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Sample records for middle hepatic vein

  1. Corrosion cast study of the canine hepatic veins.

    PubMed

    Uršič, M; Vrecl, M; Fazarinc, G

    2014-11-01

    This study presents a detailed description of the distribution, diameters and drainage patterns of hepatic veins on the basis of the corrosion cast analysis in 18 dogs. We classified the hepatic veins in three main groups: the right hepatic veins of the caudate process and right lateral liver lobe, the middle hepatic veins of the right medial and quadrate lobes and the left hepatic veins of both left liver lobes and the papillary process. The corrosion cast study showed that the number of the veins in the Nomina Anatomica Veterinaria and most anatomical textbooks is underestimated. The number of various-sized hepatic veins of the right liver division ranged from 3 to 5 and included 1 to 4 veins from the caudate process and 2 to 4 veins from the right lateral liver lobe. Generally, in all corrosion casts, one middle-sized vein from the right part of the right medial lobe, which emptied separately in the caudal vena cava, was established. The other vein was a large-sized vein from the remainder of the central division, which frequently joined the common left hepatic vein from the left liver lobes. The common left hepatic vein was the largest of all the aforementioned hepatic veins.

  2. Preservation of segment 4 inferior by distal middle hepatic vein reconstruction combined with extended right hepatectomy after portal vein embolization in a patient with a huge initially unresectable HCC.

    PubMed

    Nakano, Hiroshi; Kikuchi, Keita; Seta, Shin-ichi; Katayama, Masafumi; Yamamura, Takuya; Otsubo, Takehito

    2007-01-01

    An extended hepatectomy combined with preoperative portal venous embolization can offer curative resection in patients with initially unresectable hepatocellular carcinoma. However, hypertrophy of the future remnant liver is occasionally unsatisfactory after portal venous embolization in some patients to remove the initially unresectable tumor. In these patients, hepatic venous reconstruction to preserve hepatic parenchyma may contribute to the possibility of resection. The present case report shows a patient with an initially unresectable huge hepatocellular carcinoma in whom transarterial chemoembolization, portal vein embolization, and an extended right hepatectomy combined with distal middle hepatic venous reconstruction were performed to preserve Segment 4 inferior. The patient was a 66-year-old male. He presented with a huge hepatocellular carcinoma located at Segment 8, 7 and 4 superior, but the volume of the left lateral segment was only 267 mL. Transarterial chemoembolization was performed twice and right portal vein embolization was performed once, but the volume of the left lateral segment was only 318 mL compared to 487 mL which was a limit of future remnant liver volume. We therefore performed an extended right hepatectomy combined with distal middle hepatic venous reconstruction to preserve Segment 4 inferior. The left saphenous venous graft was used for this hepatic venous reconstruction. His postoperative course was almost uneventful. Postoperative abdominal computed tomography showed the satisfactorily preserved Segment 4 inferior. Distal hepatic venous reconstruction combined with an extended hepatectomy may further offer a chance of a curative resection for patients in whom enough hypertrophy of the future remnant liver is not obtained after portal venous embolization.

  3. Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein

    PubMed Central

    Badawy, Mohamad T.; Soliman, Hosam El-Din; El-Gendy, Magdy; Ibrahim, Tarek; Davidson, Brian R.

    2013-01-01

    Introduction. The difficulty and challenge of recovering a right lobe graft without MHV drainage is reconstructing the outflow tract of the hepatic veins. With the inclusion or the reconstruction of the MHV, early graft function is satisfactory. The inclusion of the MHV or not in the donor's right lobectomy should be based on sound criteria to provide adequate functional liver mass for recipient, while keeping risk to donor to the minimum. Objective. Reviewing the results of a policy for right lobe grafts transplant without MHV and analyzing methods of venous reconstruction related to outcome. Materials and Methods. We have two groups Group A (with more than one HV anast.) (n = 16) and Group B (single HV anast.) (n = 24). Both groups were compared regarding indications for reconstruction, complications, and operative details and outcomes, besides describing different modalities used for venous reconstruction. Results. Significant increase in operative details time in Group A. When comparison came to complications and outcomes in terms of laboratory findings and overall hospital stay, there were no significant differences. Three-month and one-year survival were better in Group A. Conclusion. Adult LDLT is safely achieved with better outcome to recipients and donors by recovering the right lobe without MHV, provided that significant MHV tributaries (segments V, VIII more than 5 mm) are reconstructed, and any accessory considerable inferior right hepatic veins (IRHVs) or superficial RHVs are anastomosed. PMID:24489434

  4. Intraoperative assessment of hepatic venous congestion with direct clamping of the hepatic vein trunk for living donor liver transplantation.

    PubMed

    Hwang, S; Lee, S G; Kim, K H; Park, K M; Lee, Y J; Ahn, C S; Moon, D B; Ha, T Y; Cho, S H; Oh, K B

    2004-06-01

    We devised a hepatic vein clamping method to assess the amount of hepatic venous congestion (HVC) before liver transection. From February 2003 to May 2003, this method was applied to 5 of 58 living donor livers especially to assess donor safety. The left portal vein and proper hepatic artery as well as the middle hepatic vein (MHV)-left hepatic vein (LHV) trunk were clamped simultaneously to assess the HVC in the remnant right lobe before performing extended left lobectomy. As three donors demonstrated the extent of the HVC equivalent to about 40% of the right lobe volume (RLV), their operations proceeded according to the preoperative plan. The territory of HVC after liver transection was the same as that observed with direct clamping of the hepatic vein. However, one donor showed massive HVC more than 50% of RLV and the operative plan was adjusted to harvest only the left lobe without the MHV trunk for donor safety. To assess the HVC in the remnant left lobe, the isolated LHV trunk was occluded after clamping the donor's proper hepatic artery. The whole left lobe except for a small area at the anterior portion of the medial segment became discolored on LHV clamping: the opposite demarcation appeared on MHV clamping. The amount of HVC was so small that we harvested the right lobe with the MHV trunk. All donors and recipients recovered uneventfully. We believe that this direct clamping method makes the assessment of HVC feasible before parenchymal transection of a donor liver. PMID:15251358

  5. Posttransplant Complex Inferior Venacava Balloon Dilatation After Hepatic Vein Stenting

    SciTech Connect

    Kohli, Vikas; Wadhawan, Manav; Gupta, Subhash; Roy, Vipul

    2010-02-15

    Orthotopic and living related liver transplantation is an established mode of treatment of end-stage liver disease. One of the major causes of postoperative complications is vascular anastomotic stenosis. One such set of such complications relates to hepatic vein, inferior vena cava (IVC), or portal vein stenosis, with a reported incidence of 1-3%. The incidence of vascular complications is reported to be higher in living donor versus cadaveric liver transplants. We encountered a patient with hepatic venous outflow tract obstruction, where the hepatic vein had been previously stented, but the patient continued to have symptoms due to additional IVC obstruction. The patient required double-balloon dilatation of the IVC simultaneously from the internal jugular vein and IVC.

  6. A method for quickly and exactly extracting hepatic vein

    NASA Astrophysics Data System (ADS)

    Xiong, Qing; Yuan, Rong; Wang, Luyao; Wang, Yanchun; Li, Zhen; Hu, Daoyu; Xie, Qingguo

    2013-02-01

    It is of vital importance that providing detailed and accurate information about hepatic vein (HV) for liver surgery planning, such as pre-operative planning of living donor liver transplantation (LDLT). Due to the different blood flow rate of intra-hepatic vascular systems and the restrictions of CT scan, it is common that HV and hepatic portal vein (HPV) are both filled with contrast medium during the scan and in high intensity in the hepatic venous phase images. As a result, the HV segmentation result obtained from the hepatic venous phase images is always contaminated by HPV which makes accurate HV modeling difficult. In this paper, we proposed a method for quick and accurate HV extraction. Based on the topological structure of intra-hepatic vessels, we analyzed the anatomical features of HV and HPV. According to the analysis, three conditions were presented to identify the nodes that connect HV with HPV in the topological structure, and thus to distinguish HV from HPV. The method costs less than one minute to extract HV and provides a correct and detailed HV model even with variations in vessels. Evaluated by two experienced radiologists, the accuracy of the HV model obtained from our method is over 97%. In the following work, we will extend our work to a comprehensive clinical evaluation and apply this method to actual LDLT surgical planning.

  7. [Mechanisms of contractile action of acetylcholine on hepatic veins].

    PubMed

    Ianchuk, P I; Prykhod'ko, T P; Pasichnichenko, O M; Tieriekhov, A A; Tsybenko, V O

    2011-01-01

    In acute experiments on anesthetized rats, acetylcholine (Ach) constricts hepatic venous vessels, causing blood mobilization from the liver, and dilates the sphincters of hepatic veins at the exit from this organ, contributing to the intensification of the outflow of blood deposited in the liver. Vasoconstrictor reactions of capacitive vessels of the liver to Ach are realized through M-cholinoreceptors on endotheliocytes with further involvement of messenger, possibly noradrenaline, which activates alpha-adrenoreceptors on smooth muscle cells (SMC) of capasitive vessels. Dilation of Hv sphincters is carried out due to Ach-induced release of messenger in the vessel wall, probably adrenaline, which in turn activates beta-adrenoreceptors on SMC of the Hv. It is possible, that in such reaction partially involved NO.

  8. Comparative research on the topography of middle and small cardiac veins in humans and other primates.

    PubMed

    Duda, Barbara; Grzybiak, Marek; Jerzemowski, Janusz

    2003-01-01

    Many researchers have been interested in cardiac veins, which at present play a very important clinical role in invasive cardiology. In this study the occurrence of middle and small cardiac veins and the topography of their outlet portions were examined. The material consisted of 150 adult human hearts of both sexes of 18 to 85 years of age and 50 adult hearts of representatives of various primates. In the material examined a middle cardiac vein was always observed, whereas the presence of a small cardiac vein was less consistent The outlet portions of the main veins of the heart were characterised by significant variability.

  9. Hepatic artery injury during left hepatic trisectionectomy for colorectal liver metastasis treated by portal vein arterialization.

    PubMed

    Hokuto, Daisuke; Nomi, Takeo; Yamato, Ichiro; Yasuda, Satoshi; Obara, Shinsaku; Yamada, Takatsugu; Kanehiro, Hiromichi; Nakajima, Yoshiyuki

    2015-01-01

    Portal vein arterialization (PVA) has been applied as a salvage procedure in hepatopancreatobiliary surgeries, including transplantation and liver resection, with revascularization for malignancies. Here we describe the use PVA as a salvage procedure following accidental injury of the hepatic artery to the remnant liver occurred during left hepatic trisectionectomy for colorectal liver metastases (CRLM). A 60-year-old man with cancer of the sigmoid colon and initially unresectable CRLM received 11 cycles of hepatic arterial infusion chemotherapy with 5-fluorouracil (1500mg/week), after which CRLM was downstaged to resectable. One month after laparoscopic sigmoidectomy, a left trisectionectomy and wedge resection of segment 6 were performed. The posterior branch of the right hepatic artery, the only feeding artery to the remnant liver, was injured and totally dissected. Because microsurgical reconstruction of the artery was impossible, PVA was used; PVA is the sole known procedure available when hepatic artery reconstruction is impossible. The patient then suffered portal hypertension, and closure of arterio-portal anastomosis using an interventional technique with angiography was eventually performed on postoperative day 73. Therefore, it is considered that because PVA is associated with severe postoperative portal hypertension, closure of the arterio-portal shunt should be performed as soon as possible on diagnosing portal hypertension. PMID:26197094

  10. The response of thrombosis in the portal vein or hepatic vein in hepatocellular carcinoma to radiation therapy

    PubMed Central

    Bae, Bong Kyung; Kim, Jae-Chul

    2016-01-01

    Purpose The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients’ prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients. PMID:27545294

  11. Paraumbilical vein patency in cirrhosis: effects on hepatic hemodynamics evaluated by Doppler sonography.

    PubMed

    Sacerdoti, D; Bolognesi, M; Bombonato, G; Gatta, A

    1995-12-01

    Doppler sonographic portal vein parameters are used for the noninvasive evaluation of portal hypertension in cirrhosis. The patency of a paraumbilical vein is a rather frequent finding in cirrhosis, which may affect hepatic hemodynamics and function. We evaluated portal and hepatic arterial parameters in 184 cirrhotic patients with and without a patent paraumbilical vein and the relationships with paraumbilical blood flow. A patent paraumbilical vein was found in 33.7% of patients. The prevalence was higher (56.8%) in Child C patients. Portal blood flow velocity (PBV) (10.8 +/- 2.2 vs. 9.8 +/- 2.4 cm/sec; P < .01) and volume (PBF) (995.0 +/- 383.8 vs. 811.6 +/- 318.7 mL/min; P < .001) was significantly higher, and effective portal liver perfusion (PLP) (portal blood flow--paraumbilical blood flow) (621.3 +/- 420.8 vs. 811.6 +/- 318.7 mL/min; P < .001) was significantly lower in patients with a patent paraumbilical vein than in those without. These differences were more evident in Child C patients (10.7 +/- 2.0 vs. 8.3 +/- 2.3 cm/sec; 935.7 +/- 378.3 vs. 680.6 +/- 239.4 mL/min; 369.0 +/- 282.0 vs. 680.6 +/- 239.4 mL/min). Portal vein diameter, the congestion index (CI) of the portal vein, hepatic arterial resistance indexes, and the severity of esophageal varices did not differ between the two groups. In patients with a patent paraumbilical vein, the Child-Pugh score and the prevalence of ascites were significantly higher than in those without. In conclusion, the evaluation of PBV and PBF in cirrhotic patients can provide misleading results if a paraumbilical vein is patent, underestimating the degree of portal hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Resection and reconstruction of the right hepatic vein with combined S4, S7 and S8 segmentectomy.

    PubMed

    Xie, Yu; Dong, Jia-Hong; Wang, Yan-Bin; Leng, Jian-Jun

    2009-10-01

    Preservation of the main branches of the right hepatic vein in hepatectomy can retain the liver function of the future remnant liver, and especially in some types of radical surgery, reconstruction of the hepatic vein is considered. A case is here presented where a high risk patient diagnosed with Caroli disease was treated effectively using precise hepatectomy.

  13. Comparison of harmonic scalpel versus conventional knot tying for transection of short hepatic veins at liver transplantation: prospective randomized study.

    PubMed

    Olmez, A; Karabulut, K; Aydin, C; Kayaalp, C; Yilmaz, S

    2012-01-01

    The objective of this study was to compare harmonic scalpel for short hepatic vein transection with conventional ligation during recipient hepatectomy with caval preservation. Sixteen patients undergoing elective living donor liver transplantation were randomized into 2 groups. We recorded number, diameter, and location of each short hepatic vein, procedure time, central venous pressure, and degree of liver failure (Child-Pugh and Model for End stage Liver Disease scores). As an end point, we observed the intraoperative and postoperative bleeding rates of the transected veins. We transected 144 veins of mean diameter of 2.6 ± 1.8 mm (range, 1-12 mm). Mean number of short hepatic veins in each person was 9 (range, 5-16). Harmonic scalpel was safe for veins with a diameter ≤ 2 mm; these veins were more prone to bleeding with conventional ligation. Bleeding rate was higher after ligation of veins in the upper half than the lower half of the cava (37% vs 21%; P = .04). Both total and per vessel procedure time did not differ between the groups. No postoperative bleeding complications occurred. Transection of veins with a diameter ≤ 2 mm by harmonic scalpel was as safe as conventional ligation. Harmonic scalpel transection of small hepatic veins (≤ 2 mm) can be even safer than conventional control by knot tying, particularly in narrow areas. PMID:22841252

  14. Malposition of a Peripherally Inserted Central Venous Catheter in the Graft Hepatic Vein.

    PubMed

    Ersoy, Zeynep; Araz, Coşkun; Taşkın, Duygu; Moray, Gökhan; Torgay, Adnan

    2015-11-01

    Central venous catheters are used for delivering medications and parenteral nutrition, measuring hemodynamic variations, and providing long-term intravenous access. In our clinic, during liver transection using a living-liver donor, peripherally inserted central venous catheters are generally preferred because they involve a less invasive technique with a lower risk of complications. In this report, we present the case of a 36-year-old male liver donor into whom we peripherally inserted a central venous catheter from his left basilic vein. After transecting the hepatic vein, the surgeon found foreign material inside the venous lumen, which turned out to be the distal segment of the catheter.

  15. Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus

    PubMed Central

    Zheng, Ninggang; Wei, Xiaodong; Zhang, Dongzhi; Chai, Wenxiao; Che, Ming; Wang, Jiangye; Du, Binbin

    2016-01-01

    Abstract The role of hepatic resection in hepatocellular carcinoma (HCC) with accompanying portal vein tumor thrombus (PVTT) remains controversial. This study aimed to evaluate the surgical outcomes of hepatic resection compared with those of transarterial chemoembolization (TACE) in HCC patients. A retrospective study was conducted using the medical records of 230 HCC patients with portal vein invasion who underwent hepatic resection (96 patients) or TACE (134 patients). The baseline characteristics, tumor characteristics, clinicopathological parameters, and overall survival rates were compared between the 2 groups. The baseline and tumor characteristics were comparable between the hepatic resection and TACE groups. The overall complication rate was 35.4% in the hepatic resection group, which was significantly lower than that in the TACE group (73.0%, P <0.001). However, the serious complication rate (grade ≥3) in the hepatic resection group was 13.5%, which was significantly higher than that in the TACE group (P = 0.003). The cumulative overall survival rates at 1, 3, and 5 years in the hepatic resection group were 86.5%, 60.4%, and 33.3%, respectively. These rates were much higher than those in the TACE group (1-year: 77.6%; 3-year: 47.8%; and 5-year: 20.9%; P = 0.021). The long-term survival was notably better in the patients with types I and II PVTT than in the patients with types III and IV PVTT (P <0.05). The univariate and multivariate analyses indicated that types III and IV PVTT and TACE may have contributed to the poor overall survival following surgery. In HCC patients with PVTT and compensated liver function, hepatic resection is a safe and effective surgical protocol, particularly for patients with type I or II PVTT. PMID:27367992

  16. Imaging and radiological interventions in extra-hepatic portal vein obstruction

    PubMed Central

    Pargewar, Sudheer S; Desai, Saloni N; Rajesh, S; Singh, Vaibhav P; Arora, Ankur; Mukund, Amar

    2016-01-01

    Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt (PSS) and revision of PSS. PMID:27358683

  17. Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

    PubMed Central

    Schleimer, Karina; Kalder, Johannes; Grommes, Jochen; Jalaie, Houman; Tawadros, Samir; Greiner, Andreas; Jacobs, Michael; Kokozidou, Maria

    2014-01-01

    In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the failing native liver has regenerated.1-3 The APOLT-method, the orthotopic implantation of auxiliary segments- averts most of the technical problems. However this method necessitates extensive resections of both the native liver and the graft.4 In 1998, Erhard developed the heterotopic auxiliary liver transplantation (HALT) utilizing portal vein arterialization (PVA) (Figure 1). This technique showed promising initial clinical results.5-6 We developed a HALT-technique with flow-regulated PVA in the rat to examine the influence of flow-regulated PVA on graft morphology and function (Figure 2). A liver graft reduced to 30 % of its original size, was heterotopically implanted in the right renal region of the recipient after explantation of the right kidney.  The infra-hepatic caval vein of the graft was anastomosed with the infrahepatic caval vein of the recipient. The arterialization of the donor’s portal vein was carried out via the recipient’s right renal artery with the stent technique. The blood-flow regulation of the arterialized portal vein was achieved with the use of a stent with an internal diameter of 0.3 mm. The celiac trunk of the graft was end-to-side anastomosed with the recipient’s aorta and the bile duct was implanted into the duodenum. A subtotal resection of the native liver was performed to induce acute hepatic failure. 7 In this manner 112 transplantations were performed. The perioperative survival rate was 90% and the 6-week survival rate was 80%. Six weeks after operation, the native liver regenerated, showing an increase in weight from 2.3±0.8 g to 9.8±1 g. At this time, the graft’s weight decreased from 3.3±0.8 g to 2.3±0.8 g. We were able to obtain promising long-term results in terms of graft morphology and function. HALT with flow-regulated PVA reliably bridges acute hepatic failure

  18. Heterotopic auxiliary rat liver transplantation with flow-regulated portal vein arterialization in acute hepatic failure.

    PubMed

    Schleimer, Karina; Kalder, Johannes; Grommes, Jochen; Jalaie, Houman; Tawadros, Samir; Greiner, Andreas; Jacobs, Michael; Kokozidou, Maria

    2014-01-01

    In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the failing native liver has regenerated.(1-3) The APOLT-method, the orthotopic implantation of auxiliary segments- averts most of the technical problems. However this method necessitates extensive resections of both the native liver and the graft.(4) In 1998, Erhard developed the heterotopic auxiliary liver transplantation (HALT) utilizing portal vein arterialization (PVA) (Figure 1). This technique showed promising initial clinical results.(5-6) We developed a HALT-technique with flow-regulated PVA in the rat to examine the influence of flow-regulated PVA on graft morphology and function (Figure 2). A liver graft reduced to 30 % of its original size, was heterotopically implanted in the right renal region of the recipient after explantation of the right kidney.  The infra-hepatic caval vein of the graft was anastomosed with the infrahepatic caval vein of the recipient. The arterialization of the donor's portal vein was carried out via the recipient's right renal artery with the stent technique. The blood-flow regulation of the arterialized portal vein was achieved with the use of a stent with an internal diameter of 0.3 mm. The celiac trunk of the graft was end-to-side anastomosed with the recipient's aorta and the bile duct was implanted into the duodenum. A subtotal resection of the native liver was performed to induce acute hepatic failure. (7) In this manner 112 transplantations were performed. The perioperative survival rate was 90% and the 6-week survival rate was 80%. Six weeks after operation, the native liver regenerated, showing an increase in weight from 2.3±0.8 g to 9.8±1 g. At this time, the graft's weight decreased from 3.3±0.8 g to 2.3±0.8 g. We were able to obtain promising long-term results in terms of graft morphology and function. HALT with flow-regulated PVA reliably bridges acute hepatic failure

  19. Central Retinal Vein Occlusion and Paracentral Acute Middle Maculopathy Diagnosed With En Face Optical Coherence Tomography.

    PubMed

    Phasukkijwatana, Nopasak; Rahimi, Mansour; Iafe, Nicholas; Sarraf, David

    2016-09-01

    A 21-year-old healthy female presented with acute-onset vision loss in the left eye. Multimodal imaging, including fundus photography and fluorescein angiography, was unremarkable. En face optical coherence tomography (OCT) demonstrated paracentral acute middle maculopathy (PAMM) lesions in a perivenular fern-like pattern leading to the diagnosis of central retinal vein occlusion (CRVO). En face OCT can be an important modality to identify the distribution of abnormalities of the middle retina such as PAMM. The distribution of PAMM lesions in the posterior pole will be a critical element in the determination of the etiologic disorder. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:862-864.]. PMID:27631483

  20. Treatment of surgical brain injury by immune tolerance induced by intrathymic and hepatic portal vein injection of brain antigens.

    PubMed

    Yang, Weijian; Liu, Yong; Liu, Baolong; Tan, Huajun; Lu, Hao; Wang, Hong; Yan, Hua

    2016-01-01

    Surgical brain injury (SBI) defines complications induced by intracranial surgery, such as cerebral edema and other secondary injuries. In our study, intrathymic and hepatic portal vein injection of allogeneic myelin basic protein (MBP) or autogeneic brain cell suspensions were administered to a standard SBI model. Serum pro-inflammatory IL-2, anti-inflammatory IL-4 concentrations and the CD4(+)T/CD8(+)T ratio were measured at 1, 3, 7, 14 and 21 d after surgery to verify the establishment of immune tolerance. Furthermore, we confirmed neuroprotective effects by evaluating neurological scores at 1, 3, 7, 14 and 21 d after SBI. Anti-Fas ligand (FasL) immunohistochemistry and TUNEL assays of brain sections were tested at 21 d after surgery. Intrathymic injections of MBP or autogeneic brain cell suspensions functioned by both suppressing secondary inflammatory reactions and improving prognoses, whereas hepatic portal vein injections of autogeneic brain cell suspensions exerted a better effect than MBP. Intrathymic and hepatic portal vein injections of MBP had equal effects on reducing secondary inflammation and improving prognoses. Otherwise, hepatic portal vein injections of autogeneic brain cell suspensions had better outcomes than intrathymic injections of autogeneic brain cell suspensions. Moreover, the benefit of injecting antigens into the thymus was outweighed by hepatic portal vein injections. PMID:27554621

  1. Treatment of surgical brain injury by immune tolerance induced by intrathymic and hepatic portal vein injection of brain antigens

    PubMed Central

    Yang, Weijian; Liu, Yong; Liu, Baolong; Tan, Huajun; Lu, Hao; Wang, Hong; Yan, Hua

    2016-01-01

    Surgical brain injury (SBI) defines complications induced by intracranial surgery, such as cerebral edema and other secondary injuries. In our study, intrathymic and hepatic portal vein injection of allogeneic myelin basic protein (MBP) or autogeneic brain cell suspensions were administered to a standard SBI model. Serum pro-inflammatory IL-2, anti-inflammatory IL-4 concentrations and the CD4+T/CD8+T ratio were measured at 1, 3, 7, 14 and 21 d after surgery to verify the establishment of immune tolerance. Furthermore, we confirmed neuroprotective effects by evaluating neurological scores at 1, 3, 7, 14 and 21 d after SBI. Anti-Fas ligand (FasL) immunohistochemistry and TUNEL assays of brain sections were tested at 21 d after surgery. Intrathymic injections of MBP or autogeneic brain cell suspensions functioned by both suppressing secondary inflammatory reactions and improving prognoses, whereas hepatic portal vein injections of autogeneic brain cell suspensions exerted a better effect than MBP. Intrathymic and hepatic portal vein injections of MBP had equal effects on reducing secondary inflammation and improving prognoses. Otherwise, hepatic portal vein injections of autogeneic brain cell suspensions had better outcomes than intrathymic injections of autogeneic brain cell suspensions. Moreover, the benefit of injecting antigens into the thymus was outweighed by hepatic portal vein injections. PMID:27554621

  2. Effects of portal vein ligation on sex hormone metabolism in male rats: relationship to lowered hepatic cytochrome P450 levels.

    PubMed

    Farrell, G C; Koltai, A; Zaluzny, L; Murray, M

    1986-02-01

    Hepatic cytochrome P450 levels in male rats fall after portal vein ligation, a procedure that produces total hepatic bypass of portal blood. The present study was undertaken to examine whether changes in sex hormone metabolism could account for these lowered cytochrome P450 levels. Portal vein ligation resulted in testicular atrophy and low serum testosterone concentrations. Serum luteinizing hormone levels were also reduced, suggesting that testicular atrophy was secondary to suppression of the hypothalamic-pituitary-gonadal axis. Serum estrone and estradiol concentrations were significantly increased after portal vein ligation, while the magnitude and delayed onset of increases in urinary total estrogen excretion suggested that this was due largely to increased estrogen production. In male rats, both castration (at 12 wk) and exogenous estrogen administration resulted in changes in hepatic cytochrome P450 levels and ethylmorphine N-demethylase activity that were qualitatively similar to those seen after portal vein ligation. In female and castrated male rats, however, cytochrome P450 was not affected by portal vein ligation. Testosterone supplementation corrected the changes of cytochrome P450 levels in castrated male rats but did not have this effect in portal vein-ligated male rats. It is concluded that changes in sex hormone metabolism do occur after portal vein ligation and may contribute to alterations in cytochrome P450 and drug-metabolizing enzyme activity. Decreased levels of serum testosterone, however, do not alone account for the changes in hepatic drug metabolism in this model, and suppression of a hypothalamic-pituitary factor appears to be important.

  3. Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein.

    PubMed

    Yoshioka, Masato; Watanabe, Go; Uchinami, Hiroshi; Kudoh, Kazuhiro; Hiroshima, Yuko; Yoshioka, Toshiaki; Nanjo, Hiroshi; Funaoka, Masato; Yamamoto, Yuzo

    2015-12-01

    A 51-year-old female had been diagnosed with a hemangioma in the hepatic segment 6 (S6). After a 6-year follow-up, enlargement of the tumor was detected. The tumor was clearly enhanced in the arterial phase, and the enhancement remained in the portal phase on computed tomography (CT). Although the primary differential diagnosis on CT was hepatocellular carcinoma (HCC), we worried about the possibility of other vessel system tumors because the tumor remained to be enhanced at the portal phase for HCC and all tumor markers of HCC were negative. We performed angiography to determine the tumor nature and to seek other tumors. Angiography showed tumor stain at the hepatic S6 with an early obvious drainage vein from the tumor flowing through the right hepatic vein into the inferior vena cava. In addition to tumor stain and the drainage vein, there were many small poolings of contrast medium in the whole liver, which were suspected as dilatation of the hepatic peripheral artery. We suspected the tumor as a benign tumor such as hepatocellular adenoma or focal nodular hyperplasia, but the possibility of HCC could not be ruled out. Hepatic posterior sectionectomy was done to completely remove the drainage vein with the tumor. Intraoperative histological examination revealed the tumor as not malignant and not HCC. Later, immunohistochemical analysis uncovered that the tumor had high expression of HMB-45 and, therefore, the final diagnosis was angiomyolipoma. We think that detecting an early drainage vein from the tumor would be a key point for diagnosing hepatic angiomyolipoma. PMID:26943379

  4. Diffuse cholangiocarcinoma presenting with hepatic failure and extensive portal and mesenteric vein thrombosis.

    PubMed

    Vakil, Abhay; Guru, Pramod; Reddy, Dereddi Raja Raja; Iyer, Vivek

    2015-06-29

    A 64-year-old previously healthy man presented with a 4-week history of vague right upper quadrant abdominal pain. Imaging studies revealed extensive portal, splenic, superior and inferior mesenteric vein thrombosis with mosaic perfusion and wedge-shaped areas of liver perfusion abnormalities. An extensive thrombophilia workup including tests for factor V Leiden, prothrombin G20210A, lupus anticoagulant, paroxysmal nocturnal haemoglobinuria, protein C and S, homocysteine and antinuclear antibody titres were all negative. Other laboratory testing revealed an elevated alkaline phosphatase (340 IU/L). Surgical exploration and catheter-directed thrombolysis were not felt to be feasible given the extensive clot burden. He was started on anticoagulation therapy. Over the next 10 days, he required intensive care unit admission due to progressive hepatic encephalopathy and fulminant liver failure. He continued to decline and eventually died of multiorgan failure. Autopsy revealed extensive, diffuse intrahepatic cholangiocarcinoma that had almost entirely replaced his normal liver parenchyma.

  5. Hepatitis B epidemiology in Asia, the Middle East and Africa.

    PubMed

    André, F

    2000-02-18

    Asia and Africa have previously been classified as areas of high endemicity for hepatitis B virus (HBV), but in some countries highly effective vaccination programmes have shifted this pattern towards intermediate or low endemicity. Thus, China is now the only country in Asia where HBV endemicity is high. Countries with intermediate endemicity include India, Korea, the Philippines, Taiwan and Thailand, and those with low endemicity include Japan, Pakistan, Bangladesh, Singapore, Sri Lanka and Malaysia. Most countries in Africa have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity. Zambia has borderline intermediate/high endemicity. In the Middle East, Bahrain, Iran, Israel and Kuwait are areas of low endemicity, Cyprus, Iraq and the United Arab Emirates have intermediate endemicity, and Egypt, Jordan, Oman, Palestine, Yemen and Saudi Arabia have high endemicity. All of these Middle East countries reach a large proportion of their population with hepatitis B vaccination, which is reducing the infection rate, particularly in Saudi Arabia. The vaccination programme in Taiwan has also greatly reduced the HBV infection rate. Future vaccination programmes must take into account the mode of transmission of HBV, the healthcare infrastructure to deliver vaccination, and the socioeconomic and political factors in each individual country, to determine the most cost-effective way of infection control.

  6. 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.

  7. Anomalous connection of the left hepatic vein to coronary sinus in a child with PAPVD. Surgical significance and diagnostic difficulties

    PubMed Central

    Mądry, Wojciech; Zacharska-Kokot, Ewa

    2016-01-01

    Left hepatic vein (LHV) that drains blood into a coronary sinus (CS) is an extremely rare congenital anomaly of systemic vein drainage with only single reports published. In most of these cases the unusual venous connection was found incidentally during diagnostics or surgery. The case of a two-year-old boy in whom the anomaly was discovered during open heart surgery for partial anomalous pulmonary venous drainage (PAPVD) is presented. Difficulties in obtaining proper diagnosis preoperatively are confronted with postoperative echo findings. Embryology and evolution of sinus venosus are discussed to explain the persistent connection between hepatic venous circulation and a coronary sinus. The authors attempt to recapitulate the possible surgical consequences of LHV-CS continuity. PMID:27212980

  8. Hepatic arterial infusion chemotherapy for hepatocellular carcinoma with tumor thrombosis of the portal vein tumor thrombosis

    PubMed Central

    Lai, Yung-Chih; Shih, Cheng-Yen; Jeng, Chin-Ming; Yang, Sien-Sing; Hu, Jui-Ting; Sung, Yung-Chuan; Liu, Han-Ting; Hou, Shaw-Min; Wu, Chi-Hwa; Chen, Tzen-Kwan

    2003-01-01

    AIM: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with poor prognosis. The aim of this prospective study was to evaluate the efficacy of hepatic arterial infusion chemotherapy (HAIC) for patients with this disease. METHODS: Eighteen HCC patients with PVTT were treated with HAIC via a subcutaneously implanted injection port. A course of chemotherapy consisted of daily cisplatin (10 mg for one hour) followed by 5-fluorouracil (250 mg for five hours) for five continuous days within a given week. The patients were scheduled to receive four consecutive courses of HAIC. Responders were defined in whom either a complete or partial response was achieved, while non-responders were defined based on stable or progressive disease status. The prognostic factors associated with survival after treatment were analyzed. RESULTS: Six patients exhibited partial response to this form of HAIC (response rate = 33%). The 3, 6, 9, 12 and 18-month cumulative survival rates for the 18 patients were 83%, 72%, 50%, 28%, and 7%, respectively. Median survival times for the six responders and 12 non-responders were 15.0 (range, 11-18) and 7.5 (range, 1-13) months, respectively. It was demonstrated by both univariate and multivariate analyses that the therapeutic response and hepatic reserve function were significant prognostic factors. CONCLUSION: HAIC using low-dose cisplatin and 5-fluorouracil may be a useful alternative for the treatment of patients with advanced HCC complicated with PVTT. There may also be survival-related benefits associated with HAIC. PMID:14669309

  9. Hepatitis C Virus Infection Associated With an Increased Risk of Deep Vein Thrombosis

    PubMed Central

    Wang, Chun-Cheng; Chang, Chiz-Tzung; Lin, Cheng-Li; Lin, I-Ching; Kao, Chia-Hung

    2015-01-01

    Abstract The association between the hepatitis C virus (HCV) infection and the risk of myocardial infarction (MI) and stroke has been previously investigated. However, the association between the HCV infection and the risk of venous thromboembolism (VTE) has not been extensively discussed. Using the Longitudinal Health Insurance Database 2000 (LHID2000), we selected 3686 patients with newly diagnosed HCV infection. We randomly selected 14,744 people with no HCV or hepatitis B virus (HBV) infection as comparison group and frequency matched them with patients with HCV infection according to their age, sex, and index year. The incidence density rates and hazard ratios (HRs) of deep vein thrombosis (DVT) and pulmonary embolism (PE) were calculated until the end of 2011. The mean follow-up duration of 5.14 years for the HCV cohort and 5.61 years for the non-HCV cohort, the overall incidence density rates of DVT were 7.92 and 3.51 per 10,000 person-years in the non-HCV group, and the HCV groups, respectively (crude HR = 2.25; 95% confidence interval [CI] = 1.21–4.21). After adjusted for age, sex, and comorbidities, the risk of DVT remained significantly higher in the HCV group than in the non-HCV group (adjusted HR = 1.96; 95% CI = 1.03–3.73). The overall incidence density rates of PE in the HCV and non-HCV groups were not significantly different (crude HR = 2.20; 95% CI = 0.94–5.14). HCV infection is associated with the risk of DVT in a long-term follow-up period. PMID:26402820

  10. Portal Vein Embolization as an Oncosurgical Strategy Prior to Major Hepatic Resection: Anatomic, Surgical, and Technical Considerations

    PubMed Central

    Orcutt, Sonia T.; Kobayashi, Katsuhiro; Sultenfuss, Mark; Hailey, Brian S.; Sparks, Anthony; Satpathy, Bighnesh; Anaya, Daniel A.

    2016-01-01

    Preoperative portal vein embolization (PVE) is used to extend the indications for major hepatic resection, and it has become the standard of care for selected patients with hepatic malignancies treated at major hepatobiliary centers. To date, various techniques with different embolic materials have been used with similar results in the degree of liver hypertrophy. Regardless of the specific strategy used, both surgeons and interventional radiologists must be familiar with each other’s techniques to be able to create the optimal plan for each individual patient. Knowledge of the segmental anatomy of the liver is paramount to fully understand the liver segments that need to be embolized and resected. Understanding the portal vein anatomy and the branching variations, along with the techniques used to transect the portal vein during hepatic resection, is important because these variables can affect the PVE procedure and the eventual surgical resection. Comprehension of the advantages and disadvantages of approaches to the portal venous system and the various embolic materials used for PVE is essential to best tailor the procedures for each patient and to avoid complications. Before PVE, meticulous assessment of the portal vein branching anatomy is performed with cross-sectional imaging, and embolization strategies are developed based on the patient’s anatomy. The PVE procedure consists of several technical steps, and knowledge of these technical tips, potential complications, and how to avoid the complications in each step is of great importance for safe and successful PVE and ultimately successful hepatectomy. Because PVE is used as an adjunct to planned hepatic resection, priority must always be placed on safety, without compromising the integrity of the future liver remnant, and close collaboration between interventional radiologists and hepatobiliary surgeons is essential to achieve successful outcomes. PMID:27014696

  11. Pre-transplant portal vein thrombosis is an independent risk factor for graft loss due to hepatic artery thrombosis in liver transplant recipients

    PubMed Central

    Stine, Jonathan G.; Pelletier, Shawn J.; Schmitt, Timothy M.; Porte, Robert J.; Northup, Patrick G.

    2015-01-01

    Background Hepatic artery thrombosis is an uncommon but catastrophic complication following liver transplantation. We hypothesize that recipients with portal vein thrombosis are at increased risk. Methods Data on all liver transplants in the U.S. during the MELD era through September 2014 were obtained from UNOS. Status one, multivisceral, living donor, re-transplants, pediatric recipients and donation after cardiac death were excluded. Logistic regression models were constructed for hepatic artery thrombosis with resultant graft loss within 90 days of transplantation. Results 63,182 recipients underwent transplantation; 662 (1.1%) recipients had early hepatic artery thrombosis; of those, 91 (13.8%) had pre-transplant portal vein thrombosis, versus 7.5% with portal vein thrombosis but no hepatic artery thrombosis (p < 0.0001). Portal vein thrombosis was associated with an increased independent risk of hepatic artery thrombosis (OR 2.17, 95% CI 1.71–2.76, p < 0.001) as was donor risk index (OR 2.02, 95% CI 1.65–2.48, p < 0.001). Heparin use at cross clamp, INR, and male donors were all significantly associated with lower risk. Discussion Pre-transplant portal vein thrombosis is associated with post-transplant hepatic artery thrombosis independent of other factors. Recipients with portal vein thrombosis might benefit from aggressive coagulation management and careful donor selection. More research is needed to determine causal mechanism. PMID:27017168

  12. Selective ligation of portal vein and hepatic artery for ruptured hepatocellular carcinoma in a 13-year-old boy.

    PubMed

    Tanaka, Hideaki; Honna, Toshiro; Muto, Mitsuru; Fujino, Akihiro; Kasahara, Mureo; Kitano, Yoshihiro; Kuroda, Tatso

    2011-05-01

    Hepatocellular carcinoma (HCC) in children is rare, and the prognosis has been poor because of its advanced stage at diagnosis and unresponsiveness to chemotherapy. We report a 13-year-old boy with ruptured HCC in the left trisegment. When hemostasis of the ruptured surface was achieved in the emergency operation, the left branch of the portal vein and the left hepatic artery were ligated at the same time. The volume of the future liver remnant (FLR), that is, his right posterior sector, increased from 56% on admission to 70% of his standard liver volume on day 2. Blood level of serum protein induced by vitamin K absence or antagonist ІІ started to decrease immediately. Left trisegmentectomy was successfully performed 10 days later, followed by chemotherapy. He has been well with a 2-year survival without recurrence. When the FLR is considered relatively small for a major hepatic resection, the selective ligation of the portal vein and the hepatic artery, which feed HCC, seems to be beneficial. This is because it may induce enlargement of the FLR, increasing the safety of the hepatectomy as preoperative portal vein embolization does before a major hepatectomy in adult patients with HCC, and the latter suppresses the tumor while waiting for the planned hepatectomy.

  13. Transarterial chemoembolization combined with sorafenib for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

    PubMed Central

    Zhang, Yong-Fa; Wei, Wei; Wang, Jia-Hong; Xu, Li; Jian, Pei-En; Xiao, Cheng-Zuo; Zhong, Xiao-Ping; Shi, Ming; Guo, Rong-Ping

    2016-01-01

    Objective To compare the treatment outcomes of sorafenib plus transarterial chemoembolization (TACE) vs TACE alone in patients with hepatocellular carcinoma (HCC) and hepatic vein tumor thrombus (HVTT). Methods Twenty patients who were initially diagnosed with HCC and HVTT and received TACE combined with sorafenib during February 2009 to October 2013 were included in the study. To minimize selection bias, these patients were compared with 60 case-matched controls selected from a pool of 81 patients (in a 1:3 ratio) who received TACE alone during the same period. The primary end point was overall survival (OS). The secondary end points were time to progression, disease control rate, and adverse events. Results After a median follow-up period of 12.5 months (range, 1.03–44.23 months), the OS of the combined group was found to be significantly higher compared with the monotherapy group (14.9 vs 6.1 months, P=0.010). The time to progression was found to be significantly longer in the combined group (4.9 vs 2.4 months, P=0.016). Univariate and multivariate analyses revealed that the treatment allocation was an independent predictor of OS. Conclusion Sorafenib plus TACE was well tolerated and was more effective in treating patients with advanced HCC and HVTT. Future trials with prospective larger samples are required to validate these results. PMID:27471398

  14. Percutaneous Transhepatic Venous Angioplasty and Stenting in a 9-Month-Old Patient with Hepatic Vein Obstruction After Partial Liver Transplantation

    SciTech Connect

    Rasekhi, A. R.; Nabavizadeh, S. A.; Malek-Hosseini, S. A.; Varedi, P.; Naderifar, M.; Soltani, S.

    2008-09-15

    Hepatic venous outflow obstruction is a rare but serious complication after liver transplantation. We report ultrasound-guided percutaneous transhepatic stent placement in a 9-month-old infant with a left lateral split liver transplantation with near-complete hepatic vein obstruction.

  15. Japanese case of Budd-Chiari syndrome due to hepatic vein thrombosis successfully treated with liver transplantation.

    PubMed

    Iwasaki, Tomohiro; Kawai, Hirokazu; Oseki, Koushi; Togashi, Tadayuki; Shioji, Kazuhiko; Yamamoto, Satoshi; Sato, Yoshinobu; Suzuki, Kenji; Toba, Ken; Nomoto, Minoru; Hatakeyama, Katsuyoshi; Aoyagi, Yutaka

    2012-02-01

    A 22-year-old Japanese woman was found to have severe esophageal varices and then suffered from hepatic encephalopathy. She was diagnosed with Budd-Chiari syndrome (BCS) due to hepatic vein (HV) thrombosis accompanied by portal vein thrombosis without inferior vena cava (IVC) obstruction. Latent myeloproliferative neoplasm (MPN) lacking the JAK2-V617F mutation was considered to be the underlying disease. Liver transplantation was strikingly effective for treating the clinical symptoms attributable to portal hypertension. Although thrombosis of the internal jugular vein occurred due to thrombocythemia, which manifested after transplantation despite anticoagulation therapy with warfarin, the thrombus immediately disappeared with the addition of aspirin. Neither thrombosis nor BCS has recurred in more than 4 years since the amelioration of the last thrombotic event, and post-transplant immunosuppression with tacrolimus has not accelerated the progression of MPN. In Japan, IVC obstruction, which was a predominant type of BCS, is suggested to have decreased in incidence with recent improvements in hygiene. The precise diagnosis of BCS and causative underlying diseases should be made with attention to the current trend of the disease spectrum, which fluctuates with environmental sanitation levels. Because the stepwise strategy, including liver transplantation, has been proven effective for patients with pure HV obstruction in Western countries, this strategy should also be validated for utilization in Japan and in developing countries where HV obstruction potentially predominates.

  16. Noninvasive visualization and measurement of middle cardiac vein flow by transthoracic Doppler echocardiography.

    PubMed

    Harada, Kenji; Tamura, Masamichi; Toyono, Manatoma

    2006-01-01

    Transthoracic Doppler echocardiography offers a noninvasive approach for imaging posterior descending coronary artery (PD) running in the posterior longitudinal sulcus along the middle cardiac vein (MCV). To evaluate whether the MCV flow velocity reserve can reflect the PD flow reserve, 22 children with various heart diseases were examined using transthoracic Doppler echocardiography. Introduction of a modified transthoracic two chamber view with the transducer rotated counterclockwise and angulated posteriorly allows visualization of the MCV and PD. Peak systolic flow velocity and average peak systolic flow velocity in the MCV and peak diastolic flow velocity and average peak diastolic flow velocity in the PD were measured at rest and hyperemic conditions (intravenous administration of adenosine of 0.16 mg/kg/min). Coronary flow reserve was defined as the ratio of peak hyperemic to basal average peak flow velocity. ATP infusion induced significant increases in the peak systolic flow velocity and average peak systolic flow velocity in the MCV. The mean MCV flow velocity reserve in the patients was 1.94 +/- 0.44. Significant increases in the peak diastolic flow velocity and the average peak diastolic flow velocity in the PD were also observed during ATP infusion, and the mean PD flow velocity reserve (2.19 +/- 0.62) was significantly higher than the GCV flow velocity reserve (p < 0.0001). There was a good correlation between the MCV flow velocity reserve and PD flow velocity reserve (r = 0.86, p < 0.0001). This study demonstrated that it was possible to measure the MCV flow velocity and MCV flow velocity reserve in pediatric patients by transthoracic Doppler echocardiography. The MCV flow reserve correlated highly with the PD flow reserve. However, the degree of the MCV flow during hyperemia was less than that of the PD flow. This underestimation should be considered when the reactive hyperemic response is evaluated from the MCV flow velocity. PMID:17031721

  17. How Far Can We Go with Laparoscopic Liver Resection for Hepatocellular Carcinoma? Laparoscopic Sectionectomy of the Liver Combined with the Resection of the Major Hepatic Vein Main Trunk

    PubMed Central

    Morise, Zenichi; Kawabe, Norihiko; Tomishige, Hirokazu; Nagata, Hidetoshi; Kawase, Jin; Arakawa, Satoshi; Isetani, Masashi

    2015-01-01

    Although the reports of laparoscopic major liver resection are increasing, hepatocellular carcinomas (HCCs) close to the liver hilum and/or major hepatic veins are still considered contraindications. There is virtually no report of laparoscopic liver resection (LLR) for HCC which involves the main trunk of major hepatic veins. We present our method for the procedure. We experienced 6 cases: 3 right anterior, 2 left medial, and 1 right posterior extended sectionectomies with major hepatic vein resection; tumor sizes are within 40–75 (median: 60) mm. The operating time, intraoperative blood loss, and postoperative hospital stay are within 341–603 (median: 434) min, 100–750 (300) ml, and 8–44 (18) days. There was no mortality and 1 patient developed postoperative pleural effusion. For these procedures, we propose that the steps listed below are useful, taking advantages of the laparoscopy-specific view. (1) The Glissonian pedicle of the section is encircled and clamped. (2) Liver transection on the ischemic line is performed in the caudal to cranial direction. (3) During transection, the clamped Glissonian pedicle and the peripheral part of hepatic vein are divided. (4) The root of hepatic vein is divided in the good view from caudal and dorsal direction. PMID:26448949

  18. 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.

  19. Fluid inclusions in veins from the Middle Devonian shales. A record of deformation conditions and fluid evolution in the Appalachian plateau

    SciTech Connect

    Evans, M.A.

    1995-03-01

    Fluid inclusion microthermometric analysis of multiple vein sets from the Middle Devonian shales provides insight into deformation conditions and fluid evolution in the Appalachian Plateau during, and since, the Alleghanian orogeny. The data illustrate a dynamic system in which deformation conditions and fluid compositions changed continually during basin subsidence in response to orogeny and postorogenic uplift and denudation. Two types of inclusions are present in the veins: (1) hydrocarbon inclusions that contain CH{sub 4}, C{sub 2}H{sub 6}, CO{sub 2}, higher hydrocarbons (more than two carbon atoms), and bitumen and (2) two-phase aqueous inclusions that contain very saline (up to 27 wt% NaCl equivalent) NaCl-CaCl{sub 2} brines. The earliest vein set, CFJV1 (cross-fold joints and veins 1), formed during the onset of hydrocarbon generation at a depth of nearly 2.3 km and contains inclusions that are composed of degraded bitumen. The next youngest vein set, CFJV2a, formed under lithostatic pore-fluid pressure conditions at a depth of at least 2.3 km and contains primary inclusions with condensate-like composition. The youngest vein set, strike-parallel SJV (strike joints and veins), formed during maximum burial, or early during uplift, of the Middle Devonian shale section. SJV, along with reopened cross-fold joints and veins, contains barite with nearly pure CH{sub 4} inclusions and two-phase aqueous inclusions. 75 refs., 12 figs., 5 tabs.

  20. Portal hypertension associated with primary hypoplasia of the hepatic portal vein in dogs.

    PubMed

    Van den Ingh, T S; Rothuizen, J; Meyer, H P

    1995-10-21

    Portal hypertension caused by primary hypoplasia of the portal vein was diagnosed in 42 dogs. The portal hypertension was manifested by the presence of multiple portosystemic collateral vessels. The main clinical signs were retarded growth or weight loss, apathy, intermittent diarrhoea and vomiting, anorexia, abdominal distension and polydipsia. Major findings at physical examination were ascites in 23 dogs and neurological signs in 16 dogs. The dogs had increased activities of liver enzymes in plasma and increased fasting levels of total bile acids and ammonia; in many of the dogs the packed red cell volume, total serum protein and albumin were low. Gross inspection of the portal vein revealed a patent but underdeveloped extrahepatic vein in 13 of the dogs. Microscopic examination of the liver revealed hypoplasia of the intrahepatic portal veins in all the dogs, and this was associated with minor arteriolar proliferation and absence of fibrosis in 12 of them, with moderate to marked arteriolar proliferation often combined with ductular proliferation in 13, and with marked portal fibrosis (formerly described as hepatoportal fibrosis) with a varying number of arteriolar and bile ductular structures in 17 of the dogs. The disease affected mainly young dogs, and was most likely to have been of congenital origin. PMID:8560700

  1. Non-Hodgkin lymphoma diagnosed by a percutaneous trans-hepatic needle biopsy of portal vein tumor emboli.

    PubMed

    Ohyagi, Hideaki; Kume, Masaaki; Shinohara, Yoshinori; Takahashi, Satsuki; Saito, Masahiro; Zuguchi, Masashi; Enomoto, Yoshitaka; Saito, Ken; Hirayama, Katsu; Takahashi, Naoto

    2015-12-01

    A 58-year-old woman was admitted to our hospital for evaluation of left flank pain. Abdominal computed tomography showed a greatly enlarged splenic tumor with a massive portal vein tumor thrombosis (PVTT). We suspected non-Hodgkin lymphoma (NHL) based on the high values of serum soluble interleukin-2 receptor and lactate dehydrogenase. Because there was no superficial lymph node enlargement, ultrasound-guided percutaneous trans-hepatic needle biopsy was performed to obtain a pathological diagnosis of PVTT, instead of a splenectomy, after the patient had provided informed consent. This procedure was thought to be less invasive than splenectomy. Histologic examination revealed CD20-positive NHL. A complete response was achieved after six courses of R-CHOP and it was confirmed by splenectomy. A PVTT due to NHL is extremely rare as compared with that due to hepatocellular carcinoma, gastric cancer, and colon cancer. However, NHL should be considered in the differential diagnosis for a patient with a PVTT, because B cell-NHL tends to have a good prognosis when rituximab combined chemotherapy is administered. We suggest that a percutaneous trans-hepatic needle biopsy may be useful for diagnosing PVTT due to NHL. PMID:26725360

  2. Occlusion of a hepatic artery to portal vein fistula with Bucrylate

    SciTech Connect

    Kerlan, R.K. Jr.; Hoddick, W.K.; Pogany, A.C.; Bank, W.O.; Sollenberger, R.D.

    1983-08-01

    A 49-year-old woman with cirrhosis and portal hypertension was evaluated for a portal-systemic shunt procedure following recurrent variceal hemorrhage. The preoperative visceral angiogram demonstrated a hepatic arterial to portal venous fistula, presumably a complication of a previous liver biopsy. The fistula was successfully closed using isobutyl-2-cyanoacrylate (Bucrylate) delivered through a flow-directed, calibrated-leak balloon microcatheter.

  3. Establishing models of portal vein occlusion and evaluating value of multi-slice CT in hepatic VX2 tumor in rabbits

    PubMed Central

    Qi, Yue-Yong; Zou, Li-Guang; Liang, Ping; Zhang, Dong

    2007-01-01

    AIM: To establish models of portal vein occlusion of hepatic VX2 tumor in rabbits and to evaluate the value of multi-slice CT. METHODS: Forty New Zealand rabbits were divided into 4 groups according to digital table: Immediate group (group A; transplantation of tumor immediately after the portal vein occlusion), 3-wk group (group B; transplantation of tumor at 3 wk after the portal vein occlusion), negative control group (group C) and positive control group (group D), 10 rabbits in each group. Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation immediately after the portal vein occlusion and at 3 wk after the portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was occluded by sham-operation, and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from the portal vein occlusion). All rabbits were scanned with multi-slice CT. RESULTS: All 40 animals were employed in the final analysis without death. Tumor did not grow in both immediate group and 3-wk group. In 3-wk group, left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was significantly smaller than that in positive control group (2.55 ± 0.46 vs 3.59 ± 0.37 cm, t = 5.57, P < 0.001). Incidences of metastasis in the liver and lung were lower in 3-wk group than those in positive control group (10% vs 40%, and 90% vs 100%, respectively). The expression intensities of the vascular endothelium growth factor (VEGF) in groups A, B, C and D were 0.10 ± 0.06, 0.66 ± 0.21, 0.28 ± 0.09 and 1.48 ± 0.32, respectively. VEGF expression level in the test group A was significantly lower than that in the negative control group C (t = 5.07; P < 0.001). In addition, VEGF expression in the test group B was significantly lower than that in the positive control group D (t = 6.38; P < 0.001). Scanning with multi-slice CT showed that displaying rate of

  4. Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis

    PubMed Central

    Lee, Jung Min; Jang, Byoung Kuk; Lee, Yoo Jin; Choi, Wang Yong; Choi, Sei Myong; Chung, Woo Jin; Hwang, Jae Seok; Kang, Koo Jeong; Kim, Young Hwan; Chauhan, Anil Kumar; Park, Soo Young; Tak, Won Young; Kweon, Young Oh; Kim, Byung Seok; Lee, Chang Hyeong

    2016-01-01

    Background/Aims: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. Methods: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). Results: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). Conclusions: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC. PMID:27044767

  5. [Successful use of danaparoid in the treatment of portal vein thrombosis that developed in a warfarin-administered hepatitis C virus-related cirrhosis patient].

    PubMed

    Nawata, Yoshitaka; Hamada, Kouichi; Tajima, Hiroko; Nishino, Noriyuki; Nakazawa, Toshihiro; Tobayashi, Kenji; Saitoh, Satoshi

    2012-08-01

    An 84-year-old woman with hepatitis C virus-related cirrhosis, hepatocellular carcinoma and atrial fibrillation, who presented with hematemesis, was initially treated with endoscopic variceal ligation (EVL) for an esophageal varix hemorrhage. However, computed tomography (CT) upon admission had revealed portal vein thrombosis, despite having received warfarin for existing atrial fibrillation. We subsequently initiated a 2-week treatment with danaparoid;warfarin being discontinued in order to reduce the risk of re-hemorrhage. A follow-up CT after treatment revealed complete reduction of the portal vein thrombosis. This is the first successful report of danaparoid use in the treatment of portal vein thrombosis that developed in a patient who had received warfarin. PMID:22863964

  6. Combination therapy using PSE and TIO ameliorates hepatic encephalopathy due to intrahepatic portosystemic venous shunt in idiopathic portal hypertension

    PubMed Central

    Kojima, Seiichiro; Ito, Hiroyuki; Takashimizu, Shinji; Ichikawa, Hitoshi; Matsumoto, Tomohiro; Hasebe, Terumitsu

    2016-01-01

    A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH). To minimize the increase in portal vein pressure after shunt obliteration, partial splenic artery embolization (PSE) was first performed to reduce portal vein blood flow. Transileocolic venous obliteration (TIO) was then performed, and intrahepatic PSS was successfully obliterated using coils with n-butyl-2-cyanoacrylate (NBCA). In the present case, hepatic encephalopathy due to intrahepatic PSS in the patient with IPH was successfully treated by combination therapy using PSE and TIO.

  7. Combination therapy using PSE and TIO ameliorates hepatic encephalopathy due to intrahepatic portosystemic venous shunt in idiopathic portal hypertension.

    PubMed

    Kojima, Seiichiro; Ito, Hiroyuki; Takashimizu, Shinji; Ichikawa, Hitoshi; Matsumoto, Tomohiro; Hasebe, Terumitsu; Watanabe, Norihito

    2016-09-01

    A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH). To minimize the increase in portal vein pressure after shunt obliteration, partial splenic artery embolization (PSE) was first performed to reduce portal vein blood flow. Transileocolic venous obliteration (TIO) was then performed, and intrahepatic PSS was successfully obliterated using coils with n-butyl-2-cyanoacrylate (NBCA). In the present case, hepatic encephalopathy due to intrahepatic PSS in the patient with IPH was successfully treated by combination therapy using PSE and TIO. PMID:27651930

  8. Combination therapy using PSE and TIO ameliorates hepatic encephalopathy due to intrahepatic portosystemic venous shunt in idiopathic portal hypertension

    PubMed Central

    Kojima, Seiichiro; Ito, Hiroyuki; Takashimizu, Shinji; Ichikawa, Hitoshi; Matsumoto, Tomohiro; Hasebe, Terumitsu

    2016-01-01

    A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH). To minimize the increase in portal vein pressure after shunt obliteration, partial splenic artery embolization (PSE) was first performed to reduce portal vein blood flow. Transileocolic venous obliteration (TIO) was then performed, and intrahepatic PSS was successfully obliterated using coils with n-butyl-2-cyanoacrylate (NBCA). In the present case, hepatic encephalopathy due to intrahepatic PSS in the patient with IPH was successfully treated by combination therapy using PSE and TIO. PMID:27651930

  9. Strategic approach to concurrent aberrant left gastric vein and aberrant left hepatic artery in laparoscopic distal gastrectomy for early gastric cancer: A case report

    PubMed Central

    Kuwada, Kazuya; Kikuchi, Satoru; Hori, Naoto; Kubota, Tetsushi; Nishizaki, Masahiko; Kagawa, Shunsuke; Fujiwara, Toshiyoshi

    2015-01-01

    Abstract An aberrant left gastric vein (ALGV) directly entering the lateral segment of the liver is a rare variation in the portal vein system, whereas an aberrant left hepatic artery (ALHA) arising from the left gastric artery is observed relatively frequently. Here we report a case in which both ALGV and ALHA were encountered before laparoscopic distal gastrectomy with curative lymphadenectomy for gastric cancer. We accurately diagnosed these vessel anomalies preoperatively on abdominal contrast‐enhanced CT. During surgery, we divided the ALGV at the point of entry to the liver and preserved the ALHA by dividing the branches toward the stomach, in consideration of curability and safety. The postoperative course was uneventful overall, although temporary mild liver dysfunction was observed. This case highlights the importance of preoperative evaluation and preparation in a rare case of concurrent ALGV and ALHA. PMID:26708584

  10. A path to eradication of hepatitis C in low- and middle-income countries.

    PubMed

    Graham, Camilla S; Swan, Tracy

    2015-07-01

    We are entering a new era in the treatment of hepatitis C virus (HCV) infection and almost all patient groups in high-income countries have the potential to be cured with all-oral, highly potent combinations of direct-acting antiviral drugs. Soon the main barrier to curing hepatitis C, even in wealthy countries, will be the high price of these all-oral regimens. The gulf between the advances in HCV drug development and access to treatment for individual patients will be even greater in low- and middle-income countries (LMIC) where 80% of the global burden of HCV infection and mortality exists. Ensuring that people in LMIC have access to regimens against HCV will require a similar level of advocacy and public-private partnerships as has transformed the control of other global diseases such as HIV. Numerous challenges will need to be overcome. These include improving low-cost diagnostic tests, especially in sub-Saharan Africa where the false-positive rate is unacceptably high, reducing iatrogenic spread of HCV, addressing transmission among people who inject drugs (PWID), and ensuring affordable access to antiviral treatment for all people living with HCV infection in LMIC. This article forms part of a symposium in Antiviral Research on "Hepatitis C: next steps toward global eradication."

  11. Hepatitis A virus in the Middle East and North Africa region: a new challenge.

    PubMed

    Melhem, N M; Talhouk, R; Rachidi, H; Ramia, S

    2014-01-01

    During the past three decades, a gradual shift in the age of infection with hepatitis A virus (HAV) from early childhood to adulthood has been observed. There is a general lack of updated data on HAV burden of disease, incidence and age-specific seroprevalence in countries of the Middle East and North Africa (MENA) region. The aim of this article is to review the published data on anti-HAV seroprevalence, an important tool to monitor infections rates, in countries of the MENA region and associated risk factors including water and socioeconomic data when available. Data on anti-HAV seroprevalence were found for 12 of 25 MENA countries. We show that MENA countries, similar to other areas in the world, have a clear shift in HAV incidence with a decline among young age groups and an increase among adults and older individuals. This would likely be associated with increased morbidity and increased risks of outbreaks among younger age groups. Consequently, the continuous surveillance of hepatitis A cases and the inclusion of hepatitis A vaccine in the expanded immunization programmes are needed in countries of the MENA.

  12. Portal vein glucose entry triggers a coordinated cellular response that potentiates hepatic glucose uptake and storage in normal but not high-fat/high-fructose-fed dogs.

    PubMed

    Coate, Katie C; Kraft, Guillaume; Irimia, Jose M; Smith, Marta S; Farmer, Ben; Neal, Doss W; Roach, Peter J; Shiota, Masakazu; Cherrington, Alan D

    2013-02-01

    The cellular events mediating the pleiotropic actions of portal vein glucose (PoG) delivery on hepatic glucose disposition have not been clearly defined. Likewise, the molecular defects associated with postprandial hyperglycemia and impaired hepatic glucose uptake (HGU) following consumption of a high-fat, high-fructose diet (HFFD) are unknown. Our goal was to identify hepatocellular changes elicited by hyperinsulinemia, hyperglycemia, and PoG signaling in normal chow-fed (CTR) and HFFD-fed dogs. In CTR dogs, we demonstrated that PoG infusion in the presence of hyperinsulinemia and hyperglycemia triggered an increase in the activity of hepatic glucokinase (GK) and glycogen synthase (GS), which occurred in association with further augmentation in HGU and glycogen synthesis (GSYN) in vivo. In contrast, 4 weeks of HFFD feeding markedly reduced GK protein content and impaired the activation of GS in association with diminished HGU and GSYN in vivo. Furthermore, the enzymatic changes associated with PoG sensing in chow-fed animals were abolished in HFFD-fed animals, consistent with loss of the stimulatory effects of PoG delivery. These data reveal new insight into the molecular physiology of the portal glucose signaling mechanism under normal conditions and to the pathophysiology of aberrant postprandial hepatic glucose disposition evident under a diet-induced glucose-intolerant condition.

  13. Hepatic venography in noncirrhotic idiopathic portal hypertension: comparison with cirrhosis of the liver

    SciTech Connect

    Futagawa, S.; Fukazawa, M.; Musha, H.

    1981-11-01

    Free and wedged hepatic venography were carried out in 37 patients with idiopathic portal hypertension (IPH) and the findings compared with those in 88 patients with cirrhosis of the liver. Characteristic changes in IPH included frequent vein-to-vein anastomoses, narrower angles between large veins and their tributaries, smooth and wavy middle-sized to large branches (giving a general ''weeping willow'' appearance), homogeneous sinusoidal filling, and minimal to absent filling of the portal venous system on wedged retrograde portography. In cirrhosis, by contrast, changes included rare vein-to-vein anastomoses, wide angles between veins and tributaries, irregular stenoses of large veins and branches at various levels, spotty sinusoidal filling, and frequent retrograde flow in the portal venous system. Hepatic venography is helpful in differentiating IPH from cirrhosis.

  14. Hepatitis

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Hepatitis KidsHealth > For Kids > Hepatitis Print A A A ... an important digestive liquid called bile . What Is Hepatitis? Hepatitis is an inflammation (say: in-fluh-MAY- ...

  15. Varicose Veins

    MedlinePlus

    Varicose veins are swollen, twisted veins that you can see just under the skin. They usually occur in ... of the body. Hemorrhoids are a type of varicose vein. Your veins have one-way valves that help ...

  16. First Left Hepatic Trisectionectomy Including Segment One with New Associated Liver Partition and Portal Vein Ligation with Staged Hepatectomy (ALPPS) Modification: How To Do It?

    PubMed Central

    Obed, Aiman; Jarrad, Anwar; Bashir, Abdalla

    2016-01-01

    Patient: Female, 36 Final Diagnosis: Synchronic CRLM Symptoms: Abdominal pain • abnormal finding in abdominal-pelvic CT scan Medication: — Clinical Procedure: Extended left hepatectomy with left hemicolectomy Specialty: Surgery Objective: Unusual clinical course Background: Associated Liver Partition and Portal vein ligation with Staged hepatectomy (ALPPS) leads to rapid hepatic hypertrophy and decreases incidence of post-hepatectomy liver failure in patients with a marginal future liver remnant. Various procedural ALPPS modifications were previously described. Here, we present the first case of a new ALPPS modification, carrying out a left hepatic trisectionectomy with segment 1. Case Report: We present the case of a 36-year-old woman with locally advanced sigmoid adeno-carcinoma and extensive left liver metastases extending to segment V and VIII, who received state-of-the-art systemic conversion chemotherapy. Preoperative CT volumetric scan demonstrated a FLR/TLV (Future Liver Remnant/Total Liver Volume) of 22%. A left hepatic trisectionectomy procedure was conducted using our new ALPPS modification. Sufficient hepatic hypertrophy of FLR was reached with a volume increase of 100%. The period between the 2 stages was 7 days. The patient underwent left trisectionectomy and left colectomy with tumor-free margins. All dissected lymph nodes were tumor-negative. The surgical intra- and postoperative course was uneventful. Medically, the patient acquired an Acinetobacter infection, with severe sepsis and acute renal injury. After 3 dialysis sessions, the renal function recovered completely. Afterwards, the patient recovered slowly, and reintroduction ambulation and oral feeding was prolonged. Later on, the patient received Xeloda 1500 mg twice daily as adjuvant chemotherapy. Conclusions: The new ALPPS modification leads to a sufficient hypertrophy of FRL within 1 week, allowing left hepatic trisectionectomy with tumor-free FRL. Despite the challenging complications

  17. Potential market size and impact of hepatitis C treatment in low- and middle-income countries.

    PubMed

    Woode, M E; Abu-Zaineh, M; Perriëns, J; Renaud, F; Wiktor, S; Moatti, J-P

    2016-07-01

    The introduction of direct-acting antiviral agents (DAAs) has made hepatitis C infection curable in the vast majority of cases and the elimination of the infection possible. Although initially too costly for large-scale use, recent reductions in DAA prices in some low- and middle-income countries (LaMICs) has improved the prospect of many people having access to these drugs/medications in the future. This article assesses the pricing and financing conditions under which the uptake of DAAs can increase to the point where the elimination of the disease in LaMICs is feasible. A Markov simulation model is used to study the dynamics of the infection with the introduction of treatment over a 10-year period. The impact on HCV-related mortality and HCV incidence is assessed under different financing scenarios assuming that the cost of the drugs is completely paid for out-of-pocket or reduced through either subsidy or drug price decreases. It is also assessed under different diagnostic and service delivery capacity scenarios separately for low-income (LIC), lower-middle-income (LMIC) and upper-middle-income countries (UMIC). Monte Carlo simulations are used for sensitivity analyses. At a price of US$ 1680 per 12-week treatment duration (based on negotiated Egyptian prices for an all oral two-DAA regimen), most of the people infected in LICs and LMICs would have limited access to treatment without subsidy or significant drug price decreases. However, people in UMICs would be able to access it even in the absence of a subsidy. For HCV treatment to have a significant impact on mortality and incidence, a significant scaling-up of diagnostic and service delivery capacity for HCV infection is needed.

  18. Potential market size and impact of hepatitis C treatment in low- and middle-income countries.

    PubMed

    Woode, M E; Abu-Zaineh, M; Perriëns, J; Renaud, F; Wiktor, S; Moatti, J-P

    2016-07-01

    The introduction of direct-acting antiviral agents (DAAs) has made hepatitis C infection curable in the vast majority of cases and the elimination of the infection possible. Although initially too costly for large-scale use, recent reductions in DAA prices in some low- and middle-income countries (LaMICs) has improved the prospect of many people having access to these drugs/medications in the future. This article assesses the pricing and financing conditions under which the uptake of DAAs can increase to the point where the elimination of the disease in LaMICs is feasible. A Markov simulation model is used to study the dynamics of the infection with the introduction of treatment over a 10-year period. The impact on HCV-related mortality and HCV incidence is assessed under different financing scenarios assuming that the cost of the drugs is completely paid for out-of-pocket or reduced through either subsidy or drug price decreases. It is also assessed under different diagnostic and service delivery capacity scenarios separately for low-income (LIC), lower-middle-income (LMIC) and upper-middle-income countries (UMIC). Monte Carlo simulations are used for sensitivity analyses. At a price of US$ 1680 per 12-week treatment duration (based on negotiated Egyptian prices for an all oral two-DAA regimen), most of the people infected in LICs and LMICs would have limited access to treatment without subsidy or significant drug price decreases. However, people in UMICs would be able to access it even in the absence of a subsidy. For HCV treatment to have a significant impact on mortality and incidence, a significant scaling-up of diagnostic and service delivery capacity for HCV infection is needed. PMID:26924428

  19. Multiple abdominal veins thrombosis secondary to protein s deficiency - a case report.

    PubMed

    Kodali, Venkata Umakant; Borra, Seshulakshmi; Mandarapu, Surendra Babu; Sanda, Mallikarjuna Rao; Bolla, Srinivasa Rao

    2014-06-01

    Abdominal venous thrombosis may present either as Budd-Chiari syndrome (BCS) caused by hepatic vein or proximal inferior vena cava (IVC) obstruction or as an extra hepatic portal obstruction (EHPVO) caused by Portal vein thrombosis or mesenteric vein thrombosis, but a mixed involvement is uncommon. Multiple abdominal venous obstructions presenting with thrombosis of hepatic vein, IVC, portal vein and renal vein are very rarely seen . We are reporting a rare case with thrombosis of IVC, hepatic vein, portal vein and renal vein, with protein S and protein C deficiencies, which was managed by giving anticoagulant therapy.

  20. Portal Vein Embolization with Radiolabeled Polyvinyl Alcohol Particles in a Swine Model: Hepatic Distribution and Implications for Pancreatic Islet Cell Transplantation

    SciTech Connect

    Owen, Richard J.; Mercer, John R.; Al-Saif, Faisal; Molinari, Michele; Ashforth, Robert A.; Rajotte, Ray V.; Conner-Spady, Barbara; Shapiro, A. M. James

    2009-05-15

    The distribution of radiolabeled polyvinyl alcohol microspheres (PVAMs) when infused into the portal vein of domestic swine was investigated, with the purpose of assessing implications for pancreatic islet cell transplantation. PVAMs measuring 100-300 {mu}m (Contour SE) and labeled with {sup 99m}Tc were infused into the main portal vein of 12 swine, with intermittent portal venous pressure measurements. The infusion catheter was introduced antegradely via direct or indirect cannulation of the portal vein. The liver was subsequently divided into anatomical segments. Radioactivity (decay corrected) was measured for {sup 99m}Tc microsphere synthesis, dose preparation, gross organ activities, tissue samples, and blood. Particulate labeling, catheter positioning, and infusion were successful in all cases. The number of particles used was (185,000 {+-} 24,000) with a volume of 1 ml. Mean portal pressure at 5 min was significantly higher than baseline, but without a significant difference at 15 min. Extrahepatic tissue and serum radioactivity was negligible. A significant difference in number of radioactive particles per gram was detected between segments 6/7 and segments 5/8. Intrasegmental activity was analyzed, and for segments 2/3 a significant difference in the percentage dose per gram across samples was demonstrated (P = 0.001). Effective and stable radiolabeling of PVAMs with {sup 99m}Tc-sulfur colloid was demonstrated. Portal venous infusion of 100- to 300-{mu}m particles showed entrapment in the sinusoidal hepatic system with transient portal pressure elevation. Preferential embolization into the right lateral and posterior segments occurs, suggesting that flow dynamics/catheter tip position plays a role in particle distribution.

  1. Hepatitis

    MedlinePlus

    ... has been associated with drinking contaminated water. Hepatitis Viruses Type Transmission Prognosis A Fecal-oral (stool to ... risk for severe disease. Others A variety of viruses can affect the liver Signs and Symptoms Hepatitis ...

  2. Infra-cardiac Total Anomalous Venous Connection to Portal Vein – Unusual Dynamic Hepatic Flow Phenomenon Demonstrated with MRI

    PubMed Central

    2016-01-01

    Functional information regarding fluid movement within the body can be derived by magnetic resonance methods. Some of the observations were overlooked in early days of magnetic resonance imaging (MRI) application. This presentation illustrates an unique, intra-hepatic haemodynamic phenomenon, demonstrated by magnetic resonance imaging, in a case of infra-cardiac Total Anomalous Pulmonary Venous Connection (TAPVC) Demonstration of such phenomena is unreported even after widespread use of cardiac MRI, although patho-physiology of such a phenomenon is expected in TAPVC. Brief explanation and possible basis of such observation in the context of current knowledge is discussed. PMID:27134968

  3. Successful Outflow Reconstruction to Salvage Traumatic Hepatic Vein-Caval Avulsion of a Normothermic Machine Ex-Situ Perfused Liver Graft

    PubMed Central

    Athanasopoulos, Panagiotis G.; Hadjittofi, Christopher; Dharmapala, Arinda Dinesh; Orti-Rodriguez, Rafael Jose; Ferro, Alessandra; Nasralla, David; Konstantinidou, Sofia K.; Malagó, Massimo

    2016-01-01

    Abstract Donor organ shortage continues to limit the availability of liver transplantation, a successful and established therapy of end-stage liver diseases. Strategies to mitigate graft shortage include the utilization of marginal livers and recently ex-situ normothermic machine perfusion devices. A 59-year-old woman with cirrhosis due to primary sclerosing cholangitis was offered an ex-situ machine perfused graft with unnoticed severe injury of the suprahepatic vasculature due to road traffic accident. Following a complex avulsion, repair and reconstruction of all donor hepatic veins as well as the suprahepatic inferior vena cava, the patient underwent a face-to-face piggy-back orthotopic liver transplantation and was discharged on the 11th postoperative day after an uncomplicated recovery. This report illustrates the operative technique to utilize an otherwise unusable organ, in the current environment of donor shortage and declining graft quality. Normothermic machine perfusion can definitely play a role in increasing the graft pool, without compromising the quality of livers who had vascular or other damage before being ex-situ perfused. Furthermore, it emphasizes the importance of promptly and thoroughly communicating organ injuries, as well as considering all reconstructive options within the level of expertise at the recipient center. PMID:27082550

  4. Thermal Ablation by High-Intensity-Focused Ultrasound Using a Toroid Transducer Increases the Coagulated Volume and Allows Coagulation Near Portal and Hepatic veins in Pigs

    SciTech Connect

    Melodelima, D.; N'Djin, W. A.; Parmentier, H.; Chapelon, J. Y.; Rivoire, M.

    2009-04-14

    A new geometry of HIFU transducer is described to enlarge the coagulated volume. The geometry of the transducer was not spherical. The surface of the transducer was built based on a toroid geometry. The transducer was generated by the revolution of a circle about an axis lying in its plane. Eight emitters operating at a frequency of 3 MHz were diced out of a single toroid piezocomposite element. Each of the eight emitters was divided into 32 transducers. The focal zone is conical and located at 70 mm from the transducer. A 7.5 MHz ultrasound imaging probe is placed in the centre of the device for guiding the treatment. Our long-term objective is to develop a device that can be used during surgery. In vivo trials have been performed on 13 pigs to demonstrate this new principle and to evaluate the vascular tolerance of the treatment. This new geometry combined with consecutive activation of the eight emitters around the toroid allows achieving a mean thermal ablation of 7.0{+-}2.5 cm3 in 40 seconds. All lesions were visible with high contrast on sonograms. The correlation between the size of lesions observed on sonograms and during gross examination was 92%. This allows the user to easily enlarge the coagulated volume by juxtaposing single lesions. The pigs tolerate the treatment well over the experimental period even when coagulation was produced through portal and/or hepatic veins.

  5. Splanchnic Vein Thrombosis.

    PubMed

    Valla, Dominique

    2015-07-01

    Splanchnic vein thrombosis includes thrombosis of the hepatic venous system (Budd-Chiari syndrome) and thrombosis of the portal venous system. Both conditions share uncommon prothrombotic disorders as causal factors, among which myeloproliferative neoplasms rank first. Budd-Chiari syndrome presents with acute or chronic, asymptomatic or severe liver disease. Diagnosis depends on noninvasive imaging of the obstructed hepatic venous outflow tract. A spontaneously fatal course can be prevented by a stepwise approach: (1) anticoagulation therapy, specific therapy for underlying disease, and medical or endoscopic management of liver-related complications, (2) angioplasty/stenting in a second step, and (3) eventually the insertion of transjugular intrahepatic stent shunt or liver transplantation. Recent portal vein thrombosis mostly jeopardizes the gut. Early anticoagulation prevents thrombus extension but is incompletely successful in achieving recanalization. Chronic portal vein thrombosis is complicated by bleeding related to portal hypertension, which can be prevented by usual pharmacological and endoscopic means. The prevention of recurrent thrombosis is achieved by anticoagulation therapy the impact of which on the risk of bleeding remains unclear. Portal vein thrombosis in patients with cirrhosis is likely neither a direct consequence of nor a direct cause for liver disease progression. Therefore, the indications and effects of anticoagulation therapy for portal vein thrombosis in patients with cirrhosis remain uncertain. PMID:26080307

  6. Focus on Varicose Veins

    MedlinePlus

    ... Other veins often mistaken for varicose veins are spider veins and reticular veins, which are the visible ... greenish-blue veins that appear in our legs. Spider veins or teleangiectesias are tiny veins that you ...

  7. Who to test and how to test for chronic hepatitis C infection - 2016 WHO testing guidance for low- and middle-income countries.

    PubMed

    Easterbrook, Philippa J

    2016-10-01

    Testing and diagnosis of hepatitis C virus (HCV) infection is the gateway for access to both treatment and prevention services, and crucial for an effective hepatitis epidemic response. In contrast to HIV, a systematic approach to hepatitis C testing has been fragmented and limited to a few countries, and there remains a large burden of undiagnosed cases globally. Key challenges in the current hepatitis testing response, include lack of simple, reliable, and low cost diagnostic tests, laboratory capacity, and testing facilities; inadequate data to guide country-specific hepatitis testing approaches and who to test; stigmatization and social marginalization of some groups with or at risk of viral hepatitis; and lack of international or national guidelines on hepatitis testing for resource-limited settings. New tools to support the hepatitis global response include the 2016 Global Hepatitis Health Sector Strategy which include targets for testing and diagnosis, and World Health Organization (WHO) 2016 hepatitis testing guidelines for adults, adolescents, and children in low- and middle-income countries. The testing guidance complements recent published WHO guidance on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. These testing guidelines outline the public health approach to strengthening and expanding current testing practices for HCV and HBV and address what serological and virological assays to use, and who to test, as well as interventions to promote linkage to prevention and care after testing. They are intended for use across all age groups and populations. See boxes for key recommendations. Future directions and innovations in viral hepatitis testing include use of point-of-care assays for nucleic acid testing (NAT) and core antigen; validation of dried blood spots specimens with different commercial serological and NAT assays; multiplex and polyvalent platforms for integrated testing of HIV, HBV and HCV; and potential

  8. Who to test and how to test for chronic hepatitis C infection - 2016 WHO testing guidance for low- and middle-income countries.

    PubMed

    Easterbrook, Philippa J

    2016-10-01

    Testing and diagnosis of hepatitis C virus (HCV) infection is the gateway for access to both treatment and prevention services, and crucial for an effective hepatitis epidemic response. In contrast to HIV, a systematic approach to hepatitis C testing has been fragmented and limited to a few countries, and there remains a large burden of undiagnosed cases globally. Key challenges in the current hepatitis testing response, include lack of simple, reliable, and low cost diagnostic tests, laboratory capacity, and testing facilities; inadequate data to guide country-specific hepatitis testing approaches and who to test; stigmatization and social marginalization of some groups with or at risk of viral hepatitis; and lack of international or national guidelines on hepatitis testing for resource-limited settings. New tools to support the hepatitis global response include the 2016 Global Hepatitis Health Sector Strategy which include targets for testing and diagnosis, and World Health Organization (WHO) 2016 hepatitis testing guidelines for adults, adolescents, and children in low- and middle-income countries. The testing guidance complements recent published WHO guidance on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. These testing guidelines outline the public health approach to strengthening and expanding current testing practices for HCV and HBV and address what serological and virological assays to use, and who to test, as well as interventions to promote linkage to prevention and care after testing. They are intended for use across all age groups and populations. See boxes for key recommendations. Future directions and innovations in viral hepatitis testing include use of point-of-care assays for nucleic acid testing (NAT) and core antigen; validation of dried blood spots specimens with different commercial serological and NAT assays; multiplex and polyvalent platforms for integrated testing of HIV, HBV and HCV; and potential

  9. Balloon Occlusion Portography to Diagnose New-Onset Left Hepatic Vein Thrombosis and Widening of an Existing Wallstent TIPS by Palmaz Stents for Recurrent Portal Hypertension and Variceal Bleeding

    SciTech Connect

    Cope, Constantin; Baum, Richard A.; Haskal, Ziv J.

    1996-09-15

    A 31-year-old man with Child's class A micronodular cirrhosis, left lobe hypertrophy, and a transjugular intrahepatic portosystemic shunt (TIPS) which had been placed 6 months earlier, was admitted for recurrent esophageal bleeding and a portosystemic gradient of 42 mmHg. Balloon occlusion portography documented unsuspected ostial thrombosis of the previously patent left hepatic vein. This was considered the cause of the pressure rise. As it was not possible to insert a second TIPS in parallel, the shunt, stented originally with 10-mm Wallstents, was overdilated to 12 mm, and two 12-mm Palmaz stents were placed coaxially, reducing the portosystemic pressure gradient to 13 mmHg.

  10. Vascular anatomy of canine hepatic venous system: a basis for liver surgery.

    PubMed

    Mari, L; Acocella, F

    2015-06-01

    Detailed knowledge of the vascular anatomy is important for improving surgical approaches to the liver. Twelve canine livers were skeletonized to describe the anatomy of their portal and hepatic veins in details. Our data suggest that the liver can be divided into two sections, three divisions, seven lobes and two to four sub-lobes. This differs from the classic division into four lobes, four sub-lobes and two processes. The right section was perfused by the right portal branch and drained by independent hepatic veins, while most of the left section, perfused by the left portal branch, was drained by the main hepatic vein deriving from the middle and the left hepatic vein confluence. Part of the right medial lobe, and in some cases the papillary process of the caudate lobe, drained directly into the caudal vena cava. A proper right hepatic vein draining blood from more than one lobe was never observed. Portal connections between the quadrate and the left medial lobe were frequently recorded. Two sub-lobes with different portal blood supply and venous drainage could be identified in the right lateral (33.3% of cases) and the left lateral (100% of cases) lobes. From our results, the classic nomenclature of the liver lobes does not reflect their vascularization. Based on similarities between canine lobes and human segments, a new nomenclature is possible and may be less confounding in surgical settings.

  11. Vein Problems Related to Varicose Veins

    MedlinePlus

    ... your doctor if you think you have them. Spider Veins Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels ...

  12. Noncommunicable diseases in HIV infection in low- and middle-income countries: gastrointestinal, hepatic, and nutritional aspects.

    PubMed

    Kelly, Paul; Saloojee, Haroon; Chen, Jennifer Y; Chung, Raymond T

    2014-09-01

    The purpose of this review was to outline the interaction between HIV and noncommunicable diseases affecting the gastrointestinal (GI) tract, liver, and nutritional disorders in low- and middle-income countries (LMICs), and to identify research priorities. Noncommunicable GI tract disorders are only moderately influenced by HIV, and peptic ulceration is actually less common. However, the impact of HIV on GI cancers needs further investigation. HIV interacts strongly with environmental enteropathy, exacerbating malabsorption of nutrients and drugs. HIV has 2 major effects on noncommunicable liver disease: drug-induced liver injury and nonalcoholic fatty liver disease (particularly in persons of African genetic descent). The effect of HIV on nutrition was one of the first markers of the epidemic in the 1980s, and HIV continues to have major nutritional consequences. Childhood malnutrition and HIV frequently coexist in some regions, for example, southern Africa, resulting in powerful negative interactions with poorer responses to standard nutritional rehabilitation. HIV and nutritional care need to be better integrated, but many questions on how best to do this remain unanswered. Across the spectrum of GI, hepatic, and nutritional disorders in HIV infection, there is increasing evidence that the microbiome may play an important role in disease pathogenesis, but work in this area, especially in low- and middle-income countries, is in its infancy. PMID:25117963

  13. Prevalence and knowledge of hepatitis C in a middle-aged population, Dunedin, New Zealand

    PubMed Central

    Vermunt, Jane; Fraser, Margaret; Herbison, Peter; Wiles, Anna; Schlup, Martin; Schultz, Michael

    2015-01-01

    AIM: To determine the prevalence of infection with hepatitis C virus (HCV) in those most at risk of advanced liver disease and to identify gaps in knowledge of HCV. METHODS: Questionnaires were mailed to randomly selected residents aged 40-59 to assess the extent of their general knowledge about HCV. The questionnaire assessed demographics, the extent of general knowledge about viral hepatitis, potential risks for infection and the prevalence of risk factors associated with increased progression of liver fibrosis. Anonymised residual laboratory blood samples from 40-59 years old people from Dunedin taken in hospital or in the community, were tested for HCV antibodies and alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transpeptidase (GGT). Linear regression was performed to examine whether the demographics sex, age, socio-economic status, qualification level and occupation sector (categorical variables) were predictors of level of general knowledge about hepatitis. For the demographics that were found to be significant predictors of score outcome, multiple regression analysis was used to determine independent effects. χ2 tests were used to compare our selected sample and our responder population demographics, to the demographics of the entire 40-59 years old population in Dunedin using the 2006 NZ census data. Exact confidence intervals for the proportion positive for HCV and HBV were calculated using the binomial distribution. RESULTS: The response rate to the mailed questionnaire was 431/1400 (30.8%). On average 59.4% questions were answered correctly. Predictors for higher scores, indicating greater knowledge about symptoms and transmission included sex (female, P < 0.01), higher level of qualification (P < 0.000) and occupation sector (P < 0.000). Sharing intravenous drug utensils was a known risk factor for disease transmission (94.4%), but the sharing of common household items such as a toothbrush was not. 93% of the population were

  14. Hand vein recognition based on orientation of LBP

    NASA Astrophysics Data System (ADS)

    Bu, Wei; Wu, Xiangqian; Gao, Enying

    2012-06-01

    Vein recognition is becoming an effective method for personal recognition. Vein patterns lie under the skin surface of human body, and hence provide higher reliability than other biometric traits and hard to be damaged or faked. This paper proposes a novel vein feature representation method call orientation of local binary pattern (OLBP) which is an extension of local binary pattern (LBP). OLBP can represent the orientation information of the vein pixel which is an important characteristic of vein patterns. Moreover, the OLBP can also indicate on which side of the vein centerline the pixel locates. The OLBP feature maps are encoded by 4-bit binary values and an orientation distance is developed for efficient feature matching. Based on OLBP feature representation, we construct a hand vein recognition system employing multiple hand vein patterns include palm vein, dorsal vein, and three finger veins (index, middle, and ring finger). The experimental results on a large database demonstrate the effectiveness of the proposed approach.

  15. Non-communicable disease in HIV infection in low- and middle-income countries: gastrointestinal, hepatic, and nutritional aspects

    PubMed Central

    Kelly, Paul; Saloojee, Haroon; Chen, Jennifer Y; Chung, Raymond T

    2014-01-01

    The purpose of this review is to outline the interaction between HIV and non-communicable diseases (NCDs) affecting the gastrointestinal (GI) tract, liver, and nutritional disorders in low- and middle-income countries (LMICs), and to identify research priorities. Non-communicable GI tract disorders are only moderately influenced by HIV, and peptic ulceration is actually less common. However, the impact of HIV on GI cancers needs further investigation. HIV interacts strongly with environmental enteropathy, exacerbating malabsorption of nutrients and drugs. HIV has two major effects on non-communicable liver disease: drug-induced liver injury and non-alcoholic fatty liver disease (NAFLD) (particularly in persons of African genetic descent). The effect of HIV on nutrition was one of the first markers of the epidemic in the 1980s, and HIV continues to have major nutritional consequences. Childhood malnutrition and HIV frequently co-exist in some regions, e.g., southern Africa, resulting in powerful negative interactions with poorer responses to standard nutritional rehabilitation. HIV and nutritional care need to be better integrated, but many questions on how best to do this remain unanswered. Across the spectrum of gastrointestinal, hepatic, and nutritional disorders in HIV infection, there is increasing evidence that the microbiome may play an important role in disease pathogenesis, but work in this area, especially in LMICs, is in its infancy. PMID:25117963

  16. Deep Vein Thrombosis

    MedlinePlus

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  17. Varicose vein - noninvasive treatment

    MedlinePlus

    Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Ambulatory phlebectomy; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose ...

  18. [Combination Chemotherapy Using Sorafenib and Hepatic Arterial Infusion with a Fine-Powder Formulation of Cisplatin for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis--A Case Report].

    PubMed

    Tsukamoto, Tadashi; Kanazawa, Akishige; Shimizu, Sadatoshi; Murata, Akihiro; Sakae, Masayuki; Kurihara, Shigeaki; Tashima, Tetsuzo; Deguchi, Sota; Nakai, Takashi; Kawasaki, Yasuko; Kioka, Kiyohide

    2015-11-01

    Sorafenib has been a standard therapy for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. Hepatic arterial infusion chemotherapy (HAIC) is still preferably performed in Japan because of its relatively good tumor-shrinking effect. We report a case of advanced multiple HCC with portal thrombus that responded to combination chemotherapy with sorafenib and repeat hepatic arterial infusion with a fine-powder formulation of cisplatin (IA-call®). A 57-year-old man presented for the treatment of HCC with alcoholic cirrhosis. Multiple HCC were found to be rapidly progressing with portal thrombosis. HAIC with IA-call® was performed, but the tumors progressed. TAE was performed 3 times thereafter and the main tumor shrunk to some extent. A month after the last TAE, the HCC was found to progress again, and oral sorafenib was administered. A reservoir and catheter were placed and HAIC with low-dose 5-fluorouracil and cisplatin was performed for 3 cycles following 1 HAIC cycle with epirubicin and mitomycin C, which was not effective. For 10 months after initial therapy, HAIC using IA-call® has been performed once for 6 weeks. After performing HAIC with IA-call® 5 times, the serum levels of HCC tumor markers AFP and PIVKA-Ⅱdecreased, and the tumors continued to shrink and were not stained on enhanced CT scan. The patient has been alive for 23 months after the initial therapy and has maintained stable disease. PMID:26805203

  19. Relative Importance of Hepatitis B and C Viruses in Hepatocellular Carcinoma in EMRO Countries and the Middle East: A Systematic Review

    PubMed Central

    Alavian, Seyed Moayed; Haghbin, Hossein

    2016-01-01

    Context Hepatocellular carcinoma (HCC) is the second most common cancer-related death worldwide. Although many factors including dietary aflatoxin B1 (AFB1) and alcoholic and non-alcoholic fatty liver diseases can lead to HCC, globally most HCC cases are due to hepatitis B virus (HBV) and hepatitis C virus (HCV). Considering the importance of these viral factors in most HCC cases and relative lack of literature from eastern Mediterranean region office of world health organization (EMRO) countries and the Middle East, we decided to perform this systematic review to find distribution of viral etiology of HCC in these regions. Evidence Acquisition In this systemic review, we included all studies from 1 January 1989 to 1 September 2015 with at least 20 samples that measured HBV surface antigen (HBsAg) and antibodies to HCV (anti-HCV). The authors searched MEDLINE, Embase, Popline, Web of Science and WHO indexed databases. We searched the following MeSH terms; hepatocellular carcinoma, hepatitis B virus and hepatitis C virus or hepacvirus. Only studies using second- and third-generation HCV assays were included. Only articles studying HCC patients from EMRO countries and the Middle East were analyzed. Duplicate results that reported the same cases more than once were found and omitted. Studies in English and Farsi were reviewed. If the study was eligible, we recorded the following data; the first author, publication year and journal, study population and number and percentage of patients with different serologic statuses. Results We found 44 studies from 12 countries in EMRO and the Middle East. HCC cases from Iran, Lebanon, Turkey and Yemen were mainly due to HBV, while those of North African nations (Egypt, Tunisia, Morocco, Algeria and Somalia) in addition to Saudi Arabia and Pakistan were mostly HCV related. Sudan showed a high seronegativity and HBV infection in its HCC cases. Unfortunately, some countries from EMRO and the Middle East did not have eligible studies

  20. Status of HIV and hepatitis C virus infections among prisoners in the Middle East and North Africa: review and synthesis

    PubMed Central

    Heijnen, Marieke; Mumtaz, Ghina R; Abu-Raddad, Laith J

    2016-01-01

    Introduction The status of HIV and hepatitis C virus (HCV) infections among incarcerated populations in the Middle East and North Africa (MENA) and the links between prisons and the HIV epidemic are poorly understood. This review synthesized available HIV and HCV data in prisons in MENA and highlighted opportunities for action. Methods The review was based on data generated through the systematic searches of the MENA HIV/AIDS Epidemiology Synthesis Project (2003 to December 15, 2015) and the MENA HCV Epidemiology Synthesis Project (2011 to December 15, 2015). Sources of data included peer-reviewed publications and country-level reports and databases. Results and discussion We estimated a population of 496,000 prisoners in MENA, with drug-related offences being a major cause for incarceration. Twenty countries had data on HIV among incarcerated populations with a median prevalence of 0.6% in Afghanistan, 6.1% in Djibouti, 0.01% in Egypt, 2.5% in Iran, 0% in Iraq, 0.1% in Jordan, 0.05% in Kuwait, 0.7% in Lebanon, 18.0% in Libya, 0.7% in Morocco, 0.3% in Oman, 1.1% in Pakistan, 0% in Palestine, 1.2% in Saudi Arabia, 0% in Somalia, 5.3% in Sudan and South Sudan, 0.04% in Syria, 0.05% in Tunisia, and 3.5% in Yemen. Seven countries had data on HCV, with a median prevalence of 1.7% in Afghanistan, 23.6% in Egypt, 28.1% in Lebanon, 15.6% in Pakistan, and 37.8% in Iran. Syria and Libya had only one HCV prevalence measure each at 1.5% and 23.7%, respectively. There was strong evidence for injecting drug use and the use of non-sterile injecting-equipment in prisons. Incarceration and injecting drugs, use of non-sterile injecting-equipment, and tattooing in prisons were found to be independent risk factors for HIV or HCV infections. High levels of sexual risk behaviour, tattooing and use of non-sterile razors among prisoners were documented. Conclusions Prisons play an important role in HIV and HCV dynamics in MENA and have facilitated the emergence of large HIV epidemics in

  1. Percutaneous Transumbilical Portal Vein Embolization in a Patient with a Ruptured Hepatocellular Carcinoma Supplied by the Portal Vein

    SciTech Connect

    Kim, Soo Chin; Kim, Hyo-Cheol Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    We describe a case of a ruptured hepatocellular carcinoma supplied by the portal vein that was successfully treated with portal vein embolization via a percutaneous transumbilical approach. A contrast material-enhanced computed tomographic (CT) scan showed the presence of a large hypervascular tumor on portal venous phase as well as right hepatic vein thrombosis and hemoperitoneum that prevented portal vein embolization by the use of the percutaneous and transjugular transhepatic approach. The use of percutaneous transumbilical portal vein embolization can be an alternative option in this situation.

  2. Hepatitis B Virus Middle Protein Enhances IL-6 Production via p38 MAPK/NF-κB Pathways in an ER Stress-Dependent Manner

    PubMed Central

    Li, Yang-Xia; Ren, Yan-Li; Fu, Hai-Jing; Zou, Ling; Yang, Ying; Chen, Zhi

    2016-01-01

    During hepatitis B virus (HBV) infection, three viral envelope proteins of HBV are overexpressed in the endoplasmic reticulum (ER). The large S protein (LHBs) and truncated middle S protein (MHBst) have been documented to play roles in regulating host gene expression and contribute to hepatic disease development. As a predominant protein at the ultrastructural level in biopsy samples taken from viremic patients, the role of the middle S protein (MHBs) remains to be understood despite its high immunogenicity. When we transfected hepatocytes with an enhanced green fluorescent protein (EGFP)-tagged MHBs expressing plasmid, the results showed that expression of MHBs cause an upregulation of IL-6 at the message RNA and protein levels through activating the p38 mitogen-activated protein kinase (p38 MAPK) and nuclear factor-kappa B (NF-κB) pathways. The use of specific inhibitors of the signaling pathways can diminish this upregulation. The use of BAPTA-AM attenuated the stimulation caused by MHBs. We further found that MHBs accumulated in the endoplasmic reticulum and increased the amount of glucose regulated protein 78 (GRP78/BiP). Our results provide a possibility that MHBs could be involved in liver disease progression. PMID:27434097

  3. Leiomyosarcoma of the adrenal vein.

    PubMed

    Shao, I-Hung; Lee, Wei-Chen; Chen, Tai-Di; Chiang, Yang-Jen

    2012-01-01

    Leiomyosarcoma of the adrenal gland is extremely rare in the literature. We present a patient with an adrenal leiomyosarcoma originating from the adrenal vein, the pathologic findings and management. A 66-year-old man who was a hepatitis B virus carrier was found to have a huge left suprarenal mass on sonography and computed axial tomography. A huge tumor in the left suprarenal area with a markedly engorged adrenal vein was found during an adrenalectomy. The tumor thrombus extended into the renal vein, close to the inferior vena cava. The left adrenal gland with the whole tumor thrombus was removed completely. Microscopically, the adrenal gland was compressed but not invaded by the spindle cell tumor, which was composed of interlacing fascicles of neoplastic smooth muscle cells. The tumor was localized within the adrenal vein and arose from the venous wall. The patient had no local recurrence for 18 months after en bloc excision of the tumor. We suggest that en bloc excision with a clear and adequate surgical margin is the most important cure procedure for adrenal leiomyosarcoma.

  4. Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: an analysis using hepatitis C virus as a proxy biomarker.

    PubMed

    Mohamoud, Yousra A; Miller, F DeWolfe; Abu-Raddad, Laith J

    2014-09-28

    The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.

  5. Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker

    PubMed Central

    Mohamoud, Yousra A; Miller, F DeWolfe; Abu-Raddad, Laith J

    2014-01-01

    The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission. PMID:25278675

  6. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    PubMed

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  7. Effective hepatic artery chemoembolization for advanced hepatocellular carcinoma with multiple tumor thrombi and pulmonary metastases: A case report

    PubMed Central

    Huang, De-Jia; Li, Yan-Hao; Luo, Yao-Chang; Huang, Jun-Zhen; He, Hai-Yuan

    2016-01-01

    Advanced hepatocellular carcinoma (HCC) with tumor thrombi invading the portal vein and extending into the right atrium (RA) through the hepatic vein is regarded as a terminal-stage condition. Intracardiac tumor thrombus and treatment via liver resection has been reported in the current literature, but results from this therapeutic approach remain unsatisfactory. The present study describes a rare case of HCC with metastatic portal vein, middle hepatic vein, inferior vena cava (IVC) and RA tumor thrombi, and pulmonary metastases. A 29-year-old woman was admitted to The First Affiliated Hospital of Guangxi Traditional Chinese Medical University (Nanning, China) subsequent to experiencing right upper quadrant abdominal pain. Following diagnosis, based on computed tomography analysis and laboratory data, the patient underwent an initial transcatheter arterial chemoembolization (TACE) treatment using fluorouracil (5-FU), pirarubicin, mitomycin C, Lipiodol and sodium alginate microball (KMG). At 1 month post-treatment, serum α-fetoprotein levels remained at >1,000 ng/ml. Subsequently, the patient underwent a second TACE treatment. At 1 month after the second treatment, the abdominal pain had been alleviated and the serum α-fetoprotein levels were reduced to <20 ng/ml. Imaging analysis indicated a marked reduction in tumor burden in the liver and the hepatic vein and IVC tumor thrombi. Furthermore, the portal vein and RA tumor thrombi, and the pulmonary metastases had disappeared. At 40 months after the second TACE therapy, the patient remains alive without any signs of recurrence. The present case demonstrates that the administration of TACE, using 5-FU, pirarubicin, mitomycin C, Lipiodol and KMG, functions as an effective treatment in cases of unresectable advanced HCC presenting with pulmonary metastases and extensive tumor thrombi in the IVC, the RA and one branch of the portal vein. PMID:27602147

  8. Preventing Deep Vein Thrombosis

    MedlinePlus

    ... Patient Education FAQs Preventing Deep Vein Thrombosis Patient Education Pamphlets - Spanish Preventing Deep Vein Thrombosis FAQ174, August 2011 PDF ... Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual ... Pamphlets Teen Health About ACOG About Us Leadership & ...

  9. Human immunodeficiency virus and viral hepatitis among high-risk groups: Understanding the knowledge gap in the Middle East and North Africa Region

    PubMed Central

    Melhem, Nada M; Rahhal, Nour; Charide, Rana; Kreidieh, Khalil; El-Khatib, Rolla

    2015-01-01

    AIM: To identify gaps in the existing knowledge on single, dual and triple infections of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) in the Middle East and North Africa (MENA) region among men who have sex with men (MSMs), female sex workers (FSWs), injecting drug users (IDUs) and prisoners. METHODS: We performed an extensive literature search on articles published on the topic in the 25 countries of the MENA region. PubMed database was used as the main search engine. Case reports, case series, qualitative studies, editorials, commentaries, authors’ replies and animal studies were excluded. Original articles and reviews dealing with the prevalence of HIV, HBV and HCV and their co-infection were included. Data on population type, sample size, age and markers of infections were extracted from the relevant studies. RESULTS: HIV, HBV and HCV are blood-borne viruses with similar modes of transmission. The categories of people at high risk of acquiring HIV-1, HBV and HCV commonly include: MSMs, FSW and IDUs. It is well established that HIV-positive individuals co-infected with HBV or HCV suffer from liver pathology associated with morbidity and mortality. Moreover, HIV-infected individuals do not respond well to treatment for HBV or HCV and hence are at increased risk of hepatic toxicity. Consequently, co-infection of HIV-positive individuals with HBV and/or HCV is a global health problem of significant magnitude. Our review reveals the paucity of epidemiological data for key populations in many countries of the region. Limited number of studies exists in the MENA region on the status of HIV, HBV and HCV and their co-infections among prisoners, MSMs and FSWs. Evidence support the continued increase of the HIV epidemic among MSMs. In addition to the lack of studies on MSMs and FSWs in the MENA region, our review highlights the lack of data on the practices, characteristics, or the status of HIV infection and viral hepatitis

  10. Branch retinal vein occlusion.

    PubMed

    Hamid, Sadaf; Mirza, Sajid Ali; Shokh, Ishrat

    2008-01-01

    Retinal vein occlusions (RVO) are the second commonest sight threatening vascular disorder. Branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) are the two basic types of vein occlusion. Branch retinal vein occlusion is three times more common than central retinal vein occlusion and- second only to diabetic retinopathy as the most common retinal vascular cause of visual loss. The origin of branch retinal vein occlusion undoubtedly includes both systemic factors such as hypertension and local anatomic factors such as arteriovenous crossings. Branch retinal vein occlusion causes a painless decrease in vision, resulting in misty or distorted vision. Current treatment options don't address the underlying aetiology of branch retinal vein occlusion. Instead they focus on treating sequelae of the occluded venous branch, such as macular oedema, vitreous haemorrhage and traction retinal detachment from neovascularization. Evidences suggest that the pathogenesis of various types of retinal vein occlusion, like many other ocular vascular occlusive disorders, is a multifactorial process and there is no single magic bullet that causes retinal vein occlusion. A comprehensive management of patients with retinal vascular occlusions is necessary to correct associated diseases or predisposing abnormalities that could lead to local recurrences or systemic event. Along with a review of the literature, a practical approach for the management of retinal vascular occlusions is required, which requires collaboration between the ophthalmologist and other physicians: general practitioner, cardiologist, internist etc. as appropriate according to each case. PMID:19385476

  11. Screening of hepatocyte proteins binding with the middle surface protein of the hepatitis B virus by the yeast two-hybrid system.

    PubMed

    Li, Zhiqun; Linghu, Enqiang; Cheng, Jun

    2014-06-01

    The effect of the middle hepatitis B virus surface protein (MHBs) remains to be elucidated. To investigate the biological function of the MHBs protein, the present study performed yeast two-hybrid screening to search for proteins that interact with the MHBs protein in hepatocytes. The bait plasmid expressing the MHBs protein was constructed by cloning the gene of the MHBs protein into pGBKT7, then the recombinant plasmid DNA was transformed into AH109 yeast (a type). The transformed yeast AH109 was mated with yeast Y187 (α type) containing the liver cDNA library plasmid in 2X yeast peptone dextrose adenine (YPDA) medium. The mated diploid yeast was plated on quadruple dropout medium (SD/-Trp-Leu-His-Ade) containing X-α-gal for selection and screening. Following extracting and sequencing of the plasmids from positive (blue) colonies, the sequence analysis was conducted and analyzed by bioinformatics methods. Two colonies were selected and sequenced. Among them, one was the human DNA sequence from the clone RP11-490D19 on chromosome 9 and the other was homo sapiens 12 BAC RP11-180M15 (Roswell Park Cancer Institute Human BAC Library). The yeast two-hybrid system is an effective method for identifying hepatocyte proteins that interact with MHBs. The MHBs protein binds with different proteins suggesting that it has multiple functions in vivo.

  12. Screening of hepatocyte proteins binding with C‑terminally truncated surface antigen middle protein of hepatitis B virus (MHBst167) by a yeast two‑hybrid system.

    PubMed

    Li, Zhi Qun; Linghu, Enqiang; Jun, Wan; Cheng, Jun

    2014-09-01

    The function of middle hepatitis B surface protein C‑terminally truncated at amino acid position 167 (MHBst167) is not currently clear. This study aimed to screen and identify the proteins that interact with MHBst167 in hepatocytes using a yeast two‑hybrid system, and to explore the effects of MHBst167 in the development of hepatocellular carcinoma and precancerous diseases of the liver. The MHBst167 gene was amplified by polymerase chain reaction (PCR) and cloned into a pGEM‑T vector. The target region was sequenced and the constructed bait plasmid, pGBKT7‑MHBst167, was transformed into AH109 yeast cells. The transformed AH109 cells were then mated with Y187 yeast cells containing the fetal liver cDNA library plasmid using a yeast two‑hybrid system. The false positives were eliminated and the true positive clones were selected by PCR and sequencing analysis. The pGBKT7‑MHBst167 bait plasmid was successfully constructed and 66 clones grew in the selective synthetic defined media lacking leucine, tryptophan, histidine and adenine. Fifty‑two clones were identified following X‑α‑Gal selection and segregation analysis. Seven proteins were found to be expressed that could interact with MHBst167 in hepatocytes by the yeast two‑hybrid system. These results have provided novel insights into the biological functions of MHBst167.

  13. Postpartum renal vein thrombosis.

    PubMed

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  14. Deep vein thrombosis - discharge

    MedlinePlus

    DVT - discharge; Blood clot in the legs - discharge; Thromboembolism - discharge; Venous thromboembolism - deep vein thrombosis; Post-phlebitic syndrome - discharge; Post-thrombotic syndrome - discharge

  15. A comparison of 31P magnetic resonance spectroscopy and microbubble-enhanced ultrasound for characterizing hepatitis c-related liver disease.

    PubMed

    Lim, A K P; Patel, N; Eckersley, R J; Fitzpatrick, J; Crossey, M M E; Hamilton, G; Goldin, R D; Thomas, H C; Vennart, W; Cosgrove, D O; Taylor-Robinson, S D

    2011-10-01

    We compared in vivo hepatic (31) P magnetic resonance spectroscopy ((31) P MRS) and hepatic vein transit times (HVTT) using contrast-enhanced ultrasound with a microbubble agent to assess the severity of hepatitis C virus (HCV)-related liver disease. Forty-six patients with biopsy-proven HCV-related liver disease and nine healthy volunteers had (31) P MRS and HVTT performed on the same day. (31) P MR spectra were obtained at 1.5 T. Peak areas were calculated for metabolites, including phosphomonoesters (PME) and phosphodiesters (PDE). Patients also had the microbubble ultrasound contrast agent, Levovist (2 g), injected into an antecubital vein, and time-intensity Doppler ultrasound signals of the right and middle hepatic veins were measured. The HVTT was calculated as the time from injection to a sustained rise in Doppler signal 10% greater than baseline. The shortest times were used for analysis. Based on Ishak histological scoring, there were 15 patients with mild hepatitis, 20 with moderate/severe hepatitis and 11 with cirrhosis. With increasing severity of disease, the PME/PDE ratio was steadily elevated, while the HVTT showed a monotonic decrease. Both imaging modalities could separate patients with cirrhosis from the mild and moderate/severe hepatitis groups. No statistical difference was observed in the accuracy of each test to denote mild, moderate/severe hepatitis and cirrhosis (Fisher's exact test P =1.00). (31) P MRS and HVTT show much promise as noninvasive imaging tests for assessing the severity of chronic liver disease. Both are equally effective and highly sensitive in detecting cirrhosis.

  16. Using hepatitis C prevalence to estimate HIV epidemic potential among people who inject drugs in the Middle East and North Africa

    PubMed Central

    Mumtaz, Ghina R.; Weiss, Helen A.; Vickerman, Peter; Larke, Natasha; Abu-Raddad, Laith J.

    2015-01-01

    Objectives: The objective of this study is to understand the association between HIV and hepatitis C virus (HCV) among people who inject drugs (PWIDs) in the Middle East and North Africa (MENA), and to estimate HIV epidemic potential among PWIDs using HCV prevalence. Design/methods: Using data from a systematic review of HIV and HCV among PWID in MENA, we conducted two analyses, stratified by HIV epidemic state: a meta-analysis of the risk ratio of HCV to HIV prevalence (RRHCV/HIV) using DerSimonian-Laird random-effects models, and multivariable linear regression predicting log HIV prevalence. The HCV-HIV association from both analyses was used to estimate HIV prevalence at endemic equilibrium. We compared predicted with current HIV prevalence to classify HIV epidemic potential at country-level as low, medium or high, using predefined criteria. Results: The review identified 88 HCV prevalence measures among PWID in MENA, of which 54 had a paired HIV prevalence measure. The pooled RRHCV/HIV were 16, 4 and 3 in low-level, emerging and established HIV epidemics, respectively. There was a significant linear relationship between HCV and HIV at endemic equilibrium (P = 0.002). The predicted endemic HIV prevalence ranged between 8% (Tunisia) and 22% (Pakistan). Of the nine countries with data, five have high and three medium HIV epidemic potential. Only one country, Pakistan, appears to have reached saturation. Conclusion: HCV prevalence could be a predictor of future endemic HIV prevalence. In MENA, we predict that there will be further HIV epidemic growth among PWID. The proposed methodology can identify PWID populations that should be prioritized for HIV prevention interventions. PMID:26372281

  17. Pathogenesis of varicose veins.

    PubMed

    Oklu, Rahmi; Habito, Roy; Mayr, Manuel; Deipolyi, Amy R; Albadawi, Hassan; Hesketh, Robin; Walker, T Gregory; Linskey, Katy R; Long, Chandler A; Wicky, Stephan; Stoughton, Julianne; Watkins, Michael T

    2012-01-01

    Despite the high prevalence of varicose veins and the recent surge in research on the condition, the precise mechanisms underlying their development remain uncertain. In the past decade, there has been a shift from initial theories based on purely mechanical factors to hypotheses pointing to complex molecular changes causing histologic alterations in the vessel wall and extracellular matrix. Despite progress in understanding the molecular aspects of venous insufficiency, therapies for symptomatic varicose veins are directed toward anatomic and physical interventions. The present report reviews current evidence identifying the underlying biochemical alterations in the pathogenesis of varicose veins.

  18. [Treatment of nontumoral portal vein thrombosis in cirrhosis].

    PubMed

    Bañares, Rafael; Catalina, María-Vega

    2014-07-01

    Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives.

  19. SUBCLAVIAN VEIN THROMBOSIS FOLLOWING FRACTURE OF THE CLAVICLE: CASE REPORT

    PubMed Central

    Terra, Bernardo Barcellos; Cocco, Luiz Fernando; Ejnisman, Benno; Fernandes, Hélio Jorge Alvachian; dos Reis, Fernando Baldy

    2015-01-01

    Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Treating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle. PMID:27027014

  20. Deep vein thrombosis.

    PubMed

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  1. Pelvic Vein Embolisation in the Management of Varicose Veins

    SciTech Connect

    Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S.; Hussain, Fuad F.; Whiteley, Mark S.; Lopez, Anthony

    2008-11-15

    Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

  2. Surgical treatment of mesenteric infarction, thoracoabdominal aortic aneurysm, and proper hepatic aneurysm in a middle-aged woman with Takayasu's arteritis.

    PubMed

    Koyama, M; Tanaka, M; Shimizu, M; Nomura, S; Kako, N; Suzuki, S; Koie, H

    1995-08-01

    Although Takayasu's arteritis may present a wide variety of signs and symptoms depending on the vessel affected, it is rarely associated with acute abdomen requiring emergency laparotomy. We report a case of Takayasu's arteritis that required several surgical interventions for mesenteric infarction, thoracoabdominal aneurysm, and proper hepatic artery aneurysm, all of which were noted in succession within a 1-year period. This is also the first report, to our knowledge, of a hepatic artery aneurysm caused by Takayasu's arteritis.

  3. Varicose vein surgery.

    PubMed

    Kendler, Micheal; Fellmer, Peter T; Wetzig, Tino

    2012-03-01

    Venous diseases are common in the general population. After a comprehensive diagnostic evaluation, an individual therapeutic approach should be selected on the basis of the findings, with the aim of treating the diseased vein segments and improving quality of life. Numerous therapeutic options are available for the treatment of varicose veins. In addition to conservative methods such as compression therapy, exercise or drugs, surgical procedures such as traditional surgery, thermal ablation techniques or sclerotherapy can be performed. Recent developments include the use of endoluminal water vapor or mechano-chemical endovenous ablation. PMID:22222053

  4. Viral Hepatitis

    MedlinePlus

    ... Public Home » For Veterans and the Public Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... the Public Veterans and Public Home How is Hepatitis C Treated? Find the facts about the newest ...

  5. Portal Vein Thrombosis

    PubMed Central

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  6. [Deep vein thrombosis prophylaxis.

    PubMed

    Sandoval-Chagoya, Gloria Alejandra; Laniado-Laborín, Rafael

    2013-01-01

    Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk for thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy. Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini's checklist for thrombosis risk assessment in adult patients. Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001). Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines.

  7. Elastomechanical properties of bovine veins.

    PubMed

    Rossmann, Jenn Stroud

    2010-02-01

    Veins have historically been discussed in qualitative, relative terms: "more compliant" than arteries, subject to "lower pressures". The structural and compositional differences between arteries and veins are directly related to the different functions of these vessels. Veins are often used as grafts to reroute flow from atherosclerotic arteries, and venous elasticity plays a role in the development of conditions such as varicose veins and valvular insufficiency. It is therefore of clinical interest to determine the elastomechanical properties of veins. In the current study, both tensile and vibration testing are used to obtain elastic moduli of bovine veins. Representative stress-strain data are shown, and the mechanical and failure properties reported. Nonlinear and viscoelastic behavior is observed, though most properties show little strain rate dependence. These data suggest parameters for constitutive modeling of veins and may inform the design and testing of prosthetic venous valves as well as vein grafts. PMID:20129420

  8. Viral Hepatitis

    MedlinePlus

    ... with hepatitis? How does a pregnant woman pass hepatitis B virus to her baby? If I have hepatitis B, what does my baby need so that she ... Can I breastfeed my baby if I have hepatitis B? More information on viral hepatitis What is hepatitis? ...

  9. Anatomical evaluation of hepatic vascular system in healthy beagles using X-ray contrast computed tomography.

    PubMed

    Oishi, Yasuhisa; Tani, Kenji; Nakazawa, Hiroshi; Itamoto, Kazuhito; Haraguchi, Tomoya; Taura, Yasuho

    2015-08-01

    Liver contrast X-ray computed tomography (CT) has been used for evaluation of hepatic vessels for liver transplantation, liver lobectomy, interventional radiology and diagnosis of hepatocellular carcinoma in humans. However, there remains scant available anatomical information on normal hepatic vessels in the veterinary field. In this study, visualization of hepatic vessels was evaluated in 32 normal beagle dogs by X-ray contrast CT using triple phase images. The following hepatic vessels were clearly visualized: arterial, portal and hepatic veins. With regards to the running patterns of the portal vein and hepatic vein, there were no significant differences between the dogs. However, the hepatic artery exhibited some differences in each dog. In particular, the hepatic artery of the quadrate lobe and the right lateral lobe had many running patterns. The results of the present study could be useful for veterinary diagnosis, surgery and interventional radiology. PMID:25843113

  10. Spontaneous Iliac Vein Rupture

    PubMed Central

    Kim, Dae Hwan; Park, Hyung Sub; Lee, Taeseung

    2015-01-01

    Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding. PMID:26217647

  11. COMPUTED TOMOGRAPHIC AND ULTRASONOGRAPHIC CHARACTERISTICS OF CAVERNOUS TRANSFORMATION OF THE OBSTRUCTED PORTAL VEIN IN SMALL ANIMALS.

    PubMed

    Specchi, Swan; Pey, Pascaline; Ledda, Gianluca; Lustgarten, Meghann; Thrall, Donald; Bertolini, Giovanna

    2015-01-01

    In humans, the process of development of collateral vessels with hepatopetal flow around the portal vein in order to bypass an obstruction is called "cavernous transformation of the portal vein." The purpose of this retrospective, cross-sectional, multicentric study was to describe presumed cavernous transformation of the portal vein in small animals with portal vein obstruction using ultrasound and multidetector-row computed tomography (MDCT). Databases from three different institutions were searched for patients with an imaging diagnosis of cavernous transformation of the portal vein secondary to portal vein obstruction of any cause. Images were retrieved and reanalyzed. With MDCT-angiography, two main portoportal collateral pathways were identified: short tortuous portoportal veins around/inside the thrombus and long portoportal collaterals bypassing the site of portal obstruction. Three subtypes of the long collaterals, often coexisting, were identified. Branches of the hepatic artery where involved in collateral circulation in nine cases. Concomitant acquired portosystemic shunts were identified in six patients. With ultrasound, cavernous transformation of the portal vein was suspected in three dogs and one cat based on visualization of multiple and tortuous vascular structures corresponding to periportal collaterals. In conclusion, the current study provided descriptive MDCT and ultrasonographic characteristics of presumed cavernous transformation of the portal vein in a sample of small animals. Cavernous transformation of the portal vein could occur as a single condition or could be concurrent with acquired portosystemic shunts.

  12. COMPUTED TOMOGRAPHIC AND ULTRASONOGRAPHIC CHARACTERISTICS OF CAVERNOUS TRANSFORMATION OF THE OBSTRUCTED PORTAL VEIN IN SMALL ANIMALS.

    PubMed

    Specchi, Swan; Pey, Pascaline; Ledda, Gianluca; Lustgarten, Meghann; Thrall, Donald; Bertolini, Giovanna

    2015-01-01

    In humans, the process of development of collateral vessels with hepatopetal flow around the portal vein in order to bypass an obstruction is called "cavernous transformation of the portal vein." The purpose of this retrospective, cross-sectional, multicentric study was to describe presumed cavernous transformation of the portal vein in small animals with portal vein obstruction using ultrasound and multidetector-row computed tomography (MDCT). Databases from three different institutions were searched for patients with an imaging diagnosis of cavernous transformation of the portal vein secondary to portal vein obstruction of any cause. Images were retrieved and reanalyzed. With MDCT-angiography, two main portoportal collateral pathways were identified: short tortuous portoportal veins around/inside the thrombus and long portoportal collaterals bypassing the site of portal obstruction. Three subtypes of the long collaterals, often coexisting, were identified. Branches of the hepatic artery where involved in collateral circulation in nine cases. Concomitant acquired portosystemic shunts were identified in six patients. With ultrasound, cavernous transformation of the portal vein was suspected in three dogs and one cat based on visualization of multiple and tortuous vascular structures corresponding to periportal collaterals. In conclusion, the current study provided descriptive MDCT and ultrasonographic characteristics of presumed cavernous transformation of the portal vein in a sample of small animals. Cavernous transformation of the portal vein could occur as a single condition or could be concurrent with acquired portosystemic shunts. PMID:25877678

  13. Preduodenal portal vein: a potential laparoscopic cholecystectomy nightmare.

    PubMed

    Bhorat, N; Thomson, S R; Anderson, F

    2009-02-01

    Variations of biliary anatomy are well described. Those of most relevance to the operative surgeon are the variations of the extrahepatic ducts and their relationships to the right hepatic artery and its branches. We describe another even rarer congenital anomaly of a preduodenal portal vein. Its embryological derivation and presentation are discussed to heighten awareness of its recognition and reduce the potential of a serious operative misadventure.

  14. [Renal vein infarction, a complication of paroxysmal nocturnal hemoglobinuria].

    PubMed

    de Charry, Charlotte; de Charry, Félicité; Lemoigne, François; Lamboley, Jean-Laurent; Pasquet, Florian; Pavic, Michel

    2012-12-01

    Paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease) is a rare acquired clonal disorder of the hematopoietic cell, to a somatic mutation in the phosphatidylinositol glycan (PIG-A). The most frequent clinical manifestations are hemolytic crisis and venous thrombosis of the mesenteric, hepatic, portal or cerebral territories. We report a case of paroxysmal nocturnal hemoglobinuria with renal vein thrombosis, a rare complication of this disease.

  15. An anomalous portal vein crossing the lesser sac and ending at the upper part of ductus venosus

    PubMed Central

    Yu, Hee Chul; Murakami, Gen; Rodríguez-Vázquez, José Francisco; Cho, Baik Hwan

    2015-01-01

    In serial sagittal sections of a fetus on week 9 (crown-rump length, 36 mm), we incidentally found absence of the usual portal vein through the hepatoduodenal ligament. Instead, an anomalous portal vein originated behind the pancreatic body, crossed the lesser sac and merged with the upper part of the ductus venosus. During the course across the lesser sac, the vein provided a deep notch of the liver caudate lobe (Spiegel's lobe). The hepatoduodenal ligament contained the hepatic artery, the common bile duct and, at the right posterior margin of the ligament, and a branch of the anomalous portal vein which communicated with the usual right branch of the portal vein at the hepatic hilum. The umbilical portion of the portal vein took a usual morphology and received the umbilical vein and gave off the ductus venosus. Although it seemed not to be described yet, the present anomalous portal vein was likely to be a persistent left vitelline vein. The hepatoduodenal ligament was unlikely to include the left vitelline vein in contrast to the usual concept. PMID:26417483

  16. An anomalous portal vein crossing the lesser sac and ending at the upper part of ductus venosus.

    PubMed

    Yu, Hee Chul; Kim, Ji Hyun; Murakami, Gen; Rodríguez-Vázquez, José Francisco; Cho, Baik Hwan

    2015-09-01

    In serial sagittal sections of a fetus on week 9 (crown-rump length, 36 mm), we incidentally found absence of the usual portal vein through the hepatoduodenal ligament. Instead, an anomalous portal vein originated behind the pancreatic body, crossed the lesser sac and merged with the upper part of the ductus venosus. During the course across the lesser sac, the vein provided a deep notch of the liver caudate lobe (Spiegel's lobe). The hepatoduodenal ligament contained the hepatic artery, the common bile duct and, at the right posterior margin of the ligament, and a branch of the anomalous portal vein which communicated with the usual right branch of the portal vein at the hepatic hilum. The umbilical portion of the portal vein took a usual morphology and received the umbilical vein and gave off the ductus venosus. Although it seemed not to be described yet, the present anomalous portal vein was likely to be a persistent left vitelline vein. The hepatoduodenal ligament was unlikely to include the left vitelline vein in contrast to the usual concept.

  17. Percutaneous Stent Placement as Treatment of Renal Vein Obstruction Due to Inferior Vena Caval Thrombosis

    SciTech Connect

    Stecker, Michael S. Casciani, Thomas; Kwo, Paul Y.

    2006-02-15

    A patient who had undergone his third orthotopic liver transplantation nearly 9 years prior to presentation developed worsening hepatic and renal function, as well as severe bilateral lower extremity edema. Magnetic resonance imaging demonstrated vena caval thrombosis from the suprahepatic venous anastomosis to the infrarenal inferior vena cava, obstructing the renal veins. This was treated by percutaneous placement of metallic stents from the renal veins to the right atrium. At 16 months clinical follow-up, the patient continues to do well.

  18. Endovascular Treatment of Acute Portal Vein Thrombosis After Liver Transplantation in a Child

    SciTech Connect

    Carnevale, Francisco Cesar Borges, Marcus Vinicius; Moreira, Airton Mota; Cerri, Giovanni Guido; Maksoud, Joao Gilberto

    2006-06-15

    Although operative techniques in hepatic transplantation have reduced the time and mortality on waiting lists, the rate of vascular complications associated with these techniques has increased. Stenosis or thrombosis of the portal vein is an infrequent complication, and if present, surgical treatment is considered the traditional management. This article describes a case of acute portal vein thrombosis after liver transplantation from a living donor to a child managed by percutaneous techniques.

  19. More vein, less plastic.

    PubMed

    Francis, David Ma

    2005-02-01

    Use of arteriovenous fistulas, grafts and central venous catheters for haemodialysis access varies considerably, because of perceived patient variables and preferences of surgeons, nephrologists and dialysis staff. Evidence clearly indicates that the arteriovenous fistula is superior to other methods of access in terms of patient survival, flow rates, patency, infection rates, expense and ease of maintenance. Strategies to increase the use and longevity of fistulas for definitive haemodialysis access include vein preservation, early referral for fistula surgery, preoperative clinical and ultrasound assessment of the venous and arterial systems, access surveillance, good cannulation technique, and aggressive conservatism in surgical and/or radiological correction of fistula problems. PMID:15705175

  20. Cephalic vein aneurysm.

    PubMed

    Faraj, Walid; Selmo, Francesca; Hindi, Mia; Haddad, Fadi; Khalil, Ismail

    2007-11-01

    Cephalic vein aneurysms are rare malformations that may develop in any part of the vascular system, and their history, presentation, and management vary depending on their site. The etiology of venous aneurysms remains unclear, although several theories have been elaborated. Venous aneurysms are unusual vascular malformations that occur equally between the sexes and are seen at any age; they can present as either a painful or a painless subcutaneous mass. No serious complications have been reported from upper extremity venous aneurysms. Surgical excision is the definitive management for most of these. The case reported here presented with a painless and mobile, soft, subcutaneous mass that caused only cosmetic concern.

  1. Liver transplantation in patients with portal vein thrombosis and central portacaval shunts.

    PubMed Central

    Shaked, A; Busuttil, R W

    1991-01-01

    The authors have analyzed the impact of pre-existing portal vein pathology on the outcome of orthotopic liver transplantation. The incidence was high in patients suffering from chronic active hepatitis, hypercoagulable states, trauma or previous dissection of the porta hepatis, and splenectomy. The existence of portal vein thrombosis (23 patients) or surgical central portosystemic shunt (10 patients) was documented by preoperative Doppler sonogram or angiography (26/33), or operative findings of occluded vein (7/33). Successful thrombectomy and dismantling of portacaval shunts were achieved in most cases (24/33). Only nine patients required the placement of an interposition vein graft to the superior mesenteric vein. The intraoperative course was characterized by increased blood loss and coagulopathy, significantly higher than in patients with a patent portal vein. When compared with all liver transplants, the immediate postoperative complication rate was higher for primary nonfunction (33% versus 8%), re-exploration for intraperitoneal bleeding and hematomas, and morbid infections. Rethrombosis rate of thrombectomized veins or vein graft was low (2/33). The mortality rate was 35% in the presence of portal vein thrombosis (PVT) and 30% for portacaval shuct (PCS), both significantly higher than the 12% for other orthotopic liver transplant (OLT) patients. These results are expected to improve with better patient selection, surgical experience, and anticipation of the complex postoperative course. The authors conclude that PVT or the presence of PCS are not contraindications to orthotopic liver transplantation. PMID:1741649

  2. Can we increase hepatic oxygen availability? The role of intentional hypercarbia.

    PubMed

    Atallah, M M; Demian, A D; el-Diasty, T A; Ma Saied, M

    2000-06-01

    Our hypothesis is that hypercarbia produces sympathetic stimulant effect and local vasodilatation. We studied the effect of intentional hypercarbia (IHC) on hepatic venous oxygen saturation. The hepatic vein (HV) was cannulated in 15 patients through either the right internal jugular vein or the femoral vein to measure HV oxygen saturation and calculate oxygen content. The inferior vena cava (IVC) was cannulated in 6 patients above and below drainage of the hepatic veins for oxygen saturation and content difference along the IVC. IHC was achieved in awake patients by breathing oxygen enriched air at a flow rate of 2L/min for 10 min, and during anesthesia by increasing anesthetic dead space and reducing tidal volume. IHC increased HV blood oxygen saturation, decreased the arterio-hepatic vein oxygen content difference and decreased oxygen saturation difference and oxygen content difference along IVC. PMID:11126503

  3. [Coronary veins and coronary sinus tributary veins in Africans].

    PubMed

    Yangni-Angate, H; Kokoua, A; Kouassi, R; Kassanyou, S; Gnagne, Y; Guessan, G N; Cowppli-Bony, P; Memel, J B

    1995-01-01

    This anatomical study carried out on 40 African adults hearts studied branches of the coronary sinus. By using of injection of the coronary arteries and corrosion of the myocardium, the study identified certain peculiarities of the small coronary vein and the posterior descending interventricular vein in Africans. PMID:8519704

  4. [Clamping procedures in hepatic surgery].

    PubMed

    Frangov, T; Dimitrova, V; Kasten, D; Bismiut, A

    2005-01-01

    The advance of liver surgery and transplantation offers a new procedures--vascular clamping. Results of hepatic resections depends essentially on proper control of intraoperative hemorrhage. We present here the different procedures for vascular clamping and discussing their indications. Four parametres can be used to define the type of clamping: 1) place of application--control of arterial or glisson pedicles and portal veins (pedicles, selective hilar, suprahilar and intrahepatic clamps), suprahepatic veins or vena cava; 2) selectivity--partial or total clamp of hepatic blood supply; 3) duration--continuous or intermittent; 4) association measures to favor tolerence to ischemia (cooling, preservation fluids) or to limit downstream consequences (extracorporal circulaton, derivation). The clamping procedures depends on the localisation of the lesion and its relationships with the great vessels, presence of liver desease and the patients general and cardiovascular status. The aim is to use clamp moderate, favoring selective clamps to avoid ischemia. PMID:18693516

  5. Infrared imaging of varicose veins

    NASA Astrophysics Data System (ADS)

    Noordmans, Herke Jan; de Zeeuw, Raymond; Verdaasdonk, Ruud M.; Wittens, Cees H. A.

    2004-06-01

    It has been established that varicose veins are better visualized with infrared photography. As near-infrared films are nowadays hard to get and to develop in the digital world, we investigated the use of digital photography of varicose veins. Topics that are discussed are illumination setup, photography and digital image enhancement and analysis.

  6. Hepatitis virus panel

    MedlinePlus

    Hepatitis A antibody test; Hepatitis B antibody test; Hepatitis C antibody test; Hepatitis D antibody test ... or past infection, or immunity to hepatitis A Hepatitis B tests: Hepatitis B surface antigen (HBsAg), you have ...

  7. Hepatitis C and HIV

    MedlinePlus

    ... Problems : Hepatitis C Subscribe Translate Text Size Print Hepatitis C What is Hepatitis? Hepatitis means inflammation of the liver. This condition ... our related pages, Hepatitis A and Hepatitis B . Hepatitis C and HIV About 25% of people living ...

  8. Hepatitis B and HIV

    MedlinePlus

    ... Problems : Hepatitis B Subscribe Translate Text Size Print Hepatitis B What is Hepatitis? Hepatitis means inflammation of the liver. This condition ... our related pages, Hepatitis A and Hepatitis C . Hepatitis B and HIV About 10% of people living ...

  9. Non-contrast-enhanced MR portography and hepatic venography with time-spatial labeling inversion pulses: comparison at 1.5 Tesla and 3 Tesla

    PubMed Central

    Isoda, Hiroyoshi; Furuta, Akihiro; Togashi, Kaori

    2015-01-01

    Background A 3 Tesla (3 T) magnetic resonance (MR) scanner is a promising tool for upper abdominal MR angiography. However, there is no report focused on the image quality of non-contrast-enhanced MR portography and hepatic venography at 3 T. Purpose To compare and evaluate images of non-contrast-enhanced MR portography and hepatic venography with time-spatial labeling inversion pulses (Time-SLIP) at 1.5 Tesla (1.5 T) and 3 T. Material and Methods Twenty-five healthy volunteers were examined using respiratory-triggered three-dimensional balanced steady-state free-precession (bSSFP) with Time-SLIP. For portography, we used one tagging pulse (selective inversion recovery) and one non-selective inversion recovery pulse; for venography, two tagging pulses were used. The relative signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were quantified, and the quality of visualization was evaluated. Results The CNRs of the main portal vein, right portal vein, and left portal vein at 3 T were better than at 1.5 T. The image quality scores for the portal branches of segment 4, 5, and 8 were significantly higher at 3 T than at 1.5 T. The CNR of the right hepatic vein (RHV) at 3 T was significantly lower than at 1.5 T. The image quality scores of RHV and the middle hepatic vein were higher at 1.5 T than at 3 T. For RHV visualization, the difference was statistically significant. Conclusion Non-contrast-enhanced MR portography with Time-SLIP at 3 T significantly improved visualization of the peripheral branch in healthy volunteers compared with1.5 T. Non-contrast-enhanced MR hepatic venography at 1.5 T was better than at 3 T. PMID:26019890

  10. The management of varicose veins.

    PubMed

    Lin, Fan; Zhang, Shiyi; Sun, Yan; Ren, Shiyan; Liu, Peng

    2015-01-01

    This study aimed to review the current management modalities for varicose veins. There are a variety of management modalities for varicose veins. The outcomes of the treatment of varicose veins are different. The papers on the management of varicose veins were reviewed and the postoperative complications and efficacy were compared. Foam sclerotherapy and radiofrequency ablation were associated with less pain and faster recovery than endovenous laser ablation and surgical stripping. Patients undergoing endovenous laser ablation and radiofrequency ablation are most likely to have a faster recovery time and earlier return to work in comparison with those undergoing conventional high ligation and stripping. A randomized controlled study in multiple centers is warranted to verify which approach is better than others for the treatment of varicose veins.

  11. The economics of vein disease.

    PubMed

    Sales, Clifford M; Podnos, Joan; Levison, Jonathan

    2007-09-01

    The management of cosmetic vein problems requires a very different approach than that for the majority of most other vascular disorders that occur in a vascular surgery practice. This article focuses on the business aspects of a cosmetic vein practice, with particular attention to the uniqueness of these issues. Managing patient expectations is critical to the success of a cosmetic vein practice. Maneuvering within the insurance can be difficult and frustrating for both the patient and the practice. Practices should use cost accounting principles to evaluate the success of their vein work. Vein surgery--especially if performed within the office--can undergo an accurate break-even analysis to determine its profitability. PMID:17911565

  12. [The status of splanchnic blood circulation in patients with varicose veins of the esophagus and stomach in liver cirrhosis].

    PubMed

    Kotenko, O G

    1999-01-01

    Complex hemodynamical investigations were done in 166 patients with liver cirrhosis and the portal hypertension syndrome. Patients with varicose veins of the esophagus and stomach versus patients with isolated varicose veins of the esophagus have significantly higher resistance of vessels of the a. hepatica and v. porta systems, more pronounced losses of portal perfusion at the expense of varicose veins of stomach, gastro- and splenorenal shunts and lower volumetric blood flow in v. lienalis. While varicose veins of the esophagus and stomach occur an absolute values of the arterial and portal blood flow in liver are lowering, common hepatic blood flow reduces. The varicose veins of the stomach existence testifies high degree of the portosystemic shunting development with subsequent lowering of volumetric blood flow in v. lienalis in comparison with such in isolated varicose veins of the esophagus.

  13. The epidemiology of viral hepatitis in Qatar.

    PubMed

    Bener, Abdulbari; Al-Kaabi, Saad; Derbala, Moutaz; Al-Marri, Ajayeb; Rikabi, Ammar

    2009-03-01

    Viral hepatitis is a major public health problem in many countries all over the world and especially in Middle East, Asia, East-Europe, and Africa. The aim of our study was to assess the incidence of viral hepatitis A, B and C in Qatar and compare it with other countries. This is a retrospective cohort study, which was conducted at Hamad General Hospital, State of Qatar from 2002-2006. Patients who were screened and diagnosed with viral hepatitis were included in this study. The diagnostic classification of definite viral hepatitis was made in accordance with criteria based on the International Classification of Disease tenth revision (ICD-10). A total of 527 cases of hepatitis C, 396 cases of hepatitis B, 162 cases of hepatitis A and 108 cases of unspecified were reported during the year 2006. Reported incidence rate per 10,000 populations during the year 2006 for hepatitis A was 1.9, hepatitis B 4.7, and Hepatitis C 6.3. The proportion of hepatitis B and C was significantly higher in male population than females across the years (2002-2006). Hepatitis A was more prevalent in children below 15 years (72.3%), hepatitis B in adults aged above 15 years, and hepatitis C in the population above 35 years of age. The incidence of hepatitis A has been declining in Qataris and increasing in expatriates. There was a significant relationship in gender and age group of the patients with hepatitis A, B and C. We conclude that hepatitis has become a national health issue in Qatar. The incidence rate of hepatitis in Qatar is comparable to its neighboring countries, United Arab Emirates and Saudi Arabia. There is a need for further research on hepatitis and the associated risk factors.

  14. [Analysis and computational fluid dynamics simulation of hemodynamic influences caused by splenic vein thrombosis].

    PubMed

    Zhou, Hongyu; Gong, Peiyun; Du, Xuesen; Wang, Meng

    2015-02-01

    This paper aims to analyze the impact of splenic vein thrombosis (SVT) on the hemodynamic parameters in hepatic portal vein system. Based on computed tomography (CT) images of a patient with portal hypertension and commercial software MIMICS, the patient's portal venous system model was reconstructed. Color Doppler ultrasound method was used to measure the blood flow velocity in portal vein system and then the blood flow velocities were used as the inlet boundary conditions of simulation. By using the computational fluid dynamics (CFD) method, we simulated the changes of hemodynamic parameters in portal venous system with and without splenic vein thrombosis and analyzed the influence of physiological processes. The simulation results reproduced the blood flow process in portal venous system and the results showed that the splenic vein thrombosis caused serious impacts on hemodynamics. When blood flowed through the thrombosis, blood pressure reduced, flow velocity and wall shear stress increased. Flow resistance increased, blood flow velocity slowed down, the pressure gradient and wall shear stress distribution were more uniform in portal vein. The blood supply to liver decreased. Splenic vein thrombosis led to the possibility of forming new thrombosis in portal vein and surroundings.

  15. Vein matching using artificial neural network in vein authentication systems

    NASA Astrophysics Data System (ADS)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  16. Significant cohort of non-alcoholic fatty liver disease with portal vein thrombosis in transplant waiting list

    PubMed Central

    Basaranoglu, Metin; Najjar, Sonia M; Demirbag, Ali Ebag; Senturk, Hakan

    2016-01-01

    AIM: To characterize non-alcoholic fatty liver disease (NAFLD) presentation with esophageal varices. METHODS: We carried out a retrospective cohort study on 258 patients with esophageal varices at a single tertiary referral center. These patients underwent diagnosis of several liver diseases, including: NAFLD-associated cirrhosis, hepatitis B, hepatitis C, Wilson disease, autoimune liver diseases, and others. RESULTS: Of the 258 patients, 39% of patients exhibited esophageal varices due to NAFLD-associated cirrhosis. Of the 38 (14.7%) patients developed hepatocellular carcinoma during follow-up, 52% were due to hepatitis B, 26% due to hepatitis C and 13.2% due to NAFLD. Of the 258 patients, 50.0% with NAFLD, 33.3% with hepatitis B, 26.3% with hepatitis C, and 58.3% with other diseases were alive at the end of the 5-year period with a significant difference according to the Kaplan-Meier log Rank test (P = 0.040). Portal vein thrombosis was detected in 47.5% of patients with NAFLD, in 29% of patients with hepatitis B, in 17% of patients with hepatitis C, and in 62% of patients with other related diseases (P < 0.0001). CONCLUSION: Our study showed a proportionally greater elevation in liver transplant candidacy in patients with NAFLD and portal vein thrombosis. Older patients were more prone to developing cirrhosis, hepatocellular carcinoma and a high mortality rate. However, younger patients exhibited more portal vein thrombosis and gastric varices. PMID:26981175

  17. Neonatal renal vein thrombosis.

    PubMed

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  18. Transsinusoidal Portal Vein Embolization with Ethylene Vinyl Alcohol Copolymer (Onyx): A Feasibility Study in Pigs

    SciTech Connect

    Smits, Maarten L. J.; Vanlangenhove, Peter Sturm, Emiel J. C.; Bosch, Maurice A. A. J. van den; Hav, Monirath Praet, Marleen; Vente, Maarten A. D.; Snaps, Frederic R.; Defreyne, Luc

    2012-10-15

    Purpose: Portal vein embolization is performed to increase the future liver remnant before liver surgery in patients with liver malignancies. This study assesses the feasibility of a transsinusoidal approach for portal vein embolization (PVE) with the ethylene vinyl alcohol copolymer, Onyx. Methods: Indirect portography through contrast injection in the cranial mesenteric artery was performed in eight healthy pigs. Onyx was slowly injected through a microcatheter from a wedged position in the hepatic vein and advanced through the liver lobules into the portal system. The progression of Onyx was followed under fluoroscopy, and the extent of embolization was monitored by indirect portography. The pigs were euthanized immediately (n = 2), at 7 days (n = 4), or at 21 days postprocedure (n = 2). All pigs underwent necropsy and the ex vivo livers were grossly and histopathologically analyzed. Results: Transsinusoidal PVE was successfully performed in five of eight pigs (63%). In 14 of 21 injections (67%), a segmental portal vein could be filled completely. A mean of 1.6 liver lobes per pig was embolized (range 1-2 lobes). There were no periprocedural adverse events. Focal capsular scarring was visible on the surface of two resected livers, yet the capsules remained intact. Histopathological examination showed no signs of recanalization or abscess formation. Mild inflammatory reaction to Onyx was observed in the perivascular parenchyma. Conclusions: The porcine portal vein can be embolized through injection of Onyx from a wedged position in the hepatic vein. Possible complications of transsinusoidal PVE and the effect on contralateral hypertrophy need further study.

  19. New perspectives on hepatitis E.

    PubMed

    Hyams, Kenneth C

    2002-08-01

    The infectious agent causing epidemic non-A, non-B hepatitis was identified in 1983 from a human challenge experiment. The novel hepatitis E virus (HEV) subsequently was cloned in 1990 and the genome sequenced. HEV transmission is highly endemic in Asia, the Middle East, and Africa. Fecal contamination of drinking water is the most common mode of spread. Although usually asymptomatic, HEV infection can cause fulminant hepatitis. Recent studies indicate that hepatitis E may be a zoonotic disease, with pigs and possibly rats serving as reservoirs for human infection. A recombinant HEV vaccine is currently in phase III clinical trials. The characterization of the major types of viral hepatitis during the last 20 years illustrates how modern genetic technology has revolutionized research in infectious diseases. Within less than two decades of the discovery of HEV, its epidemiology has been described, serologic tests have been developed, and a candidate vaccine has been evaluated in clinical trials. PMID:12149176

  20. How Are Varicose Veins Treated?

    MedlinePlus

    ... Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical ... shun) therapy uses lasers or radiowaves to create heat to close off a varicose vein. Your doctor ...

  1. Right hepatic artery crossing the common hepatic artery: an unusual blood supply to the liver.

    PubMed

    Felli, Emanuele; Vennarecci, Giovanni; Santoro, Roberto; Guglielmo, Nicola; Ettorre, Giuseppe Maria

    2016-04-01

    To perform hepatic surgery a precise preoperative and intraoperative study of liver vascular supply is mandatory. Detecting vascular variations may have great importance on surgical strategy and outcome, and details of anatomy do not concern only academical knowledge but become deeply involved in practice. We present a case of unusual blood supply to the liver, the common hepatic artery was directed to the right liver and a right hepatic artery originating from the superior mesenteric artery was directed to the left liver. The right hepatic artery crossed the common hepatic artery in the proximal part of the hepatic pedicle, anterior to the portal vein. To our knowledge this type of anatomical variation has not been described before and it represents a rare finding that has to be kept in mind, especially in case of major hepatectomies and more demanding splitting liver procedures such as A.L.P.P.S., in situ split, ex situ split and living donor liver transplantation. PMID:26198115

  2. Resolution of Large Azygos Vein Aneurysm Following Stent-Graft Shunt Placement in a Patient with Ehlers-Danlos Syndrome Type IV

    SciTech Connect

    D'Souza, Estelle S.; Williams, David M.; Deeb, G.M.; Cwikiel, Wojciech

    2006-10-15

    Ehlers-Danlos syndrome (EDS) type IV is a rare connective tissue disorder associated with thin-walled, friable arteries and veins predisposing patients to aneurysm formation, dissection, fistula formation, and vessel rupture. Azygos vein aneurysm is an extremely rare condition which has not been reported in association with EDS in the literature. We present a patient with EDS type IV and interrupted inferior vena cava (IVC) with azygos continuation who developed an azygos vein aneurysm. In order to decrease flow through the azygos vein and reduce the risk of aneurysm rupture, a stent-graft shunt was created from the right hepatic vein to the azygos vein via a transhepatic, retroperitoneal route. At 6 month follow-up the shunt was open and the azygos vein aneurysm had resolved.

  3. Hepatitis C: Treatment

    MedlinePlus

    ... Public Home » Hepatitis C » Hepatitis C Treatment Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... Enter ZIP code here Enter ZIP code here Hepatitis C Treatment for Veterans and the Public Treatment ...

  4. Hepatitis C and Incarceration

    MedlinePlus

    HEPATITIS C & INCARCERATION What is hepatitis? “Hepatitis” means inflammation or swelling of the liver. The liver is an important ... viral hepatitis: Hepatitis A, Hepatitis B, and Hepatitis C. They are all different from each other and ...

  5. Hepatitis A

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis A, is caused by the hepatitis A virus (HAV). The disease spreads through contact with ... washed in untreated water Putting into your mouth a finger or object that came into contact with ...

  6. Autoimmune hepatitis

    MedlinePlus

    Lupoid hepatitis; Chronic acute liver disease ... This form of hepatitis is an autoimmune disease . The body's immune system cannot tell the difference between healthy body tissue and harmful, outside ...

  7. Hepatitis D

    MedlinePlus

    ... if the hepatitis B virus is also present. Transmission Hepatitis D can be found in the blood, ... other body fluids of people who are infected. Transmission happens when infected body fluid enters another person’s ...

  8. Hepatitis C

    MedlinePlus

    ... 2014 Select a Language: Fact Sheet 507 Hepatitis C WHAT IS HEPATITIS C? HOW IS IT DIAGNOSED? ... treatment may be less likely to work. Hep C treatment is less effective for coinfected people. Cure ...

  9. Hepatitis A

    MedlinePlus

    ... Organizations ​​ (PDF, 341 KB)​​​​​ Alternate Language URL Español Hepatitis A Page Content On this page: What is ... Nutrition Points to Remember Clinical Trials What is hepatitis A? Hepatitis * A is a virus , or infection, ...

  10. Autoimmune Hepatitis

    MedlinePlus

    ... Organizations ​​ (PDF, 341 KB)​​​​​ Alternate Language URL Autoimmune Hepatitis Page Content On this page: What is autoimmune ... Points to Remember Clinical Trials What is autoimmune hepatitis? Autoimmune hepatitis is a chronic—or long lasting— ...

  11. Hepatitis C

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with ... childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If ...

  12. Portal vein thrombosis treated using danaparoid sodium and antithrombin III.

    PubMed

    Uchiyama, T; Hirokazu, Takahashi; Hosono, K; Endo, H; Akiyama, T; Yoneda, K; Inamori, M; Abe, Y; Kubota, K; Saito, S; Nakajima, A

    2010-01-01

    A 45-year-old man under treatment for liver cirrhosis (LC) due to chronic hepatitis C and hemophilia A was seen in our emergency room because of a 10-kg weight gain in the previous week due to ascites. Portal vein thrombosis (PVT) was detected with computer tomography (CT) and ultrasonographic (US). Danaparoid sodium (DS) and antithrombin III (AT III) were administrated and doppler US images showed improvement of portal venous blood flow. DS or AT III may be safe and alternative therapies for PVT. PMID:20422871

  13. Acute Effects of Liver Vein Occlusion by Stent-Graft Placed in Transjugular Intrahepatic Portosystemic Shunt Channel: An Experimental Study

    SciTech Connect

    Keussen, Inger Bergqvist, Lennart; Rissler, Pehr; Cwikiel, Wojciech

    2006-02-15

    The purpose of this study was to evaluate the effects of hepatic vein occlusion by stent-graft used in transjugular intrahepatic portosystemic shunt (TIPS). The experiments were performed in six healthy pigs under general anesthesia. Following percutaneous transhepatic implantation of a port-a-cath in the right hepatic vein, TIPS was created with a stent-graft (Viatorr; W L Gore, Flagstaff, AZ, USA). The outflow from the hepatic vein, blocked by the stent-graft was documented by injection of contrast medium and repeated injections of {sup 99}Tc{sup m}-labeled human serum albumin through the port-a-cath. After 2 weeks, the outflow was re-evaluated, the pigs were sacrificed, and histopathologic examination of the liver was performed. Occlusion of the hepatic vein by a stent-graft had a short and temporary effect on the outflow. Histopathological examination from the affected liver segment showed no divergent pattern. Stent-grafts used in TIPS block the outflow from the liver vein, but do not have a prolonged circulatory effect and do not affect the liver parenchyma.

  14. Occlusion of the pig superior sagittal sinus, bridging and cortical veins: multistep evolution of sinus-vein thrombosis.

    PubMed

    Fries, G; Wallenfang, T; Hennen, J; Velthaus, M; Heimann, A; Schild, H; Perneczky, A; Kempski, O

    1992-07-01

    Cerebral sinus-vein thrombosis may lead to severe hemodynamic changes, elevated intracranial pressure (ICP), and brain edema. It is supposed that progression of the thrombus from the sinus into bridging and cortical veins plays a key role in the development of these pathophysiological changes, but this hypothesis lacks experimental proof. The aim of this study, using a novel animal model of sinus-vein thrombosis, was to evaluate the effects of a standardized occlusion of the superior sagittal sinus and its bridging and cortical veins on hemodynamic alterations, on brain water content, and on ICP in domestic pigs. In 10 animals, the middle third of the superior sagittal sinus was occluded with a catheter-guided balloon. Five of these pigs received an additional injection of 1 ml fibrin glue into the superior sagittal sinus anterior to the inflated balloon, leading to an obstruction of bridging and cortical veins. In five control animals the balloon was inserted but not inflated. Five pigs underwent cerebral angiography. Four hours after occlusion, the brains were frozen in liquid nitrogen, and coronal slices were examined for Evans blue dye extravasation, regional water content, and histological changes. Occlusion of the superior sagittal sinus alone did not affect ICP or cerebral perfusion pressure (CPP). The additional injection of fibrin glue caused an obstruction of cortical and bridging veins as well as severe increases in mean (+/- standard deviation) ICP to 49.4 +/- 14.3 mm Hg, compared with 8.3 +/- 4.5 mm Hg in sham-treated controls and 7.1 +/- 3.9 mm Hg in animals with occlusion of the superior sagittal sinus alone. There was also a steep fall in the mean CPP to 34.2 +/- 19.6 mm Hg compared with 96.4 +/- 13.8 mm Hg in the control group. White-matter water content anterior to the occlusion site was elevated to 81.9 +/- 3.7 gm/100 gm frozen weight in the fibrin group as compared to 70.7 +/- 2.2 gm/100 gm in controls. Posterior to the occlusion site, water

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

    PubMed

    Firdouse, Mohammed; Agarwal, Arnav; Mondal, Tapas

    2014-12-01

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

  16. Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization

    PubMed Central

    Su, Zhao-jie; Li, Wen-gang; Huang, Jun-li; Xiao, Lin-feng; Chen, Fu-zhen; Wang, Bo-liang

    2016-01-01

    Abstract Background: Three-dimensional visualization reconstruction, the 3-D visualization model reconstructed by software using 2-D CT images, has been widely applied in medicine; but it has rarely been applied in pancreaticoduodenectomy. Although the hepatic artery is very important for the liver, it has to be removed when tumor invades it. Therefore, portal vein arterialization has been used in clinic as a remedial measure, but there still is professional debate on portal vein arterialization. Methods: Here, we report 1 case that was diagnosed with poorly differentiated adenocarcinoma of the duodenum. The tumor had large size and invaded surrounding organs and vessels. Results: Preliminary diagnoses were poorly differentiated adenocarcinoma of the duodenum and viral hepatitis B. Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization were performed in this case. The tumor was removed. Liver function returned to normal limits 1 week after operation. Digital subtraction arteriography showed compensatory artery branches within the liver 1 month after operation. Conclusion: 3-D visualization reconstruction can provide a reliable assistance for the accurate assessment and surgical design before pancreatoduodenectomy, and it is certainly worth adopting portal vein arterialization when retention of hepatic artery is impossible or conventional arterial anastomosis is required during pancreatoduodenectomy. PMID:27603365

  17. Functional anatomy of bronchial veins.

    PubMed

    Charan, Nirmal B; Thompson, William H; Carvalho, Paula

    2007-01-01

    The amount of bronchial arterial blood that drains into the systemic venous system is not known. Therefore, in this study we further delineated the functional anatomy of the bronchial venous system in six adult, anesthetized, and mechanically ventilated sheep. Through a left thoracotomy, the left azygos vein was dissected and the insertion of the bronchial vein into the azygos vein was identified. A pouch was created by ligating the azygos vein on either side of the insertion of the bronchial vein. A catheter was inserted into this pouch for the measurement of bronchial venous occlusion pressure and bronchial venous blood flow. An ultrasonic flow probe was placed around the common bronchial branch of the bronchoesophageal artery to monitor the bronchial arterial blood flow. Catheters were also placed into the carotid artery and the pulmonary artery. The mean bronchial blood flow was 20.6+/-4.2mlmin(-1) (mean+/-SEM) and, of this, only about 13% of the blood flow drained into the azygos vein. The mean systemic artery pressure was 72.4+/-4.1mmHg whereas the mean bronchial venous occlusion pressure was 38.1+/-2.1mmHg. The mean values for blood gas analysis were as follows: bronchial venous blood pH=7.54+/-0.02, PCO(2)=35+/-2.6, PO(2)=95+/-5.7mmHg; systemic venous blood-pH=7.43+/-0.02, PCO(2)=48+/-3.2, PO(2)=42+/-2.0mmHg; systemic arterial blood-pH=7.51+/-0.03, PCO(2)=39+/-2.1, PO(2)=169+/-9.8mmHg. We conclude that the major portion of the bronchial arterial blood flow normally drains into the pulmonary circulation and only about 13% drains into the bronchial venous system. In addition, the oxygen content of the bronchial venous blood is similar to that in the systemic arterial blood.

  18. Hepatitis Vaccines

    PubMed Central

    Ogholikhan, Sina; Schwarz, Kathleen B.

    2016-01-01

    Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406

  19. [Autoimmune hepatitis].

    PubMed

    Ostojić, Rajko

    2003-01-01

    Autoimmune hepatitis is an unresolving, hepatocellular inflammation of unknown cause that is characterized by the presence of periportal hepatitis on histologic examination, tissue autoantibodies in serum, and hypergammaglobulinemia. By international consensus, the designation autoimmune hepatitis has replaced alternative terms for the condition. Three types of autoimmune hepatitis have been proposed based on immunoserologic findings. Type 1 autoimmune hepatitis is characterized by the presence of antinuclear antibodies (ANA) or smooth muscle antibodies (SMA) (or both) in serum. Seventy percent of patients with type 1 of autoimmune hepatitis are women. This type is the most common form and accounts for at least 80% of cases. Type 2 is characterized by the presence of antibodies to liver-kidney microsome type 1 (anti-LKM1) in serum. Patients with this type of autoimmune hepatitis are predominantly children. Type 3 autoimmune hepatitis is characterized by the presence of antibodies to soluble liver antigen (anti-SLA) in serum. There are no individual features that are pathognomonic of autoimmune hepatitis, and its diagnosis requires the confident exclusion of other conditions. The large majority of patients show satisfactory response to corticosteroid (usually prednisone or prednisolone) therapy. For the past 30 years it has been customary to add azathioprine as a "steroid sparing" agent to allow lower doses of steroids to be used and remission, once achieved, can be sustained in many patients with azathioprine alone after steroid withdrawal. Patients with autoimmune hepatitis who have decompensated during or after corticosteroid therapy are candidates for liver transplantation.

  20. Viral hepatitis*

    PubMed Central

    Deinhardt, F.; Gust, I. D.

    1982-01-01

    Three forms of viral hepatitis can be recognized: hepatitis A, hepatitis B, and hepatitis non-A, non-B. Hepatitis A is caused by a picornavirus, is transmitted by the faceal—oral route, does not become chronic, and no chronic virus carriers exist. The virus can be grown in cell cultures, and killed as well as live attenuated virus vaccines are under development. Hepatitis B is caused by an enveloped virus containing a circular, double-stranded form of DNA. The disease is transmitted parenterally through inoculation of blood or blood products containing virus or through close personal contact with a virus-positive person. Hepatitis B becomes chronic in a certain number of cases and can lead to cirrhosis and primary liver cell carcinoma. The blood and certain body secretions of individuals with a persistent or chronic infection may remain infectious for many years. The hepatitis B virus cannot be grown in cell cultures but the entire genome has been sequenced and cloned in bacterial and eukaryotic cells. An inactivated virus vaccine has been prepared from hepatitis B surface antigen present in the plasma of hepatitis B virus carriers and further vaccines are under development. The agents of hepatitis non-A, non-B have not been identified. It is possible to distinguish between a predominantly parenterally transmitted and an orally transmitted form of hepatitis non-A, non-B. The latter is reported to be caused by a picornavirus that does not, however, have any antigenic relationship with hepatitis A virus. PMID:6817933

  1. Thrombosis of the Saphenous Vein Stump after Varicose Vein Surgery

    PubMed Central

    2016-01-01

    We evaluated thrombus extension in the proximal stump of the saphenous vein at 6 days, 4 weeks, and 16 weeks after saphenous vein surgery performed between July 2013 and March 2014 (18 patients, 29 limbs, and 31 stumps) using duplex ultrasonography. All thrombotic events were classified as endovenous heat-induced thrombosis (EHIT). Thrombus was observed in 27 stumps (87.1%), with only four (12.9%) stumps remaining without thrombus on postoperative day 6. Thrombus as EHIT class 2 was observed in one stump and as EHIT class 3 in another; in the remaining 25 stumps, it was observed as EHIT class 1 postoperatively. No further extension of thrombus was found at 4 and 16 weeks after surgery. The rate of thrombus formation in the proximal stump of the saphenous vein after conventional surgery is comparatively higher than that after thermoablation techniques. Further studies are required to determine adequate evaluation methods and appropriate therapies for stump thrombosis after varicose vein surgery. (This article is a translation of J Jpn Coll Angiol 2015; 55: 105–110). PMID:27738460

  2. Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification

    PubMed Central

    Wani, Zeeshan A.; Bhat, Riyaz A.; Bhadoria, Ajeet S.; Maiwall, Rakhi

    2015-01-01

    Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized. PMID:26021771

  3. Extrahepatic portal vein obstruction and portal vein thrombosis in special situations: Need for a new classification.

    PubMed

    Wani, Zeeshan A; Bhat, Riyaz A; Bhadoria, Ajeet S; Maiwall, Rakhi

    2015-01-01

    Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized.

  4. Autoimmune hepatitis.

    PubMed

    Roberts, E A

    1995-01-01

    Autoimmune hepatitis can present as either acute or chronic disease in children. Clinical and laboratory features, including association with extrahepatic autoimmune syndromes and prompt response to immunosuppressive treatment, circulating autoantibodies and hypergammaglobulinemia, suggest an immune etiology. However, the disease mechanism remains uncertain. Different types of autoimmune hepatitis are defined on the basis of which autoantibodies are present: anti-smooth muscle (type 1), anti-liver/kidney microsomal (type 2), or anti-soluble liver antigen (type 3). Diseases which may be clinically similar to autoimmune hepatitis must be excluded before the diagnosis of autoimmune hepatitis is established: Wilson's disease, primary sclerosing cholangitis, chronic hepatitis B or C, and drug-induced liver disease are among the most important entities. Corticosteroids alone or with azathioprine constitute the usual treatment for autoimmune hepatitis. Although some children achieve a complete remission, or even recovery, and can stop immunosuppressive treatment, others required low-dose prednisone treatment indefinitely.

  5. Asymptomatic anomalous pulmonary veins in a Siberian Husky.

    PubMed

    Abraham, L A; Slocombe, R F

    2003-07-01

    A 2-year-old, neutered male Siberian Husky presented with depression, weight loss and an inability to prehend food and water. Cerebrospinal fluid was collected under general anaesthesia prior to euthanasia. The elevated white cell count comprised mostly mononuclear cells. Histological changes within the brain were variable and multifocal. Non-suppurative meningitis secondary to lymphoma was diagnosed. At necropsy, abnormal venous drainage of the right cranial and middle lung lobes was found. A dilated major pulmonary vein from these lobes passed across the lateral aspect of the right caudal lung lobe prior to entering the heart, and subpleural veins from the affected lobes were enlarged and tortuous. These vascular abnormalities were considered incidental. There were no apparent congenital abnormalities of the heart and the animal's clinical signs were related to lymphoma of the brain.

  6. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis.

    PubMed

    Bercu, Zachary L; Sheth, Sachin B; Noor, Amir; Lookstein, Robert A; Fischman, Aaron M; Nowakowski, F Scott; Kim, Edward; Patel, Rahul S

    2015-10-01

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  7. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis

    SciTech Connect

    Bercu, Zachary L. Sheth, Sachin B.; Noor, Amir; Lookstein, Robert A. Fischman, Aaron M. Nowakowski, F. Scott Kim, Edward Patel, Rahul S.

    2015-10-15

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  8. Blackberry Yellow Vein Disease Complex

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A new virus disease has emerged in the Midsouth and Southeastern United States and was named blackberry yellow vein disease (BYVD). Originally, it was thought the disease was caused by Tobacco ringspot virus (TRSV) as the virus was found in many diseased plants and symptoms were very similar to thos...

  9. Diagnosis of deep vein thrombosis.

    PubMed Central

    Douketis, J. D.; Ginsberg, J. S.

    1996-01-01

    Deep vein thrombosis (DVT), a common disease, can be difficult to diagnose because its clinical features are nonspecific. Venography is the standard test, but other less expensive, easily performed, noninvasive tests are available. At present, duplex ultrasonography is the noninvasive test of choice. PMID:8616289

  10. Hepatitis B Vaccine

    MedlinePlus

    ... as a combination product containing Hepatitis A Vaccine, Hepatitis B Vaccine) ... What is hepatitis B?Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus. ...

  11. Hepatitis C: Clinical Trials

    MedlinePlus

    ... and Public Home » Hepatitis C » Treatment Decisions Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... can I find out about participating in a hepatitis C clinical trial? Many trials are being conducted ...

  12. Hepatitis B

    MedlinePlus

    ... A Hepatitis B HPV (Human Papillomavirus) Influenza (Flu) Measles Meningococcal Disease Mumps Pertussis (Whooping Cough) Pneumococcal Disease Rubella (German Measles) Shingles (Herpes Zoster) Tetanus (Lockjaw) Professional Resources Adult ...

  13. [The importance of postoperative circulatory alterations in hepatic surgery].

    PubMed

    Koós, Olivér; Kovács, Tibor; Fülöp, András; Pekli, Damján; Ónody, Péter; Lukovich, Péter; Harsányi, László; Kupcsulik, Péter; Hahn, Oszkár; Szijártó, Attila

    2015-11-29

    There are two afferent (hepatic artery, portal vein) and one efferent (hepatic veins) systems responsible for the unique circulation of the liver. Given this special form of vasculature, acute, isolated (i.e. involving selectively one particular vessel) vascular occlusions may lead to different, however still life threatening conditions. Hence, it is essential to recognize these anomalies in order to preserve the healthy state of both the liver and the patient's lives. Acute circulatory failures are dominantly associated with liver surgery. Adequate therapy can only be provided promptly, if the clinician is well aware of the peculiarities of these conditions. The aim of this study is to overview the etiology and symptoms of these clinical conditions; furthermore to offer technical proposals for the required diagnostic and therapeutical steps via case reports. Furthermore, hepatic injury, caused by ischemia-reperfusion secondary to total vascular occlusion (Pringle maneuver) used in hepatic surgery is outlined.

  14. Surgical Access to Jejunal Veins for Local Thrombolysis and Stent Placement in Portal Vein Thrombosis

    SciTech Connect

    Schellhammer, Frank; Esch, Jan Schulte am; Hammerschlag, Sascha; Knoefel, Wolfram Trudo; Fuerst, Guenter

    2008-07-15

    Portal vein thrombosis is an infrequent entity, which may cause high morbidity and mortality. We report a case of portal vein thrombosis due to benign stenosis following partial pancreatoduodenectomy with segmental replacement of the portal vein by a Gore-tex graft. Using a surgical access to jenunal veins, local thrombolysis, mechanical fragmentation of thrombus, and stent placement were successfully performed.

  15. Left renal vein ligation: a technique to mitigate low portal flow from splenic vein siphon during liver transplantation.

    PubMed

    Slater, R R; Jabbour, N; Abbass, A Abou; Patil, V; Hundley, J; Kazimi, M; Kim, D; Yoshida, A; Abouljoud, M

    2011-08-01

    Low portal vein flows in liver transplant have been associated with poor allograft survival. Identifying and ameliorating causes of inadequate portal flow is paramount. We describe successful reversal of significant splenic vein siphon from a spontaneous splenorenal shunt during liver transplant. The patient is a 43-year-old male with cirrhosis from hepatitis C and Budd-Chiari syndrome, who had a variceal hemorrhage necessitating an emergent splenorenal shunt with 8 mm PTFE graft. Imaging in 2006 revealed thrombosis of the splenorenal shunt and evidence of a new spontaneous splenorenal shunt. The patient developed hepatocellular carcinoma and underwent transplant in 2009. After reperfusion, portal flows were low (150-200 mL/min). A mesenteric varix was ligated without improvement. Due to adhesions, direct collateral ligation was not attempted. In order to redirect the splenic siphon, the left renal vein was stapled at its confluence with the inferior vena cava. Portal flows subsequently increased to 1.28 L/min. Postoperatively, the patient had stable renal and liver function. We conclude that spontaneous splenorenal shunts can cause low portal flows. A diligent search for shunts with understanding of flow patterns is critical; ligation or rerouting of splanchnic flow may be necessary to improve portal flows and allograft outcomes.

  16. [Autoimmune hepatitis].

    PubMed

    Marcais, O; Larrey, D

    1994-01-01

    Acute and chronic autoimmune hepatitis are uncommon inflammatory liver diseases, mainly occurring in young women, in association with hypergammaglobulinemia and serum autoantibodies. Different types have been described: type 1 characterized by anti-smooth muscle and anti-nuclear antibodies; type 2 characterized by anti-LKM1 antibodies; type 3 characterized by anti-SLA antibodies. Other types, still not clearly defined, may exist. Autoimmune hepatitis are associated with HLA A1 B8 DR3 and HLA DR4. Without any treatment, the disease leads to cirrhosis and, uncommonly, to fulminant hepatitis. Large doses of corticosteroids usually allow to control the disease. Relapse of hepatitis is frequent after corticosteroid withdrawal. Concomitant administration of immunosuppressive agents such as azathioprine allows to reduce corticosteroid dosage and contributes to maintain the remission of the disease. Liver transplantation may be indicated in cases of severe cirrhosis or fulminant hepatitis.

  17. Nephrotic Syndrome Associated with Renal Vein Thrombosis

    PubMed Central

    Kang, Sung Kyew; Park, Sung Kwang

    1987-01-01

    The coexistence of nephrotic syndrome and renal vein thrombosis has been of medical interest since Rayer’s description in 1840. Renal vein thrombosis has been underdiagnosed because of its variable clinical and radiological findings but it becomes a more frequently recognizable clinical entity since diagnosis can be easily established by modern angiographic techniques. Generally it has been believed that renal vein thrombosis may cause nephrotic syndrome. But recent articles strongly suggest that renal vein thrombosis is a complication of the nephrotic syndrome rather than a cause. We report three cases of nephrotic syndrome associated with renal vein thrombosis. PMID:3154812

  18. Fenestrated internal jugular vein: a rare finding in neck dissection.

    PubMed

    Moreno-Sánchez, M; Hernández Vila, C; González-García, R; Monje, F

    2015-09-01

    Fenestration of the internal jugular vein (IJV) is an extremely rare phenomenon. An 85-year-old woman was referred to our department with T2N0M0 squamous cell carcinoma of the right floor of the mouth. The patient underwent local resection, an ipsilateral modified type 3 radical neck dissection, and microsurgical reconstruction. During neck dissection, a fenestration was observed in the middle of the IJV. No structure passed through the fenestration. Such anatomical variations are rare, but clinicians and surgeons should be aware of them in order to avoid damage to the important vascular structures, especially if a neck dissection is performed.

  19. [Deep vein thrombosis: epidemiology, risk factors and natural history].

    PubMed

    Coiteux, I; Mazzolai, L

    2006-03-22

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are major sources of morbidity and mortality. In young individuals the incidence of DVT is of 1/100,000 people; at middle age it is approximately 1/1000, which is also the overall incidence; thereafter, it increases steeply and in old age approaches 1%/year. DVT is a multifactorial disease involving a variety of risk factors, many of which are common. It is nowadays accepted that the interaction of multiple risk factors over time determines the risk of thrombosis.

  20. The Relationships between Metabolic Disorders (Hypertension, Dyslipidemia, and Impaired Glucose Tolerance) and Computed Tomography-Based Indices of Hepatic Steatosis or Visceral Fat Accumulation in Middle-Aged Japanese Men

    PubMed Central

    Yokokawa, Hirohide; Naito, Toshio; Sasabe, Noriko; Okumura, Mitsue; Iijima, Kimiko; Shibuya, Katsuhiko; Hisaoka, Teruhiko; Fukuda, Hiroshi

    2016-01-01

    Background Most studies on the relationships between metabolic disorders (hypertension, dyslipidemia, and impaired glucose tolerance) and hepatic steatosis (HS) or visceral fat accumulation (VFA) have been cross-sectional, and thus, these relationships remain unclear. We conducted a retrospective cohort study to clarify the relationships between components of metabolic disorders and HS/VFA. Methods The participants were 615 middle-aged men who were free from serious liver disorders, diabetes, and HS/VFA and underwent multiple general health check-ups at our institution between 2009 and 2013. The data from the initial and final check-ups were used. HS and VFA were assessed by computed tomography. HS was defined as a liver to spleen attenuation ratio of ≤1.0. VFA was defined as a visceral fat cross-sectional area of ≥100 cm2 at the level of the navel. Metabolic disorders were defined using Japan’s metabolic syndrome diagnostic criteria. The participants were divided into four groups based on the presence (+) or absence (-) of HS/VFA. The onset rates of each metabolic disorder were compared among the four groups. Results Among the participants, 521, 55, 24, and 15 were classified as HS(-)/VFA(-), HS(-)/VFA(+), HS(+)/VFA(-), and HS(+)/VFA(+), respectively, at the end of the study. Impaired glucose tolerance was more common among the participants that exhibited HS or VFA (p = 0.05). On the other hand, dyslipidemia was more common among the participants that displayed VFA (p = 0.01). Conclusions It is likely that VFA is associated with impaired glucose tolerance and dyslipidemia, while HS might be associated with impaired glucose tolerance. Unfortunately, our study failed to detect associations between HS/VFA and metabolic disorders due to the low number of subjects that exhibited fat accumulation. Although our observational study had major limitations, we consider that it obtained some interesting results. HS and VFA might affect different metabolic disorders

  1. Deep vein thrombosis in pregnancy.

    PubMed

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  2. A Case of Congenital Hepatic Fibrosis Associated With Medullary Sponge Kidney-Radiologic and Pathologic Features

    PubMed Central

    Zhu, Lei; Zhao, Gang; Jia, Chong-Fu; Li, Yan

    2012-01-01

    Congenital hepatic fibrosis is an exceedingly rare disease in China, where only very few cases with sufficient evidences and clinical data have been reported up to now. Here we reported a young patient, onset of hematemesis and melena, who had striking portal hypertension but without liver function damage. Computer tomography scans showed hepatosplenomegaly, intra-hepatic bile ducts dilation, thickening portal vein and tortuous spleen vein, and medullary sponge kidney. Liver biopsy found significant fibrosis in the portal area and ectasia of bile ductules. With sufficient radiologic and pathologic data, our case revealed the features of congenital hepatic fibrosis associated with medullary sponge kidney.

  3. [ENDOVENOUS LASER TREATMENT FOR VARICOSE VEINS].

    PubMed

    Tezuka, Masahiro; Kanaoka, Yuji; Ohki, Takao

    2015-05-01

    Varicose veins are a common condition attecting approximately 10 million patients in Japan. The main cause of varicose veins is reflux of the saphenous vein, and conventional treatment for several decades was stripping the affected saphenous vein and phlebectomy. Endovenous laser treatment (EVLT) is a less-invasive treatment method in which the saphenous vein is ablated with a laser under local anesthesia. EVLT has been approved by the Japanese Ministry of Health, Labor and Welfare since 2011, and we have performed EVLT on 5,160 legs with saphenous insufficiency with no severe complications including deep vein thrombosis except for one case of arteriovenous fistula. EVLT appears to be a safe, effective treatment option for varicose veins with saphenous insufficiency.

  4. Management of varicose veins and venous insufficiency.

    PubMed

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  5. Transjugular Intrahepatic Portosystemic Shunt in a Patient with Cavernomatous Portal Vein Occlusion

    SciTech Connect

    Kawamata, Hiroshi; Kumazaki, Tatsuo; Kanazawa, Hidenori; Takahashi, Shuji; Tajima, Hiroyuki; Hayashi, Hiromitsu

    2000-03-15

    A 23-year-old woman with liver cirrhosis secondary to primary sclerosing cholangitis was referred to us for the treatment of recurrent bleeding from esophageal varices that had been refractory to endoscopic sclerotherapy. Her portal vein was occluded, associated with cavernous transformation. A transjugular intrahepatic portosystemic shunt (TIPS) was performed after a preprocedural three-dimensional computed tomographic angiography evaluation to determine feasibility. The portal vein system was recanalized and portal blood flow increased markedly after TIPS. Esophageal varices disappeared 3 weeks after TIPS. Re-bleeding and hepatic encephalopathy were absent for 3 years after the procedure. We conclude that with adequate preprocedural evaluation, TIPS can be performed safely even in patients with portal vein occlusion associated with cavernous transformation.

  6. Everted cervical vein for carotid patch angioplasty.

    PubMed

    Yu, A; Dardik, H; Wolodiger, F; Raccuia, J; Kapadia, I; Sussman, B; Kahn, M; Pecoraro, J P; Ibrahim, I M

    1990-11-01

    Because of the theoretic benefits of autologous vein we undertook an investigation to evaluate cervical veins (facial, external jugular) as patch material after carotid endarterectomy. A device that stimulated both circumferential fixation by sutures and radial tension exerted on in vivo patches was constructed to measure burst strength of tissue. Mean bursting pressure for groin saphenous vein (n = 10) was 94.5 +/- 15.1 pounds per square inch (psi), 75.5 +/- 8.9 psi for ankle saphenous vein (n = 10), 83.3 +/- 14.5 psi for everted (double layer) cervical vein (n = 5) and 10 +/- 3.3 psi for single layer cervical vein (n = 5). No significant differences between saphenous vein at any level and everted (double layer) cervical vein, but all were significantly different from single layer cervical vein (p less than 0.05). From June 1987 through November 1989, 19 patients underwent 21 carotid endarterectomies complemented with adjunctive everted cervical vein patch angioplasty. Indications for surgery were asymptomatic stenosis (53%), transient ischemic attack (29%), and cerebrovascular accident with recovery (18%). All patients were studied after surgery with duplex scanning. Asymptomatic recurrent stenosis was observed in one patient. Transient hypoglossal nerve dysfunction occurred in one other patient. One postoperative death occurred as a result of massive aspiration. These results indicate that everted cervical vein is comparable to the saphenous vein in resistance to bursting and can yield similar results as patch material after carotid endarterectomy. Accordingly, saphenous vein can be spared and lower extremity incisions avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Resolution of preoperative portal vein thrombosis after administration of antithrombin III in living donor liver transplantation: case report.

    PubMed

    Imai, H; Egawa, H; Kajiwara, M; Nakajima, A; Ogura, Y; Hatano, E; Ueda, M; Kawaguchi, Y; Kaido, T; Takada, Y; Uemoto, S

    2009-11-01

    A 59-year-old man with hepatitis C virus-associated liver cirrhosis was transferred to our hospital to undergo living donor liver transplantation. Coagulation was impaired (prothrombin time [International Normalized Ratio], 3.27), and antithrombin III (AT-III) activity was 23% (normal, 87%-115%). Contrast-enhanced computed tomography scans revealed portal vein thrombosis (PVT) from the junction between the splenic and superior mesenteric vein to the porta hepatica; the portal vein was completely obstructed (PVT). To prevent further development of PVT, 1500 U of AT-III was administered for 3 days, elevating the AT-III activity to 50%. A contrast-enhanced computed tomography scan obtained 9 days after AT-III administration showed resolution of PVT. Living donor liver transplantation was safely performed without portal vein grafting. Thus, a low AT-III concentration may have an important role in the pathogenesis of PVT in patients with cirrhosis.

  8. Hepatitis B

    MedlinePlus

    ... U.S. Preventive Services Task Force recommendation statement. Ann Intern Med . 2014;161(1):58-66. PMID 24863637 ... Development Conference Statement: Management of hepatitis B. Ann Intern Med . 2009;150:104-10. PMID: 19124811 www. ...

  9. Hepatitis B

    MedlinePlus

    ... and Change Plan Wallet card for patients to record their alcohol use over a 4-week period as a way to monitor and reduce their drinking behavior. Glossary Definitions of terms commonly used with viral hepatitis and ...

  10. Hepatitis B

    MedlinePlus

    ... All babies should get the vaccine, but older children and adults can get it too. If you travel to countries where Hepatitis B is common, you should get the vaccine. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  11. Hepatic Sarcoidosis.

    PubMed

    Tadros, Micheal; Forouhar, Faripour; Wu, George Y

    2013-12-01

    Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Pulmonary involvement is the most common site of disease activity. However, hepatic involvement is also common in sarcoidosis, occurring in up to 70% of patients. Most patients with liver involvement are asymptomatic. Therefore, the majority of cases are discovered incidentally, frequently by the finding of elevated liver enzymes. Pain in the right upper quadrant of the abdomen, fatigue, pruritus, and jaundice may be associated with liver involvement. Portal hypertension and cirrhosis are complications linked to long-standing hepatic sarcoidosis. Liver biopsy is usually required to confirm the diagnosis. It is important to differentiate hepatic sarcoidosis from other autoimmune and granulomatous liver diseases. Not all cases of hepatic sarcoidosis require treatment. For symptomatic patients, the first line treatment includes corticosteroids or ursodeoxycholic acid. Various immunosuppressant agents can be used as second line agents. Rarely, severe cases require liver transplantation.

  12. Autoimmune hepatitis.

    PubMed

    Heneghan, Michael A; Yeoman, Andrew D; Verma, Sumita; Smith, Alastair D; Longhi, Maria Serena

    2013-10-26

    Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.

  13. Ischemia and hepatic reperfusion: is it possible to reduce hepatic alterations?

    PubMed

    Lanteri, Raffaele; Greco, Raffaele; Licitra, Edelweiss; Di Benedetto, Fabrizio; Li Destri, Giovanni; Di Cataldo, Antonio

    2003-01-01

    Our aim was to evaluate liver damage after ischemia and reperfusion, and at the same time test the effectiveness of some drugs in preventing these alterations. For this study, we utilized 50 rats divided into four groups: three underwent hepatic ischemia through occlusion of the portal vein and hepatic artery for 30 min, and one underwent a sham operation. In all groups, hepatic enzymes and bilirubine were tested at 2 h, 3 h, 4 h, 24 h, and 30 h. The drugs utilized were: L-arginine, donor of nitric oxide, and L-canavanine, inhibitor of nitric oxide synthase (NOS). Our data showed that the drugs tested could make an improvement in hepatic function after ischemia/reperfusion, preventing its damage. These preliminary results could suggest a clinical application in order to prolong ischemic period during liver transplantation or liver resection in cirrhotic patients.

  14. Hepatitis C FAQs

    MedlinePlus

    ... of Viral Hepatitis Contact Us Quick Links to Hepatitis ... A | B | C | D | E Viral Hepatitis Home ... Outbreaks State and Local Partners & Grantees Resource Center Hepatitis C FAQs for the Public Recommend on Facebook ...

  15. Hepatitis B FAQs

    MedlinePlus

    ... of Viral Hepatitis Contact Us Quick Links to Hepatitis ... A | B | C | D | E Viral Hepatitis Home ... Outbreaks State and Local Partners & Grantees Resource Center Hepatitis B FAQs for the Public Recommend on Facebook ...

  16. Hepatitis A Test

    MedlinePlus

    ... be limited. Home Visit Global Sites Search Help? Hepatitis A Testing Share this page: Was this page ... HAV-Ab total; Anti-HAV Formal name: Viral Hepatitis A Antibody Related tests: Hepatitis B Testing ; Hepatitis ...

  17. Delta agent (Hepatitis D)

    MedlinePlus

    Hepatitis D virus ... Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. HDV may make liver ... B virus but who never had symptoms. Hepatitis D infects about 15 million people worldwide. It occurs ...

  18. Gold Veins near Great Falls, Maryland

    USGS Publications Warehouse

    Reed, John Calvin, Jr.; Reed, John C.

    1969-01-01

    Small deposits of native gold are present along an anastomosing system of quartz veins and shear zones just east of Great Falls, Montgomery County, Md. The deposits were discovered in 1861 and were worked sporadically until 1951, yielding more than 5,000 ounces of gold. The vein system and the principal veins within it strike a few degrees west of north, at an appreciable angle to foliation and fold axial planes in enclosing rocks of the Wissahickon Formation of late Precambrian (?) age. The veins cut granitic rocks of Devonian or pre-Devonian age and may be as young as Triassic. Further development of the deposits is unlikely under present economic conditions because of their generally low gold content and because much of the vein system lies on park property, but study of the Great Falls vein system may be useful in the search for similar deposits elsewhere in the Appalachian Piedmont.

  19. [Steam ablation of varicose veins].

    PubMed

    van den Bos, Renate R; Malskat, Wendy S J; Neumann, H A M Martino

    2013-01-01

    In many western countries endovenous thermal ablation techniques have largely replaced classical surgery for the treatment of saphenous varicose veins as they are more effective and patient friendly. Because these treatments can be performed under local tumescent anaesthesia, patients can mobilize immediately after the procedure. A new method of thermal ablation is endovenous steam ablation, which is a fast and easy procedure. Steam ablation may cause less pain than laser ablation and it is also cheaper and more flexible than segmental radiofrequency ablation. PMID:23484513

  20. Acute abdomen caused by brucellar hepatic abscess.

    PubMed

    Ibis, Cem; Sezer, Atakan; Batman, Ali K; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, Figen; Cakir, Bilge; Coskun, Irfan

    2007-10-01

    Brucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.

  1. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

  2. Preduodenal portal vein: its surgical significance.

    PubMed

    Makey, D A; Bowen, J C

    1978-11-01

    Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

  3. Laser leg vein treatment: a brief overview.

    PubMed

    Ross, Victor; Domankevitz, Yacov

    2003-12-01

    Laser treatment of leg veins has been associated with a number of disadvantages, but the introduction of new devices has increased the role of lasers in the treatment of leg veins. This paper reviews the role of laser devices applied from the surface in the treatment of reticular and spider veins. Success is determined by the proper selection of wavelength, fluence, pulse duration, spot size, and number and frequency of treatments. PMID:14741827

  4. Sinter-vein correlations at Buckskin Mountain, National district, Humboldt County, Nevada

    USGS Publications Warehouse

    Vikre, P.G.

    2007-01-01

    At Buckskin Mountain (elev 2,650 m, 8,743 ft), Humboldt County, Nevada, a hydrothermal system, imposed on a middle Miocene volcanic sequence with contrasting permeabilities and tensile strengths, produced alteration assemblages controlled by elevation, from Hg-mineralized sinter to subjacent precious metal veins over a vertical distance exceeding 790 m. Sinter and epiclastic deposits, interpreted to be remnant paleosurface basinal strata enclosed by 16.6 to 16.1 Ma rhyolites, overlie older volcaniclastic basinal deposits and were part of a regional fluvial-lacustrine system developed among ca. 16 to 12 Ma basalt-rhyolite eruptive centers throughout the northern Great Basin. Because of contrasting erosional resistance among altered and unaltered rocks, Buckskin Mountain represents inverse topography with sinter and silicified epiclastic deposits at the summit. Sinter and veins, correlated by common elements, similar mineralogy, age constraints, textures, S isotope compositions, and fluid inclusion microthermometry, were deposited by sinter-vein fluid, the first of two sequential hydrothermal fluid regimes that evolved in response to magmatism, tectonism, hydrology, and topography. Thermal quenching of distally derived sinter-vein fluid in planar conduits caused deposition of banded quartz-silicate-selenide-sulfide veins ???270 to > 440 m below sinter at 16.1 Ma; vei??ns were initially enveloped by zoned selvages of proximal K-feldspar + K-mica + quartz + pyrite and distal illite + chlorite + calcite + pyrite. Mixing of sinter-vein fluid with local meteoric water in saturated basinal deposits caused deposition of silica, Hg-Se-S-Cl minerals, and precious metals in sinter and epiclastic deposits. Elevated ???Se/???S in sinter-vein fluid, and the relatively large stability fields of reduced aqueous selenide species in the temperature range of 250?? to <100??C, enabled (but was not the cause of) codeposition of selenide-sulfide minerals and common element associations

  5. Tissue remodeling investigation in varicose veins

    PubMed Central

    Ghaderian, Sayyed Mohammad Hossein; Khodaii, Zohreh

    2012-01-01

    Although the etiology of varicose veins remains unknown, recent studies have focused on endothelial cell integrity and function because the endothelium regulates vessel tone and synthesizes many pro- and anti-inflammatory factors. The aim of this study was to investigate the evidence involving the endothelium in the development of varicose vein disease. In addition, tissue remodeling was investigated in varicose veins to determine the expression of different types of collagen. Tissue specimens of superficial varicose veins and control saphenous vein were used for immunohistochemical and transmission electron microscope (TEM). α-smooth muscle actin, and collagen I, III, IV antibodies were applied for immunohistochemical investigation. Findings of this study showed alterations of the intima, such as focal intimal discontinuity and denudation of endothelium; and the media, such as irregular arrangements of smooth muscle cells and collagen fibres in varicose veins. Our findings showed some changes in terms of distribution of types I, III and IV collagen in the intima and media of varicose vein walls compared with controls. These alterations to the media suggest that the pathological abnormality in varicose veins may be due to the loss of muscle tone as a result of the breakup of its regular structure by the collagen fibres. These findings only described some changes in terms of distribution of these types of collagen in the intima and media of varicose vein walls which may result in venous wall dysfunction in varicosis. PMID:24551759

  6. Sonographic Findings in Fetal Renal Vein Thrombosis.

    PubMed

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  7. 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.

  8. Morphological description of great cardiac vein in pigs compared to human hearts

    PubMed Central

    Alejandro Gómez, Fabian; Ballesteros, Luis Ernesto; Stella Cortés, Luz

    2015-01-01

    Introduction In spite of its importance as an experimental model, the information on the great cardiac vein in pigs is sparse. Objective To determine the morphologic characteristics of the great cardiac vein and its tributaries in pigs. Methods 120 hearts extracted from pigs destined to the slaughterhouse with stunning method were studied. This descriptive cross-over study evaluated continuous variables with T test and discrete variables with Pearson χ square test. A level of significance P<0.05 was used. The great cardiac vein and its tributaries were perfused with polyester resin (85% Palatal and 15% Styrene) and then subjected to potassium hydroxide infusion to release the subepicardial fat. Calibers were measured, and trajectories and relations with adjacent arterial structures were evaluated. Results The origin of the great cardiac vein was observed at the heart apex in 91 (76%) hearts. The arterio-venous trigone was present in 117 (97.5%) specimens, corresponding to the open expression in its lower segment and to the closed expression in the upper segment in the majority of the cases (65%). The caliber of the great cardiac vein at the upper segment of the paraconal interventricular sulcus was 3.73±0.79 mm. An anastomosis between the great cardiac vein and the middle cardiac vein was found in 59 (49%) specimens. Conclusion The morphological and biometric characteristics of the great cardiac vein and its tributaries had not been reported in prior studies, and due to their similitude with those of the human heart, allows us to propose the pig model for procedural and hemodynamic applications. PMID:25859869

  9. Hepatitis C: Sex and Sexuality

    MedlinePlus

    ... with Hepatitis » Sex and Sexuality: Entire Lesson Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... hepatitis C virus through sex. Can you pass hepatitis C to a sex partner? Yes, but it ...

  10. What Are the Signs and Symptoms of Varicose Veins?

    MedlinePlus

    ... from the NHLBI on Twitter. What Are the Signs and Symptoms of Varicose Veins? The signs and symptoms of varicose veins include: Large veins ... skin in the area around the varicose vein. Signs of telangiectasias are clusters of red veins that ...

  11. Hepatitis C

    PubMed Central

    Mehta, Bharti; Kumar Dharma, Vijay; Chawla, Sumit; Jindal, Harashish; Bhatt, Bhumika

    2014-01-01

    Hepatitis C Virus (HCV) infection is a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Following acute infection, 20% of people eliminate the virus over weeks or months and are often asymptomatic. The remaining 80% of people will develop chronic disease, of which approximately 20% will eventually develop liver cirrhosis and 1–5% will develop liver cancer. About 150 million people are chronically infected with HCV, and more than 350 000 people die every year from hepatitis C related liver diseases. The economic cost of hepatitis C is significant both to the individual and to the society. In the United States the average lifetime cost of the disease was estimated at $33 407 USD with the cost of a liver transplant approximately $200 000 USD. PEG-IFN and ribavirin treatment is also expensive and, at an average cost of approximately GB £7000 in the UK for a treatment course, is unaffordable in developing countries. Hepatitis C, not only brings down the quality of the life of individuals but also affect progress of the nation by adding financial burden. If we prevent the disease from occurring or find a perfect cure of the disease, in form of a prophylactic or therapeutic vaccine, it will be a boon to not only to the individual but to the nation as a whole. PMID:24165512

  12. Idiopathic Bilateral External Jugular Vein Thrombosis

    PubMed Central

    Hindi, Zakaria; Fadel, Ehab

    2015-01-01

    Patient: Male, 21 Final Diagnosis: Idiopathic bilateral external jugular vein thrombosis Symptoms: Face engorgement • neck swelling Medication: — Clinical Procedure: None Specialty: Hematology Objective: Unknown ethiology Background: Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow’s triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. Case Report: This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Conclusions: Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present

  13. Hepatic encephalopathy.

    PubMed

    Córdoba, Juan; Mínguez, Beatriz

    2008-02-01

    Hepatic encephalopathy is a severe complication of cirrhosis that is related to the effects of ammonia. Analysis of interorgan ammonia trafficking has identified an important role of skeletal muscle in ammonia removal and has highlighted the importance of the nutritional status. Ammonia causes neurotransmitter abnormalities and induces injury to astrocytes that is partially mediated by oxidative stress. These disturbances lead to astrocyte swelling and brain edema, which appear to be involved in the pathogenesis of neurological manifestations. Inflammatory mediators worsen brain disturbances. New methods for assessing hepatic encephalopathy include clinical scales, neuropsychological tests, imaging of portal-systemic circulation, and magnetic resonance of the brain. Reappraisal of current therapy indicates the need for performing placebo-controlled trials and the lack of evidence for administering diets with restricted protein content. Liver transplant should be considered in selected patients with hepatic encephalopathy. Future prospects include new drugs that decrease plasma ammonia, measures to reduce brain edema, and liver-support devices. PMID:18293278

  14. A new technique for complete portal vein and superior mesenteric vein thrombosis in a liver transplant recipient.

    PubMed

    Song, Sanghyun; Kwon, Choon Hyuck David; Shin, Milljae; Kim, Tae-Seok; Lee, Sanghoon; Moon, Hyung Hwan; Park, Jae Berm; Kim, Sung Joo; Joh, Jae-Won; Lee, Suk-Koo

    2014-02-01

    We describe a deceased-donor liver transplant recipient with grade 3 complete portal vein and superior mesenteric vein thromboses, which was successfully managed with an extensive thrombectomy through the venotomy site of superior mesenteric vein. In this case report, we suggest our method as an option for grade 3 portal vein thromboses, and discuss other options available for recipients with portal vein thromboses.

  15. Fibrous obliterative lesions of veins contribute to progressive fibrosis in chronic liver allograft rejection.

    PubMed

    Nakazawa, Y; Jonsson, J R; Walker, N I; Kerlin, P; Steadman, C; Lynch, S V; Strong, R W; Clouston, A D

    2000-12-01

    Fibrosis in liver allografts undergoing chronic rejection (CR) is variable and poorly understood. The temporal and spatial relationships of venous, arterial, and biliary lesions were studied to clarify their potential contributions to graft fibrosis. The severity, prevalence, and morphology of intimal lesions of vessels were analyzed and compared with the fibrosis stage. Three groups were found; group 1 (n = 5) with no hepatic vein (HV) lesions, group 2 (n = 5) with HV lesions only, and group 3 with lesions of both HV and portal veins (PV). The earliest lesion to develop, in 71% of grafts, was concentric intimal thickening of small HV. This was significantly more severe and frequent in grafts from group 3. With increasing frequency and severity of small HV sclerosis, fibrosis developed in medium/large veins. The morphology of larger vessel lesions suggested organized thrombus. Centrilobular fibrosis was significantly more severe in group 3 and developed unpredictably and sometimes rapidly. Conversely, portal fibrosis scores were significantly higher in grafts with ductular proliferation and did not correlate with venous lesions. This suggests that in CR, veno-occlusive-like lesions develop commonly in terminal hepatic venules, probably caused by immune-mediated damage. In only a proportion, with increased frequency and severity of the lesions, stasis and thrombosis in portal and larger veins occur and could result in loss of hepatic and portal venous outflow, which leads to ischemia and fibrosis. The stage of fibrosis did not correlate with foam-cell arteriopathy. A second pathway of portal fibrosis occurs in patients with longstanding biliary proliferation.

  16. Hepatic sarcoidosis.

    PubMed

    Karagiannidis, Alexandros; Karavalaki, Maria; Koulaouzidis, Anastasios

    2006-01-01

    Sarcoidosis is a multisystem disease of unknown aetiology. Histological evidence of non-caseating granulomas represents the main finding. It affects mostly young people, targeting primary the lung and hilar lymph nodes although liver involvement is often encountered. Hepatic sarcoidosis covers a broad spectrum from asymptomatic hepatic granulomas formation and slightly deranged liver function tests to clinically evident disease with cholestasis or, in advanced cases, cirrhosis and portal hypertension. Other granulomatous diseases (mainly systemic infections like tuberculosis) should be excluded prior to treatment, as longstanding corticosteroid administration is the main stem of therapy. In advanced cases, liver transplantation represents the ultimate therapeutic option.

  17. Improving the management of varicose veins.

    PubMed

    Onida, Sarah; Lane, Tristan R A; Davies, Alun H

    2013-01-01

    Up to 30% of the UK population are affected by varicose veins. They are a manifestation of increased venous pressure in the lower limb caused by impaired venous return. Primary varicosities result from poor drainage from the superficial to the deep venous system. Secondary varicosities arise as a result of underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy or obesity. Patients with bleeding varicose veins should be referred to a vascular service immediately. Referral is also indicated in the following cases: symptomatic primary or recurrent varicose veins; lower limb skin changes thought to be caused by chronic venous insufficiency; superficial vein thrombosis and suspected venous incompetence; a venous leg ulcer or healed venous leg ulcer. Imaging is crucial in the assessment of the superficial and deep venous system to enable assessment of venous competence. The gold standard imaging technique is colour duplex ultrasonography. Duplex ultrasound should be used to confirm the diagnosis of varicose veins and the extent of truncal reflux, and to plan treatment for patients with suspected primary or recurrent varicose veins. Superficial vein ligation, phlebectomy and stripping have been the mainstay of treatment. In recent years, new techniques have been developed that are minimally invasive, enabling treatment of superficial venous incompetence with reduced morbidity. NICE recommends that endothermal ablation, in the form of radiofrequency or laser treatment, should be offered as treatment for patients with confirmed varicose veins and truncal reflux.

  18. Pancreatic pseudocyst rupture into the portal vein.

    PubMed

    Dawson, Brian C; Kasa, David; Mazer, Mark A

    2009-07-01

    A patient with a pancreatic pseudocyst rupture into the portal vein with a resultant noninfectious systemic inflammatory response syndrome and subsequent portal vein thrombosis diagnosed by computed tomography and ultrasonography is reported. A review of the existing English literature on this rare complication is also provided. PMID:19561436

  19. Element transport in veins during serpentinization

    NASA Astrophysics Data System (ADS)

    Schwarzenbach, E. M.; Beard, J. S.; Caddick, M. J.

    2013-12-01

    Serpentinization of ultramafic rocks has wide ranging implications for the petrology, rheology, and petrophysical properties of the oceanic lithosphere. During hydration of the peridotite, fluid-rock ratios and temperature control mineral formation in the veins. We studied a partly serpentinized peridotite from the Santa Elena ophiolite complex in Costa Rica and tracked element mobility during water-rock interaction. Serpentinization of the studied harzburgite is around 30 to 40%, with serpentinization of olivine being more advanced than serpentinization of orthopyroxene. Element mapping and point analyses show that the veins preserve characteristic element distributions within orthopyroxene and olivine, and with distance to orthopyroxene-hosted serpentine veins. With increasing distance from the orthopyroxene the following vein assemblages were observed in olivine: pure serpentine veins, serpentine + brucite veins, serpentine + brucite + magnetite veins. Veins are enriched in SiO2 in the proximity of orthopyroxene suggesting that a net transfer of SiO2 takes place from serpentinizing orthopyroxene to olivine. The magnetite-bearing serpentine veins mostly consist of Mg-rich serpentine (Mg# = 90 - 95) and Fe-rich brucite (Mg# = 70 - 75) finely intergrown. In contrast, the center of these veins contains a thin zone of high-Mg serpentine (Mg# 97), and high-Mg brucite (Mg# 92 - 94) next to magnetite. We infer from thermodynamic calculations that these mineral assemblages are controlled by H2O activity and low SiO2 activities. Within orthopyroxene, serpentine (Mg# = 84 - 89) with an elevated Al2O3 content (< 4.14wt.%) was detected, but talc was absent, indicating net loss of SiO2 from orthopyroxene during serpentinization. CaO and Al2O3 migrate from orthopyroxene, but occur only as trace components in serpentine at > 100 μm and > 200 μm, respectively, from the orthopyroxene. We infer that brucite is not stable in close proximity to orthopyroxene due to elevated SiO2

  20. Retinal vein occlusion: current treatment.

    PubMed

    Lattanzio, Rosangela; Torres Gimeno, Ana; Battaglia Parodi, Maurizio; Bandello, Francesco

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management. PMID:20938213

  1. Retinal vein occlusion: current treatment.

    PubMed

    Lattanzio, Rosangela; Torres Gimeno, Ana; Battaglia Parodi, Maurizio; Bandello, Francesco

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management.

  2. [Trapped popliteal vein and artery].

    PubMed

    Allal, J; Gallimard, J F; Goubbault, F; Lelong, J; Barbier, J; Barraine, R

    1986-03-01

    A report is made of 3 observations of vascular constrictions in the knee hollow of three young adults: two constrictions of the popliteal artery, one by abnormal insertion of a tendon of the gastrocnemius muscle and of the arterial passage, the other by a fibrous band surrounding the artery. In one observation, the disorder was revealed by acute ischemia of one limb. The third observation was of a sural phlebitis with secondary repetition at the constriction of the popliteal vein by Soleaire's arcade. In all cases examination using the Doppler effect, in baseline and especially dynamic position, gives a diagnosis and allows postoperative monitoring. Bilateral arteriography, both static and dynamic, allows a precise diagnosis to be given and reveals the extent of vascular lesions, which conditions the operative technique. Treatment is always surgical, with exploration of the contralateral side if a constriction is suspected, even if it is asymptomatic. PMID:3707018

  3. 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.

  4. 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

  5. [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.

  6. [SUBFASCIAL ENDOSCOPIC PERFORATOR VEIN SURGERY IN THE TREATMENT OF SEVERE VARICOSE VEINS].

    PubMed

    Tabuchi, Atsushi; Masaki, Hisao; Tanemoto, Kazuo

    2015-05-01

    Surgical treatment of severe varicose veins (CEAP classification : C4b-C6) should involve not only interruption of incompetent superficial veins to prevent venous regurgitation due to valve incompetence but also interruption of incompetent perforator veins. Subfascial endoscopic perforator vein surgery (SEPS) is performed via a small skin incision and involves interruption of perforator veins by the insertion of an endoscope into the subfascial space. SEPS produces good surgical outcomes: it is accurate in detecting and transecting perforator veins; has a low frequency of surgical wound complications; prevents lipodermatosclerosis and formation of pigmented skin lesions; and is minimally invasive compared with Linton's operation. Thus, SEPS is an excellent procedure for patients with incompetent perforator veins. SEPS has been covered by the Japanese national health insurance system since April 2014, and it is expected that SEPS will be further developed and become more widespread in use. PMID:26281656

  7. Spasms of the Hepatic Artery Following Percutaneous Transluminal Angioplasty and Tolazoline Administration in a Liver Transplant Patient

    SciTech Connect

    Propst, Albert; Waldenberger, Peter; Propst, Theresa; Vogel, Wolfgang; Koenigsrainer, Alfred

    1996-05-15

    Vascular complications after liver transplantation include occlusion or stenosis near the sites of anastomosis in the hepatic artery, portal vein, and vena cava. Balloon angioplasty of these stenoses carries little risk and is a useful procedure for the treatment of these problems. Here we describe the case of a liver transplant patient who underwent balloon angioplasty for stenosis of the hepatic artery and who developed spasms of the hepatic artery which were aggravated following intraarterial administration of Tolazoline.

  8. Hepatitis C.

    PubMed

    Liddle, C

    1996-04-01

    The hepatitis C virus (HCV) genome was isolated during the late 1980s using molecular cloning techniques. It is recognized as the cause of most cases of percutaneously transmitted non-A, non-B hepatitis. Prevalence of antibodies to HCV(anti-HCV) in the general Australian population is 0.3%. However, among regular intravenous drug users the prevalence exceeds 90%. The predominant risk factors for HCV are intravenous drug use, tattoos, exposure to blood products, occupational risk and ethnicity. In contrast to hepatitis B, sexual spread and vertical transmission of HCV from mother to neonate are relatively uncommon. The risk of acquiring HCV from a single HCV-contaminated needlestick accident is about 5%. Most cases of acute HCV infection are asymptomatic, but 50 to 80% progress to chronic disease. The percentage of those with chronic HCV progressing to cirrhosis is not accurately known, but is probably 20%. Treatment strategies for HCV, utilizing recombinant interferons, are proving useful in patients with mild to moderate liver disease, but fare less well in patients with cirrhosis. Currently, there is no vaccine for hepatitis C, so pre-exposure prophylaxis is not possible. Equally, no post-exposure intervention, for example with gamma globulin, has been shown to be beneficial, though there may be a role for early interferon therapy.

  9. Personal authentication through dorsal hand vein patterns

    NASA Astrophysics Data System (ADS)

    Hsu, Chih-Bin; Hao, Shu-Sheng; Lee, Jen-Chun

    2011-08-01

    Biometric identification is an emerging technology that can solve security problems in our networked society. A reliable and robust personal verification approach using dorsal hand vein patterns is proposed in this paper. The characteristic of the approach needs less computational and memory requirements and has a higher recognition accuracy. In our work, the near-infrared charge-coupled device (CCD) camera is adopted as an input device for capturing dorsal hand vein images, it has the advantages of the low-cost and noncontact imaging. In the proposed approach, two finger-peaks are automatically selected as the datum points to define the region of interest (ROI) in the dorsal hand vein images. The modified two-directional two-dimensional principal component analysis, which performs an alternate two-dimensional PCA (2DPCA) in the column direction of images in the 2DPCA subspace, is proposed to exploit the correlation of vein features inside the ROI between images. The major advantage of the proposed method is that it requires fewer coefficients for efficient dorsal hand vein image representation and recognition. The experimental results on our large dorsal hand vein database show that the presented schema achieves promising performance (false reject rate: 0.97% and false acceptance rate: 0.05%) and is feasible for dorsal hand vein recognition.

  10. Preduodenal portal vein in the adult.

    PubMed

    Papaziogas, T; Papaziogas, B; Paraskevas, G; Lazaridis, C; Patsas, A

    2000-09-01

    We present three cases of preduodenal portal vein in adult people, which were diagnosed in our department. All of them were identified during elective operation for cholelithiasis, caused some technical difficulties to the performance of the operation, but led to no major intraoperative or postoperative complications. None of them had any preoperative symptoms, which could be related to this anomaly. The preduodenal portal vein is a rare congenital anomaly, which is usually discovered in infants or children due to the obstruction of the duodenum. In adults, it is often asymptomatic, and is usually discovered as an accidental finding during laparotomy for other reason. The postcontrast CT can set the diagnosis, when this anomaly is suspected. Despite its rarity, this anomaly is of great surgical importance, because it can predispose to intraoperative complications including hemorrhage from the abnormal vein, or damage to the biliary tract or the distented duodenum. The anterior position of the portal vein results from the persistence of the ventral anastomosis between the two vitelline veins and the distal portion of the right vitelline vein, with subsequent atrophy of the cranial part of the left vitelline and dorsal anastomotic vein.

  11. Radiological features of azygous vein aneurysm.

    PubMed

    Choudhary, Arabinda Kumar; Moore, Michael

    2014-04-01

    Mediastinal masses are most commonly associated with malignancy. Azygous vein aneurysm is a very rare differential diagnosis of mediastinal mass. We report here three cases of azygous vein aneurysm including children and adult patients. In the pediatric patient it was further complicated by thrombosis and secondary pulmonary embolism. We describe the radiological features on CXR, MRI, CT, PET-CT, US and angiogram and their differential diagnosis. Imaging findings of continuity with azygous vein, layering of contrast medium on enhanced CT and dynamic MRA showing filling of the mass at the same time as the azygous vein without prior enhancement will be strongly suggestive of azygous vein aneurysm with transtracheal ultrasound being the definitive test in these patients. It is important to keep a vascular origin mass in the differential diagnosis of mediastinal masses. Also, in young healthy patients with pulmonary embolism, a vascular etiology such as azygous vein aneurysm should be carefully evaluated. This article will help the clinicians to learn about the imaging features of azygous vein aneurysm on different imaging modalities.

  12. Image fusion for visualization of hepatic vasculature and tumors

    NASA Astrophysics Data System (ADS)

    Chou, Jin-Shin; Chen, Shiuh-Yung J.; Sudakoff, Gary S.; Hoffmann, Kenneth R.; Chen, Chin-Tu; Dachman, Abraham H.

    1995-05-01

    We have developed segmentation and simultaneous display techniques to facilitate the visualization of the three-dimensional spatial relationships between organ structures and organ vasculature. We concentrate on the visualization of the liver based on spiral computed tomography images. Surface-based 3-D rendering and maximal intensity projection algorithms are used for data visualization. To extract the liver in the serial of images accurately and efficiently, we have developed a user-friendly interactive program with a deformable-model segmentation. Surface rendering techniques are used to visualize the extracted structures, adjacent contours are aligned and fitted with a Bezier surface to yield a smooth surface. Visualization of the vascular structures, portal and hepatic veins, is achieved by applying a MIP technique to the extracted liver volume. To integrate the extracted structures they are surface-rendered and their MIP images are aligned and a color table is designed for simultaneous display of the combined liver/tumor and vasculature images. By combining the 3-D surface rendering and MIP techniques, portal veins, hepatic veins, and hepatic tumor can be inspected simultaneously and their spatial relationships can be more easily perceived. The proposed technique will be useful for visualization of both hepatic neoplasm and vasculature in surgical planning for tumor resection or living-donor liver transplantation.

  13. Hagen-Poiseuille's law: The link between cirrhosis, liver stiffness, portal hypertension and hepatic decompensation.

    PubMed

    Lake-Bakaar, Gerond; Ahmed, Muneeb; Evenson, Amy; Bonder, Alan; Faintuch, Salomao; Sundaram, Vinay

    2015-01-27

    The onset of hepatic decompensation in cirrhosis heralds an accelerated downhill course with poor outcome. The sole predictor of this decompensation in cirrhosis is increased hepatic vein to portal vein gradient hepatic venous pressure gradient (HVPG). Surrogate markers of liver function or hepatic reserve appear to be less relevant. The hepatic sinusoids become less elastic and more rigid as liver fibrosis and cirrhosis progress. We propose that the Hagen-Poiseuille's law, which applies to rigid, but not elastic vessels, determines the pressure-flow characteristics in the sinusoids. In the rigid cirrhotic liver, HVPG rises dramatically with any change in net surface area or radius, r(4) of the vasculature that follows surgical resection. This review relates liver stiffness to the risk of decompensation in patients with cirrhosis. The liver has a unique dual blood supply comprising a low pressure portal vein and high pressure hepatic artery. We compare the complexity of autoregulation in the normal elastic liver with that in the rigid cirrhotic liver. Therapeutic modalities to reduce portal pressure may reduce the risk of hepatic decompensation and improve outcomes in cirrhosis.

  14. Hagen-Poiseuille’s law: The link between cirrhosis, liver stiffness, portal hypertension and hepatic decompensation

    PubMed Central

    Lake-Bakaar, Gerond; Ahmed, Muneeb; Evenson, Amy; Bonder, Alan; Faintuch, Salomao; Sundaram, Vinay

    2015-01-01

    The onset of hepatic decompensation in cirrhosis heralds an accelerated downhill course with poor outcome. The sole predictor of this decompensation in cirrhosis is increased hepatic vein to portal vein gradient hepatic venous pressure gradient (HVPG). Surrogate markers of liver function or hepatic reserve appear to be less relevant. The hepatic sinusoids become less elastic and more rigid as liver fibrosis and cirrhosis progress. We propose that the Hagen-Poiseuille’s law, which applies to rigid, but not elastic vessels, determines the pressure-flow characteristics in the sinusoids. In the rigid cirrhotic liver, HVPG rises dramatically with any change in net surface area or radius, r4 of the vasculature that follows surgical resection. This review relates liver stiffness to the risk of decompensation in patients with cirrhosis. The liver has a unique dual blood supply comprising a low pressure portal vein and high pressure hepatic artery. We compare the complexity of autoregulation in the normal elastic liver with that in the rigid cirrhotic liver. Therapeutic modalities to reduce portal pressure may reduce the risk of hepatic decompensation and improve outcomes in cirrhosis. PMID:25624993

  15. 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

  16. Varicose veins--Who should be referred?

    PubMed

    Onida, Sarah; Davies, Alun H; Franklin, Ian

    2015-11-01

    Varicose veins are a common, progressive condition in the UK, with significant negative effects on patients' quality of life. Despite their prevalence, access to secondary care for the assessment and treatment of varicose veins can be variable throughout the country.The National Institute of Health and Care Excellence guidelines developed in 2013 provide evidence-based guidance on the referral, assessment, and management of the patient with venous disease.In this article, we review the development of the guidelines for the management of varicose veins over the last 15 years, highlighting the latest changes in referral criteria.

  17. [FEATURES LIVER TRANSPLANTATION IN PORTAL VEIN THROMBOSIS].

    PubMed

    Abbasov, P A

    2015-07-01

    In 2012 - 2013 years in 265 patients for liver transplantation was performed, including in 224 (84.5%)--from a living donor, in 41 (15.5%)--from the dead body. Using a Foley catheter to stop bleeding, and the imposition of vascular sutures during endovenectomy in portal vein thrombosis (PVT) and its possible damage under all conditions. In particular, PVT IV degree (Grade IV) in order to restore blood flow in the graft using the left gastric and renal vein is an alternative, if they are cryopreserved vein may be suitably used.

  18. Ventriculoatrial shunting via the azygos vein.

    PubMed

    Balasubramaniam, C; DuBois, J J; Laurent, J P; Pokorny, W J; Harberg, F J; Cheek, W R

    1990-06-01

    The treatment of hydrocephalus has evolved through many stages but the "cure" is still elusive. It is not unusual for the neurosurgeon to find that the commonly used routes for catheter placement or sites for drainage of cerebrospinal fluid (CSF) cannot be employed. The azygos vein was used to gain access to the right atrium when the CSF could not be drained into the peritoneal cavity, nor could the neck veins be used to place the catheter into the right atrium. The azygos vein is a convenient and safe route to reach the right atrium in selected patients.

  19. Auto immune hepatitis.

    PubMed

    van Gerven, Nicole Mf; de Boer, Ynto S; Mulder, Chris Jj; van Nieuwkerk, Carin Mj; Bouma, Gerd

    2016-05-21

    To provide an update of the latest trends in epidemiology, clinical course, diagnostics, complications and treatment of auto immune hepatitis (AIH). A search of the MEDLINE database was performed using the search terms: "auto immune hepatitis", "clinical presentation", "symptoms", "signs", "diagnosis", "auto antibodies", "laboratory values", "serology", "histopathology", "histology", "genetics", "HLA genes", "non-HLA genes", "environment", "epidemiology", "prevalence", "incidence", "demographics", "complications", "HCC", "PBC", "PSC", "corticosteroid", "therapy", "treatment", "alternative treatment". English-language full-text articles and abstracts were considered. Articles included reviews, meta-analysis, prospective retrospective studies. No publication date restrictions were applied. AIH is an immune meditated progressive inflammatory liver disease that predominantly affects middle-aged females but may affect people of all ages. The clinical spectrum of AIH is wide, ranging from absent or mild symptoms to fulminant hepatic failure. The aetiology of AIH is still unknown, but is believed to occur as the consequence of an aberrant immune response towards an un-known trigger in a genetically susceptible host. In the absence of a gold standard, diagnosis is based on the combination of clinical, biochemical and histopathological criteria. Immunosuppressive treatment has been the cornerstone of treatment since the earliest description of the disease in 1950 by Waldenström. Such treatment is often successful at inducing remission and generally leads to normal life expectancy. Nevertheless, there remain significant areas of unmet aetiological a clinical needs including fundamental insight in disease pathogenesis, optimal therapy, duration of treatment and treatment alternatives in those patients unresponsive to standard treatment regimens. PMID:27217697

  20. [The stage of portal blood flow in patients with hemoblastosis combined with chronic hepatitis].

    PubMed

    Pospelova, T I; Koptev, V D; Volkova, I I; Loseva, M I; Ageeva, T A; Soldatova, G S

    2008-01-01

    109 patients with hemoblastosis (HB) were examined. Average age was 31.8 +/- 1.4 years in group of lymphogranulomatosis patients, and 44 +/- 5.3 years in group of acute leukemia patients. Group of 46 patients with clinical laboratory signs of hepatic lesion was marked out. Since features of portal blood flow (PBF) revealed at dopplerography did not depend on hepatitis aetiology, all patients with chronic hepatitis were analyzed in one group. These patients were examined clinicobiochemically: functional hepatic tests, markers of viral hepatitis B and C, ultrasonic abdominal scanning, PBF dopplerography, puncture biopsy of hepar. All patients had PBF disturbances such as decrease of portal vein blood flow, increase of venous drainage of hepar and spleen. The degree of disturbances intensity increased depending on degree of chronic hepatitis activity (the index of histological activity) and hepatic fibrosis stage. Thus, presence of chronic hepatitis in HB patients regardless of aetiology, is the factor aggravating patients' stage and corrupting PBF. PBF disturbances (decrease of arterial and venous inflow and increase of venous outflow) and development of fibrous changes apparently related with compression of vessels by connective tissue around central veins, inside of lobules and among of hepatic cells. Consequence of it is including anastomosises in blood flow which leads to redistribution of PBF and portal hypertension forming. PMID:18494289

  1. Combined branch retinal vein and artery occlusion in toxoplasmosis.

    PubMed

    Aggio, Fabio Bom; Novelli, Fernando José de; Rosa, Evandro Luis; Nobrega, Mário Junqueira

    2016-01-01

    A 22-year-old man complained of low visual acuity and pain in his left eye for five days. His ophthalmological examination revealed 2+ anterior chamber reaction and a white, poorly defined retinal lesion at the proximal portion of the inferotemporal vascular arcade. There were retinal hemorrhages in the inferotemporal region extending to the retinal periphery. In addition, venous dilation, increased tortuosity, and ischemic retinal whitening along the inferotemporal vascular arcade were also observed. A proper systemic work-up was performed, and the patient was diagnosed with ocular toxoplasmosis. He was treated with an anti-toxoplasma medication, and his condition slowly improved. Inferior macular inner and middle retinal atrophy could be observed on optical coherence tomography as a sequela of ischemic injury. To our knowledge, this is the first report of combined retinal branch vein and artery occlusion in toxoplasmosis resulting in a striking and unusual macular appearance. PMID:27463632

  2. Hepatitis B virus (image)

    MedlinePlus

    Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is ... population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for ...

  3. What Is Hepatitis?

    MedlinePlus

    ... Twitter Facebook Google + iTunes Play Store What is hepatitis? Online Q&A Reviewed July 2016 Q: What ... Question and answer archives Submit a question World Hepatitis Day Know hepatitis - Act now Event notice Key ...

  4. Drug-induced hepatitis

    MedlinePlus

    Toxic hepatitis ... to get liver damage. Some drugs can cause hepatitis with small doses, even if the liver breakdown ... liver. Many different drugs can cause drug-induced hepatitis. Painkillers and fever reducers that contain acetaminophen are ...

  5. Liver Function After Irradiation Based on Computed Tomographic Portal Vein Perfusion Imaging

    SciTech Connect

    Cao Yue Pan, Charlie; Balter, James M.; Platt, Joel F.; Francis, Isaac R.; Knol, James A.; Normolle, Daniel; Ben-Josef, Edgar; Haken, Randall K. ten; Lawrence, Theodore S.

    2008-01-01

    Purpose: To determine whether individual and regional liver sensitivity to radiation could be assessed by measuring liver perfusion during a course of treatment using dynamic contrast-enhanced computed tomography scanning. Methods and Materials: Patients with intrahepatic cancer undergoing conformal radiotherapy underwent dynamic contrast-enhanced computed tomography (to measure perfusion distribution) and an indocyanine extraction study (to measure liver function) before, during, and 1 month after treatment. We hoped to determine whether the residual functioning liver (i.e., those regions showing portal vein perfusion) could be used to predict overall liver function after irradiation. Results: Radiation doses from 45 to 84 Gy resulted in undetectable regional portal vein perfusion 1 month after treatment. The volume of each liver with undetectable portal vein perfusion ranged from 0 to 39% and depended both on the patient's sensitivity and on dose distribution. There was a significant correlation between indocyanine green clearance and the mean of the estimated portal vein perfusion in the functional liver parenchyma (p < 0.001). Conclusion: This study reveals substantial individual variability in the sensitivity of the liver to irradiation. In addition, these findings suggest that hepatic perfusion imaging may be a marker for liver function and has the potential to be a tool for individualizing therapy.

  6. LIVER FUNCTION AFTER IRRADIATION BASED UPON CT PORTAL VEIN PERFUSION IMAGING

    PubMed Central

    Cao, Yue; Pan, Charlie; Balter, James M.; Platt, Joel F.; Francis, Isaac R.; Knol, James A.; Normolle, Daniel; Ben-Josef, Edgar; Ten Haken, Randall K.; Lawrence, Theodore S.

    2009-01-01

    Purpose The role of radiation in the treatment of intrahepatic cancer is limited by the development of radiation-induced liver disease (RILD), which occurs weeks after the course of radiation is completed. We hypothesized that, as the pathophysiology of RILD is veno-occlusive disease, we could assess individual and regional liver sensitivity to radiation by measuring liver perfusion during a course of treatment using dynamic contrast enhanced CT (DCE-CT) scanning. Materials and Methods Patients with intrahepatic cancer undergoing conformal radiotherapy underwent DCE-CT (to measure perfusion distribution) and an indocyanine extraction study (to measure liver function) prior to, during, and one month after treatment. We wished to determine if the residual functioning liver (i.e. those regions showing portal vein perfusion) could be used to predict overall liver function after irradiation. Results Radiation doses from 45 to 84 Gy resulted in undectable regional portal vein perfusion one month after treatment. The volume of each liver with undectable portal vein perfusion ranged from 0% to 39% and depended both on the patient’s sensitivity and dose distribution. There was a significant correlation between indocyanine green clearance and the mean of the estimated portal vein perfusion in the functional liver parenchyma (P < .001). Conclusion This study reveals substantial individual variability in the sensitivity of the liver to irradiation. In addition, these findings suggest that hepatic perfusion imaging may be a marker for liver function, and has the potential to be a tool for individualizing therapy. PMID:17855011

  7. [Retinal vein occlusion in a young patient].

    PubMed

    Zemba, Mihail; Ochinciuc, Uliana; Sarbu, Laura; Avram, Corina; Camburu, Raluca; Stamate, Alina

    2013-01-01

    We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

  8. Subclavian vein catheterisation for parenteral nutrition.

    PubMed Central

    Fletcher, J. P.; Little, J. M.

    1988-01-01

    Two hundred and twenty-six central venous catheters were placed in 195 consecutive patients requiring central venous catheterisation for total parenteral nutrition (TPN). Of these 226 catheters, 198 were placed percutaneously into the subclavian vein by the infraclavicular route. In 99 consecutive subclavian catheter insertions, a 12G needle with introducing sheath was used to puncture the vein (Group 1). The Seldinger method of catheterisation was used in another 99 consecutive subclavian catheter insertions (Group 2), the vein being punctured with a 19G needle. Pneumothorax occurred on three occasions (3.0%) in Group 1 but did not occur in Group 2. However, there were two episodes of pleural extravasation in Group 2 (2.0%) which may have been due to guide wire perforation of a central vein; this complication did not occur in Group 1. Although the Seldinger technique of insertion should reduce the incidence of pneumothorax, care should be taken in passage of the guide wire. PMID:3136691

  9. Ovarian vein thrombosis following total laparoscopic hysterectomy.

    PubMed

    Tanaka, Yusuke; Kato, Hiroyasu; Hosoi, Ayako; Isobe, Masanori; Koyama, Shinsuke; Shiki, Yasuhiko

    2012-11-01

    Ovarian vein thrombosis usually occurs in pregnant patients, especially during the postpartum period. However, it is a rare complication following laparoscopic surgery in gynecology. The risk of a thromboembolic event is not well defined, and evidence-based guidelines regarding deep vein thrombosis prophylaxis in gynecological laparoscopic surgery are still lacking. Herein we report a rare case of ovarian vein thrombosis following total laparoscopic hysterectomy in a 35-year-old woman who developed a fever of unknown origin on postoperative day 3. A complete fever work-up was done. Her urine, vaginal stump and blood culture were all negative, and her white blood cell count was normal. CT revealed left ovarian vein thrombosis. The patient responded well to anticoagulation in conjunction with antibiotic therapy.

  10. Access to hepatitis C medicines.

    PubMed

    Edwards, Danny J; Coppens, Delphi Gm; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

    2015-11-01

    Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world's largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines.

  11. Access to hepatitis C medicines

    PubMed Central

    Coppens, Delphi GM; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

    2015-01-01

    Abstract Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world’s largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines. PMID:26549908

  12. Hepatitis E: A disease of reemerging importance.

    PubMed

    Sridhar, Siddharth; Lau, Susanna K P; Woo, Patrick C Y

    2015-08-01

    Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. Originally considered to be restricted to humans, it is now clear that HEV and HEV-like viruses have several animal reservoirs with complex ecology and genetic diversity, as exemplified by the recent discovery of HEV in dromedaries, a previously underestimated reservoir of zoonotic viruses prior to the emergence of Middle East Respiratory Syndrome coronavirus. Zoonotic foodborne transmission from pigs and feral animals such as wild boar is of increasing importance in the rapidly industrializing countries of the Asia Pacific region. Such zoonotic hepatitis E infection has particular relevance to the increasing population living with immunosuppression, due to the risk of chronic hepatitis E in these patients. Fortunately, major strides have been made recently in the management of chronic hepatitis E patients. Furthermore, an effective vaccine is also available that promises better control of hepatitis E burden in the near future. This review highlights these major recent developments in the epidemiology, treatment, and prevention of hepatitis E.

  13. Hepatitis E: A disease of reemerging importance.

    PubMed

    Sridhar, Siddharth; Lau, Susanna K P; Woo, Patrick C Y

    2015-08-01

    Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. Originally considered to be restricted to humans, it is now clear that HEV and HEV-like viruses have several animal reservoirs with complex ecology and genetic diversity, as exemplified by the recent discovery of HEV in dromedaries, a previously underestimated reservoir of zoonotic viruses prior to the emergence of Middle East Respiratory Syndrome coronavirus. Zoonotic foodborne transmission from pigs and feral animals such as wild boar is of increasing importance in the rapidly industrializing countries of the Asia Pacific region. Such zoonotic hepatitis E infection has particular relevance to the increasing population living with immunosuppression, due to the risk of chronic hepatitis E in these patients. Fortunately, major strides have been made recently in the management of chronic hepatitis E patients. Furthermore, an effective vaccine is also available that promises better control of hepatitis E burden in the near future. This review highlights these major recent developments in the epidemiology, treatment, and prevention of hepatitis E. PMID:25773541

  14. Primary leiomyosarcoma of the innominate vein.

    PubMed

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  15. Renal Vein Injury During Percutaneous Nephrolithotomy Procedure

    PubMed Central

    Toffeq, Hewa Mahmood

    2016-01-01

    Abstract Background: Percutaneous nephrostolithotomy is an important approach for removing kidney stones. Puncturing and dilatation are two mandatory steps in percutaneous nephrolithotomy (PCNL). Uncommonly, during dilatation, the dilators can cause direct injury to the main renal vein or to their tributaries. Case Presentation: A 75-year-old female underwent PCNL for partial staghorn stone in the left kidney. During puncturing and dilatation, renal vein tributary was injured, and the nephroscope entered the renal vein and inferior vena cava, which was clearly recognized. Injection of contrast material through the nephroscope confirms the false pathway to the great veins (renal vein and inferior vena cava). Bleeding was controlled intraoperatively by applying Amplatz sheath over the abnormal tract, the procedure was continued and stones were removed. At the end of the procedure, a Foley catheter was used as a nephrostomy tube and its balloon was inflated inside the renal pelvis and pulled back with light pressure to the lower calix, which was the site of injury to the renal vein tributaries, then the nephrostomy tube was closed; by this we effectively controlled the bleeding. The patient remained hemodynamically stable; antegrade pyelography was done on the second postoperative day, there was distally patent ureter with no extravasation, neither contrast leak to renal vein, and was discharged home at third postoperative day. After 2 weeks, the nephrostomy tube was gradually removed in the operative room, without bleeding, on the next day, Double-J stent was removed. Conclusion: Direct injury and false tract to the renal vein tributaries during PCNL can result in massive hemorrhage, and can be treated conservatively in hemodynamically stable patients, using a nephrostomy catheter as a tamponade. PMID:27704054

  16. Primary leiomyosarcoma of the innominate vein.

    PubMed

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread. PMID:17349340

  17. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

    PubMed Central

    Prasad, G. Raghavendra; Billa, Srikar; Bhandari, Pavaneel; Hussain, Aijaz

    2013-01-01

    Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI) bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric – inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up. PMID:23798814

  18. Insight into congenital absence of the portal vein: Is it rare?

    PubMed Central

    Shen, Guo-Hua Hu‚ Lai-Gen; Zhu, Jin Yang‚ Jin-Hua Mei‚ Yue-Feng

    2008-01-01

    Congenital absence of portal vein (CAPV) was a rare event in the past. However, the number of detected CAPV cases has increased in recent years because of advances in imaging techniques. Patients with CAPV present with portal hypertension (PH) or porto-systemic encephalopathy (PSE), but these conditions rarely occur until the patients grow up or become old. The patients usually visit doctors for the complications of venous shunts, hepatic or cardiac abnormalities detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). The etiology of this disease is not clear, but most investigators consider that it is associated with abnormal embryologic development of the portal vein. Usually, surgical intervention can relieve the symptoms and prevent occurrence of complications in CAPV patients. Moreover, its management should be stressed on a case-by-case basis, depending on the type or anatomy of the disease, as well as the symptoms and clinical conditions of the patient. PMID:18932274

  19. [Mesenteric infarction of the small bowel in the course of portal vein thrombosis - a case report].

    PubMed

    Iyluk, Andrzej; Jagielski, Wojciech

    2013-01-01

    Portal vein thrombosis is a rare entity, usually concomitant with hepatic cirrhosis and malignancies. Spontaneous disease occurs very rarely, and it presents with venous small bowel mesenteric infarction, causing intestinal ischaemia extremely rarely. We present a patient who was operated on because of symptoms and signs of "acute abdomen" and in whom segmental ischaemia of the small bowel and mesenteric thrombosis were found intraoperatively. The correct diagnosis, mesenteric infarction of the small bowel in the course of portal vein thrombosis, was made after performing an abdominal computer tomography scan a week after surgery. The course of the treatment, complications, and data from the literature are presented about this very rare condition, which may constitute a difficult diagnostic problem for a surgeon.

  20. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to indicate the location of a vein by revealing variations in the surface temperature of...

  1. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a device used to indicate the location of a vein by revealing variations in the surface temperature of...

  2. Anatomic variations of feline internal and external jugular veins.

    PubMed

    Specchi, Swan; Olive, Julien; Auriemma, Edoardo; Blond, Laurent

    2012-01-01

    We evaluated 50 feline head and neck computed tomography examinations to determine the prevalence of vascular variation in the internal and external jugular veins. We identified three distinct anatomic conformations of the internal jugular vein. No variation of external jugular vein morphology was detected. Feline patients can have different internal jugular vein morphology that should be recognized for surgical planning. PMID:22548331

  3. Veins Improve Fracture Toughness of Insect Wings

    PubMed Central

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect’s flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material’s resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing’s toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically ‘optimal’ solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial ‘venous’ wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species. PMID:22927966

  4. Subclavian vein thrombosis: A continuing challenge

    SciTech Connect

    Hill, S.L.; Berry, R.E. )

    1990-07-01

    Subclavian vein thrombosis is a relatively uncommon but potentially morbid disease entity. To determine the frequency, cause, and best mode of treatment of this problem, we performed a chart review of all patients with a diagnosis of subclavian vein thrombosis at two major metropolitan hospitals during a 6-year period. A total of 40 patients were identified with subclavian vein thrombosis, which represented 3.5% of all venous thromboses detected during the 6-year period. No side or sex predilection was noted and the majority of patients were outpatients. The cause was fairly evenly divided among intravenous catheters (32%), anatomic abnormalities (45%), and carcinoma with postoperative radiation (22.5%). Despite the increasing use of the subclavian veins for pacemaker leads, hyperalimentation, and permanent intravenous access for chemotherapy, there has not been an increase in diagnosed subclavian vein thrombosis. Anatomic abnormalities with compression of the vein respond well to either heparinization or lytic therapy but require surgery if the venous abnormality persists. Treatment consisted of lytic therapy in 20%, heparinization in 55%, and elevation with removal of the central line in 25% of patients. All patients responded well to treatment, with a decrease in swelling and symptoms; no patient progressed to venous gangrene and only one (2.5%) had a documented pulmonary embolus. Medical treatment provides excellent long-term benefit in most cases unless complicated by an anatomic abnormality.

  5. Veins improve fracture toughness of insect wings.

    PubMed

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

  6. The lollipop sign: a new cross-sectional sign of hepatic epithelioid hemangioendothelioma.

    PubMed

    Alomari, Ahmad I

    2006-09-01

    In four cases of hepatic epithelioid hemangioendothelioma (HEHE), multiple liver lesions were depicted on enhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) scans. A peculiar sign, a hepatic or portal vein terminating at or just within the periphery of some of the liver lesions, was noted in all four; the images look like a lollipop. Imaging findings of HEHE can suggest other diseases, but this sign buttressed by other radiological findings, seems to be specific for this entity. PMID:16644166

  7. Nutcracker syndrome complicated by left renal vein thrombosis.

    PubMed

    Mallat, Faouzi; Hmida, Wissem; Jaidane, Mehdi; Mama, Nadia; Mosbah, Faouzi

    2013-01-01

    Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  8. Gonadal vein tumor thrombosis due to renal cell carcinoma.

    PubMed

    Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei

    2015-01-01

    Renal cell carcinoma (RCC) had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC.

  9. Middle East

    SciTech Connect

    Hemer, D.O.; Mason, J.F.; Hatch, G.C.

    1981-10-01

    Petroleum production in Middle East countries during 1980 totaled 6,747,719,000 bbl or an average rate of 18,436,390,000 bbl/d, down 13.9% from 1979. Increases were in Saudi Arabia and Syria. Significant decreases occurred in Iraq, Iran, Kuwait, and Turkey. New discoveries were made in Abu Dhabi, Iran, Saudi Arabia, Sharjah, and Oman. New areas were explored in Bahrain, Oman, Syria, and Yemen. 9 figures, 16 tables.

  10. Deep vein thrombosis: a clinical review

    PubMed Central

    Kesieme, Emeka; Kesieme, Chinenye; Jebbin, Nze; Irekpita, Eshiobo; Dongo, Andrew

    2011-01-01

    Background: Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein) or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality. Aim: To present an update on the causes and management of DVT. Methods: A review of publications obtained from Medline search, medical libraries, and Google. Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome. Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran) and selective factor Xa inhibitors (rivaroxaban and apixaban). Others are currently undergoing trials. Thrombolytics and vena caval filters are very rarely indicated in special circumstances. PMID:22287864

  11. Confluence of the right internal iliac vein into a compressed left common iliac vein.

    PubMed

    Caggiati, Alberto; Amore, Miguel; Sedati, Pietro

    2016-03-01

    The authors describe the abnormal confluence of the right internal iliac vein into a left common iliac vein compressed by the overlying right common iliac artery. The prevalence of this combination of abnormalities, evaluated in cadavers and in living subjects by CT, was 0.9%. The possible obstacle to venous pelvic return by these anomalies is pointed out.

  12. Transcatheter ovarian vein embolisation without renal vein stenting for pelvic venous congestion and nutcracker anatomy.

    PubMed

    Perkov, Dražen; Vrkić Kirhmajer, Majda; Novosel, Luka; Popić Ramač, Jelena

    2016-01-01

    The diagnosis of a nutcracker syndrome can be aggravated by overlap of a nutcracker phenomenon with other pathologies. In patients with nutcracker anatomy and predominantly pelvic congestion symptoms, ovarian vein embolization without left renal vein stenting could be considered a first line therapy. PMID:27428503

  13. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis.

    PubMed

    Kim, Young-Kyun; Chun, Ho Jong; Hwang, Jeong Kye; Kim, Ji Il; Kim, Sang Dong; Park, Sun-Cheol; Moon, In Sung

    2016-07-01

    Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  14. [Hepatic encephalopathy].

    PubMed

    Festi, Davide; Marasco, Giovanni; Ravaioli, Federico; Colecchia, Antonio

    2016-07-01

    Hepatic encephalopathy (HE) is a common complication of liver cirrhosis and it can manifest with a broad spectrum of neuropsychiatric abnormalities of varying severity, acuity and time course with important clinical implications. According to recent guidelines, HE has been classified into different types, depending on the severity of hepatic dysfunction, the presence of porto-systemic shunts and the number of previous episodes or persistent manifestations. From a clinical point of view, HE can be recognized as unimpaired, covert (that deals with minimal and grade 1 according to the grading of mental state), and overt (that is categorized from grade 2 to grade 4). Different and only partially known pathogenic mechanisms have been identified, comprising ammonia, inflammatory cytokines, benzodiazepine-like compounds and manganese deposition. Different therapeutic strategies are available for treating HE, in particular the overt HE, since covert HE needs to be managed case by case. Recognition and treatment of precipitating factors represent fundamental part of the management. The more effective treatments, which can be performed separately or combined, are represented by non-absorbable disaccharides (lactulose and lactitol) and the topic antibiotic rifaximin; other possible therapies, mainly used in patients non responders to previous treatments, are represented by branched chain amino acids and metabolic ammonia scavengers. PMID:27571468

  15. Protect Yourself from Hepatitis

    MedlinePlus

    ... develop yellowish eyes and skin. All the hepatitis viruses can cause acute, or short-term, hepatitis. Some can also cause chronic hepatitis, in which the infection lasts a long time, sometimes for your whole life. Chronic hepatitis can eventually lead to scarring of ...

  16. Veining Failure and Hydraulic Fracturing in Shales

    NASA Astrophysics Data System (ADS)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6

  17. Animal Model of Acute Deep Vein Thrombosis

    SciTech Connect

    Roy, Sumit; Laerum, Frode; Brosstad, Frank; Kvernebo, Knut; Sakariassen, Kjell S.

    1998-07-15

    Purpose: To develop an animal model of acute deep vein thrombosis (DVT). Methods: In part I of the study nine juvenile domestic pigs were used. Each external iliac vein was transluminally occluded with a balloon catheter. Thrombin was infused through a microcatheter in one leg according to one of the following protocols: (1) intraarterial (IA): 1250 U at 25 U/min in the common femoral artery (n= 3); (2) intravenous (IV): 5000 U in the popliteal vein at 500 U/min (n= 3), or at 100 U/min (n= 3). Saline was administered in the opposite leg. After the animals were killed, the mass of thrombus in the iliofemoral veins was measured. The pudendoepiploic (PEV), profunda femoris (PF), and popliteal veins (PV) were examined. Thrombosis in the tributaries of the superficial femoral vein (SFVt) was graded according to a three-point scale (0, +, ++). In part II of the study IV administration was further investigated in nine pigs using the following three regimens with 1000 U at 25 U/min serving as the control: (1) 1000 U at 100 U/min, (2) 250 U at 25 U/min, (3) 250 U at 6.25 U/min. Results: All animals survived. In part I median thrombus mass in the test limbs was 1.40 g as compared with 0.25 g in the controls (p= 0.01). PEV, PFV and PV were thrombosed in all limbs infused with thrombin. IV infusion was more effective in inducing thrombosis in both the parent veins (mass 1.32-1.78 g) and SVFt (++ in 4 of 6 legs), as compared with IA infusion (mass 0.0-1.16 g; SFVt ++ in 1 of 3 legs). In part II thrombus mass in axial veins ranged from 1.23 to 2.86 g, and showed no relationship with the dose of thrombin or the rate of infusion. Tributary thrombosis was less extensive with 250 U at 25 U/min than with the other regimens. Conclusion: Slow distal intravenous thrombin infusion in the hind legs of pigs combined with proximal venous occlusion induces thrombosis in the leg veins that closely resembles clinical DVT in distribution.

  18. Portal vein aneurysm: What to know.

    PubMed

    Laurenzi, Andrea; Ettorre, Giuseppe Maria; Lionetti, Raffaella; Meniconi, Roberto Luca; Colasanti, Marco; Vennarecci, Giovanni

    2015-11-01

    Portal vein aneurysm is an unusual vascular dilatation of the portal vein, which was first described by Barzilai and Kleckner in 1956 and since then less than 200 cases have been reported. The aim of this article is to provide an overview of the international literature to better clarify various aspects of this rare nosological entity and provide clear evidence-based summary, when available, of the clinical and surgical management. A systematic literature search of the Pubmed database was performed for all articles related to portal vein aneurysm. All articles published from 1956 to 2014 were examined for a total of 96 reports, including 190 patients. Portal vein aneurysm is defined as a portal vein diameter exceeding 1.9 cm in cirrhotic patients and 1.5 cm in normal livers. It can be congenital or acquired and portal hypertension represents the main cause of the acquired version. Surgical indication is considered in case of rupture, thrombosis or symptomatic aneurysms. Aneurysmectomy and aneurysmorrhaphy are considered in patients with normal liver, while shunt procedures or liver transplantation are the treatment of choice in case of portal hypertension. Being such a rare vascular entity its management should be reserved to high-volume tertiary hepato-biliary centres. PMID:26188840

  19. Robotic Assisted Cannulation of Occluded Retinal Veins

    PubMed Central

    Meenink, Thijs C. M.; Janssens, Tom; Vanheukelom, Valerie; Naus, Gerrit J. L.; Beelen, Maarten J.; Meers, Caroline; Jonckx, Bart; Stassen, Jean-Marie

    2016-01-01

    Purpose To develop a methodology for cannulating porcine retinal venules using a robotic assistive arm after inducing a retinal vein occlusion using the photosensitizer rose bengal. Methodology Retinal vein occlusions proximal to the first vascular branch point were induced following intravenous injection of rose bengal by exposure to 532nm laser light delivered by slit-lamp or endolaser probe. Retinal veins were cannulated by positioning a glass catheter tip using a robotically controlled micromanipulator above venules with an outer diameter of 80μm or more and performing a preset piercing maneuver, controlled robotically. The ability of a balanced salt (BSS) solution to remove an occlusion by repeat distention of the retinal vein was also assessed. Results Cannulation using the preset piercing program was successful in 9 of 9 eyes. Piercing using the micromanipulator under manual control was successful in only 24 of 52 attempts, with several attempts leading to double piercing. The best location for cannulation was directly proximal to the occlusion. Infusion of BSS did not result in the resolution of the occlusion. Conclusion Cannulation of venules using a robotic microassistive arm can be achieved with consistency, provided the piercing is robotically driven. The model appears robust enough to allow testing of therapeutic strategies aimed at eliminating a retinal vein thrombus and its evolution over time. PMID:27676261

  20. A new approach for sclera vein recognition

    NASA Astrophysics Data System (ADS)

    Thomas, N. L.; Du, Yingzi; Zhou, Zhi

    2010-04-01

    The vein structure in the sclera is stable over time, unique to each person, and well suited for human identification. A few researchers have performed sclera vein pattern recognition and reported promising initial results. Sclera recognition poses several challenges: the vein structure moves and deforms with the movement of the eye; images of sclera patterns are often defocused and/or saturated; and, most importantly, the vein structure in the sclera is multi-layered and has complex non-linear deformation. In this paper, we proposed a new method for sclera recognition: First, we developed a color-based sclera region estimation scheme for sclera segmentation. Second, we designed a Gabor wavelet-based sclera pattern enhancement method, and an adaptive thresholding method to emphasize and binarize the sclera vein patterns. Third, we proposed a line descriptor-based feature extraction, registration, and matching method that is illumination-, scale-, orientation-, and deformation-invariant, and can mitigate the multi-layered deformation effects exhibited in the sclera and tolerate segmentation error. It is empirically verified using the UBIRIS database that the proposed method can perform accurate sclera recognition.

  1. In vivo quantitation of the rat liver's ability to eliminate endotoxin from portal vein blood

    SciTech Connect

    Yamaguchi, Y.; Yamaguchi, K.; Babb, J.L.; Gans, H.

    1982-12-01

    The in vivo uptake of endotoxin by the liver from portal vein blood was assessed during a single passage through the liver. /sup 51/Cr labeled and unlabeled endotoxin were infused in different amounts into the femoral vein of three groups of lead-sensitized rats: a nonoperated, a sham-operated, and a surgically created reversed Eck fistula (REF) group. Whereas in the former two the infused endotoxin encounters the lung as the first filter organ, the liver performs this function in the latter experimental model. The mortality rates observed in control and sham-operated, lead-sensitized rats were found to correlate closely and reproducibly to the degree of endotoxemia. This assay was then applied to determine the amount of endotoxin eliminated by the liver by establishing, in the REF rat, the amounts of endotoxin that escaped hepatic clearance. The capacity of the liver to eliminate endotoxin from portal vein blood during a single passage increases as the portal vein endotoxin level rises; it approaches a maximum, suggesting that endotoxin's interaction with the Kupffer cells conforms to classical saturation kinetics. A Lineweaver-Burk plot prepared from these data indicates that the maximal in vivo capacity of the liver to remove endotoxin from portal vein blood approximates 1.5 micrograms/gm liver/hr. Data obtained with the use of radiolabeled endotoxin corroborate the information obtained with the bioassay technique. Endotoxin eliminated by the Kupffer cells in these quantities is slowly disintegrated; 4 hr after termination of the endotoxin infusion, less than 4% of the radiolabel is found in the urine and none in the bile. These observations indicate that the Kupffer cell's functional capacity to sequester and detoxify endotoxin is extensive and far exceeds the requirements imposed by physiological and most pathological conditions.

  2. Effect of acid-base alterations on hepatic lactate utilization

    PubMed Central

    Goldstein, Philip J.; Simmons, Daniel H.; Tashkin, Donald P.

    1972-01-01

    1. The effect of acid-base changes on hepatic lactate utilization was investigated in anaesthetized, mechanically ventilated dogs. 2. Portal vein flow and hepatic artery flow were measured with electromagnetic flowmeters, lactate concentration of portal vein, arterial and mixed hepatic venous blood was determined by an enzymatic technique, and hepatic lactate uptake was calculated using the Fick principle. 3. Respiratory alkalosis (Δ pH 0·25 ± 0·02) in four dogs resulted in a significant fall in total hepatic blood flow (-22 ± 4%) and a significant rise in both arterial lactate concentration (2·18 ± 0·32 m-mole/l.) and hepatic lactate utilization (3·9 ± 1·2 μmole/min.kg). 4. 0·6 M-Tris buffer infusion (Δ pH 0·21 ± 0·02) in four dogs produced no significant changes in liver blood flow, arterial lactate concentration or hepatic lactate uptake. 5. Respiratory acidosis (Δ pH -0·20 ± 0·03) in six dogs and metabolic acidosis (Δ pH -0·20 ± 0·02) in four dogs produced no significant changes in liver blood flow, decreases in arterial lactate concentration of 0·38 ± 0·09 m-mole/l. (P < 0·05) and 0·13 ± 0·13 m-mole/l., respectively, and no significant changes in hepatic lactate uptake. 6. A significant correlation (r = 0·63; P < 0·01) was found between hepatic lactate utilization and arterial lactate concentration during the hyperlactataemia associated with respiratory alkalosis. 7. Hyperlactataemia induced in four dogs by infusion of buffered sodium lactate (Δ pH 0·05 ± 0·01;% Δ liver blood flow 29 ± 7%) was also significantly correlated with hepatic lactate utilization (r = 0·70; P < 0·01) and the slope of the regression was similar to that during respiratory alkalosis. 8. These data suggest that the hyperlactataemia of alkalosis is not due to impaired hepatic utilization of lactate and that the principal determinant of hepatic lactate uptake during alkalosis or lactate infusion is blood lactate concentration, rather than liver

  3. Fracture and vein characterization of a crystalline basement reservoir, central Yemen

    NASA Astrophysics Data System (ADS)

    Veeningen, R.; Grasemann, B.; Decker, K.; Bischoff, R.; Rice, A. H. N.

    2012-04-01

    The country of Yemen is located in the south-western part of the Arabian plate. The Pan-African basement found in western and central Yemen is highly deformed during the Proterozoic eon and is part of the Arabian-Nubian shield ANS (670-540Ma). This ANS is a result of the amalgamation of high-grade gneiss terranes and low-grade island arcs. The development of an extensive horst-and-graben system related to the breakup of Gondwana in the Mesozoic, has reactivated the Pan-African basement along NW-SE trending normal faults. As a result, younger Meosozoic marls, sandstones, clastics and limestones are unconformably overlying the basement. Some of these formations act as a source and/or reservoir for hydrocarbons. Due to fracturing of the basement, hydrocarbons have migrated horizontally into the basement, causing the crystalline basement to be a potential hydrocarbon reservoir. Unfortunately, little is known about the Pan-African basement in Central Yemen and due its potential as a reservoir, the deformation and oil migration history (with a main focus on the fracturing and veining history) of the basement is investigated in high detail. Representative samples are taken from 2 different wells from the Habban Field reservoir, located approximately 320 ESE of Sana'a. These samples are analysed using e.g. the Optical Microscope, SEM, EDX and CL, but also by doing Rb-Sr age dating, isotope analysis and fluid inclusion analysis. In well 1, the only lithology present is an altered gneiss with relative large (<5 cm diameter) multi-mineralic veins. In well 3, quartzite (top), gneiss (middle) and quartz porphyry's (middle) are intruded by a so called "younger" granitoid body (592.6±4.1Ma). All lithologies record polyphase systems of mineral veins. Pyrite and saddle dolomite in these veins have euhedral shapes, which means that they have grown in open cavities. Calcite is the youngest mineral in these veins, closing the vein and aborting the fluid flow. Fluid inclusions inside

  4. The anatomy of the cardiac veins in mice

    PubMed Central

    Ciszek, Bogdan; Skubiszewska, Daria; Ratajska, Anna

    2007-01-01

    Although the cardiac coronary system in mice has been the studied in detail by many research laboratories, knowledge of the cardiac veins remains poor. This is because of the difficulty in marking the venous system with a technique that would allow visualization of these large vessels with thin walls. Here we present the visualization of the coronary venous system by perfusion of latex dye through the right caudal vein. Latex injected intravenously does not penetrate into the capillary system. Murine cardiac veins consist of several principal branches (with large diameters), the distal parts of which are located in the subepicardium. We have described the major branches of the left atrial veins, the vein of the left ventricle, the caudal veins, the vein of the right ventricle and the conal veins forming the conal venous circle or the prepulmonary conal venous arch running around the conus of the right ventricle. The venous system of the heart drains the blood to the coronary sinus (the left cranial caval vein) to the right atrium or to the right cranial caval vein. Systemic veins such as the left cranial caval, the right cranial caval and the caudal vein open to the right atrium. Knowledge of cardiac vein location may help to elucidate abnormal vein patterns in certain genetic malformations. PMID:17553104

  5. Hepatic Perfusion Therapy.

    PubMed

    Rajeev, Rahul; Gamblin, T Clark; Turaga, Kiran K

    2016-04-01

    Isolated hepatic perfusion uses the unique vascular supply of hepatic malignancies to deliver cytotoxic chemotherapy. The procedure involves vascular isolation of the liver and delivery of chemotherapy via the hepatic artery and extraction from retrohepatic vena cava. Benefits of hepatic perfusion have been observed in hepatic metastases of ocular melanoma and colorectal cancer and primary hepatocellular carcinoma. Percutaneous and prophylactic perfusions are avenues of ongoing research.

  6. Ultrastructure of internal jugular vein defective valves

    PubMed Central

    Tisato, V; Menegatti, E; Mascoli, F; Gianesini, S; Salvi, F; Secchiero, P

    2015-01-01

    Objectives To study the ultrastructure of intraluminal defects found in the internal jugular vein by using a scanning electron microscopy. Methods Using a scanning electron microscopy, intraluminal septa and/or defective valves blocking the flow in the distal internal jugular vein of seven patients were studied together with the adjacent wall and compared with control specimen. Results The internal jugular veins’ wall showed a significant derangement of the endothelial layer as compared to controls. Surprisingly, no endothelial cells were found in the defective cusps, and the surface of the structure is covered by a fibro-reticular lamina. Conclusions Although the lack of endothelial cells in the internal jugular vein intraluminal obstacles is a further abnormality found in course of chronic cerebrospinal venous insufficiency, our investigation cannot clarify whether this finding is primary or caused by progressive loss of endothelium in relation to altered haemodynamic forces and/or to a past post-thrombotic/inflammatory remodelling. PMID:24972760

  7. Spontaneous Resolution of Portal Vein Thrombosis

    PubMed Central

    Banumukala, Vishnu; Babu, Adarsh

    2008-01-01

    A 56-year-old male was admitted with symptoms of belching, abdominal pain and weight loss of 2 weeks duration. Examination revealed hepatosplenomegaly which was confirmed by computed tomography (CT). CT images also revealed filling defects in the portal vein and intrahepatic branches consistent with thrombosis and hepatosplenic infarcts. Alkaline phosphatase was elevated at 688 units, all other investigations, including full blood count, coagulation screen and tumour markers, were normal. Magnetic resonance cholangiopancreatography did not reveal any mass in the porta hepatis. Upper gastrointestinal endoscopy and colonoscopy were normal. Liver biopsy was normal and did not reveal any evidence of lymphoma. The raised alkaline phosphatase settled to reference range over a period of 3 weeks. Thrombophilia screen was negative. Contrast CT of the abdomen performed after 4 weeks displayed revascularisation of the previously thrombosed portal vein and intrahepatic branches. The patient has remained asymptomatic since and we note spontaneous recanalisation of the previously occluded portal vein. PMID:21490872

  8. Spontaneous resolution of portal vein thrombosis.

    PubMed

    Banumukala, Vishnu; Babu, Adarsh

    2008-01-01

    A 56-year-old male was admitted with symptoms of belching, abdominal pain and weight loss of 2 weeks duration. Examination revealed hepatosplenomegaly which was confirmed by computed tomography (CT). CT images also revealed filling defects in the portal vein and intrahepatic branches consistent with thrombosis and hepatosplenic infarcts. Alkaline phosphatase was elevated at 688 units, all other investigations, including full blood count, coagulation screen and tumour markers, were normal. Magnetic resonance cholangiopancreatography did not reveal any mass in the porta hepatis. Upper gastrointestinal endoscopy and colonoscopy were normal. Liver biopsy was normal and did not reveal any evidence of lymphoma. The raised alkaline phosphatase settled to reference range over a period of 3 weeks. Thrombophilia screen was negative. Contrast CT of the abdomen performed after 4 weeks displayed revascularisation of the previously thrombosed portal vein and intrahepatic branches. The patient has remained asymptomatic since and we note spontaneous recanalisation of the previously occluded portal vein. PMID:21490872

  9. Can tuffisite veins help dictate eruption styles?

    NASA Astrophysics Data System (ADS)

    Kolzenburg, S.; Heap, M. J.; Lavallee, Y.; Russell, J. K.; Meredith, P. G.; Dingwell, D. B.

    2010-12-01

    The ability of magmas to degas during ascent may affect eruption style. The permeability of the magma and/or the conduit wall rocks may therefore dictate whether an eruption will be explosive or effusive. Fractures increase permeability. Fractures filled by veins of autoclastic, cataclastic and tuffisitic glass shards and crystal fragments are common in shallow conduit systems. These veins have the potential to dramatically increase permeability and provide pathways for gas loss. Here we present the first study on the porosity, permeability, strength, P-and S-wave and dynamic elastic moduli of andesite containing tuffisite veins at Volcán de Colima, Mexico. Porosity was measured via pycnometry. The strength and mechanisms of deformation were investigated on tuffisite-bearing and tuffisite-free samples in a uniaxial press at 940°C by loading at 2 MPa/min until failure. The permeability, P- and S-wave velocity, and dynamic elastic moduli were measured in a high-pressure permeameter/pore volumometer up to effective confining pressures of 50 MPa (ca. 2km depth). Measurements were made on cylindrical samples prepared as: (1) without tuffisite veins and with tuffisite veins (2) perpendicular and (3) sub-parallel to flow (i.e., the samples’ axial direction). Petrographic analysis reveals that the tuffisites are comprised almost exclusively of micron-size crystal fragments. Dilatometric measurements of tuffisite (10°C/min up to 1000°C), failed to reveal a Tg, indicating the absence of interstitial glass. In contrast, the dome rocks exhibits viscous relaxation between 770 and 885 °C, indicating glass. The high-temperature (940°C) deformation experiments on samples containing tuffisite veins showed an absence of ductile deformation and a uniaxial strength of 116 MPa; i.e, slightly weaker than tuffisite-free rock (~130 MPa) and stronger than erupted dome lavas (~30 MPa). The presence of tuffisite increases the porosity. Permeability measurements show that tuffisite

  10. Pathogenesis of varicose veins - lessons from biomechanics.

    PubMed

    Pfisterer, Larissa; König, Gerd; Hecker, Markus; Korff, Thomas

    2014-03-01

    The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.

  11. Middle Years. For Middle Level Educators.

    ERIC Educational Resources Information Center

    Hechinger, Fred M.; And Others

    1992-01-01

    This supplement offers 10 articles focusing on middle school education. Topics include remembering adolescence, resources and teaching tips, active middle school students, adolescent development, challenges in middle school education, integrated studies, planning middle school special events, a writing-science-consumerism miniunit on popcorn,…

  12. Auto immune hepatitis

    PubMed Central

    van Gerven, Nicole MF; de Boer, Ynto S; Mulder, Chris JJ; van Nieuwkerk, Carin MJ; Bouma, Gerd

    2016-01-01

    To provide an update of the latest trends in epidemiology, clinical course, diagnostics, complications and treatment of auto immune hepatitis (AIH). A search of the MEDLINE database was performed using the search terms: “auto immune hepatitis”, “clinical presentation”, “symptoms”, “signs”, “diagnosis”, “auto antibodies”, “laboratory values”, “serology”, “histopathology”, “histology”, “genetics”, “HLA genes”, “non-HLA genes”, “environment”, “epidemiology”, “prevalence”, “incidence”, “demographics”, “complications”, “HCC”, “PBC”, “PSC”, “corticosteroid”, “therapy”, “treatment”, “alternative treatment”. English-language full-text articles and abstracts were considered. Articles included reviews, meta-analysis, prospective retrospective studies. No publication date restrictions were applied. AIH is an immune meditated progressive inflammatory liver disease that predominantly affects middle-aged females but may affect people of all ages. The clinical spectrum of AIH is wide, ranging from absent or mild symptoms to fulminant hepatic failure. The aetiology of AIH is still unknown, but is believed to occur as the consequence of an aberrant immune response towards an un-known trigger in a genetically susceptible host. In the absence of a gold standard, diagnosis is based on the combination of clinical, biochemical and histopathological criteria. Immunosuppressive treatment has been the cornerstone of treatment since the earliest description of the disease in 1950 by Waldenström. Such treatment is often successful at inducing remission and generally leads to normal life expectancy. Nevertheless, there remain significant areas of unmet aetiological a clinical needs including fundamental insight in disease pathogenesis, optimal therapy, duration of treatment and treatment alternatives in those patients unresponsive to standard treatment regimens. PMID:27217697

  13. Cystic adventitial disease of the common femoral vein.

    PubMed

    Jayaraj, Arjun; Shalhub, Sherene; Deubner, Heike; Starnes, Benjamin W

    2011-05-01

    Cystic adventitial disease of blood vessels is a rare condition, more so when veins are involved. We report the case of a 36-year-old man who was referred to us after an intraoperative diagnosis of a left common femoral vein mass. This patient, who had a history of deep vein thrombosis and pulmonary embolism, had presented to an outside facility with recurrent left lower extremity pain and swelling. At our hospital, he underwent excision of the vein mass with interposition vein grafting using the left internal jugular vein. In this report, we discuss the presentation, diagnosis, treatment, and pathology of this rare condition. PMID:21549936

  14. [Retinal vein occlusion: an interdisciplinary approach].

    PubMed

    Hatz, Katja; Martinez, Maria

    2016-01-01

    Retinal vein occlusion provide a common cause of significant visual reduction but also late ocular complications. The medical care of these patients pursue two goals: On the one hand vision threatening complications need to be identified and treated, and on the other hand treatable risk factors are need to be identified and treated. This paper summarizes the common ophthalmological therapeutic approaches as well as recommended medical evaluations carried out by the general practitioner. This supports the interdisciplinary approach in evaluating and treating retinal vein occlusions by ophthalmologists and the general practitioners/specialist in internal medicine. PMID:26982647

  15. Renal actinomycosis with concomitant renal vein thrombosis.

    PubMed

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  16. Surgical treatment of central retinal vein occlusion.

    PubMed

    Berker, Nilufer; Batman, Cosar

    2008-05-01

    The treatment of central retinal vein occlusion (CRVO) is still a subject of debate. Medical therapy efforts, as well as retinal laser photocoagulation, have mostly dealt with management of the sequelae of CRVO, and have shown limited success in improving visual acuity. The unsatisfactory results of such therapeutic efforts led to the development of new treatment strategies focused on the surgical treatment of the occluded retinal vein. The purpose of this review is to summarize the outcomes of commonly reported surgical treatment strategies and to review different opinions on the various surgical approaches to the treatment of CRVO.

  17. Conduits for Coronary Bypass: Vein Grafts

    PubMed Central

    Farkas, Emily A

    2012-01-01

    The saphenous vein has been the principal conduit for coronary bypass grafting from the beginning, circa 1970. This report briefly traces this history and concomitantly presents one surgeons experience and personal views on use of the vein graft. As such it is not exhaustive but meant to be practical with a modest number of references. The focus is that of providing guidance and perspective which may be at variance with that of others and recognizing that there may be many ways to accomplish the task at hand. Hopefully the surgeon in training/early career may find this instructive on the journey to surgical maturity. PMID:23130300

  18. Conduits for coronary bypass: vein grafts.

    PubMed

    Barner, Hendrick B; Farkas, Emily A

    2012-10-01

    The saphenous vein has been the principal conduit for coronary bypass grafting from the beginning, circa 1970. This report briefly traces this history and concomitantly presents one surgeons experience and personal views on use of the vein graft. As such it is not exhaustive but meant to be practical with a modest number of references. The focus is that of providing guidance and perspective which may be at variance with that of others and recognizing that there may be many ways to accomplish the task at hand. Hopefully the surgeon in training/early career may find this instructive on the journey to surgical maturity. PMID:23130300

  19. [A case of severe posterior hepatic lesion caused by contusion trauma].

    PubMed

    Cortese, F; Di Giusto, F; Borghi, M E; Ghisletti, P; Meazza, G

    1991-06-30

    A case of blunt liver trauma with massive peritoneal hemorrhage due to a major intraparenchymal injury with active bleeding from a posterior tributary of the right hepatic vein is reported. The treatment consisted of resectional debridement of the VII and VI segment of Couinaud and hemostasis was possible in total vascular exclusion without an intracaval shunt. PMID:1961595

  20. Changes in Hepatic Blood Flow During Transcatheter Arterial Infusion with Heated Saline in Hepatic VX2 Tumor

    SciTech Connect

    Cao Wei; Li Jing; Wu Zhiqun; Zhou Changxi; Liu Xi; Wan Yi; Duan Yunyou

    2013-06-15

    Purpose. This study evaluates the influence of transcatheter arterial infusion with heated saline on hepatic arterial and portal venous blood flows to tumor and normal hepatic tissues in a rabbit VX2 tumor model. Methods. All animal experiments were approved by the institutional animal care and use committee. Twenty rabbits with VX2 liver tumors were divided into the following two groups: (a) the treated group (n = 10), which received a 60 mL transarterial injection of 60 Degree-Sign C saline via the hepatic artery; (b) the control group (n = 10), which received a 60 mL injection of 37 Degree-Sign C saline via the hepatic artery. Using ultrasonography, the blood flows in both the portal vein and hepatic artery were measured, and the changes in the hemodynamic indices were recorded before and immediately after the injection. The changes in the tumor and normal liver tissues of the two groups were histopathologically examined by hematoxylin and eosin staining after the injection. Results. After the transcatheter arterial heated infusion, there was a decrease in the hepatic arterial blood flow to the tumor tissue, a significant decrease in the hepatic artery mean velocity (P < 0.05), and a significant increase in the resistance index (P < 0.05). On hematoxylin and eosin staining, there were no obvious signs of tissue destruction in the normal liver tissue or the tumor tissue after heated perfusion, and coagulated blood plasma was observed in the cavities of intratumoral blood vessels in the treated group. Conclusions. The changes in tumor blood flow in the rabbit VX2 tumor model were presumably caused by microthrombi in the tumor vessels, and the portal vein likely mediated the heat loss in normal liver tissue during the transarterial heated infusion.

  1. Delayed reconstruction of the superior mesenteric vein with autogenous femoral vein.

    PubMed

    Tulip, Hans H; Smith, Sumona V; Valentine, R James

    2012-06-01

    A 38-year-old man underwent ligation of the superior mesenteric vein due to traumatic disruption. He developed severe bowel edema with large fluid losses through the open abdominal incision. On postoperative day 9, a superior mesenteric vein bypass was performed with autogenous femoral vein, and this resulted in prompt resolution of the bowel edema and allowed abdominal wound closure. He was able to resume a normal diet and was discharged on postinjury day 39. A magnetic resonance imaging scan performed 1 year later showed a patent graft.

  2. Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy

    SciTech Connect

    Sakurabayashi, Shin; Sezai, Shuichi; Yamamoto, Yoshihiro; Hirano, Masanori; Oka, Hiroshi

    1997-03-15

    Purpose. To evaluate the efficacy of embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy (CRHE). Methods. Seven cirrhotic patients with CRHE refractory to medical treatment (3 men and 4 women, mean age 66 years) were studied. Five patients had splenorenal shunts, 1 had a gastrorenal shunt, and 1 had an intrahepatic portal vein-hepatic vein shunt. Shunt embolization was performed using stainless steel coils, with a percutaneous transhepatic portal vein approach in 4 patients and a transrenal vein approach in 3 patients. Results. After embolization, the shunt disappeared in 4 patients on either ultrasound pulsed Doppler monitoring or portography. Complications observed in the 7 patients were fever, transient pleural effusion, ascites, and mild esophageal varices. For 3-6 months after embolization, the 4 patients whose shunts disappeared showed minimal or no reappearance of a shunt, and had no recurrence of encephalopathy. The serum ammonia levels decreased and electroencephalograms also improved. One of the 4 patients, who developed mild esophageal varices, required no treatment. Treatment was effective in 3 of the 4 patients (75%) who underwent embolization via a transhepatic portal vein. Conclusion. Transvascular embolization of shunts improved the outcome in 4 of 7 patients. The most effective embolization was achieved via the percutaneous transhepatic portal vein approach.

  3. THE "DARK SIDE" OF DEEP VEIN THROMBOSIS--CASE REPORT.

    PubMed

    Costache, Irina Iullana; Buburuz, Ann-Maria; Fotea, V; Cozma, A; Aursulesei, Viviana

    2016-01-01

    Venous thromboembolism (VTE) is an increasingly common cause of morbidity and mortality in cancer patients. In various malignancies the incidence of thrombosis ranges from 5% to 60%, that is four times higher in cancer patients compared to the general population. Large retrospective studies have shown that in men the tumors which are most commonly associated with VTE are lung cancer and pancreatic cancer and, in women cancer of the genital area, pancreas, colon and rectum. Thromboembolic events may often occur before the cancer diagnosis. We present the case of a 41-year-old female patient with a history of genital cancer which was surgically treated and who is now admitted for clinical signs of ileofemoral deep vein thrombosis (DVT) of the left leg. The diagnosis was confirmed by laboratory data and Doppler ultrasound and the patient received anticoagulant treatment. Given the history of the patient, abdominal and pelvic ultrasound and computer tomography (CT) were performed to detect the cause who predisposed to the thrombotic event. These confirmed the ovarian cancer, this time on the right side, and the presence of hepatic and pulmonary metastasis. This case highlights the importance of screening for a cause of the thromboembolic event in patients, especially in those who have a history of a neoplasia.

  4. Viral hepatitis: Indian scenario.

    PubMed

    Satsangi, Sandeep; Chawla, Yogesh K

    2016-07-01

    Viral hepatitis is a cause for major health care burden in India and is now equated as a threat comparable to the "big three" communicable diseases - HIV/AIDS, malaria and tuberculosis. Hepatitis A virus and Hepatitis E virus are predominantly enterically transmitted pathogens and are responsible to cause both sporadic infections and epidemics of acute viral hepatitis. Hepatitis B virus and Hepatitis C virus are predominantly spread via parenteral route and are notorious to cause chronic hepatitis which can lead to grave complications including cirrhosis of liver and hepatocellular carcinoma. Around 400 million people all over the world suffer from chronic hepatitis and the Asia-Pacific region constitutes the epicentre of this epidemic. The present article would aim to cover the basic virologic aspects of these viruses and highlight the present scenario of viral hepatitis in India. PMID:27546957

  5. The pulmonary veins of the pig as an anatomical model for the development of a new treatment for atrial fibrillation.

    PubMed

    Vandecasteele, T; Vandevelde, K; Doom, M; Van Mulken, E; Simoens, P; Cornillie, P

    2015-02-01

    The layout of the porcine atriopulmonary junction and immediately adjacent structures was investigated by gross anatomical and vascular corrosion casting studies to meet the need for more in-depth anatomical insights when using the pig as an animal model in the development of innovative approaches for surgical cardiac ablation in man. The veins from the right cranial and middle lung lobes drain through a common ostium in the left atrium, whereas a second ostium receives the blood returning from all other lung lobes, although limited variation to this pattern was observed. Surrounding anatomical structures that are most vulnerable to ablation damage as reported in man are located at a safer distance from the pulmonary veins in pigs, yet a certain locations, comparable risks are to be considered. Additionally, it was histologically confirmed that myocardial sleeves extend to over a centimetre in the wall of the pulmonary veins.

  6. Endovascular stenting of an extracranial–intracranial saphenous vein high-flow bypass graft: Technical case report

    PubMed Central

    Maselli, Giuliano; Tommasi, Claudio De; Ricci, Alessandro; Gallucci, Massimo; Galzio, Renato J.

    2011-01-01

    Background: The authors describe a case of endovascular stenting of an extracranial–intracranial saphenous vein high-flow bypass graft in the management of a complex bilateral carotid aneurysm case. Case Description: A 43-year-old woman was admitted with progressive visual field restriction and headache. Imaging studies revealed bilateral supraclinoid carotid aneurysms. The right carotid aneurysm was clipped and the left one was treated by an endovascular procedure, after performing an internal carotid artery–middle cerebral artery (ICA-MCA) saphenous vein bypass graft. A few months following the bypass procedure, a 70–80% stenosis of the graft was discovered and treated endovascularly with a stenting procedure. Follow-up at 36 months after the first operation showed the patency of the venous graft and no neurological deficits. Conclusions: Endovascular stenting of the extracranial–intracranial saphenous vein high-flow bypass graft is technically feasible when postoperative graft occlusion is discovered. PMID:21660272

  7. Hepatitis Information for the Public

    MedlinePlus

    ... of Viral Hepatitis Contact Us Quick Links to Hepatitis ... A | B | C | D | E Viral Hepatitis Home ... Outbreaks State and Local Partners & Grantees Resource Center Hepatitis Information for the Public Recommend on Facebook Tweet ...

  8. Diabetes and Hepatitis B Vaccination

    MedlinePlus

    Diabetes and Hepatitis B Vaccination Information for Diabetes Educators What is hepatitis B? Hepatitis B is a contagious liver disease that results from infection with the hepatitis B virus. When first infected, a person can develop ...

  9. Post-TIPS Hepatic Encephalopathy Treated by Occlusion Balloon-Assisted Retrograde Embolization of a Coexisting Spontaneous Splenorenal Shunt

    SciTech Connect

    Shioyama, Yasukazu; Matsueda, Kiyoshi; Horihata, Koushi; Kimura, Masashi; Nishida, Norifumi; Kishi, Kazushi; Terada, Masaki; Sato, Morio; Yamada, Ryusaku

    1996-11-15

    A 51-year-old man with posthepatitis cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for bleeding of recurrent esophageal varices. The patient had a coexisting, spontaneous, splenorenal shunt. He subsequently developed hepatic encephalopathy, presumably due to excessive portosystemic shunting. Since medical management resulted in no significant improvement, the splenorenal shunt was embolized from the jugular vein approach via renal vein access during temporary balloon occlusion. Within a few days, the patient's hepatic encephalopathy resolved. Twelve months later the patient showed no recurrence of encephalopathy and had maintained a patent TIPS.

  10. Pancreatectomy with vein reconstruction: technique matters

    PubMed Central

    Dua, Monica M; Tran, Thuy B; Klausner, Jill; Hwa, Kim J; Poultsides, George A; Norton, Jeffrey A; Visser, Brendan C

    2015-01-01

    Background A variety of techniques have been described for portal vein (PV) and/or superior mesenteric vein (SMV) resection/reconstruction during a pancreatectomy. The ideal strategy remains unclear. Methods Patients who underwent PV/SMV resection/reconstruction during a pancreatectomy from 2005 to 2014 were identified. Medical records and imaging were retrospectively reviewed for operative details and outcomes, with particular emphasis on patency. Results Ninety patients underwent vein resection/reconstruction with one of five techniques: (i) longitudinal venorrhaphy (LV, n = 17); (ii) transverse venorrhaphy (TV, n = 9); (iii) primary end-to-end (n = 28); (iv) patch venoplasty (PV, n = 17); and (v) interposition graft (IG, n = 19). With a median follow-up of 316 days, thrombosis was observed in 16/90 (18%). The rate of thrombosis varied according to technique. All patients with primary end-to-end or TV remained patent. LV, PV and IG were all associated with significant rates of thrombosis (P = 0.001 versus no thrombosis). Comparing thrombosed to patent, there were no differences with respect to pancreatectomy type, pre-operative knowledge of vein involvement and neoadjuvant therapy. Prophylactic aspirin was used in 69% of the total cohort (66% of patent, 81% of thrombosed) and showed no protective benefit. Conclusions Primary end-to-end and TV have superior patency than the alternatives after PV/SMV resection and should be the preferred techniques for short (<3 cm) reconstructions. PMID:26223388

  11. Puzzles in practice: splenic vein thrombosis.

    PubMed

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  12. Endoscopic vein harvesting: technique, outcomes, concerns & controversies

    PubMed Central

    Sarang, Zubair

    2013-01-01

    The choice of the graft conduit for coronary artery bypass grafting (CABG) has significant implications both in the short- and long-term. The patency of a coronary conduit is closely associated with an uneventful postoperative course, better long-term patient survival and superior freedom from re-intervention. The internal mammary artery is regarded as the primary conduit for CABG patients, given its association with long-term patency and survival. However, long saphenous vein (LSV) continues to be utilized universally as patients presenting for CABG often have multiple coronary territories requiring revascularization. Traditionally, the LSV has been harvested by creating incisions from the ankle up to the groin termed open vein harvesting (OVH). However, such harvesting methods are associated with incisional pain and leg wound infections. In addition, patients find such large incisions to be cosmetically unappealing. These concerns regarding wound morbidity and patient satisfaction led to the emergence of endoscopic vein harvesting (EVH). Published experience comparing OVH with EVH suggests decreased wound related complications, improved patient satisfaction, shorter hospital stay, and reduced postoperative pain at the harvest site following EVH. Despite these reported advantages concerns regarding risk of injury at the time of harvest with its potential detrimental effect on vein graft patency and clinical outcomes have prevented universal adoption of EVH. This review article provides a detailed insight into the technical aspects, outcomes, concerns, and controversies associated with EVH. PMID:24251019

  13. Normal variants of the accessory hemiazygos vein

    PubMed Central

    Blackmon, J M; Franco, A

    2011-01-01

    This short communication describes two normal variants of the accessory hemiazygous vein in a 15-year-old female. The article demonstrates that knowledge of the aberrant venous anatomy and the collateral pathway is important for the practising radiologist. PMID:21697414

  14. Puzzles in practice: splenic vein thrombosis.

    PubMed

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology. PMID:27157637

  15. [Two cases of toxic hepatitis caused by arrowroot juice].

    PubMed

    Kim, Seung Young; Yim, Hyung Joon; Ahn, Jae Hong; Kim, Jeong Han; Kim, Jin Nam; Yoon, Ik; Kim, Dong Il; Lee, Hong Sik; Lee, Sang Woo; Choi, Jai Hyun

    2009-12-01

    Herbal remedies and health foods are widely used, and their side effects have been reported. We describe two cases of symptomatic toxic hepatitis that developed in middle-aged women after ingesting arrowroot juice. The clinical manifestations were nausea, vomiting, and jaundice. The diagnosis of toxic hepatitis was made using the Roussel Uclaf Causality Assessment Method score on the basis of the patient's history and laboratory data. After supportive care, the patients showed rapid improvements of clinical symptoms, laboratory findings, and liver stiffness. Clinicians should be aware that the consumption of arrowroot juice can cause toxic hepatitis. PMID:20037269

  16. [Two cases of toxic hepatitis caused by arrowroot juice].

    PubMed

    Kim, Seung Young; Yim, Hyung Joon; Ahn, Jae Hong; Kim, Jeong Han; Kim, Jin Nam; Yoon, Ik; Kim, Dong Il; Lee, Hong Sik; Lee, Sang Woo; Choi, Jai Hyun

    2009-12-01

    Herbal remedies and health foods are widely used, and their side effects have been reported. We describe two cases of symptomatic toxic hepatitis that developed in middle-aged women after ingesting arrowroot juice. The clinical manifestations were nausea, vomiting, and jaundice. The diagnosis of toxic hepatitis was made using the Roussel Uclaf Causality Assessment Method score on the basis of the patient's history and laboratory data. After supportive care, the patients showed rapid improvements of clinical symptoms, laboratory findings, and liver stiffness. Clinicians should be aware that the consumption of arrowroot juice can cause toxic hepatitis.

  17. Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver.

    PubMed

    de Leede, Eleonora M; Burgmans, Mark C; Martini, Christian H; Tijl, Fred G J; van Erkel, Arian R; Vuyk, Jaap; Kapiteijn, Ellen; Verhoef, Cornelis; van de Velde, Cornelis J H; Vahrmeijer, Alexander L

    2016-01-01

    Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn unresectable metastases into resectable ones. Some patients however, suffer from side effects or progression under systemic treatment. For patients with metastasized uveal melanoma there are no standard systemic therapy options. For patients without extrahepatic disease, isolated liver perfusion (IHP) may enable local disease control with limited systemic side effects. Previously, this was performed during open surgery with satisfying results, but morbidity and mortality related to the open procedure, prohibited a widespread application. Therefore, percutaneous hepatic perfusion (PHP) with simultaneous chemofiltration was developed. Besides decreasing morbidity and mortality, this procedure can be repeated, hopefully leading to a higher response rate and improved survival (by local control of disease). During PHP, catheters are placed in the proper hepatic artery, to infuse the chemotherapeutic agent, and in the inferior caval vein to aspirate the chemosaturated blood returning through the hepatic veins. The caval vein catheter is a double balloon catheter that prohibits leakage into the systemic circulation. The blood returning from the hepatic veins is aspirated through the catheter fenestrations and then perfused through an extra-corporeal filtration system. After filtration, the blood is returned to the patient by a third catheter in the right internal jugular vein. During PHP a high dose of melphalan is infused into the liver, which is toxic and would lead to life threatening complications when administered systemically. Because of the significant hemodynamic instability resulting from the combination of caval vein occlusion and chemofiltration, hemodynamic monitoring and hemodynamic support is of paramount importance during this complex procedure. PMID:27501370

  18. Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver.

    PubMed

    de Leede, Eleonora M; Burgmans, Mark C; Martini, Christian H; Tijl, Fred G J; van Erkel, Arian R; Vuyk, Jaap; Kapiteijn, Ellen; Verhoef, Cornelis; van de Velde, Cornelis J H; Vahrmeijer, Alexander L

    2016-07-31

    Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn unresectable metastases into resectable ones. Some patients however, suffer from side effects or progression under systemic treatment. For patients with metastasized uveal melanoma there are no standard systemic therapy options. For patients without extrahepatic disease, isolated liver perfusion (IHP) may enable local disease control with limited systemic side effects. Previously, this was performed during open surgery with satisfying results, but morbidity and mortality related to the open procedure, prohibited a widespread application. Therefore, percutaneous hepatic perfusion (PHP) with simultaneous chemofiltration was developed. Besides decreasing morbidity and mortality, this procedure can be repeated, hopefully leading to a higher response rate and improved survival (by local control of disease). During PHP, catheters are placed in the proper hepatic artery, to infuse the chemotherapeutic agent, and in the inferior caval vein to aspirate the chemosaturated blood returning through the hepatic veins. The caval vein catheter is a double balloon catheter that prohibits leakage into the systemic circulation. The blood returning from the hepatic veins is aspirated through the catheter fenestrations and then perfused through an extra-corporeal filtration system. After filtration, the blood is returned to the patient by a third catheter in the right internal jugular vein. During PHP a high dose of melphalan is infused into the liver, which is toxic and would lead to life threatening complications when administered systemically. Because of the significant hemodynamic instability resulting from the combination of caval vein occlusion and chemofiltration, hemodynamic monitoring and hemodynamic support is of paramount importance during this complex procedure.

  19. Varicose Veins: Role of Mechanotransduction of Venous Hypertension

    PubMed Central

    Atta, Hussein M.

    2012-01-01

    Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

  20. Percutaneous Transhepatic Portography for the Treatment of Early Portal Vein Thrombosis After Surgery

    SciTech Connect

    Adani, Gian Luigi Baccarani, Umberto; Risaliti, Andrea; Sponza, Massimo; Gasparini, Daniele; Bresadola, Fabrizio; Anna, Dino de; Bresadola, Vittorio

    2007-11-15

    We treated three cases of early portal vein thrombosis (PVT) by minimally invasive percutaneous transhepatic portography. All patients developed PVT within 30 days of major hepatic surgery (one case each of orthotopic liver transplantation, splenectomy in a previous liver transplant recipient, and right extended hepatectomy with resection and reconstruction of the left branch of the portal vein for tumor infiltration). In all cases minimally invasive percutaneous transhepatic portography was adopted to treat this complication by mechanical fragmentation and pharmacological lysis of the thrombus. A vascular stent was also positioned in the two cases in which the thrombosis was related to a surgical technical problem. Mechanical fragmentation of the thrombus with contemporaneous local urokinase administration resulted in complete removal of the clot and allowed restoration of normal blood flow to the liver after a median follow-up of 37 months. PVT is an uncommon but severe complication after major surgery or liver transplantation. Surgical thrombectomy, with or without reconstruction of the portal vein, and retransplantation are characterized by important surgical morbidity and mortality. Based on our experience, minimally invasive percutaneous transhepatic portography should be considered an option toward successful recanalization of early PVT after major liver surgery including transplantation. Balloon dilatation and placement of a vascular stent could help to decrease the risk of recurrent thrombosis when a defective surgical technique is the reason for the thrombosis.

  1. Increased expression of hepatic pyruvate dehydrogenase kinases 2 and 4 in young and middle-aged Otsuka Long-Evans Tokushima Fatty rats: induction by elevated levels of free fatty acids.

    PubMed

    Bajotto, Gustavo; Murakami, Taro; Nagasaki, Masaru; Qin, Bolin; Matsuo, Yoshiyuki; Maeda, Ken; Ohashi, Masayo; Oshida, Yoshiharu; Sato, Yuzo; Shimomura, Yoshiharu

    2006-03-01

    The activity of the pyruvate dehydrogenase complex (PDC) is regulated by covalent modification of its E1 component, which is catalyzed by specific pyruvate dehydrogenase kinases (PDKs) and phosphatases. In the liver, PDK2 and PDK4 are the most abundant PDK isoforms, which are responsible for inactivation of PDC when glucose availability is scarce in the body. In the present study, regulatory mechanisms of hepatic PDC were examined before and after the onset of type 2 diabetes mellitus in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, using Long-Evans Tokushima Otsuka (LETO) rats as controls. Plasma glucose and insulin concentrations were at normal levels in rats aged 8 weeks, but were significantly higher in OLETF than in LETO rats aged 25 weeks, indicating insulin resistance in OLETF rats. Plasma free fatty acids (FFAs) were 1.6-fold concentrated, and the liver PDC activity was significantly lower in OLETF than in LETO rats at both ages, suggesting suppression of pyruvate oxidative decarboxylation in OLETF rats before and after the onset of diabetes. Pyruvate dehydrogenase kinase activity and abundance of PDK2 and PDK4 proteins, as well as mRNAs, were greater in OLETF rats at both ages. These results suggest that persistently elevated levels of circulating free fatty acid in normal and diabetic OLETF rats play an important role in stimulating PDK2 and PDK4 expression in liver. PMID:16483874

  2. The impact of hepatic pressurization on liver shear wave speed estimates in constrained versus unconstrained conditions

    NASA Astrophysics Data System (ADS)

    Rotemberg, V.; Palmeri, M.; Nightingale, R.; Rouze, N.; Nightingale, K.

    2012-01-01

    Increased hepatic venous pressure can be observed in patients with advanced liver disease and congestive heart failure. This elevated portal pressure also leads to variation in acoustic radiation-force-derived shear wave-based liver stiffness estimates. These changes in stiffness metrics with hepatic interstitial pressure may confound stiffness-based predictions of liver fibrosis stage. The underlying mechanism for this observed stiffening behavior with pressurization is not well understood and is not explained with commonly used linear elastic mechanical models. An experiment was designed to determine whether the stiffness increase exhibited with hepatic pressurization results from a strain-dependent hyperelastic behavior. Six excised canine livers were subjected to variations in interstitial pressure through cannulation of the portal vein and closure of the hepatic artery and hepatic vein under constrained conditions (in which the liver was not free to expand) and unconstrained conditions. Radiation-force-derived shear wave speed estimates were obtained and correlated with pressure. Estimates of hepatic shear stiffness increased with changes in interstitial pressure over a physiologically relevant range of pressures (0-35 mmHg) from 1.5 to 3.5 m s-1. These increases were observed only under conditions in which the liver was free to expand while pressurized. This behavior is consistent with hyperelastic nonlinear material models that could be used in the future to explore methods for estimating hepatic interstitial pressure noninvasively.

  3. Reconstruction of portal vein and superior mesenteric vein after extensive resection for pancreatic cancer

    PubMed Central

    Kim, Suh Min; Park, Daedo; Min, Sang-Il; Jang, Jin-Young; Kim, Sun-Whe; Ha, Jongwon; Kim, Sang Joon

    2013-01-01

    Purpose Tumor invasion to the portal vein (PV) or superior mesenteric vein (SMV) can be encountered during the surgery for pancreatic cancer. Venous reconstruction is required, but the optimal surgical methods and conduits remain in controversies. Methods From January 2007 to July 2012, 16 venous reconstructions were performed during surgery for pancreatic cancer in 14 patients. We analyzed the methods, conduits, graft patency, and patient survival. Results The involved veins were 14 SMVs and 2 PVs. The operative methods included resection and end-to-end anastomosis in 7 patients, wedge resection with venoplasty in 2 patients, bovine patch repair in 3 patients, and interposition graft with bovine patch in 1 patient. In one patient with a failed interposition graft with great saphenous vein (GSV), the SMV was reconstructed with a prosthetic interposition graft, which was revised with a spiral graft of GSV. Vascular morbidity occurred in 4 cases; occlusion of an interposition graft with GSV or polytetrafluoroethylene, segmental thrombosis and stenosis of the SMV after end-to-end anastomosis. Patency was maintained in patients with bovine patch angioplasty and spiral vein grafts. With mean follow-up of 9.8 months, the 6- and 12-month death-censored graft survival rates were both 81.3%. Conclusion Many of the involved vein segments were repaired primarily. When tension-free anastomosis is impossible, the spiral grafts with GSV or bovine patch grafts are good options to overcome the size mismatch between autologous vein graft and portomesenteric veins. Further follow-up of these patients is needed to demonstrate long-term patency. PMID:23741692

  4. Hepatic abscesses

    PubMed Central

    Rajagopalan, S.; Langer, V.

    2012-01-01

    Hepatic abscesses are potentially lethal diseases if early diagnosis and treatment are not instituted. They are prevalent all over the globe and pyogenic abscesses are predominant over amoebic. With better control of intra abdominal and systemic infections by a spectrum of antibiotics, aetiology of pyogenic abscesses are secondary to interventions and diseases in the biliary tree to a large extent today. The common organisms isolated are the Gram negative group. Amoebic abscesses continue to plague some regions of the world where hygiene and sanitation are questionable. Over the years, diagnosis, treatment and prognosis have evolved remarkably. Imaging modalities like ultrasonography and CT scan have become the cornerstone of diagnosis. The absence of ionizing radiation makes MRI an attractive alternative in patients who require multiple follow up scans. Serological testing in amoebic abscesses has become more reliable. Though antibiotics have remained the principal modality of management, percutaneous drainage of abscesses have vastly improved the chances of cure and bring down the morbidity drastically in pyogenic abscesses. Amoebic abscesses respond well to medical treatment with nitroimidazoles, and minimally invasive surgical drainage is an option in cases where open surgery is indicated. PMID:24532886

  5. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  6. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  7. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  8. Venous thrombosis in subclavian, axillary, brachial veins with extension to internal jugular vein, right sigmoid sinus and simultaneous pulmonary embolism

    PubMed Central

    Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam

    2013-01-01

    We present a rare case of Venous Thrombosis in Subclavian, Axillary, Brachial Veins with extension to Internal Jugular vein, right sigmoid sinus and simultaneous Pulmonary embolism during the treatment with low molecular weight heparin. PMID:23901341

  9. Budd-Chiari Syndrome in a Patient with Hepatitis C.

    PubMed

    Frankl, Joseph; Hennemeyer, Charles; Flores, Michael S; Desai, Archita P

    2016-01-01

    Chronic Budd-Chiari syndrome can present with cirrhosis and signs and symptoms similar to those of other chronic liver diseases. We present a case of Budd-Chiari syndrome discovered during attempted transjugular intrahepatic portosystemic shunting in a patient with decompensated cirrhosis believed to be secondary to hepatitis C. Although the patient had hepatocellular carcinoma, the Budd-Chiari syndrome was a primary disease due to hepatic venous webs. Angioplasty was performed in this case, which resolved the patient's symptoms related to portal hypertension. Follow-up venography 5 months after angioplasty demonstrated continued patency of the hepatic veins. A biopsy was obtained in the same setting, which showed centrilobular fibrosis indicating that venous occlusion was indeed the cause of cirrhosis. It is important to consider a second disease when treating a patient with difficult to manage portal hypertension. PMID:27525135

  10. Budd-Chiari Syndrome in a Patient with Hepatitis C

    PubMed Central

    Hennemeyer, Charles; Flores, Michael S.

    2016-01-01

    Chronic Budd-Chiari syndrome can present with cirrhosis and signs and symptoms similar to those of other chronic liver diseases. We present a case of Budd-Chiari syndrome discovered during attempted transjugular intrahepatic portosystemic shunting in a patient with decompensated cirrhosis believed to be secondary to hepatitis C. Although the patient had hepatocellular carcinoma, the Budd-Chiari syndrome was a primary disease due to hepatic venous webs. Angioplasty was performed in this case, which resolved the patient's symptoms related to portal hypertension. Follow-up venography 5 months after angioplasty demonstrated continued patency of the hepatic veins. A biopsy was obtained in the same setting, which showed centrilobular fibrosis indicating that venous occlusion was indeed the cause of cirrhosis. It is important to consider a second disease when treating a patient with difficult to manage portal hypertension. PMID:27525135

  11. Rupture of a hepatic artery aneurysm caused by Wegener's granulomatosis.

    PubMed

    den Bakker, M A; Tangkau, P L; Steffens, T W; Tjiam, S L; van der Loo, E M

    1997-01-01

    Among vasculitis syndromes Wegener's granulomatosis (WG) is characterized by involvement of the upper and lower airways and kidneys. The associated vasculitis involves small and medium sized arteries and veins. Aneurysm formation and a segmental pattern of involvement of larger arteries is not typically seen in WG--a presentation more in keeping with polyarteritis nodosa. We report on a patient hospitalized with classical manifestations of WG who died suddenly of hypovolemic shock caused by intraperitoneal hemorrhage resulting from rupture of a hepatic artery aneurysm. The aneurysm was caused by involvement of the hepatic artery in the disease process. To our knowledge aneurysmatic dilatation of the hepatic artery due to WG has not been previously described. This case illustrates an unusual disease course in WG and the overlap which exists in classical vasculitis syndromes.

  12. Hepatitis A - children

    MedlinePlus

    ... hepatitis A. Children can get hepatitis A at day care center from other children or from child care ... treatment with immunoglobulin therapy. If your child attends day care: Make sure the children and staff at the ...

  13. Hepatitis B Test

    MedlinePlus

    ... IgM; anti-HBe; Hepatitis B e Antibody; HBV DNA Formal name: Hepatitis B Virus Testing Related tests: ... produced by the virus, and others detect viral DNA . The main uses for HBV tests include: To ...

  14. Hepatitis C (image)

    MedlinePlus

    Hepatitis C is a virus-caused liver inflammation which may cause jaundice, fever and cirrhosis. Persons who are most at risk for contracting and spreading hepatitis C are those who share needles for injecting drugs ...

  15. First jejunal artery, an alternative graft for right hepatic artery reconstruction.

    PubMed

    Aryal, Bibek; Komokata, Teruo; Kadono, Jun; Motodaka, Hiroyuki; Ueno, Tetsuya; Furoi, Akira; Imoto, Yutaka

    2015-04-01

    Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.

  16. Retinal vein-to-vein anastomoses in Sturge-Weber syndrome documented by ultra-widefield fluorescein angiography.

    PubMed

    Quan, Ann V; Moore, Grant H; Tsui, Irena

    2015-06-01

    We report the case of a 6-year-old boy with Sturge-Weber syndrome and unilateral glaucoma in his left eye. He was born with a port wine mark involving his upper left eyelid. On ultra-widefield fluorescein angiography, he was found to have several vein-to-vein anastomoses in his left retina. To our knowledge, this is the first documentation of retinal vein-to-vein anastomoses in Sturge-Weber syndrome. PMID:25944745

  17. Integrating bio-prosthetic valves in the Fontan operation - Novel treatment to control retrograde flow in caval veins

    NASA Astrophysics Data System (ADS)

    Vukicevic, Marija; Conover, Timothy; Zhou, Jian; Hsia, Tain-Yen; Figliola, Richard

    2012-11-01

    For a child born with only one functional heart ventricle, the sequence of palliative surgeries typically culminates in the Fontan operation. This procedure is usually successful initially, but leads to later complications, for reasons not fully understood. Examples are respiratory-dependent retrograde flows in the caval and hepatic veins, and increased pulmonary vascular resistance (PVR), hypothesized to be responsible for elevated pressure in the liver and disease of the liver and intestines. Here we study the parameters responsible for retrograde flows in the inferior vena cava (IVC) and hepatic vein (HV), and investigate two novel interventions to control retrograde flow: implanting either a Medtronic Contegra valved conduit or an Edwards lifescience pericardial aortic valve in the IVC or HV. We performed the experiments in a multi-scale, patient specific mock circuit, with normal and elevated PVR, towards the optimization of the Fontan circulation. The results show that both valves can significantly reduce retrograde flows in the veins, suggesting potential advantages in the treatment of the patients with congenital heart diseases. Fondation Leducq

  18. Isotopic and geologic studies of the veins of the Bowling Green Fault Zone, Ohio, and their genetic implications

    SciTech Connect

    Carlson, E.H. . Dept. of Geology)

    1992-01-01

    The veins of the Bowling Green Fault Zone, a prominent tectonic feature in the eastern Midwest, provide new data on the control of this structure by a zone of basement weakness. The dominant phase of the veins is brown calcite which contains a component of radiogenic strontium that is absent in the vug calcite of the region. These 1--50 cm thick veins occur along the margins of the northerly trending fault zone and occupy steeply dipping extension fractures that strike approximately N40 W. Similar northwest trending extension veins that lack the brown calcite are common elsewhere in the area at sites distanced from the fault. The Sr-87/Sr-86 ratio of the brown calcite is 0.70897 [+-] 2 while those of the Late Silurian host dolostone and vug calcite at Waterville, Ohio, are 0.70861 [+-] 2 and 0.70854 [+-] 2, respectively. Minor pyrite, which coats the walls, and successive layers of solid hydrocarbons and colorless calcite, which line vugs in the veins, allow the broken calcite to be placed in the paragenetic sequence of the region. The vein calcite is both UV fluorescent and cathodoluminescent; minor amounts of manganese are present in this material. The strontium of the brown calcite was derived from the underlying rocks, supporting a genetic link between the Bowling Green Fault and the Grenville Front. The vein calcite postdates the last movement of the Bowling Green Fault and predates the Late Paleozoic hydrocarbons and brine-deposited zinc and lead sulfides that are widespread in the vuggy Silurian and Devonian carbonate rocks of the region. The temporal equivalence of these sulfides and those occurring below along fractures zones in the Middle Ordovician Trenton Limestone is probable, based on the similarity of their parageneses.

  19. A tectonic model for the spatial occurrence of porphyry copper and polymetallic vein deposits - applications to Central Europe

    USGS Publications Warehouse

    Drew, Lawrence J.

    2006-01-01

    A structural-tectonic model, which was developed to assess the occurrence of undiscovered porphyry copper deposits and associated polymetallic vein systems for the Matra Mountains, Hungary, has been expanded here and applied to other parts of central Europe. The model explains how granitoid stocks are emplaced and hydrothermal fluids flow within local strain features (duplexes) within strike-slip fault systems that develop in continental crust above subducting plates. Areas of extension that lack shear at the corners and along the edges of the fault duplexes are structural traps for the granitoid stocks associated with porphyry copper deposits. By contrast, polymetallic vein deposits are emplaced where shear and extension are prevalent in the interior of the duplexes. This model was applied to the Late Cretaceous-age porphyry copper and polymetallic vein deposits in the Banat-Timok-Srednogorie region of Romania-Serbia-Bulgaria and the middle Miocene-age deposits in Romania and Slovakia. In the first area, porphyry copper deposits are most commonly located at the corners, and occasionally along the edges, of strike-slip fault duplexes, and the few polymetallic vein deposits identified are located at interior sites of the duplexes. In the second area, the model accounts for the preferred sites of porphyry copper and polymetallic vein deposits in the Apuseni Mountains (Romania) and central Slovakian volcanic field (Slovakia).

  20. Hepatic artery reinforcement after post pancreatectomy haemorrhage caused by pancreatitis.

    PubMed

    Merdrignac, Aude; Bergeat, Damien; Levi Sandri, Giovanni Battista; Agus, Marina; Boudjema, Karim; Sulpice, Laurent; Meunier, Bernard

    2016-08-01

    Post-pancreatectomy hemorrhage (PPH) is a major complication occurring in 6-8% of patients after pancreaticoduodenectomy (PD). Arterial bleeding is the most frequent cause. Mortality rate could reach 30% after grade C PPH according to ISGPS classification. Complete interruption of hepatic arterial flow has to be a salvage procedure because of the high risk of intrahepatic abscess following the procedure. We report a technique to perform an artery reinforcement after PPH caused by pancreatitis. A PD according to Whipple's procedure with child's reconstruction was performed in a 68-year-old man. At postoperative day 12, the patient presented a sudden violent abdominal pain with arterial hypotension and tachycardia. Computed tomography (CT) with intravenous contrast injection was performed. Arterial and venous phases showed a contrast extravasation on the hepatic artery. Origin of PPH was found as an erosion of hepatic artery caused by pancreatic leak. A peritoneal patch was placed around hepatic artery to reinforce damaged arterial wall. The peritoneal patch was harvested from right hypochondrium with a thin preperitoneal fat layer. The patch was sutured around hepatic artery with musculoaponeurotic face placed on the arterial wall. A CT was performed and hepatic artery was permeable with normal caliber in the portion of peritoneal patch reinforcement. The technique described in the present case consists in reinforcing directly arterial wall after occurrence of PPH. The use of a peritoneal patch during pancreatic surgery has first been described to replace a portion of portal vein after venous resection with the peritoneal layer placed on the intraluminal side of the vein. The present case describes a salvage technique to reinforce damaged artery after PPH in context of pancreatic leak. This simple technique could be useful to avoid complex arterial reconstruction and recurrent bleeding in septic context. PMID:27563565

  1. Hepatic artery reinforcement after post pancreatectomy haemorrhage caused by pancreatitis

    PubMed Central

    Merdrignac, Aude; Bergeat, Damien; Levi Sandri, Giovanni Battista; Agus, Marina; Boudjema, Karim; Sulpice, Laurent

    2016-01-01

    Post-pancreatectomy hemorrhage (PPH) is a major complication occurring in 6–8% of patients after pancreaticoduodenectomy (PD). Arterial bleeding is the most frequent cause. Mortality rate could reach 30% after grade C PPH according to ISGPS classification. Complete interruption of hepatic arterial flow has to be a salvage procedure because of the high risk of intrahepatic abscess following the procedure. We report a technique to perform an artery reinforcement after PPH caused by pancreatitis. A PD according to Whipple’s procedure with child’s reconstruction was performed in a 68-year-old man. At postoperative day 12, the patient presented a sudden violent abdominal pain with arterial hypotension and tachycardia. Computed tomography (CT) with intravenous contrast injection was performed. Arterial and venous phases showed a contrast extravasation on the hepatic artery. Origin of PPH was found as an erosion of hepatic artery caused by pancreatic leak. A peritoneal patch was placed around hepatic artery to reinforce damaged arterial wall. The peritoneal patch was harvested from right hypochondrium with a thin preperitoneal fat layer. The patch was sutured around hepatic artery with musculoaponeurotic face placed on the arterial wall. A CT was performed and hepatic artery was permeable with normal caliber in the portion of peritoneal patch reinforcement. The technique described in the present case consists in reinforcing directly arterial wall after occurrence of PPH. The use of a peritoneal patch during pancreatic surgery has first been described to replace a portion of portal vein after venous resection with the peritoneal layer placed on the intraluminal side of the vein. The present case describes a salvage technique to reinforce damaged artery after PPH in context of pancreatic leak. This simple technique could be useful to avoid complex arterial reconstruction and recurrent bleeding in septic context. PMID:27563565

  2. Hemodynamic changes in the hepatic circulation after the modulation of the splenic circulation in an in vivo human experimental model.

    PubMed

    Akamatsu, Nobuhisa; Sugawara, Yasuhiko; Satou, Shouichi; Mitsui, Tetsuya; Ninomiya, Riki; Komagome, Masahiko; Ozawa, Fumiaki; Beck, Yoshifumi

    2014-01-01

    Recent advances in liver surgery have highlighted the effects of the splenic circulation on the hepatic circulation with respect to the hepatic arterial buffer response (HABR). The aim of the present study was to investigate the actual hemodynamic effects of splenic artery embolization/ligation and splenectomy on the hepatic circulation in patients who underwent pancreaticoduodenectomy through in vivo experimental models. In vivo models of splenic artery embolization/ligation (only splenic artery clamping) and splenectomy (simultaneous clamping of both the splenic artery and the splenic vein) were created in 40 patients who underwent pancreaticoduodenectomy for various reasons. The portal venous flow velocity, the portal venous flow volume, the hepatic arterial flow velocity, and the hepatic arterial resistance index were measured with color Doppler ultrasonography. Clamping of the splenic artery induced an immediate and significant increase (16%) in the hepatic artery velocity (P < 0.001), and the portal venous flow also decreased significantly (10%, P = 0.03). Fifteen minutes after the clamping of the splenic artery, the hepatic artery velocity remained significantly increased at the level of the initial clamping, and the portal venous flow significantly decreased (16%, P < 0.001). Clamping of the splenic vein, which was performed after the clamping of the splenic artery, resulted in an immediate and significant decrease (30%) in the portal venous flow (P < 0.001), but the hepatic arterial flow was not affected. Fifteen minutes after the clamping of the splenic vein, there was no change in the portal flow, which remained significantly lower (28%) than the flow in controls, whereas the hepatic arterial flow further significantly increased (31%, P < 0.001). In conclusion, our findings indicate that both splenic artery embolization/ligation and splenectomy are effective for increasing hepatic arterial flow and decreasing portal flow, with splenectomy providing a

  3. Transcutaneous laser treatment of leg veins.

    PubMed

    Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C

    2014-03-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption

  4. Hepatitis E Pathogenesis

    PubMed Central

    Lhomme, Sébastien; Marion, Olivier; Abravanel, Florence; Chapuy-Regaud, Sabine; Kamar, Nassim; Izopet, Jacques

    2016-01-01

    Although most hepatitis E virus (HEV) infections are asymptomatic, some can be severe, causing fulminant hepatitis and extra-hepatic manifestations, including neurological and kidney injuries. Chronic HEV infections may also occur in immunocompromised patients. This review describes how our understanding of the pathogenesis of HEV infection has progressed in recent years. PMID:27527210

  5. Hepatitis B (HBV)

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Hepatitis B (HBV) KidsHealth > For Teens > Hepatitis B (HBV) Print A A A Text Size ... Prevented? How Is It Treated? What Is It? Hepatitis (pronounced: hep-uh-TIE-tiss) is a disease ...

  6. Hepatitis E Pathogenesis.

    PubMed

    Lhomme, Sébastien; Marion, Olivier; Abravanel, Florence; Chapuy-Regaud, Sabine; Kamar, Nassim; Izopet, Jacques

    2016-01-01

    Although most hepatitis E virus (HEV) infections are asymptomatic, some can be severe, causing fulminant hepatitis and extra-hepatic manifestations, including neurological and kidney injuries. Chronic HEV infections may also occur in immunocompromised patients. This review describes how our understanding of the pathogenesis of HEV infection has progressed in recent years. PMID:27527210

  7. Biometric Authentication Using Infrared Imaging of Hand Vein Patterns

    NASA Astrophysics Data System (ADS)

    Bhattacharyya, Debnath; Shrotri, A.; Rethrekar, S. C.; Patil, M. H.; Alisherov, Farkhod A.; Kim, Tai-Hoon

    Hand vein patterns are unique and universal. Vein pattern is used as biometric feature in recent years. But, it is not very much popular biometric system as compared to other systems like fingerprint, iris etc, because of the higher cost. For conventional algorithm, it is necessary to use high quality images, which demand high-priced collection devices. There are two approaches for vein authentication, these are hand dorsa and hand ventral. Currently we are working on hand dorsa vein patterns. Here we are putting forward the new approach for low cost hand dorsa vein pattern acquisition using low cost device and proposing a algorithm to extract features from these low quality images.

  8. Direct Superficial Temporal Vein Approach for Dural Carotid Cavernous Fistula

    PubMed Central

    Matsubara, S.; Kazekawa, K.; Aikawa, H.; Onizuka, M.; Tsutsumi, M.; Ikou, M.; Kodama, T.; Nii, K.; Nagata, S.; Tanaka, A.

    2007-01-01

    Summary We present an alternative endovascular approach to treat dural carotid cavernous fistulae (dural CCF) that drain only into the superior ophthalmic vein. Four cases of cavernous dural AVFs that could not be treated via the inferior petrosal vein were accessed via the direct superficial temporal vein approach through the superior ophthalmic vein. Successful embolization was documented radiographically and clinically in all patients. The trans-superficial temporal vein approach is safe and useful for inaccessible dural CCFs through the inferior petrosal sinus. PMID:20566079

  9. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis.

    PubMed

    Fremed, Daniel I; Faries, Peter L; Schanzer, Harry R; Marin, Michael L; Ting, Windsor

    2014-12-01

    Only a small number of venous leiomyosarcomas have been previously reported. Of these tumors, those of saphenous origin comprise a minority of cases. A 59-year-old man presented with symptoms of deep vein thrombosis and was eventually diagnosed with primary leiomyosarcoma of great saphenous vein origin. The tumor was treated with primary resection and femoral vein reconstruction with autologous patch. Although extremely rare, saphenous leiomyosarcoma can present as deep vein thrombosis. Vascular tumors should be included in the differential diagnosis of atypical extremity swelling refractory to conventional deep vein thrombosis management.

  10. Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru

    NASA Astrophysics Data System (ADS)

    Chauvet, Alain; Bailly, Laurent; André, Anne-Sylvie; Monié, Patrick; Cassard, Daniel; Tajada, Fernando Llosa; Vargas, Juan Rosas; Tuduri, Johann

    2006-07-01

    The epithermal Shila-Paula Au-Ag district is characterized by numerous veins hosted in Tertiary volcanic rocks of the Western Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E-W vein with secondary N55-60°W veins—two directions that are also reflected by the orientation of fluid-inclusion planes in quartz crystals of the host rock. In areas where this pattern is not recognized, such as the Apacheta sector, vein emplacement seems to have been guided by regional N40°E and N40°W fractures. Two main vein-filling stages are identified. stage 1 is a quartz-adularia-pyrite-galena-sphalerite-chalcopyrite-electrum-Mn silicate-carbonate assemblage that fills the main E-W veins. stage 2, which contains most of the precious-metal mineralization, is divided into pre-bonanza and bonanza substages. The pre-bonanza substage consists of a quartz-adularia-carbonate assemblage that is observed within the secondary N45-60°W veins, in veinlets that cut the stage 1 assemblage, and in final open-space fillings. The two latter structures are finally filled by the bonanza substage characterized by a Fe-poor sphalerite-chalcopyrite-pyrite-galena-tennantite-tetrahedrite-polybasite-pearceite-electrum assemblage. The ore in the main veins is systematically brecciated, whereas the ore in the secondary veins and geodes is characteristic of open-space crystallization. Microthermometric measurements on sphalerite from both stages and on quartz and calcite from stage 2 indicate a salinity range of 0 to 15.5 wt% NaCl equivalent and homogenization temperatures bracketed between 200 and 330°C. Secondary CO2-, N2- and H2S-bearing fluid inclusions are also identified. The age of vein emplacement, based on 40Ar/39Ar ages obtained on adularia of different veins, is estimated at around 11 Ma, with some overlap between adularia of stage 1 (11.4±0.4 Ma) and of stage 2 (10.8±0.3 Ma). A three-phase tectonic model has been constructed to explain the

  11. Successful Portal Vein Stent Placement in a Child with Cavernomatous Replacement of the Portal Vein After Partial Liver Transplantation: The Importance of a Recognizable Portal Vein Remnant.

    PubMed

    Miraglia, Roberto; Maruzzelli, Luigi; Caruso, Settimo; Ricotta, Calogero; Riva, Silvia; Burgio, Gaetano; Spada, Marco; Luca, Angelo

    2015-12-01

    Late portal vein thrombosis with cavernomatous replacement has been reported in 4.5% of pediatric patients who have undergone partial liver transplantation. In such cases, minimally invasive radiological treatments have a high failure rate. We report a successful case of percutaneous recanalization of the portal vein remnant, and subsequent stent placement, in a pediatric patient who underwent left lateral split liver transplantation with cavernomatous replacement of the portal vein. PMID:25809240

  12. Role of leucine in hepatic ketogenesis

    SciTech Connect

    Kulaylat, M.N.; Frexes-Steed, M.; Geer, R.; Williams, P.E.; Abumrad, N.N.

    1988-03-01

    Isolated hepatocyte studies demonstrated that leucine can be a precursor of ketone bodies. In this study we examine the relative contribution of leucine to hepatic ketogenesis in vivo. Three groups of conscious dogs with long-term indwelling catheters in the femoral artery, hepatic vein, and portal vein were studied. Group I (n = 3) animals were fasted overnight for 24 hours, and those in groups II and III (n = 4, each) were fasted for 62 to 68 hours (designated 3-day fast). Groups I and III received intravenous saline solution (0.9%) and served as controls. In group II selective acute insulin deficiency (SAID) was induced by a peripheral intravenous somatostatin (SRIF) infusion and intraportal glucagon (0.55 ng/body weight/min). Net hepatic production (NHP) of ketone bodies (kb) and leucine (leu) was measured by the arteriovenous difference technique. Hepatic conversion of leucine to ketone bodies was measured by continuous infusion of L-U-(/sup 14/C)-leucine and by determination of the appearance of (/sup 14/C)-ketone bodies across the liver. In the group fasted overnight NHPleu was 0.02 +/- 0.01 mumol/kg/min, a value not different from zero. NHPkb was 3.1 +/- 0.1 mumol/kg/min and hepatic conversion of leucine to ketone bodies accounted for 3.5% of NHPkb. Insulin deficiency after 3 day's fasting resulted in a near 70% increase in NHPleu (from basal values of 0.31 +/- 0.1 mumol/kg/min to 0.52 +/- 0.06 mumol/kg/min during SAID, p less than 0.01). NHPkb increased from 11.0 +/- 1.0 to 15.5 mumol/kg/min (p less than 0.05). The rate of leucine conversion to ketone bodies (L-C) increased from 1.1 +/- 0.25 to 2.4 +/- 0.3 mumol/kg/min (p less than 0.01) with SAID.

  13. Quantification of Hepatic Vascular and Parenchymal Regeneration in Mice

    PubMed Central

    Xie, Chichi; Schwen, Lars Ole; Wei, Weiwei; Schenk, Andrea; Zafarnia, Sara; Gremse, Felix; Dahmen, Uta

    2016-01-01

    Background Liver regeneration consists of cellular proliferation leading to parenchymal and vascular growth. This study complements previous studies on cellular proliferation and weight recovery by (1) quantitatively describing parenchymal and vascular regeneration, and (2) determining their relationship. Both together are needed to (3) characterize the underlying growth pattern. Methods Specimens were created by injecting a polymerizing contrast agent in either portal or hepatic vein in normal or regenerating livers after 70% partial hepatectomy. 3D image data were obtained through micro-CT scanning. Parenchymal growth was assessed by determining weight and volume of the regenerating liver. Vascular growth was described by manually determined circumscribed parameters (maximal vessel length and radius of right inferior portal/hepatic vein), automatically determined cumulative parameters (total edge length and total vascular volume), and parameters describing vascular density (total edge length/volume, vascular volume fraction). The growth pattern was explored by comparing the relative increase of these parameters to the increase expected in case of isotropic expansion. Results Liver volume recovery paralleled weight recovery and reached 90% of the original liver volume within 7 days. Comparing radius-related vascular parameters immediately after surgical resection and after virtual resection in-silico revealed a slight increase, possibly reflecting the effect of resection-induced portal hyperperfusion. Comparing length-related parameters between post-operative day 7 and after virtual resection showed similar vascular growth in both vascular systems investigated. In contrast, radius-related parameters increased slightly more in the portal vein. Despite the seemingly homogeneous 3D growth, the observed vascular parameters were not compatible with the hypothesis of isotropic expansion of liver parenchyma and vascular structures. Conclusion We present an approach for

  14. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  15. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

  16. Augmented reality based real-time subcutaneous vein imaging system

    PubMed Central

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  17. Finger vein extraction using gradient normalization and principal curvature

    NASA Astrophysics Data System (ADS)

    Choi, Joon Hwan; Song, Wonseok; Kim, Taejeong; Lee, Seung-Rae; Kim, Hee Chan

    2009-02-01

    Finger vein authentication is a personal identification technology using finger vein images acquired by infrared imaging. It is one of the newest technologies in biometrics. Its main advantage over other biometrics is the low risk of forgery or theft, due to the fact that finger veins are not normally visible to others. Extracting finger vein patterns from infrared images is the most difficult part in finger vein authentication. Uneven illumination, varying tissues and bones, and changes in the physical conditions and the blood flow make the thickness and brightness of the same vein different in each acquisition. Accordingly, extracting finger veins at their accurate positions regardless of their thickness and brightness is necessary for accurate personal identification. For this purpose, we propose a new finger vein extraction method which is composed of gradient normalization, principal curvature calculation, and binarization. As local brightness variation has little effect on the curvature and as gradient normalization makes the curvature fairly uniform at vein pixels, our method effectively extracts finger vein patterns regardless of the vein thickness or brightness. In our experiment, the proposed method showed notable improvement as compared with the existing methods.

  18. Clinical evaluation of vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Zeman, Herbert D.

    2002-05-01

    A clinical study is underway to compare an experimental infrared (IR) device, OnTarget OnTarget at LeBonheur Children's Medical Center, Methodist Healthcare, in Memphis, TN, while the adult study site is the clinical research center at Bowld Hospital, also in Memphis, TN. Early results on 35 pediatric and 25 adult subjects indicate that OnTarget years' experience in accessing veins in pediatric subjects, and that it could be very helpful to a phlebotomist with limited experience when accessing veins in both adult and pediatric subjects. The study uses monitor based OnTarget area of the patients anatomy enlarged and contrast enhanced on a LCD monitor. The phlebotomist can then compare the OnTarget or feel when examining a subject.

  19. Ovarian vein thrombosis in a polytrauma patient.

    PubMed

    Toman, Emma; Beaven, Alastair; Balogun, Moji; Porter, Keith

    2015-12-18

    A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein. CT of the abdomen 1 week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries. A multidisciplinary, consultant-led plan was made to slowly increase enoxaparin to a therapeutic dose under close surveillance and to then switch to warfarin following an outpatient consultation with a consultant haematologist. A MR venogram was performed after 3 months of anticoagulation, and this demonstrated complete resolution of the OVT and normal appearances of the ovary.

  20. Emergency intravenous access through the femoral vein.

    PubMed

    Swanson, R S; Uhlig, P N; Gross, P L; McCabe, C J

    1984-04-01

    A study was undertaken to assess the efficacy and safety of femoral venous catheterization for resuscitation of critically ill patients in the emergency department setting. From May 1982 to April 1983, 100 attempts were made at percutaneous insertion of a large-bore catheter into the femoral veins of patients presenting to our emergency department in cardiac arrest or requiring rapid fluid resuscitation. Eighty-nine attempts were successful. Insertion was generally considered easy, and flow rates were excellent. The only noted complications were four arterial punctures and one minor groin hematoma. This study suggests that short-term percutaneous catheterization of the femoral vein provides rapid, safe, and effective intravenous access. PMID:6703430

  1. Deep dorsal vein arterialisation in vascular impotence.

    PubMed

    Wespes, E; Corbusier, A; Delcour, C; Vandenbosch, G; Struyven, J; Schulman, C C

    1989-11-01

    A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

  2. [Treatment of renal vein thrombosis associated with nephrotic syndrome].

    PubMed

    Funami, M; Takaba, T; Tanaka, H; Murakami, A; Kadokura, M; Hori, G; Ishii, J

    1988-06-01

    Renal vein thrombosis is a rare entity in which true incidence is unknown. The disease occurs most frequently in patients with nephrotic syndrome, but it also can occur in the presence of other hypercoagulable state. Two cases of renal vein thrombosis with nephrotic syndrome which were treated by thrombectomy are reported here. One patient was successfully treated by renal vein and inferior vena cava thrombectomy before developing severe pulmonary embolism. The other was treated by renal vein thrombectomy by which fatal shock was able to be prevented. In those cases, immediate operation was indicated, primarily to prevent additional, possibly fatal, pulmonary embolism and also to improve perfusion of the kidney. In the hope of salvaging the kidney, thrombectomy may be the treatment of choice for acute renal vein thrombosis, complication of pulmonary embolism and inferior vena cava thrombosis, right renal vein thrombosis without collateral flow and acute renal vein thrombosis with shock.

  3. [How to do: central vein catheterization].

    PubMed

    Allgäuer, Sebastian

    2016-03-01

    The cannulation of a central vein is a standard acces to the vascular system of critically ill patients. It can be used for administration of medication and parenteral nutrition, haemodynamic monitoring as well as hemodialsis via Shaldon catheter.The technique of implantation of a central venous catheter is described step by step in this article. Moreover, advantages and disadvantages of the different techniques and puncture sites as well as indications and contraindications are critically discussed regarding the most recent literature.

  4. Brucellosis Associated with Deep Vein Thrombosis

    PubMed Central

    Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah

    2014-01-01

    Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg. PMID:25568754

  5. Pathogenesis of Hepatic Encephalopathy

    PubMed Central

    Ciećko-Michalska, Irena; Szczepanek, Małgorzata; Słowik, Agnieszka; Mach, Tomasz

    2012-01-01

    Hepatic encephalopathy can be a serious complication of acute liver failure and chronic liver diseases, predominantly liver cirrhosis. Hyperammonemia plays the most important role in the pathogenesis of hepatic encephalopathy. The brain-blood barrier disturbances, changes in neurotransmission, neuroinflammation, oxidative stress, GABA-ergic or benzodiazepine pathway abnormalities, manganese neurotoxicity, brain energetic disturbances, and brain blood flow abnormalities are considered to be involved in the development of hepatic encephalopathy. The influence of small intestine bacterial overgrowth (SIBO) on the induction of minimal hepatic encephalopathy is recently emphasized. The aim of this paper is to present the current views on the pathogenesis of hepatic encephalopathy. PMID:23316223

  6. [Treatment of varicose veins and limb lymphedema].

    PubMed

    Vignes, S

    2014-02-01

    Two questions arise when considering the treatment of varicose veins and the development of lymphedema: can the treatment cause lymphedema? Can it worsen it? Primary lymphedema is rarely associated with varicose veins except in the lymphedema-distichiasis syndrome. Data available in the literature is essentially based on surgical treatment. Stripping on a normal limb may induce chronic lymphedema in almost 0.1% of cases. The risk of lymphedema after stripping in patients with previous pelvic surgery including lymph node excision and/or radiotherapy remains unknown. In patients with lower limb lymphedema wearing strong elastic compression stockings, stripping provides little clinical improvement and can worsen volume. The main objective is also to avoid venous complications. Lymphatic lesions related to stripping can be evaluated by lymphography or lymphoscintigraphy. New techniques for treating varicose veins (sclerotherapy, endovenous laser treatment, radiofrequency ablation) seem to induce fewer lymphatic complications. Further studies are required to confirm these results. Indications for treatment should be unquestionable and patients must be alerted to the potential risk of lymphedema or its worsening. PMID:24315933

  7. [Treatment of varicose veins and limb lymphedema].

    PubMed

    Vignes, S

    2014-02-01

    Two questions arise when considering the treatment of varicose veins and the development of lymphedema: can the treatment cause lymphedema? Can it worsen it? Primary lymphedema is rarely associated with varicose veins except in the lymphedema-distichiasis syndrome. Data available in the literature is essentially based on surgical treatment. Stripping on a normal limb may induce chronic lymphedema in almost 0.1% of cases. The risk of lymphedema after stripping in patients with previous pelvic surgery including lymph node excision and/or radiotherapy remains unknown. In patients with lower limb lymphedema wearing strong elastic compression stockings, stripping provides little clinical improvement and can worsen volume. The main objective is also to avoid venous complications. Lymphatic lesions related to stripping can be evaluated by lymphography or lymphoscintigraphy. New techniques for treating varicose veins (sclerotherapy, endovenous laser treatment, radiofrequency ablation) seem to induce fewer lymphatic complications. Further studies are required to confirm these results. Indications for treatment should be unquestionable and patients must be alerted to the potential risk of lymphedema or its worsening.

  8. Unexpectedly high incidence of indigenous acute hepatitis E within South Hampshire: time for routine testing?

    PubMed

    De Silva, Aminda N; Muddu, Ajay K; Iredale, John P; Sheron, Nick; Khakoo, Salim I; Pelosi, Emanuela

    2008-02-01

    Hepatitis E indigenous to developed countries (hepatitis EIDC) is a form of hepatitis E in persons with no travel history to highly endemic areas. It has been recognized recently as an emerging clinical entity in a significant number of economically developed countries including UK. However, it is still perceived as a rare disease and routine laboratory testing for hepatitis E is not performed. A series of 13 cases of hepatitis EIDC, diagnosed in a 13-month period from June 2005 within a single center in South Hampshire, UK, is presented. These patients were identified after implementing a novel-screening algorithm that introduced routine hepatitis E serological investigations. Patients were middle aged or elderly and males were affected more commonly. Four patients (31%) required hospital admission. All reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed cases carried hepatitis E virus (HEV) genotype-3, which bore close sequence homology to HEV circulating in UK pigs. None of these patients recalled eating undercooked pork products or close contact with pigs during the 2 months preceding the onset of acute hepatitis. In comparison, during the same period, only two cases of hepatitis A and five cases of acute hepatitis B were diagnosed. These data illustrate the importance of introducing routine hepatitis E testing in all patients with unexplained acute liver disease and absence of relevant travel history. Routine testing can clarify hepatitis E epidemiology whilst improving the clinical management of patients with acute liver disease. PMID:18098134

  9. Comparison between mechanical properties of human saphenous vein and umbilical vein

    PubMed Central

    2012-01-01

    Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD) is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG) is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress–strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein’s stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels’ stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as rat aortic vessels. As

  10. Hepatitis: protecting BMETs & CEs.

    PubMed

    Baker, S A

    1994-01-01

    Hepatitis is the primary occupational hazard for healthcare workers. Not until the 1970s were hepatitis viruses isolated and identified as types A and B. In the late 1970s, hepatitis D was discovered as a major cause of fulminant hepatitis. Soon, it was evident that another type was also at work. Because testing was only available for types A and B, the new category was referred to as non-A, non-B. In the 1980s, scientists identified two more viruses from this non-A, non-B group, namely hepatitis E and hepatitis C. These five types of hepatitis have different modes of transmission. The fecal-to-oral route is the mode of transmission for hepatitis types A and E. But, types B and D are bloodborne pathogens. With the advent of a safe vaccine for hepatitis B, this category is declining. To date, hepatitis C appears to have multiple routes of transmission, with half the cases being posttransfusion. In the United States, 85,000 people per year develop chronic hepatitis C, which ultimately leads to severe liver damage. This paper addresses each of the five viruses that have been grouped by routes of transmission, prevention techniques for BMETs and CEs, and statistics of reported cases to the Centers for Disease Control and Prevention (CDCP) over the last 20 years. PMID:10139739

  11. Lung Matrix Metalloproteinase Activation following Partial Hepatic Ischemia/Reperfusion Injury in Rats

    PubMed Central

    Ferrigno, Andrea; Rizzo, Vittoria; Tarantola, Eleonora

    2014-01-01

    Purpose. Warm hepatic ischemia-reperfusion (I/R) injury can lead to multiorgan dysfunction. The aim of the present study was to investigate whether acute liver I/R does affect the function and/or structure of remote organs such as lung, kidney, and heart via modulation of extracellular matrix remodelling. Methods. Male Sprague-Dawley rats were subjected to 30 min partial hepatic ischemia by clamping the hepatic artery and the portal vein. After a 60 min reperfusion, liver, lung, kidney, and heart biopsies and blood samples were collected. Serum hepatic enzymes, creatinine, urea, Troponin I and TNF-alpha, and tissue matrix metalloproteinases (MMP-2, MMP-9), myeloperoxidase (MPO), malondialdehyde (MDA), and morphology were monitored. Results. Serum levels of hepatic enzymes and TNF-alpha were concomitantly increased during hepatic I/R. An increase in hepatic MMP-2 and MMP-9 activities was substantiated by tissue morphology alterations. Notably, acute hepatic I/R affect the lung inasmuch as MMP-9 activity and MPO levels were increased. No difference in MMPs and MPO was observed in kidney and heart. Conclusions. Although the underlying mechanism needs further investigation, this is the first study in which the MMP activation in a distant organ is reported; this event is probably TNF-alpha-mediated and the lung appears as the first remote organ to be involved in hepatic I/R injury. PMID:24592193

  12. The vertebral venous plexuses: the internal veins are muscular and external veins have valves.

    PubMed

    Stringer, Mark D; Restieaux, Matthew; Fisher, Amanda L; Crosado, Brynley

    2012-07-01

    The internal and external vertebral venous plexuses (VVP) extend the length of the vertebral column. Authoritative sources state that these veins are devoid of valves, permitting bidirectional blood flow and facilitating the hematogenous spread of malignant tumors that have venous connections with these plexuses. The aim of this investigation was to identify morphologic features that might influence blood flow in the VVP. The VVP of 12 adult cadavers (seven female, mean age 79.5 years) were examined by macro- and micro-dissection and representative veins removed for histology and immunohistochemistry (smooth muscle antibody staining). A total of 26, mostly bicuspid, valves were identified in 19 of 56 veins (34%) from the external VVP, all orientated to promote blood flow towards the internal VVP. The internal VVP was characterized by four main longitudinal channels with transverse interconnections; the maximum caliber of the longitudinal anterior internal VVP veins was significantly greater than their posterior counterparts (P < 0.001). The luminal architecture of the internal VVP veins was striking, consisting of numerous bridging trabeculae (cords, thin membranes and thick bridges) predominantly within the longitudinal venous channels. Trabeculae were composed of collagen and smooth muscle and also contained numerous small arteries and nerve fibers. A similar internal venous trabecular meshwork is known to exist within the dural venous sinuses of the skull. It may serve to prevent venous overdistension or collapse, to regulate the direction and velocity of venous blood flow, or is possibly involved in thermoregulation or other homeostatic processes. PMID:21976364

  13. Repair of isolated partial anomalous pulmonary venous connection of the right upper pulmonary veins to the left vertical vein.

    PubMed

    Podzolkov, Vladimir P; Chiaureli, Mikhail R; Kovalev, Dmitry V; Zaets, Sergey B

    2016-09-01

    The most common form of partial anomalous pulmonary venous connection is drainage of the right pulmonary veins to the superior vena cava. On the contrary, partial anomalous venous connection of right pulmonary veins to the left vertical vein is described in few reports. The goal of this publication is to present the case of diagnosis and surgical repair of this extremely rare pathology in a 19-year old female. Methods of preoperative examination included but were not limited to spiral computed tomography and angiocardiography. Intraoperative examination confirmed that the collector of right upper pulmonary veins was connected to the vertical vein that continued to the innominate vein and then to the superior vena cava draining into the right atrium. During surgical intervention, the vertical vein was transected in the area of connection to the innominate vein with the suturing of inlet area. The collector of the right upper pulmonary veins was then anastomosed with the left atrial appendage. Postoperative course was uneventful. In conclusion, isolated partial anomalous pulmonary venous connection of the right upper pulmonary veins to the left vertical vein is a very rare congenital defect. Existing modern techniques contribute to the precise and timely diagnosis of this anomaly.

  14. Hepatitis A, B, and C: Learn the Differences

    MedlinePlus

    ... adoptee’s arrival in the U.S. • People with chronic liver disease, including HCV • People working with HAV in a ... Europe, or the Middle East); • People with chronic liver disease Who should be tested ? Hepatitis C caused by ...

  15. Alcoholic hepatitis.

    PubMed

    Damgaard Sandahl, Thomas

    2014-10-01

    Alcoholic hepatitis (AH) is an acute inflammatory syndrome causing significant morbidity and mortality. The prognosis is strongly dependent on disease severity, as assessed by clinical scoring systems. Reliable epidemiological data as well as knowledge of the clinical course of AH are essential for planning and resource allocation within the health care system. Likewise, individual evaluation of risk is desirable in the clinical handling of patients with AH as it can guide treatment, improve patient information, and serve as strata in clinical trials. The present PhD thesis is based on three studies using a cohort of nearly 2000 patients diagnosed with AH in Denmark from 1999 to 2008 as a cohort, in a population-based study design. The aims of this thesis were as follows. (1) To describe the incidence and short- and long-term mortality, of AH in Denmark (Study I). (2) To validate and compare the ability of the currently available prognostic scores to predict mortality in AH (Study II). (3) To investigate the short- and long-term causes of death of patients with AH (Study III). During the study decade, the annual incidence rate in the Danish population rose from 37 to 46 per 106 for men and from 24 to 34 per 106 for women. Both short- and long-term mortality rose for men and women, and the increase in short-term mortality was attributable to increasing patient age and prevalence of cirrhosis. Our evaluation of the most commonly used prognostic scores for predicting the mortality of patients with AH showed that all scores performed similarly, with Area under the Receiver Operator Characteristics curves giving values between 0.74 and 0.78 for 28-day mortality assessed on admission. Our study on causes of death showed that in the short-term (< 84 days after diagnosis), patients with AH were likely to die from liver-related events and infections. In the long-term (≥ 84 days after diagnosis), those who developed cirrhosis mainly died from liver-related causes, and

  16. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    NASA Astrophysics Data System (ADS)

    Ota, Ryuhei; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2009-04-01

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm2, and the irradiation time was 20 s. In this study, the contrast agent Levovist® was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10-5. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  17. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    SciTech Connect

    Ota, Ryuhei; Yoshinaka, Kiyoshi; Takagi, Shu; Matsumoto, Yoichiro; Suzuki, Jun; Deguchi, Juno; Miyata, Tetsuro

    2009-04-14

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm{sup 2}, and the irradiation time was 20 s. In this study, the contrast agent Levovist registered was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10{sup -5}. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  18. Abdominal thromboses of splanchnic, renal and ovarian veins.

    PubMed

    De Stefano, Valerio; Martinelli, Ida

    2012-09-01

    Thromboses of abdominal veins outside the iliac-caval axis are rare but clinically relevant. Early deaths after splanchnic vein thrombosis occur in 5-30% of cases. Sequelae can be liver failure or bowel infarction after splanchnic vein thrombosis, renal insufficiency after renal vein thrombosis, ovarian infarction after ovarian vein thrombosis. Local cancer or infections are rare in Budd-Chiari syndrome, and common for other sites. Inherited thrombophilia is detected in 30-50% of patients. Myeloproliferative neoplasms are the main cause of splanchnic vein thrombosis: 20-50% of patients have an overt myeloproliferative neoplasm and/or carry the molecular marker JAK2 V617F. Renal vein thrombosis is closely related to nephrotic syndrome; finally, ovarian vein thrombosis can complicate puerperium. Heparin is used for acute treatment, sometimes in conjunction with systemic or local thrombolysis. Vitamin K-antagonists are recommended for 3-6 months, and long-term in patients with Budd-Chiari syndrome, unprovoked splanchnic vein thrombosis, or renal vein thrombosis with a permanent prothrombotic state such as nephrotic syndrome.

  19. Variations of Gonadal Veins: Embryological Prospective and Clinical Significance

    PubMed Central

    Gupta, Raman; Aggarwal, Navita

    2015-01-01

    Introduction: An adequate knowledge of anomalies of gonadal veins will help the radiologists and surgeons in recognition and protection of these veins which play major roles in thermo-regulation that is essential for the efficient functioning of testis on which the survival of the human species depends. Aim: The aim of this work is to present an analysis of the anatomical variations of gonadal veins. An effort has also been made to explicate the possible embryological model of development of such variants and to present the variable clinical aspects concerning them. Materials and Methods: Gonadal veins in 60 dissection room cadavers were examined for variations from the classic anatomic description. Result: In the present study, out of 60 cases, male: female ratio was 2:1(40:20) in which no variation was found in ovarian veins. In the 18 (45%) cases, testicular veins showed variations which consist of duplication and atypical drainage. Discussion: Variations of drainage of gonadal vein are due to error of embryological development in venous shift and alteration in anastomotic channel of post-cardinal, supra-cardinal and sub cardinal veins. Conclusion: The gonadal veins present numeric variations as well as variations in its site of drainage, which attributed to the various pathological conditions as varicocele and pelvic congestion syndrome, leading to infertility in patients. Hence, in -depth knowledge of these developmental anomalies of gonadal veins is important. PMID:25859438

  20. Superficial veins of the foot in the baboon Papio anubis.

    PubMed

    Dyl, L; Topol, M

    2007-02-01

    Although the baboon is considered a good animal model in biomedical research, no description of the superficial veins of the foot in Papio anubis is found in the available literature. The current study was conducted to document the anatomy of these veins in the baboon foot. A macroscopic anatomical investigation was carried out on 20 hind legs (10 cadavers) of the adult Papio anubis (9 males and 1 female). The circulatory system of the entire body was filled with coloured latex. Traditional methods were used for the preparation of the veins of the legs. These were then compared with the venous system of the lower extremities in humans as presented in the literature. The medial and lateral metatarsal veins, the dorsal venous network, the long saphenous vein and the short saphenous vein in Papio anubis were described according to their origin, course, opening, length and diameter. The network observed was divided into three types with respect to the connections between the superficial veins. The investigation revealed no symmetry in the venous system of the baboon foot. The short saphenous vein appeared to be the main vein of the hind leg in Papio anubis and the long saphenous vein ran as a double vessel.

  1. On the phenomenology of the perforating vein of the elbow.

    PubMed

    Lomonte, Carlo; Basile, Carlo

    2009-01-01

    The perforating veins, as the name suggests, are the veins that perforate the muscular aponeuroses ensuring communication between the superficial and the deep veins. Located at the bend of the elbow, almost constantly, there is a vein, named perforating vein of the elbow, which is of great interest to the nephrologist who is responsible for the management of vascular access for hemodialysis (HD). It represents, in fact, because of its intrinsic characteristics and topographical reasons, a valuable resource for the creation of a vascular access for HD, especially in obese patients, elderly patients, diabetics, and patients affected by peripheral vasculopathy. Arterio-venous fistulae (AVF) constructed with the perforating vein of the elbow are relatively easy to perform, have an excellent patency rate, a low incidence of early thrombosis, adequate flows, and a low incidence of the steal syndrome. In other types of AVFs, the perforating vein of the elbow subtracts flow to the superficial veins slowing or preventing their full maturation, and can become a problem in measuring the blood flow of the AVF. But still, its presence can maintain patent a fistula in case of poor compliance of the superficial veins, while awaiting for interventional procedures able to accelerate a subsequent maturation. This review intends to explore the role that the perforating vein of the elbow plays in the physiology and pathology of the AVF, in relation to the issues that most frequently occur in clinical practice. PMID:19573011

  2. Automated detection of periventricular veins on 7 T brain MRI

    NASA Astrophysics Data System (ADS)

    Kuijf, Hugo J.; Bouvy, Willem H.; Zwanenburg, Jaco J. M.; Viergever, Max A.; Biessels, Geert Jan; Vincken, Koen L.

    2015-03-01

    Cerebral small vessel disease is common in elderly persons and a leading cause of cognitive decline, dementia, and acute stroke. With the introduction of ultra-high field strength 7.0T MRI, it is possible to visualize small vessels in the brain. In this work, a proof-of-principle study is conducted to assess the feasibility of automatically detecting periventricular veins. Periventricular veins are organized in a fan-pattern and drain venous blood from the brain towards the caudate vein of Schlesinger, which is situated along the lateral ventricles. Just outside this vein, a region-of- interest (ROI) through which all periventricular veins must cross is defined. Within this ROI, a combination of the vesselness filter, tubular tracking, and hysteresis thresholding is applied to locate periventricular veins. All detected locations were evaluated by an expert human observer. The results showed a positive predictive value of 88% and a sensitivity of 95% for detecting periventricular veins. The proposed method shows good results in detecting periventricular veins in the brain on 7.0T MR images. Compared to previous works, that only use a 1D or 2D ROI and limited image processing, our work presents a more comprehensive definition of the ROI, advanced image processing techniques to detect periventricular veins, and a quantitative analysis of the performance. The results of this proof-of-principle study are promising and will be used to assess periventricular veins on 7.0T brain MRI.

  3. Endovascular Laser Therapy for Varicose Veins

    PubMed Central

    2010-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular laser therapy (ELT) for the treatment of primary symptomatic varicose veins (VV). Background The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition VV are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad or worse as other chronic diseases such as

  4. Hepatic encephalopathy: a review.

    PubMed

    Lizardi-Cervera, Javier; Almeda, Paloma; Guevara, Luis; Uribe, Misael

    2003-01-01

    Hepatic encephalopathy (HE) is a complication that presents in as many as 28% of patients with cirrhosis, and reported up to ten years after the diagnosis of cirrhosis. Commonly, it is observed in patients with severe hepatic failure and is characterized by neuropsychiatric manifestations that can range in severity from a mild alteration in mental state to a coma; additionally, some neuromuscular symptoms can be observed. This complication of either acute or chronic hepatic disease is the result of a diminished hepatic reservoir and inability to detoxify some toxins that originate in the bowel. Today, the role of astrocytes, specifically the Alzheimer type II cells, is known to be very important in the pathogenesis of the hepatic encephalopathy, and will be reviewed later. In conclusion, the objectives of this review are: To understand the pathogenesis of hepatic encephalopathy, To recognize the precipitating factors, as well as preventive measures for the development of the hepatic encephalopathy, To describe the new classification of hepatic encephalopathy and its clinical implications, To recognize the clinical manifestations and stages of the disease, To understand the main diagnostic tests used to detect the hepatic encephalopathy, To describe the main therapeutic treatments of hepatic encephalopathy. PMID:15115963

  5. Hepatitis virus protein X-Phenylalanine Hydroxylase fusion proteins identified in PKU mice treated with AAV-WPRE vectors

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Utilizing the Pahenu2 mouse model for phenylketonuria (PKU), we developed an improved expression vector containing the Woodchuck Hepatitis Virus post-transcriptional regulatory element inserted into a rAAV-mPAH construct (rAAV-mPAH-WPRE) for treatment of PKU. Following portal vein delivery of these ...

  6. Glucose absorption, hormonal release and hepatic metabolism after guar gum ingestion

    NASA Technical Reports Server (NTRS)

    Simoes Nunes, C.; Malmlof, K.

    1992-01-01

    Six non-anaesthetized Large White pigs (mean body weight 59 +/- 1.7 kg) were fitted with permanent catheters in the portal vein, the brachiocephalic artery and the right hepatic vein and with electromagnetic flow probes around the portal vein and the hepatic artery. The animals were provided a basal none-fibre diet (diet A) alone or together with 6% guar gum (diet B) or 15% purified cellulose (diet C). The diets were given for 1 week and according to a replicated 3 x 3 latin-square design. On the last day of each adaptation period test meals of 800 g were given prior to blood sampling. The sampling was continued for 8 h. Guar gum strongly reduced the glucose absorption as well as the insulin, gastric inhibitory polypeptide (GIP) and insulin-like growth factor-1 (IGF-1) production. However, the reduction in peripheral blood insulin levels caused by guar gum was not associated with a change in hepatic insulin extraction. IGF-1 appeared to be strongly produced by the gut. The liver had a net uptake of the peptide. Ingestion of guar gum increased the hepatic extraction coefficient of gut produced IGF-1. Guar gum ingestion also appeared to decrease pancreatic glucagon secretion. Cellulose at the level consumed had very little effect on the parameters considered. It is suggested that the modulation of intestinal mechanisms by guar gum was sufficient to mediate the latter internal metabolic effects.

  7. Feature Hepatitis: Hepatitis Can Strike Anyone

    MedlinePlus

    ... please turn Javascript on. From Hollywood's "Walk of Stars" to Main Street, USA, people from all walks ... that includes many well-known names: Legendary television star Larry Hagman was diagnosed with advanced hepatitis C ...

  8. Chemical gradients and progressive veining in a partly serpentinized harzburgite

    NASA Astrophysics Data System (ADS)

    Schwarzenbach, Esther; Caddick, Mark; Beard, James; Bodnar, Robert

    2016-04-01

    Serpentinized ultramafic rocks constitute a major part of the oceanic lithosphere. They form when water interacts with olivine and pyroxene to produce a dense network of veins comprised of secondary minerals: Serpentine + brucite ± magnetite veins occur in olivine, Al-rich serpentine + talc veins occur in orthopyroxene, and Al-rich serpentine ± talc ± brucite veins occur at the boundary between orthopyroxene and olivine. Here, we present a detailed study on a harzburgite from the Santa Elena Ophiolite in Costa Rica that is ~30% serpentinized in order to provide new constraints on the effect of variable water (H2O) and silica (SiO2) activities on vein formation in peridotites. The studied sample records 1) mineralogical and chemical zonations in olivine-hosted veins that show a distinct pattern with increasing width of the veins (consumption of olivine), 2) varying brucite composition depending on whether or not it is associated with magnetite, and 3) chemical gradients in Si, Al, Cr, and Ca at the boundary between orthopyroxene- and olivine-hosted veins. These observed chemical variations suggest fluid mediated mass transport within and between orthopyroxene- and olivine-hosted veins. We use thermodynamic models to show that an increase in vein width and progressive evolution of olivine-hosted veins is accompanied by an increase in water-rock ratios. This is associated with the development of chemical gradients (e.g. gradients in water and silica activity) between the fluid-rich center of serpentine veins and the olivine grain boundaries as typically expressed by the abundance of brucite in the vein center and a dominance of serpentine at the boundary with olivine. The increase in water-rock ratios within the vein center also leads to the formation of magnetite from Fe-rich brucite ± Fe-rich serpentine. Mass transfer between vein core and vein rim may exist on the submicron-scale along grain boundaries of the finely intergrown serpentine-brucite mixture. We

  9. Comparison of blood glucose concentrations after administration of a glucose solution via the jugular vein and portal vein in cows.

    PubMed

    Braun, U; Heusmann, B; Camenzind, D; Haessig, M

    2007-10-01

    The goals of the present study were to determine whether the infusion of a glucose solution into the portal vein is tolerated in cows and whether the glucose concentration differs after administration of glucose into the jugular vein and portal vein. Fifteen healthy Swiss Braunvieh cows were used. An indwelling catheter was placed in both jugular veins and a balloon-tipped indwelling catheter with a diameter of 2 mm was placed in the portal vein under the guidance of ultrasonography. Three cows received 500 ml of 20% glucose solution over 60 min via the left jugular vein. Three other cows received the same solution over 60 min via the portal vein. Blood samples were collected from the right jugular vein before and for 24 h after the infusion of glucose for the determination of the concentrations of glucose and bilirubin and the activities of glutamate dehydrogenase, sorbitol dehydrogenase and gamma-glutamyl transferase. Infusion via the portal vein did not result in abnormalities in the general condition of the cows or increases in the concentration of bilirubin or the activities of liver enzymes. The blood glucose concentration increased to the same extent after both intraportal and intrajugular infusion. Over a 12-h period, three cows received 10 l of 20% glucose solution via the left jugular vein and three others received the same solution over a 12-h period via the portal vein. Blood samples were collected from the right jugular vein before and for 30 h after the start of infusion. Infusion via the portal vein did not affect the general condition of the cows or the activities of the liver enzymes. There was no significant difference in the blood glucose concentration between the two groups throughout the study.

  10. Combination hepatitis a-hepatitis B vaccine.

    PubMed

    Wagstaff, A J; Balfour, J A

    1997-09-01

    The adult formulation of this combination hepatitis A-hepatitis B vaccine contains 720 enzyme-linked immunosorbent assay units (EU) of formalin-inactivated hepatitis A virus strain HM175 and 20mug of recombinant DNA yeast-derived hepatitis B surface antigen adsorbed onto aluminium salts in 1ml for injection. The paediatric formulation contains half this dosage in 0.5ml for injection. The combination vaccine has been shown to be highly immunogenic in healthy young adults after the full dosage schedule of 3 doses at 0, 1 and 6 months. Trials in older adults and children indicate that immunogenicity is adequate in these groups also. The immunogenicity of the combination vaccine appears to be similar to that of hepatitis A vaccine and hepatitis B vaccine administered separately. Possible advantages for the combination vaccine recipient include fewer injections and lower costs. Local adverse reactions such as soreness at the injection site, redness and swelling occur often with the first dose of the series, but the incidence falls with subsequent doses. Local reactions are usually mild and transient, and reported systemic reactions (fatigue, headache) are thought not to have a causal link with the vaccine. PMID:18020513

  11. Diagnosis of uterine vein thrombosis on transvaginal ultrasound.

    PubMed

    Mavrelos, D; Cohen, H; Pateman, K; Hoo, W; Foo, X; Jurkovic, D

    2013-10-01

    Deep venous thrombosis (DVT) is a potentially serious medical disorder, which may result in pulmonary embolism and death. Compression ultrasound is the investigation modality of choice for the diagnosis of DVT of the lower limb. Diagnosis of proximal thrombosis involving the pelvic veins is difficult and is usually made only after the thrombus extends into the veins of the lower limb. We present six cases of incidental uterine vein thrombosis diagnosed by transvaginal ultrasound. Our aim is to describe the technique of the examination of pelvic veins and criteria that could be used to diagnose uterine vein thrombosis. We also highlight difficulties in the management of women diagnosed with asymptomatic uterine vein thrombi as there is little evidence to guide clinicians in choosing between different treatment options.

  12. Pulmonary Vein Stenosis Complicating Radiofrequency Catheter Ablation

    PubMed Central

    Lu, Hai-Wen; Wei, Ping; Jiang, Sen; Gu, Shu-yi; Fan, Li-Chao; liang, Shuo; Ji, Xiaobin; Rajbanshi, Bhavana; Xu, Jin-Fu

    2015-01-01

    Abstract The aim of this study is to characterize the clinical manifestations and features of pulmonary vein stenosis (PVS) by retrospectively analyzing clinical data of patients in addition to reviewing the literature simultaneously to improve the understanding of PVS complicating radiofrequency catheter ablation and to provide evidence for early diagnosis and timely treatment. Clinical, imaging, and follow-up data of 5 patients with PVS-complicating radiofrequency catheter ablation were retrospectively analyzed between January 2012 and December 2014 in Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. Relevant studies previously reported were also reviewed. Three out of 5 patients received pulmonary angiography. The initial symptoms were not specific, presenting chest pain in 3 cases, hemoptysis in 2 cases. The average duration between radiofrequency ablation to the onset of symptoms was 5.8 months. The chest image results were consolidation and pleural effusion mainly. Veins distributed in the left lungs were mostly influenced in 4 patients, and the inferior veins in 3 patients. Cardiac ultrasound examinations showed pulmonary arterial hypertension in 2 patients. Two patients received selective bronchial artery embolization after bronchial artery radiography because of hemoptysis. One patient underwent video-assisted thoracoscopic biopsy because of the suspicion of tumor. PVS is a condition mostly undetected because of its silent manifestations and inconsistent follow-up. The accurate clinical diagnosis is very difficult. A careful review of medical history and follow-up observation may be useful for all the patients who received the radiofrequency catheter ablation to recognize PVS in the early stage. PMID:26313772

  13. Science Linking Pulmonary Veins and Atrial Fibrillation

    PubMed Central

    Mahida, Saagar; Sacher, Frederic; Derval, Nicolas; Berte, Benjamin; Yamashita, Seigo; Hooks, Darren; Denis, Arnaud; Amraoui, Sana; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre

    2015-01-01

    Over the past few decades, significant progress has been made in understanding the mechanistic basis of atrial fibrillation (AF). One of the most important discoveries in this context has been that pulmonary veins (PV) play a prominent role in the pathogenesis of AF. PV isolation has since become the most widely used technique for treatment of paroxysmal AF. Multiple studies have demonstrated that the electrophysiological and anatomical characteristics of PVs create a proarrhythmogenic substrate. The following review discusses the mechanistic links between PVs and AF. PMID:26835098

  14. Treatment of Primary Varicose Veins in Japan: Japanese Vein Study XVII

    PubMed Central

    Yamaki, Takashi; Iwata, Hirohide; Sakata, Masahiro; Sugano, Norihide; Nishibe, Toshiya; Mo, Makoto; Yamada, Norikazu; Iwai, Takehisa

    2016-01-01

    Purpose: This study aimed at clarifying the changes in treatments for primary varicose veins in Japan. Methods: A questionnaire was mailed to the members of the Japanese Society of Phlebology. The contents of the survey covered the treatment and treatment strategy of varicose vein cases in 2013. The results were examined and compared with the results of previous surveys conducted by the aforesaid society in 1998, 2004 and 2009. Results: Of 36078 patients, 43958 limbs were reported from 201 institutions. Saphenous type was the most common type of varicose veins that developed in patients aged 70–79 years. The C4–6 cases according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification occurred significantly more in males than in females (p <0.01). For the treatments of saphenous type and of segment type (dilatation of peripheral branch), endovenous laser ablation (EVLA) was performed most frequently (51%), while the frequency of stripping and of high ligation decreased. EVLA was performed with tumescent local anesthesia, which required one day of hospitalization. Conclusion: In our study, the number of patients with varicose veins increased especially in the elderly. Surgical treatments were selected for a number of patients, and EVLA was the most commonly adopted method of treatment in Japan. (This article is a translation of Jpn J Phlebol 2016: 27; 249-57.) PMID:27738459

  15. Hepatitis C: Information on Testing and Diagnosis

    MedlinePlus

    HEPATITIS C Information on Testing & Diagnosis What is Hepatitis C? Hepatitis C is a serious liver disease that results from infection with the Hepatitis C virus. Hepatitis C has been called a silent ...

  16. Architecture of the pulmonary veins: relevance to radiofrequency ablation

    PubMed Central

    Ho, S; Cabrera, J; Tran, V; Farre, J; Anderson, R; Sanchez-Quintana, D

    2001-01-01

    BACKGROUND—Radiofrequency ablation of tissues in pulmonary veins can eliminate paroxysmal atrial fibrillation.
OBJECTIVE—To explore the characteristics of normal pulmonary veins so as to provide more information relevant to radiofrequency ablation.
METHODS—20 structurally normal heart specimens were examined grossly. Histological sections were made from 65 pulmonary veins.
RESULTS—The longest myocardial sleeves were found in the superior veins. The sleeves were thickest at the venoatrial junction in the left superior pulmonary veins. For the superior veins, the sleeves were thickest along the inferior walls and thinnest superiorly. The sleeves were composed mainly of circularly or spirally oriented bundles of myocytes with additional bundles that were longitudinally or obliquely oriented, sometimes forming mesh-like arrangements. Fibrotic changes estimated at between 5% and 70% across three transverse sections were seen in 17 veins that were from individuals aged 30 to 72 years.
CONCLUSIONS—The myocardial architecture in normal pulmonary veins is highly variable. The complex arrangement, stretch, and increase in fibrosis may produce greater non-uniform anisotropic properties.


Keywords: arrhythmias; catheter ablation; fibrillation; cardiac veins PMID:11514476

  17. Finger-Vein Verification Based on Multi-Features Fusion

    PubMed Central

    Qin, Huafeng; Qin, Lan; Xue, Lian; He, Xiping; Yu, Chengbo; Liang, Xinyuan

    2013-01-01

    This paper presents a new scheme to improve the performance of finger-vein identification systems. Firstly, a vein pattern extraction method to extract the finger-vein shape and orientation features is proposed. Secondly, to accommodate the potential local and global variations at the same time, a region-based matching scheme is investigated by employing the Scale Invariant Feature Transform (SIFT) matching method. Finally, the finger-vein shape, orientation and SIFT features are combined to further enhance the performance. The experimental results on databases of 426 and 170 fingers demonstrate the consistent superiority of the proposed approach. PMID:24196433

  18. Finger-vein verification based on multi-features fusion.

    PubMed

    Qin, Huafeng; Qin, Lan; Xue, Lian; He, Xiping; Yu, Chengbo; Liang, Xinyuan

    2013-01-01

    This paper presents a new scheme to improve the performance of finger-vein identification systems. Firstly, a vein pattern extraction method to extract the finger-vein shape and orientation features is proposed. Secondly, to accommodate the potential local and global variations at the same time, a region-based matching scheme is investigated by employing the Scale Invariant Feature Transform (SIFT) matching method. Finally, the finger-vein shape, orientation and SIFT features are combined to further enhance the performance. The experimental results on databases of 426 and 170 fingers demonstrate the consistent superiority of the proposed approach.

  19. Suitability of Varicose Veins for Endovenous Treatments

    SciTech Connect

    Goode, S. D.; Kuhan, G.; Altaf, N.; Simpson, R.; Beech, A.; Richards, T.; MacSweeney, S. T.; Braithwaite, B. D.

    2009-09-15

    The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median patient age was 55 years (interquartile range 45-66), and 62% patients were women. A set of criteria based on duplex ultrasonography was used to select patients for each procedure. Great saphenous vein (GSV) reflux was present in 77% (446 of 577) of legs. Overall, 328 (73%) of the legs were suitable for at least one of the endovenous options. Of the 114 legs with recurrent GSV reflux disease, 83 (73%) were suitable to receive endovenous therapy. Patients with increasing age were less likely to be suitable for endovenous therapy (P = 0.03). Seventy-three percent of patients with VVs caused by GSV incompetence are suitable for endovenous therapy.

  20. Biomolecular mechanisms in varicose veins development.

    PubMed

    Segiet, Oliwia Anna; Brzozowa-Zasada, Marlena; Piecuch, Adam; Dudek, Damian; Reichman-Warmusz, Edyta; Wojnicz, Romuald

    2015-02-01

    Varicose veins (VVs) can be described as tortuous and dilated palpable veins, which are more than 3 mm in diameter. They are one of the clinical presentations of chronic venous disorders, which are a significant cause of morbidity. The prevalence of VVs has been estimated at 25-33% in women and 10-20% in men and is still increasing at an alarming rate. Family history, older age, female, pregnancy, obesity, standing occupations, and a history of deep venous thrombosis are the predominant risk factors. A great amount of factors are implicated in the pathogenesis of VVs, including changes in hydrostatic pressure, valvular incompetence, deep venous obstruction, ineffective function of calf muscle pump, biochemical and structural alterations of the vessel wall, extracellular matrix abnormalities, impaired balance between growth factors or cytokines, genetic alterations, and several other mechanisms. Nevertheless, the issue of pathogenesis in VVs is still not completely known, even if a great progress has been made in understanding their molecular basis. This kind of studies appears promising and should be encouraged, and perhaps the new insight in this matter may result in targeted therapy or possibly prevention.

  1. Arterialization and anomalous vein wall remodeling in varicose veins is associated with upregulated FoxC2-Dll4 pathway.

    PubMed

    Surendran, Sumi; S Ramegowda, Kalpana; Suresh, Aarcha; Binil Raj, S S; Lakkappa, Ravi Kumar B; Kamalapurkar, Giridhar; Radhakrishnan, N; C Kartha, Chandrasekharan

    2016-04-01

    Varicose veins of lower extremities are a heritable common disorder. Mechanisms underlying its pathogenesis are still vague. Structural failures such as valve weakness and wall dilatation in saphenous vein result in venous retrograde flow in lower extremities of body. Reflux of blood leads to distal high venous pressure resulting in distended veins. In an earlier study, we observed a positive association between c.-512C>T FoxC2 gene polymorphism and upregulated FoxC2 expression in varicose vein specimens. FoxC2 overexpression in vitro in venous endothelial cells resulted in the elevated mRNA expression of arterial endothelial markers such as Delta-like ligand 4 (Dll4) and Hairy/enhancer-of-split related with YRPW motif protein 2 (Hey2). We hypothesized that an altered FoxC2-Dll4 signaling underlies saphenous vein wall remodeling in patients with varicose veins. Saphenous veins specimens were collected from 22 patients with varicose veins and 20 control subjects who underwent coronary artery bypass grafting. Tissues were processed for paraffin embedding and sections were immunostained for Dll4, Hey2, EphrinB2, α-SMA, Vimentin, and CD31 antigens and examined under microscope. These observations were confirmed by quantitative real-time PCR and western blot analysis. An examination of varicose vein tissue specimens by immunohistochemistry indicated an elevated expression of Notch pathway components, such as Dll4, Hey2, and EphrinB2, and smooth muscle markers, which was further confirmed by gene and protein expression analyses. We conclude that the molecular alterations in Dll4-Hey2 signaling are associated with smooth muscle cell hypertrophy and hyperplasia in varicose veins. Our observations substantiate a significant role for altered FoxC2-Dll4 signaling in structural alterations of saphenous veins in patients with varicose veins.

  2. Monitoring of Systemic and Hepatic Hemodynamic Parameters in Mice

    PubMed Central

    Xie, Chichi; Wei, Weiwei; Zhang, Tao; Dirsch, Olaf; Dahmen, Uta

    2014-01-01

    The use of mouse models in experimental research is of enormous importance for the study of hepatic physiology and pathophysiological disturbances. However, due to the small size of the mouse, technical details of the intraoperative monitoring procedure suitable for the mouse were rarely described. Previously we have reported a monitoring procedure to obtain hemodynamic parameters for rats. Now, we adapted the procedure to acquire systemic and hepatic hemodynamic parameters in mice, a species ten-fold smaller than rats. This film demonstrates the instrumentation of the animals as well as the data acquisition process needed to assess systemic and hepatic hemodynamics in mice. Vital parameters, including body temperature, respiratory rate and heart rate were recorded throughout the whole procedure. Systemic hemodynamic parameters consist of carotid artery pressure (CAP) and central venous pressure (CVP). Hepatic perfusion parameters include portal vein pressure (PVP), portal flow rate as well as the flow rate of the common hepatic artery (table 1). Instrumentation and data acquisition to record the normal values was completed within 1.5 h. Systemic and hepatic hemodynamic parameters remained within normal ranges during this procedure. This procedure is challenging but feasible. We have already applied this procedure to assess hepatic hemodynamics in normal mice as well as during 70% partial hepatectomy and in liver lobe clamping experiments. Mean PVP after resection (n= 20), was 11.41±2.94 cmH2O which was significantly higher (P<0.05) than before resection (6.87±2.39 cmH2O). The results of liver lobe clamping experiment indicated that this monitoring procedure is sensitive and suitable for detecting small changes in portal pressure and portal flow rate. In conclusion, this procedure is reliable in the hands of an experienced micro-surgeon but should be limited to experiments where mice are absolutely needed. PMID:25350047

  3. Hepatic ischemia-reperfusion syndrome after partial liver resection (LR): hepatic venous oxygen saturation, enzyme pattern, reduced and oxidized glutathione, procalcitonin and interleukin-6.

    PubMed

    Kretzschmar, Michael; Krüger, Antie; Schirrmeister, Wulf

    2003-06-01

    The hepatic ischemia-reperfusion syndrome was investigated in 28 patients undergoing elective partial liver resection with intraoperative occlusion of hepatic inflow (Pringle maneuver) using the technique of liver vein catheterization. Hepatic venous oxygen saturation (ShvO2) was monitored continuously up to 24 hours after surgery. Aspartate aminotransferase, glutamate dehydrogenase, gamma-glutamyl transpeptidase, pseudocholinesterase, alpha-glutathione S-transferase, reduced and oxidized glutathione, procalcitonine, and interleukin-6 were serially measured both before and after Pringle maneuver during the resection and postoperatively in arterial and/or hepatic venous blood. ShvO2 measurement demonstrated that peri- and postoperative management was suitable to maintain an optimal hepatic oxygen supply. As expected, we were able to demonstrate a typical enzyme pattern of postischemic liver injury. There was a distinct decrease of reduced glutathione levels both in arterial and hepatic venous plasma after LR accompanied by a strong increase in oxidized glutathione concentration during the phase of reperfusion. We observed increases in procalcitonin and interleukin-6 levels both in arterial and hepatic venous blood after declamping. Our data support the view that liver resection in man under conditions of inflow occlusion resulted in ischemic lesion of the liver (loss of glutathione synthesizing capacity with disturbance of protection against oxidative stress) and an additional impairment during reperfusion (liberation of reactive oxygen species, local and systemic inflammation reaction with cytokine production). Additionally, we found some evidence for the assumption that the liver has an export function for reduced glutathione into plasma in man. PMID:12877355

  4. 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

  5. Experimental research of Fuaile medical adhesive for portal vein embolization in white rabbit models

    PubMed Central

    JIANG, TIANPENG; WANG, LIZHOU; LI, XING; SONG, JIE; WU, XIAOPING; AN, TIANZHI; ZHOU, SHI

    2015-01-01

    The aim of the present study was to investigate the feasibility and efficacy of Fuaile medical adhesive for portal vein embolization in the treatment of a rabbit model. This study used 26 white rabbits, 14 of which were selected and assigned into seven groups (n=2) for the preliminary experiment. Fuaile medical adhesive was mixed with lipiodol at different ratios of 1:0, 1:1, 1:2, 1:3, 1:4, 1:5 and 0:1, respectively, and administered via the portal trunk. The remaining 12 white rabbits were randomly divided into two groups (n=6). The evaluation of the results included the degree of adhesion to the vessels, the extent of embolization and the reaction of the rabbit. Hepatic and renal functions were detected prior to and at 1, 7 and 14 days post-embolization, respectively. Angiography, CT scans and pathological examinations were conducted at post-embolization. Histological examinations revealed that the topical swollen lesions were darker. Light microscopy showed embolic agents in the portal venous blood vessels and the formation of a secondary thrombus. Hepatic necrosis appeared surrounding the embolization area. Inflammatory cell infiltration of different degrees occurred in the early stage and inflammatory fibroplasia occurred in the late stage. Alanine aminotransferase and aspartate aminotransferase levels increased at 1 day post-embolization, peaked at 7 days and was in the normal range at 14 days. The levels of blood urea nitrogen and ceruloplasmin were elevated at 1 day post-embolization and lowered to normal at 7 days. Fuaile medical adhesive is an effective, safe and inexpensive agent, used for effectively inducing embolization in the portal trunk, and the first and second branches of rabbit portal veins. The use of Fuaile therefore merits widespread application in clinical practice. PMID:26137115

  6. Middle ear infection (image)

    MedlinePlus

    A middle ear infection is also known as otitis media. It is one of the most common of childhood infections. With this illness, the middle ear becomes red, swollen, and inflamed because of bacteria ...

  7. Management of hepatocellular carcinoma with portal vein tumor thrombosis: Review and update at 2016

    PubMed Central

    Chan, Stephen L; Chong, Charing C N; Chan, Anthony W H; Poon, Darren M C; Chok, Kenneth S H

    2016-01-01

    Portal vein tumor thrombosis (PVTT) is a common phenomenon in hepatocellular carcinoma (HCC). Compared to HCC without PVTT, HCC with PVTT is characterized by an aggressive disease course, worse hepatic function, a higher chance of complications related to portal hypertension and poorer tolerance to treatment. Conventionally, HCC with PVTT is grouped together with metastatic HCC during the planning of its management, and most patients are offered palliative treatment with sorafenib or other systemic agents. As a result, most data on the management of HCC with PVTT comes from subgroup analyses or retrospective series. In the past few years, there have been several updates on management of HCC with PVTT. First, it is evident that HCC with PVTT consists of heterogeneous subgroups with different prognoses. Different classifications have been proposed to stage the degree of portal vein invasion/thrombosis, suggesting that different treatment modalities may be individualized to patients with different risks. Second, more studies indicate that more aggressive treatment, including surgical resection or locoregional treatment, may benefit select HCC patients with PVTT. In this review, we aim to discuss the recent conceptual changes and summarize the data on the management of HCC with PVTT. PMID:27621575

  8. Unusual shunt for symptomatic portal vein thrombosis after liver transplantation - Clatworthy revisited.

    PubMed

    Mali, V P; Robless, P A; Aw, M; Loh, D L; Quak, S H; Prabhakaran, K

    2012-06-01

    PV thrombosis is not an uncommon occurrence following pediatric LT. Symptomatic PHT following PV thrombosis is treated medically, surgical portosystemic shunting (mesorex, splenorenal, and mesocaval) being reserved for refractory cases. A 10-yr-old boy suffered recurrent malena and hemorrhagic shock because of chronic PV thrombosis following LT nine yr ago (1999). Extensive work-up failed to localize the bleeding source. The liver function remained normal. Initial attempts at surgical shunts failed owing to thrombosis (mesocaval 2001, splenorenal, inferior mesenteric-left renal vein, splenic-left external iliac vein 2008). In this situation, we performed a Clatworthy shunt by anastomosing the divided lower end of the LCIV to the side of SMV. There was a single, large caliber anastomosis. Post-operatively, the malena stopped completely, and clinically, there was no lower limb edema or encephalopathy. Doppler USG revealed persistence of hepatopetal flow within the portal collaterals. Follow-up at two yr reveals stable hepatic function with a patent shunt. To the best of our knowledge, we are not aware of a Clatworthy shunt being performed in a transplant setting. We reviewed the literature pertaining to this shunt in non-transplant patients with PHT.

  9. Management of hepatocellular carcinoma with portal vein tumor thrombosis: Review and update at 2016

    PubMed Central

    Chan, Stephen L; Chong, Charing C N; Chan, Anthony W H; Poon, Darren M C; Chok, Kenneth S H

    2016-01-01

    Portal vein tumor thrombosis (PVTT) is a common phenomenon in hepatocellular carcinoma (HCC). Compared to HCC without PVTT, HCC with PVTT is characterized by an aggressive disease course, worse hepatic function, a higher chance of complications related to portal hypertension and poorer tolerance to treatment. Conventionally, HCC with PVTT is grouped together with metastatic HCC during the planning of its management, and most patients are offered palliative treatment with sorafenib or other systemic agents. As a result, most data on the management of HCC with PVTT comes from subgroup analyses or retrospective series. In the past few years, there have been several updates on management of HCC with PVTT. First, it is evident that HCC with PVTT consists of heterogeneous subgroups with different prognoses. Different classifications have been proposed to stage the degree of portal vein invasion/thrombosis, suggesting that different treatment modalities may be individualized to patients with different risks. Second, more studies indicate that more aggressive treatment, including surgical resection or locoregional treatment, may benefit select HCC patients with PVTT. In this review, we aim to discuss the recent conceptual changes and summarize the data on the management of HCC with PVTT.

  10. Management of hepatocellular carcinoma with portal vein tumor thrombosis: Review and update at 2016.

    PubMed

    Chan, Stephen L; Chong, Charing C N; Chan, Anthony W H; Poon, Darren M C; Chok, Kenneth S H

    2016-08-28

    Portal vein tumor thrombosis (PVTT) is a common phenomenon in hepatocellular carcinoma (HCC). Compared to HCC without PVTT, HCC with PVTT is characterized by an aggressive disease course, worse hepatic function, a higher chance of complications related to portal hypertension and poorer tolerance to treatment. Conventionally, HCC with PVTT is grouped together with metastatic HCC during the planning of its management, and most patients are offered palliative treatment with sorafenib or other systemic agents. As a result, most data on the management of HCC with PVTT comes from subgroup analyses or retrospective series. In the past few years, there have been several updates on management of HCC with PVTT. First, it is evident that HCC with PVTT consists of heterogeneous subgroups with different prognoses. Different classifications have been proposed to stage the degree of portal vein invasion/thrombosis, suggesting that different treatment modalities may be individualized to patients with different risks. Second, more studies indicate that more aggressive treatment, including surgical resection or locoregional treatment, may benefit select HCC patients with PVTT. In this review, we aim to discuss the recent conceptual changes and summarize the data on the management of HCC with PVTT. PMID:27621575

  11. Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings.

    PubMed

    Kubo, Takatoshi; Kiryu, Shigeru; Akai, Hiroyuki; Ota, Yasunori; Tojo, Arinobu; Yoshida, Hideo; Kato, Naoya; Nakano, Yoshiyasu; Ohtomo, Kuni

    2016-01-01

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically. PMID:27587965

  12. Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings

    PubMed Central

    Kubo, Takatoshi; Akai, Hiroyuki; Ota, Yasunori; Tojo, Arinobu; Yoshida, Hideo; Kato, Naoya; Nakano, Yoshiyasu; Ohtomo, Kuni

    2016-01-01

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically. PMID:27587965

  13. Age and origin of base and precious metal veins of the Coeur d'Alene mining district, Idaho

    USGS Publications Warehouse

    Fleck, R.J.; Criss, R.E.; Eaton, G.F.; Cleland, R.W.; Wavra, C.S.; Bond, W.D.

    2002-01-01

    Ore-bearing quartz-carbonate veins of the Coeur d'Alene mining district yield 87Sr/86Sr ratios of 0.74 to >1.60 for low Rb/Sr, carbonate gangue minerals, similar to current ranges measured in Middle Proterozoic, high Rb/Sr rocks of the Belt Supergroup. Stable isotope and fluid inclusion studies establish a genetic relationship between vein formation and metamorphic-hydrothermal systems of the region. These extraordinary 87Sr/86Sr ratios require accumulation of radiogenic 87Sr in a high Rb/Sr system over an extended period prior to incorporation of Sr into the hydrothermal veins. Evaluation of the age and composition of potential sources of highly radiogenic Sr indicates that the ore-bearing veins of the Coeur d'Alene district formed during the Cretaceous from components scavenged from rocks of the Belt Supergroup, the primary host rocks of the district. Proterozoic Pb isotope ratios observed in galena from many Coeur d'Alene veins were established when Pb separated from uranium during deposition or diagenesis of the Belt Supergroup at 1400 to 1500 Ma, possibly as disseminated syngenetic deposits. K-Ar and Rb-Sr apparent ages and ??18O values of Belt Supergroup rocks decrease from the Coeur d'Alene district toward the Idaho and Kaniksu batholiths, approximately normal to the trends of metamorphic isograds, fold axes, foliation, and the major reverse faults of the district. Isoclinal folding, thrust faulting, high-temperature metamorphism, granitic plutonism, and regional-scale metamorphic-hydrothermal activity is documented in the region between 140 and 45 Ma, representing the only such combination of events in the Coeur d'Alene region subsequent to about 1300 Ma. The Sr and oxygen results and geologic evidence favor formation of the ore-bearing carbonate veins by fluids related to a complex metamorphic-hydrothermal system during the Cretaceous. Pb with Proterozoic isotopic compositions was probably mobilized and incorporated like other metals into the hydrothermal

  14. Hepatitis (For Parents)

    MedlinePlus

    ... people at risk for contracting hepatitis. But frequent hand washing and good hygiene practices can reduce this risk. All kids in ... to prevent viral hepatitis you should: Follow good hygiene and avoid crowded, ... their hands thoroughly after using the toilet and before eating. ...

  15. Veins in the northern part of the Boulder batholith, Montana

    USGS Publications Warehouse

    Pinckney, D.M.

    1965-01-01

    About 20 miles north of Butte and extending nearly to Helena, is an area of 350 square miles containing hundreds of veins and altered zones. The bedrock of the area is 1) late Cretaceous volcanic rocks, forerunners of the Boulder batholith, 2) the Boulder batholith of late Cretaceous to early Tertiary age and 3) two groups of Tertiary volcanic rocks lying on the eroded batholith. The veins are post-batholith and pre-Tertiary in age. The veins are largely either quartz-sulfide veins of mesothermal type or chalcedony veins of epithermal type. The relations of these two types of veins have been the subject of conflicting ideas for 60 years. Three workers have proposed three different genetic classifications. This report shows that the quartz veins and the chalcedony veins are closely related parts of a strongly zoned hypogene vein system. Strong zonal patterns were established using the grain size of quartz (or pyrite vs. carbonate in one district) as well as features of the altered rocks. The scale of the zoning ranges from single veins through groups of veins or mining districts to the entire mineralized area. Single veins are zoned around a core of coarse-grained quartz; the quartz outward from the core becoming progressively finer-grained. The cores are zoned around eight major centers and several lesser ones. The centers and their nearby related veins are assigned to central, intermediate, and peripheral zones. Nearly all of the veins around the edge of the mineralized area are chalcedony. Envelopes of altered rocks consist of seven major bands representing three major groups of constituents, aluminum silicates, iron-bearing minerals, and silica. Plagioclase altered successively to montomorillite, kaolinite, and sericite; potassium feldspar altered to sericite (aluminum silicate group). Biotite released iron which formed successively, iron oxides, iron-bearing carbonate, and pyrite (iron-bearing minerals). Excess silica formed silicified bands. Constituents for

  16. Making Middle Schools Work.

    ERIC Educational Resources Information Center

    Wiles, Jon W.; Bondi, Joseph W.

    Over the past 20 years, the middle school has been a major innovative movement changing the face of intermediate education. While hard to define exactly, middle schools have different priorities and purposes than junior high schools. The former serve preadolescents (ages 10 to 14) through a balanced, comprehensive program. Middle school programs…

  17. Through Middle Eastern Eyes.

    ERIC Educational Resources Information Center

    Pearson, Robert P.; Clark, Leon E., Ed.

    This book, intended for use with secondary and college students, presents a Middle Eastern view of the Middle East and the world. Most of the material in the book has been written by Middle Easterners, and it comes from a variety of sources including autobiographies, fiction, poetry, newspaper and magazine articles, letters, diaries,…

  18. [Update chronic viral hepatitis].

    PubMed

    Ziegenhagen, D J

    2016-03-01

    More than 500,000 people in Germany have chronic viral hepatitis. The interferon-based treatments formerly used in hepatitis B have been widely replaced by life-long oral medication with nucleoside or nucleotide analogues. Treatment for chronic hepatitis C has been improved substantially by the development of new and very expensive drug combinations. Up to 90% of patients can now be cured with certainty, and one to two years after successful treatment there is no relevant risk of recurrence. These individuals expect to receive insurance cover under appropriate conditions. Vaccination programmes are very efficient at decreasing the incidence of hepatitis B, but no vaccine against hepatitis C is likely to become available in the next decade. PMID:27111951

  19. Update on Alcoholic Hepatitis.

    PubMed

    Torok, Natalie J

    2015-11-02

    Alcoholic liver disease is one of the most prevalent liver diseases worldwide, and a major cause of morbidity and mortality. Alcoholic hepatitis is a severe form of liver injury in patients with alcohol abuse, can present as an acute on chronic liver failure associated with a rapid decline in liver synthetic function, and consequent increase in mortality. Despite therapy, about 30%-50% of patients with severe alcoholic hepatitis eventually die. The pathogenic pathways that lead to the development of alcoholic hepatitis are complex and involve oxidative stress, gut dysbiosis, and dysregulation of the innate and adaptive immune system with injury to the parenchymal cells and activation of hepatic stellate cells. As accepted treatment approaches are currently limited, a better understanding of the pathophysiology would be required to generate new approaches that improve outcomes. This review focuses on recent advances in the diagnosis, pathogenesis of alcoholic hepatitis and novel treatment strategies.

  20. Update on Alcoholic Hepatitis

    PubMed Central

    Torok, Natalie J.

    2015-01-01

    Alcoholic liver disease is one of the most prevalent liver diseases worldwide, and a major cause of morbidity and mortality. Alcoholic hepatitis is a severe form of liver injury in patients with alcohol abuse, can present as an acute on chronic liver failure associated with a rapid decline in liver synthetic function, and consequent increase in mortality. Despite therapy, about 30%–50% of patients with severe alcoholic hepatitis eventually die. The pathogenic pathways that lead to the development of alcoholic hepatitis are complex and involve oxidative stress, gut dysbiosis, and dysregulation of the innate and adaptive immune system with injury to the parenchymal cells and activation of hepatic stellate cells. As accepted treatment approaches are currently limited, a better understanding of the pathophysiology would be required to generate new approaches that improve outcomes. This review focuses on recent advances in the diagnosis, pathogenesis of alcoholic hepatitis and novel treatment strategies. PMID:26540078

  1. Perivascular mast cells regulate vein graft neointimal formation and remodeling

    PubMed Central

    Grassia, Gianluca; Cambrook, Helen; Ialenti, Armando; MacRitchie, Neil; Carberry, Jaclyn; Lawrence, Catherine

    2015-01-01

    Objective. Emerging evidence suggests an important role for mast cells in vein graft failure. This study addressed the hypothesis that perivascular mast cells regulate in situ vascular inflammatory and proliferative responses and subsequent vein graft neointimal lesion formation, using an optimized local mast cell reconstitution method. Methods and Results. Neointimal hyperplasia was induced by insertion of a vein graft into the right carotid artery in wild type and mast cell deficient KitW−sh/W−sh mice. In some experiments, mast cells were reconstituted systemically (tail vein injection of bone marrow-derived mast cells) or locally (directly into the right neck area) prior to vein grafting. Vein graft neointimal lesion formation was significantly (P < 0.05) reduced in KitW−sh/W−sh mice. Mast cell deficiency reduced the number of proliferating cells, and inhibited L-selectin, CCL2, M-CSF and MIP-3α expression in the vein grafts. Local but not systemic mast cell reconstitution restored a perivascular mast cell population that subsequently promoted neointimal formation in mast cell deficient mice. Conclusion. Our data demonstrate that perivascular mast cells play a key role in promoting neointima formation by inducing local acute inflammatory and proliferative responses. These results suggest that ex vivo intraoperative targeting of mast cells may have therapeutic potential for the prevention of pathological vein graft remodeling. PMID:26312183

  2. Increased distensibility in dependent veins following prolonged bedrest.

    PubMed

    Kölegård, Roger; Mekjavic, Igor B; Eiken, Ola

    2009-07-01

    Displacement of blood to the lower portion of the body that follows a postural transition from recumbent to erect is augmented by a prolonged period of recumbency (bedrest). Information is scarce as to what extent this augmented blood-volume shift to dependent veins is attributable to increased distensibility of the veins. Accordingly, we studied the effect of 5 weeks of horizontal bedrest on the pressure-distension relationship in limb veins. Elevation of venous distending pressure was induced by exposure of the body except the tested limb to supra-atmospheric pressure with the subject seated in a pressure chamber with one arm, or supine with a lower leg, protruding through a hole in the chamber door. Diameter changes in response to an increase of intravenous pressure (distensibility) from 60 to about 140 mmHg were measured in the brachial and posterior tibial veins using ultrasonographic techniques. Prior to bedrest, the distensibility was substantially less in the tibial than in the brachial vein. Bedrest increased (P < 0.01) pressure distension in the tibial vein by 86% from 7 +/- 3% before to 13 +/- 3% after bedrest. In the brachial vein, bedrest increased (P < 0.05) pressure distension by 36% from 14 +/- 5% before to 19 +/- 5% after bedrest. Thus, removal of the gravity-dependent pressure components that act along the blood vessels in erect posture increases the distensibility of dependent veins.

  3. Looking after your health. 3. Avoiding varicose veins.

    PubMed

    Randall, Sara

    2015-02-01

    This article is to summarise key concepts for the health of the midwife with particular focus on standing for prolonged periods. One of the resultant factors relating to standing postures is the slow but avoidable progression of varicose veins. There is a strong genetic bias to these veins, which can be distressing, but here we will highlight awareness and current research.

  4. Endovascular exclusion of a large external iliac vein aneurysm.

    PubMed

    Todorov, Mina; Hernandez, Diego

    2013-07-01

    Iliac vein aneurysms are uncommon, and there is no consensus on optimal treatment. We present a case of venous exclusion using an endovascular approach. To our knowledge, this is the first reported case of a large external iliac vein aneurysm treated endovascularly. We have demonstrated the feasibility of this approach with satisfactory 1-year follow-up.

  5. Surgical management of tricuspid atresia and anomalous left brachiocephalic vein.

    PubMed

    Koutlas, T C; Wernovsky, G; Slack, M C; Weinberg, P M; Spray, T L

    1998-06-01

    An anomalous left brachiocephalic vein is an uncommon systemic venous anomaly, which usually has no clinical significance. We describe a case of tricuspid atresia with such an anomalous left brachiocephalic vein. The presence of this unusual venous anomaly had a number of implications in the surgical management of the tricuspid atresia. PMID:9647100

  6. [Treatment of pulmonary vein stenosis secondary to radiofrequency ablation].

    PubMed

    Ferrero Guadagnoli, Adolfo; Contreras, Alejandro E; Leonardi, Carlos R; Ballarino, Miguel A; Atea, Leonardo; Peirone, Alejandro R

    2014-01-01

    Isolation of the pulmonary veins by applying radiofrequency is an effective treatment for atrial fibrillation. One of the potential complications with higher clinical compromise utilizing this invasive technique is the occurrence of stenosis of one or more pulmonary veins. This complication can be treated by angioplasty with or without stent implantation, with an adequate clinical improvement, but with a high rate of restenosis.

  7. Epigenetic lead, zinc, silver, antimony, tin, and gold veins in Boulder Basin, Blaine and Custer counties, Idaho; potential for economic tin mineralization

    USGS Publications Warehouse

    Ratchford, Michael E.

    2002-01-01

    Boulder Basin is in a northwest-trending belt of allochthonous Paleozoic rocks in the Boulder Mountains of central Idaho. Regional Tertiary extension resulted in widespread normal faulting and coeval emplacement of shallow-level intrusions and extrusive rocks of the Challis Volcanic Group. Epigenetic lead-zinc-silver-antimony-tin-gold vein deposits formed during Tertiary extension and are hosted within Paleozoic strata. The major orebodies are in the lower plate of the Boulder Basin thrust fault, in massive quartzite of the Middle Pennsylvanian to Lower Permian Wood River Formation. Anomalous concentrations of tin are present in the base-metal mineral assemblage of the Boulder Basin ore deposits. The tin-bearing veins in Boulder Basin are strikingly similar to Bolivian tin deposits. The deposit model for Bolivian tin deposits identifies buried tin porphyry below the tin-bearing vein system.

  8. Antisense oligonucleotide for tissue factor inhibits hepatic ischemic reperfusion injury.

    PubMed

    Nakamura, Kenji; Kadotani, Yayoi; Ushigome, Hidetaka; Akioka, Kiyokazu; Okamoto, Masahiko; Ohmori, Yoshihiro; Yaoi, Takeshi; Fushiki, Shinji; Yoshimura, Rikio; Yoshimura, Norio

    2002-09-27

    Tissue factor (TF) is an initiation factor for blood coagulation and its expression is induced on endothelial cells during inflammatory or immune responses. We designed an antisense oligodeoxynucleotide (AS-1/TF) for rat TF and studied its effect on hepatic ischemic reperfusion injury. AS-1/TF was delivered intravenously to Lewis rats. After 10 h, hepatic artery and portal vein were partially clamped. Livers were reperfused after 180 min and harvested. TF expression was studied using immunohistochemical staining. One of 10 rats survived in a 5-day survival rate and TF was strongly stained on endothelial cells in non-treatment group. However, by treatment with AS-1/TF, six of seven survived and TF staining was significantly reduced. Furthermore, we observed that fluorescein-labeled AS-1/TF was absorbed into endothelial cells. These results suggest that AS-1/TF can strongly suppress the expression of TF and thereby inhibit ischemic reperfusion injury to the rat liver. PMID:12270110

  9. Supra hepatic inferior vena cava and right atrial thrombosis following a traffic car crash

    PubMed Central

    Sabzi, Feridoun; Karim, Hosein; Haghi, Marjan

    2016-01-01

    Abstract: We present a case of nephrotic syndrome associated with right atrial and supra hepatic vein part of inferior vena caval thrombosis. This patient presented with dyspena, lower extremity edema and back pain after a vehicle accident and blunt trauma to the abdomen. Trauma should be considered not only as a thrombophilic pre-disposition, but also as a predisposing factor to IVC endothelium injury and thrombosis formation. Echocardiography revealed supra hepatic vein IVC thrombosis floating to the right atrium. A C-T scan with contrast also showed pulmonary artery emboli to the left upper lobe. With open heart surgery, the right atrial and IVC clot were extracted and the main left and right pulmonary arteries were evaluated for possible clot lodging. The patient had an uneventful postoperative recovery and thrombosis has not reoccurred with periodical follow-up examinations. PMID:26836612

  10. Supra hepatic inferior vena cava and right atrial thrombosis following a traffic car crash.

    PubMed

    Sabzi, Feridoun; Karim, Hosein; Haghi, Marjan

    2016-07-01

    We present a case of nephrotic syndrome associated with right atrial and supra hepatic vein part of inferior vena caval thrombosis. This patient presented with dyspena, lower extremity edema and back pain after a vehicle accident and blunt trauma to the abdomen. Trauma should be considered not only as a thrombophilic pre-disposition, but also as a predisposing factor to IVC endothelium injury and thrombosis formation. Echocardiography revealed supra hepatic vein IVC thrombosis floating to the right atrium. A C-T scan with contrast also showed pulmonary artery emboli to the left upper lobe. With open heart surgery, the right atrial and IVC clot were extracted and the main left and right pulmonary arteries were evaluated for possible clot lodging. The patient had an uneventful postoperative recovery and thrombosis has not reoccurred with periodical follow-up examinations. PMID:26836612

  11. Clinical Features and Developing Risks of Saphenous Vein Thrombophlebitis

    PubMed Central

    2016-01-01

    We evaluated the clinical features and the risks of 14 patients with 14 limbs affected by saphenous vein thrombophlebitis from April 2007 to May 2013 and compared the results with patients undergoing operative repair of varicose veins (127 patients, 193 limbs) during the study period. The frequency of patients with a body mass index over 25 (78.6% vs. 35.3%, p = 0.0018), varicose change in the saphenous vein (78.6% vs. 6.2%, p <0.0001), and concurrent thrombosis in another vein (50.0% vs. 7.1%, p <0.0001) were all significantly higher than those of the patients under operative repair for varicose veins. These patients with clinical features above may be at an elevated risk of thrombophlebitis of the saphenous trunk. (This article is a translation of J Jpn Coll Angiol 2014; 54: 151–157). PMID:27375800

  12. Spontaneous common iliac vein rupture: a case report

    PubMed Central

    DePass, Ian E.

    1998-01-01

    A 68-year-old woman, admitted because of acute lower quadrant abdominal pain but no history of trauma, underwent laparotomy for a suspected ruptured aortic aneurysm. Exploration revealed a 20-mm longitudinal tear in the left iliac vein. The vein was repaired primarily. Her postoperative course was complicated by deep vein thrombosis. Spontaneous rupture of the iliac vein without trauma is rare. but occurs predominantly in healthy white women between the ages of 40 and 80 years. Various causative mechanisms have been described: inflammation of the vessel wall secondary to thrombophlebitis, proximal obstruction of the iliac vein and spontaneous rupture without obstruction or thrombosis. In many cases an increase in intra-abdominal pressure is noted. PMID:9854541

  13. Connexin43 Inhibition Prevents Human Vein Grafts Intimal Hyperplasia

    PubMed Central

    Longchamp, Alban; Allagnat, Florent; Alonso, Florian; Kuppler, Christopher; Dubuis, Céline; Ozaki, Charles-Keith; Mitchell, James R.; Berceli, Scott; Corpataux, Jean-Marc

    2015-01-01

    Venous bypass grafts often fail following arterial implantation due to excessive smooth muscle cells (VSMC) proliferation and consequent intimal hyperplasia (IH). Intercellular communication mediated by Connexins (Cx) regulates differentiation, growth and proliferation in various cell types. Microarray analysis of vein grafts in a model of bilateral rabbit jugular vein graft revealed Cx43 as an early upregulated gene. Additional experiments conducted using an ex-vivo human saphenous veins perfusion system (EVPS) confirmed that Cx43 was rapidly increased in human veins subjected ex-vivo to arterial hemodynamics. Cx43 knock-down by RNA interference, or adenoviral-mediated overexpression, respectively inhibited or stimulated the proliferation of primary human VSMC in vitro. Furthermore, Cx blockade with carbenoxolone or the specific Cx43 inhibitory peptide 43gap26 prevented the burst in myointimal proliferation and IH formation in human saphenous veins. Our data demonstrated that Cx43 controls proliferation and the formation of IH after arterial engraftment. PMID:26398895

  14. Jugular-axillary vein bypass for salvage of arteriovenous access.

    PubMed

    Fulks, K D; Hyde, G L

    1989-01-01

    Stenosis or occlusion of the subclavian vein can cause incapacitating upper extremity swelling and venous hypertension in the patient with an arteriovenous (AV) access. A case of subclavian vein occlusion is reported that was treated with internal jugular-axillary vein bypass. This procedure resulted in salvage of the access and rapid resolution of the associated upper extremity swelling. It was concluded that jugular-axillary vein bypass should be considered in patients who have massive upper extremity edema resulting from a functioning AV access and ipsilateral subclavian vein occlusion. Patients undergoing creation of an AV access who have had previous temporary subclavian catheters or previous early failure of an AV access should have phlebography before surgery.

  15. IVC agenesis: a rare cause of deep vein thrombosis.

    PubMed

    Man, Louise; Hendricks, Nicholas; Maitland, Hillary

    2016-04-01

    We present the case of a healthy, young Caucasian female who presented to an outside hospital with phlegmasia cerulea dolens of both lower extremities. Computed tomography angiography revealed inferior vena cava (IVC) occlusion. She was initiated on heparin infusion and transferred to University of Virginia Medical Center. Our evaluation revealed aplasia of the IVC from the infrahepatic segment to the confluence of the common iliac veins and acute bilateral iliac vein thromboses. An extensive network of collateral veins was noted. These findings were consistent with IVC agenesis. She was not pregnant or using contraception. Primary thrombophilia workup was negative. She underwent bilateral iliac vein thrombolysis and was started on anticoagulation. While IVC agenesis is rare, it carries risk for development of thrombotic sequelae and bears consideration when evaluating young patients with unexplained deep vein thrombosis, especially if extensive and bilateral.

  16. Aging techniques for deep vein thrombosis: a systematic review.

    PubMed

    Dharmarajah, B; Sounderajah, V; Rowland, S P; Leen, E L S; Davies, A H

    2015-03-01

    Deep vein thrombosis is common with an incidence of 1 in 1000. Acute thrombus removal for extensive proximal deep vein thrombosis using catheter-directed techniques highlights the need for accurate assessment of thrombus age. This systematic review summarises experimental and clinical evidence of imaging techniques for aging deep vein thrombosis. Ultrasound elastography and magnetic resonance imaging were highlighted as the most studied imaging modalities. Elastography was shown to distinguish between acute and chronic clots, despite demonstrating difficulty in accurate aging of clots older than 10 days in rat models. Elastography is noted as a feasible adjunct to current first-line imaging for deep vein thrombosis using duplex ultrasonography. Combinations of magnetic resonance imaging techniques can identify acute, sub-acute and chronic thrombi using endogenous contrast agents and provide objective standardisation of the diagnostic process, with reduced onus upon operator dependency. Further validation is required of these novel imaging techniques prior to clinical implementation for deep vein thrombosis aging.

  17. Disastrous Portal Vein Embolization Turned into a Successful Intervention

    SciTech Connect

    Dobrocky, Tomas; Kettenbach, Joachim; Lopez-Benitez, Ruben Kara, Levent

    2015-10-15

    Portal vein embolization (PVE) may be performed before hemihepatectomy to increase the volume of future liver remnant (FLR) and to reduce the risk of postoperative liver insufficiency. We report the case of a 71-year-old patient with hilar cholangiocarcinoma undergoing PVE with access from the right portal vein using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil. During the procedure, nontarget embolization of the left portal vein occurred. An aspiration maneuver of the polymerized plug failed; however, the embolus obstructing portal venous flow in the FLR was successfully relocated into the right portal vein while carefully bypassing the plug with a balloon catheter, inflating the balloon, and pulling the plug into the main right portal vein.

  18. Internal Jugular Vein Thrombosis following Oropharyngeal Infection.

    PubMed

    Bostanci, Asli; Turhan, Murat

    2015-01-01

    Internal jugular vein thrombosis (IJVT) is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV) drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications. PMID:26457221

  19. Portal Vein Embolization: What Do We Know?

    SciTech Connect

    Denys, Alban; Prior, John; Bize, Pierre; Duran, Rafael; Baere, Thierry De; Halkic, Nermin; Demartines, Nicolas

    2012-10-15

    Portal vein embolization (PVE) has been developed to increase the size of the future remnant liver (FRL) left in place after major hepatectomy, thus reducing the risk of postoperative liver insufficiency. PVE consist in embolizing preoperatively portal branches of the segments that will be resected. Indication is based on preoperative measurements of the FRL by computed tomography and its ratio with either the theoretical liver volume or by direct measurement of the functional liver volume. After PVE, the volume and function of the FRL increases in 3 to 6 weeks, permitting extensive resections in patients otherwise contraindicated for liver resection. The PVE technique is variable from one center to another; however n-butyl-cyano-acrylate provides an interesting compromise between hypertrophy rate and procedure risk.

  20. Development of HIFU Treatment for Lower Extremity Varicose Veins

    NASA Astrophysics Data System (ADS)

    Senoo, Naohiko; Ushijima, Hiroyuki; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    High-intensity focused ultrasound (HIFU) has recently been developed as a noninvasive therapeutic method. In our study, a novel noninvasive therapy with HIFU was proposed for occlusion of lower extremity varicose veins. The temperature increase caused by HIFU is used to occlude varicose veins. Occluded veins became fibrotic, resulting in complete recovery. Our final goal is the medical application of HIFU treatment for varicose veins. In this study, we attempted to occlude the veins of rabbits. Prior to venous occlusion experiments, the area heated by HIFU was investigated using bovine serum albumin (BSA) gel, which denatures at >70 °C. The results indicate that the size of the heated area mainly depends on intensity at the focal point and the exposure time. A tendency was also seen for the heated area to extend toward the transducer with increasing exposure time. In animal experiments, skin burns during HIFU exposure represented a critical problem. We therefore examined the safe range of HIFU intensities in abdominal exposure experiments before conducting venous occlusion experiments. The ultrasound frequency was 1.7 MHz. Intensity at the focal point was 900 W/cm2, and the exposure time was 20 s. Rabbits underwent chemical depilation and echo gel was applied to the exposed skin to fill the boundary gap. Target veins were compressed during HIFU exposure to avoid thermal dissipation, and hyaluronan water solution was injected between the veins and skin to maintain the distance between the skin and veins at ≥5 mm. Veins were then exposed to HIFU and occluded. The capability of HIFU treatment to occlude lower extremity varicose veins was verified by the present study.

  1. Ipomoviruses: Squash vein yellowing virus, Cucumber vein yellowing virus, Cassava brown streak virus, and Ugandan cassava brown streak virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ipomoviruses including Squash vein yellowing virus, Cucumber vein yellowing virus and Cassava brown streak virus are currently causing significant economic impact on crop production in several regions of the world. Only recently have results of detailed characterization of their whitefly transmissi...

  2. Leaf hydraulic conductance varies with vein anatomy across Arabidopsis thaliana wild-type and leaf vein mutants.

    PubMed

    Caringella, Marissa A; Bongers, Franca J; Sack, Lawren

    2015-12-01

    Leaf venation is diverse across plant species and has practical applications from paleobotany to modern agriculture. However, the impact of vein traits on plant performance has not yet been tested in a model system such as Arabidopsis thaliana. Previous studies analysed cotyledons of A. thaliana vein mutants and identified visible differences in their vein systems from the wild type (WT). We measured leaf hydraulic conductance (Kleaf ), vein traits, and xylem and mesophyll anatomy for A. thaliana WT (Col-0) and four vein mutants (dot3-111 and dot3-134, and cvp1-3 and cvp2-1). Mutant true leaves did not possess the qualitative venation anomalies previously shown in the cotyledons, but varied quantitatively in vein traits and leaf anatomy across genotypes. The WT had significantly higher mean Kleaf . Across all genotypes, there was a strong correlation of Kleaf with traits related to hydraulic conductance across the bundle sheath, as influenced by the number and radial diameter of bundle sheath cells and vein length per area. These findings support the hypothesis that vein traits influence Kleaf , indicating the usefulness of this mutant system for testing theory that was primarily established comparatively across species, and supports a strong role for the bundle sheath in influencing Kleaf .

  3. Surgically assisted trans-hepatic anterior approach for central venous catheter placement: safety and efficacy.

    PubMed

    Diamanti, Antonella; Rollo, Massimo; Monti, Lidia; Candusso, Manila; de Ville de Goyet, Jean

    2012-12-01

    We describe a child dependent on parenteral nutrition who developed loss of all conventional central venous catheter insertion sites coupled with very unusual collateralization due to extensive thrombosis of both the superior and inferior vena cava, including the azygos vein. We successfully achieved trans-hepatic anterior access to the infra-diaphragmatic vena cava. Since the success rate for this technique is low due to catheter dislodgement, the procedure was surgically assisted for increased safety and efficacy.

  4. Visual disturbance following sclerotherapy for varicose veins, reticular veins and telangiectasias: a systematic literature review.

    PubMed

    Willenberg, T; Smith, P C; Shepherd, A; Davies, A H

    2013-04-01

    The objective of the study was to review the literature reporting visual disturbance (VD)following sclerotherapy for varicose veins. Underlying mechanisms will be discussed. A literature search of the databases Medline and Google Scholar was performed. Original articles including randomized trials, case series and case reports reporting VD in humans following sclerotherapy for varicose veins were included. Additional references were also obtained if they had been referenced in related publications. The search yielded 4948 results of which 25 reports were found to meet the inclusion criteria. In larger series with at least 500 included patients the prevalence of VD following sclerotherapy ranges from 0.09% to 2%. In most reports foam sclerotherapy was associated with VD (19); exclusive use of liquid sclerosant was reported in two cases, some reports included foam and liquid sclerosant (4). There were no persistent visual disorders reported. VD occurred with polidocanol and sodium tetradecyl sulphate in different concentrations (0.25–3%). Various forms of foam preparation including various ways of foam production and the liquid –air ratio (1 or 2 parts of liquid mixed with 3, 4 or 5 parts of air) were reported in association with the occurrence of VD. VDs following sclerotherapy for varicose veins are rare and all reported events were transient. Bubble embolism or any kind of embolism seems unlikely to be the only underlying mechanism. A systemic inflammatory response following sclerotherapy has been suggested. Further research to clarify the mechanism of action of sclerosants is required.

  5. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach.

    PubMed

    Tefera, Endale; Bermudez-Cañete, Ramon

    2014-01-01

    Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion. PMID:24701089

  6. Intrapetrous internal carotid artery aneurysm diagnosed on the basis of middle ear effusion: A case report

    PubMed Central

    WANG, YING; GUAN, BING; TIAN, TONGTONG; PENG, XIN; XU, LI

    2015-01-01

    The present study reports a rare case of a giant intrapetrous internal carotid aneurysm that compressed the internal jugular vein causing recurrent middle ear effusion in a 13-year-old female. Images obtained by computed tomography revealed middle ear effusion occupying the right side of the attic. Digital subtraction angiography (DSA) resulted in a diagnosis of a giant aneurysm of the right intrapetrous carotid artery, with a diameter of 25 mm and a neighboring area of compression of the internal jugular vein. The patient was treated successfully using coil embolization. The present study therefore indicates that DSA should be considered in the differential diagnosis of patients with middle ear effusion. Early treatment with coil embolization or other surgical treatments can be a life-saving therapeutic approach. PMID:26171015

  7. Living Donor Liver Transplantation for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis after Concurrent Chemoradiation Therapy

    PubMed Central

    Han, Dai Hoon; Joo, Dong Jin; Kim, Myoung Soo; Choi, Gi Hong; Choi, Jin Sub; Park, Young Nyun; Seong, Jinsil

    2016-01-01

    Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea. CCRT [45 Gy over 5 weeks with 5-fluorouracil (5-FU) as HAIC] was followed by HAIC (5-FU/cisplatin combination every 4 weeks for 3–12 months), adjusted for tumor response. Down-staging succeeded in all eight patients, leaving no viable tumor thrombi in major vessels, although three patients first underwent hepatic resections. Due to deteriorating liver function, transplantation was the sole therapeutic option and offered a chance for cure. The 1-year disease-free survival rate was 87.5%. There were three instances of post-transplantation tumor recurrence during follow-up monitoring (median, 17 months; range, 10–22 months), but no deaths occurred. Median survival time from initial diagnosis was 33 months. Four postoperative complications recorded in three patients (anastomotic strictures: portal vein, 2; bile duct, 2) were resolved through radiologic interventions. Using an intensive tumor down-staging protocol of CCRT followed by HAIC, LDLT may be a therapeutic option for selected patients with locally advanced HCC and portal vein tumor thrombosis. PMID:27401662

  8. Living Donor Liver Transplantation for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis after Concurrent Chemoradiation Therapy.

    PubMed

    Han, Dai Hoon; Joo, Dong Jin; Kim, Myoung Soo; Choi, Gi Hong; Choi, Jin Sub; Park, Young Nyun; Seong, Jinsil; Han, Kwang Hyub; Kim, Soon Il

    2016-09-01

    Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea. CCRT [45 Gy over 5 weeks with 5-fluorouracil (5-FU) as HAIC] was followed by HAIC (5-FU/cisplatin combination every 4 weeks for 3-12 months), adjusted for tumor response. Down-staging succeeded in all eight patients, leaving no viable tumor thrombi in major vessels, although three patients first underwent hepatic resections. Due to deteriorating liver function, transplantation was the sole therapeutic option and offered a chance for cure. The 1-year disease-free survival rate was 87.5%. There were three instances of post-transplantation tumor recurrence during follow-up monitoring (median, 17 months; range, 10-22 months), but no deaths occurred. Median survival time from initial diagnosis was 33 months. Four postoperative complications recorded in three patients (anastomotic strictures: portal vein, 2; bile duct, 2) were resolved through radiologic interventions. Using an intensive tumor down-staging protocol of CCRT followed by HAIC, LDLT may be a therapeutic option for selected patients with locally advanced HCC and portal vein tumor thrombosis. PMID:27401662

  9. Experimental hepatic fibrosis due to Capillaria hepatica infection (differential features presented by rats and mice).

    PubMed

    Andrade, Stelamares Boyda de; Andrade, Zilton A

    2004-06-01

    Rats and mice are among the most susceptible hosts for the helminth Capillaria hepatica. More information on the similarities and differences between the hepatic pathology presented by these two parasite hosts are needed, since they may represent good models for the study of hepatic fibrosis. Early changes are similar for both hosts and are represented by necro-inflammatory lesions around dead parasites and their eggs and diffuse and intense reactive hepatitis. Although worms remain alive longer in mice than in rats, hepatic changes are more rapidly and deeply modulated in the former, even leading to almost complete disappearance of fibrosis. As for the rats, the modulation of the focal lesions is followed by the formation of septal fibrosis, a process where fine and long fibrous septa appear connecting portal spaces and central veins in such a way as to form a final morphologic picture of cirrhosis. Hepatic functional changes usually present good correlations with the morphologic findings at the different phases of the infection evolution. Therefore C. hepatica infection in rats and mice represent two different models of hepatic fibrosis and these differences, if properly known and understood, can be explored to answer different questions regarding several aspects of hepatic fibrosis.

  10. The hepatitis C crisis.

    PubMed

    St John, Tina M; Sandt, Lorren

    2005-01-01

    An estimated 170 million persons (3% of the world's population) are infected with the hepatitis C virus (HCV), and 3 to 4 million persons are newly infected each year. Of those infected, 70%-85% develop chronic viremia with the potential for devastating long-term sequelae, including chronic liver disease, cirrhosis, hepatic failure, and hepatocellular carcinoma. The passivity in the public health sector and in the medical community at large with respect to hepatitis C portends a myriad of societal, fiscal, and personal costs for the United States within the next two decades unless immediate actions are taken to intervene in the natural history of this emerging public health crisis. PMID:15822840

  11. Influence of vein fabric on strain distribution and fold kinematics

    NASA Astrophysics Data System (ADS)

    Torremans, Koen; Muchez, Philippe; Sintubin, Manuel

    2014-05-01

    Abundant pre-folding, bedding-parallel fibrous dolomite veins in shale are found associated with the Nkana-Mindola stratiform Cu-Co deposit in the Central African Copperbelt, Zambia. These monomineralic veins extend for several meters along strike, with a fibrous infill orthogonal to low-tortuosity vein walls. Growth morphologies vary from antitaxial with a pronounced median surface to asymmetric syntaxial, always with small but quantifiable growth competition. Subsequently, these veins were folded. In this study, we aim to constrain the kinematic fold mechanism by which strain is accommodated in these veins, estimate paleorheology at time of deformation and investigate the influence of vein fabric on deformation during folding. Finally, the influence of the deformation on known metallogenetic stages is assessed. Various deformation styles are observed, ultimately related to vein attitude across tight to close lower-order, hectometre-scale folds. In fold hinges, at low to average dips, veins are (poly-)harmonically to disharmonically folded as parasitic folds in single or multilayer systems. With increasing distance from the fold hinge, parasitic fold amplitude decreases and asymmetry increases. At high dips in the limbs, low-displacement duplication thrusts of veins at low angles to bedding are abundant. Slickenfibres and slickenlines are sub-perpendicular to fold hinges and shallow-dipping slickenfibre-step lineations are parallel to local fold hinge lines. A dip isogon analysis of reconstructed fold geometries prior to homogeneous shortening reveals type 1B parallel folds for the veins and type 1C for the matrix. Two main deformation mechanisms are identified in folded veins. Firstly, undulatory extinction, subgrains and fluid inclusions planes parallel the fibre long axis, with deformation intensity increasing away from the fold hinges, indicate intracrystalline strain accumulation. Secondly, intergranular deformation through bookshelf rotation of fibres, via

  12. Feature Hepatitis: The Dangers of Hepatitis: What you should know from A to E

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis The Dangers of Hepatitis: What you should know from A to E ... drugs. In some cases, hepatitis lasts a lifetime. Hepatitis: Acute or Chronic? Acute hepatitis is the initial ...

  13. [RADIOFREQUENCY ABLATION FOR THE TREATMENT OF VARICOSE VEINS].

    PubMed

    Sugiyama, Satoru; Miyade, Yoshio; Inaki, Yasuhiko

    2015-05-01

    Significant advances in the endovenous technique for treating incompetent saphenous veins could change the surgical strategy in patients with varicose veins. Radiofrequency ablation (RFA) was approved as a new technique for the treatment of varicose veins in Japan in June 2014. In RFA, the ablation temperature is controlled by a sensor at the upper end of the catheter. The vein wall is heated with stable conductive power of 120 degrees C, resulting in endothelial denudation. The RFA method was approved in 1998 in Europe and in 1999 in the USA. The ClosurePLUS catheter was developed in 2003 and ClosureFAST in 2006. High occlusion rates and lower postoperative complication rates were reported with ClosureFAST than with ClosurePLUS. It is expected that this new ablation technique will control saphenous vein reflux with less pain and less ecchymosis after surgery. The treatment of varicose veins is less invasive with RFA devices and will become widely accepted as an alternative to conventional surgery for varicose veins in Japan.

  14. Palm Vein Verification Using Multiple Features and Locality Preserving Projections

    PubMed Central

    Bu, Wei; Wu, Xiangqian; Zhao, Qiushi

    2014-01-01

    Biometrics is defined as identifying people by their physiological characteristic, such as iris pattern, fingerprint, and face, or by some aspects of their behavior, such as voice, signature, and gesture. Considerable attention has been drawn on these issues during the last several decades. And many biometric systems for commercial applications have been successfully developed. Recently, the vein pattern biometric becomes increasingly attractive for its uniqueness, stability, and noninvasiveness. A vein pattern is the physical distribution structure of the blood vessels underneath a person's skin. The palm vein pattern is very ganglion and it shows a huge number of vessels. The attitude of the palm vein vessels stays in the same location for the whole life and its pattern is definitely unique. In our work, the matching filter method is proposed for the palm vein image enhancement. New palm vein features extraction methods, global feature extracted based on wavelet coefficients and locality preserving projections (WLPP), and local feature based on local binary pattern variance and locality preserving projections (LBPV_LPP) have been proposed. Finally, the nearest neighbour matching method has been proposed that verified the test palm vein images. The experimental result shows that the EER to the proposed method is 0.1378%. PMID:24693230

  15. Functional abnormalities of experimental autogenous vein graft neoendothelium.

    PubMed Central

    Cross, K S; el-Sanadiki, M N; Murray, J J; Mikat, E M; McCann, R L; Hagen, P O

    1988-01-01

    When a vein is grafted into the arterial circulation, the endothelium of the graft is damaged. Regeneration of an intact neoendothelium occurs, but the functional properties of this surface have not been clarified. In this study, the functional integrity of the neoendothelium of veins grafted into the carotid artery of the rabbit was assessed through the use of acetylcholine and histamine to stimulate the production of the important endothelium-derived relaxing factor (EDRF). Control veins, precontracted with norepinephrine [10(-5) M], relaxed after exposure to acetylcholine [( 10(-7) M], 42.4% +/- 6.4%, p = 0.008) and histamine [( 10(-6) M], 30.6% +/- 4.3%, p = 0.03). This relaxation response was abolished after mechanical removal of the endothelium. By contrast, neither acetylcholine nor histamine caused an endothelium-dependent relaxation in the vein grafts, even though scanning electron microscopy demonstrated the presence of a morphologically intact endothelium. However, addition of stabilized EDRF purified from cultured endothelial cells induced relaxation of the vein grafts (35.8% +/- 3.6%, p = 0.002). These data indicate that vein graft endothelium is unable to produce EDRF in response to exposure to acetylcholine or histamine. The inability to produce this potent smooth muscle cell relaxing factor and anti-aggregatory substance may be a predisposition to vein graft failure. Images Figs. 4A-C. Fig. 4. (Continued) Fig. 4. (Continued) Figs. 5A-C. Fig. 5. (Continued) Fig. 5. (Continued) Fig. 6. PMID:3263843

  16. Hepatic sarcoidosis complicating treatment-naive viral hepatitis

    PubMed Central

    Aravinthan, Aloysious; Gelson, William; Limbu, Anita; Brais, Rebecca; Richardson, Paul

    2012-01-01

    Hepatic sarcoidosis is usually asymptomatic but rarely leads to adverse liver-related outcome. Co-existence of viral hepatitis and hepatic sarcoidosis is a rare, but recognised phenomenon. Obtaining a balance between immune suppression and anti-viral therapy may be problematic. Immunosuppression in the presence of viral hepatitis can lead to rapid deterioration of liver disease. Similarly, anti-viral therapy may exacerbate granulomatous hepatitis. Here we present two cases of viral hepatitis co-existing with sarcoidosis that illustrate successful management strategies. In one, hepatitis B replication was suppressed with oral anti-viral therapy before commencing prednisolone. In the second, remission of hepatic sarcoidosis was achieved with prednisolone, before treating hepatitis C and obtaining a sustained virological response with pegylated interferon and ribavirin therapy. PMID:23355920

  17. [A Measurement Method for the Hepatic Functional Reserves Anti Oxygen Fluctuations].

    PubMed

    Liu, Guang-da; Chen, Yong; Wang, Jing-jing

    2015-06-01

    Hepatic functional reserves parameters are the key indictors to assess if the hepatic metabolic function is normal, they are also the important basis to a successful hepatectomy. Currently clinical hepatic functional reserves parameters are achieved through Indocyanine Green (ICG) concentration measurement in the method of pulse dye spectrophotometry, with the assumption that blood oxygen saturation is 100%, this hypothetical bias leads to an error in the calculated value of the hepatic functional reserves parameters. In order to solve this problem, hepatic functional reserves parameters measurement that resist fluctuation from blood is presented. The method is based on the modified Lambert Beer's law and realize the correction of ICG concentration measurement in the method of pulse dye spectrophotometry. While the ICG is injected into the patient's body by the cubital veins, using the data acquisition unit that developed by project team to collect 805 nm, 940 nm wavelengths of transmission signals and 730 nm, 805 nm and 890 nm wavelengths of reflected signals in the fingertip skin synchronously, and then upload 5 sets of data to the computer. Draw the ICG concentration curve according the collected data and blood oxygen saturation before injecting ICG to the human body and then calculate the characteristic parameters, according to the characteristic parameters calculate the hepatic reserves functional parameters. Taking the measurement of effective hepatic blood flow as an example, the relative error was obviously decreased when comparing this method and the pulse dye concentration method with the electromagnetic flowmeter (EMF) measurement which is the most accurate method to measure effective hepatic blood flow (EHBF) respectively. The results demonstrate that this method can improve the accuracy of hepatic reserves parameters, and it can also provide a more accurate detection method of hepatic functional reserves parameters for clinical application.

  18. Physiological regulation of penile arteries and veins.

    PubMed

    Prieto, D

    2008-01-01

    Recent experimental evidence suggests that arterial insufficiency precedes the structural and functional changes in corpora cavernosa (CC) leading to organic erectile dysfunction (ED). The present review gives an overview of the physiological factors involved in the regulation of penile vasculature. Sympathetic nerves maintain flaccidity and tonically released noradrenaline induces vasoconstriction of both arteries and veins through alpha(1)- and alpha(2)-postsynaptic receptors and downregulates its own release and that of nitric oxide (NO) through alpha(2)-presynaptic receptors. The sympathetic cotransmitter neuropeptide Y (NPY) modulates noradrenergic vasoconstriction in penile small arteries by both enhancing and depressing noradrenaline contractions through Y(1)- and Y(2)-postsynaptic and a NO-independent atypical endothelial receptor, respectively. Activation of alpha(1)-adrenoceptors involves both Ca(2+) influx through L-type and receptor-operated Ca(2+) channels (ROC) and Ca(2+) sensitization mechanisms mediated by protein kinase C (PKC), tyrosine kinases (TKs) and Rho kinase (RhoK). In addition, RhoK can regulate Ca(2+) entry in penile arteries upon receptor stimulation. Vasodilatation of penile arteries and large veins during erection is mediated by neurally released NO. The subsequent increased arterial inflow to the cavernosal sinoids and shear stress on the endothelium lining penile arteries activates endothelial NO production through Akt phosphorylation of endothelial NO synthase (eNOS). NO stimulates guanylate cyclase and increased cyclic guanin 3'-monophosphate (cGMP) levels in turn activate protein kinase G (PKG), which enhances K(+) efflux through Ca(2+)-activated (K(Ca)) and voltage-dependent Ca(2+) (K(v)) channels in penile arteries and veins, respectively. PKG-mediated decrease in Ca(2+) sensitivity and its regulation by RhoK remains to be clarified in penile vasculature. Phosphodiesterase type 5 (PDE5) inhibitors are potent vasodilators of

  19. Hyperbilirubinaemia and haemolytic anaemia in acute alcoholic hepatitis: there's oil in them thar veins

    PubMed Central

    Hashmi, Salman; Allison, Michael G; McCurdy, Michael T; Reed, Robert M

    2014-01-01

    A Caucasian woman in her late 30s was evaluated after a period of binge drinking and found to have hyperbilirubinaemia for which she was referred for consideration of cholecystectomy. After exclusion of other possibilities, Zieve's syndrome was diagnosed. This is a condition of hyperbilirubinaemia, Coombs’ negative haemolytic anaemia and hyperlipidaemia associated with alcoholism. Abstinence from alcohol remains the only known effective treatment, and appreciation of the entity can prevent unnecessary biliary procedures. The patient improved with supportive measures and was discharged in stable condition. PMID:24748143

  20. Hepatitis Risk Assessment

    MedlinePlus

    ... About the Division of Viral Hepatitis Contact Us File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel ...

  1. [Patient education of hepatitis].

    PubMed

    Boyer, Dominique; Faillebin, Françoise; de la Brière, Aice

    2013-11-01

    The therapeutic education of patients with hepatitis C helps to improve their health and quality of life. The aim is to encourage compliance with the treatment and the fight against side effects, through to the patient's recovery. PMID:24409616

  2. XTC-induced hepatitis.

    PubMed

    Oranje, W A; von Pol, P; vd Wurff, A; Zeijen, R N; Stockbrügger, R W; Arends, J W

    1994-02-01

    An increasing number of severe complications associated with the use of XTC is being reported. After 11 earlier case reports we describe an acute hepatitis due to occasional use of XTC in a 25-year-old woman.

  3. HIV and Viral Hepatitis

    MedlinePlus

    ... prevalent among blacks as among whites. Viral Hepatitis Transmission People can be infected with the three most ... risk for HAV. • • New data suggest that sexual transmission of HCV among MSM with HIV occurs more ...

  4. Hepatitis A FAQs

    MedlinePlus

    ... 185°F (85°C), kill the virus, although freezing temperatures do not. Symptoms Does Hepatitis A cause ... food, such as drinking beverages (with or without ice) of unknown purity, eating uncooked shellfish, and eating ...

  5. Hepatitis B - children

    MedlinePlus

    ... tests detect liver damage and the risk for liver cancer from chronic hepatitis B: Albumin level Liver function tests Prothrombin time Liver biopsy Abdominal ultrasound Liver cancer tumor markers such as alpha fetoprotein The provider ...

  6. AGE AND ORIGIN OF BASE- AND PRECIOUS-METAL VEINS OF THE COEUR D'ALENE MINING DISTRICT, IDAHO

    SciTech Connect

    Fleck, R J; Criss, R E; Eaton, G F; Cleland, R W; Wavra, C S; Bond, W D

    2000-11-07

    Ore-bearing quartz-carbonate veins of the Coeur d'Alene mining district yield {sup 87}Sr/{sup 86}Sr ratios of 0.74 to >1.60 for low-Rb/Sr, carbonate gangue minerals, similar to current ranges measured in Middle Proterozoic, high-Rb/Sr rocks of the Belt Supergroup. Stable-isotope and fluid-inclusion studies establish a genetic relationship between vein formation and metamorphic-hydrothermal systems of the region. These extraordinary {sup 87}Sr/{sup 86}Sr ratios require accumulation of radiogenic {sup 87}Sr in a high Rb/Sr system over an extended period prior to incorporation of Sr into the veins by hydrothermal processes. Evaluation of the age and composition of potential sources of highly radiogenic Sr indicates that the ore-bearing veins of the Coeur d'Alene district formed within the last 200 Ma from components scavenged from sedimentary and metasedimentary rocks of the Belt Supergroup, the primary host-rocks of the district. These results are consistent with a Cretaceous or Early Tertiary age for these veins. Pb-Zn deposits that yield Pb isotope, K-Ar, and Ar-Ar results indicative of a Proterozoic age probably formed during deposition or diagenesis of the Belt Supergroup at 1350-1500 Ma, possibly as Sullivan-type syngenetic deposits. K-Ar and Rb-Sr apparent ages and {delta}{sup 18}O values of Belt Supergroup rocks decrease southward from the Coeur d'Alene district toward the Idaho batholith, normal to the trends of metamorphic isograds, fold axes, foliation, and the major reverse faults of the district. Isoclinal folding, thrust faulting, high-temperature metamorphism, granitic plutonism, and regional-scale metamorphic-hydrothermal activity is documented in the region between 140 Ma and 45 Ma, but no similar combination of events is recognized for Late Proterozoic time. Combined with Sr results from the veins, the evidence strongly favors formation of the ore-bearing carbonate veins of the district by fluids related to a complex metamorphic-hydrothermal system

  7. A phyllosilicate-sulfide vein in Kaidun. [Abstract only

    NASA Technical Reports Server (NTRS)

    Ivanov, A. V.; Zolensky, M. E.; Brandstatter, F.; Kurat, G.; Kononkova, N. N.

    1994-01-01

    A fragment of a carbonaceous chondrite (#53.12, maximal dimension about 2 mm) containing a phyllosilicate-sulfide vein was found during an inspection of small pieces of the Kaidun meteorite. Phyllosilicate veins are apparently rare in carbonaceous chondrites and have so far only been reported from the Y82162 CI chondrite. In hand sample the vein was visible on two perpendicular faces. The polished section prepared from one side displays a complex structure. A single vein, 150 microns in width, bifurcates, and each branch narrows toward a large rounded object (RO). The section contains abundant ROs, most of them less than or equal to 100 microns in diameter. The vein has sharp contacts to the surrounding matrix, whereas the RO contacts are diffuse. The phyllosilicate in the main vein has a massive texture along the contact, which becomes platy toward the vein center where the crystals protrude into an open space. The texture of the largest RO resembles that of a barred olivine (BO) chondrule. Some of the smaller ROs also texturally resemble chondrules. The BO chondrule contains rounded sulfide-silicate objects and small metal grains covered by oxides. Phyllosilicates of the main vein consist mainly of serpentine. The phyllosilicate near the contact with the matrix has low contents of minor elements and a high Mg/Fe ratio. The composition changes in a regular manner toward the center: Al, Na, Ca, Ni, and S increase, indicating increasing amounts of sulfates admixed. The phyllosilicate vein could only have formed after a substantial rock was formed. Mechanical stress probably opened a crack that was subsequently filled by phyllosilicate, pyrrhotite, and finally by a (Fe,Mg)-sulfate. The source of the matter mobilized to form the vein could have been within the rock itself or outside. No compositional or mineralogical zoning is apparent at the vein-rock contacts. The nature of the transporting agent (liquid H2O or vapor) must also remain an enigma. M. Zolensky has

  8. Endovenous radiofrequency ablation for the treatment of varicose veins.

    PubMed

    Kayssi, Ahmed; Pope, Marc; Vucemilo, Ivica; Werneck, Christiane

    2015-04-01

    Varicose veins are a common condition that can be treated surgically. Available operative modalities include saphenous venous ligation and stripping, phlebectomy, endovenous laser therapy and radiofrequency ablation. Radiofrequency ablation is the newest of these technologies, and to our knowledge our group was the first to use it in Canada. Our experience suggests that it is a safe and effective treatment for varicose veins, with high levels of patient satisfaction reported at short-term follow-up. More studies are needed to assess long-term effectiveness and compare the various available treatment options for varicose veins.

  9. Total Anomalous Pulmonary Venous Connection to the Portal Vein

    SciTech Connect

    Wyttenbach, Marina; Carrel, Thierry; Schuepbach, Peter; Tschaeppeler, Heinz; Triller, Juergen

    1996-03-15

    Anomalous pulmonary venous return represents a rare congenital anomaly with wide anatomic and physiologic variability. We report a case of a newborn with a rare form of total infracardiac anomalous pulmonary venous connection (TAPVC). The pulmonary veins draining both lungs formed two vertical veins, which joined to a common pulmonary trunk below the diaphragm. This venous channel connected to the portal vein through the esophageal hiatus. The diagnosis was suggested by color Doppler sonography and confirmed by intravenous digital subtraction angiography, which allowed definition of the anatomy.

  10. Transjugular Portal Venous Stenting in Inflammatory Extrahepatic Portal Vein Stenosis

    SciTech Connect

    Schaible, Rolf; Textor, Jochen; Decker, Pan; Strunk, Holger; Schild, Hans

    2002-12-15

    We report the case of a 37-year-old man with necrotizing pancreatitis associated with inflammatory extrahepatic portal vein stenosis and progressive ascites. Four months after the acute onset, when no signs of infection were present, portal decompression was performed to treat refractory ascites. Transjugulartranshepatic venoplasty failed to dilate the stenosis in the extrahepatic portion of the portal vein sufficiently. Therefore a Wallstent was implanted, resulting in almost normal diameter of the vessel. In follow-up imaging studies the stent and the portal vein were still patent 12 months after the intervention and total resolution of the ascites was observed.

  11. Unusual Presentation of Renal Vein Thrombosis in a Preterm Infant.

    PubMed

    Yang, Chang-Yo; Fu, Ren-Huei; Lien, Reyin; Yang, Peng-Hong

    2014-05-01

    Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants undergoing intensive care. In this study, we report the case of a preterm infant with left renal vein and inferior vena cava thrombosis, presented with gross hematuria, thrombocytopenia, transient hypertension, and adrenal hemorrhage. Supportive care was offered instead of heparin therapy or thrombolytic agents. In conclusion, our case teaches that, despite the lack of a clinically obvious shock event, renal vein thrombosis should be considered in a macrohematuric newborn without renal failure.

  12. Combined arteriovenous thrombolytic infusion for refractory renal vein thrombosis.

    PubMed

    Heafner, Thomas A; Scott, Daniel; Watson, J Devin; Propper, Brandon; Johnson, Chatt; Arthurs, Zachary M

    2014-08-01

    Acute renal vein thrombosis can rapidly lead to significant impairment and eventual loss of renal function. Classically presenting with flank pain, hematuria, and laboratory markers consistent with acute kidney injury, therapeutic anticoagulation is the mainstay of treatment. However, endovascular surgery offers a safe and effective alternative for renal salvage in the setting of acute renal vein thrombosis. Described is the use of combined arteriovenous thrombolytic infusion for refractory renal vein thromboses to quickly and effectively decrease clot burden in the micro- and macrovenous circulations while limiting systemic exposure.

  13. Experience of vein grafting in Göttingen minipigs.

    PubMed

    Tsutsumi, H; Miyawaki, F; Arakawa, H; Tsuji, T; Tanigawa, M

    2001-04-01

    We experimented with vein grafting surgery on Göttingen minipigs. Using the internal jugular vein for the tissue graft, we performed side-to-side anastomosis to the carotid artery, to which it runs parallel. One key point in this surgery was to prevent vasospasm of the carotid artery so as to keep the lumen sufficiently patent during anastomosis. The histopathological findings in the grafts which remained patent resembled those of vein grafts in humans. We therefore considered that this technique in minipigs can be applied for the study of coronary artery bypass surgery in humans.

  14. Postpartum ovarian vein thrombosis after cesarean delivery: a case report

    PubMed Central

    Royo, Pedro; Alonso-Burgos, Alberto; García-Manero, Manuel; Lecumberri, Ramón; Alcázar, Juan Luis

    2008-01-01

    Introduction Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%. It most often occurs during the 2–15 days following delivery. Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. Conclusion Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis. PMID:18400095

  15. [Initial division of the left renal vein before dissection of left renal vein occluded by intracaval tumor thrombus].

    PubMed

    Kurosawa, Kazuhiro; Okita, Ryuji; Motoshima, Takanobu; Fujioka, Masashi; Abe, Hiromitsu; Morikawa, Hirofumi; Okaneya, Toshikazu; Komatsu, Hideki

    2011-09-01

    Between November 2008 and March 2010, we performed initial division of the left renal vein occluded by the tumor thrombus in six cases of left renal cancer at Toranomon Hospital. The left renal vein was completely occluded by the tumor thrombus in all cases. In order to ligate the left renal artery first behind the dilated left renal vein, we must dissect the left kidney with arterial blood flow. Massive bleeding from the numerous engorged collateral veins around the left kidney is inevitable. Furthermore, access to the left renal artery is difficult because of the large tumor. We therefore initially divided the left renal vein without arterial blood flow followed by division of the left renal artery. After nephrectomy by dissecting the tumor without blood flow we extirpated the intracaval tumor thrombus. The median time of the operation was 7 hours 35 minutes and the median amount of blood loss was 2,869 ml. The tumor stage was pT3b in four cases and pT3c in two cases. No complications were observed during and after surgery except for one case of lymphocele and another case of chylous ascites. The initial division of the left renal vein is considered to be a useful surgical approach in left renal cancer with occluded left renal vein, especially when the tumor is large.

  16. Immigration and viral hepatitis.

    PubMed

    Sharma, Suraj; Carballo, Manuel; Feld, Jordan J; Janssen, Harry L A

    2015-08-01

    WHO estimates reveal that the global prevalence of viral hepatitis may be as high as 500 million, with an annual mortality rate of up to 1.3 million individuals. The majority of this global burden of disease is borne by nations of the developing world with high rates of vertical and iatrogenic transmission of HBV and HCV, as well as poor access to healthcare. In 2013, 3.2% of the global population (231 million individuals) migrated into a new host nation. Migrants predominantly originate from the developing countries of the south, into the developed economies of North America and Western Europe. This mass migration of individuals from areas of high-prevalence of viral hepatitis poses a unique challenge to the healthcare systems of the host nations. Due to a lack of universal standards for screening, vaccination and treatment of viral hepatitis, the burden of chronic liver disease and hepatocellular carcinoma continues to increase among migrant populations globally. Efforts to increase case identification and treatment among migrants have largely been limited to small outreach programs in urban centers, such that the majority of migrants with viral hepatitis continue to remain unaware of their infection. This review summarizes the data on prevalence of viral hepatitis and burden of chronic liver disease among migrants, current standards for screening and treatment of immigrants and refugees, and efforts to improve the identification and treatment of viral hepatitis among migrants. PMID:25962882

  17. Delta hepatitis in Malaysia.

    PubMed

    Sinniah, M; Dimitrakakis, M; Tan, D S

    1986-06-01

    Sera from one hundred and fifty nine Malaysian individuals were screened for the prevalence of delta markers. These included 15 HBsAg positive homosexuals, 16 acute hepatitis B cases, 9 chronic hepatitis B patients, 13 healthy HBsAg carriers and 106 intravenous (i.v.) drug abusers, of whom 27 were positive for HBsAg only and the rest were anti-HBc IgG positive but HBsAg negative. The prevalence of delta markers in the homosexuals was found to be 6.7%, in the HBsAg positive drug abusers 17.8%, in acute hepatitis B cases 12.5%. No evidence of delta infection was detected in healthy HBsAg carriers, chronic hepatitis B cases and HBsAg negative i.v. drug abusers. With reference to i.v. drug abusers, the prevalence of delta markers was higher in Malays (23%) than in Chinese (7%) although the latter had a higher HBsAg carrier rate. Although the HBsAg carrier rate in the homosexuals was high, their delta prevalence rate was low as compared to drug abusers. In Malaysia, as in other non-endemic regions, hepatitis delta virus transmission appeared to occur mainly via the parenteral and sexual routes. This is the first time in Malaysia that a reservoir of delta infection has been demonstrated in certain groups of the population at high risk for hepatitis B. PMID:3787309

  18. Immigration and viral hepatitis.

    PubMed

    Sharma, Suraj; Carballo, Manuel; Feld, Jordan J; Janssen, Harry L A

    2015-08-01

    WHO estimates reveal that the global prevalence of viral hepatitis may be as high as 500 million, with an annual mortality rate of up to 1.3 million individuals. The majority of this global burden of disease is borne by nations of the developing world with high rates of vertical and iatrogenic transmission of HBV and HCV, as well as poor access to healthcare. In 2013, 3.2% of the global population (231 million individuals) migrated into a new host nation. Migrants predominantly originate from the developing countries of the south, into the developed economies of North America and Western Europe. This mass migration of individuals from areas of high-prevalence of viral hepatitis poses a unique challenge to the healthcare systems of the host nations. Due to a lack of universal standards for screening, vaccination and treatment of viral hepatitis, the burden of chronic liver disease and hepatocellular carcinoma continues to increase among migrant populations globally. Efforts to increase case identification and treatment among migrants have largely been limited to small outreach programs in urban centers, such that the majority of migrants with viral hepatitis continue to remain unaware of their infection. This review summarizes the data on prevalence of viral hepatitis and burden of chronic liver disease among migrants, current standards for screening and treatment of immigrants and refugees, and efforts to improve the identification and treatment of viral hepatitis among migrants.

  19. Mechanisms of Hepatic Fibrogenesis

    PubMed Central

    Friedman, Scott L.

    2010-01-01

    Substantial improvements in the treatment of chronic liver disease have accelerated interest in uncovering the mechanisms underlying hepatic fibrosis and its resolution. Activation of resident hepatic stellate cells into proliferative, contractile, and fibrogenic cells in liver injury remains a dominant theme driving the field. However, several new areas of rapid progress in the past 5–10 years also have taken root, including: (1) identification of different fibrogenic populations apart from resident stellate cells, for example, portal fibroblasts, fibrocytes, and bone-marrow– derived cells, as well as cells derived from epithelial mesenchymal transition; (2) emergence of stellate cells as finely regulated determinants of hepatic inflammation and immunity; (3) elucidation of multiple pathways controlling gene expression during stellate cell activation including transcriptional, post-transcriptional, and epigenetic mechanisms; (4) recognition of disease-specific pathways of fibrogenesis; (5) re-emergence of hepatic macrophages as determinants of matrix degradation in fibrosis resolution and the importance of matrix cross-linking and scar maturation in determining reversibility; and (6) hints that hepatic stellate cells may contribute to hepatic stem cell behavior, cancer, and regeneration. Clinical and translational implications of these advances have become clear, and have begun to impact significantly on the management and outlook of patients with chronic liver disease. PMID:18471545

  20. Arteries and Veins of the Sylvian Fissure and Insula: Microsurgical Anatomy.

    PubMed

    Delion, Matthieu; Mercier, Philippe; Brassier, Gilles

    2016-01-01

    We present a vascular anatomical study of the arteries and veins of the sylvian fissure and insula.A good knowledge of the sylvian fissure, the insula, and their vascular relationship would seem mandatory before performing surgery in this area, whatever the type of surgery (aneurysms, arteriovenous malformations, insular tumors).We start with the sylvian fissure and insula morphology, followed by the MCA description and its perforators, with special attention paid to the insular perforators. We demonstrate that the long insular perforators penetrating in the superior part of the posterior short gyrus and long gyri vascularize, respectively, the corticonuclear and corticospinal fasciculi. We particularly insist too on three anatomical constants regarding the vascularization of the insula, already described in the literature: The superior periinsular sulcus is the only sulcus on the lateral surface of the brain without an artery along its axis; the superior branch of the MCA supplies the anterior insular pole and both the anterior and middle short gyri in 100 % of cases; in at least 90 % of cases, the artery that supplied the central insular sulcus continued on to become the central artery.We end with the anatomical study of the veins and cisterns.

  1. A 250,000-year climatic record from great basin vein calcite: Implications for Milankovitch theory

    USGS Publications Warehouse

    Winograd, I.J.; Szabo, B. J.; Coplen, T.B.; Riggs, A.C.

    1988-01-01

    A continuous record of oxygen-18 (??18O) variations in the continental hydrosphere during the middle-to-late Pleistocene has been obtained from a uranium-series dated calcitic vein in the southern Great Basin. The vein was deposited from ground water that moved through Devils Hole - an open fault zone at Ash Meadows, Nevada - between 50 and 310 ka (thousand years ago). The configuration of the ??18O versus time curve closely resembles the marine and Antarctic ice core (Vostok) ??18O curves; however, the U-Th dates indicate that the last interglacial stage (marine oxygen isotope stage 5) began before 147 ?? 3 ka, at least 17,000 years earlier than indicated by the marine ??18O record and 7,000 years earlier than indicated by the less well dated Antarctic ??18O record. This discrepancy and other differences in the timing of key climatic events suggest that the indirectly dated marine ??18O chronology may need revision and that orbital forcing may not be the principal cause of the Pleistocene ice ages.

  2. Mars Opportunity rover finds gypsum veins

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2011-12-01

    Bright linear features about the width of a human thumb that were found on Mars by NASA's Mars Exploration Rover Opportunity appear to be gypsum veins deposited by groundwater, a team of scientists announced at a 7 December news briefing at the AGU Fall Meeting in San Francisco, Calif. “To me, this is the single most powerful piece of evidence for liquid water on Mars that has been discovered by the Opportunity rover,” said Steve Squyres, a geoscientist at Cornell University in Ithaca, N. Y., and principal investigator for NASA Mars Exploration Rovers Opportunity and Spirit. “We have found sulfates before. Those sulfates were formed somewhere; we don't know where. They have been moved around by the wind, they've been mixed with other materials. It's a big, jumbled, fascinating mess. This stuff was formed right here. There was a fracture in the rock, water flowed through it, gypsum was precipitated from the water. End of story. Okay, there is no ambiguity about this. This is what makes it so cool.”

  3. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    PubMed Central

    Toker, Serdar; Hak, David J.; Morgan, Steven J.

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients. PMID:22084663

  4. Deep vein thrombosis prophylaxis in trauma patients.

    PubMed

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  5. Videothoracoscopic management of a perforated central vein and pleura after ultrasound-guided internal jugular vein cannulation: a case report

    PubMed Central

    Kim, Jeong-Eun; Jeon, Joon-Pyo; Kim, Yongsuk; Jeong, Su Ah

    2014-01-01

    A 23-year-old male underwent a left internal jugular vein catheterization during extended surgery for treatment of multiple fractures due to a traffic accident. Although the catheterization was performed under ultrasound (US) guidance, iatrogenic perforation of the central vein and pleura occurred. The catheter was removed, and the perforated site was addressed under thoracoscopy rather than an open thoracotomy. This case suggests that using US does not completely guarantee a complication-free outcome, and that catheter placement should be carefully confirmed. In addition, this case suggests that thoracoscopy may be an ideal method of resolving a perforation of the central vein and pleura. PMID:24851167

  6. Personal authentication using hand vein triangulation and knuckle shape.

    PubMed

    Kumar, Ajay; Prathyusha, K Venkata

    2009-09-01

    This paper presents a new approach to authenticate individuals using triangulation of hand vein images and simultaneous extraction of knuckle shape information. The proposed method is fully automated and employs palm dorsal hand vein images acquired from the low-cost, near infrared, contactless imaging. The knuckle tips are used as key points for the image normalization and extraction of region of interest. The matching scores are generated in two parallel stages: (i) hierarchical matching score from the four topologies of triangulation in the binarized vein structures and (ii) from the geometrical features consisting of knuckle point perimeter distances in the acquired images. The weighted score level combination from these two matching scores are used to authenticate the individuals. The achieved experimental results from the proposed system using contactless palm dorsal-hand vein images are promising (equal error rate of 1.14%) and suggest more user friendly alternative for user identification. PMID:19447728

  7. Deep vein thrombosis: a rare signature of herpes zoster.

    PubMed

    Maity, Pranab Kumar; Chakrabarti, Nandini; Mondal, Manas; Patar, Kartick; Mukhopadhyay, Mainak

    2014-01-01

    Reactivation of varicella zoster Infection is known to cause manifold complications. However, deep vein thrombosis has been rarely described as an associate. Here we present the case of a young immunocompetent male with such a predicament.

  8. Finger vein recognition based on local directional code.

    PubMed

    Meng, Xianjing; Yang, Gongping; Yin, Yilong; Xiao, Rongyang

    2012-01-01

    Finger vein patterns are considered as one of the most promising biometric authentication methods for its security and convenience. Most of the current available finger vein recognition methods utilize features from a segmented blood vessel network. As an improperly segmented network may degrade the recognition accuracy, binary pattern based methods are proposed, such as Local Binary Pattern (LBP), Local Derivative Pattern (LDP) and Local Line Binary Pattern (LLBP). However, the rich directional information hidden in the finger vein pattern has not been fully exploited by the existing local patterns. Inspired by the Webber Local Descriptor (WLD), this paper represents a new direction based local descriptor called Local Directional Code (LDC) and applies it to finger vein recognition. In LDC, the local gradient orientation information is coded as an octonary decimal number. Experimental results show that the proposed method using LDC achieves better performance than methods using LLBP. PMID:23202194

  9. Stent Recanalization of Chronic Portal Vein Occlusion in a Child

    SciTech Connect

    Cwikiel, Wojciech; Solvig, Jan; Schroder, Henrik

    2000-07-15

    An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years.

  10. Anti-GBM disease and renal vein thrombosis.

    PubMed

    Bailey, Phillippa; Sarfraz, Farook; Ravanan, Rommel

    2011-11-15

    A 23-year-old female who presented with advanced renal failure was subsequently diagnosed with renal vein thrombosis and antiglomerular basement membrane (GBM) antibody disease. A previous case of renal vein thrombosis has been reported in association with anti-GBM disease, but to our knowledge, this is the first reported case in which the presentation of anti-GBM disease and renal vein thrombosis was concurrent. Further study is essential to understand if the association of anti-GBM disease and renal vein thrombosis as seen in our case was pure coincidence or is in fact occurs more frequently. It may be that the dual diagnosis is not made as establishing one sufficient diagnosis for renal failure may halt further investigations for additional diagnoses.

  11. Acute scrotal pain: an uncommon manifestation of renal vein thrombosis.

    PubMed

    Jou, Yeong-Chin; Jong, Ing-Chin; Hsieh, Ying-Chen; Kang, Chun-Hsiung

    2014-03-01

    The clinical manifestation of renal vein thrombosis varies with the speed and degree of venous occlusion. Such patients may be asymptomatic, have minor nonspecific symptoms such as nausea or weakness, or have more specific symptoms such as upper abdominal pain, flank pain, or hematuria. Acute scrotal pain is a very uncommon clinical expression of renal vein thrombosis. Here, we report a case of membranous glomerulonephritis-induced renal vein thrombosis presented with the symptom of acute scrotal pain caused by thrombosis-induced varicocele. This case report suggests that renal vein thrombosis should be considered in the diagnosis of acute scrotal pain; it also emphasizes that an investigation of retroperitoneum should be performed for adult patients with the sudden onset of varicocele.

  12. 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.

  13. Circumaortic Left Renal Vein-A Rare Case Report

    PubMed Central

    Panagar, Anupama Doddappaiah; Subhash, R. Lakshmi Prabha; Suresh, B.S.; Nagaraj, D.N.

    2014-01-01

    During routine dissection which was carried out for the medical students, a circumaortic left renal vein draining into inferior vena cava was observed. There were 2 renal veins through which the left kidney drained into the inferior vena cava, of which the larger one ran ventral to aorta and the other smaller one ran posterior to aorta and received lumbar veins before opening into inferior vena cava. This is a relatively rare condition which can result in left renal hypertension (LRVH) syndrome which is otherwise called as anterior and posterior nutcracker syndromes. This venous anomaly results from the errors of embryological development. It is of clinical significance, mainly during retroperitoneal surgeries and intra caval interventions. It is also important in conditions which warrant extensive venous dissections, venous reconstructions as in transplantations and invasion of veins by cancerous tissue, resulting in life threatening haemorrhage. PMID:24783096

  14. Squash vein yellowing virus affecting watermelon in Puerto Rico

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this study, we report the first detection of Squash vein yellowing virus (SqVYV)-induced watermelon vine decline outside of the continental U.S. This has implications for management of cucurbit virus diseases throughout the Caribbean....

  15. Bypass Surgery for Lower Extremity Limb Salvage: Vein Bypass

    PubMed Central

    2012-01-01

    Bypass surgery for limb salvage in cases of chronic limb ischemia is a well-established treatment modality. Use of an autogenous vein provides the best conduit for infrainguinal arterial bypass procedures, particularly for bypass to the infrapopliteal arteries. In this article, we discuss infrainguinal vein bypass surgery including indications, perioperative care, and long-term follow up. We also discuss the outcomes of the procedure with regard to patient survival and limb salvage. The autogenous vein continues to be the best available conduit with the highest patency rate and the best treatment option. Compared to all other revascularization options for infrainguinal disease, the vein bypass has the best limb salvage and long-term survival in patients appropriately selected for the procedure. PMID:23342187

  16. [Recanalisation therapy of deep leg and pelvic vein thrombosis].

    PubMed

    Mumme, A; Hummel, T

    2015-05-01

    The conservative treatment of deep leg and pelvic vein thrombosis leads to permanent damage of recanalised veins, which in cases of long distance clots as well as involvement of the pelvic level, increase the risk of developing a postthrombotic syndrome. Such subsequent damage of the deep veins can only be avoided if occluded veins are rapidly recanalised and the function of the valves is successfully reestablished. Recanalisation may consist of surgical, fibrolytic and interventional methods and aims to minimize any subsequent damage; however no potential benefit of recanalisation versus standard treatment has yet been proven by means of methodologically adequate comparative studies. Thus, the indications for recanalisation must remain strict and be founded on a thorough risk-benefit assessment.

  17. Role of N Glycosylation of Hepatitis B Virus Envelope Proteins in Morphogenesis and Infectivity of Hepatitis Delta Virus

    PubMed Central

    Sureau, Camille; Fournier-Wirth, Chantal; Maurel, Patrick

    2003-01-01

    Hepatitis delta virus (HDV) particles are coated with the large (L), middle (M), and small (S) hepatitis B virus envelope proteins. In the present study, we constructed glycosylation-defective envelope protein mutants and evaluated their capacity to assist in the maturation of infectious HDV in vitro. We observed that the removal of N-linked carbohydrates on the S, M, and L proteins was tolerated for the assembly of subviral hepatitis B virus (HBV) particles but was partially inhibitory for the formation of HDV virions. However, when assayed on primary cultures of human hepatocytes, virions coated with S, M, and L proteins lacking N-linked glycans were infectious. Furthermore, in the absence of M, HDV particles coated with nonglycosylated S and L proteins retained infectivity. These results indicate that carbohydrates on the HBV envelope proteins are not essential for the in vitro infectivity of HDV. PMID:12692255

  18. Bilateral Renal Vein Thrombosis due to Elevated Factor VIII Levels.

    PubMed

    Patole, Shalom; Ramya, I

    2015-08-01

    Recent evidence has shown that high level of factor VIII is associated with increased risk of thromboembolism. High factor VIII levels are associated with a seven-fold increase in the risk of venous thrombosis. Renal vein thrombosis is usually associated with nephrotic syndrome, procoagulant state or oral contraceptive pills. We report a case of a lady who presented with bilateral renal vein thrombosis due to high factor VIII levels and oral contraceptive pills (OCP) use. PMID:27604446

  19. Preduodenal Portal Vein with Situs Inversus Totalis causing Duodenal Obstruction.

    PubMed

    D'souza, Flavia; Nage, Amol; Bendre, Pradnya

    2016-01-01

    Congenital duodenal obstruction sometimes may be secondary to unusual entities like preduodenal portal vein (PDPV) the identification of which is very important to avoid inadvertent injury or incorrect surgery. A 6-day old neonate presented with congenital duodenal obstruction. Investigations revealed situs inversus totalis with many congenital cardiovascular anomalies. At operation preduodenal portal vein and malrotation were found. Correction of malrotation and bypass duodeno-duodenostomy were done.

  20. Preduodenal Portal Vein with Situs Inversus Totalis causing Duodenal Obstruction

    PubMed Central

    D’souza, Flavia; Bendre, Pradnya

    2016-01-01

    Congenital duodenal obstruction sometimes may be secondary to unusual entities like preduodenal portal vein (PDPV) the identification of which is very important to avoid inadvertent injury or incorrect surgery. A 6-day old neonate presented with congenital duodenal obstruction. Investigations revealed situs inversus totalis with many congenital cardiovascular anomalies. At operation preduodenal portal vein and malrotation were found. Correction of malrotation and bypass duodeno-duodenostomy were done. PMID:27398325