oblique surgery: when and how?

    PubMed Central

    Şekeroğlu, Hande Taylan; Sanac, Ali Sefik; Arslan, Umut; Sener, Emin Cumhur

    2013-01-01

    Background The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes. Methods A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries. Results The review identified 40 (20 male, 20 female) patients with a median age of 6 (2–45) years. Nineteen patients (47.5%) had Brown syndrome, eleven (27.5%) had fourth nerve palsy, and ten (25.0%) had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5%) patients followed by superior oblique tuck in eleven (27.5%) patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both) and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02). Conclusion Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary position. PMID:23946644

  12. Limitations of using synthetic blood clots for measuring in vitro clot capture efficiency of inferior vena cava filters

    PubMed Central

    Robinson, Ronald A; Herbertson, Luke H; Das, Srilekha Sarkar; Malinauskas, Richard A; Pritchard, William F; Grossman, Laurence W

    2013-01-01

    The purpose of this study was first to evaluate the clot capture efficiency and capture location of six currently-marketed vena cava filters in a physiological venous flow loop, using synthetic polyacrylamide hydrogel clots, which were intended to simulate actual blood clots. After observing a measured anomaly for one of the test filters, we redirected the focus of the study to identify the cause of poor clot capture performance for large synthetic hydrogel clots. We hypothesized that the uncharacteristic low clot capture efficiency observed when testing the outlying filter can be attributed to the inadvertent use of dense, stiff synthetic hydrogel clots, and not as a result of the filter design or filter orientation. To study this issue, sheep blood clots and polyacrylamide (PA) synthetic clots were injected into a mock venous flow loop containing a clinical inferior vena cava (IVC) filter, and their captures were observed. Testing was performed with clots of various diameters (3.2, 4.8, and 6.4 mm), length-to-diameter ratios (1:1, 3:1, 10:1), and stiffness. By adjusting the chemical formulation, PA clots were fabricated to be soft, moderately stiff, or stiff with elastic moduli of 805 ± 2, 1696 ± 10 and 3295 ± 37 Pa, respectively. In comparison, the elastic moduli for freshly prepared sheep blood clots were 1690 ± 360 Pa. The outlying filter had a design that was characterized by peripheral gaps (up to 14 mm) between its wire struts. While a low clot capture rate was observed using large, stiff synthetic clots, the filter effectively captured similarly sized sheep blood clots and soft PA clots. Because the stiffer synthetic clots remained straight when approaching the filter in the IVC model flow loop, they were more likely to pass between the peripheral filter struts, while the softer, physiological clots tended to fold and were captured by the filter. These experiments demonstrated that if synthetic clots are used as a surrogate for animal or human blood

  13. Diagnostic value of computerized tomography venography in detecting stenosis and occlusion of subclavian vein and superior vena in chronic renal failure patients

    PubMed Central

    Bakhshoude, Banafsheh; Ravari, Hassan; Kazemzadeh, Gholam Hosein; Rad, Masoud Pezeshki

    2016-01-01

    Introduction Currently, venography is the standard diagnostic method to examine veins before implementing access, which is invasive in nature. Computerized tomography venography (CTV) can simultaneously indicate deep and superficial venous systems in the upper extremity and their relation to the surrounding anatomical structures; however, its diagnostic value in the detection of central venous disease has yet to be defined. The aim of this study was to determine the diagnostic value of CT venography compared to venography in the diagnosis of stenosis and the occlusion of subclavian veins and the superior vena in renal failure patients. Methods This cross-sectional study was conducted from January to September 2015 on patients with chronic renal failure undergoing upper extremity venography at the Radiology Department of Imam Reza Hospital in Mashhad, Iran. We excluded patients with catheters in their jugular and subclavian vein routes, venous hypertension with reverse-function fistula, or sensitivity to contrast agents. Several factors, including age, gender, catheterization record in jugular and subclavian veins, and fistula record in the upper extremity, as well as clinical symptoms consisting of edema, dermatitis, and ulcers in these organs, were recorded in the corresponding form. Then, the patients consecutively underwent indirect venography and CT venography and traces of stenosis (more than 50%) or complete occlusion in the subclavian vein and superior vena were recorded. The data were analyzed using SPSS software by the chi-squared test, and sensitivity, specificity, and positive and negative predictive values were calculated by means of MedCalc Online, version 16.2. Results The study was conducted on 40 patients (26 males and 14 females) with a mean age of 46.7 ± 10.4 years. In this study, 58 subclavian veins, as well as 32 superior vena cava, were studied. The results showed that the diagnostic value of CTV in the detection of subclavian stenosis had a

  14. CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach

    SciTech Connect

    Kos, Sebastian Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.

    2010-02-15

    A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

  15. Streptococcus constellatus Causing Septic Thrombophlebitis of the Right Ovarian Vein with Extension into the Inferior Vena Cava

    PubMed Central

    Haidar, Abdallah; Haddad, Amy; Naqvi, Amir; Onyesoh, Ngozi U.; Malik, Rushdah; Williams, Michael

    2015-01-01

    Introduction. Streptococcus constellatus collectively with Streptococcus anginosus and Streptococcus intermedius constitute the Streptococcus anginosus (formerly Streptococcus milleri) group. Though they are commonly associated with abscesses, bacteremia with subsequent septic thrombophlebitis is extremely rare, and resulting mortality is infrequent. Case Presentation. We report a case of a previously healthy 60-year-old African American female who presented with Streptococcus constellatus bacteremia associated with septic thrombophlebitis to the right ovarian vein extending into the inferior vena cava. She was urgently treated with antibiotics and anticoagulation. Conclusion. Septic thrombophlebitis has a clinical presentation that is often misleading. Therefore, a high clinical index of suspicion and the use of appropriate imaging modalities (computed tomography) are essential in recognizing and confirming this diagnosis. Prompt treatment is warranted. Surgical thrombectomies have been successfully replaced by a combination of antibiotics and anticoagulation therapy. PMID:26171262

  16. The Transmediastinal, Intrapericardial Inferior Vena Cava Approach for Hepatectomy of a Large Liver Tumor Invading the Hepatic Vein Confluence.

    PubMed

    Tohyama, Taiji; Tamura, Kei; Takai, Akihiro; Hatano, Masahide; Kageyama, Shoichi; Inoue, Hitoshi; Watanabe, Jota; Takada, Yasutsugu

    2015-05-01

    We report the case of a large multilocular upper liver tumor invading the hepatic vein confluence in a 41-year-old male, and the safe resection of the tumor using a transmediastinal, intrapericardial inferior vena cava (IVC) approach. Several methods for exposing suprahepatic IVCs on the cranial side of the diaphragm have been reported. However, the approach to supradiaphragmatic IVCs varies, and there are currently no reports that provide a detailed description of the anatomical landmarks during the intrapericardial IVC approach. In the case reported herein, anatomic landmarks, including the prepericardial fat in the pericardial trigone, were confirmed during the transmediastinal, intrapericardial IVC approach. We believe that such anatomic landmarks are important to ensure a safe approach to the pericardium and the intrapericardial IVC through the anterior mediastinum. We think this case report is useful in elucidating the resection of large liver tumors invading the hepatic vein confluence.

  17. Permanent versus Retrievable Inferior Vena Cava Filters: Rethinking the "One-Filter-for-All" Approach to Mechanical Thromboembolic Prophylaxis.

    PubMed

    Ghatan, Christine E; Ryu, Robert K

    2016-06-01

    Inferior vena cava (IVC) filtration for thromboembolic protection is not without risks, and there are important differences among commercially available IVC filters. While retrievable filters are approved for permanent implantation, they may be associated with higher device-related complications in the long term when compared with permanent filters. Prospective patient selection in determining which patients might be better served by permanent or retrievable filter devices is central to resource optimization, in addition to improved clinical follow-up and a concerted effort to retrieve filters when no longer needed. This article highlights the differences between permanent and retrievable devices, describes the interplay between these differences and the clinical indications for IVC filtration, advises against a "one-filter-for-all" approach to mechanical thromboembolic prophylaxis, and discusses strategies for optimizing personalized device selection.

  18. Protective efficacy of an Ecklonia cava extract used to treat transient focal ischemia of the rat brain

    PubMed Central

    Kim, Jeong Hwan; Lee, Nam Seob; Jeong, Yeong Gil; Lee, Je-Hun; Kim, Eun Ji

    2012-01-01

    Phlorotannins (marine algal polyphenols) have been reported to exhibit beneficial biological activities, serving as both antioxidants and anti-inflammatory agents. Among marine algae, Ecklonia cava, a member of the Laminariaceae, is a very popular food regarded as healthy in Korea and Japan. Recently, benefits afforded by phlorotannins in the treatment of various clinical conditions have been reported, but any therapeutic effects of such materials in the treatment of neurodegenerative diseases such as stroke remain unclear. Also, the mechanisms of action of the algal components remain poorly understood. In the present in vivo study, administration of Ecklonia cava polyphenols (ECP) at 10 mg/kg and 50 mg/kg intraperitoneally (i.p.) significantly decreased infarct size and the extent of brain edema in the rat after induction of transient focal ischemia via middle cerebral artery occlusion (MCAO). Further, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay revealed dose-dependent blockage of neuronal apoptosis upon intravenous ECP treatment. Neurobehavioral tests performed over the 6 days after MCAO revealed a reduction in neurological motor performance in control animals, but administration of ECP (50 mg/kg i.p.) prevented this decline. In vitro, a significant neuroprotective effect of ECP was evident when cell viability was assayed after induction of H2O2-mediated oxidative stress, upon retinoic acid treatment, in the differentiated neuroblastoma cell line SH-SY5Y. Interestingly, ECP blocked the rise in cytosolic calcium, in a dose-dependent manner, in differentiated SH-SY5Y cells exposed to H2O2. Together, the results suggest that ECP exerts neuroprotective effects in the focally ischemic brain by reducing Ca2+-mediated neurotoxicity. PMID:22822465

  19. Retrievable Inferior Vena Cava Filters Can Be Placed and Removed with a High Degree of Success: Initial Experience

    PubMed Central

    Cohoon, Kevin P.; McBride, Joseph; Friese, Jeremy L.; McPhail, Ian R.

    2014-01-01

    Objectives Evaluate the success rate of retrievable inferior vena cava filter (IVC) removal in a tertiary care practice. Background Retrievable IVC filters became readily available in the United States following Food and Drug Administration approval in 2003, and their use has increased dramatically. They represent an attractive option for patients with contraindications to anticoagulation who may only need short-term protection against pulmonary embolism. Methods All patients who had undergone placement of a retrievable IVC filter at Mayo Clinic between 2003 and 2005 were retrospectively reviewed to evaluate our initial experience with retrievable inferior vena cava filters at a large tertiary care center. Results During a three-year-period of time, Mayo Clinic, Rochester, MN placed 892 IVC filters, of which 460 were retrievable. Of the 460 retrievable filters placed (249 Günther Tulip®, 207 Recovery®, and 4 OptEase®), retrieval was attempted in 223 (48.5%). Of 223 initial attempts, 196 (87.9%) were initially successful and 27 (12.1%) were unsuccessful. Of the 27 unsuccessful initial retrieval attempts, 23 (85.2%) were due to the presence of significant thrombus within the filter and 4 (14.8%) were due to tilting and strut perforation. Of the 23 filters containing significant thrombus, 9 (39.1%) were later retrieved after a period of anticoagulation and resolution of the thrombus. Conclusions Retrievable IVC filters can be removed with a high degree of success. Approximately one in ten retrievable IVC filter removal attempts may fail initially, usually because of significant thrombus within the filter. This does not preclude possible removal at a later date. PMID:25367646

  20. Complex Adaptive Systems of Systems (CASOS) engineering environment.

    SciTech Connect

    Detry, Richard Joseph; Linebarger, John Michael; Finley, Patrick D.; Maffitt, S. Louise; Glass, Robert John, Jr.; Beyeler, Walter Eugene; Ames, Arlo Leroy

    2012-02-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex physical-socio-technical systems which we must understand to design a secure future for the nation. The Phoenix initiative implements CASoS Engineering principles combining the bottom up Complex Systems and Complex Adaptive Systems view with the top down Systems Engineering and System-of-Systems view. CASoS Engineering theory and practice must be conducted together to develop a discipline that is grounded in reality, extends our understanding of how CASoS behave and allows us to better control the outcomes. The pull of applications (real world problems) is critical to this effort, as is the articulation of a CASoS Engineering Framework that grounds an engineering approach in the theory of complex adaptive systems of systems. Successful application of the CASoS Engineering Framework requires modeling, simulation and analysis (MS and A) capabilities and the cultivation of a CASoS Engineering Community of Practice through knowledge sharing and facilitation. The CASoS Engineering Environment, itself a complex adaptive system of systems, constitutes the two platforms that provide these capabilities.

  1. Differentiation in Coregonus zenithicus in Lake Superior

    USGS Publications Warehouse

    Todd, Thomas N.; Smith, Gerald R.

    1980-01-01

    Morphological variation in Coregonus zenithicus has long plagued biologists working on Lake Superior ciscoes. Some of this variation is due to allometric growth; earlier workers incorrectly recognized large C. zenithicus as a distinct species, C. nigripinnis cyanopterus. Coregonus reighardi dymondi is a variant of C. zenithicus in northern bays of Lake Superior and Lake Nipigon. The morphological differences between members of spring and fall spawning populations of C. zenithicus in Lake Superior are no greater than those between geographically separate populations. We conclude that spawning time and geographic isolation act similarly in effecting differentiation of coregonine populations, and that populations with different spawning times do not necessarily represent different species.Key words: Coregonus zenithicus, cisco, Great Lakes, multivariate morphometrics, endangered species, taxonomy

  2. Superior sinus of the pericardium: CT appearance

    SciTech Connect

    Aronberg, D.J.; Peterson, R.R.; Glazer, H.S.; Sagel, S.S.

    1984-11-01

    On computed tomography, a mass-like density is often observed, just posterior to the ascending aorta, that occasionally has been mistaken for mediastinal lymph node enlargement. Cadaver studies confirmed this retroaortic structure to be an extension of the periocardial cavity, the superior sinus. Anatomic studies revealed the presence of a superior sinus in all of the 28 cadavers studied. Retrospective review of 116 consecutive adult chest computed tomographic examinations disclosed its presence in 49%. This normal variant has a characteristic location, shape, and attenuation value by CT that should allow recognition and prevent misinterpretation.

  3. The state of Lake Superior in 1992

    USGS Publications Warehouse

    Hansen, Michael J.

    1994-01-01

    The Lake Superior fish community in 1992 is substantially different than it was a half century ago and is far from a state desired by management agencies. Fish-community objectives were established for Lake Superior in response to A Joint Strategic Plan for Management of Great Lakes Fisheries (Great Lakes Fishery Commission 1980) and are the template for this report on the state of the lake. Reporting on progress toward meeting stated goals and objectives will focus attention on critical fishery issues and enhance understanding among fishery- and environmental-management agencies, political bodies, and the public.

  4. Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear*

    PubMed Central

    Simão, Marcelo Novelino; Vinson, Emily N.; Spritzer, Charles E.

    2016-01-01

    Objective The objective of this study was to determine the incidence of a "meniscoid" superior labrum. Materials and Methods This was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra. Results A meniscoid superior labrum was identified in 48 (10.2%) of the 472 cases evaluated. Arthroscopic proof was available in 21 cases (43.8%). In 10 (47.6%) of those 21 cases, the operative report did not include the mention a superior labral tear, thus suggesting the presence of a meniscoid labrum. In only one of those cases were there specific comments about a mobile superior labrum (i.e., meniscoid labrum). In the remaining 11 (52.4%), surgical correlation demonstrated superior labral tears. Conclusion A meniscoid superior labrum is not an infrequent finding. Depending upon assumptions and the requirement of surgical proof, the prevalence of a meniscoid superior labrum in this study was between 2.1% (surgically proven) and 4.8% (projected). However, superior labral tears are just as common and are often confused with meniscoid labra. PMID:27777474

  5. [Inferior vena cava thrombosis reaching the right atrium after removal of the central venous catheter at femoral vein in a patient with diabetic ketoacidosis].

    PubMed

    Morita, Yoko; Ariyama, Jun; Mieda, Tsutomu; Terao, Kazuhisa; Ueshima, Hironobu; Imanishi, Hirokazu; Kitamura, Akira

    2014-05-01

    A 19-year-old male was admitted with diabetic ketoacidosis. A central venous catheter for fluid loading and insulin administration was inserted from the right femoral vein. The catheter was placed for 4days and was removal. Three days after removal thrombus was pointed out with echocardiography. Cardiac ultrasound revealed floating thrombi in the right atrium. Venography demonstrated a large thrombus from the right femoral vein to the end of the inferior vena cava. Emergency surgery was performed. A tubular thrombus was trapped from the inferior vena cava departure at the right atrium under cardiopulmonary bypass. The surgeon also implanted an inferior vena caval filter. The patient was weaned from ventilator assist next day and was discharged from the hospital 13 days later. This case suggests that deep vein thrombosis should be checked in diabetic ketoacidosis even after removal of a central venous catheter implanted at the femoral vein.

  6. [Radical nephrectomy and thrombectomy in patients with renal cell cancer complicated by tumoral thrombosis of the renal vein and vena cava inferior].

    PubMed

    Rusyn, V I; Korsak, V V; Rusyn, A V; Boĭko, S O

    2013-01-01

    Surgical treatment was conducted in 81 patients, suffering renocellular cancer (RCC), complicated by a renal vein and vena cava inferior thrombosis. According to the Mayo clinic classification, the level of a tumoral thrombus spread was established: the 0 level--in 37 patients, the level I--in 19, the level II--in 17, the level III --in 6, and the level IV--in 2. There were substantiated the optimal surgical accesses and technique of radical nephrectomy and thrombectomy for RCC, complicated by a renal vein and vena cava inferior thrombosis. It is recommended to apply transabdominal accesses: the extended median laparotomic, bilateral subcostal of a "Chevron" or "Mercedes" type. There was shown, that the access choice depends on the level of the tumoral thrombus localization.

  7. The Lake Superior Game: Use Versus Abuse.

    ERIC Educational Resources Information Center

    Liukkonen, Barbara

    1988-01-01

    Described is a role playing activity in which students are asked to assume roles that represent a variety of individuals who use Lake Superior. Discussed are the goals, materials and preparation, and procedures for the game. Examples of role cards are provided. (CW)

  8. Ecology of Lake Superior: Preface and Prospectus

    EPA Science Inventory

    This Special Issue of Aquatic Ecosystem Health and Management (AEHM) is the first of a two-volume set based on papers presented at a three-day International Conference in Duluth MN held in June 2010, and titled “Ecology of Lake Superior: Integrated Approaches and Challenges for t...

  9. COSEE Superior Creates Passion for Science

    EPA Science Inventory

    COSEE was a transformative educational experience that has changed the way I teach. In July, I participated in the COSEE Lake Superior Shipboard and Shoreline Science program. I spent a week on the US EPA’s R/V Lake Guardian with 14 other teachers and a crew of sailors and scient...

  10. Significant Reading Experiences of Superior English Students.

    ERIC Educational Resources Information Center

    Whitman, Robert S.

    1964-01-01

    Superior high school students (975 finalists in the NCTE Achievement Awards Program) were surveyed to find what one book was most significant to each of them in their high school experiences, and the reason for the significance. In response to questionnaires, the students cited 416 different titles, 72% of which were novels. The top 10 books were…

  11. 75 FR 62756 - Superior National Forest, Minnesota

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... effects from a proposed land exchange between the USDA Superior National Forest (SNF) and PolyMet Mining, Inc. (PolyMet). The SNF will join the USACE and MNDNR as a third lead agency responsible for EIS preparation because the land where the mine is proposed is owned by the SNF. Cooperating Agencies...

  12. Perturbation resilience and superiorization of iterative algorithms

    NASA Astrophysics Data System (ADS)

    Censor, Y.; Davidi, R.; Herman, G. T.

    2010-06-01

    Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a 'superiorized version' of it that retains its computational efficiency but nevertheless goes a long way toward solving an optimization problem. This is possible to do if the original algorithm is 'perturbation resilient', which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image.

  13. Simultaneous removal of a tumour of the right atrium and inferior vena cava and coronary bypass-grafting in a patient with recurrent clear renal cell carcinoma

    PubMed Central

    Pietrzyk, Edward; Głuszek, Stanisław; Michta, Kamil; Kot, Marta; Wożakowska-Kapłon, Beata

    2015-01-01

    Metastatic cardiac tumours are the most common malignant cardiac tumours. In the early stages they are usually asymptomatic, but their consequences can be very serious, and the prognosis is poor. We present a patient with recurrent renal cell carcinoma as a tumour of the right atrium and the vena cava inferior in whom cancerous masses were removed with simultaneously coronary artery bypass-grafting. PMID:26855653

  14. Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

    SciTech Connect

    Zhang, Wen Yan, Zhiping Luo, Jianjun Fang, Zhuting Wu, Linlin Liu, QingXin Qu, Xudong Liu, Lingxiao Wang, Jianhua

    2013-10-15

    Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX{sub 2} was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy, and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan-Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 {+-} 0.12 kg, 57.83 {+-} 8.68 days, (16.73 {+-} 5.18 %), (29.47 {+-} 7.18 %), and 2.03 {+-} 0.13 kg, 43.67 {+-} 5.28 days, (63.01 {+-} 2.01 %), (6.02 {+-} 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT

  15. Preparation and experimental research into retrievable rapamycin- and heparin-coated vena cava filters: a pilot study.

    PubMed

    Zhao, Hui; Zhang, Fuxian; Liang, Gangzhu; Ye, Lin; Zhang, Huan; Niu, Luyuan; Cheng, Long; Zhang, Mingyi

    2016-04-01

    The use of retrievable vena cava filters (RVCFs) was once commonplace, but filter retrieval was often very difficult. Most unsuccessful retrieval was due to intimal hyperplasia of the inferior vena cava and in-filter thrombosis. This pilot study aimed to design a drug-eluting RVCF. The hypothesis was that coated drugs could be released continuously to inhibit vena intimal hyperplasia and thrombosis, and thus improve the retrieval rates of RVCFs. Various concentrations of polycaprolactone (PCL)/chloroform solution were made from a mixture of Rapamycin and Heparin according to the quality of PCL. The drug was coated onto the surface of the filters by a process of dipping. In vitro tests were performed to check stability and in vitro drug release. Animals receiving filter implantation were divided into 4 groups, the experimental intervention group (EI), experimental laparotomy group (EL), control intervention group (CI), and control laparotomy group (CL). Filters were retrieved by laparotomy in the EL and CL groups, and by interventional operation in the EI and CI groups at 10, 20 and 30 days after implantation. Pathological endothelia biopsies were performed with wood grain-eosin (HE) staining and immunohistochemical examination, with the proliferating cell nuclear antigen (PCNA) index, and the results were compared between the experimental and control groups. The weight of thrombus within the filters was also measured by scale and compared. The coating concentration that succeeded in completely covering the surface was 0.2 g/ml. There was better coverage by SEM at this concentration, and the coated drugs had no obvious loss after filter release. The drug release curves showed that the amount of Heparin released was more than 50 % at day 1; Rapamycin released little in the first few days, beginning in earnest at 20 to 30 days. The filters were easy to retrieve at 10 days for both groups, while neither could be retrieved at 30 days. However, at 20 days the filter in

  16. Simultaneous thrombosis of superior mesenteric artery and superior mesenteric vein following chemotherapy: MDCT findings.

    PubMed

    Olgun, Deniz Cebi; Bakan, Selim; Samanci, Cesur; Tutar, Onur; Demiryas, Suleyman; Korkmazer, Bora; Kantarci, Fatih

    2014-02-01

    A case of acute mesenteric ischemia due to thrombosis of superior mesenteric artery and vein in a 44-year-old woman following chemotherapy for invasive laryngeal carcinoma was diagnosed on a multi-detector CT scan. Although the link between malignancy and thromboembolism is widely recognized in patients with cancer, chemotherapy further elevates the risk of thrombosis. Acute mesenteric ischemia associated or not associated with chemotherapy rarely occurs in patients with cancer. Moreover, co-occurrence of superior mesenteric artery and superior mesenteric vein thrombosis is reported for the first time.

  17. Longevity of Lake Superior lake trout

    USGS Publications Warehouse

    Schram, Stephen T.; Fabrizio, Mary C.

    1998-01-01

    The age structure of mature lake trout Salvelinus namaycush from the Wisconsin waters of Lake Superior increased following a population recovery that has taken place since the 1960s. As the population aged, it became apparent that scales were unreliable aging structures. Beginning in 1986, we examined both scale and sagittal otolith ages from tagged fish with a known period at liberty. We found large discrepancies in scale and sagittal otolith ages of mature fish, such that scale ages were biased low. We estimated lake trout living up to 42 years, which is greater than previously reported from Lake Superior. Investigators studying lake trout population dynamics in the Great Lakes should be aware that lake trout can live longer than previously thought.

  18. Birds of Isle Royale in Lake Superior

    USGS Publications Warehouse

    Krefting, L.W.; Lee, F.B.; Shelton, P.C.; Gilbert, K.T.

    1966-01-01

    This report constitutes an annotated list of 197 species of birds reported from Isle Royale National Park, a 210-square-mile archipelago in northwestern Lake Superior including some 200 islets and rock outcrops. The island is 45 miles long and 8 miles wide at its widest point. Bird distribution and habitats are described, along with geography and vegetation; 62 species are known to have bred at least once, 26 are thought to be breeders, and the rest are migrants.

  19. Gamma rays produce superior seedless citrus

    SciTech Connect

    Pyrah, D.

    1984-10-01

    Using gamma radiation, seedless forms of some varieties of oranges and grapefruit are being produced. Since it has long been known that radiation causes mutations in plants and animals, experiments were conducted to determine if seediness could be altered by exposing seeds or budwood to higher than natural doses of gamma radiation. Orange and grapefruit seeds and cuttings exposed to gamma rays in the early 1970's have produced trees that bear fruit superior to that now on the market.

  20. Fontan's circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy

    PubMed Central

    Singh, Preet Mohinder; Borle, Anuradha; Ramachandran, Rashmi; Trikha, Anjan; Goudra, Basavana Gouda

    2016-01-01

    Fontan's circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow) or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan's physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC). As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE) (increased afterload). In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations. PMID:26750698

  1. Fontan's circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy.

    PubMed

    Singh, Preet Mohinder; Borle, Anuradha; Ramachandran, Rashmi; Trikha, Anjan; Goudra, Basavana Gouda

    2016-01-01

    Fontan's circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow) or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan's physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC). As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE) (increased afterload). In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations.

  2. Ecklonia cava Polyphenol Has a Protective Effect against Ethanol-Induced Liver Injury in a Cyclic AMP-Dependent Manner.

    PubMed

    Yamashita, Haruka; Goto, Mayu; Matsui-Yuasa, Isao; Kojima-Yuasa, Akiko

    2015-06-18

    Previously, we showed that Ecklonia cava polyphenol (ECP) treatment suppressed ethanol-induced increases in hepatocyte death by scavenging intracellular reactive oxygen species (ROS) and maintaining intracellular glutathione levels. Here, we examined the effects of ECP on the activities of alcohol-metabolizing enzymes and their regulating mechanisms in ethanol-treated hepatocytes. Isolated hepatocytes were incubated with or without 100 mM ethanol. ECP was dissolved in dimethylsulfoxide. ECP was added to cultured cells that had been incubated with or without ethanol. The cells were incubated for 0-24 h. In cultured hepatocytes, the ECP treatment with ethanol inhibited cytochrome P450 2E1 (CYP2E1) expression and activity, which is related to the production of ROS when large quantities of ethanol are oxidized. On the other hand, ECP treatment with ethanol increased the activity of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase. These changes in activities of CYP2E1 and ADH were suppressed by treatment with H89, an inhibitor of protein kinase A. ECP treatment with ethanol enhanced cyclic AMP concentrations compared with those of control cells. ECP may be a candidate for preventing ethanol-induced liver injury via regulating alcohol metabolic enzymes in a cyclic AMP-dependent manner.

  3. Primary Renal Rhabdomyosarcoma in an Adolescent With Tumor Thrombosis in the Inferior Vena Cava and Right Atrium

    PubMed Central

    Lin, Wei-Ching; Chen, Jeon-Hor; Westphalen, Antonio; Chang, Han; Chiang, I-Ping; Chen, Cheng-Hong; Wu, Hsi-Chin; Lin, Chien-Heng

    2016-01-01

    Abstract Although the second peak of the age distribution of rhabdomyosarcoma (RMS) is at adolescence, renal RMS is extremely rare at this age group. This tumor is indistinguishable from other renal tumors based on clinical and imaging findings, and the diagnosis relies on histology and immunohistochemical staining. We report a unique case of adolescent renal RMS associated with tumor thrombus extending into the inferior vena cava (IVC) and right atrium. An 18-year-old female adolescent presented with shortness of breath and palpitations, associated with right flank discomfort, and hematuria. A pleomorphic-type renal RMS with Budd–Chiari syndrome and arrhythmia induced by IVC and RA thrombosis was diagnosed. Despite complete tumor resection, the patient developed multiple lung metastases a month after surgery. Chemotherapy was recommended, but the patient declined. She died within a year of the initial operation. Adolescent renal RMS is rare and associated with poor outcome. Early aggressive multimodal therapy seems to be appropriate, in particular, in the presence of tumor thrombosis. PMID:27227946

  4. [Survival after Sorafenib Treatment for Advanced Recurrent Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava].

    PubMed

    Matoba, Hideaki; Seta, Shinsuke

    2015-11-01

    A 72-year-old man with chronic viral hepatitis type B undergoing surgery for hepatocellular carcinoma was found to have a recurrent tumor in the left liver with peritoneal dissemination near the inferior vena cava(IVC)and tumor thrombus in the IVC. For this patient diagnosed with Barcelona clinic liver cancer (BCLC) classification stage C hepatocellular carcinoma, we initiated 800 mg/body sorafenib. Two weeks after the initiation of sorafenib, the patient experienced grade 3 hand-foot syndrome, after which, the dose of sorafenib was reduced to 400 mg/body. After 1 year, CT showed an enlarged tumor in the left liver and multiple metastases to the lung. However, no remarkable difference was observed in the peritoneal dissemination and the tumor thrombus. He has been receiving sorafenib for 19 months with a good quality of life. Sorafenib can be provided on an outpatient basis and it may facilitate long-term survival for patients with advanced recurrent hepatocellular carcinoma with IVC tumor thrombus. This clinical condition is very rare, and the standard treatment for it still has not been established.

  5. Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement

    SciTech Connect

    Juszkat, Robert; Pukacki, Fryderyk; Zarzecka, Anna; Kulesza, Jerzy; Majewski, Waclaw

    2009-07-15

    We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The procedure was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.

  6. Relationship of the lumbar lordosis angle to the abdominal aortic bifurcation and inferior vena cava confluence levels.

    PubMed

    Moussallem, Charbel D; Abou Hamad, Ibrahim; El-Yahchouchi, Christine A; Moussallem, Maroun D; Arnalsteen, Damien M; Mertl, Patrice; Havet, Eric

    2012-10-01

    The objective of this study is to determine the relationship of the variations of the lumbar lordosis angle (LLA) to the aortic bifurcation level and inferior vena cava (IVC) confluence level using CT angiography. A retrospective study was conducted using the data available on abdominopelvic CT angiography scans. The LLA, the level and angle of bifurcation of the aorta, the level and angle of confluence of the IVC were identified using multiplanar and 3D reconstruction. Linear regression models were fitted to the data. We interpreted 181 scans for 181 individuals having a mean age of 55 years (18-89). The most common site of aortic bifurcation was at L4-L5 disc space (34.8%) and that of vena confluence was at the upper of L5 (29.3%). The mean LLA was 34.65° (13°-77°). The mean aortic bifurcation angle was 47.43° (17°-100°) and the mean IVC confluence angle was 71.86° (30°-120°). The positions of the aortic bifurcation and venous confluence levels showed a proximal shift with an increasing LLA P < 0.001. This study showed that the level of bifurcation of the aorta and the level of confluence of the IVC may vary with the variations of the LLA.

  7. A Non-invasive Method for Assessment of Intravascular Fluid Status: Inferior Vena Cava Diameters and Collapsibility Index

    PubMed Central

    Karacabey, Sinan; Sanri, Erkman; Guneysel, Ozlem

    2016-01-01

    Objective: To evaluate the correlation between central venous pressure (CVP) and inferior vena cava (IVC) diameters measured by ultrasonography (Ultrasound) in critically ill patients. Methods: Intubated critically ill patients were enrolled. The CVP values were measured using a U-tube manometer and were compared to the IVC diameters and collapsibility index, which were measured by bedside Ultrasound. Patients younger than 18 years old, who were not intubated, who had an abdominal pressure greater than 12 mmHg, and/or who were admitted for trauma were excluded from the study. Results: Eighty three patients with a mean age of 73.6±11.2 years were enrolled. The most common diagnosis was sepsis (21 patients, 25.30%). IVC inspiration measurements were statistically significantly correlated with CVP measurements (p0.05, r: 0.1). IVC collapsibility measurements showed a negative correlation with CVP measurements (p<0.01, r: 0.68). Conclusions: There is a strong correlation between CVP and IVC diameters and the collapsibility index. This is a new formula for evaluating CVP, based on our statistical analyses. PMID:27648024

  8. Ecklonia cava Polyphenol Has a Protective Effect against Ethanol-Induced Liver Injury in a Cyclic AMP-Dependent Manner

    PubMed Central

    Yamashita, Haruka; Goto, Mayu; Matsui-Yuasa, Isao; Kojima-Yuasa, Akiko

    2015-01-01

    Previously, we showed that Ecklonia cava polyphenol (ECP) treatment suppressed ethanol-induced increases in hepatocyte death by scavenging intracellular reactive oxygen species (ROS) and maintaining intracellular glutathione levels. Here, we examined the effects of ECP on the activities of alcohol-metabolizing enzymes and their regulating mechanisms in ethanol-treated hepatocytes. Isolated hepatocytes were incubated with or without 100 mM ethanol. ECP was dissolved in dimethylsulfoxide. ECP was added to cultured cells that had been incubated with or without ethanol. The cells were incubated for 0–24 h. In cultured hepatocytes, the ECP treatment with ethanol inhibited cytochrome P450 2E1 (CYP2E1) expression and activity, which is related to the production of ROS when large quantities of ethanol are oxidized. On the other hand, ECP treatment with ethanol increased the activity of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase. These changes in activities of CYP2E1 and ADH were suppressed by treatment with H89, an inhibitor of protein kinase A. ECP treatment with ethanol enhanced cyclic AMP concentrations compared with those of control cells. ECP may be a candidate for preventing ethanol-induced liver injury via regulating alcohol metabolic enzymes in a cyclic AMP-dependent manner. PMID:26096275

  9. Right Double Inferior Vena Cava (IVC) with Preaortic Iliac Confluence – Case Report and Review of Literature

    PubMed Central

    Babu, C.S. Ramesh; Lalwani, Rekha; Kumar, Indra

    2014-01-01

    Anomalies of the inferior vena cava (IVC) are uncommon and most of them remain asymptomatic. Though rare, anomalies of IVC can lead to severe hemorrhagic complications especially during aortoiliac surgery. Prior knowledge of these variations facilitates proper interpretation of radiological images and safe performance of interventional procedures and surgeries. During routine anatomical dissection of abdomen in a female cadaver we observed the presence of right sided duplication of IVC. Both IVCs were present on the right side of abdominal aorta, one ventral and the other more dorsal in position and named ventral right IVC and dorsal right IVC. The ventrally and medially placed IVC, which appeared to be the main IVC was formed by the union of two common iliac veins in front of the right common iliac artery (Preaortic iliac confluence-“Marsupial Cava”). The right external iliac vein continued as the more dorsally and laterally placed dorsal right IVC. The right internal iliac vein after receiving a transverse anastomotic vein from the external iliac continued as the right common iliac vein. This transverse anastomosis was present behind the right common iliac artery. The narrower dorsal right IVC joined the wider ventral right IVC just below the level of renal veins to form a single IVC. The abdominal aorta presented a convexity to the left. PMID:24701503

  10. [Survival after Sorafenib Treatment for Advanced Recurrent Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava].

    PubMed

    Matoba, Hideaki; Seta, Shinsuke

    2015-11-01

    A 72-year-old man with chronic viral hepatitis type B undergoing surgery for hepatocellular carcinoma was found to have a recurrent tumor in the left liver with peritoneal dissemination near the inferior vena cava(IVC)and tumor thrombus in the IVC. For this patient diagnosed with Barcelona clinic liver cancer (BCLC) classification stage C hepatocellular carcinoma, we initiated 800 mg/body sorafenib. Two weeks after the initiation of sorafenib, the patient experienced grade 3 hand-foot syndrome, after which, the dose of sorafenib was reduced to 400 mg/body. After 1 year, CT showed an enlarged tumor in the left liver and multiple metastases to the lung. However, no remarkable difference was observed in the peritoneal dissemination and the tumor thrombus. He has been receiving sorafenib for 19 months with a good quality of life. Sorafenib can be provided on an outpatient basis and it may facilitate long-term survival for patients with advanced recurrent hepatocellular carcinoma with IVC tumor thrombus. This clinical condition is very rare, and the standard treatment for it still has not been established. PMID:26805098

  11. Topographic anatomy of the fetal inferior vena cava, coronary sinus, and pulmonary veins: Variations in Chiari's network.

    PubMed

    Naito, Michiko; Yu, Hee Chul; Kim, Ji Hyun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2015-07-01

    To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults.

  12. Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases

    SciTech Connect

    McConville, R. M. Kennedy, P. T.; Collins, A. J.; Ellis, P. K.

    2009-01-15

    Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to reduce the risk of possible epidural haematoma. Retrievable inferior vena cava filters (IVCFs) offer protection against pulmonary embolism during this high-risk period, when anticoagulation is discontinued, while avoiding potential long-term sequelae of a permanent IVCF. Here we report two patients who presented in the third trimester of pregnancy with floating ileofemoral deep vein thrombosis. Both patients were initially treated with standard anticoagulation; however, shortly before delivery both patients had a retrievable IVCF placed in a suprarenal position. In both patients, retrieval failed at 28 days after insertion because of filter tilt. The timing and mechanism of filter tilt remains uncertain. We believe that a number of factors could have been involved, including change in the anatomic configuration with lateral displacement of the IVCF as a result of the gravid uterus as well as forceful uterine contractions during labour, which modified the shape and diameter of the IVC. We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.

  13. In Vivo Evaluation of a Retrievable Vena Cava Filter-The Dibie-Musset Filter: Experimental Results

    SciTech Connect

    Dibie, Alain; Musset, Dominique; Heissler, Marc; Fournet, Jean-Christophe; Palau, Robert; Laborde, Francois

    1998-03-15

    Purpose: To evaluate, in an animal model, the efficacy and safety of a 7 Fr percutaneous vena cava filter for temporary or permanent use. Methods: The Dibie-Musset (DM) filter is a wire preformed into a double-spiral shape with a spring effect. The experiment was performed in 15 adult sheep and consisted of the insertion of 45 filters, clot trapping tests, and filter retrieval. Follow-up in all sheep consisted of radiologic (abdominal radiograph, inferior vena cavogram, abdominal computed tomography), macroscopic, and microscopic examinations between days 8 and 386 after filter placement. Results: Of the 45 filters implanted in 15 sheep, 29 were retrieved between day 0 and day 15. Filtration efficiency was 100% for clots 4 x 4 x 20 mm. No long-term (1 year) side-effects were detectable. Microscopic examination of the vein wall showed only a dense intimal fibrosis without signs of acute inflammation at 1 year. Conclusion: These results support the efficiency and safety of the DM filter in an animal model.

  14. Chemoembolization and stenting combined with iodine-125 seed strands for the treatment of hepatocellular carcinoma with inferior vena cava obstruction

    PubMed Central

    LI, WENHUI; DAI, ZHENYU; YAO, LIZHENG; LUO, JIANJUN; YAN, ZHIPING

    2015-01-01

    The aim of the present study was to investigate the efficacy and safety of stenting combined with radioactive iodine-125 seed strands following chemoembolization for the treatment of patients with hepatocellular carcinoma and inferior vena cava (IVC) obstruction. A retrospective analysis was conducted of 52 hepatocellular carcinoma patients with IVC obstruction. All patients received chemoembolization of tumor-supplying arteries and IVC stents, and 18 patients additionally received iodine-125 seed strands, which were fixed to the stents. Improvement of IVC obstruction and the tumor response rates were compared between the two groups with a median follow-up time of 2.5 months. In both groups the stents were successfully deployed. At the 2-month post-procedural follow-up, the mean diameter of the IVC obstruction site, the mean pressure difference between the distal IVC obstructive segment and the right atrium as well as the obstruction scoring did not differ significantly between the two groups. By contrast, the tumor response rate of the iodine-125 seed strand group was 94.4%, whereas for the group without iodine-125 seed strands it was 35.3% (P<0.001). The combination of stent and iodine-125 seed strands was effective and safe for the treatment of hepatocellular carcinoma with IVC obstruction. PMID:26622424

  15. The Holocene Paleolimnology of Lake Superior

    NASA Astrophysics Data System (ADS)

    Hyodo, A.; Longstaffe, F. J.

    2010-12-01

    This study describes contributions of glacial meltwater to Lake Superior over the last 11,000 cal BP. Rhythmites (interpreted as varves), lithological and mineralogical variations, and radiocarbon dating were used to establish chronostratigraphic correlation among four sediment cores from Lake Superior (Duluth, Caribou and Ile Parisienne basins, Thunder Bay Trough). Glacial sediments were deposited between 10,850 and 8,800 cal BP. The oxygen-isotope compositions of ostracodes record the presence of glacial meltwater in ancient Lake Superior as the Laurentide Ice Sheet waxed and waned. Glacial meltwater was increasingly dominant between ~10,850 and ~9,250 cal BP, particularly as thick varves formed in northern portions of the Lake Superior Basin (10,400-10,200, 9,900 and 9,300-9,200 cal BP). Glacial meltwater supply was reduced in the Thunder Bay Trough between 9,250 and 8,950 cal BP, but returned from 8,950 to 8,800 cal BP. Glacial meltwater flow from the Lake Superior Basin probably bypassed the Huron Basin several times during this period. Final termination of glacial meltwater supply occurred at 8,800 cal BP - coincident with cessation of varve formation and inception of ancient Lakes Agassiz-Ojibway and Houghton. Primary productivity was very low and algal growth occurred under conditions of extreme nitrogen deficiency - as determined using TOC, TN and C/N ratios - until glacial meltwater supply to the Basin was ended. The postglacial sediments are non-calcareous. The diatom silica proxy record shows that oxygen-isotope compositions of water rapidly increased after glacial meltwater termination, reaching -10 per mil during the Holocene Thermal Maximum. The oxygen-isotope compositions of water decreased at 3,000 cal BP in response to the Holocene Neoglacial Interval before gradually rising to Lake Superior’s modern value of -8.7 per mil. Aquatic primary productivity, inferred using TOC, TN, and the carbon- and nitrogen isotope compositions, has increased

  16. Blood Pool Segmentation Results in Superior Virtual Cardiac Models than Myocardial Segmentation for 3D Printing.

    PubMed

    Farooqi, Kanwal M; Lengua, Carlos Gonzalez; Weinberg, Alan D; Nielsen, James C; Sanz, Javier

    2016-08-01

    The method of cardiac magnetic resonance (CMR) three-dimensional (3D) image acquisition and post-processing which should be used to create optimal virtual models for 3D printing has not been studied systematically. Patients (n = 19) who had undergone CMR including both 3D balanced steady-state free precession (bSSFP) imaging and contrast-enhanced magnetic resonance angiography (MRA) were retrospectively identified. Post-processing for the creation of virtual 3D models involved using both myocardial (MS) and blood pool (BP) segmentation, resulting in four groups: Group 1-bSSFP/MS, Group 2-bSSFP/BP, Group 3-MRA/MS and Group 4-MRA/BP. The models created were assessed by two raters for overall quality (1-poor; 2-good; 3-excellent) and ability to identify predefined vessels (1-5: superior vena cava, inferior vena cava, main pulmonary artery, ascending aorta and at least one pulmonary vein). A total of 76 virtual models were created from 19 patient CMR datasets. The mean overall quality scores for Raters 1/2 were 1.63 ± 0.50/1.26 ± 0.45 for Group 1, 2.12 ± 0.50/2.26 ± 0.73 for Group 2, 1.74 ± 0.56/1.53 ± 0.61 for Group 3 and 2.26 ± 0.65/2.68 ± 0.48 for Group 4. The numbers of identified vessels for Raters 1/2 were 4.11 ± 1.32/4.05 ± 1.31 for Group 1, 4.90 ± 0.46/4.95 ± 0.23 for Group 2, 4.32 ± 1.00/4.47 ± 0.84 for Group 3 and 4.74 ± 0.56/4.63 ± 0.49 for Group 4. Models created using BP segmentation (Groups 2 and 4) received significantly higher ratings than those created using MS for both overall quality and number of vessels visualized (p < 0.05), regardless of the acquisition technique. There were no significant differences between Groups 1 and 3. The ratings for Raters 1 and 2 had good correlation for overall quality (ICC = 0.63) and excellent correlation for the total number of vessels visualized (ICC = 0.77). The intra-rater reliability was good for Rater A (ICC = 0.65). Three models were successfully printed

  17. Blood Pool Segmentation Results in Superior Virtual Cardiac Models than Myocardial Segmentation for 3D Printing.

    PubMed

    Farooqi, Kanwal M; Lengua, Carlos Gonzalez; Weinberg, Alan D; Nielsen, James C; Sanz, Javier

    2016-08-01

    The method of cardiac magnetic resonance (CMR) three-dimensional (3D) image acquisition and post-processing which should be used to create optimal virtual models for 3D printing has not been studied systematically. Patients (n = 19) who had undergone CMR including both 3D balanced steady-state free precession (bSSFP) imaging and contrast-enhanced magnetic resonance angiography (MRA) were retrospectively identified. Post-processing for the creation of virtual 3D models involved using both myocardial (MS) and blood pool (BP) segmentation, resulting in four groups: Group 1-bSSFP/MS, Group 2-bSSFP/BP, Group 3-MRA/MS and Group 4-MRA/BP. The models created were assessed by two raters for overall quality (1-poor; 2-good; 3-excellent) and ability to identify predefined vessels (1-5: superior vena cava, inferior vena cava, main pulmonary artery, ascending aorta and at least one pulmonary vein). A total of 76 virtual models were created from 19 patient CMR datasets. The mean overall quality scores for Raters 1/2 were 1.63 ± 0.50/1.26 ± 0.45 for Group 1, 2.12 ± 0.50/2.26 ± 0.73 for Group 2, 1.74 ± 0.56/1.53 ± 0.61 for Group 3 and 2.26 ± 0.65/2.68 ± 0.48 for Group 4. The numbers of identified vessels for Raters 1/2 were 4.11 ± 1.32/4.05 ± 1.31 for Group 1, 4.90 ± 0.46/4.95 ± 0.23 for Group 2, 4.32 ± 1.00/4.47 ± 0.84 for Group 3 and 4.74 ± 0.56/4.63 ± 0.49 for Group 4. Models created using BP segmentation (Groups 2 and 4) received significantly higher ratings than those created using MS for both overall quality and number of vessels visualized (p < 0.05), regardless of the acquisition technique. There were no significant differences between Groups 1 and 3. The ratings for Raters 1 and 2 had good correlation for overall quality (ICC = 0.63) and excellent correlation for the total number of vessels visualized (ICC = 0.77). The intra-rater reliability was good for Rater A (ICC = 0.65). Three models were successfully printed

  18. Extraocular Muscle Compartments in Superior Oblique Palsy

    PubMed Central

    Suh, Soh Youn; Clark, Robert A.; Le, Alan; Demer, Joseph L.

    2016-01-01

    Purpose To investigate changes in volumes of extraocular muscle (EOM) compartments in unilateral superior oblique (SO) palsy using magnetic resonance imaging (MRI). Methods High-resolution, surface-coil MRI was obtained in 19 patients with unilateral SO palsy and 19 age-matched orthotropic control subjects. Rectus EOMs and the SO were divided into two anatomic compartments for volume analysis in patients with unilateral SO palsy, allowing comparison of total compartmental volumes versus controls. Medial and lateral compartmental volumes of the SO muscle were compared in patients with isotropic (round shape) versus anisotropic (elongated shape) SO atrophy. Results The medial and lateral compartments of the ipsilesional SO muscles were equally atrophic in isotropic SO palsy, whereas the lateral compartment was significantly smaller than the medial in anisotropic SO palsy (P = 0.01). In contrast to the SO, there were no differential compartmental volume changes in rectus EOMs; however, there was significant total muscle hypertrophy in the ipsilesional inferior rectus (IR) and lateral rectus (LR) muscles and contralesional superior rectus (SR) muscles. Medial rectus (MR) volume was normal both ipsi- and contralesionally. Conclusions A subset of patients with SO palsy exhibit selective atrophy of the lateral, predominantly vertically acting SO compartment. Superior oblique atrophy is associated with whole-muscle volume changes in the ipsilesional IR, ipsilesional LR, and contralesional SR; however, SO muscle atrophy is not associated with compartmentally selective volume changes in the rectus EOMs. Selective compartmental SO pathology may provide an anatomic mechanism that explains some of the variability in clinical presentations of SO palsy. PMID:27768791

  19. Superior mesenteric vein aneurysm: a case report.

    PubMed

    Truong, Tuan; Vu, Jonathan-Hien; Matteo, Jerry

    2012-01-01

    A 46-year-old female was found to have a saccular superior mesenteric vein (SMV) aneurysm on computed tomography (CT) scan during workup for abdominal pain. It measured 3.5 cm in diameter. The SMV aneurysm was successfully resected, and the SMV was repaired with femoral vein patch angioplasty. She was placed on coumadin for 3 months. At follow-up, the vein patch repair was patent and the patient was doing well with complete resolution of her abdominal pain. PMID:22156158

  20. Motor Functions of the Superior Colliculus

    PubMed Central

    Gandhi, Neeraj J.; Katnani, Husam A.

    2013-01-01

    The mammalian superior colliculus (SC) and its nonmammalian homolog, the optic tectum, constitute a major node in processing sensory information, incorporating cognitive factors, and issuing motor commands. The resulting action—to orient toward or away from a stimulus—can be accomplished as an integrated movement across oculomotor, cephalomotor, and skeletomotor effectors. The SC also participates in preserving fixation during intersaccadic intervals. This review highlights the repertoire of movements attributed to SC function and analyzes the significance of results obtained from causality-based experiments (microstimulation and inactivation). The mechanisms potentially used to decode the population activity in the SC into an appropriate movement command are also discussed. PMID:21456962

  1. Laparoscopic Management of Superior Mesenteric Artery Syndrome

    PubMed Central

    Fenoglio, Michael E.

    2003-01-01

    Objectives: The differential diagnosis of intestinal obstruction includes mechanical obstruction, obstruction secondary to systemic disease, and idiopathic intestinal pseudo-obstruction. The causes of these are extensive; however, the majority of cases involve a mechanical cause. Superior mesenteric artery syndrome (SMAS) is a rare and controversial form of mechanical obstruction with just over 300 well-defined cases described in the literature. The diagnosis is often difficult to establish, even after surgery. In addition, this syndrome sometimes may be managed conservatively, leaving a definitive diagnosis unproven. We describe herein 2 patients with SMAS successfully treated with laparoscopic duodenojejunostomy. Methods: Two cases of SMAS occurred in young men ages 23 and 34. The workup included a consultation with a gastroenterologist, an upper gastrointestinal (GI) endoscopy, upper GI series with small bowel follow-through, computed tomography scan, ultrasound of the abdomen, and abdominal aortogram. This diagnosis was established after consultation with the surgeon and the gastroenterologist in each case. Results: Laparoscopic duodenojejunostomy was performed in each case, and both patients have had complete resolution of their preoperative symptoms. Conclusions: A laparoscopic approach to the management of superior mesenteric artery syndrome is a reasonable and successful way of treating these patients. PMID:12856847

  2. Inferior vena cava diameter correlates with invasive hemodynamic measures in mechanically ventilated intensive care unit patients with sepsis.

    PubMed

    Schefold, Joerg C; Storm, Christian; Bercker, Sven; Pschowski, Rene; Oppert, Michael; Krüger, Anne; Hasper, Dietrich

    2010-06-01

    Early optimization of fluid status is of central importance in the treatment of critically ill patients. This study aims to investigate whether inferior vena cava (IVC) diameters correlate with invasively assessed hemodynamic parameters and whether this approach may thus contribute to an early, non-invasive evaluation of fluid status. Thirty mechanically ventilated patients with severe sepsis or septic shock (age 60 +/- 15 years; APACHE-II score 31 +/- 8; 18 male) were included. IVC diameters were measured throughout the respiratory cycle using transabdominal ultrasonography. Consecutively, volume-based hemodynamic parameters were determined using the single-pass thermal transpulmonary dilution technique. This was a prospective study in a tertiary care academic center with a 24-bed medical intensive care unit (ICU) and a 14-bed anesthesiological ICU. We found a statistically significant correlation of both inspiratory and expiratory IVC diameter with central venous pressure (p = 0.004 and p = 0.001, respectively), extravascular lung water index (p = 0.001, p < 0.001, respectively), intrathoracic blood volume index (p = 0.026, p = 0.05, respectively), the intrathoracic thermal volume (both p < 0.001), and the PaO(2)/FiO(2) oxygenation index (p = 0.007 and p = 0.008, respectively). In this study, IVC diameters were found to correlate with central venous pressure, extravascular lung water index, intrathoracic blood volume index, the intrathoracic thermal volume, and the PaO(2)/FiO(2) oxygenation index. Therefore, sonographic determination of IVC diameter seems useful in the early assessment of fluid status in mechanically ventilated septic patients. At this point in time, however, IVC sonography should be used only in addition to other measures for the assessment of volume status in mechanically ventilated septic patients.

  3. Effect of Antithrombotic Agents on the Patency of PTFE-Covered Stents in the Inferior Vena Cava: An Experimental Study

    SciTech Connect

    Makutani, Shiro; Kichikawa, Kimihiko; Uchida, Hideo; Maeda, Munehiro; Konishi, Noboru; Hiasa, Yoshio; Yoshikawa, Tomohiro; Kimura, Yukio

    1999-05-15

    Purpose: To evaluate the efficacy of antithrombotic agents in the prevention of stenosis of polytetrafluoroethylene (PTFE)-covered stents in the venous system. Methods: Spiral Z stents covered with PTFE (PTFE-covered stents) were placed in the inferior vena cava (IVC) of 34 dogs. Nineteen dogs, used as a control group, were sacrificed at 2, 4, and 12 weeks. Fifteen dogs, previously given antithrombotic agents [cilostazol (n= 5), warfarin potassium (n= 5), cilostazol plus warfarin potassium (n= 5)] were sacrificed at 4 weeks, and then examined angiographically and histopathologically. The effect of the antithrombotic agents was compared between groups. Results: The patency rate of the antithrombotic agent group was 93% (14/15), which was higher than the control group rate of 63% (12/19). The mean stenosis rate of the patent stent at both ends and at the midportion was lower at 4 weeks in the antithrombotic agent group than in the control group. In particular, the mean stenosis rate in the cilostazol plus warfarin potassium group was significantly lower than the control group (Tukey's test, p < 0.05). The mean neointimal thickness of the patent stent at both ends and at the midportion was thinner at 4 weeks in the antithrombotic agent group than in the control group. In particular, the thickness of the neointima in the cilostazol plus warfarin potassium group was significantly decreased when compared with the control group (Tukey's test p < 0.05). At 4 weeks, endothelialization in the antithrombotic agent group tended to be almost identical to that in the control group. Conclusion: The present study suggests that administration of an antithrombotic agent is an effective way of preventing the stenosis induced by a neointimal thickening of PTFE-covered stents in the venous system.

  4. Outpatient Use of Focused Cardiac Ultrasound to Assess the Inferior Vena Cava in Patients With Heart Failure.

    PubMed

    Saha, Narayan M; Barbat, Julian J; Fedson, Savitri; Anderson, Allen; Rich, Jonathan D; Spencer, Kirk T

    2015-10-15

    Accurate assessment of volume status is critical in the management of patients with heart failure (HF). We studied the utility of a pocket-sized ultrasound device in an outpatient cardiology clinic as a tool to guide volume assessment. Inferior vena cava (IVC) size and collapsibility were assessed in 95 patients by residents briefly trained in focused cardiac ultrasound (FCU). Cardiologist assessment of volume status and changes in diuretic medication were also recorded. Patients were followed for occurrence of 30-day events. There was a 94% success rate of obtaining IVC size and collapsibility, and agreement between visual and calculated IVC parameters was excellent. Most patients were euvolemic by both FCU IVC and clinical bedside assessment (51%) and had no change in diuretic dose. Thirty-two percent had discrepant FCU IVC and clinical volume assessments. In clinically hypervolemic patients, the FCU evaluation of the IVC suggested that the wrong diuretic management plan might have been made 46% of the time. At 30 days, 14 events occurred. The incidence of events increased significantly with FCU IVC imaging categorization, from 11% to 23% to 36% in patients with normal, intermediate, and plethoric IVCs. By comparison, when grouped in a binary manner, there was no significant difference in event rates for patients who were deemed to be clinically volume overloaded. Assessment of volume status in an outpatient cardiology clinic using FCU imaging of the IVC is feasible in a high percentage of patients. A group of patients were identified with volume status discordant between FCU IVC and routine clinic assessment, suggesting that IVC parameters may provide a valuable supplement to the in-office physical examination.

  5. Social and Demographic Factors Influencing Inferior Vena Cava Filter Retrieval at a Single Institution in the United States

    SciTech Connect

    Smith, S. Christian Shanks, Candace Guy, Gregory Yang, Xiangyu Dowell, Joshua D.

    2015-10-15

    PurposeRetrievable inferior vena cava filters (IVCFs) are associated with long-term adverse events that have increased interest in improving filter retrieval rates. Determining the influential patient social and demographic factors affecting IVCF retrieval is important to personalize patient management strategies and attain optimal patient care.Materials and MethodsSeven-hundred and sixty-two patients were retrospectively studied who had a filter placed at our institution between January 2011 and November 2013. Age, gender, race, cancer history, distance to residence from retrieval institution, and insurance status were identified for each patient, and those receiving retrievable IVCFs were further evaluated for retrieval rate and time to retrieval.ResultsOf the 762 filters placed, 133 were permanent filters. Of the 629 retrievable filters placed, 406 met the inclusion criteria and were eligible for retrieval. Results revealed patients with Medicare were less likely to have their filters retrieved (p = 0.031). Older age was also associated with a lower likelihood of retrieval (p < 0.001) as was living further from the medical center (p = 0.027). Patients who were white and had Medicare were more likely than similarly insured black patients to have their filters retrieved (p = 0.024).ConclusionsThe retrieval rate of IVCFs was most influenced by insurance status, distance from the medical center, and age. Race was statistically significant only when combined with insurance status. The results of this study suggest that these patient groups may need closer follow-up in order to obtain optimal IVCF retrieval rates.

  6. Outcomes of retrievable inferior vena cava filters in patients with deep vein thrombosis and transient contraindication for anticoagulation

    PubMed Central

    Kim, Hyung-Kee; Song, Incheol; Jang, Ji-Hoon; Oh, Chang-Wug; Lee, Jong-Min

    2015-01-01

    Purpose To determine the efficacy of a retrievable inferior vena cava filter (IVCF) for patients with deep vein thrombosis (DVT) and transient contraindication for anticoagulant therapy, and to analyze the risk factors for filter thrombus in these patients. Methods We retrospectively reviewed the records of 70 patients who received a retrievable IVCF from January 2007 to June 2014 because of documented DVT and transient contraindication for anticoagulant therapy. The protocol for follow-up care generally consisted of anticoagulant therapy after high-risk periods, follow-up CT around 2 weeks after IVCF placement, and retrieval if possible. Results The 70 patients had a mean age of 61.8 years (range, 17-88 years), and 30 were male (43%). The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients. Follow-up CT of 61 patients (87%) was performed. Aggravation or new development of pulmonary embolism (PE) was not found in any patient. Filter thrombus was detected in 23% of patients with follow-up CT (14/61). Filter thrombus was not detected in patients with isolated calf vein thrombosis (ICVT) (P = 0.079). The risk factor for filter thrombus was DVT progression on follow-up CT (P = 0.007) on multivariate analysis. Conclusion For patients with DVT and transient contraindication for anticoagulant therapy, a retrievable IVCF could prevent the aggravation or new development of PE. DVT progression on follow-up CT was associated with filter thrombus and ICVT was not related to filter thrombus in the present study. PMID:26131442

  7. Efficacy and Safety of Endovascular Intervention for the Management of Primary Entire-Inferior Vena Cava Occlusion

    SciTech Connect

    Zhang, Qingqiao Huang, Qianxin Shen, Bin Sun, Jingmin Wang, Xiaolong Liu, Hongtao

    2015-06-15

    PurposeThis study was designed to investigate the safety and efficacy of endovascular intervention for the treatment of primary entire-inferior vena cava (IVC) occlusion.MethodsEndovascular interventions were performed in six patients for the treatment of primary entire-IVC occlusion. IVC and hepatic venography were performed via the jugular and femoral veins. Balloon angioplasty was used to revascularize the hepatic vein and IVC and a stent was placed in the IVC to maintain patency. Postoperative color Doppler ultrasonography was performed at 1, 3, 6, and 12 months, and then annually, to monitor the patency of the hepatic vein and IVC.ResultsThe IVC and one or two hepatic veins were successfully revascularized in five patients. Revascularization was successful in the right and left hepatic veins in one patient; however, IVC patency could not be established in this patient. Eleven Z-type, self-expanding stents were placed into the IVCs of five patients (three stents in two patients, two stents in two patients, and one stent in one patient). There were no instances of postoperative bleeding or mortality. Follow-up was conducted for 18–90 months (42.8 ± 26.5 months). None of the five patients suffered restenosis of the IVC or hepatic veins. However, there was one of the six cases of right hepatic vein restenosis at 18 months postprocedure that was revascularized after a second balloon dilatation.ConclusionsEndovascular intervention is safe and efficacious for the treatment of primary entire-IVC occlusion.

  8. Impact of intra-abdominal pressure on retrohepatic vena cava shape and flow in mechanically ventilated pigs.

    PubMed

    Bendjelid, Karim; Viale, Jean-Paul; Duperret, Serge; Colling, Joëlle; Piriou, Vincent; Merlani, Paolo; Jacques, Didier

    2012-04-01

    Conflicting results have been found regarding correlations between right atrial pressure (RAP) and inferior vena cava (IVC) diameter in mechanically ventilated patients. This finding could be related to an increase in intra-abdominal pressure (IAP). This study was designed to clarify whether variations in IVC flow rate caused by positive pressure ventilation are associated with changes in the retrohepatic IVC cross-section (ΔIVC) during major changes in volume status and IAP. Nine pigs were anesthetized, mechanically ventilated and equipped. IAP was set at 0, 15 and 30 mmHg during two conditions, i.e. normovolemia and hypovolemia, generated by blood removal to obtain a mean arterial pressure value lower than 60 mmHg. At each IAP increment, cardiac output, IVC flow and surface area were respectively assessed by flowmeters and transesophageal echocardiography. At normal IAP, even in presence of respiratory changes in IVC flows, no ΔIVC were observed during the two conditions. At high IAP, neither ΔIVC nor modulations of IVC flow were observed whatever the volemic status. The majority of animals with an IVC area of less than 0.65 cm(2) showed evidence of IAP greater than RAP values. Negative RAP-IAP pressure gradients were found to occur with an IVC area of less than 0.65 cm(2), suggesting that IVC dimensions determined using standard ultrasound techniques may indicate the direction of the RAP-IAP gradient. The clinical relevance of the present findings is that volume status should not be estimated from retrohepatic IVC dimensions in cases of high IAP. PMID:22418601

  9. Triphlorethol-A from Ecklonia cava up-regulates the oxidant sensitive 8-oxoguanine DNA glycosylase 1.

    PubMed

    Kim, Ki Cheon; Lee, In Kyung; Kang, Kyoung Ah; Piao, Mei Jing; Ryu, Min Ju; Kim, Jeong Mi; Lee, Nam Ho; Hyun, Jin Won

    2014-11-01

    This study investigated the protective mechanisms of triphlorethol-A, isolated from Ecklonia cava, against oxidative stress-induced DNA base damage, especially 8-oxoguanine (8-oxoG), in Chinese hamster lung fibroblast V79-4 cells. 8-Oxoguanine DNA glycosylase-1 (OGG1) plays an important role in the removal of 8-oxoG during the cellular response to DNA base damage. Triphlorethol-A significantly decreased the levels of 8-oxoG induced by H2O2, and this correlated with increases in OGG1 mRNA and OGG1 protein levels. Furthermore, siOGG1-transfected cell attenuated the protective effect of triphlorethol-A against H2O2 treatment. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor for OGG1, and Nrf2 combines with small Maf proteins in the nucleus to bind to antioxidant response elements (ARE) in the upstream promoter region of the OGG1 gene. Triphlorethol-A restored the expression of nuclear Nrf2, small Maf protein, and the Nrf2-Maf complex, all of which were reduced by oxidative stress. Furthermore, triphlorethol-A increased Nrf2 binding to ARE sequences and the resulting OGG1 promoter activity, both of which were also reduced by oxidative stress. The levels of the phosphorylated forms of Akt kinase, downstream of phosphatidylinositol 3-kinase (PI3K), and Erk, which are regulators of OGG1, were sharply decreased by oxidative stress, but these decreases were prevented by triphlorethol-A. Specific PI3K, Akt, and Erk inhibitors abolished the cytoprotective effects of triphlorethol-A, suggesting that OGG1 induction by triphlorethol-A involves the PI3K/Akt and Erk pathways. Taken together, these data indicate that by activating the DNA repair system, triphlorethol-A exerts protective effects against DNA base damage induced by oxidative stress. PMID:25353254

  10. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    SciTech Connect

    Ganguli, Suvranu Kalva, Sanjeeva; Oklu, Rahmi; Walker, T. Gregory; Datta, Neil; Grabowski, Eric F.; Wicky, Stephan

    2012-10-15

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12-72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 {+-} 20.2 months (range 3.8-54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  11. 15. Stress Sheet, Truss number 2, span number 6, Superior ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Stress Sheet, Truss number 2, span number 6, Superior Avenue viaduct. Drawing courtesy Engineering Dept., City of Cleveland. - Superior Avenue Viaduct, Cleveland East & West side, Cuyahoga Valley Vicinity, Cleveland, Cuyahoga County, OH

  12. Inferior vena cava filter misplacement in the right atrium and migration to the right ventricle followed by successful removal using the endovascular technique: A case report and review of the literature

    PubMed Central

    Takeuchi, Wataru; Yamazaki, Kyohei

    2015-01-01

    Inferior vena cava filters are effective for preventing the passage of thrombi into the pulmonary arteries in patients with pulmonary embolism and deep vein thrombosis. These filters are indicated in patients with contraindications to anticoagulant therapy or in patients with recurrent acute pulmonary embolism despite the administration of anticoagulant therapy. However, the occurrence of filter-related complications, such as filter migration to the heart, has been increasing. Herein, we report a case of OptEase inferior vena cava filter misplacement in the right atrium. Although the filter migrated to the right ventricle, it was successfully removed and repositioned in the inferior vena cava using endovascular techniques. Unfortunately, moderate tricuspid regurgitation developed, due to the damage to the tricuspid valve that was caused by the procedure. We have also reviewed the relevant literature and discussed the possible strategies for managing cases of filter migration to the heart and preventing filter misplacement. PMID:27489693

  13. Cold-Adapted Viral Attenuation (CAVA): Highly Temperature Sensitive Polioviruses as Novel Vaccine Strains for a Next Generation Inactivated Poliovirus Vaccine.

    PubMed

    Sanders, Barbara P; de Los Rios Oakes, Isabel; van Hoek, Vladimir; Bockstal, Viki; Kamphuis, Tobias; Uil, Taco G; Song, Yutong; Cooper, Gillian; Crawt, Laura E; Martín, Javier; Zahn, Roland; Lewis, John; Wimmer, Eckard; Custers, Jerome H H V; Schuitemaker, Hanneke; Cello, Jeronimo; Edo-Matas, Diana

    2016-03-01

    The poliovirus vaccine field is moving towards novel vaccination strategies. Withdrawal of the Oral Poliovirus Vaccine and implementation of the conventional Inactivated Poliovirus Vaccine (cIPV) is imminent. Moreover, replacement of the virulent poliovirus strains currently used for cIPV with attenuated strains is preferred. We generated Cold-Adapted Viral Attenuation (CAVA) poliovirus strains by serial passage at low temperature and subsequent genetic engineering, which contain the capsid sequences of cIPV strains combined with a set of mutations identified during cold-adaptation. These viruses displayed a highly temperature sensitive phenotype with no signs of productive infection at 37°C as visualized by electron microscopy. Furthermore, decreases in infectious titers, viral RNA, and protein levels were measured during infection at 37°C, suggesting a block in the viral replication cycle at RNA replication, protein translation, or earlier. However, at 30°C, they could be propagated to high titers (9.4-9.9 Log10TCID50/ml) on the PER.C6 cell culture platform. We identified 14 mutations in the IRES and non-structural regions, which in combination induced the temperature sensitive phenotype, also when transferred to the genomes of other wild-type and attenuated polioviruses. The temperature sensitivity translated to complete absence of neurovirulence in CD155 transgenic mice. Attenuation was also confirmed after extended in vitro passage at small scale using conditions (MOI, cell density, temperature) anticipated for vaccine production. The inability of CAVA strains to replicate at 37°C makes reversion to a neurovirulent phenotype in vivo highly unlikely, therefore, these strains can be considered safe for the manufacture of IPV. The CAVA strains were immunogenic in the Wistar rat potency model for cIPV, inducing high neutralizing antibody titers in a dose-dependent manner in response to D-antigen doses used for cIPV. In combination with the highly productive

  14. Cold-Adapted Viral Attenuation (CAVA): Highly Temperature Sensitive Polioviruses as Novel Vaccine Strains for a Next Generation Inactivated Poliovirus Vaccine

    PubMed Central

    Sanders, Barbara P.; de los Rios Oakes, Isabel; van Hoek, Vladimir; Bockstal, Viki; Kamphuis, Tobias; Uil, Taco G.; Song, Yutong; Cooper, Gillian; Crawt, Laura E.; Martín, Javier; Zahn, Roland; Lewis, John; Wimmer, Eckard; Custers, Jerome H. H. V.; Schuitemaker, Hanneke; Cello, Jeronimo; Edo-Matas, Diana

    2016-01-01

    The poliovirus vaccine field is moving towards novel vaccination strategies. Withdrawal of the Oral Poliovirus Vaccine and implementation of the conventional Inactivated Poliovirus Vaccine (cIPV) is imminent. Moreover, replacement of the virulent poliovirus strains currently used for cIPV with attenuated strains is preferred. We generated Cold-Adapted Viral Attenuation (CAVA) poliovirus strains by serial passage at low temperature and subsequent genetic engineering, which contain the capsid sequences of cIPV strains combined with a set of mutations identified during cold-adaptation. These viruses displayed a highly temperature sensitive phenotype with no signs of productive infection at 37°C as visualized by electron microscopy. Furthermore, decreases in infectious titers, viral RNA, and protein levels were measured during infection at 37°C, suggesting a block in the viral replication cycle at RNA replication, protein translation, or earlier. However, at 30°C, they could be propagated to high titers (9.4–9.9 Log10TCID50/ml) on the PER.C6 cell culture platform. We identified 14 mutations in the IRES and non-structural regions, which in combination induced the temperature sensitive phenotype, also when transferred to the genomes of other wild-type and attenuated polioviruses. The temperature sensitivity translated to complete absence of neurovirulence in CD155 transgenic mice. Attenuation was also confirmed after extended in vitro passage at small scale using conditions (MOI, cell density, temperature) anticipated for vaccine production. The inability of CAVA strains to replicate at 37°C makes reversion to a neurovirulent phenotype in vivo highly unlikely, therefore, these strains can be considered safe for the manufacture of IPV. The CAVA strains were immunogenic in the Wistar rat potency model for cIPV, inducing high neutralizing antibody titers in a dose-dependent manner in response to D-antigen doses used for cIPV. In combination with the highly productive

  15. Inferior vena cava/aorta diameter index in the assessment of the body fluid status - a comparative study of measurements performed by experienced and inexperienced examiners in a group of young adults.

    PubMed

    Durajska, Kaja; Januszkiewicz, Emilia; Szmygel, Łukasz; Kosiak, Wojciech

    2014-09-01

    The assessment of the body fluid status is one the most challenging tasks in clinical practice. Although there are many methods to assess the body fluid status of patients, none of them is fully satisfactory in contemporary medical sciences. In the article below, we compare the results of measurements performed by experienced and inexperienced examiners based on the inferior vena cava/aorta diameter index in a sonographic hydration assessment. The study enrolled 50 young students at the age of 19-26 (the median age was 22.95) including 27 women and 23 men. The volunteers were examined in the supine position with GE Logiq 7 system and a convex transducer with the frequency of 2-5 MHz. The measurements were performed in the longitudinal and transverse planes by two inexperienced examiners - the authors of this paper, following a four-hour training conducted by an experienced sonographer. The longitudinal values of the inferior vena cava/aorta diameter index obtained in this study were similar to those found in the literature. The reference value for the inferior vena cava/aorta index determined by Kosiak et al., which constituted 1.2 ± 2 SD, for SD = 0.17, was similar to the values obtained by the authors of this paper which equaled 1.2286 ± 2 SD, for SD = 0.2. The article presented below proves that measuring the inferior vena cava/aorta diameter index is not a complex examination and it may be performed by physicians with no sonographic experience. Furthermore, the paper demonstrates that the inferior vena cava/aorta diameter index measured in the transverse plane is similar to the inferior vena cava/aorta diameter index determined in the longitudinal plane. Thus, both measurements may be used interchangeably to assess the hydration status of patients.

  16. 14 CFR 385.7 - Exercise of authority by superiors.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned...

  17. 14 CFR 385.7 - Exercise of authority by superiors.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned...

  18. 14 CFR 385.7 - Exercise of authority by superiors.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned...

  19. 14 CFR 385.7 - Exercise of authority by superiors.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned...

  20. 14 CFR 385.7 - Exercise of authority by superiors.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned...

  1. Monitoring Land Cover Change in the Lake Superior Basin

    EPA Science Inventory

    Lake Superior is the largest freshwater lake in the world by area and the third largest by volume. It is also the most pristine of the Great Lakes (Lake Superior Lakewide Management Plan 2006). Even still, Lake Superior is not without its threats ranging from chemical contamina...

  2. Feeling superior is a bipartisan issue: extremity (not direction) of political views predicts perceived belief superiority.

    PubMed

    Toner, Kaitlin; Leary, Mark R; Asher, Michael W; Jongman-Sereno, Katrina P

    2013-12-01

    Accusations of entrenched political partisanship have been launched against both conservatives and liberals. But is feeling superior about one's beliefs a partisan issue? Two competing hypotheses exist: the rigidity-of-the-right hypothesis (i.e., conservatives are dogmatic) and the ideological-extremism hypothesis (i.e., extreme views on both sides predict dogmatism). We measured 527 Americans' attitudes about nine contentious political issues, the degree to which they thought their beliefs were superior to other people's, and their level of dogmatism. Dogmatism was higher for people endorsing conservative views than for people endorsing liberal views, which replicates the rigidity-of-the-right hypothesis. However, curvilinear effects of ideological attitude on belief superiority (i.e., belief that one's position is more correct than another's) supported the ideological-extremism hypothesis. Furthermore, responses reflecting the greatest belief superiority were obtained on conservative attitudes for three issues and liberal attitudes for another three issues. These findings capture nuances in the relationship between political beliefs and attitude entrenchment that have not been revealed previously. PMID:24096379

  3. Cytoarchitecture of the human superior olivary complex: medial and lateral superior olive.

    PubMed

    Kulesza, Randy J

    2007-03-01

    The superior olivary complex is a group of brainstem nuclei involved in hearing and includes the medial superior olive (MSO) and the lateral superior olive (LSO), surrounded by periolivary cell groups. The structure and functional roles of the MSO and LSO have been the subject of many investigations in laboratory animals and it has largely been assumed that these findings are directly transferable to humans. However, little is known conclusively regarding the detailed organization of the human superior olivary complex. The goal of this study is to provide a detailed analysis of the cytoarchitecture of the human MSO and LSO. Results from the examination of eight human brainstems confirm the existence of a conserved MSO and provide evidence of a prominent and highly ordered LSO. Unbiased stereological estimates of neuronal number indicate approximately 15,500 neurons in the MSO and 5600 neurons in the LSO. Additionally, a three-dimensional model of the MSO and LSO was constructed and provides evidence that the human LSO is composed of medial and lateral segments. Finally, an analysis of neuronal morphology, in Nissl stained and Golgi impregnated tissue, provides evidence of multiple neuronal classes within each nucleus and further that these neurons demonstrate a precise geometric arrangement (depending on the nucleus) that is suggestive of isofrequency laminae.

  4. Lightning activity during the 1999 Superior derecho

    NASA Astrophysics Data System (ADS)

    Price, Colin G.; Murphy, Brian P.

    2002-12-01

    On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators of severe weather.

  5. Lightning Activity During the 1999 Superior Derecho

    NASA Astrophysics Data System (ADS)

    Price, C. G.; Murphy, B. P.

    2002-12-01

    On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators of severe weather.

  6. Superior Colliculus and Visual Spatial Attention

    PubMed Central

    Krauzlis, Richard J.; Lovejoy, Lee P.; Zénon, Alexandre

    2013-01-01

    The superior colliculus (SC) has long been known to be part of the network of brain areas involved in spatial attention, but recent findings have dramatically refined our understanding of its functional role. The SC both implements the motor consequences of attention and plays a crucial role in the process of target selection that precedes movement. Moreover, even in the absence of overt orienting movements, SC activity is related to shifts of covert attention and is necessary for the normal control of spatial attention during perceptual judgments. The neuronal circuits that link the SC to spatial attention may include attention-related areas of the cerebral cortex, but recent results show that the SC's contribution involves mechanisms that operate independently of the established signatures of attention in visual cortex. These findings raise new issues and suggest novel possibilities for understanding the brain mechanisms that enable spatial attention. PMID:23682659

  7. Ankyloglossia superior syndrome: Case report and updated literature review.

    PubMed

    Shay, Sophie; West, Alisha N

    2016-07-01

    Ankyloglossia superior (palatoglossal adhesion) is an extremely rare congenital condition with only 14 previously reported cases. When found in conjunction with other congenital abnormalities, such as cleft palate, gastrointestinal malformations, and limb malformations, this anomaly is considered part of ankyloglossia superior syndrome. We present a case of a newborn female found to have ankyloglossia superior syndrome. Surgical repair is also described. We review the available literature and discuss theories regarding the etiology of ankyloglossia superior syndrome. Clinicians should have a high degree of suspicion for other congenital anomalies when a neonate is found to have ankyloglossia superior.

  8. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

    PubMed

    Petri, Maximilian; Greenspoon, Joshua A; Millett, Peter J

    2015-12-01

    Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability. Promising clinical results have been reported in 1 case series of 23 patients, indicating that superior capsular reconstruction may be a promising tool to manage massive irreparable rotator cuff tears. This article describes our preferred technique for arthroscopic superior capsule reconstruction. PMID:27284506

  9. Primary epithelial tumour in the right atrium of the heart and inferior vena cava in NZR/gd inbred rats; pathology of 18 cases.

    PubMed

    Goodall, C M; Christie, G S; Hurley, J V

    1975-08-01

    In NZR/Gd inbred albino rats, tumours occurred in the right atrium or inferior vena cava of approximately 20 per cent. of untreated animals, of both sexes, over the age of 1 yr. The tumours were centred in the wall of the right atrium in 15 cases, and in the inferior vena cava in another three cases; they appeared to be primary in these sites. The tumours were slowly growing, but eventually malignant. Light- and electron-microscopic study showed the tumours were composed of epithelial alveoli imbedded in a collagenous connective tissue containing spindle cells and thin-walled blood capillaries. The epithelium varied from flat to low columnar, and often secreted mucoid material into the lumina, or sometimes into surrounding tissue. This tumour, for which the name atrio-caval epithelial mesothelioma is suggested, very closely resembles a rare epithelial tumour of the right atrium previously described in humans under a variety of names. An underlying embryological anomaly had been postulated in these tumours in humans, and the occurrence of pathologically similar lesions in high incidence in hearts of NZR/Gd inbred rats should help test the hypothesis of genetic and developmental causes in the genesis of this rare cardiac neoplasm.

  10. Application of BACE1 immobilized enzyme reactor for the characterization of multifunctional alkaloids from Corydalis cava (Fumariaceae) as Alzheimer's disease targets.

    PubMed

    Chlebek, Jakub; De Simone, Angela; Hošťálková, Anna; Opletal, Lubomír; Pérez, Concepción; Pérez, Daniel I; Havlíková, Lucie; Cahlíková, Lucie; Andrisano, Vincenza

    2016-03-01

    In our ongoing study focused on Corydalis cava (Fumariaceae), used in folk medicine in the treatment of memory dysfunctions, we have investigated fifteen previously isolated alkaloids for their potential multifunctional activity on Alzheimer's disease (AD) targets. Determination of ß-site amyloid precursor protein cleaving enzyme 1 (BACE1) inhibition was carried out using a BACE1-Immobilized Enzyme Reactor (IMER) by validating the assay with a multi-well plate format Fluorescence Resonance Energy Transfer (FRET) assay. Seven alkaloids out of fifteen were found to be active, with (-)-corycavamine (3) and (+)-corynoline (5) demonstrating the highest BACE1 inhibition activity, in the micromolar range, in a concentration dependent manner. BACE1-IMER was found to be a valid device for the fast screening of inhibitors and the determination of their potency. In a permeation assay (PAMPA) for the prediction of blood-brain barrier (BBB) penetration, the most active compounds, (-)-corycavamine (3) and (+)-corynoline (5), were found to be able to cross the BBB. Not all compounds showed activity against glycogen synthase kinase-3β (GSK-3β) and casein kinase-1δ (CK-1δ). On the basis of the reported results, we found that some C. cava alkaloids have multifunctional activity against AD targets (prolyl oligopeptidase, cholinesterases and BACE1). Moreover, we tried to elucidate the treatment effectivity (rational use) of its extract in memory dysfunction in folk medicine. PMID:26779945

  11. Application of BACE1 immobilized enzyme reactor for the characterization of multifunctional alkaloids from Corydalis cava (Fumariaceae) as Alzheimer's disease targets.

    PubMed

    Chlebek, Jakub; De Simone, Angela; Hošťálková, Anna; Opletal, Lubomír; Pérez, Concepción; Pérez, Daniel I; Havlíková, Lucie; Cahlíková, Lucie; Andrisano, Vincenza

    2016-03-01

    In our ongoing study focused on Corydalis cava (Fumariaceae), used in folk medicine in the treatment of memory dysfunctions, we have investigated fifteen previously isolated alkaloids for their potential multifunctional activity on Alzheimer's disease (AD) targets. Determination of ß-site amyloid precursor protein cleaving enzyme 1 (BACE1) inhibition was carried out using a BACE1-Immobilized Enzyme Reactor (IMER) by validating the assay with a multi-well plate format Fluorescence Resonance Energy Transfer (FRET) assay. Seven alkaloids out of fifteen were found to be active, with (-)-corycavamine (3) and (+)-corynoline (5) demonstrating the highest BACE1 inhibition activity, in the micromolar range, in a concentration dependent manner. BACE1-IMER was found to be a valid device for the fast screening of inhibitors and the determination of their potency. In a permeation assay (PAMPA) for the prediction of blood-brain barrier (BBB) penetration, the most active compounds, (-)-corycavamine (3) and (+)-corynoline (5), were found to be able to cross the BBB. Not all compounds showed activity against glycogen synthase kinase-3β (GSK-3β) and casein kinase-1δ (CK-1δ). On the basis of the reported results, we found that some C. cava alkaloids have multifunctional activity against AD targets (prolyl oligopeptidase, cholinesterases and BACE1). Moreover, we tried to elucidate the treatment effectivity (rational use) of its extract in memory dysfunction in folk medicine.

  12. [On the venous system in the retroperitoneal region (a contribution to the persistence of the primitive vena cava system) (author's transl)].

    PubMed

    Besier, H; Stofft, E

    1977-01-01

    A vasal anomaly in the region of the Vena cava inferior is being described in the corpse of a 25-year-old man. 1. In the course of development the V. subcardinalis has not been joined to the Pars hepatica of the V. cava inferior, which originates from the V. hepatis revehens communis. In our case the Anastomosis intersubcardinalis remains and is subjected to a slight retroaortal displacement to the left. 2. Among the Vv. sacrocardinales the V. sacrocardinalis sinistra, which ought to involute after the sixth embryonal week, has been retained together with the Anastomosis intersacrocardinalis. 3. The Vv. supracardinales are connected with the intersubcardinal anastomosis and the intersupracardinal transversal anastomosis has been retained. 4. The Vv. caudales end in the Anastomosis sacrocardinalis at a point before the Sacrum and the Anastomosis intercaudalis has been retained, too. 5. The caudal section of the right lower cardinal vein in its prerenal part is retained with an anastomosis to the right subcardinal vein. 6. The portal blood of the liver is directly distributed to the atrium dextrum after it has passed through three Vv. hepaticae. The Lig. venosum is intrahepatic and is joined to the Vv. hepaticae. 7. The primitive bilateral-symmetric veinous system of the caudal half of the body continues to exist almost completely. PMID:603065

  13. Bilateral massive pulmonary thromboembolism in a young patient treated with supportive measures and an inferior vena cava filter with excellent outcome

    PubMed Central

    Sule, Ashish Anil; Chin, Tay J; Pandit, Nihar; Rajendran, Joseph

    2010-01-01

    Acute pulmonary embolism (PE) is a common and often fatal disease with a mortality rate of more than 30% in untreated patients. There is a twofold increase in mortality in patients with massive PEs who do not receive treatment. Recurrent embolism is the most common cause of death. A 48-year-old woman presented to Tan Tock Seng Hospital, Singapore, on December 16, 2009, with a massive pulmonary thromboembolism. She was admitted to the intensive care unit and treated with supportive measures, ventilatory support, antibiotics and ionotropes. The patient was diagnosed with urosepsis with septicemic shock, disseminated intravascular coagulation, acute renal failure, high anion gap metabolic acidosis, iron-deficiency anemia secondary to menorrhagia, and a uterine mass with high cancer antigen 125, although malignancy was ruled out. Anticoagulation or thrombolysis could not be provided in view of coagulopathy. The patient subsequently underwent inferior vena cava filter insertion on December 31, 2009. The patient showed clinical improvement over the next two weeks with antibiotics and supportive measures. If there is a contraindication to anticoagulation or thrombolysis, massive pulmonary thromboembolism should be treated aggressively with supportive measures. Inferior vena cava filter insertion should be instituted early to prevent recurrent PE, which can be fatal. It may take weeks before the patient displays clinical improvement. PMID:22477620

  14. Modulation of some estrogen-responsive genes in the vena cava of ovariectomised Wistar rats by griffonianone C, an isoflavone derived from Millettia griffoniana Baill. (Fabaceae).

    PubMed

    Ketcha Wanda, Germain Jean Magloire; Kretzschmar, Georg; Njamen, Dieudonné; Tagatsing Fotsing, Maurice; Yankep, Emmanuel; Vollmer, Günter

    2010-12-01

    In the present study, we investigated whether griffonianone C (Griff C), extracted from root bark of Millettia griffoniana, changes the expression of several estrogen-responsive genes in the vena cava of ovariectomised rats. For this purpose, we subcutaneously administered Griff C (2, 10, or 20mg/kg/d BW), 17β-estradiol (E2: 10μg/kg/d BW) as positive control, and a vehicle control respectively for three days. Relative expression levels of estrogen receptor α (ERα), progesterone receptor (PR), cyclooxygenase2 (Cox-2), vascular endothelial growth factor (VEGF), VEGF-receptor 2, angiotensin converting enzyme (ACE), endothelial NO synthase (eNOS), proliferating cell nuclear antigen (PCNA) and Ki67 mRNA extracted from the vena cava of these rats were quantified by real-time PCR. Results showed that Griff C up-regulated the expression of PR, ACE, ERα, VEGF, VEGFR2 and Ki67. However, the results of Cox-2, PCNA, and eNOS expression did not reach significance in the E2 and Griff C treated samples. These results show that griffonianone C regulated a few of the analysed genes in a similar fashion than estradiol; however, others showed a different pattern. This suggests that some of the biological effects attributed to M. griffoniana are mediated via ER pathway others may be mediated via other pathways. PMID:20732395

  15. A South Indian Cadaveric Study About the Relationship of Hepatic Segment of Inferior Vena Cava with the Liver

    PubMed Central

    Surendran, Sudarshan; Nelluri, Venu Madhav; Kumar, Naveen; Aithal, Ashwini P

    2016-01-01

    Introduction Inferior Vena Cava (IVC) is the largest vein of the body. It runs vertically upwards in the abdomen, behind the liver. Its course is very constant in relation to liver. However, the amount of liver parenchyma related to it can vary from person to person. The data regarding its course and relations may be very useful to radiologists and surgeons during surgical treatment procedures for Budd-Chiari syndrome, liver carcinoma, liver transplant, venous cannulations and many other clinical procedures. Aim Aim of this study was to document the incidence of straight and curved course of IVC in relation to liver and also to note the pattern in which the liver tissue was related to the IVC. Materials and Methods In the current study, 95 adult cadaveric livers were observed; specifically to study the course/direction of the hepatic segment of IVC in relation to the liver. The extent of liver tissue related to various aspects of IVC was also studied. The course of the IVC was classified as straight and curved; and the relationship of liver parenchyma to the IVC was classified into 6 categories. The data was expressed as percentage incidence. Results In 78.94% cases, the IVC had a straight course in relation to the liver; whereas in 21.06% cases, it had a left sided curve (concavity of the curve towards the caudate lobe) in its course. In 6.31% cases, IVC travelled in a tunnel, being encircled by the liver parenchyma all around; in 36.84% cases, it was covered by liver parenchyma on front and sides so that only posterior surface of IVC was visible; in 3.15% cases it was covered by liver tissue on front, sides and also partly on posterior aspect; in 50.52% of cases, its anterior surface, sides and left edge of the posterior surface was covered by liver tissue; and in 3.15% cases it was covered only from the front by the liver tissue. Conclusion The data being reported here might be useful for surgeons while planning and executing various hepatic surgeries and also

  16. Characterization and Formation of longitudinal pinch-out geometries in turbidite systems: the Peira Cava syncline (Annot Sandstone Formation)

    NASA Astrophysics Data System (ADS)

    daghdevirenian, L. J.; Migeon, S.; Rubino, J.; Gorini, C.

    2013-12-01

    The Grès d'Annot sandstones of Late Eocene/early Oligocene is a well-known example of turbidite accumulations deposited in a foreland basin setting. In such settings, turbidite systems are usually laterally control by syntectonic activity generating lateral pinch-outs of the infilling accumulation against the basin walls. Such tectonic activity together with progradation and retrogradation stages of the whole turbidite system could also lead to local disconnection between the continental-slope and the basin deposits and to the formation of sealed potential sand-rich reservoirs. The aim of the work is to better constrain how turbidite systems pinch out longitudinally, in both upstream and downstream directions and to characterize some typical lithofacies evolutions. Our work focused on the Peîra Cava syncline (Maritime Alps, France) where particles are sourced from the Maures, Esterel and Corso-Sarde mountains and flow towards the north following structurally-controlled conduits. Thirty lithological logs 100-m thick were acquired following the western N170-trending side of the syncline. Correlations made between the various sections allowed reconstructing the topography of the top of the blue marls that existed before the emplacement of the turbidite accumulation. This reconstruction revealed the occurrence of two types of longitudinal pinch-out geometries against relatively high-slope angles, and trending either downcurrent or upcurrent. The strongest evolution of depositional facies is observed close to upstream pinch-out surfaces. Here, turbidite deposits thin and fine longitudinally while cohesive debris-flow deposits stop over distances as short as 200 m. Then, going upward in the serie above the pinch-out surface, both turbidite and debris-flow deposits are lesser affected and finally become continuous. These observations allowed defining a depositional model for gravity flows within a confined basin. It revealed similarities with the "fill and spill" model

  17. Carbon phosphide monolayers with superior carrier mobility.

    PubMed

    Wang, Gaoxue; Pandey, Ravindra; Karna, Shashi P

    2016-04-28

    Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great promise for applications in high-performance electronics and optoelectronics. PMID:27067002

  18. Morphological characteristics of the superior cerebellar artery.

    PubMed

    Dodevski, A; Tosovska Lazarova, D; Zhivadinovik, J; Lazareska, M; Stojovska-Jovanovska, E

    2015-01-01

    With the introduction of new techniques in diagnostic and interventional radiology and progress in micro neurosurgery, accurate knowledge of the brain blood vessels is essential for daily clinical work. The aim of this study was to describe the morphological characteristics of the superior cerebellar artery and to emphasize their clinical significance. In this study we examined radiographs of 109 patients who had CT angiography at the University Clinic for Radiology in Skopje, R. Macedonia. This study included 49 females and 60 males, ranging in age from 27 to 83 years; mean age 57.4 ± 11.8 years. In 105 patients SCA arose from the basilar artery on both sides as a single vessel. In two patients SCA arose as a duplicate trunk from the basilar artery. We found unilateral duplication on the right SCA in one patient, and bilateral duplication in one patient. In two patients was noticed origin of the SCA from PCA as a single trunk from adult type of the PCA. Through knowledge of the anatomy and variations of SCA is important for clinicians as well as basic scientists who deal with problems related to intracranial vasculature in daily basis for save performance of diagnostic and interventional procedures. PMID:26076777

  19. Morphological characteristics of the superior cerebellar artery.

    PubMed

    Dodevski, A; Tosovska Lazarova, D; Zhivadinovik, J; Lazareska, M; Stojovska-Jovanovska, E

    2015-01-01

    With the introduction of new techniques in diagnostic and interventional radiology and progress in micro neurosurgery, accurate knowledge of the brain blood vessels is essential for daily clinical work. The aim of this study was to describe the morphological characteristics of the superior cerebellar artery and to emphasize their clinical significance. In this study we examined radiographs of 109 patients who had CT angiography at the University Clinic for Radiology in Skopje, R. Macedonia. This study included 49 females and 60 males, ranging in age from 27 to 83 years; mean age 57.4 ± 11.8 years. In 105 patients SCA arose from the basilar artery on both sides as a single vessel. In two patients SCA arose as a duplicate trunk from the basilar artery. We found unilateral duplication on the right SCA in one patient, and bilateral duplication in one patient. In two patients was noticed origin of the SCA from PCA as a single trunk from adult type of the PCA. Through knowledge of the anatomy and variations of SCA is important for clinicians as well as basic scientists who deal with problems related to intracranial vasculature in daily basis for save performance of diagnostic and interventional procedures.

  20. Text legibility and the letter superiority effect.

    PubMed

    Sheedy, James E; Subbaram, Manoj V; Zimmerman, Aaron B; Hayes, John R

    2005-01-01

    Effects of font design and electronic display parameters upon text legibility were determined using a threshold size method. Participants' visual acuity (inverse of the minimum detection size, representing the threshold legibility for each condition) was measured using upper- and lowercase letters and lowercase words in combinations of 6 fonts, 3 font-smoothing modes, 4 font sizes, 10 pixel heights, and 4 stroke widths. Individual lowercase letters were 10% to 20% more legible than lowercase words (i.e., lowercase words must be 10%-20% larger to have the same threshold legibility). This letter superiority effect suggests that individual letters play a large role and word shape plays a smaller role, if any, in word identification at threshold. Pixel height, font, stroke width, and font smoothing had significant main effects on threshold legibility. Optimal legibility was attained at 9 pixels (10 points). Verdana and Arial were the most legible fonts; Times New Roman and Franklin were least legible. Subpixel rendering (ClearType) improved threshold legibility for some fonts and, in combination with Verdana, was the most legible condition. Increased stroke width (bold) improved threshold legibility but only at the thinnest width tested. Potential applications of this research include optimization of font design for legibility and readability. PMID:16553067

  1. Functioning pancreas graft with thromboses of splenic and superior mesenteric arteries after simultaneous pancreas-kidney transplantation: a case report.

    PubMed

    Matsumoto, I; Shinzeki, M; Asari, S; Goto, T; Shirakawa, S; Ajiki, T; Fukumoto, T; Ku, Y

    2014-04-01

    Graft thrombosis is the most common cause of early graft loss after pancreas transplantation. The grafted pancreas is difficult to salvage after complete thrombosis, especially arterial thrombosis, and graft pancreatectomy is required. We describe a patient presenting with a functioning pancreas graft with thromboses of the splenic artery (SA) and superior mesenteric artery (SMA) after simultaneous pancreas-kidney transplantation (SPK). A 37-year-old woman with a 20-year history of type 1 diabetes mellitus underwent SPK. The pancreaticoduodenal graft was implanted in the right iliac fossa with enteric drainage. A Carrel patch was anastomosed to the recipient's right common iliac artery, and the graft gastroduodenal artery was anastomosed to the common hepatic artery using an arterial I-graft. The donor portal vein was anastomosed to the recipient's inferior vena cava. Four days after surgery, graft thromboses were detected by Doppler ultrasound without increases in the serum amylase and blood glucose levels. Contrast enhanced computed tomography revealed thromboses in the SA, splenic vein and SMA. Selective angiography showed that blood flow was interrupted in the SA and SMA. However, pancreatic graft perfusion was maintained by the I-graft in the head of the pancreas and the transverse pancreatic artery in the body and tail of the pancreas. We performed percutaneous direct thrombolysis and adjuvant thrombolytic therapy. However, we had to stop the thrombolytic therapy because of gastrointestinal hemorrhage. Thereafter, the postoperative course was uneventful and the pancreas graft was functioning with a fasting blood glucose level of 75 mg/dL, HbA1c of 5.1%, and serum C-peptide level of 1.9 ng/mL at 30 months post-transplantation.

  2. The middle suprarenal artery arising from the superior mesenteric artery.

    PubMed

    Honma, Satoru; Kudo, Motoi

    2012-01-01

    We observed a rare case of the middle suprarenal artery branching out from the superior mesenteric artery in a 78-year-old male. This atypical artery enters the right suprarenal gland that was also supplied by the superior and the inferior suprarenal arteries as usual. In embryonic stages, vasculature of the vitelline system and the gonadal system is differentially organized. The superior mesenteric artery has been generally thought to be pure vitelline, since there has been no evidence that the superior mesenteric artery supplies other organs than digestive. We then speculate that the present middle suprarenal artery is a remnant of the embryonic gonadal artery from the superior mesenteric artery, whereas a stem artery to the testis disappeared. Surgeons should take notice of the middle suprarenal artery when operations are conducted around the superior mesenteric artery.

  3. Carbon phosphide monolayers with superior carrier mobility

    NASA Astrophysics Data System (ADS)

    Wang, Gaoxue; Pandey, Ravindra; Karna, Shashi P.

    2016-04-01

    Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great promise for applications in high-performance electronics and optoelectronics.Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great

  4. Vocal premotor activity in the superior colliculus.

    PubMed

    Sinha, Shiva R; Moss, Cynthia F

    2007-01-01

    Chronic neural recordings were taken from the midbrain superior colliculus (SC) of echolocating bats while they were engaged in one of two distinct behavioral tasks: virtual target amplitude discrimination (VTAD) and real oscillating target tracking (ROTT). In the VTAD task, bats used a limited range of sonar call features to discriminate the amplitude category of echoes, whereas in the ROTT task, the bat produced dynamically modulated sonar calls to track a moving target. Newly developed methods for chronic recordings in unrestrained, behaving bats reveal two consistent bouts of SC neural activity preceding the onset of sonar vocalizations in both tasks. A short lead bout occurs tightly coupled to vocal onset (VTAD, -5.1 to -2.2 ms range, -3.6 +/- 0.7 ms mean lead time; ROTT, -3.0 to + 0.4 ms range, -1.2 +/- 1.3 ms mean lead time), and this activity may play a role in marking the time of each sonar emission. A long lead bout in SC activity occurs earlier and spreads over a longer interval (VTAD, -40.6 to -8.4 ms range, -22.2 +/- 3.9 ms mean lead time; ROTT, -29.8 to -7.1 ms range, -17.5 +/- 9.1 ms mean lead time) when compared with short lead events. In the goal-directed ROTT task, the timing of long lead event times vary with the bat's sonar call duration. This finding, along with behavioral studies demonstrating that bats adjust sonar call duration as they track targets at changing distance, suggests the bat SC contributes to range-dependent adjustments of sonar call duration. PMID:17202477

  5. Superior temporal gyrus, language function, and autism.

    PubMed

    Bigler, Erin D; Mortensen, Sherstin; Neeley, E Shannon; Ozonoff, Sally; Krasny, Lori; Johnson, Michael; Lu, Jeffrey; Provencal, Sherri L; McMahon, William; Lainhart, Janet E

    2007-01-01

    Deficits in language are a core feature of autism. The superior temporal gyrus (STG) is involved in auditory processing, including language, but also has been implicated as a critical structure in social cognition. It was hypothesized that subjects with autism would display different size-function relationships between the STG and intellectual-language-based abilities when compared to controls. Intellectual ability was assessed by either the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) or Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), where three intellectual quotients (IQ) were computed: verbal (VIQ), performance (PIQ), and full-scale (FSIQ). Language ability was assessed by the Clinical Evaluation of Language Fundamentals-Third Edition (CELF-3), also divided into three index scores: receptive, expressive, and total. Seven to 19-year-old rigorously diagnosed subjects with autism (n = 30) were compared to controls (n = 39; 13 of whom had a deficit in reading) of similar age who were matched on education, PIQ, and head circumference. STG volumes were computed based on 1.5 Tesla magnetic resonance imaging (MRI). IQ and CELF-3 performance were highly interrelated regardless of whether subjects had autism or were controls. Both IQ and CELF-3 ability were positively correlated with STG in controls, but a different pattern was observed in subjects with autism. In controls, left STG gray matter was significantly (r = .42, p < or = .05) related to receptive language on the CELF-3; in contrast, a zero order correlation was found with autism. When plotted by age, potential differences in growth trajectories related to language development associated with STG were observed between controls and those subjects with autism. Taken together, these findings suggest a possible failure in left hemisphere lateralization of language function involving the STG in autism.

  6. The Business Value of Superior Energy Performance

    SciTech Connect

    McKane, Aimee; Scheihing, Paul; Evans, Tracy; Glatt, Sandy; Meffert, William

    2015-08-04

    Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing the collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.

  7. Vocal premotor activity in the superior colliculus.

    PubMed

    Sinha, Shiva R; Moss, Cynthia F

    2007-01-01

    Chronic neural recordings were taken from the midbrain superior colliculus (SC) of echolocating bats while they were engaged in one of two distinct behavioral tasks: virtual target amplitude discrimination (VTAD) and real oscillating target tracking (ROTT). In the VTAD task, bats used a limited range of sonar call features to discriminate the amplitude category of echoes, whereas in the ROTT task, the bat produced dynamically modulated sonar calls to track a moving target. Newly developed methods for chronic recordings in unrestrained, behaving bats reveal two consistent bouts of SC neural activity preceding the onset of sonar vocalizations in both tasks. A short lead bout occurs tightly coupled to vocal onset (VTAD, -5.1 to -2.2 ms range, -3.6 +/- 0.7 ms mean lead time; ROTT, -3.0 to + 0.4 ms range, -1.2 +/- 1.3 ms mean lead time), and this activity may play a role in marking the time of each sonar emission. A long lead bout in SC activity occurs earlier and spreads over a longer interval (VTAD, -40.6 to -8.4 ms range, -22.2 +/- 3.9 ms mean lead time; ROTT, -29.8 to -7.1 ms range, -17.5 +/- 9.1 ms mean lead time) when compared with short lead events. In the goal-directed ROTT task, the timing of long lead event times vary with the bat's sonar call duration. This finding, along with behavioral studies demonstrating that bats adjust sonar call duration as they track targets at changing distance, suggests the bat SC contributes to range-dependent adjustments of sonar call duration.

  8. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    PubMed Central

    Akgül, Turgut; Bayraktar, Adem; Dikici, Fatih; Balık, Emre

    2014-01-01

    Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment. PMID:25405053

  9. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspectives

    PubMed Central

    Aggarwal, Neelam; Gadhinglajkar, Shrinivas; Sreedhar, Rupa; Dharan, Baiju S.; Chigurupati, Keerthi; Babu, Saravana

    2016-01-01

    Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperative events were recorded from the medical records. The categorical variables and the continuous variables were expressed as number (percentages) and mean ± SD respectively. Results: A total of 35 patients were operated for Warden repair during the study period. Anesthesia was induced with the aim to prevent any fall in pulmonary vascular resistance. The right internal jugular vein was cannulated under ultrasound guidance using a short length cannula to monitor right superior vena cava pressure. Intraoperative TEE revealed the drainage of PAPVC high into RSVC in 22 patients. Persistent LSVC was found in 9 patients. After repair, TEE imaging detected a high gradient at Warden anastomotic site in 5 patients and 3 of them required revision of surgery. Rerouted pulmonary veins required surgical correction in 2 patients in view of obstruction. None of them had pulmonary venous and SVC obstruction in the postoperative period. Conclusion: The primary aim of anesthesia is to avoid any fall in PVR. Right IJV cannulation can be beneficial. The intraoperative TEE can help in delineating the anatomy of lesion and detecting anastomotic site obstruction. PMID:27052072

  10. Food of lake trout in Lake Superior

    USGS Publications Warehouse

    Dryer, William R.; Erkkila, Leo F.; Tetzloff, Clifford L.

    1965-01-01

    Stomachs were examined from 1,492 lake trout and 83 siscowets collected from Lake Superior. Data are given on the food of lake trout of legal size (17 inches or longer) by year, season, and depth of water, and on the relation between food and size among smaller lake trout. Fish contributed 96.7 to 99.9 per cent of the total volume of food in the annual samples. Ciscoes (Coregonus spp.) were most common (52.2 to 87.5 per cent of the volume) in 1950 to 1953 and American smelt ranked first (65.6 per cent of the volume) in 1963. Cottids were in 8.9 to 12.3 per cent of the stomachs in 1950 to 1953 but in only 4.3 per cent in 1963. Insects ranked second to fish in occurrence (9.6 per cent for the combined samples) and crustaceans followed at 3.9 per cent. The greatest seasonal changes in the food of lake trout were among fish caught at 35 fathoms and shallower. The occurrence of Coregonus increased from 34.6 per cent in February-March to 71.1 per cent in October-December. Smelt were in 76.9 per cent of the stomachs in February-March but in only 2.2 per cent in October-December. Cottids, Mysis relicta, and insects were most common in the July-September collections. Lake trout taken at depths greater than 35 fathoms had eaten a higher percentage of Cottidae and Coregonus than had those captured in shallower water. Smelt, ninespine sticklebacks, Mysis, and insects were more frequent in stomachs of lake trout from less than 35 fathoms. Crustaceans comprised more than 70 per cent of the total volume of food for 4.0- to 7.9-inch lake trout but their importance decreased as the lake trout grew larger. Pontoporeia affinis was the most common in the stomachs of 4.0- to 6.9-inch lake trout and Mysis held first rank at 7.0 to 12.9 inches. Ostracods were important only to 4.0- to 4.9-inch lake trout. As the lake trout became larger, the importance of fish grew from 4.4-per cent occurrence at 5.0 to 5.9 inches to 93.9 per cent at 16.0 to 16.9 inches. Smelt were most commonly eaten by

  11. Crashworthy Seats Would Afford Superior Protection

    NASA Technical Reports Server (NTRS)

    Gohmert, Dustin

    2009-01-01

    Seats to prevent or limit crash injuries to astronauts aboard the crew vehicle of the Orion spacecraft are undergoing development. The design of these seats incorporates and goes beyond crash-protection concepts embodied in prior spacecraft and racing-car seats to afford superior protection against impacts. Although the seats are designed to support astronauts in a recumbent, quasi-fetal posture that would likely not be suitable for non-spacecraft applications, parts of the design could be adapted to military and some civilian aircraft seats and to racing car seats to increase levels of protection. The main problem in designing any crashworthy seat is to provide full support of the occupant against anticipated crash and emergency-landing loads so as to safely limit motion, along any axis, of any part of the occupant s body relative to (1) any other part of the occupant s body, (2) the spacecraft or other vehicle, and (3) the seat itself. In the original Orion spacecraft application and in other applications that could easily be envisioned, the problem is complicated by severe limits on space available for the seat, a requirement to enable rapid egress by the occupant after a crash, and a requirement to provide for fitting of the seat to a wide range of sizes and shapes of a human body covered by a crash suit, space suit, or other protective garment. The problem is further complicated by other Orion-application-specific requirements that must be omitted here for the sake of brevity. To accommodate the wide range of crewmember body lengths within the limits on available space in the original Orion application, the design provides for taller crewmembers to pull their legs back closer toward their chests, while shorter crewmembers can allow their legs to stretch out further. The range of hip-support seat adjustments needed to effect this accommodation, as derived from NASA s Human Systems Integration Standard, was found to define a parabolic path along which the knees

  12. Word superiority, pseudoword superiority, and learning to read: a comparison of dyslexic and normal readers.

    PubMed

    Grainger, Jonathan; Bouttevin, Sébastien; Truc, Cathy; Bastien, Mireille; Ziegler, Johannes

    2003-12-01

    Identification of letters embedded in briefly presented words (e.g., TABLE), pseudowords (e.g., TOBLE), and illegal nonwords (e.g., TPBFE) was measured using the Reicher-Wheeler paradigm. Children diagnosed as dyslexic and showing a clear disadvantage in recognizing and reading aloud words and pseudowords (compared to chronological age-matched controls) showed a pattern of results that was qualitatively identical to both reading age and chronological age control children. In all three groups a small nonsignificant advantage was obtained for letter identification in words compared to pseudowords, and a massive advantage for letter identification in pseudowords compared to illegal nonwords. A group of adult participants tested with the same materials showed the classic word superiority effect as well as a pseudoword advantage over illegal nonwords. These results suggest that the pseudoword superiority effect is subtended by regularities operating at the level of sublexical orthographic representations (orthotactic constraints). This phenomenon could provide a useful tool for future investigations of the development of orthotactic constraints during reading acquisition. PMID:14642545

  13. The Development of the Picture-Superiority Effect

    ERIC Educational Resources Information Center

    Whitehouse, Andrew J. O.; Maybery, Murray T.; Durkin, Kevin

    2006-01-01

    When pictures and words are presented serially in an explicit memory task, recall of the pictures is superior. While this effect is well established in the adult population, little is known of the development of this picture-superiority effect in typical development. This task was administered to 80 participants from middle childhood to…

  14. [Aneurysm of the superior mesenteric artery in a child].

    PubMed

    Michalský, R

    2000-12-01

    A case report of the ruptured aneurysma of the superior mesenteric artery at 12-year-old girl which was successfully treated by resection and substitution by means of venous graft. There is illustrated good long-term result more than 7 years after operation. Superior mesenteric artery aneurysma diagnosis in childhood is very rare.

  15. 33 CFR 117.495 - Superior Oil Canal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Superior Oil Canal. 117.495 Section 117.495 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.495 Superior Oil Canal. The draw...

  16. Retrograde superior mesenteric artery stenting for acute mesenteric arterial thrombosis.

    PubMed

    Do, Natalie; Wisniewski, Paul; Sarmiento, Jose; Vo, Trung; Aka, Paul K; Hsu, Jeffrey H; Tayyarah, Majid

    2010-08-01

    Retrograde superior mesenteric artery stenting (ROMS) represents a significant development in the treatment of acute mesenteric ischemia. Compared to traditional surgical mesenteric bypass, ROMS is a less invasive technique that avoids many complications associated with emergent mesenteric bypass. This case report illustrates that retrograde superior mesenteric artery (SMA) stenting is an option for the treatment of acute mesenteric ischemia for patients in extremis.

  17. 33 CFR 117.495 - Superior Oil Canal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Superior Oil Canal. 117.495 Section 117.495 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.495 Superior Oil Canal. The draw...

  18. 33 CFR 117.495 - Superior Oil Canal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Superior Oil Canal. 117.495 Section 117.495 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.495 Superior Oil Canal. The draw...

  19. 33 CFR 117.495 - Superior Oil Canal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Superior Oil Canal. 117.495 Section 117.495 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.495 Superior Oil Canal. The draw...

  20. FORAGE FISH AND ZOOPLANKTON COMMUNITY COMPOSITION IN WESTERN LAKE SUPERIOR

    EPA Science Inventory

    We assessed the abundance, size, and species composition of the fish and zooplankton communities of western Lake Superior during 1996 and 1997. Data were analyzed for 3 ecoregions (Duluth-Superior (1), Apostle Islands (2), Minnesota coast (3) differing in lake bathymetry, phsiodo...

  1. 77 FR 48856 - Safety Zone; Superior Bay, Duluth, MN

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... Department of Homeland Security FR Federal Register NPRM Notice of Proposed Rulemaking A. Regulatory History... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Superior Bay, Duluth, MN AGENCY: Coast... Zone; Superior Bay, Duluth, MN. (a) Location. The following area is a temporary safety zone: All...

  2. Usefulness of ultrasonographic measurement of the diameter of the inferior vena cava to predict responsiveness to intravascular fluid administration in patients with cancer

    PubMed Central

    Arredondo-Armenta, Juan M.; Guevara-García, Humberto; Barragán-Dessavre, Mireya; García-Guillén, Francisco J.; Sánchez-Hurtado, Luis A.; Córdova-Sánchez, Bertha; Bautista-Ocampo, Andoreni R.; Herrera-Gómez, Angel; Meneses-García, Abelardo

    2016-01-01

    We conducted an observational, longitudinal prospective study in which we measured the diameters of the inferior vena cava (IVC) of 47 patients using ultrasonography. The aim of our study was to assess the state of blood volume and to determine the percentage of patients who responded to intravascular volume expansion. Only 17 patients (36%) responded to fluid management. A higher number of responding patients had cardiovascular failure compared with nonresponders (82% vs. 50%, P = 0.03). Among the patients with cardiovascular failure, the probability of finding responders was 4.6 times higher than that of not finding responders (odds ratio, 4.66; 95% confidence interval, 1.10–19.6; P = 0.04). No significant difference was observed in the mortality rate between the two groups (11% vs. 23%, P = 0.46). In conclusion, responding to intravascular volume expansion had no impact on patient survival in the intensive care unit. PMID:27695165

  3. Catheter-Directed Thrombolysis of Acute Deep Vein Thrombosis in the Lower Extremity of a Child with Interrupted Inferior Vena Cava

    SciTech Connect

    Oguzkurt, Levent Ozkan, Ugur; Tercan, Fahri; Koc, Zafer

    2007-04-15

    We present the case of a 14-year-old girl who developed acute deep vein thrombosis (DVT) in her right lower extremity. Laboratory testing revealed protein S deficiency, and the patient's father also had this abnormality with a history of lower extremity DVT. Manual thromboaspiration followed by catheter-directed thrombolysis resulted in total clearance of all thrombi. Computed tomography and later venography revealed an interrupted inferior vena cava. Catheter-directed thrombolysis is an established treatment for adults with acute DVT. To the best of our knowledge, this report is the first to describe catheter-directed thrombolysis in a pediatric patient with lower extremity DVT. Our results suggest that catheter-directed thrombolysis is safe and effective for use in selected older children and adolescents with acute DVT in the lower extremity.

  4. Usefulness of ultrasonographic measurement of the diameter of the inferior vena cava to predict responsiveness to intravascular fluid administration in patients with cancer

    PubMed Central

    Arredondo-Armenta, Juan M.; Guevara-García, Humberto; Barragán-Dessavre, Mireya; García-Guillén, Francisco J.; Sánchez-Hurtado, Luis A.; Córdova-Sánchez, Bertha; Bautista-Ocampo, Andoreni R.; Herrera-Gómez, Angel; Meneses-García, Abelardo

    2016-01-01

    We conducted an observational, longitudinal prospective study in which we measured the diameters of the inferior vena cava (IVC) of 47 patients using ultrasonography. The aim of our study was to assess the state of blood volume and to determine the percentage of patients who responded to intravascular volume expansion. Only 17 patients (36%) responded to fluid management. A higher number of responding patients had cardiovascular failure compared with nonresponders (82% vs. 50%, P = 0.03). Among the patients with cardiovascular failure, the probability of finding responders was 4.6 times higher than that of not finding responders (odds ratio, 4.66; 95% confidence interval, 1.10–19.6; P = 0.04). No significant difference was observed in the mortality rate between the two groups (11% vs. 23%, P = 0.46). In conclusion, responding to intravascular volume expansion had no impact on patient survival in the intensive care unit.

  5. Pharmacomechanical thrombectomy and catheter-directed thrombolysis of acute lower extremity deep venous thrombosis in a 9-year-old boy with inferior vena cava atresia.

    PubMed

    Hamidian Jahromi, Alireza; Coulter, Amy H; Bass, Patrick; Zhang, Wayne W; Tan, Tze-Woei

    2015-04-01

    Lower extremity deep venous thrombosis (DVT) is uncommon in the pediatric population, but it can be associated with severe symptoms and potential long-term morbidity secondary to post-thrombotic syndrome. Inferior vena cava (IVC) atresia can predispose a patient to the development of extremity DVT. There is no clear consensus on optimal management of extensive extremity DVT in pediatric patients, especially in patients with IVC anomalies. We report a case of iliofemoral DVT in a 9-year-old boy with IVC atresia and presumed protein S deficiency that was treated successfully using pharmacomechanical thrombectomy and catheter-directed thrombolysis. He was maintained on long-term anticoagulation and remained symptom free at 6 months' follow-up.

  6. Phlegmasia Caerulea Dolens in a Patient With an Inferior Vena Cava Filter: Treatment of Massive Iliocaval Thrombosis Using Local Intravenous Catheter-Directed Thrombolysis

    SciTech Connect

    Cookson, Daniel; Caldwell, Stuart

    2012-10-15

    Phlegmasia caerulea dolens (PCD) is a potentially disastrous complication of inferior vena cava filter insertion, and its optimum management has not been clearly established. We present a case report of a patient with pulmonary embolism and acute adrenal haemorrhage who developed PCD secondary to massive iliocaval thrombosis after insertion of a Cook Celect removable filter. Local intravenous catheter-directed thrombolysis (CDT), followed by systemic anticoagulation, achieved limb salvage and virtual resolution of symptoms at 3 months without complications. CDT can be a successful primary treatment of filter-associated PCD and can be safe in selected patients with acute nontraumatic haemorrhage. Systemic anticoagulation may subsequently restore complete venous patency and may therefore be a useful approach to postthrombolysis management of residual iliocaval thrombus when filter removal is indicated.

  7. RELEASE OF MERCURY FROM MINE RESIDUES INTO LAKE SUPERIOR

    EPA Science Inventory

    Using recent compilations of mine production and discharge rates, we will demonstrate that the cumulative Hg inputs to Lake Superior from mining activities are much higher than from atmosphereic deposition.

  8. Superior Mesenteric Artery Embolism Treated with Percutaneous Mechanical Thrombectomy

    SciTech Connect

    Popovic, Peter Kuhelj, Dimitrij; Bunc, Matjaz

    2011-02-15

    A case of acute superior mesenteric artery embolism treated with percutaneous thrombus aspiration is described. A 63-year-old man with chronic atrial fibrillation was admitted to the hospital with progressive abdominal pain. Computed tomography angiography revealed an occlusion of the distal part of the superior mesenteric artery. The patient was effectively treated using transaxillary percutaneous mechanical thrombectomy using a 6F Aspirex thrombectomy catheter.

  9. The eyes are sufficient to produce a threat superiority effect.

    PubMed

    Fox, Elaine; Damjanovic, Ljubica

    2006-08-01

    The research described in this article used a visual search task and demonstrated that the eye region alone can produce a threat superiority effect. Indeed, the magnitude of the threat superiority effect did not increase with whole-face, relative to eye-region-only, stimuli. The authors conclude that the configuration of the eyes provides a key signal of threat, which can mediate the search advantage for threat-related facial expressions.

  10. 2. View of pier #3, West approach, Detroit Superior High ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View of pier #3, West approach, Detroit Superior High Level bridge (1914-1917). Pier #3 and #4 support the steel rive span. They are 116 feet by 80 feet at the base and rest on stiff blue clay 45 feet below the surface of the river. Cast-steel bolsters of the three-hinge steel arch are anchored by structural steel grillage to the masory piers. - Detroit Superior High Level Bridge, Cleveland, Cuyahoga County, OH

  11. Superior memorizers employ different neural networks for encoding and recall.

    PubMed

    Mallow, Johannes; Bernarding, Johannes; Luchtmann, Michael; Bethmann, Anja; Brechmann, André

    2015-01-01

    Superior memorizers often employ the method of loci (MoL) to memorize large amounts of information. The MoL, known since ancient times, relies on a complex process where information to be memorized is bound to landmarks along mental routes in a previously memorized environment. However, functional magnetic resonance imaging data on groups of trained superior memorizer are rare. Based on the memorizing strategy reported by superior memorizers, we developed a scheme of the processes successively employed during memorizing and recalling digits and relate these to brain activation that is specific for the encoding and recall period. In the examined superior memorizers several regions, suggested to be involved in mental navigation and digit-to-word processing, were specifically activated during encoding: bilateral early visual cortex, retrosplenial cortex, left parahippocampus, left visual cortex, and left superior parietal cortex. Although the scheme suggests that some steps during encoding and recall seem to be analog, none of the encoding areas were specifically activated during the recall. Instead, we found strong activation in left anterior superior temporal gyrus, which we relate to recalling the sequential order of the digits, and right motor cortex that may be related to reciting the digits.

  12. Superior memorizers employ different neural networks for encoding and recall.

    PubMed

    Mallow, Johannes; Bernarding, Johannes; Luchtmann, Michael; Bethmann, Anja; Brechmann, André

    2015-01-01

    Superior memorizers often employ the method of loci (MoL) to memorize large amounts of information. The MoL, known since ancient times, relies on a complex process where information to be memorized is bound to landmarks along mental routes in a previously memorized environment. However, functional magnetic resonance imaging data on groups of trained superior memorizer are rare. Based on the memorizing strategy reported by superior memorizers, we developed a scheme of the processes successively employed during memorizing and recalling digits and relate these to brain activation that is specific for the encoding and recall period. In the examined superior memorizers several regions, suggested to be involved in mental navigation and digit-to-word processing, were specifically activated during encoding: bilateral early visual cortex, retrosplenial cortex, left parahippocampus, left visual cortex, and left superior parietal cortex. Although the scheme suggests that some steps during encoding and recall seem to be analog, none of the encoding areas were specifically activated during the recall. Instead, we found strong activation in left anterior superior temporal gyrus, which we relate to recalling the sequential order of the digits, and right motor cortex that may be related to reciting the digits. PMID:26441560

  13. Design of a fifth generation air superiority fighter

    NASA Astrophysics Data System (ADS)

    Atique, Md. Saifuddin Ahmed; Barman, Shuvrodeb; Nafi, Asif Shahriar; Bellah, Masum; Salam, Md. Abdus

    2016-07-01

    Air Superiority Fighter is considered to be an effective dogfighter which is stealthy & highly maneuverable to surprise enemy along with improve survivability against the missile fire. This new generation fighter aircraft requires fantastic aerodynamics design, low wing loading (W/S), high thrust to weight ratio (T/W) with super cruise ability. Conceptual design is the first step to design an aircraft. In this paper conceptual design of an Air Superiority Fighter Aircraft is proposed to carry 1 crew member (pilot) that can fly at maximum Mach No of 2.3 covering a range of 1500 km with maximum ceiling of 61,000 ft. Payload capacity of this proposed aircraft is 6000 lb that covers two advanced missiles & one advanced gun. The Air Superiority Fighter Aircraft was designed to undertake all the following missions like: combat air petrol, air to air combat, maritime attack, close air support, suppression, destruction of enemy air defense and reconnaissance.

  14. Status of the shortjaw cisco (Coregonus zenithicus) in Lake Superior

    USGS Publications Warehouse

    Hoff, Michael H.; Todd, Thomas N.

    2004-01-01

    The shortjaw cisco (Coregonus zenithicus) was historically found in Lakes Huron, Michigan, and Superior, but has been extirpated in Lakes Huron and Michigan apparently as the result of commercial overharvest. During 1999-2001, we conducted an assessment of shortjaw cisco abundance in five areas, spanning the U.S. waters of Lake Superior, and compared our results with the abundance measured at those areas in 1921-1922. The shortjaw cisco was found at four of the five areas sampled, but abundances were so low that they were not significantly different from zero. In the four areas where shortjaw ciscoes were found, abundance declined significantly by 99% from the 1920s to the present. To increase populations of this once economically and ecologically important species in Lake Superior, an interagency rehabilitation effort is needed. Population monitoring is recommended to assess population trends and to evaluate success of rehabilitation efforts.

  15. Superior gluteal nerve: safe area in hip surgery.

    PubMed

    Pérez, M Miguel; Llusá, M; Ortiz, J-C; Lorente, M; Lopez, I; Lazaro, A; Pérez, A; Götzens, V

    2004-06-01

    Injuries to the superior gluteal nerve are very bad complications in hip surgery. An exact knowledge of its course may be helpful in avoiding such problems. Nineteen half pelvises from ten male and female adult cadavers were dissected. Dissections revealed that the nerve divided into two (89.48%) or three (10.52%) branches after leaving the pelvis. The more caudal branch was responsible for innervation of tensor fascia latae. The distance and the angle from the entry points of all branches of the superior gluteal nerve into the deep surface of the gluteus medium and minimus muscles to the mid-point of the superior border of the greater trochanter were measured. The branch that innerved the tensor fascia latae was also followed. These data were subjected to several statistical tests. Based on these findings, and in order to prevent nerve damage, we propose to define a 2-3 cm safe area above the great trochanter.

  16. Revealing the superior perceptibility of words in Arabic.

    PubMed

    Jordan, Timothy R; Paterson, Kevin B; Almabruk, Abubaker A A

    2010-01-01

    When alphabetic stimuli are presented very briefly, people perceive real words better than nonwords. It is generally accepted that this word superiority effect reflects the efficiency of visual word perception. However, much of what is known about this effect comes from research conducted in languages using the Latin alphabet (eg English, French, Italian), and little is known about whether alphabetic languages with visual properties fundamentally different from Latinate languages also produce word superiority effects. We report an experiment in which stimuli (words, illegal nonwords, and pseudowords) were presented in Arabic, which is a cursive script, read from right to left. The findings revealed advantages for words over pseudowords and illegal nonwords, and for pseudowords over illegal nonwords, indicating that the superiority effects reported for Latinate languages are also observed in Arabic. Implications of these findings for understanding the processes involved in word recognition are discussed. PMID:20465177

  17. Movements of adult lake trout in Lake Superior

    USGS Publications Warehouse

    Rahrer, Jerold F.

    1968-01-01

    Returns from mature lake trout (Salvelinus namaycush) tagged in western Lake Superior in 1959 and 1962-65 described here suggest that trout disperse widely from the spawning grounds after spawning and return in subsequent years. Although the data were not extensive, returns from lake trout tagged near Keweenaw Point in 1950 and off Marquette, Michigan, in 1952 suggested similar movement. Loftus stated that river-spawning lake trout of eastern Lake Superior returned annually to the same spawning streams. Movements of lake trout must be understood to manage and evaluate the rehabilitation of lake trout stocks in Lake Superior, especially when the trout move across interstate and international boundaries and are subject to different fishing regulations and fishing pressures.

  18. Transhepatic approach to create stent fenestration in the extracardiac Fontan conduit in a child with dextrocardia and interrupted inferior vena cava with azygos continuation.

    PubMed

    Kobayashi, Daisuke; Turner, Daniel R; Forbes, Thomas J

    2013-04-01

    Plastic bronchitis is a rare life-threatening complication of Fontan operation. When medical treatment is ineffective in the setting of high systemic venous pressures, Fontan fenestration may be considered to decompress venous pressures and improve cardiac output by creation of the right-to-left shunting. However, transcatheter approach can be difficult in patients with complex venous anatomy. We report a 4-year-old girl born with hypoplastic left ventricle and heterotaxy syndrome, who developed plastic bronchitis following extracardiac Fontan procedure. Her venous anatomy was complex with dextrocardia and interrupted inferior vena cava with azygos continuation. Stent fenestration was successfully performed via transhepatic approach, which was selected based on the anatomical relationship (between extracardiac conduit, left atrium, and hepatic veins) delineated by pre-catheterization cardiac MRI. Simultaneous transesophageal echocardiography guided the intervention. Her plastic bronchitis improved significantly in 3 months but slowly progressed after the stent fenestration. At her 8-month follow-up, stent fenestration remains open and she is currently under heart transplantation evaluation due to persistent plastic bronchitis. Treatment of plastic bronchitis can be undertaken with Fontan fenestration, with pre-procedural MRI playing an essential role in patients with complex venous anatomy.

  19. Depressive effects on the central nervous system and underlying mechanism of the enzymatic extract and its phlorotannin-rich fraction from Ecklonia cava edible brown seaweed.

    PubMed

    Cho, Suengmok; Han, Daeseok; Kim, Seon-Bong; Yoon, Minseok; Yang, Hyejin; Jin, Young-Ho; Jo, Jinho; Yong, Hyeim; Lee, Sang-Hoon; Jeon, You-Jin; Shimizu, Makoto

    2012-01-01

    Marine plants have been reported to possess various pharmacological properties; however, there have been few reports on their neuropharmacological effects. Terrestrial plants have depressive effects on the central nervous system (CNS) because of their polyphenols which make them effective as anticonvulsants and sleep inducers. We investigated in this study the depressive effects of the polyphenol-rich brown seaweed, Ecklonia cava (EC), on CNS. An EC enzymatic extract (ECEE) showed significant anticonvulsive (>500 mg/kg) and sleep-inducing (>500 mg/kg) effects on the respective mice seizure induced by picrotoxin and on the mice sleep induced by pentobarbital. The phlorotannin-rich fraction (PTRF) from ECEE significantly potentiated the pentobarbital-induced sleep at >50 mg/kg. PTRF had binding activity to the gamma aminobutyric acid type A (GABA(A))-benzodiazepine (BZD) receptors. The sleep-inducing effects of diazepam (DZP, a well-known GABA(A)-BZD agonist), ECEE, and PTRF were completely blocked by flumazenil, a well-known antagonist of GABA(A)-BZD receptors. These results imply that ECEE produced depressive effects on CNS by positive allosteric modulation of its phlorotannins on GABA(A)-BZD receptors like DZP. Our study proposes EC as a candidate for the effective treatment of neuropsychiatric disorders such as anxiety and insomnia.

  20. Deep Venous Thrombosis of the Leg, Associated with Agenesis of the Infrarenal Inferior Vena Cava and Hypoplastic Left Kidney (KILT Syndrome) in a 14-Year-Old Child

    PubMed Central

    Bami, Sakshi; Vazquez, Yarelis; Chorny, Valeriy; Amodio, John

    2015-01-01

    Agenesis of the inferior vena cava (IVC) is a rare anomaly which can be identified as incidental finding or can be associated with iliofemoral vein thrombosis. IVC agenesis has a known association with renal anomalies which are mainly confined to the right kidney. We describe a case of a 14-year-old male who presented with left leg swelling and pain. Ultrasonography confirmed the presence of left leg deep vein thrombosis (DVT). No underlying hematologic risk factors were identified. A CT scan was obtained which demonstrated absent infrarenal IVC and extensive thrombosis in the left deep venous system and development of collateral venous flow into the azygous/hemiazygous system, with extension of thrombus into paraspinal collaterals. An additional finding in the patient was an atrophic left kidney and stenosis of an accessory left renal artery. Agenesis of the IVC should be considered in a young patient presenting with lower extremity DVT, especially in patients with no risk factors for thrombosis. As agenesis of the IVC cannot be corrected, one should be aware that there is a lifelong risk of lower extremity DVT. PMID:25685585

  1. Double lumen bi-cava cannula for veno-venous extracorporeal membrane oxygenation as bridge to lung transplantation in non-intubated patient.

    PubMed

    Reeb, Jérémie; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

    2012-01-01

    Extracorporeal membrane oxygenation (ECMO) is used for refractory respiratory failure. Normally, ECMO is implanted in intubated patients as a last resort. We report the case of a non-intubated patient who benefited from veno-venous (VV) ECMO. A 35-year old cystic fibrosis man presented a severe respiratory decompensation with refractory hypercapnia. We opted for an ECMO instead of mechanical ventilation (MV). We implanted a double lumen bi-cava cannula (DLC) (Avalon Elite(TM)) in the right jugular vein. Before ECMO implantation, the patient presented refractory respiratory failure (pH = 7.1, PaO(2) = 83 mmHg, PaCO(2 )= 103 mmHg). We proposed that the patient be placed on the high emergency lung transplantation waiting list after failure to wean him from ECMO. This registration was effective 10 days after ECMO implantation. The patient was grafted the next day. Under ECMO, mean PaO(2), PaCO(2) and TCA were 80.6 ± 14.2, 53.8 ± 6.4 mmHg and 56.2 ± 9.7 s, respectively. The patient could eat, drink, talk and practice chest physiotherapy. The evolution was uneventful under ECMO. Weaning from ECMO was done in the operating theatre after transplantation. VV ECMO with DLC is safe and feasible in non-intubated patients. It avoids potential complications of MV, and allows respiratory assistance as bridge to transplantation. PMID:22108944

  2. Clinical and histopathological effects of presurgical treatment with sunitinib for renal cell carcinoma with inferior vena cava tumor thrombus at a single institution

    PubMed Central

    Ujike, Takeshi; Kawashima, Atsunari; Nagahara, Akira; Fujita, Kazutoshi; Miyagawa, Yasushi; Nonomura, Norio

    2016-01-01

    To evaluate the clinical and histopathological effects of presurgical treatment with sunitinib on inferior vena cava (IVC) tumor thrombus. Between 2010 and 2014, we treated seven patients with renal cell carcinoma and IVC tumor thrombus presurgically with sunitinib. We retrospectively evaluated primitive tumor size, the level of tumor thrombus according to Novick’s classification, its distance above the renal vein, thrombus diameter at its widest segment, and histopathological change after sunitinib treatment. Three patients were diagnosed histologically. Percutaneous biopsy of the renal mass before sunitinib treatment was performed in two patients. One patient was diagnosed after sunitinib treatment following nephrectomy. The primitive tumors shrank upon sunitinib therapy in four cases; however, although the caval thrombus was downstaged (from level II to I) in one patient, the level of caval thrombus did not change in five patients and increased in one patient (from level III to IV). We evaluated the histopathological effects in two patients. In one patient, the IVC tumor thrombus was mostly replaced with necrotic tissue, but its thrombus level was not downstaged. In the other patient, the IVC tumor thrombus was downstaged, but tumor thrombus was not replaced with necrotic tissue and viable tumor cells remained. Presurgical treatment with sunitinib for renal cell carcinoma with IVC tumor thrombus appears to have limited effect on IVC tumor thrombus, in contrast to its effects on primitive tumor shrinkage. In the absence of evidence of presurgical benefits from prospective studies, this treatment may not be systematically advisable. PMID:27557138

  3. Can Nephrologists Use Ultrasound to Evaluate the Inferior Vena Cava? A Cross-Sectional Study of the Agreement between a Nephrologist and a Cardiologist

    PubMed Central

    Muniz Pazeli, José; Fagundes Vidigal, Daniel; Cestari Grossi, Tarcísio; Silva Fernandes, Natália Maria; Colugnati, Fernando; Baumgratz de Paula, Rogério; Sanders-Pinheiro, Hélady

    2014-01-01

    Background/Aims The costs and the need for a specialist impair the implementation of ultrasonography for evaluating the inferior vena cava (IVC) to assess the volemic status in hemodialysis patients. We investigated whether a nephrologist with limited ultrasound training can accurately assess the IVC in patients undergoing hemodialysis. Methods A cardiologist and a nephrologist consecutively measured the indexed IVC expiratory diameter (VCDi) and the IVC collapsibility index (IVCCI) of 52 patients during hemodialysis sessions. In protocol I, the nephrologist used a regular ultrasound system (RUS) and the cardiologist used a cardiovascular ultrasound equipment; in protocol II, the machines were interchanged. Pearson and kappa coefficients and the interexaminer agreement by the Bland-Altman method were calculated. Results The VCDi measurements showed a strong correlation in both protocols (r = 0.88 and 0.84 in protocols I and II, respectively). The volemic classifications were excellent in protocol I (kappa = 0.82 and 0.93 by VCDi and IVCCI, respectively) and substantial in protocol II (kappa = 0.77 and 0.75 by VCDi and IVCCI, respectively). The interexaminer agreement on the VCDi measurements was very good in both protocols. Conclusions Ultrasound evaluation of the IVC can be performed by nephrologists using an RUS to assess the volemic status in hemodialysis patients. PMID:24926312

  4. Incidence of inferior vena cava thrombosis detected by transthoracic echocardiography in the immediate postoperative period after adult cardiac and general surgery.

    PubMed

    Saranteas, T; Kostopanagiotou, G; Tzoufi, M; Drachtidi, K; Knox, G M; Panou, F

    2013-11-01

    Venous thromboembolism is an important complication after general and cardiac surgery. Using transthoracic echocardiography, this study assessed the incidence of inferior vena cava (IVC) thrombosis among a total of 395 and 289 cardiac surgical and major surgical patients in the immediate postoperative period after cardiac and major surgery, respectively. All transthoracic echocardiography was performed by a specialist intensivist within 24 hours after surgery with special emphasis on using the subcostal view in the supine position to visualise the IVC. Of the 395 cardiac surgical patients studied, the IVC was successfully visualised using the subcostal view in 315 patients (79.8%) and eight of these patients (2.5%) had a partially obstructive thrombosis in the IVC. In 250 out of 289 (85%) general surgical patients, the IVC was also clearly visualised, but only one patient (0.4%) had an IVC thrombosis (2.5 vs 0.4%, P <0.05). In summary, visualisation of the IVC was feasible in most patients in the immediate postoperative period after both adult cardiac and major surgery. IVC thrombosis appeared to be more common after adult cardiac surgery than general surgery. A large prospective cohort study is needed to define the risk factors for IVC thrombus and whether early thromboprophylaxis can reduce the incidence of IVC thrombus after adult cardiac surgery.

  5. Primary Renal Rhabdomyosarcoma in an Adolescent With Tumor Thrombosis in the Inferior Vena Cava and Right Atrium: A Case Report and Review of the Literature.

    PubMed

    Lin, Wei-Ching; Chen, Jeon-Hor; Westphalen, Antonio; Chang, Han; Chiang, I-Ping; Chen, Cheng-Hong; Wu, Hsi-Chin; Lin, Chien-Heng

    2016-05-01

    Although the second peak of the age distribution of rhabdomyosarcoma (RMS) is at adolescence, renal RMS is extremely rare at this age group. This tumor is indistinguishable from other renal tumors based on clinical and imaging findings, and the diagnosis relies on histology and immunohistochemical staining. We report a unique case of adolescent renal RMS associated with tumor thrombus extending into the inferior vena cava (IVC) and right atrium.An 18-year-old female adolescent presented with shortness of breath and palpitations, associated with right flank discomfort, and hematuria. A pleomorphic-type renal RMS with Budd-Chiari syndrome and arrhythmia induced by IVC and RA thrombosis was diagnosed. Despite complete tumor resection, the patient developed multiple lung metastases a month after surgery. Chemotherapy was recommended, but the patient declined. She died within a year of the initial operation.Adolescent renal RMS is rare and associated with poor outcome. Early aggressive multimodal therapy seems to be appropriate, in particular, in the presence of tumor thrombosis. PMID:27227946

  6. Do high functioning persons with autism present superior spatial abilities?

    PubMed

    Caron, M-J; Mottron, L; Rainville, C; Chouinard, S

    2004-01-01

    This series of experiments was aimed at assessing spatial abilities in high functioning individuals with autism (HFA), using a human-size labyrinth. In the context of recent findings that the performance of individuals with HFA was superior to typically developing individuals in several non-social cognitive operations, it was expected that the HFA group would outperform a typically developing comparison group matched on full-scale IQ. Results showed that individuals with autism performed all spatial tasks at a level at least equivalent to the typically developing comparison group. No differences between groups were found in route and survey tasks. Superior performance for individuals with HFA was found in tasks involving maps, in the form of superior accuracy in graphic cued recall of a path, and shorter learning times in a map learning task. We propose that a superior ability to detect [Human Perception and Performance 27 (3) (2001) 719], match [Journal of Child Psychology and Psychiatry 34 (1993) 1351] and reproduce [Journal of Child Psychology and Psychiatry 40 (5) (1999) 743] simple visual elements yields superior performance in tasks relying on the detection and graphic reproduction of the visual elements composing a map. Enhanced discrimination, detection, and memory for visually simple patterns in autism may account for the superior performance of persons with autism on visuo-spatial tasks that heavily involve pattern recognition, either in the form of recognizing and memorizing landmarks or in detecting the similarity between map and landscape features. At a neuro-anatomical level, these findings suggest an intact dorso-lateral pathway, and enhanced performance in non social tasks relying on the infero-temporal pathway. PMID:14728920

  7. Superior mesenteric artery thrombosis after abrupt discontinuation of rivaroxaban.

    PubMed

    Adams, Christopher B; Acquisto, Nicole M; Rotoli, Jason M; LoStracco, Thomas; Shamaskin, Ann R; Pasternack, Joel S

    2016-04-01

    We report a case of superior mesenteric artery thrombosis after the abrupt discontinuation of rivaroxaban in a 59-year-old male patient. The initial presentation was of sudden onset abdominal pain, nausea, vomiting, diarrhea, and hematochezia in the setting of recently holding rivaroxaban anticoagulation for an atrial flutter ablative procedure. Imaging revealed thrombosis of the superior mesenteric artery and acute mesenteric ischemia requiring emergent surgical intervention for embolectomy. Upon exploratory laparotomy, the bowel was found to be viable, and an embolectomy with patch angioplasty was successful without complication. This case illustrates the need for emergency medicine clinician familiarity with this possible medication adverse event with rivaroxaban.

  8. Superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy.

    PubMed

    Pineda, Lucas; Sarhan, Mohammad; Ahmed, Leaque

    2013-08-01

    Laparoscopic procedures for morbid obesity are becoming standard of care which, in experienced hands, has a very low mortality and morbidity. Superior mesenteric vein thrombosis has been reported in the literature after different bariatric and nonbariatric laparoscopic procedures. Laparoscopic sleeve gastrectomy is a relatively new procedure in the treatment of morbid obesity; its complications being well-known including staple line leak, bleeding, and stricture among others. We present a case of superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy successfully managed conservatively with therapeutic anticoagulation, and propose a different hypothesis for the development of such a complication.

  9. Endoscopic-Assisted Repair of Superior Canal Dehiscence.

    PubMed

    Cheng, Yew Song; Kozin, Elliott D; Lee, Daniel J

    2016-10-01

    Superior canal dehiscence (SCD) is a bony defect of the superior canal that can cause vestibular and/or auditory symptoms. Surgical repair of SCD provides effective relief from symptoms, and the middle fossa craniotomy approach with binocular microscopy offers direct visualization and surgical access to the arcuate eminence. However, for SCDs located along the downsloping tegmen medial to the peak of the arcuate eminence, a direct light of sight may be obscured, rendering visualization with traditional microscopy difficult. The endoscope is the ideal adjunct in middle fossa craniotomy approach SCD surgery and offers a safe, effective means to identify and repair arcuate eminence defects hidden from microscopic view. PMID:27565386

  10. Evidence of spring spawning lake trout in Lake Superior

    USGS Publications Warehouse

    Bronte, Charles R.

    1993-01-01

    In 1992, the U. S. Fish and Wildlife Service began research on the life history, population dynamics, and stock delineation of siscowet lake trout Salvelinus namaycush siscowet in Lake Superior. Siscowet were captured with gill nets in 80-150 m of water on 23-26 April 1992 north of the Apostle Islands in western Lake Superior. Of 91 captured siscowets, one male had fully developed testes in nearly ripe condition and one female had eggs running from the vent. This observation represents the earliest dates that lake trout of any morphotype have been found in spawning or near-spawning condition.

  11. Imaging Evaluation of Superior Labral Anteroposterior (SLAP) Tears.

    PubMed

    Grubin, Jeremy; Maderazo, Alex; Fitzpatrick, Darren

    2015-10-01

    Superior labral anteroposterior (SLAP) tears are common injuries that are best evaluated with magnetic resonance arthrography (MRA), as it provides the most detailed evaluation of the bicipital labral complex. Given the variety and complexity of SLAP tears, distention of the joint with intra-articular dilute gadolinium contrast properly separates the intra-articular biceps tendon, superior labrum, glenoid cartilage and glenohumeral ligaments to optimize assessment of these structures. This allows for increased diagnostic confidence of the interpreting radiologist and provides a better road map for the surgeon prior to arthroscopy. Indirect MRA and high-field magnetic resonance imaging are sensitive and specific alternative modalities if MRA cannot be performed.

  12. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report.

    PubMed

    Corbacioglu, Kerem Seref; Aksel, Gokhan; Yildiz, Altan

    2016-03-01

    Pseudoaneurysm of the superior gluteal artery (SGA) is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options. PMID:27239635

  13. A rare anatomic variant of the superior glenohumeral ligament.

    PubMed

    Pradhan, R L; Itoi, E; Watanabe, W; Yamada, S; Nagasawa, H; Shimizu, T; Wakabayashi, I; Sato, K

    2001-01-01

    The attachment of the superior glenohumeral ligament (SGHL) to the upper pole of the glenoid is variable and 3 types have been described. We report an anatomic variant of SGHL attachment to the upper pole of the glenoid that has not heretofore been reported in the literature. In this case, the SGHL overrode the biceps origin, continued to the superior labrum posteriorly, and had no attachment to the middle glenohumeral ligament or the anterior labrum. This variant was detected during routine arthroscopic examination undertaken before surgery on a rotator cuff tear.

  14. Thermally stimulated luminescence studies of undoped, Cu- and Mn-doped CaSO4 compounds

    NASA Astrophysics Data System (ADS)

    Manam, J.; Das, S.

    Thermally stimulated luminescence (TSL) of undoped and doped CaSO4 with activators such as Cu and Mn has been investigated. The polycrystalline samples of undoped and doped CaSO4 are prepared by the melting method. The formation of CaSO4 compound is confirmed by X-ray diffraction and Fourier transform infrared studies. Scanning electron microscopic studies of CaSO4 are also carried out. The TSL glow curves of undoped CaSO4, Cu- and Mn-doped CaSO4 are studied. Comparison of the thermoluminescence (TL) intensity of the most intensive glow peak of Cu-doped CaSO4 compound with that of undoped CaSO4 shows that addition of Cu impurity in CaSO4 compound enhances the TL intensity by about four times. However, the addition of Mn impurity to undoped CaSO4 increases the TL intensity by about three times when compared with that of undoped CaSO4. The TL-dose dependence of all three samples was studied and was observed to be almost linear in the studied range of irradiation time. Among the samples studied, namely undoped CaSO4 and Cu- and Mn-doped CaSO4, Cu-doped CaSO4 is found to be the most sensitive. The trap parameters, namely order of kinetics (b), activation energy (E) and frequency factor (s) associated with the most intensive glow peaks of CaSO4:Mn, CaSO4:Cu and CaSO4 phosphors were determined using the glow curve shape (Chen's) method.

  15. La implantacion del enfoque constructivista en el aula de ciencia: Estudio de caso multiple

    NASA Astrophysics Data System (ADS)

    Arroyo Betancourt, Luz I.

    Esta investigacion estudia la implantacion del enfoque constructivista en tres aulas de ciencia del contexto puertorriqueno. Se auscultaron las practicas educativas que utilizan maestras consideradas constructivistas y la correspondencia de sus practicas educativas con los elementos esenciales de la didactica que proponen los teoricos de los planteamientos constructivistas. Se ausculto, ademas, a que vision del enfoque constructivista responden las expresiones de las maestras acerca de su practica educativa y como compara con su quehacer, a la luz de los elementos esenciales de las visiones constructivistas piagetiana, social y radical. Se utilizo el diseno de estudio descriptivo de caso multiple. El estudio se baso en entrevistas a profundidad, revision de documentos y observacion no participativa a la sala de clases. El contexto fueron tres escuelas publicas de la Region Educativa de San Juan, una elemental, una intermedia y una superior. Los resultados confirmaron que la transicion hacia el enfoque constructivista es un proceso que toma tiempo, dedicacion y la participacion en adiestramientos y readiestramientos acerca del nuevo enfoque. Las maestras coinciden en la mayoria de las practicas educativas que utilizan para implantar el enfoque constructivista de ensenanza y difieren en algunas debido, probablemente, a que han tenido que adaptarlas a los correspondientes niveles de ensenanza: elemental, intermedio y superior. Dos de las maestras planifican por conceptos generadores, mientras que una de ellas planifica siguiendo la guia que recibe del Departamento de Educacion. Difieren ademas, en el enfasis que confieren al inquirir cientifico. Con relacion a la correspondencia entre la vision manifestada por las maestras a la luz de las visiones piagetiana, social y radical, aparentemente, las preguntas del protocolo de entrevistas no lograron evocar la informacion con suficiente profundidad, por lo que la investigadora tuvo que inferir las visiones de las

  16. Impairments in Tactile Search Following Superior Parietal Damage

    ERIC Educational Resources Information Center

    Skakoon-Sparling, Shayna P.; Vasquez, Brandon P.; Hano, Kate; Danckert, James

    2011-01-01

    The superior parietal cortex is critical for the control of visually guided actions. Research suggests that visual stimuli relevant to actions are preferentially processed when they are in peripersonal space. One recent study demonstrated that visually guided movements towards the body were more impaired in a patient with damage to superior…

  17. 7. Photocopy of map (from Superior Court of Chatham County ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. Photocopy of map (from Superior Court of Chatham County Land Records, Book 2G, p. 299) John McKinnon (County Surveyor), delineator 11 January 1817 PLAT OF SITE, SHOWING EASTERN PORTION OF BUILDING - William Taylor Store, 204 West Bay Street, Savannah, Chatham County, GA

  18. HABITAT: LAKE SUPERIOR - STATE OF THE LAKE 2005

    EPA Science Inventory

    This presentation briefly describes the state of research and management in Lake Superior concerning fisheries and their association to habitat. It discusses a general habitat classification for the lake and an increasing interest in the nearshore, summarizing the status of cont...

  19. Biological Motion Task Performance Predicts Superior Temporal Sulcus Activity

    ERIC Educational Resources Information Center

    Herrington, John D.; Nymberg, Charlotte; Schultz, Robert T.

    2011-01-01

    Numerous studies implicate superior temporal sulcus (STS) in the perception of human movement. More recent theories hold that STS is also involved in the "understanding" of human movement. However, almost no studies to date have associated STS function with observable variability in action understanding. The present study directly associated STS…

  20. Process reduces pore diameters to produce superior filters

    NASA Technical Reports Server (NTRS)

    Todd, H. H.

    1966-01-01

    Porous metal structure with very small pore diameters is produced by heating the structure in oxygen for an oxidized surface layer, cooling it, and heating it in hydrogen to deoxidize the oxidized portion. Such structures are superior catalyst beds and filters.

  1. The Quagga mussel invades the Lake Superior basin - journal article

    EPA Science Inventory

    Prior studies recognized the presence of a single dreissenid species in Lake Superior--the zebra mussel Dreissena polymorpha. However, taxonomic keys based on traditional shell morphology are not always able to differentiate dreissenid species with confidence. We thus employed ge...

  2. Massive superior mesenteric venous aneurysm with portal venous thrombosis.

    PubMed

    Starikov, Anna; Bartolotta, Roger J

    2015-01-01

    Portal venous aneurysm is a rare and sometimes dangerous vascular pathology, which can result in thrombosis or rupture. We present the computed tomography, magnetic resonance, and sonographic imaging of a 27-year-old man with superior mesenteric venous aneurysm and subsequent thrombosis following acute pancreatitis. This multimodality imaging approach can prove useful in the evaluation of these rare aneurysms.

  3. Compression of superior sagittal sinus by neonatal calvarial molding.

    PubMed

    Newton, T H; Gooding, C A

    1975-06-01

    Compression of the superior sagittal sinus may result from overlapping of the parietal and occipital bones in the newborn infant. Such compression has been documented angiographically and the resultant decreased blood flow confirmed with a Doppler ultrasound probe. This compression may increase intracerebral venous pressures and thereby contribute to the high incidence of intracerebral hemorrhage in premature infants with respiratory distress syndrome.

  4. Lake Superior Phytoplankton Characterization from the 2006 Probability Based Survey

    EPA Science Inventory

    We conducted a late summer probability based survey of Lake Superior in 2006 which consisted of 52 sites stratified across 3 depth zones. As part of this effort, we collected composite phytoplankton samples from the epilimnion and the fluorescence maxima (Fmax) at 29 of the site...

  5. Early detection of non-indigenous fishes in Lake Superior

    EPA Science Inventory

    Invasive species pose a serious threat to the ecological stability of the Great Lakes warranting continual monitoring for the arrival of new species. Three locations in Lake Superior were identified as “high risk” for new introductions: St. Louis River near Duluth, M...

  6. Early detection of invasive fishes in Lake Superior

    EPA Science Inventory

    Invasive species pose a serious threat to the Great Lakes warranting continual monitoring for the arrival of new species. Three locations in Lake Superior were identified as "high risk" for new introductions: St. Louis River near Duluth, MN, Upper St. Marys River near S...

  7. The pygmy whitefish, Coregonus coulteri, in Lake Superior

    USGS Publications Warehouse

    Eschmeyer, Paul H.; Bailey, Reeve M.

    1955-01-01

    Other cold-water fishes–cottids, ninespine sticklebacks, smelt, and four species of coregonines–were the most frequent associates of the pygmy whitefish. Lake trout and trout-perch were also taken with it at the same stations or in the same trawl hauls. Its closest relative in Lake Superior, the round whitefish, was not an ecological associate.

  8. Depth-specific Analyses of the Lake Superior Food Web

    EPA Science Inventory

    Characteristics of large, deep aquatic systems include depth gradients in community composition, in the quality and distribution of food resources, and in the strategies that organisms use to obtain their nutrition. In Lake Superior, nearshore communities that rely upon a combina...

  9. Area contingency plan western lake Superior Coastal zone. (COTP Duluth)

    SciTech Connect

    1995-02-15

    The Area Contingency Plan, mandated under the Oil Pollution Act, was developed by the Western Lake Superior Area Committee, which is chaired by the Coast Guard and consists of local, state, federal, and private members. The plan prepares in advance for an oil or hazardous substance spill in the COTP Duluth Coastal Zone.

  10. Morphological variation of siscowet lake trout in Lake Superior

    USGS Publications Warehouse

    Bronte, C.R.; Moore, S.A.

    2007-01-01

    Historically, Lake Superior has contained many morphologically distinct forms of the lake trout Salvelinus namaycush that have occupied specific depths and locations and spawned at specific times of the year. Today, as was probably the case historically, the siscowet morphotype is the most abundant. Recent interest in harvesting siscowets to extract oil containing omega-3 fatty acids will require additional knowledge of the biology and stock structure of these lightly exploited populations. The objective of this study was to determine whether shape differences exist among siscowet populations across Lake Superior and whether these shape differences can be used to infer stock structure. Morphometric analysis (truss protocol) was used to differentiate among siscowets sampled from 23 locations in Lake Superior. We analyzed 31 distance measurements among 14 anatomical landmarks taken from digital images of fish recorded in the field. Cluster analysis of size-corrected data separated fish into three geographic groups: The Isle Royale, eastern (Michigan), and western regions (Michigan). Finer scales of stock structure were also suggested. Discriminant function analysis demonstrated that head measurements contributed to most of the observed variation. Cross-validation classification rates indicated that 67–71% of individual fish were correctly classified to their region of capture. This is the first study to present shape differences associated with location within a lake trout morphotype in Lake Superior.

  11. Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment

    SciTech Connect

    Gregorio, Miguel Angel de; Gimeno, Maria Jose; Medrano, Joaquin; Schoenholz, Caudio; Rodriguez, Juan; D'Agostino, Horacio

    2004-09-15

    We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

  12. ZOOBENTHOS ASSEMBLAGES AS INDICATORS OF LAKE SUPERIOR COASTAL WETLAND CONDITIONS

    EPA Science Inventory

    Little is known about the diversity or structure of zoobenthos assemblages in Great Lakes coastal wetlands. As part of a comparative study in western Lake Superior we wanted to investigate whether these assemblages might be useful as indicators of wetland condition. We also wante...

  13. Repair of the superior sulcus deformity using autogenous costal cartilage.

    PubMed

    Sutula, F C; Thomas, O

    1982-05-01

    Superior sulcus deformity is a late sequela of surgical anophthalmos. Many methods have been proposed to treat this difficult problem. A technique using autogenous costal cartilage that has resulted in satisfactory repair is presented. In addition to standard photographs and exophthalmometry measurements to follow these patients, a specific device to accurately measure orbital volume gain after operation was fashioned. PMID:7099560

  14. Word and pseudoword superiority effects reflected in the ERP waveform.

    PubMed

    Coch, Donna; Mitra, Priya

    2010-05-01

    A variant of the Reicher-Wheeler task was used to determine when in the event-related potential (ERP) waveform indices of word and pseudoword superiority effects might be present, and whether ERP measures of superiority effects correlated with standardized behavioral measures of orthographic fluency and single word reading. ERPs were recorded to briefly presented, masked letter strings that included real words (DARK/PARK), pseudowords (DARL/PARL), nonwords (RDKA/RPKA), and letter-in-xs (DXXX, PXXX) stimuli. Participants decided which of two letters occurred at a given position in the string (here, forced-choice alternatives D and P). Behaviorally, both word (more accurate choices for letters in words than in baseline nonwords or letter-in-xs) and pseudoword (more accurate choices for letters in pseudowords than in baseline conditions) superiority effects were observed. Electrophysiologically, effects of orthographic regularity and familiarity were apparent as early as the P150 time window (100-160ms), an effect of lexicality was observed as early as the N200 time window (160-200ms), and peak amplitude of the N300 and N400 also differentiated word and pseudoword as compared to baseline stimuli. Further, the size of the P150 and N400 ERP word superiority effects was related to standardized behavioral measures of fluency and reading. Results suggest that orthographic fluency is reflected in both lower-level, sublexical, perceptual processing and higher-level, lexical processing in fluently reading adults. PMID:20211607

  15. Memory for Pictorial Information and the Picture Superiority Effect.

    ERIC Educational Resources Information Center

    Maisto, Albert A.; Queen, Debbie Elaine

    1992-01-01

    The performance of 53 younger adults (mean age 20.7) and 52 older adults (mean age 68.3) was compared in a memory task involving pictures, words, and pictures-plus-words. Results showed (1) significantly higher recall scores for younger adults; (2) equivalent picture superiority effect for both groups; and (3) decline in older adults' performance…

  16. A Developmental, Interactive Activation Model of the Word Superiority Effect.

    ERIC Educational Resources Information Center

    Chase, Christopher H.; Tallal, Paula

    1990-01-01

    Examined effects of orthographic context on the letter recognition skills of dyslexic children, comparing their performance to that of adults and of chronological and reading age-matched groups. Results showed that the two matched groups showed strong word superiority effect (WSE) for words and pseudowords over nonwords. Dyslexic readers did not…

  17. Neural correlates of active avoidance behavior in superior colliculus

    PubMed Central

    Cohen, Jeremy D.; Castro-Alamancos, Manuel A.

    2010-01-01

    Active avoidance of harmful situations seems highly adaptive, but the underlying neural mechanisms are largely unknown. Rats can effectively use the superior colliculus during active avoidance to detect a salient whisker conditioned stimulus (WCS) that signals an aversive event. Here, we recorded unit and field potential activity in the intermediate layers of the superior colliculus of rats during active avoidance behavior. During the period preceding the onset of the WCS, avoids are associated with a higher firing rate than escapes (unsuccessful avoids), indicating that a prepared superior colliculus is more likely to detect the WCS and lead to an avoid. Moreover, during the WCS, a robust ramping up of overall firing rate is observed for trials leading to avoids. The firing rate ramping is not due to shuttling, and may serve to drive downstream circuits to avoid. Therefore, a robust neural correlate of active avoidance behavior is found in the superior colliculus, emphasizing its role in the detection of salient sensory signals that require immediate action. PMID:20573897

  18. Sound induced vertigo: superior canal dehiscence resulting from blast exposure.

    PubMed

    Mehlenbacher, Adam; Capehart, Bruce; Bass, Dale; Burke, James R

    2012-04-01

    Barotrauma is common in modern warfare. We present the first description of sound induced vertigo caused by superior canal dehiscence (SCD) precipitated by blast exposure. Patients who complain of balance or visual changes after military or terrorist blast exposure should be evaluated for SCD.

  19. Word and pseudoword superiority effects reflected in the ERP waveform

    PubMed Central

    Coch, Donna; Mitra, Priya

    2010-01-01

    A variant of the Reicher-Wheeler task was used to determine when in the event-related potential (ERP) waveform indices of word and pseudoword superiority effects might be present, and whether ERP measures of superiority effects correlated with standardized behavioral measures of orthographic fluency and single word reading. ERPs were recorded to briefly presented, masked letter strings that included real words (DARK/PARK), pseudowords (DARL/PARL), nonwords (RDKA/RPKA), and letter-in-xs (DXXX, PXXX) stimuli. Participants decided which of two letters occurred at a given position in the string (here, forced-choice alternatives D and P). Behaviorally, both word (more accurate choices for letters in words than in baseline nonwords or letter-in-xs) and pseudoword (more accurate choices for letters in pseudowords than in baseline conditions) superiority effects were observed. Electrophysiologically, effects of orthographic regularity and familiarity were apparent as early as the P150 time window (100–160 ms), an effect of lexicality was observed as early as the N200 time window (160–200 ms), and peak amplitude of the N300 and N400 also differentiated word and pseudoword as compared to baseline stimuli. Further, the size of the P150 and N400 ERP word superiority effects was related to standardized behavioral measures of fluency and reading. Results suggest that orthographic fluency is reflected in both lower-level, sublexical, perceptual processing and higher-level, lexical processing in fluently reading adults. PMID:20211607

  20. Water resources of the Lake Superior watershed, northeastern Minnesota

    USGS Publications Warehouse

    Olcott, Perry G.; Ericson, D.W.; Felsheim, P.E.; Broussard, W.L.

    1978-01-01

    The Nemadji River and tributaries drain the Nemadji Basin, the southern detached part of the watershed. Topographically, the Nemadji Basin is roughly spoon shaped with maximum total relief in Minnesota of about 800 ft (244 m). More than half of the approximately 55-mi (88-km) long river flows northeastward through Wisconsin before reaching Lake Superior.

  1. A new look at the Lake Superior biomass size spectrum

    EPA Science Inventory

    We synthesized data from multiple sampling programs and years to describe the Lake Superior pelagic biomass size structure for two time periods separated by 5 years. The data consisted of water analyzed on a Coulter counter for algae, in situ measurements with a laser optical pl...

  2. A thermal scanning study of coastal upwelling in Lake Superior

    NASA Technical Reports Server (NTRS)

    Scarpace, F. L.; Green, T., III; Madding, R. P.

    1979-01-01

    The use of a thermal scanner to monitor the time evolution of the thermal structure of the coastal waters in Lake Superior during an upwelling event is described. Mosaics of thermal imagery from ten different times are described. Qualitative descriptions of the imagery give insight into the upwelling event. Recommendations for future use of a thermal scanner to monitor an upwelling event are discussed.

  3. Superiority of Vicarious over Direct Experience in Interpersonal Conflict Resolution

    ERIC Educational Resources Information Center

    Braver, Sanford L.; Rohrer, Van

    1978-01-01

    A laboratory experiment compared the relative effects of observing and participating in a first Prisoner's Dilemma Game (PDG) on subsequent PDG encounters by the original observer and participant. Concludes that vicarious experience is superior to direct experience in producing responses that reduce interpersonal conflict. Available from: Sage…

  4. Benthic and Pelagic Contributions to Mysis Nutrition across Lake Superior

    EPA Science Inventory

    Quantification of the sources of nutrition to Mysis diluviana is needed to better understand the basis for production in Mysis lakes and to improve models of migration-driven nutrient and contaminant transport. We collected Mysis, plankton, and benthos across Lake Superior using ...

  5. 28 CFR 2.60 - Superior program achievement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Superior program achievement. 2.60 Section 2.60 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees §...

  6. Why Is Visual Search Superior in Autism Spectrum Disorder?

    ERIC Educational Resources Information Center

    Joseph, Robert M.; Keehn, Brandon; Connolly, Christine; Wolfe, Jeremy M.; Horowitz, Todd S.

    2009-01-01

    This study investigated the possibility that enhanced memory for rejected distractor locations underlies the superior visual search skills exhibited by individuals with autism spectrum disorder (ASD). We compared the performance of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children in a standard static search task…

  7. [Examination of the hypothesis 'the factors and mechanisms of superiority'].

    PubMed

    Sierra-Fitzgerald, O; Quevedo-Caicedo, J; López-Calderón, M G

    INTRODUCTION. The hypothesis of Geschwind and Galaburda suggests that specific cognitive superiority arises as a result of an alteration in development of the nervous system. In this article we review the co existence of superiority and inferiority . PATIENTS AND METHODS. A study was made of six children aged between 6 and 8 years old at the Instituto de Belles Artes Antonio Maria Valencia in Cali,Columbia with an educational level between second and third grade at a primary school and of medium low socio economic status. The children were considered to have superior musical ability by music experts, which is the way in which the concept of superiority was to be tested. The concept of inferiority was tested by neuropsychological tests = 1.5 DE below normal for the same age. We estimated the perinatal neurological risk in each case. Subsequently the children s general intelligence and specific cognitive abilities were evaluated. In the first case the WISC R and MSCA were used. The neuropsychological profiles were obtained by broad evaluation using a verbal fluency test, a test using counters, Boston vocabulary test, the Wechster memory scale, sequential verbal memory test, super imposed figures test, Piaget Head battery, Rey Osterrieth complex figure and the Wisconsin card classification test. The RESULTS showed slight/moderate deficits in practical construction ability and mild defects of memory and concept abilities. In general the results supported the hypothesis tested. The mechanisms of superiority proposed in the classical hypothesis mainly involve the contralateral hemisphere: in this study the ipsilateral mechanism was more important.

  8. Surgical outcomes of superior versus inferior glaucoma drainage device implantation

    PubMed Central

    Martino, Amy Z.; Iverson, Shawn; Feuer, William J.; Greenfield, David S.

    2013-01-01

    Purpose To compare the safety and intraocular pressure (IOP) lowering efficacy of initial glaucoma drainage device (GDD) implantation performed at the superior versus inferior limbus. Methods A retrospective chart review was conducted to identify glaucoma patients that had undergone initial Baerveldt GDD surgery at the inferior limbus for uncontrolled IOP. All eyes had a minimum of 6 months of postoperative follow-up. These eyes were frequency matched to eyes with initial Baerveldt GDD implantation performed at the superior limbus to within 5 years of age and 6 months of follow-up. Baseline demographic and clinical information, as well as preoperative and postoperative IOP, visual acuity, and number of anti-glaucoma medications were extracted. Failure was defined as IOP > 21 mmHg or not reduced by 20% below baseline on two consecutive follow-up visits after 3 months, IOP ≤ 5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, or loss of light perception vision. Statistical methods consisted of Student's t-tests, chi-squared test, and Kaplan-Meier time to failure analysis. Results Fifty eyes (17 inferior, 33 superior) of 43 patients were enrolled. Mean postoperative follow-up in both groups were similar (mean 26.2 ± 15.2 for inferior and 23.9 ± 10.43 months for superior, p=0.54). Prior trabeculectomy had been performed in 8/17 (47%) and 11/33 (33%) eyes (p=0.34) with inferior and superior implants, respectively. Mean preoperative IOP (mmHg) in the superior group (26 ± 11) was significantly higher (p=0.02) than in the inferior group (21 ± 7). Success rates were similar (p>0.05) between the inferior and superior GDD groups during the study period, with 64.7% and 75.8% classified as successful at 1-year of follow-up and 43.1% and 65.7% at 2-years of follow-up, respectively. There was no difference in cumulative proportions of eyes failing between the groups (p=0.20, log-rank test). Mean postoperative IOP and number of anti

  9. The Penokean orogeny in the Lake Superior region

    USGS Publications Warehouse

    Schulz, K.J.; Cannon, W.F.

    2007-01-01

    The Penokean orogeny began at about 1880 Ma when an oceanic arc, now the Pembine-Wausau terrane, collided with the southern margin of the Archean Superior craton marking the end of a period of south-directed subduction. The docking of the buoyant craton to the arc resulted in a subduction jump to the south and development of back-arc extension both in the initial arc and adjacent craton margin to the north. A belt of volcanogenic massive sulfide deposits formed in the extending back-arc rift within the arc. Synchronous extension and subsidence of the Superior craton resulted in a broad shallow sea characterized by volcanic grabens (Menominee Group in northern Michigan). The classic Lake Superior banded iron-formations, including those in the Marquette, Gogebic, Mesabi and Gunflint Iron Ranges, formed in that sea. The newly established subduction zone caused continued arc volcanism until about 1850 Ma when a fragment of Archean crust, now the basement of the Marshfield terrane, arrived at the subduction zone. The convergence of Archean blocks of the Superior and Marshfield cratons resulted in the major contractional phase of the Penokean orogeny. Rocks of the Pembine-Wausau arc were thrust northward onto the Superior craton causing subsidence of a foreland basin in which sedimentation began at about 1850 Ma in the south (Baraga Group rocks) and 1835 Ma in the north (Rove and Virginia Formations). A thick succession of arc-derived turbidites constitutes most of the foreland basin-fill along with lesser volcanic rocks. In the southern fold and thrust belt tectonic thickening resulted in high-grade metamorphism of the sediments by 1830 Ma. At this same time, a suite of post-tectonic plutons intruded the deformed sedimentary sequence and accreted arc terranes marking the end of the Penokean orogeny. The Penokean orogen was strongly overprinted by younger tectonic and thermal events, some of which were previously ascribed to the Penokean. Principal among these was a

  10. Bioaccumulation of toxaphene congeners in the lake superior food web

    USGS Publications Warehouse

    Muir, D.C.G.; Whittle, D.M.; De Vault, D. S.; Bronte, C.R.; Karlsson, H.; Backus, S.; Teixeira, C.

    2004-01-01

    The bioaccumulation and biotransformation of toxaphene was examined in the food webs of Lake Superior and Siskiwit Lake (Isle Royale) using congener specific analysis as well as stable isotope ratios of carbon and nitrogen to characterize food webs. Toxaphene concentrations (calculated using technical toxaphene) in lake trout (Salvelinus namaycush) from the western basin of Lake Superior (N = 95) averaged (±SD) 889 ± 896 ng/g wet wt and 60 ± 34 ng/g wet wt in Siskiwit Lake. Major congeners in lake trout were B8-789 (P38), B8-2226 (P44), B9-1679 (P50), and B9-1025 (P62). Toxaphene concentrations were found to vary seasonally, especially in lower food web organisms in Lake Superior and to a lesser extent in Siskiwit Lake. Toxaphene concentrations declined significantly in lake herring (Coregonus artedii), rainbow smelt (Omerus mordax), and slimy sculpin (Cottus cognatus) as well as in zooplankton (> 102 &mn;m) and Mysis (Mysis relicta) between May and October. The seasonal variation may reflect seasonal shifts in the species abundance within the zooplankton community. Trophic magnification factors (TMF) derived from regressions of toxaphene congener concentrations versus δ15N were > 1 for most octa- and nonachlorobornanes in Lake Superior except B8-1413 (P26) and B9-715. Log bioaccumulation factors (BAFs) for toxaphene congeners in lake trout (ng/g lipid/ng/L dissolved) ranged from 4.54 to 9.7 and were significantly correlated with log octanol-water partition coefficients. TMFs observed for total toxaphene and congener B9-1679 in Lake Superior were similar to those in Arctic lakes, as well as to previous studies in the Great Lakes, which suggests that the bioaccumulation behavior of toxaphene is similar in pelagic food webs of large, cold water systems. However, toxaphene concentrations were lower in lake trout from Siskiwit Lake and lakes in northwestern Ontario than in Lake Superior possibly because of shorter food chains and greater reliance on zooplankton or

  11. Creation of an iOS and Android Mobile Application for Inferior Vena Cava (IVC) Filters: A Powerful Tool to Optimize Care of Patients with IVC Filters.

    PubMed

    Deso, Steven E; Idakoji, Ibrahim A; Muelly, Michael C; Kuo, William T

    2016-06-01

    Owing to a myriad of inferior vena cava (IVC) filter types and their potential complications, rapid and correct identification may be challenging when encountered on routine imaging. The authors aimed to develop an interactive mobile application that allows recognition of all IVC filters and related complications, to optimize the care of patients with indwelling IVC filters. The FDA Premarket Notification Database was queried from 1980 to 2014 to identify all IVC filter types in the United States. An electronic search was then performed on MEDLINE and the FDA MAUDE database to identify all reported complications associated with each device. High-resolution photos were taken of each filter type and corresponding computed tomographic and fluoroscopic images were obtained from an institutional review board-approved IVC filter registry. A wireframe and storyboard were created, and software was developed using HTML5/CSS compliant code. The software was deployed using PhoneGap (Adobe, San Jose, CA), and the prototype was tested and refined. Twenty-three IVC filter types were identified for inclusion. Safety data from FDA MAUDE and 72 relevant peer-reviewed studies were acquired, and complication rates for each filter type were highlighted in the application. Digital photos, fluoroscopic images, and CT DICOM files were seamlessly incorporated. All data were succinctly organized electronically, and the software was successfully deployed into Android (Google, Mountain View, CA) and iOS (Apple, Cupertino, CA) platforms. A powerful electronic mobile application was successfully created to allow rapid identification of all IVC filter types and related complications. This application may be used to optimize the care of patients with IVC filters.

  12. Effects of 12-week oral supplementation of Ecklonia cava polyphenols on anthropometric and blood lipid parameters in overweight Korean individuals: a double-blind randomized clinical trial.

    PubMed

    Shin, Hyeon-Cheol; Kim, Seong Ho; Park, Yongju; Lee, Bong Ho; Hwang, Hye Jeong

    2012-03-01

    The effects of 12-week supplementation with a polyphenol extract from Ecklonia cava (ECP) on anthropometry, serum biochemistry and hematology have been investigated. Ninety-seven overweight male and female adults (average age 40.5 ± 9.2 yr and body mass index (BMI) of 26.5 ± 1.6 kg/m²) were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Subjects were randomly allocated into three groups designated as PC (placebo), LD (low-dose, 72 mg-ECP/day) and HD (high-dose, 144 mg-ECP/day). Both LD and HD groups showed significant decreases in BMI, body fat ratio, waist circumference, waist/hip ratio, total cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol/high-density lipoprotein (HDL) cholesterol and atherogenic index (AI) after 12 weeks, as compared with the placebo group. The HD group also showed a significant increase in serum HDL cholesterol as compared with the placebo group. Only the HD group showed significant decreases in serum glucose and systolic blood pressure after 12 weeks. There was no significant adverse event related with ingestion of ECP, and serum biochemical and hematological parameters were maintained within normal range during the intervention period. In conclusion, these results demonstrated that ECP supplementation significantly contributed to lowering body fat and serum lipid parameters such as total and LDL cholesterols with dose dependence. Further studies using different populations, dosages or biological markers are highly recommended to better understand the physiological features of this polyphenol.

  13. Creation of an iOS and Android Mobile Application for Inferior Vena Cava (IVC) Filters: A Powerful Tool to Optimize Care of Patients with IVC Filters.

    PubMed

    Deso, Steven E; Idakoji, Ibrahim A; Muelly, Michael C; Kuo, William T

    2016-06-01

    Owing to a myriad of inferior vena cava (IVC) filter types and their potential complications, rapid and correct identification may be challenging when encountered on routine imaging. The authors aimed to develop an interactive mobile application that allows recognition of all IVC filters and related complications, to optimize the care of patients with indwelling IVC filters. The FDA Premarket Notification Database was queried from 1980 to 2014 to identify all IVC filter types in the United States. An electronic search was then performed on MEDLINE and the FDA MAUDE database to identify all reported complications associated with each device. High-resolution photos were taken of each filter type and corresponding computed tomographic and fluoroscopic images were obtained from an institutional review board-approved IVC filter registry. A wireframe and storyboard were created, and software was developed using HTML5/CSS compliant code. The software was deployed using PhoneGap (Adobe, San Jose, CA), and the prototype was tested and refined. Twenty-three IVC filter types were identified for inclusion. Safety data from FDA MAUDE and 72 relevant peer-reviewed studies were acquired, and complication rates for each filter type were highlighted in the application. Digital photos, fluoroscopic images, and CT DICOM files were seamlessly incorporated. All data were succinctly organized electronically, and the software was successfully deployed into Android (Google, Mountain View, CA) and iOS (Apple, Cupertino, CA) platforms. A powerful electronic mobile application was successfully created to allow rapid identification of all IVC filter types and related complications. This application may be used to optimize the care of patients with IVC filters. PMID:27247483

  14. Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children

    PubMed Central

    Achar, Shreepathi Krishna; Sagar, Maddani Shanmukhappa; Shetty, Ranjan; Kini, Gurudas; Samanth, Jyothi; Nayak, Chaitra; Madhu, Vidya; Shetty, Thara

    2016-01-01

    Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15% or <15% after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2%, for which sensitivity, specificity, positive predictive value and negative predictive value were 100%, 94%, 96% and 100%, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5%, for which sensitivity, specificity, positive predictive value and negative predictive value were 91%, 89%, 91% and 89%, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children. PMID:27013751

  15. Inferior vena cava filter insertion through the popliteal vein: enabling the percutaneous endovenous intervention of deep vein thrombosis with a single venous access approach in a single session

    PubMed Central

    Kim, Hyoung Ook; Kim, Jae Kyu; Park, Jin Gyoon; Yim, Nam Yeol; Kang, Yang Jun; Jung, Hye Doo

    2016-01-01

    PURPOSE We aimed to evaluate the efficiency of placing an inferior vena cava (IVC) filter through the same popliteal vein access site used for percutaneous endovenous intervention in patients with extensive lower extremity deep vein thrombosis. METHODS This retrospective study included 21 patients who underwent IVC filter insertion through the popliteal vein over a three-year period. Patient medical records were reviewed for the location of the deep vein thrombosis, result of filter removal, and total number of endovascular procedures needed for filter insertion and recanalization of the lower extremity venous system. Follow-up lower extremity computed tomography (CT) venography was also reviewed in each patient to assess the degree of filter tilt in the IVC. RESULTS All patients had extensive lower extremity deep vein thrombosis involving the iliac vein and/or femoral vein. Seventeen patients showed deep vein thrombosis of the calf veins. In all patients, IVC filter insertion and the recanalization procedure were performed during a single procedure through the single popliteal vein access site. In the 17 patients undergoing follow-up CT, the mean tilt angle of the filter was 7.14°±4.48° in the coronal plane and 8.77°±5.49° in the sagittal plane. Filter retrieval was successful in 16 of 17 patients (94.1%) in whom filter retrieval was attempted. CONCLUSION Transpopliteal IVC filter insertion is an efficient technique that results in low rates of significant filter tilt and enables a single session procedure using a single venous access site for filter insertion and percutaneous endovenous intervention. PMID:27559713

  16. Superior mesenteric vein rotation: a CT sign of midgut malrotation

    SciTech Connect

    Nichols, D.M.; Li, D.K.

    1983-10-01

    Computed tomography (CT) of the pancreas, with its excellent display of peripancreatic anatomy, allows visualization of the major vessels entering the mesenteric root. In scans of the normal upper abdomen obtained at or just below the level of the uncinate process of the pancreas, the proximal superior mesenteric vein (SMV) easily can be identified lying on the right ventral aspect of the superior mesenteric artery (SMA). The authors have observed a characteristic abnormality in this normal vascular arrangement on CT scans of the pancreas in three adult patients with suspected chronic pancreatitis who were subsequently proved to have midgut malrotation. They called this the SMV rotation sign and believe that its detection even on CT scans limited to the level of the pancreas should alert the radiologist to the presence of a midgut malrotation that may have been unsuspected.

  17. Geology and tectonics of the Archean Superior Province, Canadian Shield

    NASA Technical Reports Server (NTRS)

    Card, K. D.

    1986-01-01

    Superior Province consists mainly of Late Archean rocks with Middle Archean gneisses in the south, and possibly in the north. The Late Archean supracrustal sequences are of island arc and interarc affinity and are cut by abundant plutonic rocks, including early arc-related intrusions, late synorogenic intrusions, and post-orogenic plutons that are possibly the product of crustal melting caused by thermal blanketing of newly-thickened continental crust combined with high mantle heat flux. The contemporaneity of magmatic and deformational events along the lengths of the belts is consistent with a subduction-dominated tectonic regime for assembly of the Kenoran Orogen. Successive addition of volcanic arcs accompanied and followed by voluminous plutonism resulted in crustal thickening and stabilization of the Superior craton prior to uplift of Kapuskasing granulites, emplacement of the Matachewan diabase dykes, and Early Proterozoic marginal rifting.

  18. Surgical approach to the superior mid-orbit.

    PubMed

    Krohn-Hansen, Dag; Nicolaissen, Bjørn; Meling, Torstein R; Haaskjold, Erling

    2013-09-01

    Access to the superior mid-orbit is required for procedures on the levator muscle in the correction of upper eyelid ptosis and in surgery aimed at local lesions in this region. The purpose with this human cadaver study was to clarify the anatomical substrate for a surgical approach to the levator muscle and the upper mid-orbit structures, in which the orbital septum and the retroseptal fat pad is not harmed during surgery. Macro-anatomical dissections and histological examinations were performed on five human orbits from three formalin embalmed cadaver heads. It was found that the orbital septum extends posteriorly from its junction with the levator aponeurosis. This posterior continuation of the orbital septum encloses the superior orbital fat pad and separates this from the anterior surface of the levator muscle. In between the orbital septum and the levator, there is a dissection space that provides a minimal invasive access corridor to the structures in the upper mid-orbit.

  19. Periphyton accumulation at remote reefs and shoals in Lake Superior

    USGS Publications Warehouse

    Edsall, Thomas A.; Stoermer, Eugene F.; Kociolek, John P.

    1991-01-01

    Observations made from a submarine showed that the bed-rock surfaces at water depths of about 5 to 14 m on Stannard Rock and Superior Shoal in Lake Superior were covered with a dense, fleece-like blanket of periphyton. Examination of the periphyton revealed it consisted primarily of structurally complex, diverse, diatom communities, but occasional small thalli of the green algae Cladophora andStigeoclonium were also noted. Extensive windrows of detritus-like material, apparently derived from the local periphyton community, were seen on soft bottoms at depths of about 20 to 60 m near the reefs. Our observations suggested that these periphyton communities may be locally important to the food web at these remote and oligotrophic sites, which are 22 to 77 km from the nearest mainland shore and are surrounded by water at least 140 m deep.

  20. Tullio phenomenon in superior semicircular canal dehiscence syndrome.

    PubMed

    Basura, Gregory J; Cronin, Scott J; Heidenreich, Katherine D

    2014-03-18

    Tullio phenomenon refers to eye movements induced by sound.(1) This unusual examination finding may be seen in superior semicircular canal dehiscence (SSCD) syndrome.(2) This disorder is due to absent bone over the superior semicircular canal (figure). Patients complain of dizziness triggered by loud sound, aural fullness, autophony, and pulsatile tinnitus. When Tullio phenomenon exists in SSCD syndrome, the patient develops a mixed vertical-torsional nystagmus in which the slow phase rotates up and away from the affected ear (video on the Neurology® Web site at Neurology.org). This pattern of nystagmus aligns in the plane of the dehiscent semicircular canal and is due to excitation of its afferent nerves.

  1. Laparoscopic Pancreaticoduodenectomy: Right Posterior Superior Mesenteric Artery "First" Approach.

    PubMed

    Pittau, Gabriella; Sànchez-Cabùs, Santiago; Laurenzi, Andrea; Gelli, Maximiliano; Cunha, Antonio Sa

    2015-12-01

    Pancreaticoduodenectomy (PD) is considered one of the most challenging abdominal operations for several reasons, including the anatomy, which is surrounded by vital vascular structures and also because of the serious complications that are possible in the postoperative period. Nowadays, thanks to the development of minimally invasive surgery and improvement of patients' selection, laparoscopic pancreatic resections have been proven to be technically feasible and safe especially in the case of left pancreatectomies. More recently, many series of laparoscopic PD for adenocarcinoma have been published demonstrating the feasibility of this technique. In pancreatic cancer, the advantage of superior mesenteric artery "first approach" is already known to achieve an oncological resection. The purpose of this video is to describe the different technical aspects of the laparoscopic superior mesenteric artery first approach in the right posterior fashion.

  2. Superior oblique muscle paresis and restriction secondary to orbital mucocele.

    PubMed

    Pineles, Stacy L; Velez, Federico G; Elliot, Richard L; Rosenbaum, Arthur L

    2007-02-01

    Mucoceles are chronic cystic lesions of the paranasal sinuses lined by respiratory epithelium. Their extension into the adjacent orbit may result in proptosis, ocular motility disorders, and diplopia. Brown syndrome secondary to extension of a mucocele into the orbit has been reported previously. Superior oblique (SO) muscle weakness, either isolated or in combination with an ipsilateral limitation to elevation in adduction, has not been previously reported in patients with orbital mucocele.

  3. Superior Labral Anterior Posterior Lesions of the Shoulder

    PubMed Central

    Malal, Joby Jacob George; Khan, Yousaf; Farrar, Graville; Waseem, Mohammed

    2013-01-01

    Superior labrum anterior and posterior (SLAP) lesion is of fairly recent description and its understanding is rapidly evolving. Its incidence and need for surgical treatment has increased exponentially in line with the increase in shoulder arthroscopies. It is of particular importance in the elite over head athlete and the young. A range of arthroscopic techniques and devices have been described with good functional results. The ability to return to pre injury level of sports remains a concern. PMID:24082975

  4. Impairments in tactile search following superior parietal damage.

    PubMed

    Skakoon-Sparling, Shayna P; Vasquez, Brandon P; Hano, Kate; Danckert, James

    2011-08-01

    The superior parietal cortex is critical for the control of visually guided actions. Research suggests that visual stimuli relevant to actions are preferentially processed when they are in peripersonal space. One recent study demonstrated that visually guided movements towards the body were more impaired in a patient with damage to superior parietal cortex. Whereas past studies have explored disordered movement in optic ataxic patients, there has been less exploration of space perception in terms of search capacity in this population. In addition, there is some debate concerning the relationship between deficits of visuomotor control and impaired attention/perception in optic ataxia. Given that the dorsal stream has been implicated in the spatial processing of stimuli in peripersonal space, and damage to this region is known to cause optic ataxia, we felt that further investigation was warranted. We examined tactile search behavior in the fronto-parallel and radial planes in a patient with right superior parietal damage and optic ataxia. We used a pegboard with removable cylindrical pegs that allowed for the reorganization of targets between trials. To better characterize three-dimensional search behavior, we included both horizontal and vertical search conditions. Results showed that the patient spent more time searching, was more accurate and revisited more targets in right versus left space. Interestingly, the patient spent the majority of her time specifically searching the lower right quadrant of the stimulus array. Further analysis revealed lower target detection rates along the outer borders of the pegboard on all sides. The search pattern observed here is unusual considering that all targets were within arm's reach. The present experiment demonstrates that damage to superior parietal cortex impairs tactile search and biases exploration towards lower right peripersonal space.

  5. Superior mesenteric arteriovenous fistula embolisation complicated by bowel ischaemia

    PubMed Central

    Hussein, Maher; Issa, Ghada; Muhsen, Shirin; Haydar, Ali

    2013-01-01

    Superior mesenteric arteriovenous fistulas are rare, especially when iatrogenic in origin. Management of these fistulas can be surgical or endovascular. Endovascular embolisation is the preferred modality with a low rate of complications. Among the reported complications, bowel ischaemia is considered an unlikely occurrence. We report a case of a complex iatrogenic arterioportal fistula that was managed by endovascular embolisation and controlled through both its inflow and outflow, and was later complicated by bowel ischaemia. PMID:23682091

  6. Information Superiority generated through proper application of Geoinformatics

    NASA Astrophysics Data System (ADS)

    Teichmann, F.

    2012-04-01

    Information Superiority generated through proper application of Geoinformatics Information management and especially geoscience information delivery is a very delicate task. If it is carried out successfully, geoscientific data will provide the main foundation of Information Superiority. However, improper implementation of geodata generation, assimilation, distribution or storage will not only waste valuable resources like manpower or money, but could also give rise to crucial deficiency in knowledge and might lead to potentially extremely harmful disasters or wrong decisions. Comprehensive Approach, Effect Based Operations and Network Enabled Capabilities are the current buzz terms in the security regime. However, they also apply to various interdisciplinary tasks like catastrophe relief missions, civil task operations or even in day to day business operations where geo-science data is used. Based on experience in the application of geoscience data for defence applications the following procedure or tool box for generating geodata should lead to the desired information superiority: 1. Understand and analyse the mission, the task and the environment for which the geodata is needed 2. Carry out a Information Exchange Requirement between the user or customer and the geodata provider 3. Implementation of current interoperability standards and a coherent metadata structure 4. Execute innovative data generation, data provision, data assimilation and data storage 5. Apply a cost-effective and reasonable data life cycle 6. Implement IT security by focusing of the three pillar concepts Integrity, Availability and Confidentiality of the critical data 7. Draft and execute a service level agreement or a memorandum of understanding between the involved parties 8. Execute a Continuous Improvement Cycle These ideas from the IT world should be transferred into the geoscience community and applied in a wide set of scenarios. A standardized approach of how to generate, provide

  7. Isolated superior mesenteric venous thrombophlebitis with acute appendicitis

    PubMed Central

    Karam, Mohsen Mohamed; Abdalla, Mohaed Fahmy; Bedair, Said

    2011-01-01

    INTRODUCTION Isolated superior mesentericveinous thrmbophlebitis is a rarely recognised condition associated with a high morbidity. It usually develops secondary to infection in the drainage area of the portal venous system, like appendix. PRESENTATION OF CASE We report a case of neglected perforated acute appendicitis complicated by superior mesenteric venous pyelephlebitis patiant represented with a vague pain to right of umlicus, which is atypical this why cat scan was done and showed obstructed superiormesentric vein, portal vein was free with acute appendicitis. Appendicectomy and treatment with broad-spectrum antibiotics, anticoagulation, and platelets led to a full recovery. Follow-up imaging after one month revealed complete canalization of superior mesentric vein. DISCUSSION Abdominal pain if atypical like our case report need imaging diagnosis. Modern diagnostic imaging techniques help the early diagnosis of acute phase pylephlebitis. CT can detect primary source of infection, extent of pylephlebitis, CT scan is the most reliable initially. Ultrasound scan with color flow Doppler is also a sensitive test for confirming partial patency of the portal vein and portal vein thrombosis accidentally discovered complete obliteration of superior mesenteric vein with thrombosis which remained not propagated by serial Doppler ultrasound of liver. Appropriate treatment should be initiated as soon as possible. To avoid extension to portal vein. The principal treatment for pylephlebitis is to remove the source of infection as appendicectomy. Anticoagulants must be used. Regarding the treatment of portal thrombosis, post operative use of heparin has been advocated. CONCLUSION Cat scan play an important role in case of atypical abdominal pain. PMID:23500734

  8. Habitat change in a perched dune system along Lake Superior

    USGS Publications Warehouse

    Loope, Walter L.; McEachern, A. Kathryn; Mac, Michael J.; Opler, Paul A.; Puckett Haecker, Catherine E.; Doran, Peter D.

    1998-01-01

    Episodes of habitat change, driven by changes in levels of the Great Lakes, must be considered when assessing human effects upon coastal vegetation and rare species. Paleoecological studies, baseline inventories, and long-term monitoring programs within the Grand Sable Dunes, a perched-dune system along Lake Superior, provide a window on vegetation change at different spatial and temporal scales and also provide an illustrative case study.

  9. Advanced bit establishes superior performance in Ceuta field

    SciTech Connect

    Mensa-Wilmot, G.

    1999-11-01

    A new-generation polycrystalline diamond compact (PDC) bit is redefining operational efficiency and reducing drilling costs in the Ceuta field, in the Lago de Maracaibo area of Venezuela. Its unique cutting structure and advancements in PDC cutter technology have established superior performance in this challenging application. The paper describes the new-generation PDC bit, advanced technology PDC cutters, and performance. A table gives cost per foot evaluation.

  10. Small bowel stricture complicating superior mesenteric vein thrombosis.

    PubMed

    Yang, Jin; Shen, Laigen; Zheng, Xueyong; Zhu, Yuefeng; Liu, Zhengjie

    2012-02-01

    Superior mesenteric vein (SMV) thrombosis is a relatively rare disease. Most patients may be successfully treated with anti-coagulation alone. However, bowel stricture may develop due to intestinal ischemia which may require surgical treatment. This report describes a rare case of small bowel stricture occurring one month after successful treatment of SMV thrombosis. After segmental resection of strictured bowel, the patient's post-operative course was uneventful.

  11. Incidental Superior Hypophygeal Artery Aneurysm Embedded within Pituitary Adenoma

    PubMed Central

    Choi, Hong-Seok; Kim, Min-Su; Jung, Young-Jin

    2013-01-01

    Intra-cranial aneurysm can be incidental findings in patients with pituitary adenomas, and are usually located outside the pituitary region. However, the coexistence of intrasellar (not intracranial) aneurysms with pituitary adenomas is extremely rare. We report a patient with an incidental superior hypophygeal aneurysm embedded within a non-functional pituitary adenoma which was treated by transsphenoidal surgery after endovascular coil embolization. PMID:24278658

  12. Pancreaticoduodenal Artery Aneurysm Formation with Superior Mesenteric Artery Stenosis

    PubMed Central

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

    2014-01-01

    Celiac stenosis or occlusion is attributed partly to increase blood flow at pancreatic arcade from the superior mesenteric artery (SMA) system and may play a causal role in true aneurysm of pancreaticoduodenal artery (PDAA) formation. However, despite possible increased blood flow in the pancreatic arcades like celiac stenosis, PDAAs with a stenotic SMA are extremely rare, with only three cases have been reported in the literature. We report a case of PDAA with SMA stenosis and review the literature. PMID:25298835

  13. Controlled movement processing: superior colliculus activity associated with countermanded saccades.

    PubMed

    Paré, Martin; Hanes, Doug P

    2003-07-23

    We investigated whether the monkey superior colliculus (SC), an important midbrain structure for the regulation of saccadic eye movements, contains neurons with activity patterns sufficient to control both the cancellation and the production of saccades. We used a countermanding task to manipulate the probability that, after the presentation of a stop signal, the monkeys canceled a saccade that was planned in response to an eccentric visual stimulus. By modeling each animal's behavioral responses, with a race between GO and STOP processes leading up to either saccade initiation or cancellation, we estimated that saccade cancellation took on average 110 msec. Neurons recorded in the superior colliculus intermediate layers during this task exhibited the discharge properties expected from neurons closely involved in behavioral control. Both saccade- and fixation-related discharged differently when saccades were counter-manded instead of executed, and the time at which they changed their activity preceded the behavioral estimate of saccade cancellation obtained from the same trials by 10 and 13 msec, respectively. Furthermore, these intervals exceed the minimal amount of time needed for SC activity to influence eye movements. The additional observation that saccade-related neurons discharged significantly less when saccades were countermanded instead of executed suggests that saccades are triggered when these neurons reach a critical activation level. Altogether, these findings provide solid evidence that the superior colliculus contains the necessary neural signals to be directly involved in the decision process that regulates whether a saccade is to be produced.

  14. Levels of processing and picture memory: the physical superiority effect.

    PubMed

    Intraub, H; Nicklos, S

    1985-04-01

    Six experiments studied the effect of physical orienting questions (e.g., "Is this angular?") and semantic orienting questions (e.g., "Is this edible?") on memory for unrelated pictures at stimulus durations ranging from 125-2,000 ms. Results ran contrary to the semantic superiority "rule of thumb," which is based primarily on verbal memory experiments. Physical questions were associated with better free recall and cued recall of a diverse set of visual scenes (Experiments 1, 2, and 4). This occurred both when general and highly specific semantic questions were used (Experiments 1 and 2). Similar results were obtained when more simplistic visual stimuli--photographs of single objects--were used (Experiments 5 and 6). As in the case of the semantic superiority effect with words, the physical superiority effect for pictures was eliminated or reversed when the same physical questions were repeated throughout the session (Experiments 4 and 6). Conflicts with results of previous levels of processing experiments with words and nonverbal stimuli (e.g., faces) are explained in terms of the sensory-semantic model (Nelson, Reed, & McEvoy, 1977). Implications for picture memory research and the levels of processing viewpoint are discussed. PMID:3157769

  15. Preference for Audiovisual Speech Congruency in Superior Temporal Cortex.

    PubMed

    Lüttke, Claudia S; Ekman, Matthias; van Gerven, Marcel A J; de Lange, Floris P

    2016-01-01

    Auditory speech perception can be altered by concurrent visual information. The superior temporal cortex is an important combining site for this integration process. This area was previously found to be sensitive to audiovisual congruency. However, the direction of this congruency effect (i.e., stronger or weaker activity for congruent compared to incongruent stimulation) has been more equivocal. Here, we used fMRI to look at the neural responses of human participants during the McGurk illusion--in which auditory /aba/ and visual /aga/ inputs are fused to perceived /ada/--in a large homogenous sample of participants who consistently experienced this illusion. This enabled us to compare the neuronal responses during congruent audiovisual stimulation with incongruent audiovisual stimulation leading to the McGurk illusion while avoiding the possible confounding factor of sensory surprise that can occur when McGurk stimuli are only occasionally perceived. We found larger activity for congruent audiovisual stimuli than for incongruent (McGurk) stimuli in bilateral superior temporal cortex, extending into the primary auditory cortex. This finding suggests that superior temporal cortex prefers when auditory and visual input support the same representation.

  16. Water quality of streams tributary to Lakes Superior and Michigan

    USGS Publications Warehouse

    Zimmerman, Jerome W.

    1968-01-01

    Water quality of streams tributary to Lakes Superior and Michigan was analyzed for 142 stations on 99 streams tributary to Lake Superior and 83 stations on 56 streams tributary to Lake Michigan during 1962-65. Concentrations of aluminum, copper, and iron were not affected greatly by flow or season. Magnesium, calcium, chlorides, total alkalinity, total hardness, and conductivity varied with the flow, temperature, and season; the lowest values were during the spring runoff and heavy rains, and the highest were during low water in late summer and the colder periods of winter. Concentrations of nitrate, silica, and sulfates were lowest in the spring and summer. Concentrations of tanninlike and ligninlike compounds were highest during the spring runoff and other high-water periods, and were lowest during freezeup when surface runoff was minimal. The pH values were highest from June to September and lowest during the spring runoff. Phenolphthalein alkalinity was detected primarily in the summer and coincided occasionally with low flows just before the spring thaw. Total hardness usually was lower in streams tributary to Lake Superior than in streams tributary to Lake Michigan. The total hardness was higher in the streams in Wisconsin than in the streams in Michigan along the west shore of Lake Michigan. It was lowest in the northernmost streams. The water quality of the streams in an area was related to the geological characteristics of the land.

  17. Prey selection by the Lake Superior fish community

    USGS Publications Warehouse

    Isaac, Edmund J.; Hrabik, Thomas R.; Stockwell, Jason D.; Gamble, Allison E.

    2012-01-01

    Mysis diluviana is an important prey item to the Lake Superior fish community as found through a recent diet study. We further evaluated this by relating the quantity of prey found in fish diets to the quantity of prey available to fish, providing insight into feeding behavior and prey preferences. We describe the seasonal prey selection of major fish species collected across 18 stations in Lake Superior in spring, summer, and fall of 2005. Of the major nearshore fish species, bloater (Coregonus hoyi), rainbow smelt (Osmerus mordax), and lake whitefish (Coregonus clupeaformis) consumed Mysis, and strongly selected Mysis over other prey items each season. However, lake whitefish also selected Bythotrephes in the fall when Bythotrephes were numerous. Cisco (Coregonus artedi), a major nearshore and offshore species, fed largely on calanoid copepods, and selected calanoid copepods (spring) and Bythotrephes (summer and fall). Cisco also targeted prey similarly across bathymetric depths. Other major offshore fish species such as kiyi (Coregonus kiyi) and deepwater sculpin (Myoxocephalus thompsoni) fed largely on Mysis, with kiyi targeting Mysis exclusively while deepwater sculpin did not prefer any single prey organism. The major offshore predator siscowet lake trout (Salvelinus namaycush siscowet) consumed deepwater sculpin and coregonines, but selected deepwater sculpin and Mysis each season, with juveniles having a higher selection for Mysis than adults. Our results suggest that Mysis is not only a commonly consumed prey item, but a highly preferred prey item for pelagic, benthic, and piscivorous fishes in nearshore and offshore waters of Lake Superior.

  18. Preference for Audiovisual Speech Congruency in Superior Temporal Cortex.

    PubMed

    Lüttke, Claudia S; Ekman, Matthias; van Gerven, Marcel A J; de Lange, Floris P

    2016-01-01

    Auditory speech perception can be altered by concurrent visual information. The superior temporal cortex is an important combining site for this integration process. This area was previously found to be sensitive to audiovisual congruency. However, the direction of this congruency effect (i.e., stronger or weaker activity for congruent compared to incongruent stimulation) has been more equivocal. Here, we used fMRI to look at the neural responses of human participants during the McGurk illusion--in which auditory /aba/ and visual /aga/ inputs are fused to perceived /ada/--in a large homogenous sample of participants who consistently experienced this illusion. This enabled us to compare the neuronal responses during congruent audiovisual stimulation with incongruent audiovisual stimulation leading to the McGurk illusion while avoiding the possible confounding factor of sensory surprise that can occur when McGurk stimuli are only occasionally perceived. We found larger activity for congruent audiovisual stimuli than for incongruent (McGurk) stimuli in bilateral superior temporal cortex, extending into the primary auditory cortex. This finding suggests that superior temporal cortex prefers when auditory and visual input support the same representation. PMID:26351991

  19. Ideomotor Apraxia Due to Injury of the Superior Longitudinal Fasciculus.

    PubMed

    Jang, Sung Ho; Jang, Woo Hyuk

    2016-08-01

    We report on a patient who showed ideomotor apraxia due to injury of the superior longitudinal fasciculus following brain tumor and tumor bleeding, which was demonstrated by diffusion tensor tractography (DTT). A 60-yr-old, right-handed male patient underwent removal of brain meningioma and drainage of intraventricular hemorrhage and intracerebral hemorrhage in the left fronto-parietal lobe. At the time of DTT scanning (5 wk after onset), he was able to move the right upper extremity against gravity. The patient exhibited an intact ideational plan for motor performance. In addition, he was able to use actual objects (scissors, eraser) using his right wrist and hand. However, he had difficulty in using his right upper extremity for pantomime of object use, imitating gestures (meaningless or meaningful), and movement of his right upper extremity proximal. Score on the ideomotor apraxia test for the right side was 4 (cut-off score < 32). DTTs for the left superior longitudinal fasciculus to the left premotor cortex and left inferior parietal lobule showed partial injury, compared with the right superior longitudinal fasciculus. These injuries appeared to be the reason for ideomotor apraxia in this patient. PMID:27003199

  20. Superior metallic alloys through rapid solidification processing (RSP) by design

    SciTech Connect

    Flinn, J.E.

    1995-05-01

    Rapid solidification processing using powder atomization methods and the control of minor elements such as oxygen, nitrogen, and carbon can provide metallic alloys with superior properties and performance compared to conventionally processing alloys. Previous studies on nickel- and iron-base superalloys have provided the baseline information to properly couple RSP with alloy composition, and, therefore, enable alloys to be designed for performance improvements. The RSP approach produces powders, which need to be consolidated into suitable monolithic forms. This normally involves canning, consolidation, and decanning of the powders. Canning/decanning is expensive and raises the fabrication cost significantly above that of conventional, ingot metallurgy production methods. The cost differential can be offset by the superior performance of the RSP metallic alloys. However, without the performance database, it is difficult to convince potential users to adopt the RSP approach. Spray casting of the atomized molten droplets into suitable preforms for subsequent fabrication can be cost competitive with conventional processing. If the fine and stable microstructural features observed for the RSP approach are preserved during spray casing, a cost competitive product can be obtained that has superior properties and performance that cannot be obtained by conventional methods.