Adoption of endovenous laser treatment as the primary treatment modality for varicose veins: the Auckland City Hospital experience.

PubMed

Fernando, Ruchira S W; Muthu, Carl

2014-08-01

To assess the effectiveness of adopting endovenous laser treatment (EVLT) as the primary treatment modality for varicose veins at Auckland City Hospital (Auckland, New Zealand). The outcomes of 354 consecutive EVLT procedures performed between 2007 and 2013 were reviewed. Data was collected from a prospectively maintained procedural database and by retrospective chart review. Of the 319 patients who had an ultrasound, at 1 month post-procedure there was a saphenous vein occlusion rate of 96%. Side effects were minimal with no cases of DVT or skin burns and one case of self-limiting neuralgia. The procedure was well tolerated with a median pain score of 3. Since the adoption of EVLT there has been a large increase in the number of patients treated for varicose veins (28 in 2007 compared to 176 in 2013). EVLT is a safe and effective treatment for varicose veins and its adoption has allowed a large increase in the number of varicose vein patients treated at Auckland City Hospital.

The Occurrence of Apparent Bilateral Aldosterone Suppression in Adrenal Vein Sampling for Primary Aldosteronism

PubMed Central

Shibayama, Yui; Wada, Norio; Naruse, Mitsuhide; Kurihara, Isao; Ito, Hiroshi; Yoneda, Takashi; Takeda, Yoshiyu; Umakoshi, Hironobu; Tsuiki, Mika; Ichijo, Takamasa; Fukuda, Hisashi; Katabami, Takuyuki; Yoshimoto, Takanobu; Ogawa, Yoshihiro; Kawashima, Junji; Ohno, Yuichi; Sone, Masakatsu; Fujita, Megumi; Takahashi, Katsutoshi; Shibata, Hirotaka; Kamemura, Kohei; Fujii, Yuichi; Yamamoto, Koichi; Suzuki, Tomoko

2018-01-01

Abstract Context In adrenal venous sampling (AVS) for patients with primary aldosteronism (PA), apparent bilateral aldosterone suppression (ABAS), defined as lower aldosterone/cortisol ratios in the bilateral adrenal veins than that in the inferior vena cava, is occasionally experienced. ABAS is uninterpretable with respect to lateralization of excess aldosterone production. We previously reported that ABAS was not a rare phenomenon and was significantly reduced after adrenocorticotropic hormone (ACTH) administration. Objective To validate the effects of ACTH administration and adding sampling positions in the left adrenal vein on the prevalence of ABAS in the larger Japan Primary Aldosteronism Study. Patients The data from 1689 patients with PA who underwent AVS between January 2006 and October 2016 were studied. All patients in the previous study, the West Japan Adrenal Vein Sampling study, were excluded. Outcome Measurements The prevalence of ABAS was investigated at two sampling positions in the left adrenal vein, the central vein and the common trunk, without and with ACTH administration. Results The prevalence of ABAS with ACTH administration was significantly lower than that without ACTH administration [without ACTH vs with ACTH: 79/440 (18.0%) vs 45/591 (7.6%); P < 0.001]. With ACTH administration, the prevalence of ABAS was not different between the sampling position, at the central vein and at the common trunk [33/591 (5.6%) vs 32/591 (5.4%); P = 1.00]. Conclusions The effectiveness of ACTH administration for the reduction of ABAS in AVS regardless of the sampling position in the left adrenal vein was confirmed in the larger cohort. PMID:29687091

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 veins during this event. The ore-bearing veins were sheared and displaced during early Tertiary northwest-trending dextral strike-slip faulting along the Osburn fault and related structures of the Lewis and Clark line.

Veno-occlusive disease and primary hepatic vein thrombosis in Israeli Arabs.

PubMed

Ghanem, J; Hershko, C

1981-05-01

In a survey of nine major Israeli hospitals, 29 patients diagnosed between 1955 and 1975 as suffering from hepatic vein thrombosis were identified. Fifteen of the patients were Jews and 14 were Arabs. In contrast to the Jewish patients, all of whom were adults, the majority of the Arab patients were children below 10 years of age. Primary hepatic vein occlusion was 2.4 times more common among Arab than among Jewish patients. Of the 11 Arab patients with primary hepatic vein occlusion, three had histological changes typical of veno-occlusive disease; whereas in five others, thrombotic occlusion of large hepatic veins or of the vena cava was documented. Although no plant alkaloids could be directly implicated in any of the Arab patients, circumstantial evidence strongly supports such an etiology. All of our Arab patients originated from small agricultural communities where ancient methods of winnowing, which expose the home-ground wheat to a high risk of contamination by grains containing pyrrolizidine alkaloids, are still in use. This report confirms the world-wide distribution of veno-occlusive disease, and under-lines the need for a systematic search for possible sources of poisoning by pyrrolizidine alkaloids.

Scattering Removal for Finger-Vein Image Restoration

PubMed Central

Yang, Jinfeng; Zhang, Ben; Shi, Yihua

2012-01-01

Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of finger-vein image degradation, a biological optical model (BOM) specific to finger-vein imaging is proposed according to the principle of light propagation in biological tissues. Based on BOM, the light scattering component is sensibly estimated and properly removed for finger-vein image restoration. Finally, experimental results demonstrate that the proposed method is powerful in enhancing the finger-vein image contrast and in improving the finger-vein image matching accuracy. PMID:22737028

Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients.

PubMed

Ronald, James; Davis, Bradley; Guevara, Carlos J; Pabon-Ramos, Waleska M; Smith, Tony P; Kim, Charles Y

2017-05-15

To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group). The 3-, 6-, and 12-month primary lesion patency for the in-stent PTS group was 73%, 57%, and 32%, respectively. The 3-, 6-, and 12-month primary patency for the in-stent PTA group was 70%, 38%, and 17% and for the native vein PTS group was 78%, 57%, and 26%, which were similar to the in-stent PTS group (p = 0.20 and 0.41, respectively). The 3-, 6-, and 12-month secondary access patency was 91%, 73%, and 65% for the in-stent PTS group. Sub-analysis of the in-stent PTS group revealed no difference in primary (p = 0.93) or secondary patency rates (p = 0.27) of bare metal stents (n = 23) compared with stent grafts (n = 12). Stent deployment for central vein in-stent stenosis refractory to angioplasty was associated with reasonable patency rates, which were similar to in-stent PTA and native vein PTS.

A Prospective Study in Comparison of Ambulatory Phlebectomy and Duplex Guided Foam Sclerotherapy in the Management of Varicosities with Isolated Perforator Incompetence.

PubMed

Kishore, R; Sankar, T Bavani; Anandi, A; Nedunchezhian, S; Murugan, Valarmathy

2016-10-01

Perforators are those which connect the superficial and deep venous system either directly to main veins or indirectly through the muscular and soleal venous plexus. The emergence of minimally invasive techniques like ambulatory phlebectomy (AP) and foam sclerotherapy (FS) has led to increasing interest about the appropriate therapy for the treatment of isolated perforator incompetence. There have been no studies which have compared the effectiveness of these in-office procedures in isolated perforator incompetence due to the low prevalence of cases. The primary goal of this study is to compare the clinical parameters (return to normal activity, primary symptom relief), functional parameters (procedure time, change in disease severity, course of venous ulcer), and duplex parameters (recurrence in treated veins, complete occlusion of treated veins) in the management of leg varicosities having isolated primary perforator incompetence by ambulatory phlebectomy and duplex guided foam sclerotherapy. Though the procedure time was shorter with FS than AP, the other parameters of primary symptom relief such as change in disease severity, faster healing of venous ulcer, complete occlusion of treated veins in follow-up duplex examination, and lower recurrence of treated veins are better with AP than FS. In conclusion, the interruption of perforators is effective in decreasing the symptoms of chronic venous insufficiency and for the rapid healing of ulcers. The interruption of the incompetent perforating veins appears to be essential to decrease ambulatory venous hypertension. It is apparent from this study that ambulatory phlebectomy stands distinct with enormous benefits and serves as a superior alternative to foam sclerotherapy in treating patients with isolated perforator incompetence.

A prospective randomised trial of PIN versus conventional stripping in varicose vein surgery.

PubMed Central

Durkin, M. T.; Turton, E. P.; Scott, D. J.; Berridge, D. C.

1999-01-01

A prospective, randomised trial was carried out to examine the efficacy of perforate invagination (PIN, Credenhill Ltd, Derbyshire, UK) stripping of the long saphenous vein (LSV) in comparison to conventional stripping (Astratech AB, Sweden) in the surgical management of primary varicose veins. Eighty patients with primary varicosities secondary to sapheno-femoral junction (SFJ) incompetence and LSV reflux were recruited. Patients were randomised to PIN or conventional stripping with all other operative techniques remaining constant. Follow-up was performed at 1 and 6 weeks postoperatively. There were no statistically significant differences between the two techniques in terms of time taken to strip the vein, percentage of vein stripped or the area of bruising at 1 week. The size of the exit site was significantly smaller with the PIN device (P < or = 0.01). Optimal use of the conventional stripper provides results comparable to the PIN device. Choice of stripping device remains the surgeon's, bearing in mind that the PIN stripper achieves slightly better cosmesis. PMID:10364948

Primary Biliary Cirrhosis

MedlinePlus

... other complications. Increased pressure in the portal vein (portal hypertension). Blood from your intestine, spleen and pancreas enters ... specific complications: Increased pressure in the portal vein (portal hypertension). Your doctor is likely to screen and monitor ...

The blind pushing technique for peripherally inserted central catheter placement through brachial vein puncture.

PubMed

Lee, Jae Myeong; Cho, Young Kwon; Kim, Han Myun; Song, Myung Gyu; Song, Soon-Young; Yeon, Jae Woo; Yoon, Dae Young; Lee, Sam Yeol

2018-03-01

The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access. Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. PICC placement was performed using the blind pushing technique and primary brachial vein access. The following data were collected from unified case report forms: access vein, obstacles during PICC advancement, procedure time, and postprocedural complications. During the 12-month study period, 1380 PICCs were placed in 1043 patients. Of these, 1092 PICCs placed in 837 patients were enrolled, with 834 PICCs (76%) and 258 PICCs (34%) placed through brachial vein and nonbrachial vein access, respectively. In both arms, obstacles were most commonly noted in the subclavian veins (n = 220) and axillary veins (n = 94). Successful puncture of the access vein was achieved at first try in 1028 PICCs (94%). The technical success rate was 99%, with 1055 PICCs (97%) placed within 120 seconds of procedure time and 1088 PICCs (99%) having the tip located at the ideal position. Follow-up Doppler ultrasound detected catheter-associated upper extremity deep venous thrombosis (UEDVT) for 18 PICCs in 16 patients and late symptomatic UEDVT for 16 PICCs in 16 patients (3.1%). Catheter-associated UEDVT was noted for 28 PICCs (82%) and 6 PICCs (18%) placed through brachial vein and nonbrachial vein access, respectively. The incidence of obstacles and the procedure time (<120 seconds) differed significantly between brachial vein and nonbrachial vein access (P = .001). There was no statistically significant difference between brachial vein and nonbrachial vein access in the incidence of UEDVT (odds ratio, 0.68; 95% confidence interval, 0.59-3.52; P = .22). The placement of pretrimmed PICCs by the blind pushing technique and primary brachial vein access is technically feasible and may represent an alternative to the conventional PICC placement technique, having low incidences of UEDVT and other complications, with no significant difference in outcomes between brachial vein and nonbrachial vein access. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Selecting a treatment for primary varicose veins.

PubMed Central

Tremblay, J; Lewis, E W; Allen, P T

1985-01-01

The treatment of varicose veins includes injection/compression sclerotherapy and surgical stripping or ligation or both. Surgery appears to be favoured when the saphenous system is involved or when the patient is 35 to 64 years old or presents with ankle edema or flare. On the other hand, sclerotherapy has been found to be more effective in patients with dilated superficial veins or incompetent perforating veins in the lower legs and to be more acceptable and less expensive than surgical treatment. PMID:3891060

Development of neural network techniques for finger-vein pattern classification

NASA Astrophysics Data System (ADS)

Wu, Jian-Da; Liu, Chiung-Tsiung; Tsai, Yi-Jang; Liu, Jun-Ching; Chang, Ya-Wen

2010-02-01

A personal identification system using finger-vein patterns and neural network techniques is proposed in the present study. In the proposed system, the finger-vein patterns are captured by a device that can transmit near infrared through the finger and record the patterns for signal analysis and classification. The biometric system for verification consists of a combination of feature extraction using principal component analysis and pattern classification using both back-propagation network and adaptive neuro-fuzzy inference systems. Finger-vein features are first extracted by principal component analysis method to reduce the computational burden and removes noise residing in the discarded dimensions. The features are then used in pattern classification and identification. To verify the effect of the proposed adaptive neuro-fuzzy inference system in the pattern classification, the back-propagation network is compared with the proposed system. The experimental results indicated the proposed system using adaptive neuro-fuzzy inference system demonstrated a better performance than the back-propagation network for personal identification using the finger-vein patterns.

Iliac vein stenosis is an underdiagnosed cause of pelvic venous insufficiency.

PubMed

Santoshi, Ratnam K N; Lakhanpal, Sanjiv; Satwah, Vinay; Lakhanpal, Gaurav; Malone, Michael; Pappas, Peter J

2018-03-01

Reflux in the ovarian veins, with or without an obstructive venous outflow component, is reported to be the primary cause of pelvic venous insufficiency (PVI). The degree to which venous outflow obstruction plays a role in PVI is currently ill-defined. We retrospectively reviewed the charts of 227 women with PVI who presented to the Center for Vascular Medicine from January 2012 to September 2015. Assessments and interventions consisted of an evaluation for other causes of chronic pelvic pain by a gynecologist; preintervention and postintervention visual analog scale (VAS) pain score; complete venous duplex ultrasound examination; and Clinical, Etiology, Anatomy, and Pathophysiology classification. All patients underwent diagnostic venography of their pelvic and left ovarian veins as well as intravascular ultrasound of their iliac veins. Patients were treated in one of six ways: ovarian vein embolization (OVE) alone (chemical ± coils), OVE with staged iliac vein stenting, OVE with simultaneous iliac vein stenting, iliac vein stenting alone, OVE with venoplasty, and venoplasty alone. Of the 227 women treated, the average age and number of pregnancies was 46.4 ± 10.4 years and 3.36 ± 1.99, respectively. Treatment distribution was the following: OVE, n = 39; OVE with staged stenting, n = 94; OVE with simultaneous stenting, n = 33; stenting alone, n = 50; OVE with venoplasty, n = 8; and venoplasty alone, n = 3. Seven patients in the OVE and stenting groups (staged) and one patient in the OVE + venoplasty group required a second embolization of the left ovarian vein. Eighty percent (181/227) of patients demonstrated an iliac stenosis >50% by intravascular ultrasound. Average VAS scores for the entire cohort before and after intervention were 8.45 ± 1.11 and 1.86 ± 1.61 (P ≤ .001). In the staged group, only 9 of 94 patients reported a decrease in the VAS score with OVE alone. VAS score decreased from 8.6 ± 0.89 before OVE to 7.97 ± 2.10 after OVE. After the planned staged stenting, VAS score decreased to 1.33 ± 2.33 (P ≤ .001). Similarly, in the simultaneous group, preintervention scores were 8.63 ± 1.07 and decreased to 2.36 ± 2.67 after OVE + stenting (P ≤ .001). The majority of patients in our series (80%) demonstrated a significant iliac vein stenosis. These observations indicate that the incidence of iliac vein outflow obstruction in PVI is greater than previously reported. In patients with combined ovarian vein reflux and iliac vein outflow obstruction, our data suggest that pelvic venous outflow lesions should be treated first and that ovarian vein reflux should be treated only if symptoms persist. In women with an outflow lesion, ovarian vein reflux, and a large pelvic reservoir, we recommend simultaneous treatment. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Kimberlite-related metasomatism recorded in MARID and PIC mantle xenoliths

NASA Astrophysics Data System (ADS)

Fitzpayne, Angus; Giuliani, Andrea; Phillips, David; Hergt, Janet; Woodhead, Jon D.; Farquhar, James; Fiorentini, Marco L.; Drysdale, Russell N.; Wu, Nanping

2018-05-01

MARID (Mica-Amphibole-Rutile-Ilmenite-Diopside) and PIC (Phlogopite-Ilmenite-Clinopyroxene) xenoliths are thought to be formed by intense "primary" mantle metasomatism. These rocks also display secondary features, such as cross-cutting veins and geochemical zonation of matrix minerals, which probably reflect later metasomatic events. To investigate the nature and origin(s) of these secondary features, 28 MARID and PIC xenoliths from southern African kimberlites and orangeites have been studied. MARID-hosted veins contain both carbonate and Ti-rich phases (e.g., titanite, phlogopite), suggesting that they formed by the infiltration of a carbonated silicate melt. Elevated TiO2 contents in MARID matrix mineral rims are spatially associated with carbonate-dominated veins, suggesting a genetic relationship between vein formation and geochemical zonation. Spongy rims around primary MARID and PIC clinopyroxene are depleted in Na2O and Al2O3 relative to their cores, possibly reflecting mineral dissolution in the xenoliths during ascent and emplacement of the entraining kimberlite. The preservation of compositional differences between primary and secondary phases in MARID and PIC xenoliths indicates that metasomatism occurred shortly before, or broadly coeval with, kimberlite/orangeite magmatism; otherwise, at typical mantle temperatures, such features would have quickly re-equilibrated. Increased Na2O in some mineral rims (e.g., K-richterite) may therefore reflect equilibration with a more Na-enriched primitive kimberlite melt composition than is commonly suggested. Vein-hosted clinopyroxene 87Sr/86Sri (0.70539 ± 0.00079) in one MARID sample is intermediate between primary clinopyroxene in the sample (0.70814 ± 0.00002) and the host Bultfontein kimberlite (0.70432 ± 0.00005), suggesting that vein minerals are derived from interactions between primary MARID phases and kimberlite-related melts/fluids. Sulfur isotope compositions of barite (δ34SVCDT = +4.69 ‰) and sulfides (δ34SVCDT = -0.69 ‰) in carbonate veins reflect equilibration at temperatures of 850-900 °C, consistent with sulfur-rich melt/fluid infiltration in the lithospheric mantle. In contrast, vein carbonate C-O isotope systematics (δ13CVPDB = -9.18 ‰; δ18OVSMOW = +17.22 ‰) are not typical of kimberlites or other mantle carbonates (δ13CVPDB = -3 to -8 ‰; δ18OVSMOW = 6 to 9 ‰), and may represent post-emplacement hydrothermal interactions of the cooling kimberlite with crustal fluids. These constraints suggest protracted metasomatism of MARID rocks shortly before and during entrainment by the host kimberlite.

Endovascular interventions for central vein stenosis.

PubMed

Agarwal, Anil K

2015-12-01

Central vein stenosis is common because of the placement of venous access and cardiac intravascular devices and compromises vascular access for dialysis. Endovascular intervention with angioplasty and/or stent placement is the preferred approach, but the results are suboptimal and limited. Primary patency after angioplasty alone is poor, but secondary patency can be maintained with repeated angioplasty. Stent placement is recommended for quick recurrence or elastic recoil of stenosis. Primary patency of stents is also poor, though covered stents have recently shown better patency than bare metal stents. Secondary patency requires repeated intervention. Recanalization of occluded central veins is tedious and not always successful. Placement of hybrid graft-catheter with a combined endovascular surgical approach can maintain patency in many cases. In the presence of debilitating symptoms, palliative approach with endovascular banding or occlusion of the access may be necessary. Prevention of central vein stenosis is the most desirable strategy.

Breast cancer metastatic to the kidney with renal vein involvement.

PubMed

Nasu, Hatsuko; Miura, Katsutoshi; Baba, Megumi; Nagata, Masao; Yoshida, Masayuki; Ogura, Hiroyuki; Takehara, Yasuo; Sakahara, Harumi

2015-02-01

The common sites of breast cancer metastases include bones, lung, brain, and liver. Renal metastasis from the breast is rare. We report a case of breast cancer metastatic to the kidney with extension into the renal vein. A 40-year-old woman had undergone left mastectomy for breast cancer at the age of 38. A gastric tumor, which was later proved to be metastasis from breast cancer, was detected by endoscopy. Computed tomography performed for further examination of the gastric tumor revealed a large left renal tumor with extension into the left renal vein. It mimicked a primary renal tumor. Percutaneous biopsy of the renal tumor confirmed metastasis from breast cancer. Surgical intervention of the stomach and the kidney was avoided, and she was treated with systemic chemotherapy. Breast cancer metastatic to the kidney may present a solitary renal mass with extension into the renal vein, which mimics a primary renal tumor.

A review of the anatomy and clinical significance of adrenal veins.

PubMed

Cesmebasi, Alper; Du Plessis, Maira; Iannatuono, Mark; Shah, Sameer; Tubbs, R Shane; Loukas, Marios

2014-11-01

The adrenal veins may present with a multitude of anatomical variants, which surgeons must be aware of when performing adrenalectomies. The adrenal veins originate during the formation of the prerenal inferior vena cava (IVC) and are remnants of the caudal portion of the subcardinal veins, cranial to the subcardinal sinus in the embryo. The many communications between the posterior cardinal, supracardinal, and subcardinal veins of the primordial venous system provide an explanation for the variable anatomy. Most commonly, one central vein drains each adrenal gland. The long left adrenal vein joins the inferior phrenic vein and drains into the left renal vein, while the short right adrenal vein drains immediately into the IVC. Multiple variations exist bilaterally and may pose the risk of surgical complications. Due to the potential for collaterals and accessory adrenal vessels, great caution must be taken during an adrenalectomy. Adrenal venous sampling, the gold standard in diagnosing primary hyperaldosteronism, also requires the clinician to have a thorough knowledge of the adrenal vein anatomy to avoid iatrogenic injury. The adrenal vein acts as an important conduit in portosystemic shunts, thus the nature of the anatomy and hypercoagulable states pose the risk of thrombosis. © 2014 Wiley Periodicals, Inc.

Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism

PubMed Central

Chang, Chin-Chen; Lee, Bo-Ching; Liu, Kao-Lang; Chang, Yeun-Chung; Wu, Vin-Cent; Huang, Kuo-How

2016-01-01

In this retrospective study, we aimed to examine the effect of applying Dyna computed tomography (CT) on the success rate of adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. A total of 100 consecutive patients with primary aldosteronism who underwent AVS between May 2012 and July 2015 were enrolled. In all the cases, Dyna CT was used in AVS to validate catheter position in the right adrenal vein. A selectivity index (cortisoladrenal vein /cortisolinferior vena cava) of ≥2.0 of both adrenal veins were required for successful AVS. Dyna CT indicated misplaced catheters in 16 patients; of these patients, 75% (12/16) eventually had successful right AVS after catheter repositioning. The success rate of initial sampling at the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT was applied (p < 0.001). The most common inadvertently catheterised vessels detected using Dyna CT were the accessory hepatic veins (56.3%, 9/16), followed by the renal capsular veins (37.5%, 6/16). The overall success rate of non-stimulated AVS using Dyna CT was 87% (87/100). Thus, the application of Dyna CT further increased the success rate of non-stimulated AVS. PMID:27876824

Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins.

PubMed

Whiteley, Mark S; Smith, Victoria C

2017-01-01

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

Lower plate deformation structures along the Costa Rica erosive plate boundary - results from IODP Expedition 344 (CRISP 2)

NASA Astrophysics Data System (ADS)

Brandstätter, Jennifer; Kurz, Walter; Micheuz, Peter; Krenn, Kurt

2015-04-01

The primary objective of Integrated Ocean Drilling Program (IODP) Expedition 344 offshore the Osa Peninsula in Costa Rica was to sample and quantify the material entering the seismogenic zone of the Costa Rican erosive subduction margin. Fundamental to this objective is an understanding of the nature of both the subducting Cocos plate crust and of the overriding Caribbean plate. The subducting Cocos plate is investigated trying to define its hydrologic system and thermal state. The forearc structures recorded by the sediment deposited on the forearc, instead, document periods of uplift and subsidence and provide important information about the process of tectonic erosion that characterizes the Costa Rica margin. Offshore the western margin of Costa Rica, the oceanic Cocos plate subducts under the Caribbean plate, forming the southern end of the Middle America Trench. Subduction parameters including the age, convergence rate, azimuth, obliquity, morphology, and slab dip all vary along strike. The age of the Cocos plate at the Middle America Trench decreases from 24 Ma offshore the Nicoya Peninsula to 15 Ma offshore the Osa Peninsula. Subduction rates vary from 70 mm/y offshore Guatemala to 90 mm/y offshore southern Costa Rica. Convergence obliquity across the trench varies from offshore Nicaragua, where it is as much as 25° oblique, to nearly orthogonal southeast of the Nicoya Peninsula. Passage of the Cocos plate over the Galapagos hotspot created the aseismic Cocos Ridge, an overthickened welt of oceanic crust. This ridge is ~25 km thick, greater than three times normal oceanic crustal thickness. During IODP Expedition 344, the incoming Cocos plate was drilled at sites U1381 and U1414. Site U1381 is located ~4.5 km seaward of the deformation front offshore the Osa Peninsula and Caño Island. It is located on a local basement high. Basement relief often focuses fluid flow, so data from this site are likely to document the vigor of fluid flow in this area. Site U1414 is located ~1 km seaward of the deformation front offshore the Osa Peninsula and Caño Island. Primary science goals at Site U1414 included characterization of the alteration state of the magmatic basement. Brittle structures within the incoming plate (sites U1380, U1414) are mineralized extensional fractures and shear fractures. The shear fractures mainly show a normal component of shear. Within the sedimentary sequence both types of fractures dip steeply (vertical to subvertical) and strike NNE-SSW. Deformation bands trend roughly ENE-WSW, sub-parallel to the trend of the Cocos ridge. Structures in the Cocos Ridge basalt mainly comprise mineralized veins at various orientations. A preferred orientation of strike directions was not observed. Some veins show straight boundaries, others are characterized by an irregular geometry characterized by brecciated wall rock clasts embedded within vein precipitates. The vein mineralization was analysed in detail by RAMAN spectroscopy. Precipitation conditions and fluid chemistry were analysed by fluid inclusions entrapped within vein minerals. Vein mineralizations mainly consist of carbonate (fibrous aragonite, calcite), chalcedony, and quartz. Vein mineralization is mainly characterized by zoned antitaxial growth of carbonate fibres including a suture along the central vein domains. Quartz is often characterized by fibre growth of crystals perpendicular to the vein boundaries, too. These zoned veins additinally have wall rock alteration seams consisting of clay minerals. The precipitation sequence basically indicates that fluid chemistry evolved from an CO2-rich towards a SiO2- rich fluid.

Multiple acquired portosystemic shunts secondary to primary hypoplasia of the portal vein in a cat.

PubMed

Sugimoto, Satoko; Maeda, Shingo; Tsuboi, Masaya; Saeki, Kohei; Chambers, James K; Yonezawa, Tomohiro; Fukushima, Kenjiro; Fujiwara, Reina; Uchida, Kazuyuki; Tsujimoto, Hajime; Matsuki, Naoaki; Ohno, Koichi

2018-06-06

A 6-year 5-month-old spayed female Scottish Fold cat presented with a one-month history of gait abnormalities, increased salivation, and decreased activity. A blood test showed hyperammonemia and increased serum bile acids. Imaging tests revealed multiple shunt vessels indicating acquired portosystemic shunt. Histopathologic analysis of liver biopsy showed features consistent with liver hypoperfusion, such as a barely recognizable portal vein, increased numbers of small arterioles, and diffuse vacuolar degeneration of hepatocytes. These findings supported the diagnosis of primary hypoplasia of the portal vein/microvascular dysplasia, (PHPV/MVD). To our knowledge, this is the first case of feline PHPV/MVD that developed multiple acquired portosystemic shunts and presented with hepatic encephalopathy.

History of Metal Veins in Acapulcoite-Lodranite Clan Meteorite GRA 95209

NASA Technical Reports Server (NTRS)

Herrin, J. S.; Mittlefehldt, D. W.; Humayun, M.

2006-01-01

Graves Nunataks (GRA) 95209 has been hailed as the missing link of core formation processes in the acapulcoitelodranite parent asteroid because of the presence of a complex cm-scale metal vein network. Because the apparent liquid temperature of the metal vein (approximately 1500 C) is higher than inferred for the metamorphic grade of the meteorite, questions regarding the vein s original composition, temperature, and mechanism of emplacement have arisen. We have determined trace siderophile element compositions of metals in veins and surrounding matrix in an effort to clarify matters. We analyzed metals in GRA 95209 in a portion of thick metal vein and adjacent metal-rich (30-40 modal%), sulfide poor (less than 1%) matrix by EPMA and LA-ICP-MS for major and trace siderophile elements using methods described by [3]. We also examined metals from a metal-poor (approximately 15 modal%) and relatively sulfide-rich (2-5 modal%) region of the sample. Kamacite is the dominant metal phase in all portions of the sample. In comparison to matrix metal, vein metal contains more schreibersite and less tetrataenite, and is less commonly associated with Fe,Mn,Mg-bearing phosphates and graphite. Vein kamacite contains higher Co, P, and Cr and lower Cu and Ge. These minor variations aside, all metal types in GRA 95209 are fairly homogeneous in terms of their levels of enrichment of compatible siderophile elements (e.g. Pt, Ir, Os) relative to incompatible siderophile elements (e.g. As, Pd, Au), consistent with the loss of metal-sulfide partial melt that characterizes much of the clan. Whatever compositional differences between matrix and vein metal that may have originally existed, they have since largely co-equilibrated to similar restitic trace element compositions. We agree with [2] that metal veins, in their present state, do not represent a liquid composition. The original vein liquid was much more S-rich and emplaced at correspondingly lower liquid temperatures. Much of the Fe,Ni component solidified in cm scale conduits while S-rich melts were expelled and continued to migrate by percolation. The higher troilite content in metal poor regions of the sample results mostly from trapping of a small portion of these melts. The troilite is not remnant primary sulfide. Strong depletions of W, Mo, and especially Ga (greater than 50%, greater than 60%, and greater than 90% depletion, respectively) in metals of the metalpoor GRA 95209 lithology are localized at scales of 10-100 micrometers in the vicinity of graphite spherules. These depletions must have occurred below the temperatures at which cm-scale equilibration occurred, and future work will seek to determine their cause.

Report of 2 cases of primary epithelioid hemangioendothelioma of the external iliac vein.

PubMed

Muñoz, Alberto; Diaz-Perez, Julio A; Romero-Rojas, Alfredo E; Hernandez, Elizabeth; Martin-Berdazco, Francisco

2013-08-01

The epithelioid hemangioendothelioma (EHE) is a rare type of endothelial neoplasm found mainly in soft tissues and visceral organs and in extraordinary cases in large veins like the iliac veins. Currently, there is an active discussion in which EHE behavior, classification, new diagnostic tools, and treatment procedures are proposed. Here, we present 2 cases of EHE and discuss our experience in diagnosis and treatment of this neoplasm.

C-Arm Computed Tomography-Assisted Adrenal Venous Sampling Improved Right Adrenal Vein Cannulation and Sampling Quality in Primary Aldosteronism.

PubMed

Park, Chung Hyun; Hong, Namki; Han, Kichang; Kang, Sang Wook; Lee, Cho Rok; Park, Sungha; Rhee, Yumie

2018-05-04

Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included. Based on the medical records, we retrospectively compared the overall, left, and right catheterization success rates of adrenal veins during the periods without C-AVS (2004 to 2010, n=32) and with C-AVS (2011 to 2016, n=134). The primary outcome was adequate bilateral sampling defined as a selectivity index (SI) >5. With C-AVS, the rates of adequate bilateral AVS increased from 40.6% to 88.7% (P<0.001), with substantial decreases in failure rates (43.7% to 0.8%, P<0.001). There were significant increases in adequate sampling rates from right (43.7% to 91.9%, P<0.001) and left adrenal veins (53.1% to 95.9%, P<0.001) as well as decreases in catheterization failure from right adrenal vein (9.3% to 0.0%, P<0.001). Net improvement of SI on right side remained significant after adjustment for left side (adjusted SI, 1.1 to 9.0; P=0.038). C-AVS was an independent predictor of adequate bilateral sampling in the multivariate model (odds ratio, 9.01; P<0.001). C-AVS improved the overall success rate of AVS, possibly as a result of better catheterization of right adrenal vein. Copyright © 2018 Korean Endocrine Society.

Uranium deposits in the Eureka Gulch area, Central City district, Gilpin County, Colorado

USGS Publications Warehouse

Sims, P.K.; Osterwald, F.W.; Tooker, E.W.

1954-01-01

The Eureka Gulch area of the Central City district, Gilpin County, Colo., was mined for ores of gold, silver, copper, lead, and zinc; but there has been little mining activity in the area since World War I. Between 1951 and 1953 nine radioactive mine dumps were discovered in the area by the U.S. Geological Survey and by prospectors. the importance of the discoveries has not been determined as all but one of the mines are inaccessible, but the distribution, quantity, and grade of the radioactive materials found on the mine dumps indicate that the area is worth of additional exploration as a possible source of uranium ore. The uranium ans other metals are in and near steeply dipping mesothermal veins of Laramide age intrusive rocks. Pitchblende is present in at least four veins, and metatorbernite, associated at places with kosolite, is found along two veins for a linear distance of about 700 feet. The pitchblends and metatorbernite appear to be mutually exclusive and seem to occur in different veins. Colloform grains of pitchblende were deposited in the vein essentially contemporaneously with pyrite. The pitchblende is earlier in the sequence of deposition than galena and sphalerite. The metatorbernite replaces altered biotite-quartz-plagioclase gneiss and altered amphibolite, and to a lesser extent forms coatings on fractures in these rocks adjacent to the veins; the kasolite fills vugs in highly altered material and in altered wall rocks. Much of the pitchblende found on the dumps has been partly leached subsequent to mining and is out of equilibrium. Selected samples of metatorbernite-bearing rock from one mine dump contain as much as 6.11 percent uranium. The pitchblende is a primary vein mineral deposited from uranium-bearing hydrothermal solutions. The metatorbernite probably formed by oxidation, solution, and transportation of uranium from primary pitchblende, but it may be a primary mineral deposited directly from fluids of different composition from these that deposited pitchblende.

Efficacy of duplex ultrasound surveillance after infrainguinal vein bypass may be enhanced by identification of characteristics predictive of graft stenosis development.

PubMed

Tinder, Chelsey N; Chavanpun, Joe P; Bandyk, Dennis F; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

2008-09-01

Controversy regarding the efficacy of duplex ultrasound surveillance after infrainguinal vein bypass led to an analysis of patient and bypass graft characteristics predictive for development of graft stenosis and a decision of secondary intervention. Retrospective analysis of a contemporary, consecutive series of 353 clinically successful infrainguinal vein bypasses performed in 329 patients for critical (n = 284; 80%) or noncritical (n = 69; 20%) limb ischemia enrolled in a surveillance program to identify and repair duplex-detected graft stenosis. Variables correlated with graft stenosis and bypass repair included: procedure indication, conduit type (saphenous vs nonsaphenous vein; reversed vs nonreversed orientation), prior bypass graft failure, postoperative ankle-brachial index (ABI) < 0.85, and interpretation of the first duplex surveillance study as "normal" or "abnormal" based on peak systolic velocity (PSV) and velocity ratio (Vr) criteria. Overall, 126 (36%) of the 353 infrainguinal bypasses had 174 secondary interventions (endovascular, 100; surgery, 74) based on duplex surveillance; resulting in 3-year Kaplan-Meier primary (46%), assisted-primary (80%), and secondary (81%) patency rates. Characteristics predictive of duplex-detected stenosis leading to intervention (PSV: 443 +/- 94 cm/s; Vr: 8.6 +/- 9) were: "abnormal" initial duplex testing indicating moderate (PSV: 180-300 cm/s, Vr: 2-3.5) stenosis (P < .0001), non-single segment saphenous vein conduit (P < .01), warfarin drug therapy (P < .01), and redo bypass grafting (P < .001). Procedure indication, postoperative ABI level, statin drug therapy, and vein conduit orientation were not predictive of graft revision. The natural history of 141 (40%) bypasses with an abnormal first duplex scan differed from "normal" grafts by more frequent (51% vs 24%, P < .001) and earlier (7 months vs 11 months) graft revision for severe stenosis and a lower 3-year assisted primary patency (68% vs 87%; P < .001). In 52 (15%) limbs, the bypass graft failed and 20 (6%) limbs required amputation. The efficacy of duplex surveillance after infrainguinal vein bypass may be enhanced by modifying testing protocols, eg, rigorous surveillance for "higher risk" bypasses, based on the initial duplex scan results and other characteristics (warfarin therapy, non- single segment saphenous vein conduit, redo bypass) predictive for stenosis development.

Primary Sutureless Repair Using Biatrial Incision: Suture-And-Open Technique.

PubMed

Kim, Hyungtae; Sung, Si Chan; Choi, Kwang Ho; Lee, Hyoung Doo; Kim, Geena; Ko, Hoon

2018-06-08

We used a suture-and-open technique with a biatrial incision for primary sutureless repair of total anomalous pulmonary venous connection (TAPVC). With this technique, the common pulmonary venous sinus and its branching pulmonary veins are opened after completion of suturing of the left atrial incision to the pericardium around the common pulmonary venous sinus and its branching veins. The technique allows the primary sutureless repair of TAPVC to be done in a less bloody field under full-flow cardiopulmonary bypass. We have performed this technique in our recent 5 consecutive TAPVC patients without significant complications. Copyright © 2018. Published by Elsevier Inc.

Correlation between the hemodynamic gain obtained after operation of primary varicose veins and chronic venous disease classification.

PubMed

Dezotti, Nei Rodrigues Alves; Joviliano, Edwaldo Edner; Moriya, Takachi; Piccinato, Carlos Eli

2011-01-01

Previous studies have demonstrated improvement of venous hemodynamics after surgical treatment of primary varicose veins of the lower extremities using air plethysmography (APG). To correlate the venous hemodynamics obtained by APG with the CEAP classification after surgical treatment of primary varicose veins. We studied 63 limbs of 39 patients (35 women and 4 men) aged on average 46.3 years, operated upon at the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, during the period from January 2001 to December 2004. The 63 limbs were divided into the three following groups according to CEAP classification: group C2 + C3 (38 limbs), group C4 (15 limbs) and group C5 + C6 (10 limbs). The patients were evaluated clinically before and 30 to 40 days after surgery by preoperative duplex ultrasonography and pre- and postoperative APG. There was an apparent hemodynamic improvement after surgical treatment of the varicose veins in the two groups of lower severity, but the improvement was significant in the most severe group based on venous filling index. Surgical treatment was beneficial for all three groups, but the greatest hemodynamic gain was observed in the group of highest clinical severity (group C5 + C6).

Current topics in surgery for isolated total anomalous pulmonary venous connection.

PubMed

Yoshimura, Naoki; Fukahara, Kazuaki; Yamashita, Akio; Doki, Yoshinori; Takeuchi, Katsunori; Higuma, Tomonori; Senda, Kazutaka; Toge, Masayoshi; Matsuo, Tatsuro; Nagura, Saori; Aoki, Masaya; Sakata, Kimimasa; Obi, Hayato

2014-12-01

Surgical correction of total anomalous pulmonary venous connection (TAPVC) remains a challenge, with reported early mortality rates of up to 20%. In this review article, we describe several topics, including surgery for neonates, diagnoses with multidetector computed tomography (MDCT), and primary sutureless repair. Several studies have reported mortality rates of around 10%, and demonstrated unchanged hospital mortality in neonates, despite improvement of the overall mortality of cohorts including older patients. Previous reports identified a low body weight at the time of the operation, preoperative pulmonary venous obstruction (PVO), and a prolonged cardiopulmonary bypass time as risk factors for hospital mortality. With the development of new technologies, MDCT has become a good diagnostic modality for use in the pre- and post-operative evaluation. MDCT delineates the drainage site of the vertical vein and the atypical vessel into the systemic vein, and it can also evaluate the existence of obstruction in the vertical vein. Following favorable experiences with post-repair PVO, the indications for sutureless repair as a primary operation have been expanded for infants, including those at risk of developing PVO after the repair of TAPVC. Primary sutureless repair has proven especially useful for difficult patient groups, such as those with congenital PVO, infracardiac TAPVC with small pulmonary veins, or mixed-type TAPVC.

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

PubMed Central

Hong, Ki Pyo

2015-01-01

Background The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence. PMID:26665106

Multiple variations of the renal and testicular vessels: possible embryological basis and clinical importance.

PubMed

Mazengenya, Pedzisai

2016-08-01

During routine dissection of the abdominal cavity of a 55-year-old African male cadaver, multiple anomalies including renal and testicular vessels were encountered. The right kidney was supplied by three right hilar renal arteries arising from the abdominal aorta at different vertebral levels whereas only one left renal artery supplied the left kidney. On the right three renal veins drained the kidney into the inferior vena cava. In contrast, the left kidney was drained by a single renal vein which received a large primary posterior tributary. The primary posterior tributary had three tributaries from the posterior lumbar region. The right testis had two sources of arterial supply; one from the subcostal artery and another from the abdominal aorta. The left testis was supplied normally by a single testicular artery. The right testis was drained by four testicular veins as follows: one drained into the subcostal vein, the other two drained separately for a longer course and joined shortly before draining into the right main renal vein, the fourth one drained into the anterior aspect of the inferior vena cava at the level of the second lumbar vertebra. On the left, the testicle was drained by two testicular veins which travelled separately from the deep inguinal ring and joined shortly before they drain into the left renal vein. This variation may represent an immature form of complicated development of kidneys and testes. Additionally, emphasis must be put on preoperative vascular examination to avoid surgical complications from variant vessels in this region.

Microsurgical treatment for central gyrus region meningioma with epilepsy as primary symptom.

PubMed

Deng, Wen-shuai; Zhou, Xiao-yang; Li, Zhao-jian; Xie, Hong-wei; Fan, Ming-chao; Sun, Peng

2014-09-01

The objective of this article was to investigate the operation outcome, complications, and the patient's quality of life after surgical therapy for central gyrus region meningioma with epilepsy as the primary symptom. All patients get at least 6 months of follow-up (range, 6-34 mo) after surgery. They underwent preoperative magnetic resonance imaging and video electroencephalography, and their clinical manifestations, imaging characteristics, microsurgical methods, and prognosis were retrospectively analyzed. The meningioma was located in the front and back of the central sulcus vein in 3 and 2 patients, respectively; in the compressed precentral gyrus and central sulcus vein in 3 patients; and in the precentral gyrus and postcentral gyrus each in 1 patient; beside the right sagittal sinus and invaded a thick draining vein on the brain surface in 1 patient and beside the right sagittal sinus and close to the precentral gyrus in 2 patients; invaded the superior sagittal sinus in 8 patients; crossed the cerebral falx and compressed cortex gyrus veins in 1 patient; invaded duramater and irritated skull hyperplasia in 3 patients; invaded duramater and its midline infiltrated into the superior sagittal sinus, was located behind the precentral gyrus, and enveloped the central sulcus vein. They were resected and classified by Simpson standards: 17 of the 26 patients had grade I, 6 patients had in grade II, and 3 patients had in grade III. Resection of central gyrus region meningioma by microsurgical technique avoids injury to the cerebral cortex, central sulcus vein, and other draining veins. Microsurgery improves the total resection rate, reduces recurrence rate, and lowers disability or death rate.

Abnormal gel flotation caused by contrast media during adrenal vein sampling.

PubMed

Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Gelati, Matteo; Bassi, Antonella; Contro, Alberto; Pizzolo, Francesca; Guidi, Gian Cesare

2016-10-15

During adrenal venous sampling (AVS) procedure, radiologists administer a contrast agent via the catheter to visualize the proper catheter position. A patient with primary aldosteronism diagnostic-hypothesis was admitted for AVS. A venogram was performed to
confirm the catheter's position with 2mL of Iopamidol 300 mg/mL. Samples were collected with syringe connected to a hydrophilic coated catheter by low-pressure aspiration from each of the four collection sites: inferior vena cava in the suprarenal portion, inferior vena cava in the infrarenal portion, left adrenal vein, and right adrenal vein; then immediately transferred from syringe to tubes with gel separator. All tubes were centrifuged at 1200 x g for 10 minutes. At the end of centrifugation process, primary blood tubes containing blood from inferior vena cava and left adrenal vein exhibited the standard gel separator barrier, while tubes from right adrenal vein showed abnormal flotation of gel separator. The radiologist confirmed the usage of 2.6 mL instead of 2.0 mL of Iopamidol 300 mg/mL. This iodinated contrast media, with 1.33 g/cm 3 of density, was used close to the right adrenal vein due to some difficulty to access it. The abnormal flotation of gel separator in samples taken from right adrenal vein can be explained by the usage of the iodinated
contrast media. We suggest using plain-tubes (without gel separator) for AVS in order to avoid preanalytical nonconformities. Moreover, a blood volume equivalent to twice the catheter extension should be discarded to eliminate residual contrast media before collection of samples for laboratory assays.

The copper-cobalt deposits of the Quartzburg district, Grant County, Oregon

USGS Publications Warehouse

Vhay, John Stewart

1960-01-01

The copper- and cobalt-bearing veins of part of the Quartzburg district are in fracture zones trending about N. 70 degrees E. in folded Permian (?) metavolcanic rocks on the southwest side of a quartz diorite stock. Along many of the veins fine-grained tourmaline and quartz have replaced the country rock. The primary ore minerals are chalcopyrite, glaucodot, safflorite, and cobaltite. The copper- and cobalt-rich parts of the deposits appear to be in separate ore shoots. Gold content is generally higher in the cobalt-bearing parts of the veins than in the copper-rich parts. The Standard mine has developed part of one vein zone. Several other vein zones that crop out may contain as much copper as the Standard vein zone. Further bulldozing and diamond drilling on the surface, and more geologic mapping, sampling, and diamond drilling underground are suggested as means to explore for more ore deposits.

Fluid inclusion petrology and microthermometry of the Cocos Ridge hydrothermal system, IODP Expedition 344 (CRISP 2), Site U1414.

PubMed

Brandstätter, Jennifer; Kurz, Walter; Krenn, Kurt; Micheuz, Peter

2016-04-01

In this study, we present new data from microthermometry of fluid inclusions entrapped in hydrothermal veins along the Cocos Ridge from the IODP Expedition 344 Site U1414. The results of our study concern a primary task of IODP Expedition 344 to evaluate fluid/rock interaction linked with the tectonic evolution of the incoming Cocos Plate from the Early Miocene up to recent times. Aqueous, low saline fluids are concentrated within veins from both the Cocos Ridge basalt and the overlying lithified sediments of Unit III. Mineralization and crosscutting relationships give constraints for different vein generations. Isochores from primary, reequilibrated, and secondary fluid inclusions crossed with litho/hydrostatic pressures indicate an anticlockwise PT evolution during vein precipitation and modification by isobaric heating and subsequent cooling at pressures between ∼210 and 350 bar. Internal over and underpressures in the inclusions enabled decrepitation and reequilibration of early inclusions but also modification of vein generations in the Cocos Ridge basalt and in the lithified sediments. We propose that lithification of the sediments was accompanied with a first stage of vein development (VU1 and VC1) that resulted from Galapagos hotspot activity in the Middle Miocene. Heat advection, either related to the Cocos-Nazca spreading center or to hotspot activity closer to the Middle America Trench, led to subsequent vein modification (VC2, VU2/3) related to isobaric heating. The latest mineralization (VC3, VU3) within aragonite and calcite veins and some vesicles of the Cocos Ridge basalt occurred during crustal cooling up to recent times. Fluid inclusion analyses and published isotope data show evidence for communication with deeper sourced, high-temperature hydrothermal fluids within the Cocos Plate. The fluid source of the hydrothermal veins reflects aqueous low saline pore water mixed with invaded seawater.

Fluid inclusion petrology and microthermometry of the Cocos Ridge hydrothermal system, IODP Expedition 344 (CRISP 2), Site U1414

PubMed Central

Brandstätter, Jennifer; Krenn, Kurt; Micheuz, Peter

2016-01-01

Abstract In this study, we present new data from microthermometry of fluid inclusions entrapped in hydrothermal veins along the Cocos Ridge from the IODP Expedition 344 Site U1414. The results of our study concern a primary task of IODP Expedition 344 to evaluate fluid/rock interaction linked with the tectonic evolution of the incoming Cocos Plate from the Early Miocene up to recent times. Aqueous, low saline fluids are concentrated within veins from both the Cocos Ridge basalt and the overlying lithified sediments of Unit III. Mineralization and crosscutting relationships give constraints for different vein generations. Isochores from primary, reequilibrated, and secondary fluid inclusions crossed with litho/hydrostatic pressures indicate an anticlockwise PT evolution during vein precipitation and modification by isobaric heating and subsequent cooling at pressures between ∼210 and 350 bar. Internal over and underpressures in the inclusions enabled decrepitation and reequilibration of early inclusions but also modification of vein generations in the Cocos Ridge basalt and in the lithified sediments. We propose that lithification of the sediments was accompanied with a first stage of vein development (VU1 and VC1) that resulted from Galapagos hotspot activity in the Middle Miocene. Heat advection, either related to the Cocos‐Nazca spreading center or to hotspot activity closer to the Middle America Trench, led to subsequent vein modification (VC2, VU2/3) related to isobaric heating. The latest mineralization (VC3, VU3) within aragonite and calcite veins and some vesicles of the Cocos Ridge basalt occurred during crustal cooling up to recent times. Fluid inclusion analyses and published isotope data show evidence for communication with deeper sourced, high‐temperature hydrothermal fluids within the Cocos Plate. The fluid source of the hydrothermal veins reflects aqueous low saline pore water mixed with invaded seawater. PMID:27570496

Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion.

PubMed

Kishino, Mitsuhiro; Yoshimoto, Takanobu; Nakadate, Masashi; Katada, Yoshiaki; Kanda, Eiichiro; Nakaminato, Shuichiro; Saida, Yukihisa; Ogawa, Yoshihiro; Tateishi, Ukihide

2017-03-31

We evaluated the influence of catheter sampling position and size on left adrenal venous sampling (AVS) in patients with primary aldosteronism (PA) and analyzed their relationship to cortisol secretion. This retrospective study included 111 patients with a diagnosis of primary aldosteronism who underwent tetracosactide-stimulated AVS. Left AVS was obtained from two catheter positions - the central adrenal vein (CAV) and the common trunk. For common trunk sampling, 5-French catheters were used in 51 patients, and microcatheters were used in 60 patients. Autonomous cortisol secretion was evaluated with a low-dose dexamethasone suppression test in 87 patients. The adrenal/inferior vena cava cortisol concentration ratio [selectivity index (SI)] was significantly lower in samples from the left common trunk than those of the left CAV and right adrenal veins, but this difference was reduced when a microcatheter was used for common trunk sampling. Sample dilution in the common trunk of the left adrenal vein can be decreased by limiting sampling speed with the use of a microcatheter. Meanwhile, there was no significant difference in SI between the left CAV and right adrenal veins. Laterality, determined according to aldosterone/cortisol ratio (A/C ratio) based criteria, showed good reproducibility regardless of sampling position, unlike the absolute aldosterone value based criteria. However, in 11 cases with autonomous cortisol co-secretion, the cortisol hypersecreting side tended to be underestimated when using A/C ratio based criteria. Left CAV sampling enables symmetrical sampling, and may be essential when using absolute aldosterone value based criteria in cases where symmetrical cortisol secretion is uncertain.

Vein grafting your way out of trouble: Examining the utility and efficacy of vein grafts in microsurgery.

PubMed

Nelson, Jonas A; Fischer, John P; Grover, Ritwik; Kovach, Stephen J; Low, David W; Kanchwala, Suhail K; Levin, L Scott; Serletti, Joseph M; Wu, Liza C

2015-06-01

There is limited data on the indications, outcomes, and associated complications with use of interpositional vein grafts (IVG) in microsurgery. This study sought to critically examine and update the utility of this microsurgical technique. All microsurgical cases at a single institution from 2005 to 2011 were examined for use of IVGs in the primary procedure or during take back or salvage attempts. We examined the cohort overall and performed a subgroup analysis by timing of initial IVG. In the study period, 1718 patients underwent 2368 free flaps. 51 IVGs were utilized in 38 patients (2.2%) and 38 flaps (1.6%). Eight (42.1%) of the primary procedure IVGs (n = 19) were planned preoperatively. Nine total flap losses (24%) occurred when IVGs were utilized, 89% of which occurred in the take back cohort (p = 0.02). However, planned IVG had a 100% success rate, and IVG utilized in the primary procedure overall had a 95% success rate. Importantly, A significantly higher rate of thrombotic events was noted in all primary cases where IVGs were utilized (p = 0.005). This study demonstrates that IVGs can be utilized in primary free flap reconstructions with success rates exceeding 95%. However, in salvage procedures, the use of vein grafts does not approach the same rate of success likely due to multiple factors. Yet when utilized appropriately with thrombectomy and resection of the thrombosed vessel to healthy intima, IVGs can provide an important tool for flap salvage. prognostic/risk category, level II. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

New insights on basivenal sclerites using 3D tools and homology of wing veins in Odonatoptera (Insecta).

PubMed

Jacquelin, Lauriane; Desutter-Grandcolas, Laure; Chintauan-Marquier, Ioana; Boistel, Renaud; Zheng, Daran; Prokop, Jakub; Nel, André

2018-01-10

Being implied in flight, mimetism, communication, and protection, the insect wings were crucial organs for the mega diversification of this clade. Despite several attempts, the problem of wing evolution remains unresolved because the basal parts of the veins essential for vein identification are hidden in the basivenal sclerites. The homologies between wing characters thus cannot be accurately verified, while they are of primary importance to solve long-standing problems, such as the monophyly of the Palaeoptera, viz. Odonatoptera, Panephemeroptera, and Palaeozoic Palaeodictyopterida mainly known by their wings. Hitherto the tools to homologize venation were suffering several cases of exceptions, rendering them unreliable. Here we reconstruct the odonatopteran venation using fossils and a new 3D imaging tool, resulting congruent with the concept of Riek and Kukalová-Peck, with important novelties, viz. median anterior vein fused to radius and radius posterior nearly as convex as radius anterior (putative synapomorphies of Odonatoptera); subcostal anterior (ScA) fused to costal vein and most basal primary antenodal crossvein being a modified posterior branch of ScA (putative synapomorphies of Palaeoptera). These findings may reveal critical for future analyses of the relationships between fossil and extant Palaeoptera, helping to solve the evolutionary history of the insects as a whole.

Improved technical success and radiation safety of adrenal vein sampling using rapid, semi-quantitative point-of-care cortisol measurement.

PubMed

Page, Michael M; Taranto, Mario; Ramsay, Duncan; van Schie, Greg; Glendenning, Paul; Gillett, Melissa J; Vasikaran, Samuel D

2018-01-01

Objective Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling studies. Adrenal vein sampling studies are technically demanding with a high failure rate in many centres. The use of intraprocedural cortisol measurement could improve the success rates of adrenal vein sampling but may be impracticable due to cost and effects on procedural duration. Design Retrospective review of the results of adrenal vein sampling procedures since commencement of point-of-care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the adrenal vein sampling Accuracy Kit. Success rate and complications of adrenal vein sampling procedures before and after use of the adrenal vein sampling Accuracy Kit. Routine use of the adrenal vein sampling Accuracy Kit device for intraprocedural measurement of cortisol commenced in 2016. Results Technical success rate of adrenal vein sampling increased from 63% of 99 procedures to 90% of 48 procedures ( P = 0.0007) after implementation of the adrenal vein sampling Accuracy Kit. Failure of right adrenal vein cannulation was the main reason for an unsuccessful study. Radiation dose decreased from 34.2 Gy.cm 2 (interquartile range, 15.8-85.9) to 15.7 Gy.cm 2 (6.9-47.3) ( P = 0.009). No complications were noted, and implementation costs were minimal. Conclusions Point-of-care cortisol measurement during adrenal vein sampling improved cannulation success rates and reduced radiation exposure. The use of the adrenal vein sampling Accuracy Kit is now standard practice at our centre.

Clinical effectiveness and cost-effectiveness of foam sclerotherapy, endovenous laser ablation and surgery for varicose veins: results from the Comparison of LAser, Surgery and foam Sclerotherapy (CLASS) randomised controlled trial.

PubMed Central

Brittenden, Julie; Cotton, Seonaidh C; Elders, Andrew; Tassie, Emma; Scotland, Graham; Ramsay, Craig R; Norrie, John; Burr, Jennifer; Francis, Jill; Wileman, Samantha; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A; MacLennan, Graeme; Prior, Maria; Bolsover, Denise; Campbell, Marion K

2015-01-01

BACKGROUND Foam sclerotherapy (foam) and endovenous laser ablation (EVLA) have emerged as alternative treatments to surgery for patients with varicose veins, but uncertainty exists regarding their effectiveness in the medium to longer term. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of foam, EVLA and surgery for the treatment of varicose veins. DESIGN A parallel-group randomised controlled trial (RCT) without blinding, and economic modelling evaluation. SETTING Eleven UK specialist vascular centres. PARTICIPANTS Seven hundred and ninety-eight patients with primary varicose veins (foam, n = 292; surgery, n = 294; EVLA, n = 212). INTERVENTIONS Patients were randomised between all three treatment options (eight centres) or between foam and surgery (three centres). PRIMARY OUTCOME MEASURES Disease-specific [Aberdeen Varicose Vein Questionnaire (AVVQ)] and generic [European Quality of Life-5 Dimensions (EQ-5D), Short Form questionnaire-36 items (SF-36) physical and mental component scores] quality of life (QoL) at 6 months. Cost-effectiveness as cost per quality-adjusted life-year (QALY) gained. SECONDARY OUTCOME MEASURES Quality of life at 6 weeks; residual varicose veins; Venous Clinical Severity Score (VCSS); complication rates; return to normal activity; truncal vein ablation rates; and costs. RESULTS The results appear generalisable in that participants' baseline characteristics (apart from a lower-than-expected proportion of females) and post-treatment improvement in outcomes were comparable with those in other RCTs. The health gain achieved in the AVVQ with foam was significantly lower than with surgery at 6 months [effect size -1.74, 95% confidence interval (CI) -2.97 to -0.50; p = 0.006], but was similar to that achieved with EVLA. The health gain in SF-36 mental component score for foam was worse than that for EVLA (effect size 1.54, 95% CI 0.01 to 3.06; p = 0.048) but similar to that for surgery. There were no differences in EQ-5D or SF-36 component scores in the surgery versus foam or surgery versus EVLA comparisons at 6 months. The trial-based cost-effectiveness analysis showed that, at 6 months, foam had the highest probability of being considered cost-effective at a ceiling willingness-to-pay ratio of £20,000 per QALY. EVLA was found to cost £26,107 per QALY gained versus foam, and was less costly and generated slightly more QALYs than surgery. Markov modelling using trial costs and the limited recurrence data available suggested that, at 5 years, EVLA had the highest probability (≈ 79%) of being cost-effective at conventional thresholds, followed by foam (≈ 17%) and surgery (≈ 5%). With regard to secondary outcomes, health gains at 6 weeks (p < 0.005) were greater for EVLA than for foam (EQ-5D, p = 0.004). There were fewer procedural complications in the EVLA group (1%) than after foam (7%) and surgery (8%) (p < 0.001). Participants returned to a wide range of behaviours more quickly following foam or EVLA than following surgery (p < 0.05). There were no differences in VCSS between the three treatments. Truncal ablation rates were higher for surgery (p < 0.001) and EVLA (p < 0.001) than for foam, and were similar for surgery and EVLA. CONCLUSIONS Considerations of both the 6-month clinical outcomes and the estimated 5-year cost-effectiveness suggest that EVLA should be considered as the treatment of choice for suitable patients. FUTURE WORK Five-year trial results are currently being evaluated to compare the cost-effectiveness of foam, surgery and EVLA, and to determine the recurrence rates following each treatment. This trial has highlighted the need for long-term outcome data from RCTs on QoL, recurrence rates and costs for foam sclerotherapy and other endovenous techniques compared against each other and against surgery. TRIAL REGISTRATION Current Controlled Trials ISRCTN51995477. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 27. See the NIHR Journals Library website for further project information. PMID:25858333

Abnormal gel flotation caused by contrast media during adrenal vein sampling

PubMed Central

Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Gelati, Matteo; Bassi, Antonella; Contro, Alberto; Pizzolo, Francesca; Guidi, Gian Cesare

2016-01-01

Introduction During adrenal venous sampling (AVS) procedure, radiologists administer a contrast agent via the catheter to visualize the proper catheter position. Materials and methods A patient with primary aldosteronism diagnostic-hypothesis was admitted for AVS. A venogram was performed to
confirm the catheter’s position with 2mL of Iopamidol 300 mg/mL. Samples were collected with syringe connected to a hydrophilic coated catheter by low-pressure aspiration from each of the four collection sites: inferior vena cava in the suprarenal portion, inferior vena cava in the infrarenal portion, left adrenal vein, and right adrenal vein; then immediately transferred from syringe to tubes with gel separator. All tubes were centrifuged at 1200 x g for 10 minutes. Results At the end of centrifugation process, primary blood tubes containing blood from inferior vena cava and left adrenal vein exhibited the standard gel separator barrier, while tubes from right adrenal vein showed abnormal flotation of gel separator. The radiologist confirmed the usage of 2.6 mL instead of 2.0 mL of Iopamidol 300 mg/mL. This iodinated contrast media, with 1.33 g/cm3 of density, was used close to the right adrenal vein due to some difficulty to access it. Conclusion The abnormal flotation of gel separator in samples taken from right adrenal vein can be explained by the usage of the iodinated
contrast media. We suggest using plain-tubes (without gel separator) for AVS in order to avoid preanalytical nonconformities. Moreover, a blood volume equivalent to twice the catheter extension should be discarded to eliminate residual contrast media before collection of samples for laboratory assays. PMID:27812311

Biocompatibility tests of components of an implantable cardiac assist device.

PubMed

von Recum, A F; Imamura, H; Freed, P S; Kantrowitz, A; Chen, S T; Ekstrom, M E; Baechler, C A; Barnhart, M I

1978-09-01

A permanently implantable in-series left ventricular assist device, the dynamic aortic patch (DAP), has been tested in chronic animal experiments. The DAP replaces a section of the intrathoracic aortic wall. Hemothorax and hematocele at the implantation site have been complications in recent experiments. Primary postoperative hemorrhage was ruled out, and the biocompatibility of all components was therefore examined. Dacron velour, Teflon felt, conductive polyurethane, segmented polyether polyurethane, and Teflon-coated polyester fiber sutures were implanted in the pleural cavities of dogs and tested in vitro by culturing canine saphenous vein explants on them. In vivo experiments demonstrated that all components elicited mild to moderate inflammatory reactions, but hematocele occurred only when the components were implanted in the aorta with direct blood contact and exposed to arterial blood pressures. In vitro, cells were cultured on all components with no signs of toxic reactions. These results indicated that the host tolerated all implant components without major inflammatory responses. However, histological data indicated that chronic slow bleeding into or through the Dacron velour in contact with the arterial blood serum could account for hemothorax or hematocele formation. Therefore, a configuration of the assist device using materials impermeable to blood may obviate these difficulties.

Arabidopsis thickvein mutation affects vein thickness and organ vascularization, and resides in a provascular cell-specific spermine synthase involved in vein definition and in polar auxin transport.

PubMed

Clay, Nicole K; Nelson, Timothy

2005-06-01

Polar auxin transport has been implicated in the induction of vascular tissue and in the definition of vein positions. Leaves treated with chemical inhibitors of polar auxin transport exhibited vascular phenotypes that include increased vein thickness and vascularization. We describe a recessive mutant, thickvein (tkv), which develops thicker veins in leaves and in inflorescence stems. The increased vein thickness is attributable to an increased number of vascular cells. Mutant plants have smaller leaves and shorter inflorescence stems, and this reduction in organ size and height is accompanied by an increase in organ vascularization, which appears to be attributable to an increase in the recruitment of cells into veins. Furthermore, although floral development is normal, auxin transport in the inflorescence stem is significantly reduced in the mutant, suggesting that the defect in auxin transport is responsible for the vascular phenotypes. In the primary root, the veins appear morphologically normal, but root growth in the tkv mutant is hypersensitive to exogenous cytokinin. The tkv mutation was found to reside in the ACL5 gene, which encodes a spermine synthase and whose expression is specific to provascular cells. We propose that ACL5/TKV is involved in vein definition (defining the boundaries between veins and nonvein regions) and in polar auxin transport, and that polyamines are involved in this process.

Arabidopsis thickvein Mutation Affects Vein Thickness and Organ Vascularization, and Resides in a Provascular Cell-Specific Spermine Synthase Involved in Vein Definition and in Polar Auxin Transport1

PubMed Central

Clay, Nicole K.; Nelson, Timothy

2005-01-01

Polar auxin transport has been implicated in the induction of vascular tissue and in the definition of vein positions. Leaves treated with chemical inhibitors of polar auxin transport exhibited vascular phenotypes that include increased vein thickness and vascularization. We describe a recessive mutant, thickvein (tkv), which develops thicker veins in leaves and in inflorescence stems. The increased vein thickness is attributable to an increased number of vascular cells. Mutant plants have smaller leaves and shorter inflorescence stems, and this reduction in organ size and height is accompanied by an increase in organ vascularization, which appears to be attributable to an increase in the recruitment of cells into veins. Furthermore, although floral development is normal, auxin transport in the inflorescence stem is significantly reduced in the mutant, suggesting that the defect in auxin transport is responsible for the vascular phenotypes. In the primary root, the veins appear morphologically normal, but root growth in the tkv mutant is hypersensitive to exogenous cytokinin. The tkv mutation was found to reside in the ACL5 gene, which encodes a spermine synthase and whose expression is specific to provascular cells. We propose that ACL5/TKV is involved in vein definition (defining the boundaries between veins and nonvein regions) and in polar auxin transport, and that polyamines are involved in this process. PMID:15894745

Endovenous laser ablation of varicose perforating veins with the 1470-nm diode laser using the radial fibre slim.

PubMed

Zerweck, Christof; von Hodenberg, Eva; Knittel, Matthias; Zeller, Thomas; Schwarz, Thomas

2014-02-01

Endovenous Laser Ablation (EVLA) is one of the most accepted treatment options for varicose veins. The aim of this study was to investigate the efficacy and safety of the new radial fiber slim (ELVeS-radial-slim kit™) for the 1470 nm diode laser in perforator veins with a 1 month follow-up. Our prospective observational cohort study comprised 69 perforating veins in 55 patients. Ninety percent of all patients were in the CEAP-stage C3-C6. The radial fiber slim was used to occlude the perforating vein and the great or small saphenous vein in the same procedure. The primary efficacy endpoint of the study was ultrasonographically proven elimination of venous reflux in the perforating vein after at least one month. Secondary efficacy and further safety end points after one month were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis (DVT), clinical pulmonary embolism (PE), or superficial vein thrombosis (SVT) as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia. Follow-up could be completed in all patients. In all treated perforating varicose veins, occlusion with elimination of reflux could be demonstrated immediately after the procedure. After one month 95.6% of the treated veins were still occluded (67/69). During follow-up, we did not diagnose any DVT, PE or SVT in the area related to the treated perforating vein. No patient died. One patient reported paresthesia distally of the puncture site. Endovenous laser treatment of varicose perforating veins with 1470 nm diode laser using the radial fiber slim is effective and safe with low recanalization rates during 1-month follow-up.

Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: A case report.

PubMed

Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

2017-11-01

Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. This patient was treated successfully with surgery. This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. The pitfall of misdiagnosing this tumor as DVT is a useful reminder.

Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis

PubMed Central

Zhang, Mei; Yan, Feng; Huang, Bin; Wu, Zhoupeng; Wen, Xiaorong

2017-01-01

Abstract Rationale: Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. Patient concerns: We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. Diagnoses: She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. Interventions: This patient was treated successfully with surgery. Outcomes: This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. Lessons: The pitfall of misdiagnosing this tumor as DVT is a useful reminder. PMID:29145269

Is total abolishment of great saphenous reflux in the invasive treatment of superficial chronic venous insufficiency always necessary?

PubMed

Navarro, T P; Nunes, T A; Ribeiro, A L; Castro-Silva, M

2009-02-01

Chronic venous insufficiency ranges from mild telangiectasias to skin ulceration with poor prognosis regarding healing and quality of life. Varicose veins are the most frequent clinical presentation, affecting 75% of such patients and 71% are due to primary reflux of great saphenous vein, which is the most compromised vein in chronic venous insufficiency. However, about 75% of these veins are not dilated. The standard treatment has been stripping of the saphenous vein, because it has 85% of good results at long term. However, saphenous vein is the main arterial substitute and should be spared whenever possible. The development of non-invasive diagnostic methods showed that hemodynamic worsening correlates with clinical severity and that the majority of patients did not have a dilated saphenous vein. Thus, several selective operations proposed to spare the saphenous vein have reported good results. Minimally invasive techniques (eco-guided foam, radiofrequency and laser) have also emerged aiming to obliterate the vein and abolishing reflux and have also reported good results, but they do not spare the vessel. Measurement of saphenous diameter has been shown to correlate with clinical and hemodynamic worsening, thus allowing planning the invasive treatment of chronic venous insufficiency. Dilated diameters (>7.2 mm) correlate with severe disease and poor prognosis, being an indication for total abolishment of saphenous vein reflux. All other presentations must be individualized, sparing saphenous vein whenever possible and and a standardized approach is not indicated for all patients.

Studies on the psychosomatic functioning of ill-health according to Eastern and Western medicine. 1. Visual observation of the sublingual vein for early detection of vital energy stagnation and blood stasis.

PubMed

Takeichi, M; Sato, T

1999-01-01

Computer-assisted image analyses were performed on the tongue color of 95 medical students without previous history of blood stasis-related condition to clarify the mutual relationship of the color of the tongue proper, the coating, and sublingual vein. The location of the measurement for the tongue proper was the underside of the tongue, and location of the measurement for the tongue coating was the upper surface of the tongue. A linear correlation analysis showed a correlation for each of the different positions for the non-normalized red value and normalized blue value. This analysis also demonstrated a statistically-significant relationship between the tongue proper and the sublingual vein using Red-Green-Blue components and normalized Red-Green-Blue components (r = +0.670 - 0.817, p < 0.0001). The most significant correlation between the tongue proper and the sublingual vein was the normalized red value and the normalized Red-Green-Blue values for minimizing the range of the standard error of the mean (r = +0.745, p < 0.0001), although non-normalized blue had the highest correlation coefficient. Therefore, it seems reasonable to select those normalized red values for the comparison in the tongue color analysis. Correlation of the color between the sublingual vein and the tongue proper strongly suggests that inspection with the naked eye of the sublingual vein is useful for the early detection of vital energy stagnation and blood stasis. Also, because of its close relation to sustained chronic stress, changes in the sublingual vein might be available as one physiological parameter of a stress reaction.

A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.

PubMed

Camkiran Firat, Aynur; Zeyneloglu, Pinar; Ozkan, Murat; Pirat, Arash

2016-09-01

To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. A 1:1 randomized controlled trial. Baskent University Medical Center. Pediatric patients scheduled for cardiac surgery. Two hundred and eighty children undergoing central venous catheterization were randomly allocated to the internal jugular vein or subclavian vein group during a period of 18 months. The primary outcome was the first-attempt success rate of central venous catheterization through either approach. The secondary outcomes were the rates of infectious and mechanical complications. The central venous catheterization success rate at the first attempt was not significantly different between the subclavian vein (69%) and internal jugular vein (64%) groups (p = 0.448). However, the overall success rate was significantly higher through the subclavian vein (91%) than the internal jugular vein (82%) (p = 0.037). The overall frequency of mechanical complications was not significantly different between the internal jugular vein (25%) and subclavian vein (31%) (p = 0.456). However, the rate of arterial puncture was significantly higher with internal jugular vein (8% vs 2%; p = 0.03) and that of catheter malposition was significantly higher with subclavian vein (17% vs 1%; p < 0.001). The rates per 1,000 catheter days for both positive catheter-tip cultures (26.1% vs 3.6%; p < 0.001) and central-line bloodstream infection (6.9 vs 0; p < 0.001) were significantly higher with internal jugular vein. There were no significant differences between the groups in the length of ICU and hospital stays or in-hospital mortality rates (p > 0.05 for all). Central venous catheterization through the internal jugular vein and subclavian vein was not significantly different in terms of success at the first attempt. Although the types of mechanical complications were different, the overall rate was similar between internal jugular vein and subclavian vein access. The risk of infectious complications was significantly higher with internal jugular vein access.

Fluid inclusion petrography and microthermometry of the Cocos Ridge hydrothermal system, IODP Expedition 344 (CRISP 2), Site U1414

NASA Astrophysics Data System (ADS)

Brandstätter, J.; Kurz, W.; Krenn, K.; Micheuz, P.

2015-12-01

We present new data from microthermometric analyses of fluid inclusions entrapped in hydrothermal veins within lithified sediments and Cocos Ridge (CCR) basalt from IODP Expedition 344 site U1414 (Costa Rica) and concern on a primary task of Expedition 344, i.e. to evaluate fluid/rock interaction, the hydrologic system, and the geochemical processes (indicated by composition and volume of fluids) active within the incoming Cocos Plate. Mineralization of the veins and crosscutting relationships gives constraints for the different generation of veins. Calcium carbonate, commonly aragonite in the upper part and calcite in the lower part of the igneous basement, is usually present in veins as a late phase following the quartz precipitation and the clay minerals formation. The sequence of vein generations in the lithified sediments close to the contact within the CCR basalt is characterized by smaller veins filled by quartz, followed by massive intersecting calcite veins. A high fluid pressure can be concluded, due to wall rock fragments embedded within the filling and fractured mineral grains in the ground mass, which are close to the veins. This requires that the magmatic basement and the lithified sediments were covered by sequences of low permeability sediments forming a barrier that enabled build up elevated fluid pressure. The investigation of fluid inclusions in the lowest units of borehole 344-U1414, give clues about the source of the fluids and about the vein evolution within the incoming Cocos Plate close to Middle American Trench. The microthermometric analyses of the primary, almost aqueous, inclusions indicate a temperature range during entrapment between 200 and 420°C. The data indicate that seawater within the Cocos Ridge aquifer communicated with high-temperature fluids and/or were modified by heat advection. We consider the Galapagos hotspot and/ or the Cocos-Nazca spreading center as heat source. Fluids originated from mobilized sediment pore water and invaded seawater. Isotope and heat flow data indicate a deep fluid source within the Cocos Plate oceanic crust too.

Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

PubMed Central

Saliba Júnior, Orlando Adas; Giannini, Mariangela; Mórbio, Ana Paula; Saliba, Orlando; Rollo, Hamilton Almeida

2014-01-01

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery. PMID:24696783

The umbilical and paraumbilical veins of man.

PubMed

Martin, B F; Tudor, R G

1980-03-01

During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein.

Extraluminal venous interruption for free-floating thrombus in the deep veins of lower limbs.

PubMed

Casian, D; Gutsu, E; Culiuc, V

2010-01-01

The free-floating thrombus (FFT) represents a particular form of deep vein thrombosis with extremely high potential of fatal pulmonary embolism. The purpose of the study was to evaluate the early results of aggressive surgical approach to FFT. During the period 2005-2008 years FFT was diagnosed in 13 patients. Demographic characteristics of patients: medium age--54.7 years, male--76.9%, significant comorbidity--5 (38.5%) cases. Localization of FFT: superficial femoral vein (SFV)--5 (38.5%), common femoral vein (CFV)--4 (30.7%), external iliac vein (EIV)--2 (15.4%), inferior cava vein (ICV)--2 (15.4%). Manifestations of previous pulmonary embolism were documented preoperatively in 3 (23.1%) cases. The following emergency surgical procedures were performed: ligation--3 (23.1%) or plication--2 (15.4%) of SFV; plication of CFV--5 (38.5%) patients, combined in 4 cases with partial thrombectomy (free-floating part of thrombus); plication of common iliac vein--1 (7.6%); plication of ICV--2 (15.4%) cases. Primary or recurrent cases of clinically significant pulmonary embolism were not detected in the postoperative period. The accumulated experience of surgical management of patients with FFT reveals the important role of deep vein ligation/plication in prevention of fatal pulmonary embolism.

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

PubMed Central

Okamura, Keisuke; Okuda, Tetsu; Shirai, Kazuyuki; Abe, Ichiro; Kobayashi, Kunihisa; Ishii, Tatsu; Haraoka, Seiji; Urata, Hidenori

2018-01-01

Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage. Previous reports have also indicated that AH may not ameliorate PA. We discussed the clinical progress of AH and the measures to prevent causing AH. PMID:29238437

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling.

PubMed

Okamura, Keisuke; Okuda, Tetsu; Shirai, Kazuyuki; Abe, Ichiro; Kobayashi, Kunihisa; Ishii, Tatsu; Haraoka, Seiji; Urata, Hidenori

2018-01-01

Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage. Previous reports have also indicated that AH may not ameliorate PA. We discussed the clinical progress of AH and the measures to prevent causing AH.

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.

Triclosan-coated sutures reduce surgical site infection after open vein harvesting in coronary artery bypass grafting patients: a randomized controlled trial†

PubMed Central

Thimour-Bergström, Linda; Roman-Emanuel, Christine; Scherstén, Henrik; Friberg, Örjan; Gudbjartsson, Tomas; Jeppsson, Anders

2013-01-01

OBJECTIVES The incidence of surgical site infection (SSI) after open vein harvesting in coronary artery bypass grafting (CABG) patients ranges in different studies between 2 and 20%. Triclosan is an antibacterial substance that reduces the growth of bacteria by inhibiting fatty acid synthesis. We hypothesized that wound closure with triclosan-coated sutures would reduce SSI after open vein harvesting. METHODS An investigator-initiated prospective randomized double-blind single-centre study was performed with 374 patients, randomized to subcutaneous and intracutaneous leg-wound closure with either triclosan-coated sutures (Vicryl Plus® and Monocryl Plus®, Ethicon, Somerville, NJ, USA) (n = 184) or identical sutures without triclosan (n = 190) from the same manufacturer. All patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). Primary endpoint was SSI within 60 days after surgery according to the definition of Center for Disease Control. Predefined secondary endpoints included culture-proven and antibiotic-treated SSI. RESULTS The primary endpoint occurred in 23 patients (12.5%) with triclosan-coated sutures and in 38 patients (20.0%) in the group without triclosan (P = 0.0497, risk ratio 0.63, (95% confidence interval 0.39–1.00). Corresponding figures for culture-proven infections were 7.6 vs 12.1%, (P = 0.15), and for antibiotic-treated infections, 10.9 vs 18.4%, (P = 0.039). Staphylococcus aureus and coagulase-negative staphylococci were the most common pathogens in both groups. Insulin-treated diabetes and vein-harvesting time were associated with SSI after vein harvesting. CONCLUSIONS Leg-wound closure with triclosan-coated sutures in CABG patients reduces SSIs after open vein harvesting. (ClinicalTrials.gov number NCT01212315). PMID:23435526

Arteriovenous Hybrid Graft with Outflow in the Proximal Axillary Vein.

PubMed

Murga, Allen G; Chiriano, Jason; Kiang, Sharon C; Patel, Sheela; Bianchi, Christian; Abou-Zamzam, Ahmed M; Teruya, Theodore H

2017-07-01

The patency of long-term hemodialysis access in end-stage renal disease patients remains a significant challenge. Often these patients are affected with limited venous outflow options, requiring limb abandonment, and creation of new access in the contralateral arm. Vascular surgeons are familiar with the exposure of the proximal axillary artery via an infraclavicular incision. The axillary vein is easily exposed through this technique. The use of the hybrid Gore graft can make the venous anastomosis easier. A hybrid graft with its venous outflow placed in the proximal axillary vein can extend the options of upper extremity access procedures. We reviewed our early experience with this technique. A review of dialysis procedures at the Loma Linda VA was performed. All patients undergoing placement of arteriovenous grafts utilizing the Gore hybrid placed into the proximal axillary vein for outflow were identified. Outcomes in terms of primary and secondary patency rates were determined. Eight patients had placement of an arteriovenous hybrid graft in the proximal axillary vein via an infraclavicular incision. All patients had exhausted other options for hemodialysis access in the ipsilateral upper extremity. All grafts were used successfully for dialysis. The mean primary and secondary patency rates at 6 months were 37.5% and 62.5%, respectively. One patient developed steal syndrome, requiring proximalization of the graft. Seven out of the 8 patients required secondary procedures including thrombectomy (n = 16) and angioplasty (n = 17). Placement of a hybrid graft in the proximal axillary vein is an effective and suitable option for patients who have exhausted arteriovenous access sites in the arm. This procedure can easily be performed in an outpatient setting with a low complication rate and allowing for preservation of the contralateral upper extremity for future use. Published by Elsevier Inc.

Leaves and fruits of Bauhinia (Leguminosae, Caesalpinioideae, Cercideae) from the Oligocene Ningming Formation of Guangxi, South China and their biogeographic implications

PubMed Central

2014-01-01

Background The pantropical genus Bauhinia, along with the northern temperate Cercis and several tropical genera, bear bilobate, bifoliolate, or sometimes unifoliolate leaves, which constitute the tribe Cercideae as sister to the rest of the family Leguminosae based on molecular phylogenetics. Hence, the fossil record of Cercideae is pivotal to understand the early evolution and biogeographic history of legumes. Results Three fossil species of Bauhinia were described from the Oligocene Ningming Formation of Guangxi, South China. Bauhinia ningmingensis sp. nov. is characterized by its bifoliolate, pulvinate leaves bearing basal acrodromous primary veins and brochidodromous secondary veins. B. cheniae sp. nov. bears moderately or deeply bilobate, pulvinate leaves, with basal actinodromous primary veins and eucamptodromous secondary veins. B. larsenii D.X. Zhang et Y.F. Chen emend. possesses shallowly or moderately bilobate, pulvinate leaves bearing basal actinodromous primary veins and brochidodromous secondary veins, as well as elliptic, stipitate, non-winged, and oligo-seeded fruits. Meanwhile, previously reported Bauhinia fossils were reviewed, and those pre-Oligocene foliage across the world are either questionable or have been rejected due to lacking of reliable evidence for their pulvini or/and basal actinodromous or acrodromous venations. Besides Oligocene leaves and fruits presented here, foliage and/or wood of Bauhinia have been documented from the Miocene–Pliocene of Thailand, India, Nepal, Uganda, and Ecuador. Conclusions Bauhinia has exhibited a certain diversity with bifoliolate- and bilobate-leafed species in a low-latitude locality–Ningming since at least the Oligocene, implying that the tropical zone of South China may represent one of the centres for early diversification of the genus. The reliable macrofossils of Bauhinia and Cercis have made their debut in the Eocene–Oligocene floras from mid-low latitudes and appeared to lack in the coeval floras at high latitudes, implying a possible Tethys Seaway origin and spread of legumes. However, detailed scenarios for the historical biogeography of Bauhinia and its relatives still need more robust dataset from palaeobotany and molecular phylogeny in future research. PMID:24758153

Leaves and fruits of Bauhinia (Leguminosae, Caesalpinioideae, Cercideae) from the Oligocene Ningming Formation of Guangxi, South China and their biogeographic implications.

PubMed

Wang, Qi; Song, Zhuqiu; Chen, Yunfa; Shen, Si; Li, Zhenyu

2014-04-24

The pantropical genus Bauhinia, along with the northern temperate Cercis and several tropical genera, bear bilobate, bifoliolate, or sometimes unifoliolate leaves, which constitute the tribe Cercideae as sister to the rest of the family Leguminosae based on molecular phylogenetics. Hence, the fossil record of Cercideae is pivotal to understand the early evolution and biogeographic history of legumes. Three fossil species of Bauhinia were described from the Oligocene Ningming Formation of Guangxi, South China. Bauhinia ningmingensis sp. nov. is characterized by its bifoliolate, pulvinate leaves bearing basal acrodromous primary veins and brochidodromous secondary veins. B. cheniae sp. nov. bears moderately or deeply bilobate, pulvinate leaves, with basal actinodromous primary veins and eucamptodromous secondary veins. B. larsenii D.X. Zhang et Y.F. Chen emend. possesses shallowly or moderately bilobate, pulvinate leaves bearing basal actinodromous primary veins and brochidodromous secondary veins, as well as elliptic, stipitate, non-winged, and oligo-seeded fruits. Meanwhile, previously reported Bauhinia fossils were reviewed, and those pre-Oligocene foliage across the world are either questionable or have been rejected due to lacking of reliable evidence for their pulvini or/and basal actinodromous or acrodromous venations. Besides Oligocene leaves and fruits presented here, foliage and/or wood of Bauhinia have been documented from the Miocene-Pliocene of Thailand, India, Nepal, Uganda, and Ecuador. Bauhinia has exhibited a certain diversity with bifoliolate- and bilobate-leafed species in a low-latitude locality-Ningming since at least the Oligocene, implying that the tropical zone of South China may represent one of the centres for early diversification of the genus. The reliable macrofossils of Bauhinia and Cercis have made their debut in the Eocene-Oligocene floras from mid-low latitudes and appeared to lack in the coeval floras at high latitudes, implying a possible Tethys Seaway origin and spread of legumes. However, detailed scenarios for the historical biogeography of Bauhinia and its relatives still need more robust dataset from palaeobotany and molecular phylogeny in future research.

Age-related variations of varicose veins anatomy.

PubMed

Caggiati, Alberto; Rosi, Caterina; Heyn, Rosemarie; Franceschini, Marco; Acconcia, Maria Cristina

2006-12-01

Primary varicose veins are commonly considered a progressive disease starting from the saphenous junctions and extending to tributaries in a retrograde fashion along the saphenous trunks. This theory has been criticized by studies indicating different patterns of development and progression of varicose veins. To contribute to the understanding of the pathogenesis of the disease, the anatomy of the venous bed was comparatively evaluated by duplex sonography in patients with varicose veins with a marked difference in age. The study included 100 varicose limbs in 82 patients aged < 30 years and 238 limbs in 183 patients aged > 60 years. Veins were designated as saphenous veins (SVs), tributaries of the SVs (STVs), and veins not connected with the SVs (NSVs). Four main anatomic patterns were comparatively evaluated: (1) varicose changes only along SVs, (2) varicose changes along SVs and STVs, (3) varicose changes only in STVs, and (4) varicose changes only in NSVs. SVs were normal in 44% of varicose limbs. In most limbs from young subjects, varicose changes afflicted only SVTs (25%) and NSVs (36%). Varicose SVs were more frequent in the older group (62%) than in younger one (39%) owing to a higher prevalence of limbs with combined SV and STV varicosities (respectively, 59% and 37%). In the older group, varicosities in the STVs were more frequently observed in association with incompetence of the SV trunks. The frequent occurrence of normal SVs in varicose limbs of all patients does not support the crucial role commonly credited to SVs in the pathogenesis of primary varicosities. Moreover, the SV trunks were normal in most varicose limbs from young patients. These findings suggest that varicose disease may progressively extend in an antegrade fashion, spreading from the STVs to the SVs. This hypothesis suggests that the saphenous trunks could be spared in the treatment of a relevant number of varicose legs. Prospective longitudinal studies with serial duplex evaluations of large series of extremities are necessary to confirm this hypothesis.

[Participation of leucocytes in pathogenesis of primary forms of lower limb chronic venous disease].

PubMed

Bogachev, V Iu; Golovanova, O V; Sergeeva, N A; Kuznetsov, A N

2011-01-01

The purpose of the study was to test the hypothesis on participation of WBCs in damaging the venous wall in patients presenting with primary forms of lower limb chronic venous diseases LLCVD . The study included a total of fifteen consecutively selected patients (13 women and 2 men) diagnosed as having grade C2-C-4 LLCVD according to the CEAP classification. Static loading (30 minutes in the sitting position) was followed by simultaneous sampling of blood from the varicose vein of the cms and ulnar vein. The total blood count including determination of both the absolute values and percentage of blood formed elements was performed using the automated haematological counter «Advia 7» («Bayer», USA). The obtained findings were statistically processed using the Microsoft Office Excel software by means of the pared two-sample τ-test for the average values. The number of leukocytes and their subpopulations in blood samples obtained from the crural varicose veins turned out to be significantly less as compared with that in blood sampled from the ulnar vein. Thus, blood sampled from the crural varicose veins demonstrated a decrease in the counts of WBC by 9.6% in fourteen (93.3%) patients, that of neutrophils by 4.9% in twelve (80%) patients, that of lymphocytes by 16,8% in fifteen (100%) patients, and that oi monocytes by 24% in twelve (80%) patients. The mentioned differences were statistically significant at a = 0.05. The eosinophilic counts in blood sampled from the upper and lower extremities appeared similar in 66.7% of the examined subjects. In 33.3% of cases the eosinophilic count in blood samples from crural varicose vein was by 16.7% lower than that for blood samples form the ulnar vein. No differences for the rest parameters of the clinical blood count were revealed. The absolute lymphocytic count in the blood samples taken after the 30-minute static loading from the crural varicose veins was significantly lower as compared with that in blood sampled form the cubital vein. The counts for RBCs and blood platelets, as well as other qualitative haematological indices (haemoglobin, haematocrit, average volume of the RBC, erythrocytic diameter, etc.) in blood sampled form crural and ulnar veins in the same patient were identical, thus strongly suggesting the lack of either haemodynamic or haemorheological phenomena capable of leading to redistribution of the blood formed elements in varicose veins. Hence a decrease in the counts of leukocytes and their subpopulations in blood sampled from crural varicose veins might be associated with the «leukocytic trap» phenomenon.

Increased Levels of Metalloproteinase 10 and Hemostatic Markers in Patients With Noncomplicated Primary Varicose Veins.

PubMed

Dzieciuchowicz, Lukasz; Espinosa, Gaudencio; Páramo, José A

2015-10-01

The purpose of the study was to analyze a systemic activation of hemostasis and concentration of matrix metalloproteinase 10 (MMP-10) in patients with primary varicose veins (PVVs). A study group consisted of 41 patients with noncomplicated PVVs. A control group consisted of 30 age- and sex-matched healthy individuals without varicose veins. The concentration of d-dimers (DD), prothrombin fragments 1 and 2 (F1+2), antigen of von Willebrand factor (vWF), and activity of plasminogen activator inhibitor (PAI-1) in plasma and concentration of MMP-10 in serum were analyzed. In patients with PVVs, higher concentrations of DD (P < .001), F1+2 (P < .001), vWF (P = .027), MMP-10 (P = .006), and higher activity of PAI-1 (P < .001) were observed. However, no correlation between the concentrations of MMP-10 and prothrombotic markers was found. Noncomplicated PVVs are associated with systemic, prothrombotic activation of hemostasis and increased concentration of MMP-10, suggesting a prothrombotic and proinflammatory state. © The Author(s) 2014.

Metoclopramide unmasks potentially misleading contralateral suppression in patients undergoing adrenal vein sampling for primary aldosteronism.

PubMed

Rossitto, Giacomo; Miotto, Diego; Battistel, Michele; Barbiero, Giulio; Maiolino, Giuseppe; Bisogni, Valeria; Sanga, Viola; Rossi, Gian Paolo

2016-11-01

As metoclopramide stimulates aldosterone secretion, we tested its usefulness in the assessment of lateralization of primary aldosteronism by adrenal vein sampling (AVS). Prospective within-patient study in consecutive patients undergoing AVS for primary aldosteronism subtyping. We compared the diagnostic accuracy of baseline and postmetoclopramide lateralization index and relative (to cortisol) aldosterone secretion indices (RASI) for each adrenal gland with aldosterone-producing adenoma (APA) determined by the four corners criteria as the reference diagnosis. We recruited 93 consecutive patients (mean age: 52 years; women 31%). Metoclopramide increased plasma aldosterone in the inferior vena cava and in both adrenal veins. The postmetoclopramide lateralization index was accurate in identifying APA, but did not increase diagnostic accuracy over baseline lateralization index, because the RASI increased similarly in both sides. Conversely, metoclopramide raised RASI to values more than 0.90 bilaterally in non-APA patients allowing accurate identification of factitious aldosterone suppression. In contrast, RASI was 0.90 or less in 48% contralateral to the tumor in APA patients. Regression analysis showed the APA patients with persistent suppression of RASI contralaterally showed a more florid primary aldosteronism phenotype. Metoclopramide does not enhance lateralization of aldosterone excess in APA, but consistently increased the value of RASI in non-APA cases, thus unmasking potentially misleading suppression of aldosterone. Postmetoclopramide RASI may therefore allow a more precise diagnosis when AVS can be achieved only unilaterally.

A 27-kg mucinous cystadenoma of the ovary presenting with deep vein thrombosis.

PubMed

Tola, Esra Nur; Erdemoğlu, Evrim; Yalçın, Yakup; Alkaya Solmaz, Filiz; Erdemoğlu, Ebru

2016-03-01

Giant ovarian adenomas are rarely observed today because of early diagnosis and treatment. Mucinous cystadenomas is a kind of tumor that mostly causes the ovary to enlarge. Theu can present with various and non-specific clinical manifestations such as deep vein thrombosis. The primary symptoms of giant ovarian tumors are abdominal enlargement and distension. Therefore, making the correct preoperative diagnosis is sometimes difficult. The appropriate treatment must include oncologic procedures and a multidisciplinary approach to minimalize complications and save the patient's life. Herein, we report a woman aged 53 years with a 27-kg ovarian mucinous cystadenoma that presented as a left popliteal vein thrombosis.

[A symptomatic parathyroid adenoma. Value of parathyroid hormone determination through selective catheterization of the thyroid veins].

PubMed

Ribot, C; Dutau, G; Manelfe, C; Bouissou, H; Rochiccioli, P

1977-02-01

A parathyroid adenoma is reported in a girl aged 12 years in whom hypercalcaemia was discovered by chance. Investigation of calcium metabolism suggested the diagnosis of hyperparathyroidism and studies of the urinary cyclic AMP and determination of the plasma parathyroid hormone concentration further added to the evidence. The diagnosis of parathyroid adenoma was made after determination of the parathyroid hormone concentration at various sights during selective catheterization of the tyroid veins. This was confirmed at surgery. In this patient the place of catheterization of the inferior thyroid veins in the early diagnosis of primary hyperparathyroidism is discussed.

Long-term survival after resection of a primary leiomyosarcoma of the innominate vein Report of a case.

PubMed

Illuminati, Giulio; Miraldi, Fabio; A Pacilè, Maria; Palumbo, Piero; Vietri, Francesco

2012-10-29

Leiomyosarcoma of the innominate vein is a rare but usually lethal disease. We report the case of a 50-year-old woman, undergoing a curative resection of the tumor. She is alive and free of disease at 88-month follow-up. Surgical excision remains the current optimal treatment able to provide a chance of cure. KEY WORDS: Late survival, Venous leiomyosarcoma.

Venous hemodynamic changes in the surgical treatment of primary varicose vein of the lower limbs.

PubMed

Kim, Ick-Hee; Joh, Jin-Hyun; Kim, Dong-Ik

2004-08-31

Venous hemodynamic changes after the surgery of primary varicose veins were evaluated. (Materials and methods) We retrospectively analyzed 1,211 patients (1,407 limbs) who underwent surgery for primary varicose veins from 1994 to 2002. The venous hemodynamics were evaluated using air- plethysmography (APG) preoperatively and one month postoperatively in the viewpoints of ambulatory venous pressure (AVP), venous volume (VV), venous filling index (VFI), and ejection fraction (EF). (Results) The surgical modalities included 958 cases of greater saphenous vein high ligation (GSV HL) and stripping with varicosectomy (VS), 222 cases of short saphenous vein (SSV) HL and VS, 143 cases of external banding valvuloplasty of GSV and VS, and 44 cases using VNUS and VS. The reduction rate of VV was 20.9 +/- 14.1% in the GSV stripping group, 12.0 +/- 14.7% in the GSV valvuloplasty group, 18.3 +/- 16.1% in the VNUS group, and 20.6 +/- 15.9% in the SSV group. The reduction rate of VFI was 63.6 +/- 20.7% in the GSV stripping group, 38.8 +/- 40.9% in the GSV valvuloplasty group, 60.1 +/- 23.9% in the VNUS group, and 37.6 +/- 30.2% in the SSV group. The increasing rate of EF was 25.0 +/- 28.2% in the GSV stripping group, 21.0 +/- 30.0% in the GSV valvuloplasty group, 29.4 +/- 31.9% in the VNUS group, and 30.0 +/- 36.5% in the SSV group. The reduction rate of AVP was 25.4 +/- 32.2% in the GSV stripping group, -6.1 +/- 58.1% in the GSV valvuloplasty group, 28.4 +/- 38.5% in the VNUS group, and 14.1 +/- 49.0% in the SSV group. All of the patients showed improvements in venous hemodynamics by showing a decrease in VV, VFI, AVP, and an increase in EF. However, there was no difference in the change of venous hemodynamics according to the type of surgery.

Composite versus conventional coronary artery bypass grafting strategy for the anterolateral territory: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background In severe coronary artery disease, coronary artery bypass grafting (CABG) surgery is indicated to re-establish an adequate blood supply to the ischemic myocardium. Effectiveness of CABG surgery for symptom relief and mortality decrease should therefore depend on bypass graft patency. As bypass using a left internal mammary artery (LIMA)-to-left anterior descending coronary artery (LAD) anastomosis allows the best results in terms of graft patency, we designed a new surgical technique using a saphenous vein graft as a venous bridge to distribute the LIMA flow to the cardiac anterolateral territory. This novel strategy could extend the patency benefits associated to the LIMA. Other potential benefits of this technique include easier surgical technique, possibility to use saphenous vein grafts as vein patch angioplasty, shorter saphenous vein grafts requirement and reduced or eliminated manipulations of the ascendant aorta (and associated stroke risk). Methods/Design Between July 2012 and 2016, 200 patients undergoing a primary isolated CABG surgery using cardiopulmonary bypass with a LAD bypass graft and at least another target on the anterolateral territory will be randomized (1:1) according to 1) the new composite strategy and 2) the conventional strategy with a LIMA-to-LAD anastomosis and revascularization of the other anterolateral target(s) with a separated aorto-coronary saphenous vein graft. The primary objective of the trial is to assess whether the composite strategy allows non-inferior anterolateral graft patency index (proportion of non-occluded CABGs out of the total number of CABGs) compared to the conventional technique. The primary outcome is the anterolateral graft patency index, evaluated at one year by 256-slice computed tomography angiography. Ten years of clinical follow-up is planned to assess clinical outcomes including death, myocardial infarction and need for revascularization. Discussion This non-inferiority trial has the potential to advance the adult cardiac surgery field, given the potential benefits associated with the composite grafting strategy. Trial registration ClinicalTrials.gov: NCT01585285. PMID:23971858

[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. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Managing leg ulceration in intravenous drug users.

PubMed

Geraghty, Jemell

2015-09-01

Chronic venous leg ulceration is a long-term condition commonly associated with lower-limb injecting and chronic venous hypertension caused by collapsed veins, incompetent valves, deep vein thrombosis and reflux. It is not usually a medical emergency, but intravenous (IV) drug users with leg ulcers can attend emergency departments (EDs) with a different primary complaint such as pain or because they cannot access local primary care or voluntary services. Leg ulceration might then be identified during history taking, so it is important that ED nurses know how to assess and manage these wounds. This article explains how to assess and manage chronic venous leg ulcers in patients with a history of IV drug use, and highlights the importance of referral to specialist services when required, and to local primary care or voluntary services, before discharge to prevent admission and re-attendance.

Standardized surgical techniques for adult living donor liver transplantation using a modified right lobe graft: a video presentation from bench to reperfusion.

PubMed

Hwang, Shin; Ha, Tae-Yong; Ahn, Chul-Soo; Moon, Deok-Bog; Kim, Ki-Hun; Song, Gi-Won; Jung, Dong-Hwan; Park, Gil-Chun; Lee, Sung-Gyu

2016-08-01

After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices. This video clip that shows the surgical technique from bench to reperfusion was a case presentation of adult LDLT using a modified right liver graft from the patient's son. Our intention behind proposing the concept of right liver graft standardization is that it can be universally applicable and may guarantee nearly the same outcomes regardless of the surgeon's experience. We believe that this reconstruction model would be primarily applied to a majority of adult LDLT cases.

Rapamycin treatment is associated with an increased apoptosis rate in experimental vein grafts.

PubMed

Schachner, Thomas; Oberhuber, Alexander; Zou, Yping; Tzankov, Alexandar; Ott, Harald; Laufer, Günther; Bonatti, Johannes

2005-02-01

Rapamycin is an immunosuppressive agent with marked antiproliferative properties and is effective in reducing in stent restenosis and vein graft neointimal hyperplasia. Apoptosis is one mechanism counterbalancing cellular proliferation. We therefore investigated the role of apoptosis in rapamycin treated vein grafts in a mouse model. C57BL6J mice underwent interposition of the inferior vena cava from isogenic donor mice into the common carotid artery using a cuff technique. In the treatment group 200 microg of rapamycin were applied locally in pluronic gel. The control group did not receive local treatment. Vein grafts were harvested at 4 weeks postoperatively and underwent morphometric analysis as well as immunohistochemical analysis for apoptosis (TUNEL). In grafted veins without treatment (controls) neointimal thickness was 50 (12-58) microm at 4 weeks postoperatively. In 200 microg rapamycin treated grafts the neointimal thickness was 17 (5-55) microm. Rapamycin treated vein grafts showed a significantly increased rate of apoptosis in the adventitia as compared with controls (P=0.032). In the neointima the apoptosis rate was lower in both groups with no significant difference between rapamycin treated grafts and controls. We conclude that treatment of experimental vein grafts with rapamycin is associated with an increased apoptosis rate in the vascular wall and a trend towards reduction of neointimal hyperplasia. These results suggest that apoptosis may be a beneficial antiproliferative component for the treatment of vein graft disease.

Hydration state of calcium sulfates in Gale crater, Mars: Identification of bassanite veins

DOE PAGES

Rapin, W.; Meslin, P. -Y.; Maurice, S.; ...

2016-08-17

In-situ analyses reveal the presence of hydrogen within calcium sulfate veins crosscutting the sediments found in Gale crater. Laboratory experiments were performed to calibrate the hydrogen signal measured by laser induced breakdown spectroscopy (LIBS) in a range applicable to martian data. The analyses indicate that all veins targeted so far at Gale consist predominantly of bassanite which most likely formed by dehydration of gypsum. This scenario thus suggests that the percolating water produced gypsum, possibly by hydration of anhydrite in aqueous solution, and remained at temperatures below ~60 °C at that time. Desiccating conditions followed, consistent with a hyperarid climatemore » and favored by burial or impacts. In addition, anhydrite with lesser bassanite has been found by XRD in samples of sediments hosting the veins. Our result suggests bassanite is likely found in the veins and anhydrite may be more common as a fine-grained component within the sediments.« less

Hydration state of calcium sulfates in Gale crater, Mars: Identification of bassanite veins

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rapin, W.; Meslin, P. -Y.; Maurice, S.

In-situ analyses reveal the presence of hydrogen within calcium sulfate veins crosscutting the sediments found in Gale crater. Laboratory experiments were performed to calibrate the hydrogen signal measured by laser induced breakdown spectroscopy (LIBS) in a range applicable to martian data. The analyses indicate that all veins targeted so far at Gale consist predominantly of bassanite which most likely formed by dehydration of gypsum. This scenario thus suggests that the percolating water produced gypsum, possibly by hydration of anhydrite in aqueous solution, and remained at temperatures below ~60 °C at that time. Desiccating conditions followed, consistent with a hyperarid climatemore » and favored by burial or impacts. In addition, anhydrite with lesser bassanite has been found by XRD in samples of sediments hosting the veins. Our result suggests bassanite is likely found in the veins and anhydrite may be more common as a fine-grained component within the sediments.« less

Boron in Calcium Sulfate Vein at Catabola, Mars

NASA Image and Video Library

2016-12-13

The highest concentration of boron measured on Mars, as of late 2016, is in this mineral vein, called "Catabola," examined with the Chemistry and Camera (ChemCam) instrument on NASA's Curiosity rover on Aug, 25, 2016, during Sol 1441 of the mission. This two-part illustration shows the context of the erosion-resistant, raised vein, in an image from Curiosity's Mast Camera (Mastcam), and a detailed inset image from ChemCam's remote micro-imager. The inset includes indicators of the boron content measured at 10 points along the vein that were analyzed with ChemCam's laser-firing spectrometer. The vein's main component is calcium sulfate. The highest boron content identified is less than one-tenth of one percent. The heights of the orange bars at each point indicate relative abundance of boron, compared with boron content at other points. The scale bar for the inset is 9.2 millimeters, or about 0.36 inch. The ChemCam image is enhanced with color information from Mastcam. http://photojournal.jpl.nasa.gov/catalog/PIA21251

Atrial development in the human heart: an immunohistochemical study with emphasis on the role of mesenchymal tissues

NASA Technical Reports Server (NTRS)

Wessels, A.; Anderson, R. H.; Markwald, R. R.; Webb, S.; Brown, N. A.; Viragh, S.; Moorman, A. F.; Lamers, W. H.

2000-01-01

The development of the atrial chambers in the human heart was investigated immunohistochemically using a set of previously described antibodies. This set included the monoclonal antibody 249-9G9, which enabled us to discriminate the endocardial cushion-derived mesenchymal tissues from those derived from extracardiac splanchnic mesoderm, and a monoclonal antibody recognizing the B isoform of creatine kinase, which allowed us to distinguish the right atrial myocardium from the left. The expression patterns obtained with these antibodies, combined with additional histological information derived from the serial sections, permitted us to describe in detail the morphogenetic events involved in the development of the primary atrial septum (septum primum) and the pulmonary vein in human embryos from Carnegie stage 14 onward. The level of expression of creatine kinase B (CK-B) was found to be consistently higher in the left atrial myocardium than in the right, with a sharp boundary between high and low expression located between the primary septum and the left venous valve indicating that the primary septum is part of the left atrial gene-expression domain. This expression pattern of CK-B is reminiscent of that of the homeobox gene Pitx2, which has recently been shown to be important for atrial septation in the mouse. This study also demonstrates a poorly appreciated role of the dorsal mesocardium in cardiac development. From the earliest stage investigated onward, the mesenchyme of the dorsal mesocardium protrudes into the dorsal wall of the primary atrial segment. This dorsal mesenchymal protrusion is continuous with a mesenchymal cap on the leading edge of the primary atrial septum. Neither the mesenchymal tissues of the dorsal protrusion nor the mesenchymal cap on the edge of the primary septum expressed the endocardial tissue antigen recognized by 249-9G9 at any of the stages investigated. The developing pulmonary vein uses the dorsal mesocardium as a conduit to reach the primary atrial segment. Initially, the pulmonary pit, which will becomes the portal of entry for the pulmonary vein, is located along the midline, flanked by two myocardial ridges. As development progresses, tissue remodeling results in the incorporation of the portal of entry of the pulmonary vein in left atrial myocardium, which is recognized because of its high level of creatine. Closure of the primary atrial foramen by the primary atrial septum occurs as a consequence of the fusion of these mesenchymal structures. Copyright 2000 Wiley-Liss, Inc.

After Superficial Ablation for Superficial Reflux Associated with Primary Deep Axial Reflux, Can Variable Outcomes be Caused by Deep Venous Valve Anomalies?

PubMed

Maleti, O; Lugli, M; Perrin, M

2017-02-01

To identify which deep anatomical anomalies can explain variable hemodynamic outcomes in patients with superficial reflux associated with primary deep axial reflux who underwent isolated superficial vein ablation without improvement. This is a retrospective study of deep venous valve anomalies in patients who underwent superficial vein ablation for superficial and associated deep reflux. A group of 21 patients who were diagnosed with saphenous reflux associated with primary deep axial reflux, were submitted to great saphenous vein ablation. In 17 patients the deep reflux was not abolished. In this subgroup, surgical exploration of the deep valve was carried out using venotomy for possible valve repair. Among the 17 subgroup patients, four post-thrombotic lesions were discovered intra-operatively in four patients; they underwent different surgical procedures. In 13 of the subgroup patients, primary valve incompetence was confirmed intra-operatively. In 11 cases the leaflets were asymmetrical and in only two were they symmetrical. After valvuloplasty, deep reflux was abolished in all 13 patients. Clinical improvement was obtained in 12/13 patients (92%). It is noteworthy that abolition of deep reflux was associated with significant improvement in air plethysmography data as well as with improvement in clinical status measured on CEAP class, VCSS and the SF-36 questionnaire. Failure to correct deep axial reflux by superficial ablation in patients with superficial and associated primary deep axial reflux may be related to asymmetry in the leaflets of the incompetent deep venous valve. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Human cerebral venous outflow pathway depends on posture and central venous pressure

PubMed Central

Gisolf, J; van Lieshout, J J; van Heusden, K; Pott, F; Stok, W J; Karemaker, J M

2004-01-01

Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position, but mainly through the vertebral plexus in the upright position. A Valsalva manoeuvre while standing completely re-opened the jugular veins. Results of ultrasound imaging of the right internal jugular vein cross-sectional area at the level of the laryngeal prominence in six healthy subjects, before and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R2 = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the primary pathway. The internal jugular veins are collapsed in the standing position and blood is shunted to an alternative venous pathway, but a marked increase in CVP while standing completely re-opens the jugular veins. PMID:15284348

Adrenal Venous Sampling: Where Is the Aldosterone Disappearing to?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Solar, Miroslav; Ceral, Jiri, E-mail: ceral.jiri@fnhk.c; Krajina, Antonin

Adrenal venous sampling (AVS) is generally considered to be the gold standard in distinguishing unilateral and bilateral aldosterone hypersecretion in primary hyperaldosteronism. However, during AVS, we noticed a considerable variability in aldosterone concentrations among samples thought to have come from the right adrenal glands. Some aldosterone concentrations in these samples were even lower than in samples from the inferior vena cava. We hypothesized that the samples with low aldosterone levels were unintentionally taken not from the right adrenal gland, but from hepatic veins. Therefore, we sought to analyze the impact of unintentional cannulation of hepatic veins on AVS. Thirty consecutivemore » patients referred for AVS were enrolled. Hepatic vein sampling was implemented in our standardized AVS protocol. The data were collected and analyzed prospectively. AVS was successful in 27 patients (90%), and hepatic vein cannulation was successful in all procedures performed. Cortisol concentrations were not significantly different between the hepatic vein and inferior vena cava samples, but aldosterone concentrations from hepatic venous blood (median, 17 pmol/l; range, 40-860 pmol/l) were markedly lower than in samples from the inferior vena cava (median, 860 pmol/l; range, 460-4510 pmol/l). The observed difference was statistically significant (P < 0.001). Aldosterone concentrations in the hepatic veins are significantly lower than in venous blood taken from the inferior vena cava. This finding is important for AVS because hepatic veins can easily be mistaken for adrenal veins as a result of their close anatomic proximity.« less

Central nervous system granulomastous phlebitis with limited extracranial involvement of the heart and lungs: An autopsy case.

PubMed

Mlakar, Jernej; Zorman, Jerneja Videčnik; Matičič, Mojca; Vrabec, Matej; Alibegović, Armin; Popović, Mara

2016-02-01

Primary angiitis of the central nervous system is a rare condition, usually with an insidious onset. There is a wide variety of histological types (granulomatous, lymphocytic or necrotizing vasculitis) and types of vessel involved (arteries, veins or both). Most cases are idiopathic. We describe a first case of idiopathic granulomatous central nervous system phlebitis with additional limited involvement of the heart and lung, exclusively affecting small and medium sized veins in a 22-year-old woman, presenting as a sub acute headache. The reasons for this peculiar limitation of inflammation to the veins and the involvement of the heart and lungs are unknown. © 2015 Japanese Society of Neuropathology.

Ultrastructure of dragonfly wing veins: composite structure of fibrous material supplemented by resilin

PubMed Central

Appel, Esther; Heepe, Lars; Lin, Chung-Ping; Gorb, Stanislav N

2015-01-01

Dragonflies count among the most skilful of the flying insects. Their exceptional aerodynamic performance has been the subject of various studies. Morphological and kinematic investigations have showed that dragonfly wings, though being rather stiff, are able to undergo passive deformation during flight, thereby improving the aerodynamic performance. Resilin, a rubber-like protein, has been suggested to be a key component in insect wing flexibility and deformation in response to aerodynamic loads, and has been reported in various arthropod locomotor systems. It has already been found in wing vein joints, connecting longitudinal veins to cross veins, and was shown to endow the dragonfly wing with chordwise flexibility, thereby most likely influencing the dragonfly’s flight performance. The present study revealed that resilin is not only present in wing vein joints, but also in the internal cuticle layers of veins in wings of Sympetrum vulgatum (SV) and Matrona basilaris basilaris (MBB). Combined with other structural features of wing veins, such as number and thickness of cuticle layers, material composition, and cross-sectional shape, resilin most probably has an effect on the vein′s material properties and the degree of elastic deformations. In order to elucidate the wing vein ultrastructure and the exact localisation of resilin in the internal layers of the vein cuticle, the approaches of bright-field light microscopy, wide-field fluorescence microscopy, confocal laser-scanning microscopy, scanning electron microscopy and transmission electron microscopy were combined. Wing veins were shown to consist of up to six different cuticle layers and a single row of underlying epidermal cells. In wing veins of MBB, the latter are densely packed with light-scattering spheres, previously shown to produce structural colours in the form of quasiordered arrays. Longitudinal and cross veins differ significantly in relative thickness of exo- and endocuticle, with cross veins showing a much thicker exocuticle. The presence of resilin in the unsclerotised endocuticle suggests its contribution to an increased energy storage and material flexibility, thus to the prevention of vein damage. This is especially important in the highly stressed longitudinal veins, which have much lower possibility to yield to applied loads with the aid of vein joints, as the cross veins do. These results may be relevant not only for biologists, but may also contribute to optimise the design of micro-air vehicles. PMID:26352411

Cytotoxicity, oxidative stress and expression of adhesion molecules in human umbilical vein endothelial cells exposed to dust from paints with or without nanoparticles.

PubMed

Mikkelsen, Lone; Jensen, Keld A; Koponen, Ismo K; Saber, Anne T; Wallin, Håkan; Loft, Steffen; Vogel, Ulla; Møller, Peter

2013-03-01

Nanoparticles in primary form and nanoproducts might elicit different toxicological responses. We compared paint-related nanoparticles with respect to effects on endothelial oxidative stress, cytotoxicity and cell adhesion molecule expression. Primary human umbilical vein endothelial cells were exposed to primary nanoparticles (fine, photocatalytic or nanosized TiO(2), aluminium silicate, carbon black, nano-silicasol or axilate) and dust from sanding reference- or nanoparticle-containing paints. Most of the samples increased cell surface expressions of vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1), but paint sanding dust samples generally generated less response than primary particles of TiO(2) and carbon black. We found no relationship between the expression of adhesion molecules, cytotoxicity and production of reactive oxygen species. In conclusion, sanding dust from nanoparticle-containing paint did not generate more oxidative stress or expression of cell adhesion molecules than sanding dust from paint without nanoparticles, whereas the primary particles had the largest effect on mass basis.

The umbilical and paraumbilical veins of man.

PubMed Central

Martin, B F; Tudor, R G

1980-01-01

During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 23 Fig. 24 Fig. 25 Fig. 26 Fig. 27 Fig. 28 Fig. 29 PMID:7400038

Predictors of Shunt Dysfunction and Overall Survival in Patients with Variceal Bleeding Treated with Transjugular Portosystemic Shunt Creation Using the Fluency Stent Graft.

PubMed

Wan, Yue-Meng; Li, Yu-Hua; Xu, Ying; Wu, Hua-Mei; Li, Ying-Chun; Wu, Xi-Nan; Yang, Jin-Hui

2018-01-16

Transjugular intrahepatic portosystemic shunt (TIPS) is an established method for portal hypertension. This study was to investigate the long-term safety, technical success, and patency of TIPS, and to determine the risk factors and clinical impacts of shunt dysfunction. A total of 154 consecutive patients undergoing embolotherapy of gastric coronary vein and/or short gastric vein and TIPS creation were prospectively studied. Follow-up data included technical success, patency and revision of TIPS, and overall survival of patients. During the study, the primary and secondary technical success rates were 98.7% and 100%, respectively. Sixty-three patients developed shunt dysfunction, 30 with shunt stenosis and 33 with shunt occlusion. The cumulative 60-month primary, primary assisted, and secondary patency rates were 19.6%, 43.0%, and 93.4%, respectively. The cumulative 60-month overall survival rates were similar between the TIPS dysfunction group and the TIPS non-dysfunction group (68.6% vs. 58.6%, P = .096). Baseline portal vein thrombosis (P < .001), use of bare stents (P = .018), and portal pressure gradient (PPG) (P = .020) were independent predictors for shunt dysfunction, hepatocellular carcinoma (P < .001), and ascites (P = .003) for overall survival. The accuracy of PPG for shunt dysfunction was statistically significant (P < .001), and a cutoff value of 8.5 had 77.8% sensitivity and 64.8% specificity. The long-term safety, technical success, and patency of TIPS were good; baseline portal vein thrombosis, use of bare stents, and PPG were significantly associated with shunt dysfunction; shunt dysfunction has little impact on patients' long-term survival because of high secondary patency rates. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A Case of Acute Budd-Chiari Syndrome Complicating Primary Antiphospholipid Syndrome Presenting as Acute Abdomen and Responding to Tight Anticoagulant Therapy.

PubMed

Chinen, Naofumi; Koyama, Yasushi; Sato, Shinji; Suzuki, Yasuo

2016-01-01

A 34-year-old woman with primary antiphospholipid syndrome was admitted to the Gastroenterology Department of our hospital with fever, acute abdomen, watery diarrhea, and extremely high levels of inflammatory parameters. She had a history of left lower limb deep vein thrombosis and pulmonary embolism and was taking warfarin potassium. Acute gastroenteritis was suspected and an antibiotic was administered, but symptoms progressed. Abdominal ultrasonography showed occlusion of the left hepatic vein and the middle hepatic vein and her D-dimer level was high. Accordingly, Budd-Chiari syndrome was diagnosed and high-dose intravenous infusion of heparin was initiated. Her abdominal symptoms improved and the levels of inflammatory parameters and D-dimer decreased rapidly. It is known that antiphospholipid syndrome can be complicated by Budd-Chiari syndrome that usually occurs as subacute or chronic onset, but acute onset is rare. It is difficult to diagnose acute Budd-Chiari syndrome complicating antiphospholipid syndrome and this complication generally has a poor outcome. However, the present case can get early diagnosis and successful treatment with tight anticoagulant therapy.

Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

NASA Astrophysics Data System (ADS)

Wang, Chun-xi; Han, Li-na; Gu, Ying; Liang, Fa-qi; Zhang, Li; Liu, Hong-yi; Zhao, Wen-guang; Wang, Qi; Wang, Xiao-ling

2007-11-01

The purpose of this article is to report long-term follow-up of improved external vulvuloplasty, intravenous laser photocoagulation and local sclerotherapy treatment of primary deep venous valvular insufficiency in eight hundred and seventy-two patients from Nov. 2000 to May 2006. Patients were evaluated clinically and with duplex ultrasound at 1, 3, and 12 months, and yearly thereafter until the fifth year to assess treatment efficacy and adverse reactions. Successful occlusion of the great saphenous vein and absence of deep vein reflux on color Doppler imaging, were noted in 956 limbs of 852 cases( 1 month follow-up), 946 limbs of 842 cases (6 month to 1 year follow-up), 717 of 626 (1~2 year follow-up), 501 of 417 (2~3 year follow-up), 352 of 296 (3~5year follow-up), 142 of 106 (5 year follow-up) after initial treatment. The cumulative total number of recurrence of reflux was fifteen cases. The respective competence rate was 95.18%, 96.23%, 94.23%, 95.25%, 94.23% and 94.12%. Of note, all recurrence occurred before 9 months, with the majority noted before 3 months. Bruising was noted in 0.7% of patients, tightness along the course of treated vein in 1.0% of limbs. There have been no paresthesia of cases, skin burns and deep vein thrombosis.

Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data meta-analysis.

PubMed

Geersing, G J; Zuithoff, N P A; Kearon, C; Anderson, D R; Ten Cate-Hoek, A J; Elf, J L; Bates, S M; Hoes, A W; Kraaijenhagen, R A; Oudega, R; Schutgens, R E G; Stevens, S M; Woller, S C; Wells, P S; Moons, K G M

2014-03-10

To assess the accuracy of the Wells rule for excluding deep vein thrombosis and whether this accuracy applies to different subgroups of patients. Meta-analysis of individual patient data. Authors of 13 studies (n = 10,002) provided their datasets, and these individual patient data were merged into one dataset. Studies were eligible if they enrolled consecutive outpatients with suspected deep vein thrombosis, scored all variables of the Wells rule, and performed an appropriate reference standard. Multilevel logistic regression models, including an interaction term for each subgroup, were used to estimate differences in predicted probabilities of deep vein thrombosis by the Wells rule. In addition, D-dimer testing was added to assess differences in the ability to exclude deep vein thrombosis using an unlikely score on the Wells rule combined with a negative D-dimer test result. Overall, increasing scores on the Wells rule were associated with an increasing probability of having deep vein thrombosis. Estimated probabilities were almost twofold higher in patients with cancer, in patients with suspected recurrent events, and (to a lesser extent) in males. An unlikely score on the Wells rule (≤ 1) combined with a negative D-dimer test result was associated with an extremely low probability of deep vein thrombosis (1.2%, 95% confidence interval 0.7% to 1.8%). This combination occurred in 29% (95% confidence interval 20% to 40%) of patients. These findings were consistent in subgroups defined by type of D-dimer assay (quantitative or qualitative), sex, and care setting (primary or hospital care). For patients with cancer, the combination of an unlikely score on the Wells rule and a negative D-dimer test result occurred in only 9% of patients and was associated with a 2.2% probability of deep vein thrombosis being present. In patients with suspected recurrent events, only the modified Wells rule (adding one point for the previous event) is safe. Combined with a negative D-dimer test result (both quantitative and qualitative), deep vein thrombosis can be excluded in patients with an unlikely score on the Wells rule. This finding is true for both sexes, as well as for patients presenting in primary and hospital care. In patients with cancer, the combination is neither safe nor efficient. For patients with suspected recurrent disease, one extra point should be added to the rule to enable a safe exclusion.

Effect of anti-sense oligodeoxynucleotides homeobox B2 on the proliferation and expression of primary human umbilical vein endothelial cells.

PubMed

Liu, Xusheng; Zhang, Xiaoqi

2002-02-01

To explore the effect of homeobox B2 (HOXB2) anti sense oligodeoxynucleotides (asodn) on the proliferation and expression of primary human umbilical vein endothelial cells (HUVECs). Various concentrations of HOXB2 asodn modified by thiophosphate transfected the induction of liposome into HUVECs. MTT a nd RT-PCR methods were employed to determine the effect of different conc ent rations of asodn on the endothelial proliferation and the expression level of HOXB2 mRNA. After the transfection of HOXB2 asodn, the endothelial proliferation was inhibited in a dose-dependent fashion. Simultaneously, the expression of HOXB2 mRNA decreased significantly. HOXB2 plays an important role in the proliferation of endothelia.

[Isn't the heart the source of energy for blood circulation? "The heart doesn't know the basic laws of physics"].

PubMed

Papp, Lajos

2008-08-03

For hundreds of years, universal medical practice has depicted the heart to be the central organ, showing the heart's function as the primary source of energy for blood circulation, paying particular importance to the role of the heart valves. At present the generally accepted paradigm: the main force component of blood circulation is the pressure-gradient generated by the working heart. In serious combined illnesses of heart valves, the function of the valve is almost nonexistent. Based on the value of pressure in the chambers of the heart and in the great arteries and veins, blood flows from a place of high pressure to lower pressure, and should work the other way around as well. It is a fact, however, that even in such cases the circulation of blood is directed from the main arteries towards the veins: without the function of the valves--seemingly opposing the basic laws of physics--it keeps its original direction. Therefore we can justifiably infer that it isn't the work of the heart muscle that provides the source of energy for blood circulation. The heart has an essential function in the maintenance of blood circulation: pulse generation. The principal role of the heart is to generate pulses and not pressure.

Autologous alternative veins may not provide better outcomes than prosthetic conduits for below-knee bypass when great saphenous vein is unavailable.

PubMed

Avgerinos, Efthymios D; Sachdev, Ulka; Naddaf, Abdallah; Doucet, Dannielle R; Mohapatra, Abhisekh; Leers, Steven A; Chaer, Rabih A; Makaroun, Michel S

2015-08-01

There is a need to better define the role of alternative autologous vein (AAV) segments over contemporary prosthetic conduits in patients with critical limb ischemia when great saphenous vein (GSV) is not available for use as the bypass conduit. Consecutive patients who underwent bypass to infrageniculate targets between 2007 and 2011 were categorized in three groups: GSV, AAV, and prosthetic. The primary outcome was graft patency. The secondary outcome was limb salvage. Cox proportional hazards regression was used to adjust for baseline confounding variables. A total of 407 infrainguinal bypasses to below-knee targets were analyzed; 255 patients (63%) received a single-segment GSV, 106 patients (26%) received an AAV, and 46 patients (11%) received a prosthetic conduit. Baseline characteristics were similar among groups, with the exception of popliteal targets and anticoagulation use being more frequent in the prosthetic group. Primary patency at 2 and 5 years was estimated at 47% and 32%, respectively, for the GSV group; 24% and 23% for the AAV group; and 43% and 38% for the prosthetic group. Primary assisted patency at 2 and 5 years was estimated at 71% and 55%, respectively, for the GSV group; 53% and 51% for the AAV group; and 45% and 40% for the prosthetic group. Secondary patency at 2 and 5 years was estimated at 75% and 60%, respectively, for the GSV group; 57% and 55% for the AAV group; and 46% and 41% for the prosthetic group. In Cox analysis, primary patency (hazard ratio [HR], 0.55; P < .001; 95% confidence interval [CI], 0.404-0.758), primary assisted patency (HR, 0.57; P = .004; 95% CI, 0.388-0.831), and secondary patency (HR, 0.56; P = .005; 95% CI, 0.372-0.840) were predicted by GSV compared with AAV, but there was no difference between AAV and prosthetic grafts except for the primary patency, for which prosthetic was protective (HR, 0.38; P < .001; 95% CI, 0.224-0.629). Limb salvage was similar among groups. AAV conduits may not offer a significant patency advantage in midterm follow-up over prosthetic bypasses. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Modeling gross primary production of an evergreen needleleaf forest using MODIS and climate data

Treesearch

Xiangming Xiao; Qingyuan Zhang; David Hollinger; John Aber; Berrien, III Moore

2005-01-01

Forest canopies are composed of photosynthetically active vegetation (PAV, chloroplasts) and nonphotosynthetic vegetation (NPV, e.g., cell wall, vein, branch). The fraction of photosynthetically active radiation (PAR) absorbed by the canopy (FAPAR) should be partitioned into FAPARPAV and FAPARNPV. Gross primary production (...

NanoSIMS analysis of organic carbon from the Tissint Martian meteorite: Evidence for the past existence of subsurface organic-bearing fluids on Mars

NASA Astrophysics Data System (ADS)

Lin, Yangting; El Goresy, Ahmed; Hu, Sen; Zhang, Jianchao; Gillet, Philippe; Xu, Yuchen; Hao, Jialong; Miyahara, Masaaki; Ouyang, Ziyuan; Ohtani, Eiji; Xu, Lin; Yang, Wei; Feng, Lu; Zhao, Xuchao; Yang, Jing; Ozawa, Shin

2014-12-01

Two petrographic settings of carbonaceous components, mainly filling open fractures and occasionally enclosed in shock-melt veins, were found in the recently fallen Tissint Martian meteorite. The presence in shock-melt veins and the deuterium enrichments (δD up to +1183‰) of these components clearly indicate a pristine Martian origin. The carbonaceous components are kerogen-like, based on micro-Raman spectra and multielemental ratios, and were probably deposited from fluids in shock-induced fractures in the parent rock of Tissint. After precipitation of the organic matter, the rock experienced another severe shock event, producing the melt veins that encapsulated a part of the organic matter. The C isotopic compositions of the organic matter (δ13C = -12.8 to -33.1‰) are significantly lighter than Martian atmospheric CO2 and carbonate, providing a tantalizing hint for a possible biotic process. Alternatively, the organic matter could be derived from carbonaceous chondrites, as insoluble organic matter from the latter has similar chemical and isotopic compositions. The presence of organic-rich fluids that infiltrated rocks near the surface of Mars has significant implications for the study of Martian paleoenvironment and perhaps to search for possible ancient biological activities on Mars.

Approaches to catheter ablation for persistent atrial fibrillation.

PubMed

Verma, Atul; Jiang, Chen-yang; Betts, Timothy R; Chen, Jian; Deisenhofer, Isabel; Mantovan, Roberto; Macle, Laurent; Morillo, Carlos A; Haverkamp, Wilhelm; Weerasooriya, Rukshen; Albenque, Jean-Paul; Nardi, Stefano; Menardi, Endrj; Novak, Paul; Sanders, Prashanthan

2015-05-07

Catheter ablation is less successful for persistent atrial fibrillation than for paroxysmal atrial fibrillation. Guidelines suggest that adjuvant substrate modification in addition to pulmonary-vein isolation is required in persistent atrial fibrillation. We randomly assigned 589 patients with persistent atrial fibrillation in a 1:4:4 ratio to ablation with pulmonary-vein isolation alone (67 patients), pulmonary-vein isolation plus ablation of electrograms showing complex fractionated activity (263 patients), or pulmonary-vein isolation plus additional linear ablation across the left atrial roof and mitral valve isthmus (259 patients). The duration of follow-up was 18 months. The primary end point was freedom from any documented recurrence of atrial fibrillation lasting longer than 30 seconds after a single ablation procedure. Procedure time was significantly shorter for pulmonary-vein isolation alone than for the other two procedures (P<0.001). After 18 months, 59% of patients assigned to pulmonary-vein isolation alone were free from recurrent atrial fibrillation, as compared with 49% of patients assigned to pulmonary-vein isolation plus complex electrogram ablation and 46% of patients assigned to pulmonary-vein isolation plus linear ablation (P=0.15). There were also no significant differences among the three groups for the secondary end points, including freedom from atrial fibrillation after two ablation procedures and freedom from any atrial arrhythmia. Complications included tamponade (three patients), stroke or transient ischemic attack (three patients), and atrioesophageal fistula (one patient). Among patients with persistent atrial fibrillation, we found no reduction in the rate of recurrent atrial fibrillation when either linear ablation or ablation of complex fractionated electrograms was performed in addition to pulmonary-vein isolation. (Funded by St. Jude Medical; ClinicalTrials.gov number, NCT01203748.).

Successful Adrenal Venous Sampling by Non-experts with Reference to CT Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morita, Satoru, E-mail: i@imodey.com; Yamazaki, Hiroshi; Sonoyama, Yasuyuki

PurposeTo establish technical success rates and safety of adrenal venous sampling (AVS) performed by non-experts with reference to CT images.Materials and Methods104 AVS procedures with adrenocorticotropic hormone stimulation were performed for patients with suspected primary aldosteronism. One of three radiology residents with 2nd, 5th, and 5th grade experience undertook the procedure under the guidance of an experienced, board-certified interventional radiologist with reference to contrast-enhanced CT images obtained in 102 cases. Successful catheterization of the adrenal veins was assessed using three criteria: an adrenal venous cortisol concentration of more than 200 μg/dL (criterion A); an adrenal vein/inferior vena cava cortisol ratio ofmore » more than 5:1 (criterion B); and an adrenal vein/inferior vena cava cortisol ratio of more than 10:1 (criterion C).ResultsThe operators were aware of the anatomy of the left adrenal veins in 102 cases (98 %) and of the right adrenal veins in 99 cases (95 %) prior to the procedure. CT identified the correct position of the right adrenal vein orifice in 82 of 99 cases (83 %). The overall technical success rates for AVS from the right adrenal vein according to criteria A, B, and C, were 96, 96, and 94 %, respectively. Those for the left adrenal vein were 97, 98, and 94 %, respectively. No significant differences in success rates were observed between the operators (p = 0.922–0.984). No major complications, including adrenal vein rupture, were observed.ConclusionsWhen CT images are used to guide AVS, the procedure can be performed successfully and safely even by non-experts.« less

Transverse closure of mesenterico-portal vein after vein resection in pancreatoduodenectomy.

PubMed

Chua, T C; de Reuver, P R; Staerkle, R F; Neale, M L; Arena, J; Mittal, A; Shanbhag, S T; Gill, A J; Samra, J S

2016-02-01

Resection of the involved mesenteric-portal vein (MPV) is increasingly performed in pancreatoduodenectomy. The primary aim of this study is to assess the rate of R0 resection in transverse closure (TC) versus segmental resection with end-to-end (EE) closure and the secondary aims are to assess the short-term morbidity and long-term survival of TC versus EE. Patients undergoing pancreatoduodenectomy with MPV resection were identified from a prospectively database. The reconstruction technique were examined and categorized. Clinical, pathological, short-term and long-term survival outcomes were compared between groups. 110 patients underwent PD with MPV resection of which reconstruction was performed with an end-to-end technique in 92 patients (84%) and transverse closure technique in 18 patients (16%). Patients undergoing transverse closure tended to have had a shorter segment of vein resected (≤2 cm) compared to the end-to-end (83% vs. 43%; P = 0.004) with no difference in R0 rate. Short-term morbidity was similar. The median and 5-year survival was 30.0 months and 18% respectively for patients undergoing transverse closure and 28.6 months and 7% respectively for patients undergoing end-to-end reconstruction (P = 0.766). Without compromising the R0 rate, transverse closure to reconstruct the mesenteric-portal vein is shown to be feasible and safe in the setting when a short segment of vein resection is required during pancreatoduodenectomy. Synopsis - We describe a vein closure technique, transverse closure, which avoids the need for a graft, or re-implantation of the splenic vein when resection of the mesenteric-portal vein confluence is required during pancreatoduodenectomy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Calf pump activity influencing venous hemodynamics in the lower extremity.

PubMed

Recek, Cestmir

2013-03-01

Calf muscle pump is the motive force enhancing return of venous blood from the lower extremity to the heart. It causes displacement of venous blood in both vertical and horizontal directions, generates ambulatory pressure gradient between thigh and lower leg veins, and bidirectional streaming within calf perforators. Ambulatory pressure gradient triggers venous reflux in incompetent veins, which induces ambulatory venous hypertension in the lower leg and foot. Bidirectional flow in calf perforators enables quick pressure equalization between deep and superficial veins of the lower leg; the outward (into the superficial veins) oriented component of the bidirectional flow taking place during calf muscle contraction is no pathological reflux but a physiological centripetal flow streaming via great saphenous vein into the femoral vein. Calf perforators are communicating channels between both systems making them conjoined vessels; they are not involved in the generation of pathological hemodynamic situations, nor do they cause ambulatory venous hypertension. The real cause why recurrences develop has not as yet been cleared. Pressure gradient arising during calf pump activity between the femoral vein and the saphenous remnant after abolition of saphenous reflux triggers biophysical and biochemical events, which might induce recurrence. Thus, abolition of saphenous reflux removes the hemodynamic disturbance, but at the same time it generates precondition for reflux recurrence and for the comeback of the previous pathological situation; this chain of events has been called hemodynamic paradox.

Transfer cell wall ingrowths and vein loading characteristics in pea leaf discs. [Pisum sativum

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wimmers, L.E.; Turgeon, R.

1987-04-01

Transfer cell wall ingrowths are thought to increase transport capacity by increasing plasmalemma surface area. Leaf minor vein phloem transfer cells presumably enhance phloem loading. In Pisum sativum cv. Little marvel grown under different light regimes (150 to 1000 ..mu..mol photons m/sup -2/ sec/sup -1/) there is a positive correlation between light intensity and wall ingrowth area in phloem transfer cells. The extent of ingrowth and correlation to light intensity is greatest in minor veins, decreasing as vein size increases. Vein loading was assayed by floating abraded leaf discs on /sup 14/C-sucrose (10 mM). There is a positive correlation betweenmore » uptake and transfer cell wall area, although the latter increased more than the former. The difference in uptake is stable throughout the photoperiod, and is also stable in mature leaves for at least four days after plants are transfered to a different light intensity. Sucrose uptake is biphasic. The saturable component of uptake is sensitive to light intensity, the Km for sucrose is negatively correlated to light intensity, while V/sub max/remains unchanged.« less

Management of traumatic popliteal vein injuries.

PubMed

Ekim, Hasan; Basel, Halil; Odabasi, Dolunay

2012-09-01

The aim of this study was to evaluate different repair methods of popliteal vein injuries, and to assess the relationship between early patency and surgical outcome. Thirty patients with popliteal vein injuries underwent surgical repair procedure at our hospital from March 2000 to April 2010. Patients who were haemodynamically unstable and those with massive bleeding from limb wounds were taken directly to the operating room. Stable patients underwent preoperative colour-flow duplex ultrasonography (CFDU). Our study group consisted of 26 males and 4 females, ranging in age from 17 to 60 years with a mean age of 25.3 ± 5.9 years. The mechanism of trauma was penetrating in 27 patients and blunt in the remaining 3 patients. Treatment included primary venous repair in 11 cases, end-to-end anastomosis in 8, interposition vein graft in 10, and interposition polytetrafluoroethylene (PTFE) graft in 1. There were 26 patients with associated arterial injury, of which 4 cases had primary repair, 9 had end-to-end anastomosis, 11 had saphenous vein graft interposition, and 2 had PTFE graft interposition. Associated bone fracture was seen in 6 patients. There were no deaths. One patient required a below-knee amputation. Postoperative CFDU revealed thrombosed venous repair in 7 cases without any sequelae. Popliteal venous injuries can be repaired with minimal downside and a good early patency rate. Additionally, transient venous patency allows for establishment of venous and lymphatic collateralisation. Alternatively, venous ligation should be considered only in unstable patients who refuse blood transfusion (Jehovah's witnesses). In these victims, adjuvant management may be required such as the use of fasciotomy and anticoagulation treatment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Precious metal-bearing epithermal deposits in western Patagonia (NE Lago Fontana region), Argentina

NASA Astrophysics Data System (ADS)

Lanfranchini, Mabel Elena; Etcheverry, Ricardo Oscar; de Barrio, Raúl Ernesto; Recio Hernández, Clemente

2013-04-01

Precious metal-bearing quartz veins occur at the northeastern sector of the Lago Fontana region in southwestern Argentina, within the context of the Andean continental magmatic arc environment. The deposits and their associated alteration zones are spatially related to a Cretaceous calc-alkaline magmatism represented by silicic dikes and hypabyssal intrusions, and hosted by a Late Jurassic to Cretaceous volcano-sedimentary sequence. The veins and related veinlets crop out discontinuously, in general terms in a NW-SE belt. The primary vein mineral assemblage is composed mostly of pyrite ± galena ± chalcopyrite > hematite ± arsenopyrite in silica gangue minerals. Chemical analyses of grab samples from selected quartz veins show as much as 5.7 ppm Au and 224 ppm Ag, as well as elevated Pb, Cu, and Zn. Hydrothermal fluids caused an innermost silicification and adularia-sericite alteration assemblage, and an external propylitic halo. Sulfur isotope values measured for sulfides (δSS from -1.90 to +1.56‰), and oxygen and hydrogen isotopes measured on quartz crystals and extracted primary fluid inclusion waters (δOO = -2.85 to +5.40‰; δDO = -106.0 to -103.4‰) indicate that mineralization probably formed from magmatic fluids, which were mixed with meteoric waters. Also, fluid inclusion data from quartz veins point out that these fluids had low salinity (1.7-4.2 wt% NaCl equiv.), and temperatures of homogenization between 180 and 325 °C. Mineralogical, petrographic and geochemical features for mineralized surface exposures indicate a typical adularia-sericite, low sulfidation epithermal system in the Lago Fontana area that represents a promising target for further exploration programs.

Detection of CTCs in portal vein was associated with intrahepatic metastases and prognosis in patients with advanced pancreatic cancer

PubMed Central

Liu, Xiaoyu; Li, Changyu; Li, Junhao; Yu, Tianzhu; Zhou, Guofeng; Cheng, Jiemin; Li, Guoping; Zhou, Yang; Lou, Wenhui; Wang, Xiaolin; Gong, Gaoquan; Liu, Lingxiao; Chen, Yi

2018-01-01

Pancreatic cancer is amongst the most lethal malignancies with increasing incidence and mortality worldwide. Distant metastases, especially intrahepatic metastases, is the leading cause of death for pancreatic cancer. Circulating tumor cells (CTCs) are neoplastic cells released from the primary tumor into circulation, and play critical roles in metastases of various types of cancers. Though clinical studies showed that detection of CTCs in peripheral circulation was associated with worse prognosis in patients with breast cancer and hepatocellular carcinoma, detection CTCs in peripheral blood of pancreatic cancer was still challenging due to hepatic filtration and technical limitations. Previous studies have demonstrated that CTCs could be detected in portal vein circulation in patients with pancreaticobiliary carcinoma. In the present study, taking advantage of ultrasonography-guided transhepatic puncture, we analysis CTCs in portal vein blood obtained from patients with advanced pancreatic cancer. CTCs were detected in all 29-portal vein blood of samples, and absolute numbers of circulating pancreatic cancer cells in portal vein was significantly higher than that in peripheral circulation. Furthermore, we found that CTC counts in portal vein was highly associated with intrahepatic metastases and indicated poorer prognosis in patients with advanced pancreatic cancer. Short-term expansion and in vitro drug sensitivity assay showed that CTCs derived from portal vein blood were highly resistant to several chemotherapy regimens. In summary, detection of CTCs in portal vein could be a powerful tool to stratify the risk of intrahepatic metastases of pancreatic cancer, and provided new insight into the biological feature of pancreatic cancer metastases and drug resistance. PMID:29896289

Improving patency of coronary conduits "valveless" veins and/or arterial grafts.

PubMed

Lajos, Thomas Z; Robicsek, Francis; Thubrikar, Mano; Urschel, Harold

2007-01-01

Veins used for coronary artery bypass operation have a well-documented limited long-term patency. Internal thoracic artery (ITA) grafts have shown exceptional "durability." Assumptions were made that other arterial conduits have similar characteristics. The purpose of this article is to compare different conduits long-term patency including saphenous veins to other available arterial conduits: inferior epigastric artery (IE), right gastroepiploic artery (RGEA), and radial artery (RA). Recent studies have shown that radial artery bypasses have lower patency rate than saphenous veins. Flow patterns, physiological flow characteristics are reviewed including native vessel disease and area of myocardium supplied. In the case of venous bypasses, the primary culprit of failure seemed to be the quality of the vein itself and the reverse venous valves in the conduit resulting in: (a) trapping-hypertension, (b) thrombosis, (c) turbulence, (d) intimal damage, (e) mismatching in size. Clinical follow-up of our patients up to 8 to 11 years (average 8.9 years) have proved the superior characteristics of the so-called "good veins." In a retrospective study of 436 patients sequential, valveless veins patency was 88.6% versus 72% of reversed valvular segments (p < 0.01). Patients' survival seemed to be significantly improved if these veins were combined with ITA grafts. Patients' survival with one valveless limb HS + ITA was 78% versus HS + SV 52% (p < or = 0.0017) and HS + ITA versus HS + ITA + SV (p < 0.0057). Selective decision-making of the surgeon at the time of the operation is required to choose the best conduit to be able to perform the best operation with the best long-term result.

Nasolabial facial artery and vein as recipient vessels for midface microsurgical reconstruction.

PubMed

Oh, Suk Joon; Jeon, Man Kyung; Koh, Sung Hoon

2011-05-01

Although free flap transfer is commonly performed to reconstruct facial defects, the submandibular facial artery and vein have historically been considered as adequate recipient vessels for microsurgical reconstruction. If the vascular pedicles of the free flap are short, vein grafts are necessary. The purpose of this study was to determine the indications for and effectiveness of using the nasolabial facial vessels for midfacial reconstruction. A retrospective chart review of 6 patients undergoing microsurgical reconstruction for defects of the face revealed 6 free tissue transfers in which the nasolabial facial artery and vein were considered for use as recipient vessels. Flap success rates were evaluated. Six patients (5 men and 1 woman) underwent 6 free flap transfers. Five anterior helix free flaps were used for the reconstruction of defects in the lower third of the nose. Nasal defects were due to trauma in 4 patients and squamous cell carcinoma in 1 patient. In 1 neurofibromatosis type 1 case, a radial forearm flap was used for reconstruction of the left orbital defect. The facial artery and vein in the nasolabial fold were used as the recipient artery and vein in every case. The mean length of follow-up was 5.8 years. All flaps survived. All patients were satisfied with the degree of aesthetic improvement after surgery.Use of the facial artery and vein in the nasolabial fold for facial reconstruction is reliable and safe. The nasolabial facial artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the midface.

Geology, geochemistry, and geochronology of the East Bay gold trend, Red Lake, Ontario, Canada

NASA Astrophysics Data System (ADS)

Gallagher, Shaun; Camacho, Alfredo; Fayek, Mostafa; Epp, Mark; Spell, Terry L.; Armstrong, Richard

2018-01-01

The Red Lake greenstone belt is situated in northwestern Ontario within the Uchi Subprovince, Superior Province. Most gold deposits therein are associated with major deformation corridors; the east-west oriented "Mine trend" hosts most of the large deposits and the northeast-southwest "East Bay trend" hosts several small deposits and showings. Gold along the East Bay trend typically occurs in quartz replacement veins that were emplaced into pre-existing quartz-carbonate veins. Gold can occur as free gold or along vein margins associated with pyrite and pyrrhotite. Most primary fluid inclusions, preserved in relatively undeformed portions of veins, are carbonaceous with lesser quantities of aqueous inclusions. The average homogenization temperature of aqueous fluids is 250 °C; however, the abundance of three-phase inclusions, variation in liquid-vapor ratios, and a wide range in homogenization temperatures indicate that immiscibility, effervescence, and fluid mixing are mechanisms associated with gold deposition. The age ( 2550 Ma) of alteration minerals in the Abino area is considerably younger (by 100 Myr) than alteration minerals in other deposits in the Red Lake district, indicating that the mineralizing fluid history was more protracted than previously thought. Along the East Bay trend, barren veins generally have lower δ18OVSMOW values (0.0 to 8.5‰) relative to auriferous veins (9.6 and 13.1‰). Consequently, the oxygen isotopic composition of quartz could be used as a vector for gold mineralization. The genetic model for the East Bay trend involves several stages of vein formation. Auriferous veins formed near the upper boundary of the mesozonal regime (depth of 5-6 km).

Cirrhotic portal hypertension: current and future medical therapy for primary and secondary prevention of variceal bleeding.

PubMed

Laleman, W; Nevens, F

2006-08-01

Portal hypertension (PHT) is the most common complication of chronic liver disease and develops in the vast majority of patients with cirrhosis. It is characterized by an increase of the portal vein pressure, and leads to the development of gastroesophageal varices, ascites, renal dysfunction and hepatic encephalopathy. Over the years, it has become clear that a decrease in portal pressure is not only protective against the risk of variceal (re)bleeding but is also associated with a lower long-term risk of developing other complications and with an improved long-term survival. At present, non-selective b-blockers remain the medical treatment of choice for both primary and secondary prophylaxis. However, recent advances in the knowledge of the pathophysiology of cirrhotic PHT have directed future therapy towards the increased intrahepatic vascular resistance, which in part is determined by an increased hepatic vascular tone. This increased vasculogenic component provides the motivation to the use of therapies aimed at increasing intrahepatic vasorelaxing capacity on the one hand and at antagonizing excessive intrahepatic vasoconstrictor force on the other hand. This review covers current and future developments in the treatment of PHT with regard to primary and secondary prophylaxis.

Antegrade scrotal sclerotherapy for treating primary varicocele in children.

PubMed

Zaupa, Paola; Mayr, Johannes; Höllwarth, Michael E

2006-04-01

To evaluate the effectiveness and limitations of antegrade sclerotherapy (AS) for the treatment of primary varicocele in childhood. From December 1996 to December 2004, 88 patients (mean age 13.3 years, range 9-18) with primary varicocele underwent AS (91 varicocele ablations in all). The indications for surgery were testicular pain (16 boys, 18%), a large varicocele with cosmetic implications, testicular hypotrophy (one) and in 71 (81%) the varicocele was detected incidentally during a routine physical examination; all were left-sided. According to the classification used by Tauber, 46 (52%) varicoceles were grade II and 42 (48%) grade III. The clinical and ultrasonography (US) results were evaluated over a median (range) follow-up of 11 (3-60) months, and the operative duration, X-ray exposure time, persistence rate of varicoceles and complications were compared with those using other techniques. In 11 patients there was a palpable difference in size between the testicles, but in only five (6%) was testicular hypotrophy (testicular volume (<75% testicular volume vs the normal side) confirmed by US. The mean (sem) operative duration for AS was 33.2 (2.14) min. In 16 (18%) patients it was necessary to expose a second or third vein because the first vein chosen was unsuitable for sclerotherapy. The mean operative radiation exposure was 2.18 (0.21) s. One patient (1%) was treated with a high ligature of the testicular vein (Palomo procedure) after initial unsuccessful AS, and was excluded from the analysis. Eighty-four (97%) patients were eligible for follow-up: six (7%) had a persistent varicocele (four grade II, two grade III), four of whom had repeat sclerotherapy successfully (no recurrence at follow-up). Fourteen (15%) patients had enlarged testicular veins only on US (varicocele grade 0). No patient developed a hydrocele after AS, There were complications after surgery in three (3%) patients (two superficial wound infections, one scrotal haematoma together with focal testicular necrosis). AS is an efficient minimally invasive surgical method for correcting varicoceles in older children, although the operative duration is sometimes longer than in adults, and surgery can be more difficult because of the smaller veins. Partial testicular necrosis, despite correct AS, is a very rare but serious complication.

Hydrothermal alteration and mass exchange in the hornblende latite porphyry, Rico, Colorado

USGS Publications Warehouse

Larson, P.B.; Cunningham, C.G.; Naeser, C.W.

1994-01-01

The Rico paleothermal anomaly, southwestern Colorado, records the effects of a large hydrothermal system that was active at 4 Ma. This hydrothermal system produced the deep Silver Creek stockwork Mo deposit, which formed above the anomaly's heat source, and shallower base and precious-metal vein and replacement deposits. A 65 Ma hornblende latite porphyry is present as widespread sills throughout the area and provided a homogenous material that recorded the effects of the hydrothermal system up to 8 km from the center. Hydrothermal alteration in the latite can be divided into a proximal facies which consists of two assemblages, quartz-illite-calcite and chlorite-epidote, and a distal facies which consists of a distinct propylitic assemblage. Temperatures were gradational vertically and laterally in the anomaly, and decreased away from the centra heat source. A convective hydrothermal plume, 3 km wide and at least 2 km high, was present above the stock-work molybdenum deposit and consisted of upwelling, high-temperature fluids that produced the proximal alteration facies. Distal facies alteration was produced by shallower cooler fluids. The most important shallow base and precious-metal vein deposits in the Rico district are at or close to the boundary of the thermal plume. Latite within the plume had a large loss of Na2O, large addition of CaO, and variable SiO2 exchante. Distal propylitized latite samples lost small amounts of Na2O and CaO and exchanged minor variable amounts of SiO2. The edge of the plume is marked by steep Na2O exchange gradients. Na2O exchange throughout the paleothermal anomaly was controlled by the reaction of the albite components in primary plagioclase and alkali feldspars. Initial feldspar alteration in the distal facies was dominated by reaction of the plagioclase, and the initial molar ratio of reactants (alkali feldspar albite component to plagioclase albite component) was 0.35. This ratio of the moles of plagioclase to alkali feldspar albite components that reacted evolved to 0.92 as the reaction progressed. Much of the alkali feldspar albite component in the proximal facies reacted while the, primary plagioclase was still unreacted, but the ratio for these assemblages increased to 1.51 when the plagioclase entered the reaction paragenesis. Plagioclase reaction during distal propylitic alteration resulted in pseudomorphic albite mixed with illite and a loss of Na2O. CaO is lost in the distal facies as hornblende reacts to chlorite, although some calcium may be fixed in calcite. CaO is added to the proximal facies as the quantity of chlorite replacing hornblende increases and epidote and calcite are produced. ?? 1994 Springer-Verlag.

Primary cutaneous vascular leiomyosarcoma: a rare subtype of leiomyosarcoma of the skin.

PubMed

Ortins-Pina, Ana; Soares-de-Almeida, Luís; Rütten, Arno

2018-05-08

Primary smooth muscle malignancies in the skin account for approximately 2-3% of all soft tissue sarcomas 1,2 . We read with interest a recent JCP report on a vascular leiomyosarcoma arising from vena saphena magna 3 . We report herein a case of primary cutaneous vascular leiomyosarcoma arising from a small-caliber dermal vein. This article is protected by copyright. All rights reserved.

Hemorrhoids and varicose veins: a review of treatment options.

PubMed

MacKay, D

2001-04-01

Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids.

Study Comparing Vein Integrity and Clinical Outcomes in Open Vein Harvesting and 2 Types of Endoscopic Vein Harvesting for Coronary Artery Bypass Grafting: The VICO Randomized Clinical Trial (Vein Integrity and Clinical Outcomes)

PubMed Central

Krishnamoorthy, Bhuvaneswari; Critchley, William R.; Thompson, Alexander J.; Payne, Katherine; Morris, Julie; Venkateswaran, Rajamiyer V.; Caress, Ann L.

2018-01-01

Background Current consensus statements maintain that endoscopic vein harvesting (EVH) should be standard care in coronary artery bypass graft surgery, but vein quality and clinical outcomes have been questioned. The VICO trial (Vein Integrity and Clinical Outcomes) was designed to assess the impact of different vein harvesting methods on vessel damage and whether this contributes to clinical outcomes after coronary artery bypass grafting. Methods In this single-center, randomized clinical trial, patients undergoing coronary artery bypass grafting with an internal mammary artery and with 1 to 4 vein grafts were recruited. All veins were harvested by a single experienced practitioner. We randomly allocated 300 patients into closed tunnel CO2 EVH (n=100), open tunnel CO2 EVH (n=100), and traditional open vein harvesting (n=100) groups. The primary end point was endothelial integrity and muscular damage of the harvested vein. Secondary end points included clinical outcomes (major adverse cardiac events), use of healthcare resources, and impact on health status (quality-adjusted life-years). Results The open vein harvesting group demonstrated marginally better endothelial integrity in random samples (85% versus 88% versus 93% for closed tunnel EVH, open tunnel EVH, and open vein harvesting; P<0.001). Closed tunnel EVH displayed the lowest longitudinal hypertrophy (1% versus 13.5% versus 3%; P=0.001). However, no differences in endothelial stretching were observed between groups (37% versus 37% versus 31%; P=0.62). Secondary clinical outcomes demonstrated no significant differences in composite major adverse cardiac event scores at each time point up to 48 months. The quality-adjusted life-year gain per patient was 0.11 (P<0.001) for closed tunnel EVH and 0.07 (P=0.003) for open tunnel EVH compared with open vein harvesting. The likelihood of being cost-effective, at a predefined threshold of £20 000 per quality-adjusted life-year gained, was 75% for closed tunnel EVH, 19% for open tunnel EVH, and 6% for open vein harvesting. Conclusions Our study demonstrates that harvesting techniques affect the integrity of different vein layers, albeit only slightly. Secondary outcomes suggest that histological findings do not directly contribute to major adverse cardiac event outcomes. Gains in health status were observed, and cost-effectiveness was better with closed tunnel EVH. High-level experience with endoscopic harvesting performed by a dedicated specialist practitioner gives optimal results comparable to those of open vein harvesting. Clinical Trial Registration URL: https://www.isrctn.com. International Standard Randomised Controlled Trial Registry Number: 91485426. PMID:28637880

Mechanochemical endovenous ablation of saphenous veins using the ClariVein: A systematic review.

PubMed

Witte, Marianne E; Zeebregts, Clark J; de Borst, Gert Jan; Reijnen, Michel M P J; Boersma, Doeke

2017-12-01

Objective To systematically review all available English literature on mechanochemical endovenous ablation and to report on the anatomical, technical, and clinical success. Methods A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on mechanochemical endovenous ablation for the treatment of insufficient great and/or small saphenous vein. Methodological quality of the included studies was evaluated using the MINORS score. The primary outcome measure was anatomical success, defined as closure of the treated vein on follow-up duplex ultrasound imaging. Secondary outcomes were technical and clinical success, and major complications defined as deep venous thrombosis, pulmonary embolisms or paresthesia. Results The literature search identified 759 records, of which 13 were included, describing 10 unique cohorts. A total of 1521 veins (1267 great saphenous vein and 254 small saphenous vein) were included, with cohort sizes ranging from 30 to 570 veins. The pooled anatomical success rate after short-term follow up was 92% (95% CI 90-94%) ( n = 1314 veins). After 6 and 12 months these numbers were 92% (95% CI 88-95%) ( n = 284) and 91% (95% CI 86-94%) ( n = 228), respectively. The long-term anatomical success rates at 2 and 3 years were 91% (95% CI 85-95%) ( n = 136) and 87% (95% CI 75-94%) ( n = 48), respectively. Major complications and especially nerve injury were very rare (≤ 0.2%). All studies were of moderate or good quality using the MINORS scoring scale. Conclusions Mechanochemical endovenous ablation using the ClariVein in combination with liquid sclerosant is associated with an anatomical success rate ranging from 87% to 92% and good clinical success. To date, no randomized controlled trials are available studying the anatomical success after mechanochemical ablation, compared to the endothermal ablation. The risk of major complications is very low after the procedure.

Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lenton, James, E-mail: jlenton@doctors.org.u; Davies, John; Homer-Vanniasinkam, S.

An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms withmore » stent-grafts has not been previously reported in the adolescent population.« less

Study of tibial nerve regeneration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments.

PubMed

Bastos Dos Santos, Ewerton; Fernandes, Marcela; Gomes Dos Santos, João Baptista; Mattioli Leite, Vilnei; Valente, Sandra Gomes; Faloppa, Flávio

2012-01-01

This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Gold (FG). The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the motor neuron count (p=0.013). The epineural neurorraphy without gap wrapped with jugular vein showed better results for nerve regeneration than the same procedure with gap. Experimental Study .

Miocene Lonchocarpus (Papilionoideae) in San Esteban Tizatlán, Tlaxcala, Mexico

NASA Astrophysics Data System (ADS)

Hernández-Damián, Ana Lilia; Calvillo-Canadell, Laura; Cevallos-Ferriz, Sergio R. S.; Sousa, Mario

2016-03-01

New leaflets from San Esteban Tizatlán, Tlaxcala, Mexico, are described and identified based on their leaf architecture. They have elliptic leaflets with pulvinate petiolule, entire margin, convex apex and base, well developed primary and craspedodromous secondary venation, with decurrent secondary veins with fused the mid-vein, a pair of obtuse basal veins, weak intersecundary veins, mixed percurrent tertiary venation dominated by the opposite type with sinuous course, alternate percurrent fourth-order venation, regular reticulate with few non ramified veinlets. All these characteristics are closely compared with members of sections Obtusifolii and Standleyi of Lonchocarpus (Leguminosae, Papillionoideae, Millettieae), but the mosaic of characters found in the fossil material granted recognition of a new species Lonchocarpus miocenicus sp. nov. This new record of Lonchocarpus from central Mexico further supports the presence of an evergreen tropical forest during the Miocene in the area, a plant community that developed from the Boreotropical Flora and contributed latter to the Neotropical Flora.

CO2 outburst events in relation to seismicity: Constraints from microscale geochronology, geochemistry of late Quaternary vein carbonates, SW Turkey

NASA Astrophysics Data System (ADS)

Ünal-İmer, Ezgi; Uysal, I. Tonguç; Zhao, Jian-Xin; Işık, Veysel; Shulmeister, James; İmer, Ali; Feng, Yue-Xing

2016-08-01

Vein and breccia carbonates precipitated in a highly fractured/faulted carbonate bedrock in SW Turkey were investigated through high-resolution U-series geochronology, microstructural and geochemical studies including C-O-Sr isotope and rare-earth element and yttrium (REY) analyses. Petrographical observations and geochronological data are interpreted as evidence that the calcite veins formed through a crack-seal mechanism, mostly accompanied/initiated by intensive hydraulic fracturing of the host limestone in response to high-pressure fluids, which is manifested by multi-stage breccia deposits. Microscale U-series dates (272.6-20.5 kyr) and geochemical compositions of the vein/breccia samples provide information on the timing and mechanism of the vein formation and identify the source of CO2-bearing fluids responsible for the carbonate precipitation. δ18OVPDB and δ13CVPDB values of the calcite veins range between -5.9 and -1.7‰, and -10.6 and -4.6‰, respectively. The isotopic compositions of the veins show highly fluctuating values as calcite grew successively perpendicular to vein walls, which, in combination with microstructural and geochronological constraints, are interpreted to reflect episodic CO2 degassing events associated with seismic and aseismic deformation. Oxygen and Sr isotope compositions (δ18OVPDB: -5.9 to -1.7‰; 87Sr/86Sr: 0.7082 to 0.7085) together with REY concentrations indicate deep infiltration of meteoric waters with various degrees of interactions mostly with the host limestone and siliciclastic parts of the basement rocks. Oxygen and carbon isotope compositions suggest CO2 degassing through intensive limestone dissolution. While majority of the veins display similar Post-Archaean Australian Shale (PAAS)-normalised REY variations, some of the veins show positive EuPAAS anomalies, which could be indicative of contributions from a deeply derived, heated, and reduced fluid component, giving rise to multiple fluid sources for the calcite veins. Vein calcite formed in fault-induced fractures offers insights into structural features, genetic characterisation of the parental fluids, and late Quaternary degassing of subsurface CO2 accumulations.

Verification of the anatomy and newly discovered histology of the G-spot complex.

PubMed

Ostrzenski, A; Krajewski, P; Ganjei-Azar, P; Wasiutynski, A J; Scheinberg, M N; Tarka, S; Fudalej, M

2014-10-01

To expand the anatomical investigations of the G-spot and to assess the G-spot's characteristic histological and immunohistochemical features. An observational study. International multicentre. Eight consecutive fresh human female cadavers. Anterior vaginal wall dissections were executed and G-spot microdissections were performed. All specimens were stained with haematoxylin and eosin (H&E). The tissues of two women were selected at random for immunohistochemical staining. The primary outcome measure was to document the anatomy of the G-spot. The secondary outcome measures were to identify the histology of the G-spot and to determine whether histological samples stained with H&E are sufficient to identify the G-spot. The anatomical existence of the G-spot was identified in all women and was in a diagonal plane. In seven (87.5%) and one (12.5%) of the women the G-spot complex was found on the left or right side, respectively. The G-spot was intimately fused with vessels, creating a complex. A large tangled vein-like vascular structure resembled an arteriovenous malformation and there were a few smaller feeding arteries. A band-like structure protruded from the tail of the G-spot. The size of the G-spot varied. Histologically, the G-spot was determined as a neurovascular complex structure. The neural component contained abundant peripheral nerve bundles and a nerve ganglion. The vascular component comprised large vein-like vessels and smaller feeding arteries. Circular and longitudinal muscles covered the G-complex. The anatomy of the G-spot complex was confirmed. The histology of the G-spot presents as neurovascular tissues with a nerve ganglion. H&E staining is sufficient for the identification of the G-spot complex. © 2014 Royal College of Obstetricians and Gynaecologists.

Pressure-temperature-fluid constraints for the Emmaville-Torrington emerald deposit, New South Wales, Australia: Fluid inclusion and stable isotope studies

NASA Astrophysics Data System (ADS)

Loughrey, Lara; Marshall, Dan; Jones, Peter; Millsteed, Paul; Main, Arthur

2012-06-01

The Emmaville-Torrington emeralds were first discovered in 1890 in quartz veins hosted within a Permian metasedimentary sequence, consisting of meta-siltstones, slates and quartzites intruded by pegmatite and aplite veins from the Moule Granite. The emerald deposit genesis is consistent with a typical granite-related emerald vein system. Emeralds from these veins display colour zonation alternating between emerald and clear beryl. Two fluid inclusion types are identified: three-phase (brine+vapour+halite) and two-phase (vapour+liquid) fluid inclusions. Fluid inclusion studies indicate the emeralds were precipitated from saline fluids ranging from approximately 33 mass percent NaCl equivalent. Formational pressures and temperatures of 350 to 400 °C and approximately 150 to 250 bars were derived from fluid inclusion and petrographic studies that also indicate emerald and beryl precipitation respectively from the liquid and vapour portions of a two-phase (boiling) system. The distinct colour zonations observed in the emerald from these deposits is the first recorded emerald locality which shows evidence of colour variation as a function of boiling. The primary three-phase and primary two-phase FITs are consistent with alternating chromium-rich `striped' colour banding. Alternating emerald zones with colourless beryl are due to chromium and vanadium partitioning in the liquid portion of the boiling system. The chemical variations observed at Emmaville-Torrington are similar to other colour zoned emeralds from other localities worldwide likely precipitated from a boiling system as well.

ALPPS and simultaneous right hemicolectomy - step one and resection of the primary colon cancer.

PubMed

Fard-Aghaie, Mohammad H; Stavrou, Gregor A; Schuetze, Kim C; Papalampros, Alexandros; Donati, Marcello; Oldhafer, Karl J

2015-03-27

Resection of the liver is often limited due to the volume of the parenchyma. To address this problem, several approaches to induce hypertrophy were developed. Recently, the 'associating liver partition and portal vein ligation for staged hepatectomy' (ALPPS) procedure was introduced and led to rapid hypertrophy in a short interval. Additionally to the portal vein occlusion, the parenchyma is transected, which disrupts the inter-parenchymal vascular connections. Since the first description of the ALPPS procedure, various reports around the world were published. In some cases, due to the high morbidity and mortality, a decent oncologic algorithm is not deliverable in a timely manner. If a patient is to be treated with a liver-first approach, the resection of the primary could sometimes be severely protracted. To overcome the problem, a simultaneous resection of the primary tumor and step one of ALPPS were performed. A 73-year-old male patient underwent portal vein embolization (PVE) after suffering from a synchronous hepatic metastasized carcinoma of the right colic flexure in order to perform a right trisectionectomy. Sufficient hypertrophy could not be obtained by PVE. Thus a 'Rescue-ALPPS' was undertaken. During step one of ALPPS, we simultaneously performed a right hemicolectomy. The postoperative course after the first step was uneventful, and sufficient hypertrophy was achieved. In order to achieve a macroscopic disease-free state and lead the patient as soon as possible to the oncologic path (with, for example, chemotherapy), sometimes a simultaneous resection of the primary with step one of the ALPPS procedure seems justified. A resection of the primary with step two is not advisable, due to the high morbidity and mortality after this step. This case shows that a simultaneous resection is feasible and safe. Whether other locations of the primary should be treated this way must be part of further investigations.

[Surgical treatment of varicose vein using the tumescent technique of local anesthesia].

PubMed

Bjelanović, Zoran; Leković, Ivan; Drasković, Miroljub; Misović, Sidor; Veljović, Milić

2011-02-01

Tumescent local anesthesia (TLA) is a technique for local and regional anesthesia of the skin and the subcutaneous tissue, using infiltration of large amounts of a diluted solution of local anesthetic. This technique is applied in plastic surgery, liposuction as well as in dermatology for the entire series of dermatocosmetic procedures. The purpose of this study was to determine efficiency of surgical treatment of varicose vein using TLA as an alternative method to a conventional treatment for varicose vein. Seventy-two patients with varicose vein were enrolled in the study. All of them were operated on applying TLA, from April 2008 to November 2009. TLA solution consisted of local anesthetics was used. TLA solutions used were: 1% prilocaine-chloride with adrenaline supplement, and 2% lidocaine-chloride and adrenaline in concentration of 0.1%-0.4%. Out of 72 patients, we stripped great saphenous vein from 60 patient and did varicectomy as well as ligation of insufficiently perforating veins. In 12 patients we did partial varicectomy and ligation of perforating veins. There were not any patients with the need for continued surgery, as well as bringing patient to the general anesthesia due to pain during the surgery. One patient came for postoperative opening wound in the groin, one for infection of the wound and one for the formation of seroma in the groin. There were not any allergic reactions or systemic complications in the operations as well as postoperative period. Postoperatively, all the patients were treated with compressive elastic bandage during the period of 6 weeks as well as anticoagulation prophylaxis in the duration of 5 days. Surgery of varicose veins with implementation of TLA is easy and safe method with very low percentage of complications and unwanted effects. It is a good alternative method to classic surgery of varicose veins. The economic aspect is a very important component because the cost of this method is significantly lower than that of a classical surgical treatment of varicose veins.

Rare Co-existence of Squamous Cell Carcinoma with Infiltration of Renal Vein and Xanthogranulomatous Pyelonephritis

PubMed Central

Vanikar, A.V.; Patel, R.D.; Nigam, L. K.; Trivedi, H. L.

2015-01-01

Primary renal squamous cell carcinoma is a very rare malignancy of the upper urinary tract. Most patients have history of chronic urolithiasis, analgesics abuse, radiotherapy or infection. Co-existence of SCC with xanthogranulomatous pyelonephritis is exceedingly rare with only few reports in the literature. We report a case of a 60-year-old male presented with right flank pain and mild tenderness of abdomen. Computed tomography of the abdomen revealed gross hydronephrosis with parenchymal thinning and irregular thick enhancing wall of pelvicalyceal system with multiple calculi in right kidney. Right renal vein appeared distended, filled with hypo dense material. Right nephrectomy was performed and sent for pathological examination. Histological evaluation revealed keratinizing squamous cell carcinoma with infiltration of renal vein and xanthogranulomatous pyelonephritis. PMID:26816904

Effect of technical parameters on transjugular intrahepatic portosystemic shunts utilizing stent grafts.

PubMed

Andring, Brice; Kalva, Sanjeeva P; Sutphin, Patrick; Srinivasa, Rajiv; Anene, Alvin; Burrell, Marc; Xi, Yin; Pillai, Anil K

2015-07-14

To assess the effect of technical parameters on outcomes of transjugular intrahepatic portosystemic shunt (TIPS) created using a stent graft. The medical records of 68 patients who underwent TIPS placement with a stent graft from 2008 to 2014 were reviewed by two radiologists blinded to the patient outcomes. Digital Subtraction Angiographic images with a measuring catheter in two orthogonal planes was used to determine the TIPS stent-to-inferior vena cava distance (SIVCD), hepatic vein to parenchymal tract angle (HVTA), portal vein to parenchymal tract angle (PVTA), and the accessed portal vein. The length and diameter of the TIPS stent and the use of concurrent variceal embolization were recorded by review of the patient's procedure note. Data on re-intervention within 30 d of TIPS placement, recurrence of symptoms, and survival were collected through the patient's chart. Cox proportional regression analysis was performed to assess the effect of these technical parameters on primary patency of TIPS, time to recurrence of symptoms, and all-cause mortality. There was no significant association between the SIVCD and primary patency (P = 0.23), time to recurrence of symptoms (P = 0.83), or all-cause mortality (P = 0.18). The 3, 6, and 12-mo primary patency rates for a SIVCD ≥ 1.5 cm were 82.4%, 64.7%, and 50.3% compared to 89.3%, 83.8%, and 60.6% for a SIVCD of < 1.5 cm (P = 0.29). The median time to stenosis for a SIVCD of ≥ 1.5 cm was 19.1 mo vs 15.1 mo for a SIVCD of < 1.5 cm (P = 0.48). There was no significant association between the following factors and primary patency: HVTA (P = 0.99), PVTA (P = 0.65), accessed portal vein (P = 0.35), TIPS stent diameter (P = 0.93), TIPS stent length (P = 0.48), concurrent variceal embolization (P = 0.13) and reinterventions within 30 d (P = 0.24). Furthermore, there was no correlation between these technical parameters and time to recurrence of symptoms or all-cause mortality. Recurrence of symptoms was associated with stent graft stenosis (P = 0.03). TIPS stent-to-caval distance and other parameters have no significant effect on primary patency, time to recurrence of symptoms, or all-cause mortality following TIPS with a stent-graft.

Complete nucleotide sequence of a monopartite Begomovirus and associated satellites infecting Carica papaya in Nepal.

PubMed

Shahid, M S; Yoshida, S; Khatri-Chhetri, G B; Briddon, R W; Natsuaki, K T

2013-06-01

Carica papaya (papaya) is a fruit crop that is cultivated mostly in kitchen gardens throughout Nepal. Leaf samples of C. papaya plants with leaf curling, vein darkening, vein thickening, and a reduction in leaf size were collected from a garden in Darai village, Rampur, Nepal in 2010. Full-length clones of a monopartite Begomovirus, a betasatellite and an alphasatellite were isolated. The complete nucleotide sequence of the Begomovirus showed the arrangement of genes typical of Old World begomoviruses with the highest nucleotide sequence identity (>99 %) to an isolate of Ageratum yellow vein virus (AYVV), confirming it as an isolate of AYVV. The complete nucleotide sequence of betasatellite showed greater than 89 % nucleotide sequence identity to an isolate of Tomato leaf curl Java betasatellite originating from Indonesian. The sequence of the alphasatellite displayed 92 % nucleotide sequence identity to Sida yellow vein China alphasatellite. This is the first identification of these components in Nepal and the first time they have been identified in papaya.

Multimodal biometric method that combines veins, prints, and shape of a finger

NASA Astrophysics Data System (ADS)

Kang, Byung Jun; Park, Kang Ryoung; Yoo, Jang-Hee; Kim, Jeong Nyeo

2011-01-01

Multimodal biometrics provides high recognition accuracy and population coverage by using various biometric features. A single finger contains finger veins, fingerprints, and finger geometry features; by using multimodal biometrics, information on these multiple features can be simultaneously obtained in a short time and their fusion can outperform the use of a single feature. This paper proposes a new finger recognition method based on the score-level fusion of finger veins, fingerprints, and finger geometry features. This research is novel in the following four ways. First, the performances of the finger-vein and fingerprint recognition are improved by using a method based on a local derivative pattern. Second, the accuracy of the finger geometry recognition is greatly increased by combining a Fourier descriptor with principal component analysis. Third, a fuzzy score normalization method is introduced; its performance is better than the conventional Z-score normalization method. Fourth, finger-vein, fingerprint, and finger geometry recognitions are combined by using three support vector machines and a weighted SUM rule. Experimental results showed that the equal error rate of the proposed method was 0.254%, which was lower than those of the other methods.

Carbon isotope evidence for a magmatic origin for Archaean gold-quartz vein ore deposits

NASA Technical Reports Server (NTRS)

Burrows, D. R.; Wood, P. C.; Spooner, E. T. C.

1986-01-01

Sediments from three sites in the Santa Barbara Basin were examined with a 160X power light microscope and TEM equipment to characterize the magnetostatic bacteria (MB) in the samples. Both the free magnetite and the crystals in the MB in the samples had lengths from 40-60 nm in length and increased in size from one end to the next. An intact magnetosome was also observed. Scanning the sediments with saturation isothermal remanent magnetization (SIRM) and altering field demagnetization techniques using a SQUID magnetometer yielded coercivity spectra which showed that the primary remanence carrier in the sediments was single domain magnetite. Although it is expected that the predominance of the bacterial magnetite component will decrease with depth in the open ocean basin, single-domain bacteria as old as 50 Myr have been observed in oceanic sediments.

Clinical effectiveness and cost-effectiveness of foam sclerotherapy, endovenous laser ablation and surgery for varicose veins: results from the Comparison of LAser, Surgery and foam Sclerotherapy (CLASS) randomised controlled trial.

PubMed

Brittenden, Julie; Cotton, Seonaidh C; Elders, Andrew; Tassie, Emma; Scotland, Graham; Ramsay, Craig R; Norrie, John; Burr, Jennifer; Francis, Jill; Wileman, Samantha; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A; MacLennan, Graeme; Prior, Maria; Bolsover, Denise; Campbell, Marion K

2015-04-01

Foam sclerotherapy (foam) and endovenous laser ablation (EVLA) have emerged as alternative treatments to surgery for patients with varicose veins, but uncertainty exists regarding their effectiveness in the medium to longer term. To assess the clinical effectiveness and cost-effectiveness of foam, EVLA and surgery for the treatment of varicose veins. A parallel-group randomised controlled trial (RCT) without blinding, and economic modelling evaluation. Eleven UK specialist vascular centres. Seven hundred and ninety-eight patients with primary varicose veins (foam, n = 292; surgery, n = 294; EVLA, n = 212). Patients were randomised between all three treatment options (eight centres) or between foam and surgery (three centres). Disease-specific [Aberdeen Varicose Vein Questionnaire (AVVQ)] and generic [European Quality of Life-5 Dimensions (EQ-5D), Short Form questionnaire-36 items (SF-36) physical and mental component scores] quality of life (QoL) at 6 months. Cost-effectiveness as cost per quality-adjusted life-year (QALY) gained. Quality of life at 6 weeks; residual varicose veins; Venous Clinical Severity Score (VCSS); complication rates; return to normal activity; truncal vein ablation rates; and costs. The results appear generalisable in that participants' baseline characteristics (apart from a lower-than-expected proportion of females) and post-treatment improvement in outcomes were comparable with those in other RCTs. The health gain achieved in the AVVQ with foam was significantly lower than with surgery at 6 months [effect size -1.74, 95% confidence interval (CI) -2.97 to -0.50; p = 0.006], but was similar to that achieved with EVLA. The health gain in SF-36 mental component score for foam was worse than that for EVLA (effect size 1.54, 95% CI 0.01 to 3.06; p = 0.048) but similar to that for surgery. There were no differences in EQ-5D or SF-36 component scores in the surgery versus foam or surgery versus EVLA comparisons at 6 months. The trial-based cost-effectiveness analysis showed that, at 6 months, foam had the highest probability of being considered cost-effective at a ceiling willingness-to-pay ratio of £20,000 per QALY. EVLA was found to cost £26,107 per QALY gained versus foam, and was less costly and generated slightly more QALYs than surgery. Markov modelling using trial costs and the limited recurrence data available suggested that, at 5 years, EVLA had the highest probability (≈ 79%) of being cost-effective at conventional thresholds, followed by foam (≈ 17%) and surgery (≈ 5%). With regard to secondary outcomes, health gains at 6 weeks (p < 0.005) were greater for EVLA than for foam (EQ-5D, p = 0.004). There were fewer procedural complications in the EVLA group (1%) than after foam (7%) and surgery (8%) (p < 0.001). Participants returned to a wide range of behaviours more quickly following foam or EVLA than following surgery (p < 0.05). There were no differences in VCSS between the three treatments. Truncal ablation rates were higher for surgery (p < 0.001) and EVLA (p < 0.001) than for foam, and were similar for surgery and EVLA. Considerations of both the 6-month clinical outcomes and the estimated 5-year cost-effectiveness suggest that EVLA should be considered as the treatment of choice for suitable patients. Five-year trial results are currently being evaluated to compare the cost-effectiveness of foam, surgery and EVLA, and to determine the recurrence rates following each treatment. This trial has highlighted the need for long-term outcome data from RCTs on QoL, recurrence rates and costs for foam sclerotherapy and other endovenous techniques compared against each other and against surgery. Current Controlled Trials ISRCTN51995477. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 27. See the NIHR Journals Library website for further project information.

The progestin levonorgestrel induces endothelium-independent relaxation of rabbit jugular vein via inhibition of calcium entry and protein kinase C: role of cyclic AMP

PubMed Central

Herkert, Olaf; Kuhl, Herbert; Busse, Rudi; Schini-Kerth, Valérie B

2000-01-01

The progestin and oestrogen component of oral contraceptives have been involved in the development of venous thromboembolic events in women. In the present study we determined the vasoactive effects of sex steroids used in oral contraceptives in isolated preconstricted rabbit jugular veins in the presence of diclofenac and examined the underlying mechanisms.The natural hormone progesterone, the synthetic progestins levonorgestrel, 3-keto-desogestrel, gestodene and chlormadinone acetate, and the synthetic estrogen 17 α-ethinyloestradiol induced concentration-dependent relaxations of endothelium-intact veins constricted with U46619. Levonorgestrel also inhibited constrictions evoked by either a high potassium (K+) solution or phorbol myristate acetate (PMA) in the absence and presence of extracellular calcium (Ca2+). In addition, levonorgestrel depressed contractions evoked by Ca2+ and reduced 45Ca2+ influx in depolarized veins.Relaxations to levonorgestrel in U46619-constricted veins were neither affected by the presence of the endothelium nor by the inhibitor of soluble guanylyl cyclase, NS2028, but were significantly improved either by the selective cyclic AMP phosphodiesterase inhibitor rolipram or in the absence of diclofenac, and decreased by the protein kinase A inhibitor, Rp-8-CPT-cAMPS. Rolipram also potentiated relaxations to levonorgestrel in PMA-constricted veins in the presence, but not in the absence of extracellular Ca2+. Levonorgestrel increased levels of cyclic AMP and inhibited PMA-induced activation of protein kinase C in veins.These findings indicate that levonorgestrel caused endothelium-independent relaxations of jugular veins via inhibition of Ca2+ entry and of protein kinase C activation. In addition, the cyclic AMP effector pathway contributes to the levonorgestrel-induced relaxation possibly by depressing Ca2+ entry. PMID:10952682

Spoof Detection for Finger-Vein Recognition System Using NIR Camera.

PubMed

Nguyen, Dat Tien; Yoon, Hyo Sik; Pham, Tuyen Danh; Park, Kang Ryoung

2017-10-01

Finger-vein recognition, a new and advanced biometrics recognition method, is attracting the attention of researchers because of its advantages such as high recognition performance and lesser likelihood of theft and inaccuracies occurring on account of skin condition defects. However, as reported by previous researchers, it is possible to attack a finger-vein recognition system by using presentation attack (fake) finger-vein images. As a result, spoof detection, named as presentation attack detection (PAD), is necessary in such recognition systems. Previous attempts to establish PAD methods primarily focused on designing feature extractors by hand (handcrafted feature extractor) based on the observations of the researchers about the difference between real (live) and presentation attack finger-vein images. Therefore, the detection performance was limited. Recently, the deep learning framework has been successfully applied in computer vision and delivered superior results compared to traditional handcrafted methods on various computer vision applications such as image-based face recognition, gender recognition and image classification. In this paper, we propose a PAD method for near-infrared (NIR) camera-based finger-vein recognition system using convolutional neural network (CNN) to enhance the detection ability of previous handcrafted methods. Using the CNN method, we can derive a more suitable feature extractor for PAD than the other handcrafted methods using a training procedure. We further process the extracted image features to enhance the presentation attack finger-vein image detection ability of the CNN method using principal component analysis method (PCA) for dimensionality reduction of feature space and support vector machine (SVM) for classification. Through extensive experimental results, we confirm that our proposed method is adequate for presentation attack finger-vein image detection and it can deliver superior detection results compared to CNN-based methods and other previous handcrafted methods.

Spoof Detection for Finger-Vein Recognition System Using NIR Camera

PubMed Central

Nguyen, Dat Tien; Yoon, Hyo Sik; Pham, Tuyen Danh; Park, Kang Ryoung

2017-01-01

Finger-vein recognition, a new and advanced biometrics recognition method, is attracting the attention of researchers because of its advantages such as high recognition performance and lesser likelihood of theft and inaccuracies occurring on account of skin condition defects. However, as reported by previous researchers, it is possible to attack a finger-vein recognition system by using presentation attack (fake) finger-vein images. As a result, spoof detection, named as presentation attack detection (PAD), is necessary in such recognition systems. Previous attempts to establish PAD methods primarily focused on designing feature extractors by hand (handcrafted feature extractor) based on the observations of the researchers about the difference between real (live) and presentation attack finger-vein images. Therefore, the detection performance was limited. Recently, the deep learning framework has been successfully applied in computer vision and delivered superior results compared to traditional handcrafted methods on various computer vision applications such as image-based face recognition, gender recognition and image classification. In this paper, we propose a PAD method for near-infrared (NIR) camera-based finger-vein recognition system using convolutional neural network (CNN) to enhance the detection ability of previous handcrafted methods. Using the CNN method, we can derive a more suitable feature extractor for PAD than the other handcrafted methods using a training procedure. We further process the extracted image features to enhance the presentation attack finger-vein image detection ability of the CNN method using principal component analysis method (PCA) for dimensionality reduction of feature space and support vector machine (SVM) for classification. Through extensive experimental results, we confirm that our proposed method is adequate for presentation attack finger-vein image detection and it can deliver superior detection results compared to CNN-based methods and other previous handcrafted methods. PMID:28974031

High-pressure polymorphs in Yamato-790729 L6 chondrite and their significance for collisional conditions

NASA Astrophysics Data System (ADS)

Kato, Yukako; Sekine, Toshimori; Kayama, Masahiko; Miyahara, Masaaki; Yamaguchi, Akira

2017-12-01

Shock pressure recorded in Yamato (Y)-790729, classified as L6 type ordinary chondrite, was evaluated based on high-pressure polymorph assemblages and cathodoluminescence (CL) spectra of maskelynite. The host-rock of Y-790729 consists mainly of olivine, low-Ca pyroxene, plagioclase, metallic Fe-Ni, and iron-sulfide with minor amounts of phosphate and chromite. A shock-melt vein was observed in the hostrock. Ringwoodite, majorite, akimotoite, lingunite, tuite, and xieite occurred in and around the shock-melt vein. The shock pressure in the shock-melt vein is about 14-23 GPa based on the phase equilibrium diagrams of high-pressure polymorphs. Some plagioclase portions in the host-rock occurred as maskelynite. Sixteen different CL spectra of maskelynite portions were deconvolved using three assigned emission components (centered at 2.95, 3.26, and 3.88 eV). The intensity of emission component at 2.95 eV was selected as a calibrated barometer to estimate shock pressure, and the results indicate pressures of about 11-19 GPa. The difference in pressure between the shock-melt vein and host-rock might suggest heterogeneous shock conditions. Assuming an average shock pressure of 18 GPa, the impact velocity of the parent-body of Y-790729 is calculated to be 1.90 km s-1. The parent-body would be at least 10 km in size based on the incoherent formation mechanism of ringwoodite in Y-790729.

Unusual Origin and Rare Presentation of Primary Cardiac Lymphoma

PubMed Central

Mohamed, Amir; Cherian, Sanjay; El-Ashmawy, Ahmed; Abdelmoneim, Salah Eldin; Soliman, Maher; Abu-Rayan, Mohamed; Kalangos, Afksendyios

2011-01-01

Non-Hodgkin lymphoblastic lymphomas are very uncommon tumors that rarely involve the heart; however, when they do, they typically cause cardiac symptoms. Herein, we describe the case of a young woman who presented with respiratory symptoms. These were caused by a high-grade lymphoblastic lymphoma, which originated in the left inferior pulmonary vein and extended into the left atrium. The tumor was surgically debulked, but it recurred in 1 month, and the patient underwent chemotherapy. Six months later, she had recurrent respiratory symptoms, and echocardiography revealed a persistent mass in the left lower lobar vein. A modified chemotherapy regimen led to complete resolution of the tumor within 2 months. We are unaware of other reports of a primary cardiac non-Hodgkin lymphoblastic lymphoma with this unusual site of origin and rare manifestation of symptoms. PMID:21841872

Coulomb Fault Mechanics at Work in the Proterozoic: Strike-Slip Faults and Regional-Scale Veining in the Mt. Isa Inlier, Australia

NASA Astrophysics Data System (ADS)

Begbie, M. J.; Sibson, R. H.; Ghisetti, F. C.

2005-12-01

The Proterozoic Mt Isa inlier, comprising greenschist to amphibolite facies metamorphic assemblages intruded by granites during the Isan Orogeny (1590-1500 Ma), is disrupted by brittle, late- or post-orogenic strike-slip faults. The faults occur in two mutually cross-cutting sets; a set of NE-SW subvertical dextral strike-slip faults, and a conjugate set of NW-SE sinistral faults. These faults thus define a regional stress field with σ1 oriented approximately E-W and σ3 oriented approximately N-S. Locally, the faults outcrop as linear blade-like ridges of silicified microbreccias-cataclasites and quartz veining that extends for kilometres across the semi-arid terrain. The informally named Spinifex Fault is one of the dextral set of subvertical faults. This fault is a classic example of coulomb fault mechanics at work in the Proterozoic. The Spinifex Fault trends ~065° across an outcropping granitic pluton, the margins of which it offsets dextrally by ~0.75 km. Locally within the pluton, the fault refracts to ~075° across an amphibolite layer. In the surrounding granitic pluton the fault trace is comparatively inconspicuous and unmineralized but where it transects the amphibolite it is defined by an upstanding ridge of silicified microbreccia-cataclasite (~10 m thick). Associated with the Spinifex Fault is a swarm of predominantly extensional subvertical quartz veins (cm to m thick) trending 090-95° and a series of mineralised fault splays trending 070-080°. Extension veins define the σ1-σ2 plane, with the Spinifex fault lying at an angle of ~25-30° to the inferred σ1. These veins are composed of colloform and crustiform banded quartz, brecciated fragments of quartz vein and wallrock that are typically rimmed with cockade overgrowths and bladed quartz after calcite pseudomorphs. Mineralised fault splays are < 50 m or so wide with a composite brittle fabric comprising: (1) bounding subvertical cataclastic `walls' <10 m or so thick made up of silicified microbreccias and cataclasites containing vein fragments; (2) innumerable subvertical quartz veins (cm to m thick) lying subparallel to the bounding shear zones with textures ranging from pure dilation to multiply recemented breccias of wallrock and quartz fragments; (3) irregular non-systematic veins; and (4) occasional minor faults from the complementary set. Mutual cross-cutting relationships between all the structural components indicate penecontemporaneous development within the inferred stress field. Slickenfibers and striations along fault components indicate predominantly strike slip motion on subvertical planes. Homogenisation temperatures from quartz hosted fluid inclusions cluster at ~210°C while vein textures record histories of incremental hydrothermal deposition under low effective stress, probably in the epizonal environment (<1-2 km depth). This regional study demonstrates the existence of a rather uniform stress province, corresponding to an Andersonian regime and initiation of faults in accord with the coulomb failure criterion.

Metasomatic hydration of the Oeyama forearc peridotites: Tectonic implications

NASA Astrophysics Data System (ADS)

Nozaka, Toshio

2014-01-01

In contrast to the widely recognized aspects of serpentinization, initial stages of hydration and tectonic processes of unserpentinized peridotites are still unclear, but have important implications for understanding the lithospheric architecture of supra-subduction zones. This study provides petrological evidence from the Oeyama ophiolite, SW Japan, of the effects of high-temperature metasomatic hydration immediately before the cooling and ductile deformation of forearc peridotites. Key findings in this study are: 1) complex association of high-temperature metasomatic minerals: tremolitic amphibole, cummingtonite, phlogopite, chlorite, olivine and orthopyroxene in veins and in mylonites; 2) the systematic variation in Si and Na + K contents of the tremolitic amphibole, corresponding to its mode of occurrence and mineral association; and 3) the presence of thin (< 0.7 mm) veins of fine-grained olivine accompanied by a narrow diffusion zone of the host primary olivine. On the basis of petrography and mineral chemistry, the temporal sequence of hydration and deformation of the Oeyama ophiolite is considered as follows: 1) infiltration of slab-derived fluids, causing decomposition of primary pyroxene and chemical modification of primary olivine, 2) metasomatic formation of variable modal amounts of amphibole, phlogopite, chlorite, vein-forming olivine and secondary orthopyroxene at 650-750 °C; 3) early-stage mylonitization of the hydrous peridotites in localized shear zones; and 4) syntectonic serpentinization at 400-600 °C to form serpentinite mylonites. Paragenesis and amphibole compositions suggest comparable temperature conditions for metasomatism and early-stage mylonitization. Mylonitization occurred exclusively in hydrous peridotites, and the peridotite mylonites were preferentially overprinted by syntectonic serpentinization. Diffusion profiles of olivine cut by a vein suggest rapid cooling immediately after the metasomatic fluid infiltration. From these observations and calculations, it is concluded that the exhumation of the forearc peridotites was closely related to the infiltration of high-temperature metasomatic fluids and hydration occurred under a wide range of temperature conditions.

Geology of the epithermal Ag-Au Huevos Verdes vein system and San José district, Deseado massif, Patagonia, Argentina

NASA Astrophysics Data System (ADS)

Dietrich, Andreas; Gutierrez, Ronald; Nelson, Eric P.; Layer, Paul W.

2012-03-01

The San José district is located in the northwest part of the Deseado massif and hosts a number of epithermal Ag-Au quartz veins of intermediate sulfidation style, including the Huevos Verdes vein system. Veins are hosted by andesitic rocks of the Bajo Pobre Formation and locally by rhyodacitic pyroclastic rocks of the Chon Aike Formation. New 40Ar/39Ar constraints on the age of host rocks and mineralization define Late Jurassic ages of 151.3 ± 0.7 Ma to 144.7 ± 0.1 Ma for volcanic rocks of the Bajo Pobre Formation and of 147.6 ± 1.1 Ma for the Chon Aike Formation. Illite ages of the Huevos Verdes vein system of 140.8 ± 0.2 and 140.5 ± 0.3 Ma are 4 m.y. younger than the volcanic host rock unit. These age dates are among the youngest reported for Jurassic volcanism in the Deseado massif and correlate well with the regional context of magmatic and hydrothermal activity. The Huevos Verdes vein system has a strike length of 2,000 m, with several ore shoots along strike. The vein consists of a pre-ore stage and three main ore stages. Early barren quartz and chalcedony are followed by a mottled quartz stage of coarse saccharoidal quartz with irregular streaks and discontinuous bands of sulfide-rich material. The banded quartz-sulfide stage consists of sulfide-rich bands alternating with bands of quartz and bands of chlorite ± illite. Late-stage sulfide-rich veinlets are associated with kaolinite gangue. Ore minerals are argentite and electrum, together with pyrite, sphalerite, galena, chalcopyrite, minor bornite, covellite, and ruby silver. Wall rock alteration is characterized by narrow (< 3 m) halos of illite and illite/smectite next to veins, grading outward into propylitic alteration. Gangue minerals are dominantly massive quartz intergrown with minor to accessory adularia. Epidote, illite, illite/smectite, and, preferentially at deeper levels, Fe-chlorite gangue indicate near-neutral pH hydrothermal fluids at temperatures of >220°C. Kaolinite occurring with the late sulfide-rich veinlet stage indicates pH < 4 and a temperature of <200°C. The Huevos Verdes system has an overall strike of 325°, dipping on average 65° NE. The orientations of individual ore shoots are controlled by vein strike and intersecting north-northwest-striking faults. We propose a structural model for the time of mineralization of the San José district, consisting of a conjugate shear pair of sinistral north-northwest- and dextral west-northwest-striking faults that correspond to R and R' in the Riedel shear model and that are related to master faults (M) of north-northeast-strike. Veins of 315° strike can be interpreted as nearly pure extensional fractures (T). Variations in vein strike predict an induced sinistral shear component for strike directions of >315°, whereas strike directions of <315° are predicted with an induced dextral strike-slip movement. The components of the structural model appear to be present on a regional scale and are not restricted to the San José district.

Evolution of supercritical fluid in deeply subducted continental crust: a case study of composite granite-quartz veins in the Sulu belt, China

NASA Astrophysics Data System (ADS)

Wang, S.; Wang, L.; Brown, M.

2016-12-01

Although fluid plays a key role in element transport and rock strength during subduction to and exhumation from ultrahigh pressure (UHP) metamorphic conditions, the source of supercritical fluid at P above the second critical endpoints (SCE) and the subsequent evolution are not well constrained. To provide insight into the evolution of supercritical fluid in continental subduction zones, we undertook an integrated study of composite granite-quartz veins in retrogressed and migmatitic UHP eclogite at General's Hill, N of Qingdao, in the central Sulu belt. The composite veins are irregularly distributed in the eclogite, which occurs as blocks within gneiss. The granite component is enriched in large ion lithophile elements and light rare earth elements but depleted in high field strength elements and heavy rare earth elements, indicating crystallization from a melt phase of crustal origin. Additionally, the granite contains high modal phengite (22-30 vol%) and clinozoisite/epidote (3-10 vol%), implying precipitation from a H2O-rich silicate melt. By contrast, the quartz component is dominated by SiO2 (99.10 wt%), and contains low total rare earth elements (ΣREE = 0.46 ppm), indicating precipitation from an aqueous fluid. The crystallization age of the composite veins is 221 ± 2 Ma, which is younger than the UHP metamorphism in the Sulu belt at ca 230 Ma, consistent with formation during exhumation. Initial 176Hf/177Hf ratios and δ18O values of metamorphic zircons from the composite veins, and Sr-Nd isotope compositions of the granites all lie between values for eclogite and gneiss, indicating a mixed source. Accordingly, we propose that a supercritical fluid generated from the gneiss and the included blocks of eclogite at P-T conditions above the SCE for both compositions became trapped in the eclogite during exhumation. At P below the SCE for the hydrous granite system, the mixed supercritical fluid separated into immiscible aqueous melt and aqueous fluid and crystallized as the composite veins. Thus, these vein systems provide information critical to understanding the evolution of supercritical fluid during exhumation and the partitioning of elements between hydrous granite and aqueous fluid. These data inform our understanding of crust-mantle interactions in continental subduction zones.

Venous organization in the transverse foramen: dissection, histology, and magnetic resonance imaging.

PubMed

Magro, Elsa; Gentric, Jean-Christophe; Talagas, Matthieu; Alavi, Zarrin; Nonent, Michel; Dam-Hieu, Phong; Seizeur, Romuald

2015-07-01

The anatomical arrangement of the venous system within the transverse foramen is controversial; there is disagreement whether the anatomy consists of a single vertebral vein or a confluence of venous plexus. Precise knowledge of this arrangement is necessary in imaging when vertebral artery dissection is suspected, as well as in surgical approaches for the cervical spine. This study aimed to better explain anatomical organization of the venous system within the transverse foramen according to the Trolard hypothesis of a transverse vertebral sinus. This was an anatomical and radiological study. For the anatomical study, 10 specimens were analyzed after vascular injection. After dissection, histological cuts were prepared. For the radiological study, a high-resolution MRI study with 2D time-of-flight segment MR venography sequences was performed on 10 healthy volunteers. Vertebral veins are arranged in a plexiform manner within the transverse canal. This arrangement begins at the upper part of the transverse canal before the vertebral vein turns into a single vein along with the vertebral artery running from the transverse foramen of the C-6. This venous system runs somewhat ventrolaterally to the vertebral artery. In most cases, this arrangement is symmetrical and facilitates radiological readings. The anastomoses between vertebral veins and ventral longitudinal veins are uniform and arranged segmentally at each vertebra. These findings confirm recent or previous anatomical descriptions and invalidate others. It is hard to come up with a common description of the arrangement of vertebral veins. The authors suggest providing clinicians as well as anatomists with a well-detailed description of components essential to the understanding of this organization.

[Role of adrenal vein sampling in differential diagnosis of primary aldosteronism subtypes].

PubMed

Li, H Y; Li, P; Shen, S M; Zhang, X B; Feng, W H; Huang, H; Chen, W; Zhu, D L

2017-11-14

Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Bilaterally simultaneous catheterization without cosyntropin stimulation and contemporaneous cortisol measurement during AVS were used. Selectivity index (SI)≥1.5 suggested that the sample was from the adrenal vein.Lateralization index (LI) ≥2 suggested unilateral disease.Clinical data was further compared and the AVS findings were analyzed. Results: AVS was successful performed in 41 cases of 50 patients, and the success rate was 82%. According to the results of AVS and postoperative pathology, 41 cases were divided into aldosterone-producing adenoma (APA)/unilateral adrenal hyperplasia (UAH) group (24 cases) and idiopathic hyperaldosteronism (IHA) group (17 cases). Compared with IHA group, patients with APA/UAH showed longer duration of hypertension[10.0 (5.0, 13.0) y vs 4.0 (2.0, 8.0) y, P =0.046], higher proportion of hypokalemia (95.8% vs 64.7%, P =0.009). Furthermore, patients with APA/UAH demonstrated lower plasma renin activity ( P =0.089), higher plasma aldosterone concentration and aldosterone to renin ratio (ARR) (both P <0.05). The diagnostic concordance between CT and adrenal vein sampling was only 48.8%(20/41). Conclusions: The application of bilaterally simultaneous catheterization and contemporaneous cortisol measurement improves success rate and diagnostic accuracy of AVS. AVS is useful in subtype diagnosis of PA with equivocal imaging findings.

Frequency of pneumothorax and haemothorax after primary open versus closed implantation strategies for insertion of a totally implantable venous access port in oncological patients: study protocol for a randomised controlled trial.

PubMed

Hüttner, Felix J; Bruckner, Tom; Alldinger, Ingo; Hennes, Roland; Ulrich, Alexis; Büchler, Markus W; Diener, Markus K; Knebel, Phillip

2015-03-31

The insertion of central venous access devices, such as totally implantable venous access ports (TIVAPs), is routine in patients who need a safe and permanent venous access. The number of port implantations is increasing due to the development of innovative adjuvant and neo-adjuvant therapies. Currently, two different strategies are being routinely used: surgical cut-down of the cephalic vein (vena section) and direct puncture of the subclavian vein. The aim of this trial is to identify the strategy for the implantation of TIVAPs with the lowest risk of pneumothorax and haemothorax. The PORTAS-3 trial is designed as a multicentre, randomised controlled trial to compare two implantation strategies. A total of 1,154 patients will be randomised after giving written informed consent. Patients must be over 18 years of age and scheduled for primary implantation of a TIVAP on the designated side. The primary endpoint will be the frequency of pneumothorax and haemothorax after insertion of a TIVAP by one of two different strategies. The experimental intervention is as follows: open strategy, defined as surgical cut-down of the cephalic vein, supported by a rescue technique if necessary, and in the case of failure, direct puncture of the subclavian vein. The control intervention is as follows: direct puncture of the subclavian vein using the Seldinger technique guided by sonography, fluoroscopy or landmark technique. The trial duration is approximately 36 months, with a recruitment period of 18 months and a follow-up period of 30 days. The PORTAS-3 trial will compare two different TIVAP implantation strategies with regard to their individual risk of postoperative pneumothorax and haemothorax. Since TIVAP implantation is one of the most common procedures in general surgery, the results will be of interest for a large community of surgeons as well as oncologists and general practitioners. The pragmatic trial design ensures that the results will be generalizable to a wide range of patients. The trial protocol was registered on 28 August 2014 with the German Clinical Trials Register (DRKS00004900) . The World Health Organization's Universal Trial Number is U1111-1142-4420.

Characteristics of the Late Devonian Tsagaan Suvarga Cu-Mo deposit, Southern Mongolia

NASA Astrophysics Data System (ADS)

Tungalag, Naidansuren; Jargalan, Sereenen; Khashgerel, Bat-Erdene; Mijiddorj, Chuluunbaatar; Kavalieris, Imants

2018-05-01

The Late Devonian Tsagaan Suvarga deposit (255 Mt at 0.55% Cu, 0.02% Mo) is located on the NW margin of the Tsagaan Suvarga Complex (TSC), which extends ENE over 15 × 10 km and comprises mainly medium-grained equigranular hornblende-biotite quartz monzonite and monzodiorite. Distinct mineralized intrusions are inferred from distribution of Cu-Mo mineralization but are not clearly discernible. The Tsagaan Suvarga Complex is a window within Carboniferous volcanic and sedimentary rocks, and wall rocks to the TSC are not known or exposed in the nearby district. Whole-rock analyses and Sr-Nd isotopes, 87Sr/86Sr0 = 0.7027 to 0.7038 (n = 12) and ɛNd0 = + 4.26 to + 2.77 (n = 12), show that the granitoids are subduction-related I-type, high K-calc-alkaline to shoshonitic series and derived from a mantle source. They exhibit fractionated light rare earth elements, without depleted Eu and depleted middle heavy rare earth elements and Y, typical of oxidized, fertile porphyry magmatic suites. Early porphyry-style quartz veins include A- and B-type. Molybdenite occurs in monomineralic veins (1-5 mm) or A veins. Copper mineralization occurs mainly as chalcopyrite and subordinate bornite, disseminated and associated with quartz-muscovite veins. Pyrite (vol%) content is less than chalcopyrite and bornite combined. Deep oxidation to about 50 m depth has formed zones of malachite and covellite in late fractures. The most important alteration is actinolite-biotite-chlorite-magnetite replacing hornblende and primary biotite. Quartz-K-feldspar alteration is minor. Late albite replaces primary K-feldspar and enhances sodic rims on plagioclase crystals. Quartz-muscovite (or sericitic alteration) overprints actinolite-biotite and porphyry-type quartz veins. Field observations and petrographic studies suggest that the bulk of the chalcopyrite-bornite mineralization at the Tsagaan Suvarga formed together with coarse muscovite alteration.

Primary venous insufficiency increases risk of deep vein thrombosis.

PubMed

Shaydakov, Maxim E; Comerota, Anthony J; Lurie, Fedor

2016-04-01

Varicose veins have been recognized as a risk factor for deep vein thrombosis (DVT). However, venous reflux has not carried the same correlation. This study evaluated the association between primary valvular reflux and DVT. We performed a nested case-control study with enrollment of outpatients presenting to the vascular laboratory with signs and symptoms of DVT. All patients had a complete bilateral venous duplex examination evaluating for DVT and superficial and deep venous valvular reflux. Eighty-seven patients with confirmed DVT on venous duplex were selected for the study group. The control group was randomly selected from the same cohort in a 4:1 ratio matched by age and gender (n = 348). Groups were compared for the prevalence of deep and superficial reflux. DVT outpatients were 4.7-times more likely to have primary valvular reflux than symptomatic controls (65.5% vs 29.0%; 95% confidence interval [CI], 2.8-7.7; P < .000001). Deep reflux was 2.1-times more prevalent (36.8% vs 21.6%; odds ratio, 2.12; 95% CI, 1.28-3.51; P = .005) and superficial reflux was 4.6-times more prevalent (43.7% vs 14.4%; odds ratio, 4.62; 95% CI, 2.75-7.77; P < .0000001) in DVT patients than in controls. DVT patients were also 2.1-times more likely to have combined deep and superficial reflux than non-DVT patients (13.8% vs 6.6%, 95% CI, 1.08-4.75; P = .044). The prevalence of primary valvular reflux in patients with DVT is significantly higher than expected. Reflux may be considered as a novel risk factor for DVT. Two-thirds of patients with DVT have pre-existent primary chronic venous disease, which is likely to contribute to post-thrombotic morbidity. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

High expression of ubiquitin-specific peptidase 39 is associated with the development of vascular remodeling

PubMed Central

He, Shuai; Zhong, Wei; Yin, Li; Wang, Yifei; Qiu, Zhibing; Song, Gang

2017-01-01

Vascular remodeling is the primary cause underlying the failure of angioplasty surgeries, including vascular stenting, transplant vasculopathy and vein grafts. Multiple restenosis-associated proteins and genes have been identified to account for this. In the present study, the functions of ubiquitin-specific peptidase 39 (USP39) were investigated in the context of two vascular remodeling models (a mouse common carotid artery ligation and a pig bilateral saphenous vein-carotid artery interposition graft). USP39 has previously been observed to be upregulated in ligated arteries, and this result was confirmed in the pig vein graft model. In addition, Transwell assay results demonstrated that vascular smooth muscle cell (VSMC) migration was suppressed by lentiviral vector-mediated downregulation of USP39 and enhanced by upregulation of USP39. Furthermore, knockdown of USP39 inhibited VSMC cell proliferation and the expression of cyclin D1 and cyclin-dependent kinase 4, as analyzed via cell counting, MTT assay and western blotting. These results suggest that USP39 may represent a novel therapeutic target for treating vascular injury and preventing vein-graft failure. PMID:28447728

Study of tibial nerve regeneration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments

PubMed Central

Bastos dos Santos, Ewerton; Fernandes, Marcela; Gomes dos Santos, João Baptista; Mattioli Leite, Vilnei; Valente, Sandra Gomes; Faloppa, Flávio

2012-01-01

Objective This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Gold (FG). Method The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. Results The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the motor neuron count (p=0.013). Conclusion The epineural neurorraphy without gap wrapped with jugular vein showed better results for nerve regeneration than the same procedure with gap. Level of Evidence: Experimental Study. PMID:24453597

Fault zone architecture of a major oblique-slip fault in the Rawil depression, Western Helvetic nappes, Switzerland

NASA Astrophysics Data System (ADS)

Gasser, D.; Mancktelow, N. S.

2009-04-01

The Helvetic nappes in the Swiss Alps form a classic fold-and-thrust belt related to overall NNW-directed transport. In western Switzerland, the plunge of nappe fold axes and the regional distribution of units define a broad depression, the Rawil depression, between the culminations of Aiguilles Rouge massif to the SW and Aar massif to the NE. A compilation of data from the literature establishes that, in addition to thrusts related to nappe stacking, the Rawil depression is cross-cut by four sets of brittle faults: (1) SW-NE striking normal faults that strike parallel to the regional fold axis trend, (2) NW-SE striking normal faults and joints that strike perpendicular to the regional fold axis trend, and (3) WNW-ESE striking normal plus dextral oblique-slip faults as well as (4) WSW-ENE striking normal plus dextral oblique-slip faults that both strike oblique to the regional fold axis trend. We studied in detail a beautifully exposed fault from set 3, the Rezli fault zone (RFZ) in the central Wildhorn nappe. The RFZ is a shallow to moderately-dipping (ca. 30-60˚) fault zone with an oblique-slip displacement vector, combining both dextral and normal components. It must have formed in approximately this orientation, because the local orientation of fold axes corresponds to the regional one, as does the generally vertical orientation of extensional joints and veins associated with the regional fault set 2. The fault zone crosscuts four different lithologies: limestone, intercalated marl and limestone, marl and sandstone, and it has a maximum horizontal dextral offset component of ~300 m and a maximum vertical normal offset component of ~200 m. Its internal architecture strongly depends on the lithology in which it developed. In the limestone, it consists of veins, stylolites, cataclasites and cemented gouge, in the intercalated marls and limestones of anastomosing shear zones, brittle fractures, veins and folds, in the marls of anastomosing shear zones, pressure solution seams and veins and in the sandstones of coarse breccia and veins. Later, straight, sharp fault planes cross-cut all these features. In all lithologies, common veins and calcite-cemented fault rocks indicate the strong involvement of fluids during faulting. Today, the southern Rawil depression and the Rhone Valley belong to one of the seismically most active regions in Switzerland. Seismogenic faults interpreted from earthquake focal mechanisms strike ENE-WSW to WNW-ESE, with dominant dextral strike-slip and minor normal components and epicentres at depths of < 15 km. All three Neogene fault sets (2-4) could have been active under the current stress field inferred from the current seismicity. This implies that the same mechanisms that formed these fault zones in the past may still persist at depth. The Rezli fault zone allows the detailed study of a fossil fault zone that can act as a model for processes still occurring at deeper levels in this seismically active region.

Serpentinization history of the Río Guanajibo serpentinite body, Puerto Rico

NASA Astrophysics Data System (ADS)

Roehrig, Erin E.; Laó-Dávila, Daniel A.; Wolfe, Amy L.

2015-10-01

The Río Guanajibo serpentinite body (RGSB) near Mayagüez, Puerto Rico, is part of an ophiolite mélange thrust in an oceanic convergent zone. The aim of this study was to characterize the extent and chronology of serpentinization within this peridotite mass. Mineralogy, microstructures, and veining episodes within the RGSB were characterized using optical microscopy, x-ray diffraction (XRD), scanning electron microscopy (SEM), and structural analyses. This study identified, for the first time, all three serpentine polymorphs (i.e., antigorite, chrysotile, lizardite) in serpentinite samples collected from Puerto Rico. Lizardite, the initial serpentine mineral formed from widespread hydration of olivine, was found throughout serpentinite samples. Chrysotile was the most abundant polymorph observed in sheared serpentinite samples, consistent with conditions favoring low fluid to rock ratios, supersaturation and abundant porosity. Antigorite was observed as a replacement texture in serpentinites that were not exposed to greenschist facies metamorphic conditions, and were frequently found in veins with a shear component. The results indicate that metamorphic conditions do not exclusively dictate polymorph formation. The mineralogy and textures observed within the different vein generations reflect the formation conditions, and deformational mechanisms, that occurred during the serpentinization process; six veining episodes (V1 - V6) were identified and grouped into four stages of serpentinization. Stage one (V1 and V2 type veins) represents the earliest stages of serpentinization and was characterized by microscopic fracture networks that formed as a result of cracking during the initial hydration of olivine under low water/rock ratios. During stage two (V3 and V4 type veins), fibrous crack - seal veins formed to accommodate continued volume expansion, via incremental fracture openings, caused by continued hydration of olivine. The ascension of serpentinite into the upper lithosphere was inferred to occur during Stage three; V5 type veins are associated with this stage. Textures and vein morphologies, representing supersaturated conditions and a decrease in temperature, were observed. Stage 4 (V6 type veins) was characterized by shear deformation features, which formed as a result of thrusting associated with the emplacement of the RGSB or Late Eocene transpression and fault reactivation along the Caribbean plate boundary.

BRILLIANT BLUE FCF IS A NON-TOXIC DYE FOR SAPHENOUS VEIN GRAFT MARKING THAT ABROGATES RESPONSE TO INJURY

PubMed Central

Hocking, Kyle M.; Luo, Weifeng; Li, Fan Dong; Komalavilas, Padmini; Brophy, Colleen; Cheung-Flynn, Joyce

2015-01-01

BACKGROUND Injury to saphenous vein grafts during surgical preparation may contribute to the subsequent development of intimal hyperplasia, the primary cause of graft failure. Surgical skin markers currently used for vascular marking contain gentian violet and isopropanol that damage tissue and impair physiologic functions. Brilliant blue FCF (FCF) is a nontoxic dye alternative that may also ameliorate preparation-induced injury. METHODS Porcine saphenous vein (PSV) was used to evaluate the effect of FCF on physiologic responses in a muscle bath. Cytotoxicity of FCF was measured using human umbilical venous smooth muscle cells (HUVSMC). Effect of FCF on the development of intimal hyperplasia was evaluated in organ culture using PSV. Intracellular calcium fluxes and contractile responses were measured in response to agonist and inhibitors in rat aorta and human saphenous vein (HSV). RESULTS Marking with FCF did not impair smooth muscle contractile responses and restored stretch injury-induced loss in smooth muscle contractility of PSV. Gentian violet has cytotoxic effects on HUVSMC while FCF is nontoxic. FCF inhibited intimal thickening in PSV in organ culture. 2′(3′)-O-(4-Benzoylbenzoyl)adenosine-5′-triphosphate-induced contraction and intracellular calcium flux were inhibited by FCF, oxidized ATP, KN62, and brilliant blue G, suggesting that FCF may inhibit the purinergic receptor P2X7. CONCLUSIONS Our studies indicated that FCF is a non-toxic marking dye for vein grafts that ameliorates vein graft injury and prevents intimal thickening, possibly due to P2X7 receptor inhibition. FCF represents a non-toxic alternative for vein graft marking and a potentially therapeutic approach to enhance outcome in autologous transplantation of HSV into the coronary and peripheral arterial circulation. PMID:25704409

Distal vein patch as a form of autologus modification for infragenicular prosthetic bypass.

PubMed

Totic, Dragan; Rustempasic, Nedzad; Djedovic, Muhamed; Solakovic, Sid; Vukas, Haris; Aslani, Ilijas; Krvavac, Alma; Rudalija, Dzejra; Ahmetasevic, Alen

2013-01-01

Preferred graft for infragenicular bypass is autologus vein. The problem is when there is not available autologus vein. Literature suggest that in these situations, prosthetic graft with some form of modification of distal anastomosis with autogenic tissue is valuable adjunctive. Frequently used modifications are Miller's cuff, Taylor's patch and St. Mary's boot. Recently, there are reports on "Distal vein patch" as a form of autologus modification which, due to its simplicity and patency rate, attracted attention. The aim of this study was to evaluate benefits of this novel modification by comparing its patencies with other autologus modification of distal anastomosis. Study was performed on 60 patients, diabetics, with critical limb ischemia (CLI). Patients were divided in two groups: Group with distal vein patch modification; and group with some other form modification - control group. Patients were followed at least 22 months. We examined patency of grafts by physical examination or using Color Doppler. For statistical purposes we used KIaplan Meier analysis and curve. Significance was determined by Mann-Whitney, Fisher's exact, Pearsons chi square or Student T test as appropriate. P value less than 0,05 was considered significant. Groups were fairly matched relative to demographics, risk factors, operative intervention and distal anastomosis site. There was not statistical difference in two year primary patency between distal vein patch and control group--50% vs 53% respectivly (X2 = 0,08; p = 0,773). Also, there was not statistically significant difference in extremity survival (77% vs 77%) and patient survival between groups (89% vs 93%; X2 = 2,458; p = 0,117). This study proved equivalent patencies of infragenicular prosthetic bypasses performed using distal vein patch technique as with any other modification of distal anastomosis.

PRIMARY MINERALIZATION OF URANIUM-BEARING "SILICEOUS REEF" VEINS IN THE BOULDER BATHOLITH, MONTANA. PART I. THE HOST ROCKS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wright, H.D.; Bieler, B.H.

1960-01-01

Between 1952 and 1956 a study was made of some of the uranium-bearing hydrothermal veins in the northern part of the Boulder batholith, Montana. Three mines, the W. Wilson, G. Washington, and Free Enterprise, were investigated in detail. The veins are characterized by a microcrystalline quartz gangue containing sparsely scattered, very fine-grained sulfide minerals and uraninite. Above the present water table, secondary uranium minerals are abundant locally. Throughout the area the veins --called "siliceous reefs"--strike east to northeast, are of steep dip, and vary in thickness from a fraction of an inch to several feet. The country rock is granodioritemore » containing, in order of abundance, plagioclase (An/sub 30/ to An/sub 36/), quartz, orthoclase, biotite, and hornblende, with apatite, zircon, and sphene. Small bodies of aplite, pegmatite, and alaskite occur along some veins. The granodiorite adjacent to the veins is rather strongly altered. The alteration is similar throughout all of the deposits studied, in barren and orebearing portions alike. The essential minerals show a characteristic sequence of alteration, in the order hornblende, andesine, biotite, orthoclase, and quartz. Successive zones of alteration are characterized, from the vein outward, by maximum development of sericite (muscovite polytype 1M, in part), kaolinite, and montmorillonite. Other alteration products are quartz, pyrite, calcite, leucoxene, and chlorite. The alteration resulted in an increase in silica and ferric iron, a decrease in alumina, total iron, ferrous iron, lime, soda, and magnesia, and little change in potash, titania, phosphorus, carbon dioxide, and sulfur. Consideration of the stability fields of the sheet structure silicate minerals indicates little basis for interpretation of the temperatures prevailing during mineralization. (auth)« less

Low Expression of lncRNA-GAS5 Is Implicated in Human Primary Varicose Great Saphenous Veins

PubMed Central

Yuan, Tian-You; Wang, Shi-Yi; Feng, Jing; Wang, Jing; Liu, Yuan; Wu, Ya-Han; Ma, Xiu-E; Ge, Jin; Cui, Ying-Yu; Jiang, Xiao-Yan

2015-01-01

The cellular mechanisms of primary varicose great saphenous veins (GSVs) involve inflammation, apoptosis, and proliferation of local cells and extracellular matrix degradation. Long non-coding RNAs (lncRNAs) play important roles in these cellular processes; however, which and how lncRNAs related to these mechanisms take effect on GSVs remain unclear. By screening lncRNAs that might experience changes in GSV varicosities, we selected the lower expressed lncRNA-GAS5 (growth arrest specific transcript 5) for functional assessments. Silencing of lncRNA-GAS5 promoted cell proliferation and migration, and cell cycle of the human saphenous vein smooth muscle cells (HSVSMCs), whereas overexpressing it inhibited these cellular behaviors and reduced apoptosis of HSVSMCs. RNA pull-down experiment revealed a direct bind of lncRNA-GAS5 to a Ca2+-dependent RNA-binding protein, Annexin A2. Further experiments showed that silencing of Annexin A2 reduced the HSVSMCs proliferation and vice versa. In the context of lncRNA-GAS5 knockdown, silencing of Annexin A2 reduced the proliferation of HSVSMCs while overexpression of Annexin A2 increased the proliferation. Thus, the low expression of lncRNA-GAS5 may facilitate HSVSMCs proliferation and migration through Annexin A2 and thereby the pathogenesis of GSV varicosities. PMID:25806802

A simple and efficient method for agroinfection of Vernonia cinerea with infectious clones of Vernonia yellow vein virus.

PubMed

Packialakshmi, R M; Usha, R

2011-12-01

Vernonia yellow vein virus (VeYVV) is a distinct monopartite begomovirus associated with a satellite DNA β. After constructing dimers of both DNA A and DNA β in binary vectors, a number of infection methods were attempted. However, only a modified stem-prick method produced up to 83% infection in the natural host Vernonia cinerea, thus, fulfilling the Koch's postulate. The presence of the viral DNA in the agroinfected plants was confirmed by rolling circle amplification (RCA), followed by Southern hybridization. DNA β induces typical symptoms of Vernonia yellow vein disease (VeYVD) when co-agroinoculated with the begomovirus to Vernonia and also leads to the accumulation of DNA A systemically. VeYVV represents a new member of the emerging group of monopartite begomoviruses requiring a satellite component for symptom induction.

Field and Laboratory Observations on Fluid Budget of the Cascadia Episodic Tremor and Slip System, Olympic Peninsula, Washington

NASA Astrophysics Data System (ADS)

Rotman, H.; Mattinson, C. G.

2009-12-01

Fluid movement in accretionary prisms has been linked to the recently discovered episodic tremor and slip (ETS) events along subduction zones. This study focuses on the exhumed accretionary prism of the Cascadia subduction zone, where ETS events are well-documented. The exposed sandstone, shale, siltstone and minor basalt in the study location were buried to 6 - 15 km, within the depth constraints of ETS. This past summer, field work focused on observations of subduction related fluid budget as evidenced by veins, metamorphism, and pore space took place along an east-west transect of the Olympic Peninsula. Approximately 40 representative samples were collected near Obstruction Peak, Hurricane Ridge, Lake Mills (Elwha), and Sore Thumb (Sol Duc). Observations indicate progressively increasing grade of metamorphism from west to east, in agreement with previous studies. Mudrocks show a clear progression from shale to phyllite, while sandstones generally appear equally micaceous across the transect, with the exception of one location. This location is unique in that micas are larger, other metamorphic indicators are visible in hand specimen, and veins make up a significant percent of the outcrop. Epidotes are visible in the rock body and veins, and the veins also contain quartz and calcite, usually as the primary mineral. Veins are oriented perpendicular to bedding and are primarily found in the coarser units. In addition to the veins, water is present in pore spaces and mineral structure. Preliminary observations indicate the veins and pore space decrease to the east, while evidence for fluid movement increases to the east. These observations will be tested and quantified by a variety of laboratory analyses. Thin section examination will determine pore space and mineral assemblages at different locations, and the mechanisms (e.g., blocky or fibrous) of vein growth. Element concentrations from whole rock analysis will determine bulk composition and element mobilization at different temperatures. Oxygen ratios from quartz and calcite, and titanium activity, will constrain temperatures.

Absence of Cortical Vein Opacification Is Associated with Lack of Intra-arterial Therapy Benefit in Stroke.

PubMed

Jansen, Ivo G H; van Vuuren, Annemieke B; van Zwam, Wim H; van den Wijngaard, Ido R; Berkhemer, Olvert A; Lingsma, Hester F; Slump, Cornelis H; van Oostenbrugge, Robert J; Treurniet, Kilian M; Dippel, Diederik W J; van Walderveen, Marianne A A; van der Lugt, Aad; Roos, Yvo B W E M; Marquering, Henk A; Majoie, Charles B L M; van den Berg, René

2018-02-01

Purpose To assess the degree of cortical vein opacification in patients with internal carotid artery or middle cerebral artery (MCA) stroke and to evaluate the relationship with treatment benefit from intra-arterial therapy (IAT). Materials and Methods Written informed consent was obtained from all patients in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands. From the trial's database, all patients (recruited from December 2010 until March 2014) with baseline computed tomographic (CT) angiograms were retrospectively included. Enhancement of the vein of Labbé, sphenoparietal sinus, and superficial middle cerebral vein was graded by one neuroradiologist, as follows: 0, not visible; 1, moderate opacification; and 2, full opacification. The sum for the ipsilateral hemisphere was calculated, resulting in the cortical vein opacification score (COVES) (range, 0-6). Primary outcome was the modified Rankin Scale score at 90 days. Association with treatment according to full cortical vein score and different dichotomized cutoff points was estimated with ordinal logistic regression. Interobserver agreement was assessed by two separate observers who reviewed 100 studies each. Results In total, 397 patients were analyzed. Interaction of the cortical vein score with treatment was significant (P = .044) when dichotomized COVES was 0 versus more than 0. The adjusted odds ratio for shift toward better functional outcome was 1.0 (95% confidence interval [CI]: 0.5, 2.0) for a COVES of 0 (n = 123) and 2.2 (95% CI: 1.6, 4.1) for a COVES greater than 0 (n = 274). The multirater κ value was 0.73. Conclusion In this study, patients with acute middle cerebral artery stroke with absence of cortical vein opacification in the affected hemisphere (COVES = 0) appeared to have no benefit from IAT, whereas patients with venous opacification (COVES >0) were shown to benefit from IAT. © RSNA, 2017 Clinical trial registration nos. NTR(1804) and ISRCTN10888758 Online supplemental material is available for this article.

Changes in tissue glutathione and mercury concentrations in rats following mercuric chloride injection through the hepatic portal vein

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chey, Sin Wun; Keong, Wong Ming; Min, Sin Yoke

The kidney is known as a primary target organ for mercury deposition. However, it is also known as an important organ for the elimination of the absorbed mercury. Tanaka and her collaborators showed that inorganic mercury when injected through caudal vein is transported to the kidney as mercury-GSH complex. If that is so, liver which contains the highest level of tissue GSH than any other organs in normal animals would appear to be a prime site for the complexion of mercury ions with GSH before they are released and transported to the kidney. In view of this, it is ofmore » interest to establish the interrelative changes of the amounts of GSH and mercury in between liver and kidney at the earlier time intervals after a direct injection of a low dosage of mercuric chloride (HgCl{sub 2}) into the hepatic portal vein.« less

Observations of rock spectral classes by the Opportunity rover's Pancam on northern Cape York and on Matijevic Hill, Endeavour Crater, Mars

NASA Astrophysics Data System (ADS)

Farrand, W. H.; Bell, J. F.; Johnson, J. R.; Rice, M. S.; Jolliff, B. L.; Arvidson, R. E.

2014-11-01

The Opportunity rover's exploration of the portion of the rim of Endeavour crater known as Cape York included examination of the sulfate-bearing Grasberg formation and the Matijevic Hill region. Multispectral visible and near-infrared (VNIR) Pancam observations were used to characterize reflectance properties of rock units. Using spectral end-member detection and classification approaches including a principal components/n-dimensional visualization, automatic sequential maximum angle convex cone method, and classification through hierarchical clustering, six main spectral classes of rock surfaces were identified: light-toned veins, Grasberg fm., the smectite-bearing Matijevic formation, the hematitic "blueberry" spherules, resistant spherules within the Matijevic fm. dubbed "newberries," and the Shoemaker formation impact breccia. Some of these could be divided into spectral subclasses. There were three types of veins: veins in the bench unit of Cape York, thinner veins in the Matijevic fm., and boxwork pattern-forming veins. The bench unit veins had higher 535 nm band depths than the other two vein subclasses and a steeper 934 to 1009 nm slope. The Grasberg fm. has VNIR spectral features that are interpreted to indicate higher fractions of red hematite than in the sulfate-bearing Burns Fm. The Matijevic fm. includes both light-toned, fine-grained matrix, and dark-toned veneers. The latter has a weak near-infrared absorption band centered near 950 nm consistent with nontronite. Observations of Rock Abrasion Tool brushed and ground newberries indicated that cuttings from the RAT grind had a longer wavelength reflectance maximum and deeper 535 nm band depth, consistent with more oxidized materials. Greater oxidation of cementing materials in the newberries is consistent with a diagenetic concretion origin.

A high-resolution geochronological and geochemical study on Aegean carbonate deposits, SW Turkey

NASA Astrophysics Data System (ADS)

Ünal-İmer, Ezgi; Uysal, I. Tonguç; Işık, Veysel; Zhao, Jian-Xin; Shulmeister, James

2014-05-01

Vein and breccia carbonates precipitated in highly fractured/faulted carbonate bedrock were investigated using high-resolution U-series geochronology, as well as through microstructural and geochemical studies including Sr-O-C isotope and REE element analyses. The study area (Kumlubük and Amos vein systems), located south of the town of Marmaris in SW Turkey, is a part of an active large-scale extensional system. Field studies show that the calcite veins generally occur sub-vertically and strike mostly NW and EW, in agreement with the regional N-S extensional stress regime. Microscopic observations indicate that the calcite veins formed through crack-seal mechanism, typically accompanied/initiated by intensive hydraulic fracturing of wall-rock evidenced by the presence of widespread breccia deposits. Vein textures are dominated by elongated, fibrous, and blocky calcites. Successive fracturing and layering of calcite with sharp contacts are traceable along the fluid inclusion bands occurring parallel to the wall rock boundary. In particular, inclusion trails aligned perpendicular to the wall-rock and calcite crystal elongation give information about the vein dilation (crack opening) vector and growth direction. High-resolution U-series dating (11-272 ka BP) and geochemical compositions of the vein and breccia samples were used to investigate the long-term behaviour as well as the general identity of the CO2-bearing fluids within deformed crust. The seismic nature of calcite veining is further assessed by stable isotopic ratio (δ18O and δ13C) plots against vein depths (distance from the wall-rock). The average δ18OPDBvalue for Kumlubük veins is -3.79o, while Amos has an average value of -4.05o. Similarly, average carbon isotope ratio (-8.30o) of the Kumlubük veins is slightly higher than that is observed for the Amos veins (-9.66o). Isotopic compositions are interpreted to reflect cyclic (or episodic) CO2 variations. This suggests the presence of several fluid sources and mechanisms (e.g. luid-rock interaction) indicating the significance of pressure and temperature controls on the evolution of the CO2-bearing fluid system. Sr-isotope ratios (87Sr/86Sr: 0.7082-0.7085) in combination with REE compositions are used to trace fluid sources. REE data of the veins from both regions show typical seawater signatures with distinct negative Ce and positive Y anomalies, which corresponds well with the REE composition of the host limestone. While majority of the samples show similar PAAS-normalised REE variations, some of the veins further display positive Eu anomalies, which could be indicative of contribution from a deeply derived, hot, and reduced fluid component.

Transcorneal Electrical Stimulation Therapy for Retinal Disease

ClinicalTrials.gov

2012-05-03

Retinitis Pigmentosa; Macula Off; Primary Open Angle Glaucoma; Hereditary Macular Degeneration; Treated Retina Detachment; Retinal Artery Occlusion; Retinal Vein Occlusion; Non-Arthritic-Anterior-Ischemic Optic-Neuropathy; Hereditary Autosomal Dominant Optic Atrophy; Dry Age Related Macular Degeneration; Ischemic Macula Edema

A randomized trial comparing treatments for varicose veins.

PubMed

Brittenden, Julie; Cotton, Seonaidh C; Elders, Andrew; Ramsay, Craig R; Norrie, John; Burr, Jennifer; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A; Francis, Jill; Tassie, Emma; Scotland, Graham; Wileman, Samantha; Campbell, Marion K

2014-09-25

Ultrasound-guided foam sclerotherapy and endovenous laser ablation are widely used alternatives to surgery for the treatment of varicose veins, but their comparative effectiveness and safety remain uncertain. In a randomized trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of foam, laser, and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success. After adjustment for baseline scores and other covariates, the mean disease-specific quality of life was slightly worse after treatment with foam than after surgery (P=0.006) but was similar in the laser and surgery groups. There were no significant differences between the surgery group and the foam or the laser group in measures of generic quality of life. The frequency of procedural complications was similar in the foam group (6%) and the surgery group (7%) but was lower in the laser group (1%) than in the surgery group (P<0.001); the frequency of serious adverse events (approximately 3%) was similar among the groups. Measures of clinical success were similar among the groups, but successful ablation of the main trunks of the saphenous vein was less common in the foam group than in the surgery group (P<0.001). Quality-of-life measures were generally similar among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam group than in the surgery group. All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; Current Controlled Trials number, ISRCTN51995477.).

Preliminary study of uranium favorability of the Boulder batholith, Montana

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castor, S.B.; Robins, J.W.

1978-01-01

The Boulder batholith of southwestern Montana is a composite Late Cretaceous intrusive mass, mostly composed of quartz monzonite and granodiorite. This study was not restricted to the plutonic rocks; it also includes younger rocks that overlie the batholith, and older rocks that it intrudes. The Boulder batholith area has good overall potential for economic uranium deposits, because its geology is similar to that of areas that contain economic deposits elsewhere in the world, and because at least 35 uranium occurrences of several different types are present. Potential is greatest for the occurrence of small uranium deposits in chalcedony veins andmore » base-metal sulfide veins. Three areas may be favorable for large, low-grade deposits consisting of a number of closely spaced chalcedony veins and enriched wall rock; the Mooney claims, the Boulder area, and the Clancy area. In addition, there is a good possibility of by-product uranium production from phosphatic black shales in the project area. The potential for uranium deposits in breccia masses that cut prebatholith rocks, in manganese-quartz veins near Butte, and in a shear zone that cuts Tertiary rhyolite near Helena cannot be determined on the basis of available information. Low-grade, disseminated, primary uranium concentrations similar to porphyry deposits proposed by Armstrong (1974) may exist in the Boulder batholith, but the primary uranium content of most batholith rocks is low. The geologic environment adjacent to the Boulder batholith is similar in places to that at the Midnite mine in Washington. Some igneous rocks in the project area contain more than 10 ppM U/sub 3/O/sub 8/, and some metasedimentary rocks near the batholith contain reductants such as sulfides and carbonaceous material.« less

TMEM16A regulates portal vein smooth muscle cell proliferation in portal hypertension.

PubMed

Zeng, Xi; Huang, Ping; Chen, Mingkai; Liu, Shiqian; Wu, Nannan; Wang, Fang; Zhang, Jing

2018-01-01

The aim of the present study was to elucidate the effect of transmembrane protein 16A (TMEM16A) on portal vein smooth muscle cell (PVSMC) proliferation associated with portal vein remodeling in portal hypertension (PHT). Sprague-Dawley rats were subjected to bile duct ligation to establish a rat model of liver cirrhosis and PHT. Sham-operated animals served as controls. At 8 weeks after bile duct ligation, the extent of liver fibrosis and the portal vein wall thickness were assessed using hematoxylin-eosin staining. The protein expression levels of TMEM16A, extracellular signal-regulated kinase 1 and 2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) in the portal vein were detected by immunohistochemistry and western blotting. In vitro , the lentivirus vectors were constructed and transfected into PVSMCs to upregulate the expression of TMEM16A. Isolated rat primary PVSMCs were treated with a small molecule inhibitor of TMEM16A, T16A-inhA01. Cell cycle was detected by flow cytometry. The activity of TMEM16A in the portal vein isolated from bile duct ligated rats was decreased, while the expression level of p-ERK1/2 was increased. However, in vitro , upregulation of TMEM16A promoted the proliferation PVSMCs, while inhibition of TMEM16A channels inhibited the proliferation of PVSMCs. The results indicated that TMEM16A contributes to PVSMCs proliferation in vitro , but in vivo , it may be a negative regulator of cell proliferation influenced by numerous factors.

[Vein thromboembolism prevention in stroke patients].

PubMed

Savić, Dejan; Savić, Ljiljana

2010-01-01

Having in mind the rate of occurrence and clinical importance, venous thromboembolism implies venous thrombosis and pulmonary embolism as a result of embolisation of the thrombotic particles from deep veins or pelvic veins. Venous thrombosis of the deep veins may result in chronic vein insufficiency, but the primary medical problem is the possibility of development of pulmonary embolism which may cause permanent respiratory function damage or even fatal outcome. The high incidence of deep vein thrombosis (30% clinically and up to 50% subclinically) in acute stroke hemiparetic and bed ridden patients within two weeks from the onset and 1-2% pulmonary embolism with the fatal outcome in the first month clinically and 17% of all fatal outcomes in postmortem investigations present a necessity for the early venous thromboembolism prevention. On the other hand, the most powerful prevention strategy--anticoagulation has important limitations in acute stroke patients: almost impossible to be used in cerebral haemorrhage and a great risk for the development of haemorrhagic transformation in cerebral infarction. The fact that other prevention strategies have limited value requires an estimation of effectivity-risk ratio in venous thromboembolism prevention in stroke. Venous thromboembolism prevention in stroke patients is necessary because of a greater risk for venous thromboembolism in these patients according to the nature of illness and functional disability, but also a problem because of limited possibility to recommend the proper medicament according to the risk of serious complications. The necessity of preventing venous thromboembolism and estimation of effectivity-risk ratio in stroke patients, beside plenty of studies and consensus conferences, remain individual and often very difficult.

Comparison of duplex ultrasound with digital subtraction angiography in the assessment of infra-inguinal autologous vein bypass grafts.

PubMed

Griffin, Nick M R; Wright, Isabel A; Buckenham, Tim M

2006-11-01

Postoperative surveillance of infra-inguinal vein grafts has arisen because of the high incidence of vein graft stenoses, which frequently progress to vein graft occlusion. The use of duplex ultrasound as the primary imaging method for graft surveillance is well established. This study aims to compare the accuracy of duplex ultrasound with the reference standard of digital subtraction angiography in the assessment of infra-inguinal vein grafts. Sixty patients underwent routine postoperative duplex ultrasound as part of the local graft surveillance programme. Angiography was subsequently carried out on 18 grafts. Each lower limb arterial tree was divided into three segments (native arteries proximal to the graft, the graft itself and native arteries distal to the graft) resulting in a total of 42 comparisons. Degree of diameter stenosis on ultrasound was compared with angiography findings to determine concordance. Agreement was also expressed as a kappa value. Overall accuracy of duplex ultrasound was 88% (37/42). A kappa value of 0.80 indicates good agreement. In three of the five discordant cases, ultrasound correctly identified a stenosis, but overestimated the degree of stenosis compared with angiography. In each of the remaining two discordant cases, ultrasound identified a focal stenosis that was not apparent on angiography. In both cases, the area of duplex described abnormality responded to balloon angioplasty. Duplex ultrasound as part of the local vein graft surveillance programme is a reliable and accurate method in the detection of failing grafts and in some instances may be more sensitive.

A prospective study of venous hemodynamics and quality of live at least five years after varicose vein stripping.

PubMed

Uema, Rogerio Takeyoshi; Dezotti, Nei Rodrigues Alves; Joviliano, Edwaldo Edner; Dalio, Marcelo Bellini; Moriya, Takachi; Piccinato, Carlos Eli

2013-11-01

To assess venous hemodynamics and quality of life at lest five years after varicose vein stripping. We conducted a prospective study with 39 patients (63 limbs) with primary lower limbs varicose veins. Preoperatively, all patients were subjected to clinical evaluation, duplex ultrassound, air plethysmography (APG), and CIVIQ questionnaire of quality of life. By APG, venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) were determined. CIVIQ addresses four domains in course of 20 questions, including states of physical, social, and psychological well-being, and pain level. Varicose veins were treated by standard venous stripping. At least five years after surgery (77.9 ± 10.9 months), patients were reassessed and had clinical examination, duplex ultrasound, APG, and CIVIQ repeated. No late follow-up data was available for 24 patients. Preoperative and late postoperative VFI levels were similar, whereas EF (P=0.05) and RVF (P=0.01), as hemodynamic variables, significantly improved following surgery. In the late postoperative period, overall CIVIQ scores were significantly lower (P=0.005), as were scores in all four domains: pain (P=0.001), physical (P=0.007), social (P=0.008), and psychological (P= 0.05). In a small prospective cohort, improvements in venous hemodynamics and in quality of life of patients submitted to standard varicose veins stripping were maintained five years after the procedure.

Automated method for the identification and analysis of vascular tree structures in retinal vessel network

NASA Astrophysics Data System (ADS)

Joshi, Vinayak S.; Garvin, Mona K.; Reinhardt, Joseph M.; Abramoff, Michael D.

2011-03-01

Structural analysis of retinal vessel network has so far served in the diagnosis of retinopathies and systemic diseases. The retinopathies are known to affect the morphologic properties of retinal vessels such as course, shape, caliber, and tortuosity. Whether the arteries and the veins respond to these changes together or in tandem has always been a topic of discussion. However the diseases such as diabetic retinopathy and retinopathy of prematurity have been diagnosed with the morphologic changes specific either to arteries or to veins. Thus a method describing the separation of retinal vessel trees imaged in a two dimensional color fundus image may assist in artery-vein classification and quantitative assessment of morphologic changes particular to arteries or veins. We propose a method based on mathematical morphology and graph search to identify and label the retinal vessel trees, which provides a structural mapping of vessel network in terms of each individual primary vessel, its branches and spatial positions of branching and cross-over points. The method was evaluated on a dataset of 15 fundus images resulting into an accuracy of 92.87 % correctly assigned vessel pixels when compared with the manual labeling of separated vessel trees. Accordingly, the structural mapping method performs well and we are currently investigating its potential in evaluating the characteristic properties specific to arteries or veins.

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

A carbon and nitrogen isotope study of carbonaceous vein material in ureilite meteorites

NASA Technical Reports Server (NTRS)

Russell, S. S.; Arden, J. W.; Franchi, I. A.; Pillinger, C. T.

1993-01-01

The ureilite meteorite group is known to be rich in carbon in the form of graphite/diamond veins that are associated with planetary type noble gases. This paper reports preliminary data from a systematic study of the carbon and nitrogen isotopic composition of this carbonaceous vein material. A previous study focused on the whole rock signatures and reported that the carbon inventory appeared to be dominated by the graphitic/diamond intergrowths, whereas the nitrogen was clearly composed of several distinct components including one that was isotopically light, possibly associated with the carbonaceous material. Recent studies have demonstrated that diamonds in the solar system formed in many different environments. C and N measurements from ureilitic diamond made in a similar way would be a useful addition to this overall study. The methods used for isolating diamonds of possible presolar origin from primitive meteorites are equally applicable to the processing of carbon bearing components in the ureilite group so that their stable isotopic composition can be determined. Herein we discuss conjoint C and N stepped combustion measurements made on crushed whole rock ureilite samples that have been treated with 1M HCl/9M HF to dissolve silicate and free metal. In addition, two samples have been further treated with oxidizing acids to leave a diamond rich residue.

Chondritic Meteorites: Nebular and Parent-Body Formation Processes

NASA Technical Reports Server (NTRS)

Rubin, Alan E.; Lindstrom, David (Technical Monitor)

2002-01-01

It is important to identify features in chondrites that formed as a result of parent-body modification in order to disentangle nebular and asteroidal processes. However, this task is difficult because unmetamorphosed chondritic meteorites are mixtures of diverse components including various types of chondrules, chondrule fragments, refractory and mafic inclusions, metal-sulfide grains and fine-grained matrix material. Shocked chondrites can contain melt pockets, silicate-darkened material, metal veins, silicate melt veins, and impact-melt-rock clasts. This grant paid for several studies that went far in helping to distinguish primitive nebular features from those produced during asteroidal modification processes.

Magma chamber cooling by episodic volatile expulsion as constrained by mineral vein distributions in the Butte, Montana Cu-Mo porphyry deposit

NASA Astrophysics Data System (ADS)

Daly, K.; Karlstrom, L.; Reed, M. H.

2016-12-01

The role of hydrothermal systems in the thermal evolution of magma chambers is poorly constrained yet likely significant. We analyze trends in mineral composition, vein thickness and overall volumetric fluid flux of the Butte, Montana porphyry Cu-Mo deposit to constrain the role of episodic volatile discharge in the crystallization of the source magma chamber ( 300 km3of silicic magma). An aqueous fluid sourced from injection of porphyritic dikes formed the Butte porphyry Cu network of veins. At least three separate pulses of fluid through the system are defined by alteration envelopes of [1] gray sericite (GS); [2] early-dark micaceous (EDM), pale-green sericite (PGS), and dark-green sericite (DGS); and [3] quartz-molybdenite (Qmb) and barren-quartz. Previous research using geothermometers and geobarometers has found that vein mineral composition, inferred temperatures and inferred pressures vary systematically with depth. Later fluid pulses are characterized by lower temperatures, consistent with progressive cooling of the source. We have digitized previously unused structural data from Butte area drill cores, and applied thermomechanical modeling of fluid release from the source magma chamber through time. Vein number density and vein thickness increase with depth as a clear function of mineralogy and thus primary temperature and pressure. We identify structural trends in the three fluid pulses which seem to imply time evolution of average vein characteristics. Pulses of Qmb-barren quartz and EDM-PGS-DGS (1st and 2nd in time) exhibit increasing vein number density (157 & 95 veins/50m, respectively) and thickness (300mm & 120mm, respectively) as a function of depth. EDM-PGS-DGS has a shallower peak in vein density (800m) than Qmb-barren quartz (>1600m). These data provide the basis for idealized mechanical models of hydrofractures, to predict driving pressures and to compare with existing source temperatures and total fluid volumes in order to estimate the total enthalpy of each fluid pulse. We then compare with models for conductive cooling and crystallization of the source magma chamber to estimate the importance of hydrothermal fluid expulsion in the total heat budget. Such models should also provide constraints on the timing and ultimately the origin of pulsed volatile release at Butte.

Adrenal Vein Sampling for Conn's Syndrome: Diagnosis and Clinical Outcomes.

PubMed

Deipolyi, Amy R; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

2015-06-19

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management.

Intravenous methylene blue venography during laparoscopic paediatric varicocelectomy.

PubMed

Keene, David J B; Cervellione, Raimondo M

2014-02-01

One of the challenges of varicocele surgery is to prevent hydrocele formation while still ensuring success. Methylene blue has been used to identify and preserve lymphatic vessels, and venography has been a standard component of sclerotherapy and percutaneous retrograde techniques. The authors have combined both approaches during laparoscopic varicocelectomy and report their experience. A prospective study was performed of adolescents with idiopathic varicocele and spontaneous venous reflux on Doppler ultrasound. A pampiniform plexus vein was cannulated via scrotal incision before creating the pneumoperitoneum. A mixture of methylene blue and Omnipaque™ was injected into the pampiniform plexus with fluoroscopic screening. Laparoscopic selective vein ligation was then performed using 5mm endoscopic clips or a bipolar vessel sealing device such as Plasmakinetic™ or Ligasure™. Venography was repeated to confirm complete ligation of the internal testicular veins. Patients were followed-up at 3, 6, and 9 months post-surgery with clinical examination and Doppler ultrasound. Data are presented as median (interquartile range). Twenty-four patients underwent laparoscopic selective vein ligation with venography and methylene blue injection. The median age was 14.7 (14.6-15.7) years. The recurrence rate was 12%. No patients developed a hydrocele. The length of surgery was 120 (100-126) minutes. Intra-operative intra-venous methylene blue injection and venography helps to identify venous duplications of the internal testicular veins and enhances the success rate of laparoscopic selective vein ligation. This approach prevents hydrocele formation but has a 12% recurrence rate, which appears to be higher than some techniques described in the literature. Copyright © 2014 Elsevier Inc. All rights reserved.

Distribution of Collagen I, III, and IV and Laminin in the Human Liver during Prenatal Development.

PubMed

Jović, Marko; Nikolić, Ivan; Todorović, Vera; Petrović, Aleksandar; Petrović, Vladimir; Mojsilović, Marijola; Denčić, Tijana

2018-06-27

In the absence of systematized data on the extracellular matrix components during prenatal liver development, the present study aimed to investigate the time of appearance and distribution of collagen types I, III, and IV and laminin. The study material included embryonic and fetal livers, aged 7-37 weeks, categorized into 3 trimesters. The material was stained using hematoxylin-eosin and immunohistochemistry methods for the identification of collagen I, III, and IV and laminin. Collagen I was detected near the end of the first trimester in the capsules and walls of interlobular veins. As the liver matures, collagen I is increasingly abundant in the capsules, portal area connective tissues, arterial walls, interlobular veins, sinusoids, and central veins. Collagen III and collagen IV appear in the middle of the first trimester in the capsules, portal areas, and walls of central veins, as well as the sinusoids particularly. In trimesters 2 and 3, these collagens are increasingly present in all the structures, but collagen IV is also present in nerve fibers. Laminin is sporadically present adjacent to the sinusoids in trimester 1, while in trimesters 2 and 3 this protein commonly appears in the walls of arteries and interlobular veins, in the basal membrane of bile ducts, and in nerve fibers. The contents of collagen I, III, and IV increase during prenatal development in the liver capsule, arterial and vein walls, sinusoids, and portal area. Laminin expression is consistent with that of the collagens with the exception that, within lobules, laminin disappears with liver maturation. © 2018 S. Karger AG, Basel.

Does the anatomical localization of lower extremity venous diseases affect the quality of life?

PubMed

Sadikoglu, Ganime; Ozcakir, Alis; Ercan, Ilker; Yildiz, Caner; Sadikoglu, Yurtkuran

2006-11-01

To investigate the effects of venous diseases at different anatomical localizations on the qualities of life of patients with varicose veins. The study included 354 cases, which was referred to a private vascular and interventional radiology center in Bursa, Turkey between January 2005 to January 2006. The cases were diagnosed with visual inspection and were clinically indicative of varicose veins. Color Doppler ultrasonography was used to radiologically examine the varicose veins. All cases were accepted as class II criteria according to the Clinical, Etiologic, Anatomic, Pathophysiologic classification. The generic Short Form Health Survey-36 (SF-36) was used to measure physical and mental quality of life (QOL). High scores indicated good QOL. The Statistical Package for Social Sciences version 13.0 program was used for the statistical evaluation. When the life SF-36 quality parameters of cases with different anatomical localizations of the varicose veins were examined, only the mental health scores were found to differ in different groups (p<0.01). In females and males with superficial venous disease, significant differences were found in physical function, physical role and pain among the physical health scale components, and in vitality and emotional role scores among the mental state determinants. When females and males with deep vein disease were compared, significant differences were found among both physical and mental health determinants. Anatomical localization of lower extremity varicose veins can be accepted as a predictive factor in determining the life qualities of patients with varicosities in their lower limb, and should be used to regulate their therapy and follow up protocols.

In search of early life: Carbonate veins in Archean metamorphic rocks as potential hosts of biomarkers

NASA Astrophysics Data System (ADS)

Peters, Carl A.; Piazolo, Sandra; Webb, Gregory E.; Dutkiewicz, Adriana; George, Simon C.

2016-11-01

The detection of early life signatures using hydrocarbon biomarkers in Precambrian rocks struggles with contamination issues, unspecific biomarkers and the lack of suitable sedimentary rocks due to extensive thermal overprints. Importantly, host rocks must not have been exposed to temperatures above 250 °C as at these temperatures biomarkers are destroyed. Here we show that Archean sedimentary rocks from the Jeerinah Formation (2.63 billion yrs) and Carawine Dolomite (2.55 billion yrs) of the Pilbara Craton (Western Australia) drilled by the Agouron Institute in 2012, which previously were suggested to be suitable for biomarker studies, were metamorphosed to the greenschist facies. This is higher than previously reported. Both the mineral assemblages (carbonate, quartz, Fe-chlorite, muscovite, microcline, rutile, and pyrite with absence of illite) and chlorite geothermometry suggest that the rocks were exposed to temperatures higher than 300 °C and probably ∼400 °C, consistent with greenschist-facies metamorphism. This facies leads to the destruction of any biomarkers and explains why the extraction of hydrocarbon biomarkers from pristine drill cores has not been successful. However, we show that the rocks are cut by younger formation-specific carbonate veins containing primary oil-bearing fluid inclusions and solid bitumens. Type 1 veins in the Carawine Dolomite consist of dolomite, quartz and solid bitumen, whereas type 2 veins in the Jeerinah Formation consist of calcite. Within the veins fluid inclusion homogenisation temperatures and calcite twinning geothermometry indicate maximum temperatures of ∼200 °C for type 1 veins and ∼180 °C for type 2 veins. Type 1 veins have typical isotopic values for reprecipitated Archean sea-water carbonates, with δ13CVPDB ranging from - 3 ‰ to 0‰ and δ18OVPDB ranging from - 13 ‰ to - 7 ‰, while type 2 veins have isotopic values that are similar to hydrothermal carbonates, with δ13CVPDB ranging from - 18 ‰ to - 4 ‰ and δ18OVPDB ranging from - 18 ‰ to - 12 ‰. Evidently, the migration and entrapment of hydrocarbons occurred after peak metamorphism under temperatures congruous with late catagenesis and from fluids of different compositions. The relatively high temperatures of vein formation and the known geotectonic history of the rocks analysed suggest a probable minimum age of 1.8 billion yrs (Paleoproterozoic). Our results demonstrate that post peak-metamorphic veins provide an exciting opportunity in the search for evidence of early life. The integration of petrological and organic geochemical techniques is crucial for any future studies that use biomarkers to reconstruct the early biosphere.

Highly Siderophile Elements and Osmium Isotope Systematics in Ureilites: Are the Carbonaceous Veins Primary Components?

NASA Technical Reports Server (NTRS)

Rankenburg, K.; Brandon, A. D.; Humayun, M.

2005-01-01

Ureilites are an enigmatic group of primitive carbon-bearing achondrites of ultramafic composition. The majority of the 143 ureilite meteorites consist primarily of olivine and pyroxene (and occasionally chromite) [1]. They are coarse-grained, slowly cooled, and depleted in incompatible lithophile elements. Minor amounts of dark interstitial material consisting of carbon, metal, sulfides, and fine-grained silicates occur primarily along silicate grain boundaries, but also intrude the silicates along fractures and cleavage planes. Variable degrees of impact shock features have also been imparted on ureilites. The prevailing two origins proposed for these rocks are either as melting residues of carbonaceous chondritic material [2], [3], or alternatively, derivation as mineral cumulates from such melts [4], [5], [6]. It has recently been proposed that ureilites are the residues of a smelting event, i.e. residues of a partial melting event under highly reducing conditions, where a solid Fe-bearing phase reacts with a melt and carbon to form Fe metal and carbon monoxide [7]. Rapid, localized extraction and loss of the basaltic component into space resulting from high eruption velocities could preserve unequilibrated oxygen isotopes and produce the observed olivine-pyroxene residues via 25-30% partial melting of chondritic-like precursor material.

Fluid mixing and ore deposition during the geodynamic evolution of the Sierra Almagrera (Betics, Spain)

NASA Astrophysics Data System (ADS)

Dyja, Vanessa; Tarantola, Alexandre; Hibsch, Christian; Boiron, Marie-Christine; Cathelineau, Michel

2013-04-01

Marine and continental intramountaineous basins developed during the Neogene orographic evolution of the Betico-rifan orogenic wedge, as well as the related uplifted ranges within the Sierra Almagrera Metamorphic Core Complexes (MCC). The NNE-SSW striking trans-Alboran transcurrent fault system crosscuts the MCC post-dating the extensional exhumation stages recorded in the metamorphic fabric. Iron ores (± Pb, Cu, Zn) are encountered either as stratabound ore deposits in the Neogene basins or as vein networks crosscutting the metamorphic fabric of graphitic phyllites from the Sierra Almagrera. These Late Miocene ore deposits are related to the activity of the N-S striking Palomares fault segment of the Trans-Alboran fault system. Three sets of quartz veins (Vα, Vαβ and Vβ) and one set of mineralized vein (Vγ, siderite, barite) are distinguished. The Vα and Vαβ respectively are totally or partially transposed into the foliation. The Vβ and Vγ veins are discordant to the foliation. The problem addressed in this study concerns the nature of the fluids involved in the metal deposits and their relationships with the main reservoir fluids, e.g. the deep metamorphic fluids, the basinal fluids, and eventually the recharge meteoric fluids. This study focuses thus on the evolution of the fluids at different stages of ductile-brittle exhumation of the metamorphic ranges (Sierras) and their role during the exhumation and later on in relation with the hydrothermalism and metal deposition at a regional scale. Paleofluids were studied as inclusions in quartz, siderite and barite from veins by microthermometry and Raman spectroscopy, and a stable isotope study is in progress. Earliest fluids recorded in (Vαβ) quartz veins are H2O- NaCl + CaCl2 (17 wt. %) - (traces of CO2, CH4, N2) metamorphic brines trapped at the ductile brittle transition at a minimum trapping temperatures (Th) of 340 °C. Older metamorphic fluids in (Vα) veins were lost during the complete recrystallization of the original quartz grains during transposition. The second fluid type is characterized by very low salinity inclusions (1.2 wt.% NaCl) found in veins discordant to the foliation (Vβ), and precedes brines (23 wt. % NaCl + CaCl2 with Th of 320 °C) trapped in transgranular fluid inclusion planes (FIP). The NW-SE to N-S directions of these FIP appears coherent with shortening directions related to Tortonian and Messinian basin development (Montenat, 1990). The halogen signatures of the latest brines confirm that they derive from primary brines issued from sea water evaporation. Fluid inclusions in barites and siderites from (Vγ) veins display a Br/Cl ratio more typical of secondary brines and a rather large range of salinities, this indicating distinct fluid movements and the dissolution of evaporates by dilute fluids may be of meteoric origin. Fluids in siderites show the lowest trapping temperature conditions around 190 °C. The existence of a sea water component in fluids was previously mentioned by Morales Ruano et al. (1995) indicate a δ34S of 22,1-23.9 ‰ for barite from Sierra Almagrera. In conclusion, during the Neogene multistage evolution of the Almagrera MCC, fluids of different origins e.g. basinal, meteoric and metamorphic fluids have circulated within the crust, and locally interacted with evaporites. The resulting brines formed Fe-(Ba, Pb, Cu) ores in discontinuities affecting both the metamorphic and sedimentary rocks. Morales Ruano, S., Both, R., and Fenoll Hach-Ali, P., 1995, Fluid evolution and mineral deposition in the Aguilas - Sierra Almagrera base metal ores, southeastern Spain.: Mineral Deposits, p. 365-368. Montenat, C., 1990, Les Bassins néogènes du domaine bétique oriental (Espagne), Documents et Travaux IGAL n°12-13, 392 p.

Adverse Outcome Pathway (AOP) framework for embryonic vascular disruption and developmental defects (SOT)

EPA Science Inventory

Vascular development commences with de novo assembly of a primary capillary plexus (vasculogenesis) followed by its expansion (angiogenesis) and maturation (angio-adaptation) into a hierarchical system of arteries and veins. These processes are tightly regulated by genetic signal...

SFE/SFHTA/AFCE consensus on primary aldosteronism, part 4: Subtype diagnosis.

PubMed

Bardet, Stéphane; Chamontin, Bernard; Douillard, Claire; Pagny, Jean-Yves; Hernigou, Anne; Joffre, Francis; Plouin, Pierre-François; Steichen, Olivier

2016-07-01

To establish the cause of primary aldosteronism (PA), it is essential to distinguish unilateral from bilateral adrenal aldosterone secretion, as adrenalectomy improves aldosterone secretion and controls hypertension and hypokalemia only in the former. Except in the rare cases of type 1 or 3 familial hyperaldosteronism, which can be diagnosed genetically and are not candidates for surgery, lateralized aldosterone secretion is diagnosed on adrenal CT or MRI and adrenal venous sampling. Postural stimulation tests and (131)I-norcholesterol scintigraphy have poor diagnostic value and (11)C-metomidate PET is not yet available. We recommend that adrenal CT or MRI be performed in all cases of PA. Imaging may exceptionally identify adrenocortical carcinoma, for which the surgical objectives are carcinologic, and otherwise shows either normal or hyperplastic adrenals or unilateral adenoma. Imaging alone carries a risk of false positives in patients over 35 years of age (non-aldosterone-secreting adenoma) and false negatives in all patients (unilateral hyperplasia). We suggest that all candidates for surgery over 35 years of age undergo adrenal venous sampling, simultaneously in both adrenal veins, without ACTH stimulation, to confirm the unilateral form of the hypersecretion. Sampling results should be confirmed on adrenal vein cortisol assay showing a concentration at least double that found in peripheral veins. Aldosterone secretion should be considered lateralized when aldosterone/cortisol ratio on the dominant side is at least 4-fold higher than contralaterally. Published by Elsevier Masson SAS.

Ultrasound Vein and Artery Mapping by General Surgery Residents During Initial Consult Can Decrease Time to Dialysis Access Creation.

PubMed

Gray, Kelsey; Korn, Abraham; Zane, Joshua; Gonzalez, Gabriel; Kaji, Amy; Bowens, Nina; de Virgilio, Christian

2018-05-01

Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended before hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. This is a retrospective review of all patients who underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents. The primary endpoints were days from initial consult to dialysis access creation, rate of arteriovenous fistula (AVF) creation, fistula maturation, and 1-year primary assisted patency. Of 242 patients, 167 (69%) had formal US, and 75 (31%) had only a resident US. The resident US group had 100% AVF creation compared with the formal US group with 92.2% AVF creation (P = 0.01). There was no difference between the groups in rate of fistula maturation (P = 0.1) and 1-year assisted patency (P = 0.9). Of the resident US 90.7% occurred in the outpatient setting. On multivariable analysis controlling for outpatient consult, the average time to the operating room was 13.7 days longer for the formal US group in the outpatient setting (P = 0.0006). Ultrasound vein and artery evaluation at the time of the initial consult by general surgery residents can decrease the time to dialysis access creation by bypassing the need for formal US with a higher rate of AVF creation and no difference in fistula maturation or 1-year primary assisted patency. Copyright © 2018 Elsevier Inc. All rights reserved.

Interobserver variability in target definition for hepatocellular carcinoma with and without portal vein thrombus: radiation therapy oncology group consensus guidelines.

PubMed

Hong, Theodore S; Bosch, Walter R; Krishnan, Sunil; Kim, Tae K; Mamon, Harvey J; Shyn, Paul; Ben-Josef, Edgar; Seong, Jinsil; Haddock, Michael G; Cheng, Jason C; Feng, Mary U; Stephans, Kevin L; Roberge, David; Crane, Christopher; Dawson, Laura A

2014-07-15

Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning, especially if differential dosing is contemplated. Guidelines for HCC GTV contouring are recommended. Copyright © 2014. Published by Elsevier Inc.

Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)

PubMed Central

2013-01-01

Background Venous thromboembolism comprising pulmonary embolism and deep vein thrombosis is a common condition with an incidence of approximately 1 per 1,000 per annum causing both mortality and serious morbidity. The principal aim of treatment of a venous thromboembolism with heparin and warfarin is to prevent extension or recurrence of clot. However, the recurrence rate following a deep vein thrombosis remains approximately 10% per annum following treatment cessation irrespective of the duration of anticoagulation therapy. Patients with raised D-dimer levels after discontinuing oral anticoagulation treatment have also been shown to be at high risk of recurrence. Post thrombotic syndrome is a complication of a deep vein thrombosis which can lead to chronic venous insufficiency and ulceration. It has a cumulative incidence after 2 years of around 25% and it has been suggested that extended oral anticoagulation should be investigated as a possible preventative measure. Methods/design Patients with a first idiopathic venous thromboembolism will be recruited through anticoagulation clinics and randomly allocated to either continuing or discontinuing warfarin treatment for a further 2 years and followed up on a six monthly basis. At each visit D-dimer levels will be measured using a Roche Cobas h 232 POC device. In addition a venous sample will be taken for laboratory D-dimer analysis at the end of the study. Patients will be examined for signs and symptoms of PTS using the Villalta scale and complete VEINES and EQ5D quality of life questionnaires. Discussion The primary aim of the study is to investigate whether extending oral anticoagulation treatment (prior to discontinuing treatment) beyond 3–6 months for patients with a first unprovoked proximal deep vein thrombosis or pulmonary embolism prevents recurrence. The study will also determine the role of extending anticoagulation for patients with elevated D-dimer levels prior to discontinuing treatment and identify the potential of D-dimer point of care testing for identification of high risk patients within a primary care setting. Trial registration ISRCTN73819751 PMID:23497371

Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hong, Theodore S., E-mail: tshong1@mgh.harvard.edu; Bosch, Walter R.; Krishnan, Sunil

2014-07-15

Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3more » had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning, especially if differential dosing is contemplated. Guidelines for HCC GTV contouring are recommended.« less

Assistance of intraoperative microvascular Doppler in the surgical obliteration of spinal dural arteriovenous fistula: cases description and technical considerations.

PubMed

Iacopino, D G; Conti, A; Giusa, M; Cardali, S; Tomasello, F

2003-02-01

Intraoperative microvascular Doppler may be valuable in assisting in the surgical obliteration of dural arteriovenous fistula of the spinal cord. It enables identification, through flow spectrum analysis, of the anatomic components and haemodynamic features of this type of vascular malformation. In two cases, intraoperative microvascular Doppler was used to assist in the surgical obliteration of dural arteriovenous fistula of the spinal cord. The fistulas were identified prior to the dura opening, and for this only minimally invasive surgery was required. Direct recordings of the arterialised draining vein and the nidus of the fistula demonstrated a pathological spectrum caused by the arterial supply and the disturbed venous outflow in which a high-resistance flow pattern and low diastolic flow resembling an arterial-like flow velocity were observed. The fistulas were obliterated by interruption of the draining vein, and Doppler measurements provided information on flow velocity changes in the medullary veins from an arterial to a venous pattern. The absence of any residual flow in the draining vein confirmed successful haemodynamic treatment. Intraoperative microvascular Doppler recording is valuable assistance in surgical closure of spinal arteriovenous fistula.

Protein kinase G regulates the basal tension and plays a major role in nitrovasodilator-induced relaxation of porcine coronary veins.

PubMed

Qi, H; Zheng, X; Qin, X; Dou, D; Xu, H; Raj, J U; Gao, Y

2007-12-01

Coronary venous activity is modulated by endogenous and exogenous nitrovasodilators. The present study was to determine the role of protein kinase G (PKG) in the regulation of the basal tension and nitrovasodilator-induced relaxation of coronary veins. Effects of a PKG inhibitor on the basal tension and responses induced by nitroglycerin, DETA NONOate, and 8-Br-cGMP in isolated porcine coronary veins were determined. Cyclic cGMP was measured with radioimmunoassay. PKG activity was determined by measuring the incorporation of 32P from gamma-32P-ATP into the specific substrate BPDEtide. Rp-8-Br-PET-cGMPS, a specific PKG inhibitor, increased the basal tension of porcine coronary veins and decreased PKG activity. The increase in tension was 38% of that caused by nitro-L-arginine. Relaxation of the veins induced by nitroglycerin and DETA NONOate was accompanied with increases in cGMP content and PKG activity. These effects were largely eliminated by inhibiting soluble guanylyl cyclase with ODQ. The increase in PKG activity induced by the nitrovasodilators was abolished by Rp-8-Br-PET-cGMPS. The relaxation caused by these dilators and by 8-Br-cGMP at their EC50 was attenuated by the PKG inhibitor by 51-66%. These results suggest that PKG is critically involved in nitric oxide-mediated regulation of the basal tension in porcine coronary veins and that it plays a primary role in relaxation induced by nitrovasodilators. Since nitric oxide plays a key role in modulating coronary venous activity, augmentation of PKG may be a therapeutic target for improving coronary blood flow.

Insulin restores gestational diabetes mellitus-reduced adenosine transport involving differential expression of insulin receptor isoforms in human umbilical vein endothelium.

PubMed

Westermeier, Francisco; Salomón, Carlos; González, Marcelo; Puebla, Carlos; Guzmán-Gutiérrez, Enrique; Cifuentes, Fredi; Leiva, Andrea; Casanello, Paola; Sobrevia, Luis

2011-06-01

To determine whether insulin reverses gestational diabetes mellitus (GDM)-reduced expression and activity of human equilibrative nucleoside transporters 1 (hENT1) in human umbilical vein endothelium cells (HUVECs). Primary cultured HUVECs from full-term normal (n = 44) and diet-treated GDM (n = 44) pregnancies were used. Insulin effect was assayed on hENT1 expression (protein, mRNA, SLC29A1 promoter activity) and activity (initial rates of adenosine transport) as well as endothelial nitric oxide (NO) synthase activity (serine(1177) phosphorylation, l-citrulline formation). Adenosine concentration in culture medium and umbilical vein blood (high-performance liquid chromatography) as well as insulin receptor A and B expression (quantitative PCR) were determined. Reactivity of umbilical vein rings to adenosine and insulin was assayed by wire myography. Experiments were in the absence or presence of l-N(G)-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) or ZM-241385 (an A(2A)-adenosine receptor antagonist). Umbilical vein blood adenosine concentration was higher, and the adenosine- and insulin-induced NO/endothelium-dependent umbilical vein relaxation was lower in GDM. Cells from GDM exhibited increased insulin receptor A isoform expression in addition to the reported NO-dependent inhibition of hENT1-adenosine transport and SLC29A1 reporter repression, and increased extracellular concentration of adenosine and NO synthase activity. Insulin reversed all these parameters to values in normal pregnancies, an effect blocked by ZM-241385 and l-NAME. GDM and normal pregnancy HUVEC phenotypes are differentially responsive to insulin, a phenomenon where insulin acts as protecting factor for endothelial dysfunction characteristic of this syndrome. Abnormal adenosine plasma levels, and potentially A(2A)-adenosine receptors and insulin receptor A, will play crucial roles in this phenomenon in GDM.

Protein kinase G regulates the basal tension and plays a major role in nitrovasodilator-induced relaxation of porcine coronary veins

PubMed Central

Qi, H; Zheng, X; Qin, X; Dou, D; Xu, H; Raj, J U; Gao, Y

2007-01-01

Background and purpose: Coronary venous activity is modulated by endogenous and exogenous nitrovasodilators. The present study was to determine the role of protein kinase G (PKG) in the regulation of the basal tension and nitrovasodilator-induced relaxation of coronary veins. Experimental approach: Effects of a PKG inhibitor on the basal tension and responses induced by nitroglycerin, DETA NONOate, and 8-Br-cGMP in isolated porcine coronary veins were determined. Cyclic cGMP was measured with radioimmunoassay. PKG activity was determined by measuring the incorporation of 32P from γ-32P-ATP into the specific substrate BPDEtide. Key results: Rp-8-Br-PET-cGMPS, a specific PKG inhibitor, increased the basal tension of porcine coronary veins and decreased PKG activity. The increase in tension was 38% of that caused by nitro-L-arginine. Relaxation of the veins induced by nitroglycerin and DETA NONOate was accompanied with increases in cGMP content and PKG activity. These effects were largely eliminated by inhibiting soluble guanylyl cyclase with ODQ. The increase in PKG activity induced by the nitrovasodilators was abolished by Rp-8-Br-PET-cGMPS. The relaxation caused by these dilators and by 8-Br-cGMP at their EC50 was attenuated by the PKG inhibitor by 51–66%. Conclusions and implications: These results suggest that PKG is critically involved in nitric oxide-mediated regulation of the basal tension in porcine coronary veins and that it plays a primary role in relaxation induced by nitrovasodilators. Since nitric oxide plays a key role in modulating coronary venous activity, augmentation of PKG may be a therapeutic target for improving coronary blood flow. PMID:17891157

38 CFR Appendix C to Part 4 - Alphabetical Index of Disabilities

Code of Federal Regulations, 2010 CFR

2010-07-01

... 7322 Ectropion 6020 Embolism, brain 8007 Emphysema, pulmonary 6603 Encephalitis, epidemic, chronic 8000... 6847 Soft tissue sarcoma: Muscle, fat, or fibrous connected 5329 Neurogenic origin 8540 Vascular origin... Varicose veins 7120 Vasculitis, primary cutaneous 7826 Vertebral fracture or dislocation 5235 Visceral...

Cyclic development of igneous features and their relationship to high-temperature hydrothermal features in the Henderson porphyry molybdenum deposit, Colorado

USGS Publications Warehouse

Carten, R.B.; Geraghty, E.P.; Walker, B.M.

1988-01-01

The Henderson porphyry molybdenum deposit was formed by the superposition of coupled alteration and mineralization events, of varying intensity and size, that were associated with each of at least 11 intrusions. Deposition of molybdenite was accompanied by time-equivalent silicic and potassic alteration. High-temperature alteration and mineralization are spatially and temporally linked to the crystallization of compositionally zoned magma in the apex of stocks. Differences in hydrothermal features associated with each intrusion (e.g., mass of ore, orientation and type of veins, density of veins, and intensity of alteration) correlate with differences in primary igneous features (e.g., composition, texture, morphology, and size). The systematic relations between hydrothermal and magmatic features suggest that primary magma compositions, including volatile contents, largely control the geometry, volume, level of emplacement, and mechanisms of crystallization of stocks. These elements in turn govern the orientations and densities of fractures, which ultimately determine the distribution patterns of hydrothermal alteration and mineralization. -from Authors

ISCHEMIC CENTRAL RETINAL VEIN OCCLUSION IN THE ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR ERA.

PubMed

Tam, Emily K; Golchet, Pamela; Yung, Madeline; DeCroos, Francis C; Spirn, Marc; Lehmann-Clarke, Lydia; Ambresin, Aude; Tsui, Irena

2018-02-01

Anti-vascular endothelial growth factor therapy has improved the prognosis for patients with central retinal vein occlusion (CRVO). However, most studies published to date exclude ischemic CRVO. The purpose of this study was to describe the outcome in eyes with ischemic CRVO treated with anti-vascular endothelial growth factor therapy. Thirty-seven patients with ischemic CRVO from 3 centers were followed for at least 6 months. Data on patient demographic, vision status, and anti-vascular endothelial growth factor treatments were collected. Average number of injections during the study period was 5. Younger age was associated with improved vision (P = 0.006). Patients with improved visual outcomes tended to have macular edema as the primary indication for treatment, whereas patients with worse outcomes tended to have neovascularization as the primary indication for treatment. This study highlights significant variability in the use of anti-vascular endothelial growth factor therapy for ischemic CRVO and underscores that eyes with neovascularization tend to have worse visual outcomes.

Peripheral nerve regeneration with conduits: use of vein tubes

PubMed Central

Sabongi, Rodrigo Guerra; Fernandes, Marcela; dos Santos, João Baptista Gomes

2015-01-01

Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit. PMID:26170802

Peripheral nerve regeneration with conduits: use of vein tubes.

PubMed

Sabongi, Rodrigo Guerra; Fernandes, Marcela; Dos Santos, João Baptista Gomes

2015-04-01

Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.

Geology and geochemistry of the shear-hosted Julie gold deposit, NW Ghana

NASA Astrophysics Data System (ADS)

Amponsah, Prince Ofori; Salvi, Stefano; Béziat, Didier; Siebenaller, Luc; Baratoux, Lenka; Jessell, Mark W.

2015-12-01

The Leo Man Craton in West Africa is host to numerous economic gold deposits. If some regions, such as the SW of Ghana, are well known for world-class mineralizations and have been extensively studied, gold occurrences elsewhere in the craton have been discovered only in the last half a century or so, and very little is known about them. The Julie gold deposit, located in the Paleoproterozoic Birimian terrane of NW Ghana, is one such case. This deposit is hosted in a series of granitoid intrusives of TTG composition, and consists of a network of deformed, boudinaged quartz lodes (A-type veins) contained within an early DJ1 E-W trending shear zone with dextral characteristics. A conjugate set of veins (C-type) perpendicular to the A-type veins contains low grade mineralization. The main ore zone defines a lenticular corridor about 20-50 m in width and about 3.5 km along strike, trending E-W and dipping between 30 and 60°N. The corridor is strongly altered, by an assemblage of sericite + quartz + ankerite + calcite + tourmaline + pyrite. This is surrounded by a second alteration assemblage, consisting of albite + sericite + calcite + chlorite + pyrite + rutile, which marks a lateral alteration that fades into the unaltered rock. Mass balance calculations show that during alteration overall mass was conserved and elemental transfer is generally consistent with sulfidation, sericitization and carbonatization of the host TTG. Gold is closely associated with pyrite, which occurs as disseminated grains in the veins and in the host rock, within the mineralized corridor. SEM imagery and LA-ICP-MS analyses of pyrites indicate that in A-type veins gold is associated with bismuth, tellurium, lead and silver, while in C-type veins it is mostly associated with silver. Pyrites in A-type veins contain gold as inclusions and as free gold on its edges and fractures, while pyrites from C-type veins contains mostly free gold. Primary and pseudosecondary fluid inclusions from both type veins indicate circulation in the system of an aqueous-carbonic fluid of low to moderate salinity, which entered the immiscibility PT region of the H2O-CO2-NaCl system, at about 220 °C and <1 kbar.

Tourniquet application after local forearm warming to improve venodilation for peripheral intravenous cannulation in young and middle-aged adults: A single-blind prospective randomized controlled trial.

PubMed

Yamagami, Yuki; Tomita, Kohei; Tsujimoto, Tomomi; Inoue, Tomoko

2017-07-01

Local forearm warming before tourniquet application is often used to promote venodilation for peripheral intravenous cannulation; however, few studies have compared the effect of tourniquet application with and without local warming on vein size. To evaluate the effectiveness of tourniquet application after local forearm warming with that of tourniquet application alone in young and middle-aged adults. A single-blind, prospective, parallel group, randomized controlled trial. A national university in Japan. Seventy-two volunteers aged 20-64 years. Participants were randomly allocated to one of two groups: tourniquet application for 30s after forearm application of a heat pack warmed to 40°C±2°C for 15min (active warming group; n=36) or tourniquet application for 30s after applying a non-warmed heat pack for 15min (passive warming group; n=36). The primary outcomes were vein cross-sectional area on the forearm, measured after the intervention by blinded research assistants using ultrasound. Secondary outcomes were shortest diameter, and longest diameter of vein on the forearm, forearm skin temperature, body temperature, pulse, systolic blood pressure, and diastolic blood pressure. All outcomes were assessed at the same site before and immediately after the intervention, once per participant. Vein cross-sectional area, shortest vein diameter, and longest vein diameter were significantly increased in the active warming group compared with the passive warming group (p <0.01). Tourniquet application after local warming was superior to tourniquet application alone in increasing vein cross-sectional, shortest diameter, and longest diameter (between-group differences of 2.2mm 2 , 0.5mm, and 0.5mm, respectively), and in raising skin temperature (between-group difference: 5.2°C). However, there were no significant differences in body temperature, pulse, or systolic or diastolic blood pressure between the groups. There were no adverse events associated with either intervention. Tourniquet application after local warming was associated with increased forearm vein size when compared with tourniquet application alone, and was demonstrated as being safe. Thus, with demonstrable effects on vein size, we recommend local warming before tourniquet application as a safe and effective technique for improving venodilation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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 in veins and sinter. Acid-sulfate fluid of the second fluid regime was derived from oxidation of H2S and other volatiles exsolved from sinter-vein fluid. Acid-sulfate fluid produced (1) a subhorizontal zone of partially leached basinal deposits and rhyolite from the paleosurface to a depth of ???60 m, and (2) laterally pervasive zones, ???100 to 200 m thick, of quartz + alunite ?? hematite and quartz + kaolinite + pyrite in volcaniclastic deposits immediately beneath partially leached rocks, but this fluid did not decompose selenide-sulfide-precious metal phases in sinter. Paragenetically late vein and wall-rock assemblages, including marcasite + pyrite, calcite, and kaolinite-replaced K minerals, record deeper transition of sinter-vein fluid into acid-sulfate fluid in vein conduits. This transition occurred as regional subsidence, manifested by the Goosey Lake depression immediately east of Buckskin Mountain, lowered the pieziometric surface at Buckskin Mountain, terminated sinter deposition, and caused boiling and/or degassing of sinter-vein fluid. The timing of subsidence is recorded by a decrease in alunite ages, from ca. 15.8 to 15.6 Ma, with depth below sinter. Lateral replacement of sinter and partially leached epiclastic deposits and rhyolite by opal-A marks the termination of the two hydrothermal regimes that lasted ???0.5 m.y. and followed rhyolitic volcanism of similar duration. Veins and sinter display textures that attest to plastic deformation, spalling, and gravitational settling, and indicate fluid-flow direction, velocity, and density stratification which, with conduit topology, may have influenced precious metal tenor in the veins. Components of sinter and veins were transported as colloids, formed in supersaturated sinter-vein fluid, that aggregated or coagulated as incompetent gelatinous layers in shallow pools and in underlying, near-vertical conduits in rhyolite and initially crystallized as opal and chalcedony. The low thermal conductivity of ho

First Observations of Boron on Mars and Implications for Gale Crater Geochemistry

NASA Astrophysics Data System (ADS)

Gasda, P. J.; Haldeman, E. B.; Wiens, R. C.; Rapin, W.; Frydenvang, J.; Maurice, S.; Clegg, S. M.; Delapp, D.; Sanford, V.; McInroy, R.

2016-12-01

Borates are potentially important precursor materials for the origin of life on Earth. It has been shown that borates are required to stabilize ribose, a component of RNA, when produced by the formose reaction, a prebiotically plausible mechanism to produce ribose from formaldehyde. Evaporites, including borates, also shed light on the history of aqueous activity on Mars. The ChemCam instrument onboard the NASA Curiosity rover provides quantitative elemental compositions of targets in Gale Crater, Mars, using laser-induced breakdown spectroscopy (LIBS). Laboratory observations of Fe-free targets indicate that a LIBS emission line is visible with as little as 10 ppm B. We have observed B lines in 23 calcium sulfate veins in Gale Crater: 3 in Yellowknife Bay and 20 in the Murray lacustrine mudstone and the Stimson eolian sandstone units since sol 727, as Curiosity arrived at the base of Mt. Sharp, a 5 km sedimentary mound in the center of Gale Crater. To calibrate these observations, samples composed of borates diluted with Hawaiian basalt have been analyzed using the LANL ChemCam engineering model. Preliminary results show that the Gale Crater veins have between 10-100 ppm B. One possible explanation for borates in veins is that Gale Lake evaporated, depositing evaporites, including borates. Later, Gale Crater was partially buried and its lacustrine and overlying eolian units were lithified and fractured. Water flowed through the evaporite-rich layers, partially dissolving them. Fluid moved through the fractures, re-precipitating the borates and sulfates as veins. ChemCam cannot directly determine mineralogy, but B is likely present as borax as the dominate borate phase in these veins, based on previous estimates of vein fluid temperature. Borates forming in this environment tend to precipitate from mildly alkaline fluids. The fluid temperature and pH implies these veins were potentially habitable environments.

Seismic tomography for charaterization of an ore vein in the research and education mine Reiche Zeche

NASA Astrophysics Data System (ADS)

Winter, Sebastian; Schlüter, Ralf; Hlousek, Felix; Buske, Stefan

2017-04-01

A test site for the design, implementation and operation of an underground in-situ bioleaching unit has been installed by the „Biohydrometallurgical Center for Strategic Elements" at the research and education mine "Reiche Zeche" of Technical University Bergakademie Freiberg. For this purpose an ore vein block will be developed and mined with the bio-hydrometallurgical in-situ leaching technology. As a site survey an underground seismic tomography experiment has been performed to investigate the spatial distribution of the ore vein within this block consisting mainly of gneiss and with dimensions of about 30 x 10 meters. The experiment was performed with a sledgehammer as source and 76 three-component receivers with source and receiver point intervals of about 1 m surrounding the approximately rectangular block. High precision laser scanning was performed to obtain accurate source and receiver positions which was particularly necessary to obtain reliable results due to the generally high wave velocities of the gneiss. The resulting seismic data set showed a high signal-to-noise ratio with clear first arrivals which were picked for all source and receiver combinations and subsequently used as input to a first-arrival tomographic inversion scheme. The resulting velocity model has very good ray coverage and shows well resolved high- and low-velocity regions within the block. These regions can be clearly assigned to mapped outcrops of the ore vein along the galleries surrounding the block, including a correlation of low velocities to fractured rock parts as well as high velocities to the undisturbed ore vein core, respectively. In summary the obtained velocity model and the inferred spatial distribution of the ore vein provides a good basis for planning and implementing the actual ore mining step using the envisaged bioleaching technology.

Effect of Ticagrelor Plus Aspirin, Ticagrelor Alone, or Aspirin Alone on Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Grafting: A Randomized Clinical Trial.

PubMed

Zhao, Qiang; Zhu, Yunpeng; Xu, Zhiyun; Cheng, Zhaoyun; Mei, Ju; Chen, Xin; Wang, Xiaowei

2018-04-24

The effect of ticagrelor with or without aspirin on saphenous vein graft patency in patients undergoing coronary artery bypass grafting (CABG) is unknown. To compare the effect of ticagrelor + aspirin or ticagrelor alone vs aspirin alone on saphenous vein graft patency 1 year after CABG. Randomized, multicenter, open-label, clinical trial among 6 tertiary hospitals in China. Eligible patients were aged 18 to 80 years with indications for elective CABG. Patients requiring urgent revascularization, concomitant cardiac surgery, dual antiplatelet or vitamin K antagonist therapy post-CABG, and who were at risk of serious bleeding were excluded. From July 2014 until November 2015, 1256 patients were identified and 500 were enrolled. Follow-up was completed in January 2017. Patients were randomized (1:1:1) to start ticagrelor (90 mg twice daily) + aspirin (100 mg once daily) (n = 168), ticagrelor (90 mg twice daily) (n = 166), or aspirin (100 mg once daily) (n = 166) within 24 hours post-CABG. Neither patients nor treating physicians were blinded to allocation. Primary outcome was saphenous vein graft patency 1 year after CABG (FitzGibbon grade A) adjudicated independently by a committee blinded to allocation. Saphenous vein graft patency was assessed by multislice computed tomographic angiography or coronary angiography. Among 500 randomized patients (mean age, 63.6 years; women, 91 [18.2%]), 461 (92.2%) completed the trial. Saphenous vein graft patency rates 1 year post-CABG were 88.7% (432 of 487 vein grafts) with ticagrelor + aspirin; 82.8% (404 of 488 vein grafts) with ticagrelor alone; and 76.5% (371 of 485 vein grafts) with aspirin alone. The difference between ticagrelor + aspirin vs aspirin alone was statistically significant (12.2% [95% CI, 5.2% to 19.2%]; P < .001), whereas the difference between ticagrelor alone vs aspirin alone was not statistically significant (6.3% [95% CI, -1.1% to 13.7%]; P = .10). Five major bleeding episodes occurred during 1 year of follow-up (3 with ticagrelor + aspirin; 2 with ticagrelor alone). Among patients undergoing elective CABG with saphenous vein grafting, ticagrelor + aspirin significantly increased graft patency after 1 year vs aspirin alone; there was no significant difference between ticagrelor alone and aspirin alone. Further research with more patients is needed to assess comparative bleeding risks. clinicaltrials.gov Identifier: NCT02201771.

Between carbonatite and lamproite—Diamondiferous Torngat ultramafic lamprophyres formed by carbonate-fluxed melting of cratonic MARID-type metasomes

NASA Astrophysics Data System (ADS)

Tappe, Sebastian; Foley, Stephen F.; Kjarsgaard, Bruce A.; Romer, Rolf L.; Heaman, Larry M.; Stracke, Andreas; Jenner, George A.

2008-07-01

New U-Pb perovskite ages reveal that diamondiferous ultramafic lamprophyre magmas erupted through the Archean crust of northern Labrador and Quebec (eastern Canada) between ca. 610 and 565 Ma, a period of strong rifting activity throughout contiguous Laurentia and Baltica. The observed Torngat carbonate-rich aillikite/carbonatite and carbonate-poor mela-aillikite dyke varieties show a large spread in Sr-Nd-Hf-Pb isotope ratios with pronounced correlations between isotope systems. An isotopically depleted component is identified solely within aillikites ( 87Sr/ 86Sr i = 0.70323-0.70377; ɛNd i = +1.2-+1.8; ɛHf i = +1.4-+3.5; 206Pb/ 204Pb i = 18.2-18.5), whereas some aillikites and all mela-aillikites range to more enriched isotope signatures ( 87Sr/ 86Sr i = 0.70388-0.70523; ɛNd i = -0.5 to -3.9; ɛHf i = -0.6 to -6.0; 206Pb/ 204Pb i = 17.8-18.2). These contrasting isotopic characteristics of aillikites/carbonatites and mela-aillikites, along with subtle differences in their modal carbonate, SiO 2, Al 2O 3, Na 2O, Cs-Rb, and Zr-Hf contents, are consistent with two distinctive metasomatic assemblages of different age in the mantle magma source region. Integration of petrologic, geochemical, and isotopic information leads us to propose that the isotopically enriched component originated from a reduced phlogopite-richterite-Ti-oxide dominated source assemblage that is reminiscent of MARID suite xenoliths. In contrast, the isotopically depleted component was derived from a more oxidized phlogopite-carbonate dominated source assemblage. We argue that low-degree CO 2-rich potassic silicate melts from the convective upper mantle were preferentially channelled into an older, pre-existing MARID-type vein network at the base of the North Atlantic craton lithosphere, where they froze to form new phlogopite-carbonate dominated veins. Continued stretching and thinning of the cratonic lithosphere during the Late Neoproterozoic remobilized the carbonate-rich vein material and induced volatile-fluxed fusion of the MARID-type veins and the cold peridotite substrate. Isotopic modelling suggests that only 5-12% trace element contribution from such geochemically extreme MARID-type material is required to produce the observed compositional shift from the isotopically most depleted aillikites/carbonatites towards enriched mela-aillikites. We conclude that cold cratonic mantle lithosphere can host several generations of contrasting vein assemblages, and that each may have formed during past tectonic and magmatic events under distinctively different physicochemical conditions. Although cratonic MARID-type and carbonate-bearing veins in peridotite can be the respective sources for lamproite and carbonatite magmas when present as the sole metasome, their concomitant fusion in a complex source region may give rise to a whole new variety of deep volatile-rich magmas and we suggest that orangeites (formerly Group 2 kimberlites), kamafugites, and certain types of ultramafic lamprophyre are formed in this manner.

Depleted and metasomatized oceanic lithosphere beneath La Palma, Canary Islands

NASA Astrophysics Data System (ADS)

Janisch, Astrid; Ntaflos, Theodoros

2017-04-01

Due to the inaccessibility of Earth's interior, xenoliths became the best possibility to study the chemical composition of the earth mantle as well as its various processes. Three samples out of the sample suite of mantle peridotites from San Antonio Volcano on La Palma, Canary Islands, have been chosen to illustrate three examples of diverse mantle metasomatic events. The first sample, a pyroxene-hornblende-peridotite, was influenced by an alkali-rich, silicic-hydrous undersaturated melt and/or fluid forming a conspicuous cross-cutting amphibole-apatite-dyke with several veins percolating through the rock. Forsterite content in olivine varies between 82.5 - 85.5 and 86.0 - 89.0, suggesting at least two different occurrences of metasomatic overprint. Clinopyroxenes are mostly found in association with amphibole and in textural equilibrium hinting that both minerals may have grown together, while orthopyroxene have only been found as remnant inclusions in olivine. These clinopyroxenes are Cr-Diopsides with En43.40-50.97-Wo43.99-48.64-Fs4.30-8.22 and Mg# between 85.54 and 92.36. Secondary clinopyroxenes are Ti-Augites with En39.86-46.81-Wo46.65-51.98-Fs5.86-8.72 and Mg# of 82.44 - 89.09. The second sample, a sp-dunite, is characterized by haüyne-bearing melt veins which clearly indicate host-basalt infiltration. The haüyne is always in contact with amphibole, spinel and clinopyroxene denoting that they have been formed at the same time because there is no evidence for reaction among these phases. The melt infiltration apparently took place prior to xenolith entrainment in the host basalt. Primary olivine has Fo content of 89.57 - 89.67 with NiO ranging from 0.32 - 0.334, in contrast Fo content in secondary olivine varies from 89.05 - 90.86 and NiO fluctuates between 0.24 - 0.31. Cr-Diopside compositions are in range of En41.63-47.05-Wo47.83-51-90-Fs4.93-6.64 and Mg# between 86.48 - 90.50. The third sample is also a sp-dunite and marked by a network of phlogopite-amphibole veins cutting through pre-existing olivine implying a formation of the veins prior to xenolith entrainment in the host basalt. During ascend melt infiltrated the peridotite mostly along these veins forming a reaction zone causing growth of secondary clinopyroxene and altering contiguous olivine. Amphiboles found in the matrix have a slightly different chemical composition compared to amphiboles forming the veins indicating that these are the result of melt influence. Clinopyroxenes are secondary Ti-Diopsides with En40.82-49.42-Wo45.20-51.63-Fs4.99-7.56 and Mg# of 84.51 - 91.09 within the phlogopite-amphibole veins and secondary Cr-Diopsides with En43.32-49.64-Wo45.85-51.61-Fs4.16-5.55 and Mg# ranging from 88.77 - 92.48 apart from the phlogopite-amphibole-veins. Olivines within the veins show Fo values of 88.18 - 89.68 whereas Fo content in primary olivines is more homogeneous and varies between 90.03 and 90.66. Amphiboles in all three samples are pargasites and kaersutitic pargasites.

Use of vascular access ports in femoral veins of dogs and cats with cancer.

PubMed

Cahalane, Alane Kosanovich; Rassnick, Kenneth M; Flanders, James A

2007-11-01

To evaluate long-term function of vascular access ports (VAPs) implanted in the femoral vein of dogs and cats undergoing cancer treatment. Prospective clinical study. 3 dogs and 6 cats treated via chemotherapy or radiation. VAPs were surgically implanted in the left femoral vein of 3 dogs and 6 cats over a 1-year period. Injection port location was alternated to either a caudal thoracic or ilial location in each patient. Duration of VAP function, ease of infusion, and ease of aspiration through the VAPs were recorded, and associated complications were assessed at each VAP use. Client satisfaction with VAP placement was evaluated by use of a questionnaire. Primary uses of the VAPs included blood sampling and delivering sedative or chemotherapeutic drugs. Median duration of successful infusion was 147 days (range, 60 to 370 days), and median duration of successful aspiration was 117 days (range, 10 to 271 days). The frequency of signs of VAP-related discomfort was low (7% of patient observations). Clients were satisfied with their decision to use VAPs. Complications included partial (n = 7) or complete (2) VAP occlusion, port migration (1), and presumptive infection (1). Results suggested that VAP implantation into the femoral vein provides an acceptable means of chronic venous access in dogs and cats undergoing cancer treatment.

Diagnosing upper extremity deep vein thrombosis with non-contrast-enhanced Magnetic Resonance Direct Thrombus Imaging: A pilot study.

PubMed

Dronkers, C E A; Klok, F A; van Haren, G R; Gleditsch, J; Westerlund, E; Huisman, M V; Kroft, L J M

2018-03-01

Diagnosing upper extremity deep vein thrombosis (UEDVT) can be challenging. Compression ultrasonography is often inconclusive because of overlying anatomic structures that hamper compressing veins. Contrast venography is invasive and has a risk of contrast allergy. Magnetic Resonance Direct Thrombus Imaging (MRDTI) and Three Dimensional Turbo Spin-echo Spectral Attenuated Inversion Recovery (3D TSE-SPAIR) are both non-contrast-enhanced Magnetic Resonance Imaging (MRI) sequences that can visualize a thrombus directly by the visualization of methemoglobin, which is formed in a fresh blood clot. MRDTI has been proven to be accurate in diagnosing deep venous thrombosis (DVT) of the leg. The primary aim of this pilot study was to test the feasibility of diagnosing UEDVT with these MRI techniques. MRDTI and 3D TSE-SPAIR were performed in 3 pilot patients who were already diagnosed with UEDVT by ultrasonography or contrast venography. In all patients, UEDVT diagnosis could be confirmed by MRDTI and 3D TSE-SPAIR in all vein segments. In conclusion, this study showed that non-contrast MRDTI and 3D TSE-SPAIR sequences may be feasible tests to diagnose UEDVT. However diagnostic accuracy and management studies have to be performed before these techniques can be routinely used in clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes

PubMed Central

Deipolyi, Amy R.; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

2015-01-01

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management. PMID:26854152

Superior Lower Extremity Vein Graft Bypass Patency among Married Patients with Peripheral Artery Disease.

PubMed

Lagergren, Emily; Kempe, Kelly; Craven, Timothy E; Kornegay, Susan T; Hurie, Justin B; Garg, Nitin; Velazquez-Ramirez, Gabriela; Edwards, Matthew S; Corriere, Matthew A

2017-10-01

Outcome disparities associated with lower extremity bypass (LEB) for peripheral artery disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative data sets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors. Consecutive patients undergoing autogenous LEB for PAD were identified and analyzed. Survival analysis and Cox proportional hazards models were used to evaluate patency stratified by marital status (married versus single, divorced, or widow[er]) adjusting for demographic, comorbidity, and anatomic factors in multivariable models. Seventy-three participants who underwent 79 autogenous vein LEB had complete data and were analyzed. Forty-three patients (58.9%) were married, and 30 (41.1%) were unmarried. Compared with unmarried patients, married patients were older at the time of their bypass procedure (67.3 ± 10.8 years vs. 62.2 ± 10.6 years; P = 0.05). Married patients also had a lower prevalence of female gender (11.6% vs. 33.3%; P = 0.02). Diabetes, hypertension, hyperlipidemia, and smoking were common among both married and unmarried patients. Minimum great saphenous vein conduit diameters were larger in married versus unmarried patients (2.82 ± 0.57 mm vs. 2.52 ± 0.65 mm; P = 0.04). Twenty-four-month primary patency was 66% for married versus 38% for unmarried patients. In a multivariable proportional hazards model adjusting for proximal and distal graft inflow/outflow, medications, gender, age, race, smoking, diabetes, and minimum vein graft diameter, married status was associated with superior primary patency (hazard ratio [HR] = 0.33; 95% confidence limits [0.11, 0.99]; P = 0.05); other predictive covariates included preoperative antiplatelet therapy (HR = 0.27; 95% confidence limits [0.10, 0.74]; P = 0.01) and diabetes (HR = 2.56; 95% confidence limits [0.93-7.04]; P = 0.07). Marital status is associated with vein graft patency following LEB. Further investigation into the mechanistic explanation for improved patency among married patients may provide insight into social or behavioral factors influencing other disparities associated with LEB outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Fault and fluid systems in supra-subduction zones: The Troodos ophiolite

NASA Astrophysics Data System (ADS)

Quandt, Dennis; Micheuz, Peter; Kurz, Walter; Krenn, Kurt

2017-04-01

The Troodos massif on the island of Cyprus represents a well-preserved and complete supra-subduction zone (SSZ) ophiolite. It includes an extrusive sequence that is subdivided into Upper (UPL) and Lower Pillow Lavas (LPL). These volcanic rocks contain mineralized fractures (veins) and vesicles that record fluid availability probably related to slab dehydration and deformation subsequent to a period of subduction initiation in the framework of a SSZ setting. Here, we present electron microprobe element mappings and cathodoluminescence studies of vein minerals as well as analyses of fluid inclusions entrapped in zeolite, calcite and quartz from veins and vesicles of the Pillow Lavas of the Troodos ophiolite. Two different zeolite type assemblages, interpreted as alteration products of compositional varying volcanic glasses, occur: (1) Na-zeolites analcime and natrolite from the UPL that require lower formation temperatures, higher Na/Ca ratios and pH values than (2) Ca-zeolites heulandite and mordenite from the LPL which indicate temporal or spatial varying fluid compositions and conditions. Calcite represents a late stage phase in incompletely sealed blocky type (1) assemblage and in syntaxial quartz veins. Additionally, calcite occurs as major phase in syntaxial and blocky veins of UPL and LPL. These syntaxial quartz and calcite veins are assumed to be related to tectonic extension. Chalcedony is associated with quartz and occurs in typical veins and vesicles of the LPL. In addition, the presence of neptunian dykes in veins suggests that seawater penetrated fractures throughout the extrusive sequence. Thus, circulation in an open system via advective transport is favored while diffusion in a closed system is a subordinate, local and late stage phenomenon. Calcite veins and quartz vesicles contain primary, partly re-equilibrated two phase (liquid, vapor) fluid inclusions. The chemical system of all studied inclusions in both host minerals is restricted to aqueous chemistry with salinities below 5 mass% based on last melting of ice between -3 and -0.8° C. Homogenization around 100-200° C occurs always to the liquid phase indicative for a pressure dominated fluid origin. Well preserved zonation textures in blocky calcite veins consisting of partly decrepitated but also re-equilibrated large fluid inclusions are related to Mn-rich areas. This fluid inclusion generation shows also homogenization to the liquid phase and points to minimum temperature conditions for formation of Mn-enriched areas of about 220° C. Calcite microstructures within the veins are characterized by type I and II twins as well as undulatory extinction and subgrain boundaries indicative for deformation temperatures of approximately 200-250° C, with differential stresses of about 50 MPa. We acknowledge financial support by the Austrian Research Fund (P27982-N29) to W. Kurz

Cretaceous joints in southeastern Canada: dating calcite-filled fractures

NASA Astrophysics Data System (ADS)

Schneider, David; Spalding, Jennifer; Gautheron, Cécile; Sarda, Philippe; Davis, Donald; Petts, Duane

2017-04-01

To resolve the timing of brittle tectonism is a challenge since the classical chronometers required for analyses are not often in equilibrium with the surrounding material or simply absent. In this study, we propose to couple LA-ICP-MS U-Pb and (U-Th)/He dating with geochemical proxies in vein calcite to tackle this dilemma. We examined intracratonic Middle Ordovician limestone bedrock that overlies Mesoproterozoic crystalline basement, which are cut by NE-trending fault zones that have historic M4-5 earthquakes along their trace. E-W to NE-SW vertical joint sets, the relatively youngest stress recorded in the bedrock, possess 1-7 mm thick calcite veins that seal fractures or coat fracture surfaces. The veins possess intragranular calcite that are lined with fine-grained calcite along the vein margin and can exhibit µm- to mm-scale offset (e.g. displaced fossil fragments in host rock). Calcite d18O and d13C values are analogous to the bulk composition of Middle to Late Ordovician limestones, and suggest vein formation from a source dominated by connate fluids. The calcite contain trails of fluid inclusions commonly along fractures, and 3He/4He analyses indicate a primitive, deep fluid signature (R/Ra: 0.5-2.7). Trace element geochemistry of the calcite is highly variable, generally following the elevated HREE and lower LREE of continental crust trends but individual crystals from a single vein may vary by three orders of magnitude. LA-ICP-MS geochemical traverse across veins show elevated concentrations along (sub)grain boundaries and the vein-host rock contact. Despite abundant helium concentrations, (U-Th)/He dating was unsuccessful yielding highly dispersed dates likely from excess helium derived from the fluid inclusions. However, LA-ICP-MS U-Pb dating on calcite separated from the veins yielded model ages of 110.7 ± 6.8 Ma (MSWD: 0.53; n: 16) to 81.4 ± 8.3 Ma (MSWD: 2.6; n: 17). Since all veins are from the same ENE-trend, we regressed all the calcite dates together, yielding an age of 101 ± 6 Ma (MSWD: 2.3). These veins are 200 km to the west and slightly younger than the c. 140-120 Ma alkaline igneous rocks which mark the surface trace of the Great Meteor Hotspot. The period of 110-90 Ma has been identified as a time of major plate reorganization that involved tectonic and magmatic events, which may be reflected in our new calcite dates. Nonetheless, LA-ICP-MS U-Pb dating of vein calcite was successful, and coupled with other geochemical information, can yield primary information about the timing and source of fluid flow through joints and fractures, which has direct applications to reducing risk associated with characterizing hydrocarbon reservoirs and deep geological repositories for nuclear waste.

Colonic, ureteral, and vascular injuries secondary to stick impalement in a dog.

PubMed

Menard, Julie; Schoeffler, Gretchen L

2011-08-01

To report the surgical repair, case management, and outcome of a dog with sepsis and severe intraabdominal trauma secondary to a penetrating stick injury. A 1.5-year-old, spayed female, mixed-breed dog was presented to the emergency service after incurring a small laceration on the medial aspect of the left pelvic limb while running in the woods. The wound was surgically explored and a primary closure achieved. The patient was discharged the same day with oral antimicrobial therapy. The following morning the dog was represented to the emergency service for acute vomiting. Abdominal radiographs were performed and demonstrated loss of serosal detail and pneumoperitoneum. An emergency celiotomy was performed and revealed distal colonic perforation, left ureteral laceration, and lacerations of the left common iliac vein. Ureteronephrectomy, as well as primary closure of the distal colonic perforation and left common iliac vein lacerations, were performed. The patient recovered and was ultimately discharged from the hospital 5 days later. Follow-up 1 year later revealed no significant physical exam or biochemical abnormalities. A seemingly benign penetrating stick injury initially deemed to be superficial in nature was later demonstrated to have resulted in sepsis following severe intraabdominal trauma that included lacerations of the distal colon, left ureter, and left common iliac vein in a dog. Successful surgical management and intensive care led to a full recovery without any residual impairment noted a year later. © Veterinary Emergency and Critical Care Society 2011.

Basilic vein transposition fistulas versus prosthetic bridge grafts in patients with end-stage renal failure.

PubMed

Basel, Halil; Ekim, Hasan; Odabasi, Dolunay; Kiymaz, Adem; Aydin, Cemalettin; Dostbil, Aysenur

2011-07-01

Basilic vein transposition fistulas (BVTFs) and prosthetic bridge grafts (PBGs) provide good vascular access for hemodialysis. To evaluate the patency and complication rates after arteriovenous fistula formation, a concurrent series of patients was reviewed. Between September 2003 and September 2009, 147 hemodialysis access procedures were performed in 147 consecutive patients at Van Research and Training Hospital and Yuzuncu Yil University Hospital, Van, Turkey. All access procedures were planned on the basis of preoperative duplex scans of arm and forearm veins. Functional patency was defined as the ability to cannulate hemodialysis patients successfully. Primary and secondary cumulative functional patency rates of BVTFs and PBGs were determined with life-table analysis and differences were analyzed with retrospective study. Differences in revision rates, including thrombolysis thrombectomies and operative revisions, were analyzed with the Fisher exact t-test. Mean follow-up was 15 months (range, 3-24 months). Risk factors were similar between the two groups. BVTFs had better patency at 15 months. The dialysis access complications were higher in the PBG group versus BVTF group, and the PBG group had a higher infection rate than the BVTF group. The primary and secondary patency rates were superior in the BVTF group. Our data strongly support the contention that as long as the patient is a candidate for an upper arm BVTF based on anatomical criteria, BVTF always be considered before a PBG. Copyright © 2011. Published by Elsevier Inc.

Origin of cone-in-cone calcite veins during calcitization of dolomites and their subsequent diagenesis: A case study from the Gogolin Formation (Middle Triassic), SW Poland

NASA Astrophysics Data System (ADS)

Kowal-Linka, Monika

2010-03-01

Although bedding-parallel cone-in-cone structure calcite veins are present in the Middle Triassic Gogolin Formation in Opole Silesia, their occurrence is limited to the Emilówka Cellular Limestone Member. Marly limestones (dedolomites) consisting of calcite pseudospar are the host rocks. The veins, which are up to 3 mm high and 30 cm long, are built of densely packed cone columns, with individual cones up to 0.7 mm high and 0.6 mm wide at their bases, and with vertex angle values ranging from 30° to 50°. The cones are microfractured, and the adjacent cones are vertically shifted in oblique planes. The exceptionally small veins consist of calcite fibres up to 0.15 mm high. The veins are built of low-magnesium and non-ferroan calcite, characterized by low δ 18O values ranging from - 6.8‰ to - 7.4‰, and low δ 13C values ranging from - 2.9‰ to - 4.5‰ vs. PDB. These isotopic values are similar to those obtained from the host rocks (δ 18O from - 6.8‰ to - 7.4‰, and δ 13C from - 3.2‰ to - 3.6‰ vs. PDB) and they are strongly depleted in comparison with the isotopic values of other carbonate particles from the Gogolin Formation. The veins only formed in one lithostratigraphic member, suggesting that their origin is related to processes which acted only locally. There are two unique processes that the Emilówka Cellular Limestone Member alone in the Gogolin Formation underwent: early diagenetic evaporitic dolomitization of lime mud in the sabkha environment, and subsequent calcitization of dolomite. Dolomitization led to sediment cohesion loss, porosity increase and initial horizontal laminae separation as a result of the transformation of calcium carbonate to dolomite within anisotropic deposits. Similar values of geochemical parameters obtained from the vein calcite and the host rock calcite are evidence that vein-filling precipitation was contemporary with dedolomitization. Geochemical data combined with sedimentological research and burial history show meteoric-derived waters saturated with respect to calcite as a source of the vein calcite. Dedolomitization and vein precipitation may have taken place from the Norian/Early Jurassic to the Late Jurassic when the study area became eroded land, and the Emilówka Cellular Limestone Member may have acted as a local paleoaquifer conducting the meteoric-derived waters. Solid inclusions in the veins, detached from the host rock and the calcitized nodules, show that the force of calcite crystallization was the main factor responsible for vein widening. Vertical shifts of adjacent cones, remnants of primary fibrous calcite crystals, as well as the burial history justify the application of Tarr's theory in interpreting the origin of the secondary cone-in-cone structure within the fibrous structure veins. The timing and the particular conditions required for the cones to develop are uncertain.

Fluid inclusion studies on the mineralized quartz-rich hydrothermal breccias and quartz veins of the Kay Tanda epithermal gold deposit, Lobo, Batangas, Philippines

NASA Astrophysics Data System (ADS)

Frias, S. M. P.; Takahashi, R.; Imai, A.; Blamey, N.

2017-12-01

The Kay Tanda epithermal deposit in Lobo, Batangas, Philippines is mainly hosted in quartz-rich hydrothermal breccia and quartz veins. These contain varying gold grades with some reaching bonanza gold grades as high as 200 ppm Au. They also contain varying amounts of base metal sulfides such as sphalerite, galena, chalcopyrite and pyrite whose abundances increase with depth. Petrographic analysis of the samples revealed different quartz textures such as colloform textures in quartz veins at shallow levels and feathery, flamboyant and mosaic textures in the matrix of hydrothermal breccias at deeper levels. These textures are indicative of boiling conditions. To elucidate the fluid conditions, fluid source, composition and processes during the formation of the deposit, fluid inclusion microthermometry, quantitative fluid inclusion gas analysis and laser Raman spectroscopy were conducted. Doubly polished thin wafers prepared from the quartz veins and quartz crystals in the matrix of hydrothermal breccias. Microthermometric analysis of primary fluid inclusions included measurements of the freezing temperature Tf, the temperature of ice melting Tm, and the homogenization temperature of the fluid phase by disappearance of vapor Th. Liquid-to-vapor (L-V) ratios are variable, thus, liquid-rich liquid-vapor inclusions and vapor-rich liquid-vapor inclusions coexist in some samples. The sizes of the primary fluid inclusions may reach 100 micrometers. The homogenization temperatures range 200 °C to 380 °C, with the mode around 250 °C to 280 °C. Salinities range from 2 to 7 wt% NaCl equivalent, with the mode around 4 to 5 wt% NaCl equivalent. Trends of the distribution of fluid inclusion populations based on their homogenization temperature and salinity suggest boiling which is consistent with the variable liquid to vapor ratios, i.e. coexistence of liquid-rich inclusions and vapor-rich inclusions.

Lead isotope compositions as guides to early gold mineralization: The North Amethyst vein system, Creede district, Colorado

USGS Publications Warehouse

Foley, Nora K.; Ayuso, Robert A.

1994-01-01

Pb isotope compositions from the late stage of the North Amethyst vein system and from the Bondholder and central and southern Creede mining districts are more radiogenic than the host volcanic rocks of the central cluster of the San Juan volcanic field. Our Pb isotope results indicate that early Au mineralization of the North Amethyst area may represent the product of an older and relatively local hydrothermal system distinct from that of the younger base metal and Ag mineralization found throughout the region. Fluids that deposited Au minerals may have derived their Pb isotope composition by a greater degree of interaction with shallow, relatively less radiogenic volcanic wall rocks. The younger, base metal and Ag-rich mineralization that overprints the Au mineralization in the North Amethyst area clearly has a more radiogenic isotopic signature, which implies that the later mineralization derived a greater component of its Pb from Proterozoic source rocks, or sediments derived from them.Paragenetically early sulfide-rich vein assemblages have the least radiogenic galenas and generally also have the highest Au contents. Thus, identification of paragenetically early vein assemblages with relatively unradiogenic Pb isotope compositions similar to those of the North Amethyst area provides an additional exploration tool for Au in the central San Juan Mountains area.

Direct implantation of scimitar vein to the left atrium via sternotomy: a reappraisal.

PubMed

Jensen, Hanna; Muthialu, Nagarajan; Furci, Barbara; Yates, Robert; Kostolny, Martin; Tsang, Victor

2014-06-01

There is no consensus about optimal surgical technique for the repair of scimitar vein, an anomalous right pulmonary venous connection to the inferior vena cava. Our current experience with a direct anastomosis of the scimitar vein to the left atrium via sternotomy may be shared with other centres, but has not been widely published. Six consecutive patients (age 6 months to 17 years, mean 5 years) operated on in 2009-12 were retrospectively reviewed. Through median sternotomy and with cardiopulmonary bypass, the mobilized anomalous right pulmonary vein was brought through a large pericardial opening posterior to the right phrenic nerve and anastomosed onto the right side of the posterior left atrium with access via an existing or a surgically created atrial septal defect. Five patients had primary venous repair and one had a previous failed repair using an intra-atrial baffle. The median cardiopulmonary bypass and cross-clamp times were 88 and 38 min, respectively. The median ventilator time was 1 day and the median stay at the intensive care unit 3.5 days. There were no deaths within a median follow-up of 28 months (range 8-41 months), nor reoperations or instances of pulmonary venous obstruction. Anatomic repair of the scimitar vein based on reimplantation onto the left atrium via sternotomy is conceptually appealing. The surgery results in a safe and reliable repair in patients with a wide age spectrum. Durability needs on-going assessment in longer-term follow-up. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

PubMed

Le, Trong Binh; Lee, Taeg Ki; Park, Keun-Myoung; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu

2018-04-25

To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P < .001). The primary patency rate of the contralateral CIV stent was 70% at 20 months. Contralateral DVT after CIV stent implantation has a relatively high incidence and often occurs late during follow-up. Overextension of the CIV stent to the IVC is associated with development of contralateral DVT, and VIH should be considered a potential cause. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

Primary intraosseous fibrosarcoma in a cat.

PubMed

Levitt, L; Doige, C E

1989-06-01

A primary intraosseous fibrosarcoma was diagnosed in a 1.5-year-old cat. Clinical signs included nonweight-bearing lameness of the right forelimb and signs of pain on palpation of the right elbow. Radiography of the right elbow revealed a well-circumscribed osteolytic lesion of the olecranon. The right fore-limb was amputated, and histologic examination revealed tumor invasion into local veins and metastasis to the axillary lymph nodes. The cat had no signs of tumor redevelopment or pulmonary metastatic disease one year after amputation.

A Constrained Maximization Model for inspecting the impact of leaf shape on optimal leaf size and stoma resistance

NASA Astrophysics Data System (ADS)

Ding, J.; Johnson, E. A.; Martin, Y. E.

2017-12-01

Leaf is the basic production unit of plants. Water is the most critical resource of plants. Its availability controls primary productivity of plants by affecting leaf carbon budget. To avoid the damage of cavitation from lowering vein water potential t caused by evapotranspiration, the leaf must increase the stomatal resistance to reduce evapotranspiration rate. This comes at the cost of reduced carbon fixing rate as increasing stoma resistance meanwhile slows carbon intake rate. Studies suggest that stoma will operate at an optimal resistance to maximize the carbon gain with respect to water. Different plant species have different leaf shapes, a genetically determined trait. Further, on the same plant leaf size can vary many times in size that is related to soil moisture, an indicator of water availability. According to metabolic scaling theory, increasing leaf size will increase total xylem resistance of vein, which may also constrain leaf carbon budget. We present a Constrained Maximization Model of leaf (leaf CMM) that incorporates metabolic theory into the coupling of evapotranspiration and carbon fixation to examine how leaf size, stoma resistance and maximum net leaf primary productivity change with petiole xylem water potential. The model connects vein network structure to leaf shape and use the difference between petiole xylem water potential and the critical minor vein cavitation forming water potential as the budget. The CMM shows that both maximum net leaf primary production and optimal leaf size increase with petiole xylem water potential while optimal stoma resistance decreases. Narrow leaf has overall lower optimal leaf size and maximum net leaf carbon gain and higher optimal stoma resistance than those of broad leaf. This is because with small width to length ratio, total xylem resistance increases faster with leaf size. Total xylem resistance of narrow leaf increases faster with leaf size causing higher average and marginal cost of xylem water potential with respect to net leaf carbon gain. With same leaf area, total xylem resistance of narrow leaf is higher than broad leaf. Given same stoma resistance and petiole water potential, narrow leaf will lose more xylem water potential than broad leaf. Consequently, narrow leaf has smaller size and higher stoma resistance at optimum.

Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

PubMed

McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

2013-04-01

Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08). The DVA group had a higher rate of completion angiogram performed (55.7% vs 37.5%; P =.002) and were more likely to be discharged on coumadin (53.4% vs 37.1%; P =.01). By multivariable analysis, use of a distal DVA was protective against MALEs (hazard ratio, 0.36; 95% confidence interval, 0.14-0.90; P = .03). This contemporary multi-institutional propensity-matched study demonstrates that patients that receive distal anastomotic vein adjuncts as part of infrainguinal prosthetic bypass operations in general have more extreme comorbidities and more technically challenging operations based on level of target vessel and prior bypass attempts. After propensity-matched analysis, the use of a DVA may protect against MALEs in prosthetic bypass surgery and should be considered when feasible. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

8D.04: CLINICAL BENEFITS OF ADMINISTERING SUPER-SELECTIVE SEGMENTAL ADRENAL VENOUS SAMPLING AND PERFORMING ADRENAL SPARING SURGERY IN THE PATIENTS WITH PRIMARY ALDOSTERONISM.

PubMed

Satoh, F; Morimoto, R; Ono, Y; Iwakura, Y; Omata, K; Kudo, M; Satani, N; Ota, H; Seiji, K; Takase, K; Nakamura, Y; Sasano, H; Ito, S

2015-06-01

Adrenal venous sampling (AVS) has been well known to play pivotal roles in clinical differential diagnosis of unilateral aldosterone producing adenoma (APA) from bilateral idiopathic hyperaldosteronism (IHA). However, it is also true that a central vein AVS or c-AVS which collects the blood from right and left central adrenal veins can by no means discriminate bilateral APA from BHA. There have been no published studies reporting the reliable clinical differential diagnosis between bilateral APA and IHA, especially IHA cases with bilateral non-functioning adenomas (NFA), which has been considered practically impossible in clinical differential diagnosis. As an attempt to this clinical dilemma, segmental AVS (S-AVS), which could evaluate segmental effluents from adrenal tributary veins, has been recently developed. We have performed S-AVS in these patients above following C-AVS, via the insertion of a microcatheter in up to three intra-adrenal first-degree tributary veins on bilateral adrenals. S-AVS did enable us to evaluate the intra-adrenal localization of corticosteroidogenesis. These data did indicate that S-AVS should be performed in the PA patients who had increased aldosterone levels in bilateral central vein and demonstrated space occupying lesions in the bilateral adrenals in order to avoid bilateral adrenalectomy or long lasting medical treatment toward persistent PA. In addition to the situations above, we have administere S-AVS to the following patients; those who had clinically suspected APA but not sufficiently high lateralization indexes according to the results of C-AVS, very young ones with higher clinical probability of recurrence and those who could benefit from partial adrenalectomy by demonstrating the sites of specific steroidogenesis. However, it is also entirely true that S-AVS is more expensive, time-consuming and labor-intensive compared to C-AVS.(Figure is included in full-text article.)The angiography during S-AVS (A, B), the coronal CT image (C), and the data in external iliac vein (EIV), each central vein (1, 4) and each tributary vein (2, 3, 5, 6) of 66 year-old male patient with bilateral APAs. We should carefully select the candidate patients who should undergo S-AVS, which will give a benefit to themselves by demonstrating intra-adrenal steroidogenesis for a safer preserving adrenalectomy.

Exploring Turkish Mathematics Teachers' Content Knowledge of Quadrilaterals

ERIC Educational Resources Information Center

Butuner, Suphi Onder; Filiz, Mehmet

2017-01-01

The aim of this research was to examine mathematics teachers' performances in defining special types of quadrilaterals, identifying their family and hierarchically classifying them. In this vein, 33 of 58 primary school mathematics teachers working in the province of Yozgat, Turkey were voluntarily recruited for this survey, and they were asked to…

Relationship between the Porco, Bolivia, Ag-Zn-Pb-Sn deposit and the Porco Caldera

USGS Publications Warehouse

Cunningham, C.G.

1994-01-01

The Porco Ag-Zn-Pb-Sn deposit, a major Ag producer in the 16th century and currently the major Zn producer in Bolivia, consists of a swarm of fissure-filling veins in the newly recognized Porco caldera. The caldera measures 5 km by 3 km and formed in response to the eruption of the 12 Ma crystal-rich dacitic Porco Tuff. The mineralization is associated with, and is probably genetically related to, the 8.6 Ma Huayna Porco stock. The Porco deposit consists of steeply dipping irregular and curvilinear veins that cut the intracaldera Porco Tuff about 1 km east of the Huayna Porco stock. Most of the veins are aligned along the structural margin (ring fracture) of the caldera. The ore deposit is zoned around the Huayna Porco stock. The primary Ag minerals are most abundant in the upper parts of the viens. Fluid inclusions in sphalerite stalactites have homogenization temperatures of about 225??C and salinities of about 8 wt% NaCl equiv. The stalactites and the presence of sparse vapor-rich inclusions suggest deposition of sphalerite under boiling conditions. -from Authors

Insulin Restores Gestational Diabetes Mellitus–Reduced Adenosine Transport Involving Differential Expression of Insulin Receptor Isoforms in Human Umbilical Vein Endothelium

PubMed Central

Westermeier, Francisco; Salomón, Carlos; González, Marcelo; Puebla, Carlos; Guzmán-Gutiérrez, Enrique; Cifuentes, Fredi; Leiva, Andrea; Casanello, Paola; Sobrevia, Luis

2011-01-01

OBJECTIVE To determine whether insulin reverses gestational diabetes mellitus (GDM)–reduced expression and activity of human equilibrative nucleoside transporters 1 (hENT1) in human umbilical vein endothelium cells (HUVECs). RESEARCH DESIGN AND METHODS Primary cultured HUVECs from full-term normal (n = 44) and diet-treated GDM (n = 44) pregnancies were used. Insulin effect was assayed on hENT1 expression (protein, mRNA, SLC29A1 promoter activity) and activity (initial rates of adenosine transport) as well as endothelial nitric oxide (NO) synthase activity (serine1177 phosphorylation, l-citrulline formation). Adenosine concentration in culture medium and umbilical vein blood (high-performance liquid chromatography) as well as insulin receptor A and B expression (quantitative PCR) were determined. Reactivity of umbilical vein rings to adenosine and insulin was assayed by wire myography. Experiments were in the absence or presence of l-NG-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) or ZM-241385 (an A2A-adenosine receptor antagonist). RESULTS Umbilical vein blood adenosine concentration was higher, and the adenosine- and insulin-induced NO/endothelium-dependent umbilical vein relaxation was lower in GDM. Cells from GDM exhibited increased insulin receptor A isoform expression in addition to the reported NO–dependent inhibition of hENT1-adenosine transport and SLC29A1 reporter repression, and increased extracellular concentration of adenosine and NO synthase activity. Insulin reversed all these parameters to values in normal pregnancies, an effect blocked by ZM-241385 and l-NAME. CONCLUSIONS GDM and normal pregnancy HUVEC phenotypes are differentially responsive to insulin, a phenomenon where insulin acts as protecting factor for endothelial dysfunction characteristic of this syndrome. Abnormal adenosine plasma levels, and potentially A2A-adenosine receptors and insulin receptor A, will play crucial roles in this phenomenon in GDM. PMID:21515851

Achondroplasia in children: correlation of ventriculomegaly, size of foramen magnum and jugular foramina, and emissary vein enlargement.

PubMed

Bosemani, Thangamadhan; Orman, Gunes; Hergan, Benedikt; Carson, Kathryn A; Huisman, Thierry A G M; Poretti, Andrea

2015-01-01

Achondroplasia is a skeletal dysplasia with diminished growth of the skull base secondary to defective enchondral bone formation. This leads to narrowing of the foramen magnum and jugular foramina, which further leads to ventricular dilatation and prominence of the emissary veins. The primary goal of our study was to determine a correlation between the degree of ventricular dilatation, jugular foramina and foramen magnum narrowing, as well as emissary vein enlargement. Conventional T2-weighted MR images were evaluated for surface area of the foramen magnum and jugular foramina, ventricular dilatation, and emissary veins enlargement in 16 achondroplasia patients and 16 age-matched controls. Ratios were calculated for the individual parameters using median values from age-matched control groups to avoid age as a confounder. Compared to age-matched controls, in children with achondroplasia, the surface area of the foramen magnum (median 0.50 cm(2), range 0.23-1.37 cm(2) vs. 3.14 cm(2), 1.83-6.68 cm(2), p < 0.001) and jugular foramina (median 0.02 cm(2), range 0-0.10 cm(2) vs. 0.21 cm(2), 0.03-0.61 cm(2), p < 0.001) were smaller, whereas ventricular dilatation (0.28, 0.24-0.4 vs. 0.26, 0.21-0.28, p < 0.001) and enlargement of emissary veins (6, 0-11 vs. 0, p < 0.001) were higher. Amongst the patients, Spearman correlation and multiple regression analysis did not reveal correlation for severity between the individual parameters. Our study suggests that in children with achondroplasia, (1) the variation in ventricular dilatation may be related to an unquantifiable interdependent relationship of emissary vein enlargement, venous channel narrowing, and foramen magnum compression and (2) stable ventricular size facilitated by interdependent factors likely obviates the need for ventricular shunt placement.

Hydrous metasomatism of oceanic sub-arc mantle, Lihir, Papua New Guinea. Part 2. Trace element characteristics of slab-derived fluids

NASA Astrophysics Data System (ADS)

Grégoire, Michel; McInnes, Brent I. A.; O'Reilly, Suzanne Y.

2001-11-01

Spinel peridotite xenoliths recovered from the Tubaf and Edison volcanoes, south of Lihir Island in the Tabar-Lihir-Tanga-Feni island arc in Papua New Guinea, are predominantly fresh, refractory harzburgites. Many of the harzburgite xenoliths have cross-cutting vein networks and show evidence of modal metasomatism. These metasomatic veins contain a secondary mineral assemblage consisting of fibrous, radiating orthopyroxene and fine-grained Fe-Ni sulfide with minor olivine, clinopyroxene, phlogopite, amphibole and magnetite. Adjacent to the veins, primary clinopyroxene is cloudy while orthopyroxene exhibits replacement by secondary fibrous orthopyroxene, similar in habit to orthopyroxene occurring in the veins. The mineralogical and geochemical characteristics of the Tubaf mantle xenoliths are the product of two major processes: an early partial melting depletion event that was overprinted by oxidation and alkali enrichment related to percolation of slab-derived, hydrous melts. HREE and MREE concentrations in clinopyroxene from the least metasomatised harzburgites indicate that they are the residues from a 15% to 25% partial melting event, consistent with formation in a MOR setting. The secondary vein assemblages show strong enrichment in the LILE (primarily Sr, Ba, Rb, Th, U and Pb) and the REE (primarily La, Ce, Nd, Sm, Eu and Gd), while the HFSE (Nb, Ta, Zr, Hf, and Ti) are neither enriched nor depleted. The mineral precipitates in the vein assemblages have high LREE/HFSE and LILE/HFSE, and reflect the relative solubility of these elements in hydrous melts. These trace element characteristics are similar to those of the Tabar-Lihir-Tanga-Feni arc lavas, and display the commonly observed HFSE depletion of arc magmatism. These findings support the hypothesis that this so-called "arc signature" is primarily dependent on the relative solubility of elements in slab-derived, hydrous melts, and the enrichment of these soluble elements in metasomatised mantle regions that are prone to preferential partial melting.

Splanchnic vein thrombosis in myeloproliferative neoplasms: risk factors for recurrences in a cohort of 181 patients

PubMed Central

De Stefano, V; Vannucchi, A M; Ruggeri, M; Cervantes, F; Alvarez-Larrán, A; Iurlo, A; Randi, M L; Pieri, L; Rossi, E; Guglielmelli, P; Betti, S; Elli, E; Finazzi, M C; Finazzi, G; Zetterberg, E; Vianelli, N; Gaidano, G; Nichele, I; Cattaneo, D; Palova, M; Ellis, M H; Cacciola, E; Tieghi, A; Hernandez-Boluda, J C; Pungolino, E; Specchia, G; Rapezzi, D; Forcina, A; Musolino, C; Carobbio, A; Griesshammer, M; Barbui, T

2016-01-01

We retrospectively studied 181 patients with polycythaemia vera (n=67), essential thrombocythaemia (n=67) or primary myelofibrosis (n=47), who presented a first episode of splanchnic vein thrombosis (SVT). Budd–Chiari syndrome (BCS) and portal vein thrombosis were diagnosed in 31 (17.1%) and 109 (60.3%) patients, respectively; isolated thrombosis of the mesenteric or splenic veins was detected in 18 and 23 cases, respectively. After this index event, the patients were followed for 735 patient years (pt-years) and experienced 31 recurrences corresponding to an incidence rate of 4.2 per 100 pt-years. Factors associated with a significantly higher risk of recurrence were BCS (hazard ratio (HR): 3.03), history of previous thrombosis (HR: 3.62), splenomegaly (HR: 2.66) and leukocytosis (HR: 2.8). Vitamin K-antagonists (VKA) were prescribed in 85% of patients and the recurrence rate was 3.9 per 100 pt-years, whereas in the small fraction (15%) not receiving VKA more recurrences (7.2 per 100 pt-years) were reported. Intracranial and extracranial major bleeding was recorded mainly in patients on VKA and the corresponding rate was 2.0 per 100 pt-years. In conclusion, despite anticoagulation treatment, the recurrence rate after SVT in myeloproliferative neoplasms is high and suggests the exploration of new avenues of secondary prophylaxis with new antithrombotic drugs and JAK-2 inhibitors. PMID:27813534

Effect of lipophilicity on in vivo iontophoretic delivery. II. Beta-blockers.

PubMed

Tashiro, Y; Sami, M; Shichibe, S; Kato, Y; Hayakawa, E; Itoh, K

2001-06-01

The objective of this study was to investigate the relationship between drug lipophilicity and the transdermal absorption processes in the iontophoretic delivery in vivo. Anodal iontophoresis of beta-blockers as model drugs having different lipophilicity (atenolol, pindolol, metoprolol, acebutolol, oxprenolol and propranolol) was performed with rats (electrical current, 0.625 mA/cm2; application period, 90 min), and the drug concentrations in skin, cutaneous vein and systemic vein were determined. Increasing the lipophilicity of beta-blockers caused a greater absorption into the skin. Exceptionally, it was found that pindolol had high skin absorption, irrespective of its hydrophilic nature. Further, the drug transfer rate from skin to cutaneous vein (R(SC)) was evaluated from the arterio-venous plasma concentration difference of drug in the skin. Normalized R(SC) by skin concentration showed a negative correlation with the logarithm of n-octanol/buffer partition coefficient (Log P, pH 7.4), suggesting the partitioning between stratum corneum and viable epidermis was a primary process to determine the transfer properties of beta-blockers to local blood circulation. Pindolol exhibited both high skin absorption and high transfer from skin to cutaneous vein. These characteristics of pindolol could be explained by the chemical structure, molecular size and hydrophilicity. These findings for pindolol should be valuable for the optimal design of drug candidates for iontophoretic transdermal delivery.

[Cost-effectiveness of the deep vein thrombosis diagnosis process in primary care].

PubMed

Fuentes Camps, Eva; Luis del Val García, José; Bellmunt Montoya, Sergi; Hmimina Hmimina, Sara; Gómez Jabalera, Efren; Muñoz Pérez, Miguel Ángel

2016-04-01

To analyse the cost effectiveness of the application of diagnostic algorithms in patients with a first episode of suspected deep vein thrombosis (DVT) in Primary Care compared with systematic referral to specialised centres. Observational, cross-sectional, analytical study. Patients from hospital emergency rooms referred from Primary Care to complete clinical evaluation and diagnosis. A total of 138 patients with symptoms of a first episode of DVT were recruited; 22 were excluded (no Primary Care report, symptoms for more than 30 days, anticoagulant treatment, and previous DVT). Of the 116 patients finally included, 61% women and the mean age was 71 years. Variables from the Wells and Oudega clinical probability scales, D-dimer (portable and hospital), Doppler ultrasound, and direct costs generated by the three algorithms analysed: all patients were referred systematically, referral according to Wells and Oudega scale. DVT was confirmed in 18.9%. The two clinical probability scales showed a sensitivity of 100% (95% CI: 85.1 to 100) and a specificity of about 40%. With the application of the scales, one third of all referrals to hospital emergency rooms could have been avoided (P<.001). The diagnostic cost could have been reduced by € 8,620 according to Oudega and € 9,741 according to Wells, per 100 patients visited. The application of diagnostic algorithms when a DVT is suspected could lead to better diagnostic management by physicians, and a more cost effective process. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

PubMed

Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

2016-01-01

The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

[Effects of HOXB2 antisense oligodeoxynucleotides on the biological properties of primary human umbilical vein endothelial cells].

PubMed

Zhang, Xiaoqi; Liu, Xusheng

2002-07-01

To explore the effects of HOXB2 antisense oligodeoxynuc leotides (Asodn) on the biological properties of primary human umbilical vein endothelial cells (ECs). Fluorescent labelled Asodn was transfected into the endothelial cells of human unbilical vein mediated liposome and its distribution within endothelia was observed. (3)H-TdR incorporation test was employed to determine its effects on the DNA synthesis. Flow cytometry was applied to determine the change of the cell cycle. In the same time, RT-PCR was adopted to study the influence of Asodn on the expression of target genes. Fifteen minutes after the transfection, weak nucleic staining was observed. The fluorescent staining was the strongest 4 approximately 8 hours after the transfection and began to weaken in 16 hours. The proportion of cells in G1/0 phase in Asodn group was 53.4 +/- 3.1, significantly higher than that in control group (35.8 +/- 7.3, P < 0.01), and the proportion of cells in S phase in Asodn group was 42.2 +/- 3.5, significantly lower than that in control group (60.8 +/- 6.2, P < 0.01). The expression of HOXB2 mRNA was remarkably decreased during 24 to 48 hours. HOXB2 Asodn exerts inhibitory effects on EC proliferation dose-dependently, delays the conversion of G1 phase to S Phase, and inhibits the expression of HOXB2 mRNA. HOXB2 gene plays an important role in proliferation of endothelial cells and the mechanism is related to cell cycle.

Dependence of diameters and oxygen saturation of retinal vessels on visual field damage and age in primary open-angle glaucoma.

PubMed

Ramm, Lisa; Jentsch, Susanne; Peters, Sven; Sauer, Lydia; Augsten, Regine; Hammer, Martin

2016-05-01

To investigate the interrelationship between the oxygen supply of the retina and its regulation with the severity of primary open-angle glaucoma (POAG). Central retinal artery (CRAE) and vein (CRVE) diameters and oxygen saturation of peripapillary retinal vessels in 41 patients suffering from POAG (64.1 ± 12.9 years) and 40 healthy volunteers (63.6 ± 14.1 years) were measured using the retinal vessel analyzer. All measures were taken before and during flicker light stimulation. The mean retinal nerve fiber layer thickness (RNFLT) was determined by OCT and the visual field mean defect (MD) was identified using perimetry. In glaucoma patients, CRAE (r = -0.48 p = 0.002) and CRVE (r = -0.394 p = 0.014) at baseline were inversely related to MD, while arterial and venous oxygen saturation showed no significant dependence on the severity of the damage. However, the flicker light-induced change in arterio-venous difference in oxygen saturation was correlated with the MD (r = 0.358 p = 0.027). The diameters of arteries and veins at baseline decreased with reduction of the mean RNFLT (arteries: r = 0.718 p < 0.001; veins: r = 0.685 p < 0.001). Vessel diameters showed a strong correlation with RNFLT and MD. This, as well as the reduction of stimulation-induced change in arterio-venous oxygen saturation difference with visual field loss, may be explained by a reduction of the retinal metabolic demand with progressive loss of neuronal tissue in glaucoma. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience.

PubMed

Teng, J; Hutchinson, M E; Doery, J C G; Choy, K W; Chong, W; Fuller, P J; Yang, J

2015-11-01

Adrenal vein sampling (AVS) is useful for distinguishing unilateral versus bilateral hypersecretion in primary aldosteronism (PA), but is technically challenging. Furthermore, the use of adrenocorticotropic hormone (ACTH)-stimulation in AVS is controversial. We implemented a Monash Health-specific AVS protocol in 2010. The audit aimed to: (i) examine the impact of a dedicated protocol on success rates of AVS at a tertiary referral centre; (ii) evaluate the impact of AVS on sub-typing of PA; and (iii) assess the utility of ACTH stimulation in AVS. AVS was performed on patients with PA confirmed by positive saline suppression testing (aldosterone level >140 pmol/L post-saline infusion), with sequential sampling of adrenal and peripheral veins, pre- and post-ACTH infusion. Patients with unilateral aldosterone-producing adenoma diagnosed on successful AVS were referred for adrenalectomy. Between 2010 and 2014 inclusive, a total of 28 AVS procedures was performed, with complete pre- and post-ACTH data for 19 procedures. Bilateral successful cannulation rates improved post-implementation of our protocol (61% vs 41%). Of the patients, 32% had discordant imaging and AVS results: four patients with unilateral adenomas did not lateralise on AVS and were managed medically; four patients with bilateral or no adenomas on imaging, lateralised on AVS and had surgery. Overall, use of ACTH did not increase successful cannulation and tended to mask lateralisation. AVS is crucial in subtype classification of PA and should be performed by a dedicated radiologist with a standardised protocol. AVS outcomes were not improved with the use of ACTH stimulation. © 2015 Royal Australasian College of Physicians.

High-Flow Vascular Malformation in the Sigmoid Mesentery Successfully Treated with a Combination of Transarterial and Transvenous Embolization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamo, Minobu, E-mail: kamomino@luke.ac.jp; Yagihashi, Kunihiro; Okamoto, Takeshi

Mesenteric high-flow vascular malformation can cause various clinical symptoms and demand specific therapeutic interventions owing to its peculiar hemodynamics. We report a case of high-flow vascular malformation in the sigmoid mesentery which presented with ischemic colitis. The main trunk of the inferior mesenteric vein was occluded. After partially effective transarterial embolization, transvenous embolization was performed using a microballoon catheter advanced to the venous component of the lesion via the marginal vein. Complete occlusion of the lesion was achieved. Combination of transarterial and transvenous embolization may allow us to apply endovascular treatment to a wider variety of high-flow lesions in themore » area and possibly avoid the bowel resection.« less

Interest of convex spherical anamorphosis in better understanding of brain AVMs' angioarchitecture.

PubMed

Clarençon, Frédéric; Maizeroi-Eugène, Franck; Maingreaud, Flavien; Bresson, Damien; Ayoub, David; Sourour, Nader-Antoine; Menjot de Champfleur, Nicolas; Chiras, Jacques; Yardin, Catherine; Mounayer, Charbel

2016-09-01

Convex spherical anamorphosis is a barrel distortion that consists of the application of a plane surface on a convex hemisphere. Applied in vascular imaging of brain arteriovenous malformations (bAVMs), this deformation may help to 'spread' the nidus and surrounding vessels (arteries/veins) and thus to differentiate the different components of bAVMs more accurately. The imaging data from 15 patients (8 male, 7 female; 14 supratentorial bAVMs, 1 infratentorial) were used to test the algorithm. The algorithm was applied to three-dimensional rotational angiography (3D-RA) volume rendering reconstructions in anteroposterior, lateral and oblique views and compared with regular 3D-RA and DSA. Arterial feeder and draining vein count and quality visualization of the main draining vein and intranidal aneurysms were compared between the three imaging techniques. Anamorphosis was able to depict more arterial feeders than 3D-RA alone (p=0.027). There was no statistically significant difference between 6 f/s DSA and anamorphosis for arterial feeder count. No difference was observed in draining vein count between the three imaging modalities. Visualization of the precise origin of the main draining vein was considered to be good in 67% of the cases with anamorphosis versus 47% and 33% for 6 f/s DSA and 3D-RA alone, respectively. Intranidal aneurysms were accurately depicted by anamorphosis (2 cases), whereas 6 f/s DSA and 3D-RA showed doubtful images in one and two additional cases, respectively, which were finally confirmed as focal venous ectasias on supraselective injection. Anamorphosis can help to visualize more precisely the main draining vein origin of the bAVM and depict more accurately intranidal aneurysms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Characterization and timing of the different types of fluids present in the barren and ore-veins of the W-Sn deposit of Panasqueira, Central Portugal

NASA Astrophysics Data System (ADS)

Noronha, F.; Doria, A.; Dubessy, J.; Charoy, B.

1992-01-01

The Panasqueira W-Sn deposit is the largest quartz-vein type deposit of the Iberian Peninsula and the most important wolframite deposit in Western Europe. The ore-veins are almost exclusively sub-horizontal. Besides ore-bearing sub-horizontal veins, the Panasqueira mine also contains barren quartz veins. There are essentially two generations of barren quartz: quartz, contemporaneous with the earliest regional metamorphism (QI), and recrystallized quartz, contemporaneous with the thermal metamorphism related to the granite intrusion (QII). Fluid inclusion studies (microthermometry and Raman) were undertaken in order to distinguish fluids contemporaneous with the barren quartz from those contemporaneous with the ore-bearing quartz (QIII). Fluid inclusion data indicate that the barren and ore-bearing quartz fluids are dominantly aqueous (93 to 98 mol% H2O), with a nearly constant bulk salinity (8 to 12 wt% eq. NaCl), with the quantity of volatile component (determined by Raman spectrometry) higher in QIII, but never greater than 5 mol%. However, the CO2/CH4 + N2 ratio is different for each type of quartz. Volatiles are dominated by CH4 (10 to 96 mol% ZCH4 and/or N2 (3 to 87 mol% ZN2) in the barren quartz and by CO2 (60 to 73 mol% ZCO2) in ore-bearing quartz. The bulk chemical composition of the fluids in QIII is comparable to that found commonly in hydrothermal fluids associated with wolframite mineralization, where Na>K>Ca and HCO3>Cl>SO4. A dispersion in TH (226 to 350 °C) found in QIII, together with a variation in the degree of filling (0.5 to 0.7) and with the consequent variation of fluid densities (0.70 to 0.79), may result from changes in the fluid pressure regime below lithostatic pressure, suggesting vein filling related to tectonic events.

A descriptive comparison of ultrasound-guided central venous cannulation of the internal jugular vein to landmark-based subclavian vein cannulation.

PubMed

Theodoro, Daniel; Bausano, Brian; Lewis, Lawrence; Evanoff, Bradley; Kollef, Marin

2010-04-01

The safest site for central venous cannulation (CVC) remains debated. Many emergency physicians (EPs) advocate the ultrasound-guided internal jugular (USIJ) approach because of data supporting its efficiency. However, a number of physicians prefer, and are most comfortable with, the subclavian (SC) vein approach. The purpose of this study was to describe adverse event rates among operators using the USIJ approach, and the landmark SC vein approach without US. This was a prospective observational trial of patients undergoing CVC of the SC or internal jugular veins in the emergency department (ED). Physicians performing the procedures did not undergo standardized training in either technique. The primary outcome was a composite of adverse events defined as hematoma, arterial cannulation, pneumothorax, and failure to cannulate. Physicians recorded the anatomical site of cannulation, US assistance, indications, and acute complications. Variables of interest were collected from the pharmacy and ED record. Physician experience was based on a self-reported survey. The authors followed outcomes of central line insertion until device removal or patient discharge. Physicians attempted 236 USIJ and 132 SC cannulations on 333 patients. The overall adverse event rate was 22% with failure to cannulate being the most common. Adverse events occurred in 19% of USIJ attempts, compared to 29% of non-US-guided SC attempts. Among highly experienced operators, CVCs placed at the SC site resulted in more adverse events than those performed using USIJ (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.05 to 3.39). While limited by observational design, our results suggest that the USIJ technique may result in fewer adverse events compared to the landmark SC approach.

Central vein sign differentiates Multiple Sclerosis from central nervous system inflammatory vasculopathies.

PubMed

Maggi, Pietro; Absinta, Martina; Grammatico, Matteo; Vuolo, Luisa; Emmi, Giacomo; Carlucci, Giovanna; Spagni, Gregorio; Barilaro, Alessandro; Repice, Anna Maria; Emmi, Lorenzo; Prisco, Domenico; Martinelli, Vittorio; Scotti, Roberta; Sadeghi, Niloufar; Perrotta, Gaetano; Sati, Pascal; Dachy, Bernard; Reich, Daniel S; Filippi, Massimo; Massacesi, Luca

2018-02-01

In multiple sclerosis (MS), magnetic resonance imaging (MRI) is a sensitive tool for detecting white matter lesions, but its diagnostic specificity is still suboptimal; ambiguous cases are frequent in clinical practice. Detection of perivenular lesions in the brain (the "central vein sign") improves the pathological specificity of MS diagnosis, but comprehensive evaluation of this MRI biomarker in MS-mimicking inflammatory and/or autoimmune diseases, such as central nervous system (CNS) inflammatory vasculopathies, is lacking. In a multicenter study, we assessed the frequency of perivenular lesions in MS versus systemic autoimmune diseases with CNS involvement and primary angiitis of the CNS (PACNS). In 31 patients with inflammatory CNS vasculopathies and 52 with relapsing-remitting MS, 3-dimensional T2*-weighted and T2-fluid-attenuated inversion recovery images were obtained during a single MRI acquisition after gadolinium injection. For each lesion, the central vein sign was evaluated according to consensus guidelines. For each patient, lesion count, volume, and brain location, as well as fulfillment of dissemination in space MRI criteria, were assessed. MS showed higher frequency of perivenular lesions (median = 88%) than did inflammatory CNS vasculopathies (14%), without overlap between groups or differences between 3T and 1.5T MRI. Among inflammatory vasculopathies, Behçet disease showed the highest median frequency of perivenular lesions (34%), followed by PACNS (14%), antiphospholipid syndromes (12%), Sjögren syndrome (11%), and systemic lupus erythematosus (0%). When a threshold of 50% perivenular lesions was applied, central vein sign discriminated MS from inflammatory vasculopathies with a diagnostic accuracy of 100%. The central vein sign differentiates inflammatory CNS vasculopathies from MS at standard clinical magnetic field strengths. Ann Neurol 2018;83:283-294. © 2018 The Authors Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.

Intra-adrenal Aldosterone Secretion: Segmental Adrenal Venous Sampling for Localization.

PubMed

Satani, Nozomi; Ota, Hideki; Seiji, Kazumasa; Morimoto, Ryo; Kudo, Masataka; Iwakura, Yoshitsugu; Ono, Yoshikiyo; Nezu, Masahiro; Omata, Kei; Ito, Sadayoshi; Satoh, Fumitoshi; Takase, Kei

2016-01-01

To use segmental adrenal venous sampling (AVS) (S-AVS) of effluent tributaries (a version of AVS that, in addition to helping identify aldosterone hypersecretion, also enables the evaluation of intra-adrenal hormone distribution) to detect and localize intra-adrenal aldosterone secretion. The institutional review board approved this study, and all patients provided informed consent. S-AVS was performed in 65 patients with primary aldosteronism (34 men; mean age, 50.9 years ± 11 [standard deviation]). A microcatheter was inserted in first-degree tributary veins. Unilateral aldosterone hypersecretion at the adrenal central vein was determined according to the lateralization index after cosyntropin stimulation. Excess aldosterone secretion at the adrenal tributary vein was considered to be present when the aldosterone/cortisol ratio from this vein exceeded that from the external iliac vein; suppressed secretion was indicated by the opposite pattern. Categoric variables were expressed as numbers and percentages; continuous variables were expressed as means ± standard errors of the mean. The AVS success rate, indicated by a selectivity index of 5 or greater, was 98% (64 of 65). The mean numbers of sampled tributaries on the left and right sides were 2.11 and 1.02, respectively. The following diagnoses were made on the basis of S-AVS results: unilateral aldosterone hypersecretion in 30 patients, bilateral hypersecretion without suppressed segments in 22 patients, and bilateral hypersecretion with at least one suppressed segment in 12 patients. None of the patients experienced severe complications. S-AVS could be used to identify heterogeneous intra-adrenal aldosterone secretion. Patients who have bilateral aldosterone-producing adenomas can be treated with adrenal-sparing surgery or other minimally invasive local therapies if any suppressed segment is identified at S-AVS. © RSNA, 2015.

Failure mode analysis in adrenal vein sampling: a single-center experience.

PubMed

Trerotola, Scott O; Asmar, Melissa; Yan, Yan; Fraker, Douglas L; Cohen, Debbie L

2014-10-01

To analyze failure modes in a high-volume adrenal vein sampling (AVS) practice in an effort to identify preventable causes of nondiagnostic sampling. A retrospective database was constructed containing 343 AVS procedures performed over a 10-year period. Each nondiagnostic AVS procedure was reviewed for failure mode and correlated with results of any repeat AVS. Data collected included selectivity index, lateralization index, adrenalectomy outcomes if performed, and details of AVS procedure. All AVS procedures were performed after cosyntropin stimulation, using sequential technique. AVS was nondiagnostic in 12 of 343 (3.5%) primary procedures and 2 secondary procedures. Failure was right-sided in 8 (57%) procedures, left-sided in 4 (29%) procedures, bilateral in 1 procedure, and neither in 1 procedure (laboratory error). Failure modes included diluted sample from correctly identified vein (n = 7 [50%]; 3 right and 4 left), vessel misidentified as adrenal vein (n = 3 [21%]; all right), failure to locate an adrenal vein (n = 2 [14%]; both right), cosyntropin stimulation failure (n = 1 [7%]; diagnostic by nonstimulated criteria), and laboratory error (n = 1 [7%]; specimen loss). A second AVS procedure was diagnostic in three of five cases (60%), and a third AVS procedure was diagnostic in one of one case (100%). Among the eight patients in whom AVS ultimately was not diagnostic, four underwent adrenalectomy based on diluted AVS samples, and one underwent adrenalectomy based on imaging; all five experienced improvement in aldosteronism. A substantial percentage of AVS failures occur on the left, all related to dilution. Even when technically nondiagnostic per strict criteria, some "failed" AVS procedures may be sufficient to guide therapy. Repeat AVS has a good yield. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

Sources and drains: Major controls of hydrothermal fluid flow in the Kokanee Range, British Columbia, Canada

NASA Astrophysics Data System (ADS)

Beaudoin, Georges; Therrien, René

1999-10-01

Vein fields are fractured domains of the lithosphere that have been infiltrated by hydrothermal fluids, which deposited minerals in response to changing physico-chemical conditions. Because oxygen is a major component of the infiltrating fluid and the surrounding rock matrix, the oxygen isotope composition of minerals found in veins is used to decipher ancient fluid flow within the lithosphere. We use a numerical model to simulate oxygen isotope transport in the Kokanee Range silver-lead-zinc vein field. The model considers advective, dispersive, and reactive transport in a three-dimensional porous rock matrix intersected by high-permeability planes representing fracture zones. Here we show that it is the geometrical configuration of the sources and of the drains of hydrothermal fluids, combined with the fracture pattern, that exerts the main control on the oxygen isotope distribution. Other factors that affect, to a lesser extent, the values and positions of oxygen isopleths are the fluids and rock-matrix isotopic compositions, the isotopic fractionation, the reaction rate constant, and hydraulic conductivities of the rock matrix and fracture zones.

Ams Fabric and Deformation of The Jawornik Granitoids In The Zloty Stok - Skrzynka Deformation Zone (sudetes, SW Poland)- Preliminary Interpretations.

NASA Astrophysics Data System (ADS)

Werner, T.; Bialek, D.

Jawornik granitoids comprise the NE-SW trending sequences of the 1cm up to 1 km thick granitoid veins surrounded by schists and gneisses of the Zloty Stok - Skrzynka deformation zone in Eastern Sudetes (SW Poland). According to conflicting theories granitoids are of magmatic origin or were formed from blastomylonitic rocks that underwent multiphase deformation. AMS studies were performed for the 53 sites lo- calized within granitoid veins and within the surrounding gneisses. AMS foliations for granitoid veins of various thickness as well as for gneisses dip at moderate to steep an- gles to N-NW. AMS lineations in the surrounding gneisses plunge subhorizontally to NE-SW that reflects the regional NE-SW shearing components. Magnetic lineations for sites within wider veins of granitoids plunge at low angles (mostly from S to W) but with more varying trends between sites. Mezoscopic tectonic foliations are record- able only in 50% of sites. They show good correlation with AMS planar fabric on the site scale. The uniformity of AMS fabric on the site scale and high AMS anisotropy within all sites (P of 1.05-1.30, T of 0.3-0.6 on average) suggest syntectonic gener- ation of granitoids. Further interpretations of the AMS and tectonic fabrics will be performed when microtectonic studies and chemical analyses results are available.

Conceptualizations of Representation Forms and Knowledge Organization of High School Teachers in Finland: "Magnetostatics"

ERIC Educational Resources Information Center

Majidi, Sharareh; Emden, Markus

2013-01-01

One of the main components of teachers' pedagogical content knowledge refers to their use of representation forms. In a similar vein, organizing concepts logically and meaningfully is an essential element of teachers' subject matter knowledge. Since subject matter and pedagogical content knowledge of teachers are tightly connected as categories…

Standard plane localization in ultrasound by radial component model and selective search.

PubMed

Ni, Dong; Yang, Xin; Chen, Xin; Chin, Chien-Ting; Chen, Siping; Heng, Pheng Ann; Li, Shengli; Qin, Jing; Wang, Tianfu

2014-11-01

Acquisition of the standard plane is crucial for medical ultrasound diagnosis. However, this process requires substantial experience and a thorough knowledge of human anatomy. Therefore it is very challenging for novices and even time consuming for experienced examiners. We proposed a hierarchical, supervised learning framework for automatically detecting the standard plane from consecutive 2-D ultrasound images. We tested this technique by developing a system that localizes the fetal abdominal standard plane from ultrasound video by detecting three key anatomical structures: the stomach bubble, umbilical vein and spine. We first proposed a novel radial component-based model to describe the geometric constraints of these key anatomical structures. We then introduced a novel selective search method which exploits the vessel probability algorithm to produce probable locations for the spine and umbilical vein. Next, using component classifiers trained by random forests, we detected the key anatomical structures at their probable locations within the regions constrained by the radial component-based model. Finally, a second-level classifier combined the results from the component detection to identify an ultrasound image as either a "fetal abdominal standard plane" or a "non- fetal abdominal standard plane." Experimental results on 223 fetal abdomen videos showed that the detection accuracy of our method was as high as 85.6% and significantly outperformed both the full abdomen and the separate anatomy detection methods without geometric constraints. The experimental results demonstrated that our system shows great promise for application to clinical practice. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Fluid inclusions in quartz crystals from South-West Africa

USGS Publications Warehouse

Kvenvolden, K.A.; Roedder, E.

1971-01-01

Quartz crystals from calcite veins of unknown age in Precambrian metasedimentary rocks at Geiaus No. 6 and Aukam farms in South-West Africa contain both primary and secondary inclusions filled with one or a variable combination of: organic liquid, moderately saline aqueous liquid, dark-colored solid, and vapor. Analysis of these materials by microscopy and by gas chromatography and mass spectrometry shows the presence of constituents of both low and high molecular weights. The former include CH4, C2H6, C3H8 and possibly C4H10 as well as CO, CO2, H2O, N2 and H2. High molecular weight components are dominantly n-alkanes and isoprenoid hydrocarbons. The n-alkanes range from at least n-C10 to n-C33. Concentrations of n-alkanes larger than n-C17 decrease regularly with increasing carbon number. An homologous series of isoprenoid hydrocarbons ranging from at least C14 to C20 is present in unusually high concentrations. Pristane (C19) is most abundant, and C17 isoprenoid is least abundant. The molecular composition and distribution of hydrocarbons suggest biological precursors for these components. Consideration of data provided by freezing, crushing and heating experiments suggests that the pressures at the time these in part supercritical fluids were trapped probably exceeded 30-40 atm, and the minimum trapping temperature was about 120-160??C. Both primary and secondary inclusions apparently containing only organic materials were trapped by the growth of the host quartz from aqueous solution. The data obtained neither prove nor preclude Precambrian, Paleozoic or younger sources for the organic materials. ?? 1971.

Avoiding the use of a femoral bridging catheter using a two-stage Hemodialysis Reliable Outflow (HeRO) graft implantation technique.

PubMed

Yoon, William J; Lorelli, David R

2015-01-01

To evaluate a two-stage Hemodialysis Reliable Outflow (HeRO) implantation technique that avoids the use of a femoral bridging catheter versus the conventional one-stage technique requiring a bridging catheter in selected patients. A retrospective review was performed on 20 end-stage renal disease patients with an internal jugular vein (IJV) catheter selected for two-stage HeRO implantation at our institution between January 2010 and March 2013. The arterial graft component (AGC) was implanted without anastomosing it to the target artery (first stage). After AGC incorporation, the venous outflow component was inserted (second stage). The preexisting IJV catheter was maintained for hemodialysis access during the interstage period. Patient characteristics, patency using Kaplan-Meier method and infection rates were analyzed. A total of 17 patients with a mean age of 59 years (70.6% women) completed the two-stage procedure. During the interstage period (mean 12 weeks, range 4-22 weeks), no graft- or surgery-related infection occurred. The need of a femoral bridging catheter was avoided by utilizing the preexisting IJV dialysis catheter. The accumulated HeRO days were 3,916 days with a mean follow-up of 7.7 months (range 1-22.6 months). The HeRO-related infection rate was 0.3/1,000 days. The primary assisted and secondary patency rates at 6 months were 69% and 82%, respectively, which were similar to those of arteriovenous grafts. Staging conferred immediate vascular accessibility. Avoiding the use of a femoral bridging catheter using the two-stage technique may lower infection rate, with comparable primary assisted and secondary patency to arteriovenous grafts and added benefit of immediate cannulatability in this subset of patients.

Matrix Metalloproteinase 9 (MMP-9) Regulates Vein Wall Biomechanics in Murine Thrombus Resolution

PubMed Central

Nguyen, Khanh P.; McGilvray, Kirk C.; Puttlitz, Christian M.; Mukhopadhyay, Subhradip; Chabasse, Christine; Sarkar, Rajabrata

2015-01-01

Objective Deep venous thrombosis is a common vascular problem with long-term complications including post-thrombotic syndrome. Post-thrombotic syndrome consists of leg pain, swelling and ulceration that is related to incomplete or maladaptive resolution of the venous thrombus as well as loss of compliance of the vein wall. We examine the role of metalloproteinase-9 (MMP-9), a gene important in extracellular remodeling in other vascular diseases, in mediating thrombus resolution and biomechanical changes of the vein wall. Methods and Results The effects of targeted deletion of MMP-9 were studied in an in vivo murine model of thrombus resolution using the FVB strain of mice. MMP-9 expression and activity significantly increased on day 3 after DVT. The lack of MMP-9 impaired thrombus resolution by 27% and this phenotype was rescued by the transplantation of wildtype bone marrow cells. Using novel biomechanical techniques, we demonstrated that the lack of MMP-9 significantly decreased thrombus-induced loss of vein wall compliance. Biomechanical analysis of the contribution of individual structural components showed that MMP-9 affected the elasticity of the extracellular matrix and collagen-elastin fibers. Biochemical and histological analyses correlated with these biomechanical effects as thrombi of mice lacking MMP-9 had significantly fewer macrophages and collagen as compared to those of wildtype mice. Conclusions MMP-9 mediates thrombus-induced loss of vein wall compliance by increasing stiffness of the extracellular matrix and collagen-elastin fibers during thrombus resolution. MMP-9 also mediates macrophage and collagen content of the resolving thrombus and bone-marrow derived MMP-9 plays a role in resolution of thrombus mass. These disparate effects of MMP-9 on various aspects of thrombus illustrate the complexity of individual protease function on biomechanical and morphometric aspects of thrombus resolution. PMID:26406902

Veiny Garden City Site and Surroundings on Mount Sharp, Mars

NASA Image and Video Library

2015-11-11

This view from the Mast Camera (Mastcam) on NASA's Curiosity Mars rover shows a site with a network of prominent mineral veins below a cap rock ridge on lower Mount Sharp. Researchers used the rover in March 2015 to examine the structure and composition of the crisscrossing veins at the "Garden City" site in the center of this scene. For geologists, the vein complex offers a three-dimensional exposure of mineralized fractures in a geological setting called the Pahrump section of the Lower Murray Formation. Curiosity spent several months examining sites in the Pahrump section below this site, before arriving at Garden City. Mineral veins such as these form where fluids move through fractured rocks, depositing minerals in the fractures and affecting chemistry of the surrounding rock. In this case, the veins have been more resistant to erosion than the surrounding host rock. The component images of this mosaic view were taken by the left-eye camera of Mastcam on March 27, 2015, during the 938th Martian day, or sol, of Curiosity's work on Mars. The scene is presented with a color adjustment that approximates white balancing, to resemble how the rocks would appear under daytime lighting conditions on Earth. For scale, the cap rock scarp is about 3 feet (1 meter) tall. Figure 1 includes scale bars of 1 meter (3.3 feet) vertically and 2 meters (6.7 feet) horizontally. Malin Space Science Systems, San Diego, built and operates Curiosity's Mastcam. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology, Pasadena, built the rover and manages the project for NASA's Science Mission Directorate, Washington. http://photojournal.jpl.nasa.gov/catalog/PIA19921

[Wells clinical prediction criteria in patients suspected of having deep vein thrombosis: evaluation of components and use in the emergency department].

PubMed

García-Castrillo Riesgo, Luis; Jiménez Hernández, Sònia; Piñera Salmerón, Pascual

2015-01-01

To determine the applicability of the Wells clinical prediction criteria for deep vein thrombosis (DVT) in patients in hospital emergency departments and to evaluate the relevance of the score's components. Prospective multicenter cohort study in consecutive hospital emergency department patients suspected of having DVT. Full-leg Doppler compression ultrasound imaging was performed on all patients. We recorded information on variables related to risk for DVT and the components of clinical prediction scales. Wells and Oudega clinical prediction scores were calculated. We studied 362 patients in 23 hospital emergency departments; the mean (SD) age was 65 (18) years and 52.8% were women. DVT was diagnosed in 254 patients (70.16%); 171 (47.2%) had proximal DVT. The clinical probability of DVT according to the Wells scale and the prevalence of proximal DVT were as follows: low probability, 57 patients (14 with DVT, 24.6%); intermediate probability, 124 (43 with DVT, 34.7%), and high probability, 181 (114 with DVT, 63%). Only 5 of the components of the Wells scale were associated with the presence of proximal DVT. The prevalence of DVT is very high in the 3 categories of clinical probability indicated by the Wells score. The prevalences do not correspond to those of the cohort used to validate the scale. It appears to be necessary to develop scales adjusted for use in hospital emergency departments when DVT is suspected.

Quartz-coesite-stishovite relations in shocked metaquartzites from the Vredefort impact structure, South Africa

NASA Astrophysics Data System (ADS)

Spray, John G.; Boonsue, Suporn

2018-01-01

Coesite and stishovite are developed in shock veins within metaquartzites beyond a radius of 30 km from the center of the 2.02 Ga Vredefort impact structure. This work focuses on deploying analytical field emission scanning electron microscopy, electron backscattered diffraction, and Raman spectrometry to better understand the temporal and spatial relations of these silica polymorphs. α-Quartz in the host metaquartzites, away from shock veins, exhibits planar features, Brazil twins, and decorated planar deformation features, indicating a primary (bulk) shock loading of >5 < 35 GPa. Within the shock veins, coesite forms anhedral grains, ranging in size from 0.5 to 4 μm, with an average of 1.25 μm. It occurs in clasts, where it displays a distinct jigsaw texture, indicative of partial reversion to a less dense SiO2 phase, now represented by microcrystalline quartz. It is also developed in the matrix of the shock veins, where it is typically of smaller size (<1 μm). Stishovite occurs as euhedral acicular crystals, typically <0.5 μm wide and up to 15 μm in length, associated with clast-matrix or shock vein margin-matrix interfaces. In this context, the needles occur as radiating or subparallel clusters, which grow into/over both coesite and what is now microcrystalline quartz. Stishovite also occurs as more blebby, subhedral to anhedral grains in the vein matrix (typically <1 μm). We propose a model for the evolution of the veins (1) precursory frictional melting in a microfault ( 1 mm wide) generates a molten matrix containing quartz clasts. This is followed by (2) arrival of the main shock front, which shocks to 35 GPa. This generates coesite in the clasts and in the matrix. (3) On initial shock release, the coesite partly reverts to a less dense SiO2 phase, which is now represented by microcrystalline quartz. (4) With continued release, stishovite forms euhedral needle clusters at solid-liquid interfaces and as anhedral crystals in the matrix. (5) With decreasing pressure-temperature, the matrix completes crystallization to yield a microcrystalline quasi-igneous texture comprising quartz-coesite-stishovite-kyanite-biotite-alkali feldspar and accessory phases. It is possible that the shock vein represents the locus of a thermal spike within the bulk shock, in which case there is no requirement for additional pressure (i.e., the bulk shock was ≃35 GPa). However, if that pressure was not realized from the main shock, then supplementary pressure excursions within the vein would have been required. These could have taken the form of localized reverberations from wave trapping, or implosion processes, including pore collapse, phase change-initiated volume reduction, and melt cavitation.

Geological setting and timing of the cassiterite vein type mineralization of the Kalima area (Maniema, Democratic Republic of Congo)

NASA Astrophysics Data System (ADS)

Dewaele, S.; Muchez, Ph; Burgess, R.; Boyce, A.

2015-12-01

The Central African Mesoproterozoic Karagwe-Ankole belt in the Great Lakes area (DRCongo, Rwanda, Burundi, Uganda and Tanzania) forms a metallogenic province that hosts a variety of granite-related mineralization, which contains cassiterite, columbite-tantalite, wolframite/ferberite, spodumene and beryl. The Kalima area in the Maniema province of the DRCongo forms one of the most important areas for cassiterite mineralization in the eastern part of the DRCongo, even after many decades of exploitation. The mineralization dominantly consists of quartz veins that are hosted in Mesoproterozoic metasediments at the contact with granitic rocks of the Kalima granite (Avuanga and Yubuli) or directly crosscutting these granitic rocks (Atondo). Only limited - and mainly unmineralized pegmatites - have been described in the Lutshurukuru area. Mineralized quartz veins - and some granite bodies - intruded following the regional tectonic foliation or existing fracture zones, confirming the late-to post-tectonic origin of the fertile granite system. The emplacement of the quartz veins resulted in an alteration of the metasedimentary and granitic host-rocks, mainly resulting in muscovitization, tourmalinization and silicification. Cassiterite itself formed relatively late during vein formation and is associated with muscovite in fractures in or along the margins of the quartz veins. 40Ar-39Ar age dating of muscovite of an unmineralized pegmatite from the Lutshurukuru area gave an excellent plateau age of 1024 ± 5.5 Ma, while the muscovite associated with mineralization gave plateau ages of 986 ± 5.3 Ma for the Atondo deposit and 992.4 ± 5.4 Ma for the Yubuli deposit. The rather large spread in ages between the supposed parental granite/pegmatite and quartz veins is interpreted to reflect different magmatic events in the evolution of a composite granite system, starting at ∼1020 Ma and ending with mineralized quartz vein formation at ∼990 Ma. The latter age corresponds with the U-Pb age reported for columbite-tantalite in the area (993 ± 1 Ma at Kamisuku), which could be interpreted as the primary formation age of a new generation of mineralized pegmatites in the Kalima area, or as the resetting age of the U-Pb system during the ∼990 Ma mineralizing event. Muscovite of a mineralized greisen sample of Avuanga gave a plateau age with relaxed constraints of 1010.3 ± 5.9 Ma, which has been interpreted as a partially resetting of muscovite formed at ∼1020 Ma age, during the ∼990 Ma event.

Isolation of pulmonary veins using a thermoreactive implantable device with external energy transfer: Evaluation in a porcine model.

PubMed

Boussy, Tim; Vandecasteele, Tim; Vera, Lisse; Schauvliege, Stijn; Philpott, Matthew; Clement, Eli; van Loon, Gunther; Willenz, Udi; Granada, Juan F; Stone, Gregg W; Reddy, Vivek Y; Van Langenhove, Glenn

2018-06-01

Pulmonary vein isolation (PVI) is a well-established method for the treatment of symptomatic paroxysmal atrial fibrillation, but is only partly successful with a high rate of electrical reconnection. We introduce a novel technique in which PVI is accomplished by noninvasive heating of a dedicated thermoresponse implant inserted into the pulmonary veins (PV), demonstrated in a porcine model. A self-expanding nitinol-based implant was positioned in the common inferior PV of 11 pigs, using a fluoroscopy-guided transatrial appendage approach. Ablation was performed through contactless energy transfer from a primary extracorporal coil to a secondary heat ring (HR) embedded in the proximal part of the implant. Electrophysiological conduction was assessed prior to and postablation, and at 3 months. Histological samples were obtained acutely (n  =  4) and after 3 months (n  =  7). In total, 13 PV implants were successfully positioned in the inferior PVs of 11 animals. Ablation was performed without injury of adjacent structures. PVI and bidirectional block was electrophysiologically confirmed in all cases immediately at the time of implantation and 3 months later in seven chronic animals in whom testing was repeated. Marked evidence of ablation around the proximal HR was evident at 3 months postprocedure, with scar tissue formation and only mild neointimal proliferation. Successful PVI can be obtained by external electromagnetic heat transfer to a novel pulmonary vein implant. © 2018 Wiley Periodicals, Inc.

Comparison between intravitreal bevacizumab and triamcinolone for macular edema secondary to branch retinal vein occlusion.

PubMed

Kim, Jin Young; Park, Sung Pyo

2009-12-01

To compare the effects of intravitreal bevacizumab to those of triamcinolone acetonide injection for the treatment of macular edema secondary to branch retinal vein occlusion. This retrospective study included 50 eyes of 50 patients who received a single injection of intravitreal bevacizumab (1.25 mg/0.05 mL, 22 eyes) or triamcinolone acetonide (4 mg/0.1 mL, 28 eyes) as the only treatment for macular edema secondary to branch retinal vein occlusion; all patients had a post-injection follow-up duration of >24 weeks. Best corrected visual acuity (BCVA), intraocular pressure (IOP), and central macular thickness (CMT) by optical coherence tomography were measured for up to 24 weeks after injection. BCVA was improved at 1, 4, 8,12 weeks post-injection in the bevacizumab group, and at 1, 4, 8 weeks post-injection in the triamcinolone group. No significant difference was found between the two groups except at 12 weeks. CMT decreased significantly within each group, and no significant difference between groups was found. In the bevacizumab group, no elevated IOP was observed, whereas IOP was significantly increased at 4, 8, and 12 weeks after triamcinolone injection; IOP was therefore significantly different between the two groups. Intravitreal bevacizumab is a comparatively simple treatment method that can effectively improve BCVA and reduce CMT without ocular and systemic complications. Consequently, intravitreal bevacizumab injections may be useful as both an alternative and primary treatment for macular edema secondary to branch retinal vein occlusion.

Individualized cryoballoon energy pulmonary vein isolation guided by real-time pulmonary vein recordings, the randomized ICE-T trial.

PubMed

Chun, K R Julian; Stich, Marie; Fürnkranz, Alexander; Bordignon, Stefano; Perrotta, Laura; Dugo, Daniela; Bologna, Fabrizio; Schmidt, Boris

2017-04-01

The ideal energy dosing remains unclear in second-generation cryoballoon (CB) pulmonary vein isolation (PVI). We aimed to investigate the effect of an individualized dosing strategy based on time to PVI (TTI). The purpose of this study was to prospectively investigate the safety and efficacy of individualized PVI using the second-generation CB guided by real-time pulmonary vein recordings. Two groups were prospectively randomized: ICE-T group: if TTI <75 seconds, then no bonus freeze; and control group: acute PVI followed by 1 empiric bonus freeze. Freeze duration was set to 240 seconds. The primary end point was single procedure sinus rhythm after 12 months (blanking period 3 months). Secondary end points included procedural data, complications, and biomarker release. In total, 100 patients with paroxysmal atrial fibrillation were randomized. The primary end point was not different (88% vs 82%). Procedure and fluoroscopy times were significantly shorter in the ICE-T group (70 ± 20 minutes vs 89 ± 21 minutes; P < .001 and 10.6 ± 3.9 minutes vs 12.7 ± 5.5 minutes; P = .03). More complications occurred in the control group (n = 9 vs n = 3) (persistent phrenic nerve injury: n = 1 vs n = 0; transient phrenic nerve injury: n = 5 vs n = 2; esophageal lesions: n = 3 vs n = 1). Postablation troponin T levels were not different (ICE-T group vs control group: 1035 ± 402 ng/L vs 1219 ± 509 ng/L; P = .099), whereas a significantly lower lactic acid dehydrogenase release was observed in the ICE-T group (259 ± 47 U/L vs 282 ± 57 U/L; P = .038). Multivariate analysis identified a mean TTI of >43 seconds as the only independent predictor of recurrent atrial tachyarrhythmia. The individualized CB PVI strategy allows faster atrial fibrillation ablation without affecting the favorable clinical outcome. A short TTI appears to predict freedom from recurrent atrial tachyarrhythmia. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Rb-Sr, K-Ar, and stable isotope evidence for the ages and sources of fluid components of gold-bearing quartz veins in the northern Sierra Nevada foothills metamorphic belt, California

USGS Publications Warehouse

Böhlke, John Karl; Kistler, R. W.

1986-01-01

Gold-bearing quartz veins occur in and near major fault zones in deformed oceanic and island-arc rocks west of the main outcrop of the Sierra Nevada composite batholith. Veins typically occupy minor reverse faults that crosscut blueschist to amphibolite-grade metamorphic rocks whose metamorphic ages range from early Paleozoic to Jurassic. Vein micas and carbonate-quartz-mica assemblages that formed by hydrothermal metasomatism of ultramafic wall rocks in the Alleghany, Grass Valley, Washington, and Mother Lode districts yield concordant K-Ar and Rb-Sr ages. The dated veins are significantly younger than prograde metamorphism, penetrative deformation, and accretion of their host rocks to the continental margin. New and previously published mineralization ages from 13 localities in the Sierra foothills range from about 140 to 110 m.y. ago, with mean and median between 120 and 115 m.y. The age relations suggest that mineralizing fluids were set in motion by deep magmatic activity related to the resumption of east-dipping subduction along the western margin of North America following the Late Jurassic Nevadan collision event.CO 2 -bearing fluids responsible for metasomatism and much of the vein mica, carbonate, albite, and quartz deposition in several northern mines were isotopically heavy (delta 18 O [asymp] 8-14ppm; delta D between about -10 and -50ppm) and do not resemble seawater, magmatic, or meteoric waters. Metasomatic and vein-filling mica, dolomite, magnesite, and quartz in altered ultramafic rocks generally formed from fluids with similar Sr and O isotope ratios at a given locality. Consistent quartz-mica delta 18 O fractionations (delta 18 O (sub Q-M) = 4.5-4.9ppm) from various localities imply uniform equilibration temperatures, probably between 300 degrees and 350 degrees C. On a local (mine) scale, fluids responsible for both carbonate alteration of mafic and ultramafic wall rocks and albitic alteration of felsic and pelitic rocks had similar Sr isotope ratios.Samples from three veins in the central Alleghany district fit a 115.7 + or - 3-m.y. Rb-Sr isochron with a ( 87 Sr/ 86 Sr) i value of approximately 0.7119. Inferred 87 Sr/ 86 Sr ratios of metasomatic fluids from mines in different parts of the foothills region vary considerably (0.704-0.718), suggesting that Sr was derived from sources ranging from "western assemblage" Mesozoic ophiolitic or arc volcanic rocks to early Paleozoic continent-derived clastic rocks of the Shoo Fly Complex. Systematic geographic variations in both Sr and O isotopes can be rationalized by assuming extensive fluid interaction with rocks similar to the ones that are exposed within a few kilometers of the veins, but the ultimate sources of the fluids, and of Au and other constituents, may be independent of these. Isotopically lighter (meteoric?) fluids deposited some late quartz overgrowths and occupied secondary fluid inclusions in earlier vein quartz.

Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

PubMed

Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

2018-03-29

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P < 0.001). The mean total blood loss was 769 in topical tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

The promoter of the Arabidopsis PIN6 auxin transporter enabled strong expression in the vasculature of roots, leaves, floral stems and reproductive organs.

PubMed

Nisar, Nazia; Cuttriss, Abby J; Pogson, Barry J; Cazzonelli, Christopher I

2014-01-01

Cellular auxin homeostasis controls many aspects of plant growth, organogenesis and development. The existence of intracellular auxin transport mediated by endoplasmic reticulum (ER)-localized PIN5, PIN6 and PIN8 proteins is a relatively recent discovery shaping a new era in understanding auxin-mediated growth processes. Here we summarize the importance of PIN6 in mediating intracellular auxin transport during root formation, leaf vein patterning and nectary production. While, it was previously shown that PIN6 was strongly expressed in rosette leaf cell types important in vein formation, here we demonstrate by use a PIN6 promoter-reporter fusion, that PIN6 is also preferentially expressed in the vasculature of the primary root, cotyledons, cauline leaves, floral stem, sepals and the main transmitting tract of the reproductive silique. The strong, vein- specific reporter gene expression patterns enabled by the PIN6 promoter emphasizes that transcriptional control is likely to be a major regulator of PIN6 protein levels, during vasculature formation, and supports the need for ER-localized PIN proteins in selecting specialized cells for vascular function in land plants.

Invaginated axial saphenectomy by a semirigid stripper: perforate-invaginate stripping.

PubMed

Goren, G; Yellin, A E

1994-12-01

This study was designed to evaluate a recently introduced form of stripping of primary varicose veins by the technique of perforate-invaginate (PIN) stripping. One hundred twelve consecutive limbs presenting with 91 long and 21 short saphenous varicosities displaying saphenofemoral or saphenopopliteal junctional escapes with varying length of greater or lesser saphenous (axial) reflux underwent operation in 1 year. All surgeries were performed in an office setting with the patient receiving locoregional anesthetic with use of the invaginated PIN stripping in conjunction with tributary hook-stab avulsion. In the 112 procedures performed, there were no tract hematomas or dysesthesias caused by nerve damage. Postoperative morbidity was nonexistent, permitting all patients to resume normal daily occupational and sporting activities immediately. PIN stripping is an excellent method of invagination stripping. There is a minimal likelihood of vein tearing. Compared with conventional ankle-to-groin (or popliteal fossa) stripping, PIN stripping is minimally invasive, does not cause damage to structures around the vein, does not require convalescence, eliminates the need for a lengthy distal second incision, can be performed in an office setting with the patient receiving locoregional anesthetic, and is most cost-efficient.

A review of microvascular ear replantation.

PubMed

Jung, Sung Won; Lee, Junsang; Oh, Suk Joon; Koh, Sung Hoon; Chung, Chul Hoon; Lee, Jong Wook

2013-03-01

Microvascular ear replantation is a significant challenge because of the small size of the vessels and the fact that traumatic amputations are frequently avulsed. The zone of trauma is therefore extended and the primary repair of the injured vessel is rendered unlikely. The purpose of this study is to review the literature of ear replantation. A review of the relevant literature that has been published since 1980 revealed 47 cases reported in 37 publications. We present 5 cases from our own experience and analyze a total 52 cases of microvascular ear replantation. The patient's age, sex, degree of amputation, cause of injury, ischemic time, method of arterial and venous anastomosis, complications, any additional outflow used, postoperative medications, the requirement for transfusions, and the number of hospital admission days are described. Successful microvascular ear replantations require anastomosis of the vessels if possible. Rather than a vein graft, primary repair of the vessels, or at least pedicled repair of the artery, should be considered to ensure flap survival. In addition, vein repair should be considered if possible to ensure the secure drainage of blood from the replant. With secure circulation, the replant can survive, resulting in a very satisfactory outcome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

What are the keys to successful adrenal venous sampling (AVS) in patients with primary aldosteronism?

PubMed

Young, William F; Stanson, Anthony W

2009-01-01

Adrenal venous sampling (AVS) is the criterion standard to distinguish between unilateral and bilateral adrenal disease in patients with primary aldosteronism. The keys to successful AVS include appropriate patient selection, careful patient preparation, focused technical expertise, defined protocol, and accurate data interpretation. The use of AVS should be based on patient preferences, patient age, clinical comorbidities, and the clinical probability of finding an aldosterone-producing adenoma. AVS is optimally performed in the fasting state in the morning. AVS is an intricate procedure because the right adrenal vein is small and may be difficult to locate - the success rate depends on the proficiency of the angiographer. The key factors that determine the successful catheterization of both adrenal veins are experience, dedication and repetition. With experience, and focusing the expertise to 1 or 2 radiologists at a referral centre, the AVS success rate can be as high as 96%. A centre-specific, written protocol is mandatory. The protocol should be developed by an interested group of endocrinologists, radiologists and laboratory personnel. Safeguards should be in place to prevent mislabelling of the blood tubes in the radiology suite and to prevent sample mix-up in the laboratory.

Is the treatment of the small saphenous veins with foam sclerotherapy at risk of deep vein thrombosis?

PubMed

Gillet, J L; Lausecker, M; Sica, M; Guedes, J M; Allaert, F A

2014-10-01

To assess the deep vein thrombosis risk of the treatment of the small saphenous veins depending on the anatomical pattern of the veins. A multicenter, prospective and controlled study was carried out in which small saphenous vein trunks were treated with ultrasound-guided foam sclerotherapy. The anatomical pattern (saphenopopliteal junction, perforators) was assessed by Duplex ultrasound before the treatment. All patients were systematically checked by Duplex ultrasound 8 to 30 days after the procedure to identify a potential deep vein thrombosis. Three hundred and thirty-one small saphenous veins were treated in 22 phlebology clinics. No proximal deep vein thrombosis occurred. Two (0.6%) medial gastrocnemius veins thrombosis occurred in symptomatic patients. Five medial gastrocnemius veins thrombosis and four cases of extension of the small saphenous vein sclerosis into the popliteal vein, which all occurred when the small saphenous vein connected directly into the popliteal vein, were identified by systematic Duplex ultrasound examination in asymptomatic patients. Medial gastrocnemius veins thrombosis were more frequent (p = 0.02) in patients with medial gastrocnemius veins perforator. A common outlet or channel between the small saphenous vein and the medial gastrocnemius veins did not increase the risk of deep vein thrombosis. Deep vein thrombosis after foam sclerotherapy of the small saphenous vein are very rare. Only 0.6% medial gastrocnemius veins thrombosis occurred in symptomatic patients. However, the anatomical pattern of the small saphenous vein should be taken into account and patients with medial gastrocnemius veins perforators and the small saphenous vein connected directly into the popliteal vein should be checked by Duplex ultrasound one or two weeks after the procedure. Recommendations based on our everyday practice and the findings of this study are suggested to prevent and treat deep vein thrombosis. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Umbilical vein oxytocin for the treatment of retained placenta (Release Study): a double-blind, randomised controlled trial.

PubMed

Weeks, Andrew D; Alia, Godfrey; Vernon, Gillian; Namayanja, Annette; Gosakan, Radhika; Majeed, Tayyaba; Hart, Anna; Jafri, Hussain; Nardin, Juan; Carroli, Guillermo; Fairlie, Fiona; Raashid, Yasmin; Mirembe, Florence; Alfirevic, Zarko

2010-01-09

Retained placenta is associated with post-partum haemorrhage. Meta-analysis has suggested that umbilical injection of oxytocin could increase placental expulsion without the need for a surgeon or anaesthetic. We assessed the effect of high-dose umbilical vein oxytocin as a treatment for retained placenta. In this double-blind, placebo-controlled trial, haemodynamically stable women with a retained placenta for more than 30 min were recruited from 13 sites in the UK, Uganda, and Pakistan. 577 women were randomly assigned by a computer-generated randomisation list stratified by centre to 30 mL saline containing either 50 IU oxytocin (n=292) or 5 mL water (n=285), which was injected into the placenta through an umbilical vein catheter. All trial participants, study workers, and data handlers were masked to individual allocations. The primary outcome was the need for manual removal of the placenta. Analysis was by intention to treat. This study is registered, number ISRCTN 13204258. The primary outcome was recorded for all participants. We detected no difference between the groups in the need for manual removal of placenta (oxytocin 179/292 [61.3%] vs placebo 177/285 [62.1%]; relative risk 0.98, 95% CI 0.87-1.12; p=0.84). The need for manual removal was higher in the UK (overall 250/361 [69%]) than in Uganda (90/190 [47%]) or Pakistan (16/26 [62%]). Adverse events did not differ between the two groups. Umbilical oxytocin has no clinically significant effect on the need for manual removal for women with retained placenta. WHO, WellBeing of Women, Pakistan Higher Education Commission. Copyright 2010 Elsevier Ltd. All rights reserved.

Pre-Clinical Model to Study Recurrent Venous Thrombosis in the Inferior Vena Cava.

PubMed

Andraska, Elizabeth A; Luke, Catherine E; Elfline, Megan A; Henke, Samuel P; Madapoosi, Siddharth S; Metz, Allan K; Hoinville, Megan E; Wakefield, Thomas W; Henke, Peter K; Diaz, Jose A

2018-06-01

 Patients undergoing deep vein thrombosis (VT) have over 30% recurrence, directly increasing their risk of post-thrombotic syndrome. Current murine models of inferior vena cava (IVC) VT model host one thrombosis event.  We aimed to develop a murine model to study IVC recurrent VT in mice.  An initial VT was induced using the electrolytic IVC model (EIM) with constant blood flow. This approach takes advantage of the restored vein lumen 21 days after a single VT event in the EIM demonstrated by ultrasound. We then induced a second VT 21 days later, using either EIM or an IVC ligation model for comparison. The control groups were a sham surgery and, 21 days later, either EIM or IVC ligation. IVC wall and thrombus were harvested 2 days after the second insult and analysed for IVC and thrombus size, gene expression of fibrotic markers, histology for collagen and Western blot for citrullinated histone 3 (Cit-H3) and fibrin.  Ultrasound confirmed the first VT and its progressive resolution with an anatomical channel allowing room for the second thrombus by day 21. As compared with a primary VT, recurrent VT has heavier walls with significant up-regulation of transforming growth factor-β (TGF-β), elastin, interleukin (IL)-6, matrix metallopeptidase 9 (MMP9), MMP2 and a thrombus with high citrullinated histone-3 and fibrin content.  Experimental recurrent thrombi are structurally and compositionally different from the primary VT, with a greater pro-fibrotic remodelling vein wall profile. This work provides a VT recurrence IVC model that will help to improve the current understanding of the biological mechanisms and directed treatment of recurrent VT. Schattauer GmbH Stuttgart.

Bioinformatic analysis of primary endothelial cell gene array data illustrated by the analysis of transcriptome changes in endothelial cells exposed to VEGF-A and PlGF.

PubMed

Schoenfeld, Jonathan; Lessan, Khashayar; Johnson, Nicola A; Charnock-Jones, D Stephen; Evans, Amanda; Vourvouhaki, Ekaterini; Scott, Laurie; Stephens, Richard; Freeman, Tom C; Saidi, Samir A; Tom, Brian; Weston, Gareth C; Rogers, Peter; Smith, Stephen K; Print, Cristin G

2004-01-01

We recently published a review in this journal describing the design, hybridisation and basic data processing required to use gene arrays to investigate vascular biology (Evans et al. Angiogenesis 2003; 6: 93-104). Here, we build on this review by describing a set of powerful and robust methods for the analysis and interpretation of gene array data derived from primary vascular cell cultures. First, we describe the evaluation of transcriptome heterogeneity between primary cultures derived from different individuals, and estimation of the false discovery rate introduced by this heterogeneity and by experimental noise. Then, we discuss the appropriate use of Bayesian t-tests, clustering and independent component analysis to mine the data. We illustrate these principles by analysis of a previously unpublished set of gene array data in which human umbilical vein endothelial cells (HUVEC) cultured in either rich or low-serum media were exposed to vascular endothelial growth factor (VEGF)-A165 or placental growth factor (PlGF)-1(131). We have used Affymetrix U95A gene arrays to map the effects of these factors on the HUVEC transcriptome. These experiments followed a paired design and were biologically replicated three times. In addition, one experiment was repeated using serial analysis of gene expression (SAGE). In contrast to some previous studies, we found that VEGF-A and PlGF consistently regulated only small, non-overlapping and culture media-dependant sets of HUVEC transcripts, despite causing significant cell biological changes.

Graft type for femoro-popliteal bypass surgery.

PubMed

Ambler, Graeme K; Twine, Christopher P

2018-02-11

Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves grafts using autologous vein, polytetrafluoroethylene (PTFE) or Dacron as a bypass conduit. This is the second update of a Cochrane review first published in 1999 and last updated in 2010. To assess the effects of bypass graft type in the treatment of stenosis or occlusion of the femoro-popliteal arterial segment, for above- and below-knee femoro-popliteal bypass grafts. For this update, the Cochrane Vascular Information Specialist searched the Vascular Specialised Register (13 March 2017) and CENTRAL (2017, Issue 2). Trial registries were also searched. We included randomised trials comparing at least two different types of femoro-popliteal grafts for arterial reconstruction in patients with femoro-popliteal ischaemia. Randomised controlled trials comparing bypass grafting to angioplasty or to other interventions were not included. Both review authors (GKA and CPT) independently screened studies, extracted data, assessed trials for risk of bias and graded the quality of the evidence using GRADE criteria. We included nineteen randomised controlled trials, with a total of 3123 patients (2547 above-knee, 576 below-knee bypass surgery). In total, nine graft types were compared (autologous vein, polytetrafluoroethylene (PTFE) with and without vein cuff, human umbilical vein (HUV), polyurethane (PUR), Dacron and heparin bonded Dacron (HBD); FUSION BIOLINE and Dacron with external support). Studies differed in which graft types they compared and follow-up ranged from six months to 10 years.Above-knee bypassFor above-knee bypass, there was moderate-quality evidence that autologous vein grafts improve primary patency compared to prosthetic grafts by 60 months (Peto odds ratio (OR) 0.47, 95% confidence interval (CI) 0.28 to 0.80; 3 studies, 269 limbs; P = 0.005). We found low-quality evidence to suggest that this benefit translated to improved secondary patency by 60 months (Peto OR 0.41, 95% CI 0.22 to 0.74; 2 studies, 176 limbs; P = 0.003).We found no clear difference between Dacron and PTFE graft types for primary patency by 60 months (Peto OR 1.67, 95% CI 0.96 to 2.90; 2 studies, 247 limbs; low-quality evidence). We found low-quality evidence that Dacron grafts improved secondary patency over PTFE by 24 months (Peto OR 1.54, 95% CI 1.04 to 2.28; 2 studies, 528 limbs; P = 0.03), an effect which continued to 60 months in the single trial reporting this timepoint (Peto OR 2.43, 95% CI 1.31 to 4.53; 167 limbs; P = 0.005).Externally supported prosthetic grafts had inferior primary patency at 24 months when compared to unsupported prosthetic grafts (Peto OR 2.08, 95% CI 1.29 to 3.35; 2 studies, 270 limbs; P = 0.003). Secondary patency was similarly affected in the single trial reporting this outcome (Peto OR 2.25, 95% CI 1.24 to 4.07; 236 limbs; P = 0.008). No data were available for 60 months follow-up.HUV showed benefits in primary patency over PTFE at 24 months (Peto OR 4.80, 95% CI 1.76 to 13.06; 82 limbs; P = 0.002). This benefit was still seen at 60 months (Peto OR 3.75, 95% CI 1.46 to 9.62; 69 limbs; P = 0.006), but this was only compared in one trial. Results were similar for secondary patency at 24 months (Peto OR 4.01, 95% CI 1.44 to 11.17; 93 limbs) and at 60 months (Peto OR 3.87, 95% CI 1.65 to 9.05; 93 limbs).We found HBD to be superior to PTFE for primary patency at 60 months for above-knee bypass, but these results were based on a single trial (Peto OR 0.38, 95% CI 0.20 to 0.72; 146 limbs; very low-quality evidence). There was no difference in primary patency between HBD and HUV for above-knee bypass in the one small study which reported this outcome.We found only one small trial studying PUR and it showed very poor primary and secondary patency rates which were inferior to Dacron at all time points.Below-knee bypassFor bypass below the knee, we found no graft type to be superior to any other in terms of primary patency, though one trial showed improved secondary patency of HUV over PTFE at all time points to 24 months (Peto OR 3.40, 95% CI 1.45 to 7.97; 88 limbs; P = 0.005).One study compared PTFE alone to PTFE with vein cuff; very low-quality evidence indicates no effect to either primary or secondary patency at 24 months (Peto OR 1.08, 95% CI 0.58 to 2.01; 182 limbs; 2 studies; P = 0.80 and Peto OR 1.22, 95% CI 0.67 to 2.23; 181 limbs; 2 studies; P = 0.51 respectively)Limited data were available for limb survival, and those studies reporting on this outcome showed no clear difference between graft types for this outcome. Antiplatelet and anticoagulant protocols varied extensively between trials, and in some cases within trials.The overall quality of the evidence ranged from very low to moderate. Issues which affected the quality of the evidence included differences in the design of the trials, and differences in the types of grafts they compared. These differences meant we were often only able to combine and analyse small numbers of participants and this resulted in uncertainty over the true effects of the graft type used. There was moderate-quality evidence of improved long-term (60 months) primary patency for autologous vein grafts when compared to prosthetic materials for above-knee bypasses. In the long term (two to five years) there was low-quality evidence that Dacron confers a small secondary patency benefit over PTFE for above-knee bypass. Only very low-quality data exist on below-knee bypasses, so we are uncertain which graft type is best. Further randomised data are needed to ascertain whether this information translates into an improvement in limb survival.

EFFECTS OF INTRAVITREAL RANIBIZUMAB AND BEVACIZUMAB ON THE RETINAL VESSEL SIZE IN DIABETIC MACULAR EDEMA.

PubMed

Kurt, Muhammed Mustafa; Çekiç, Osman; Akpolat, Çetin; Elçioglu, Mustafa

2018-06-01

The goal of this study was to assess the effects of a single injection of intravitreal ranibizumab (RAN) or bevacizumab (BEV) on the retinal vessel size in eyes with diabetic macular edema. In total, 32 patients were enrolled in the RAN group, and 30 patients were included in BEV group. Each of these groups was also subdivided into two others groups: a study group and a control group. The study groups were composed of the injected eyes, whereas the noninjected fellow eyes served as the control groups. The patients underwent complete ophthalmic examinations, including optical coherence tomography and fundus fluorescein angiography, and the primary outcome measures included the central retinal artery equivalent, central retinal vein equivalent, and artery-to-vein ratio. In the RAN study group (n = 32), the preinjection mean central retinal artery equivalent (175.42 μm) decreased to 169.01 μm after 1 week, and to 167.47 μm after 1 month (P < 0.001), whereas the baseline central retinal vein equivalent (235.29 μm) decreased initially to 219.90 μm after 1 week, and to 218.36 μm after 1 month (P < 0.001). In the BEV study group (n = 30), the preinjection central retinal artery equivalent (150.21 μm) decreased to 146.25 μm after 1 week, and to 145.89 μm after 1 month (P < 0.001); whereas the baseline central retinal vein equivalent (211.87 μm) decreased initially to 204.59 μm after 1 week and was 205.24 μm after 1 month (P < 0.001). The preinjection artery-to-vein ratio values changed significantly (P = 0.001) after 1 week and after 1 month in the RAN group, but no significant alteration in the artery-to-vein ratio was observed in the BEV group (P = 0.433). In both the RAN (n = 32) and BEV (n = 30) control groups, none of the 3 parameters changed throughout the study period, when compared with the baseline. The results of this study showed that both RAN and BEV injections significantly constricted the retinal blood vessel diameters.

Morphology, origin and infrared microthermometry of fluid inclusions in pyrite from the Radka epithermal copper deposit, Srednogorie zone, Bulgaria

NASA Astrophysics Data System (ADS)

Kouzmanov, Kalin; Bailly, Laurent; Ramboz, Claire; Rouer, Olivier; Bény, Jean-Michel

2002-08-01

Pyrite samples from the Radka epithermal, replacement type, volcanic rock-hosted copper deposit, Bulgaria, have been studied using near-infrared (IR) microscopy. Two generations of pyrite based on their textures, composition and behaviour in IR light can be distinguished. Electron microprobe analyses, X-ray elemental mapping and Fourier transform infrared spectroscopy were used to study the relationship between crystal zoning, trace element contents and IR transmittance of pyrite. The observed crystal zoning is related to variable arsenic contents in massive fine-grained and colloform pyrite from the early pyrite-quartz assemblage, and cobalt contents in pyrite crystals from the late quartz-pyrite vein assemblage. There is a negative correlation between trace element content and IR transmittance of pyrite. The IR transparency of pyrite is thus a sensitive indicator of changes in trace element concentrations. Fluid inclusions have only been found in the second pyrite generation. Scanning electron microscopy observations on open fluid inclusion cavities permitted the crystallographic features of vacuoles to be determined. A characteristic feature of primary fluid inclusions in pyrite is a negative crystal habit, shaped mainly by {100}, {111} and {210}. This complicated polyhedral morphology is the reason for the observed opacity of some isometric primary inclusions. Secondary fluid inclusion morphology depends on the nature of the surface of the healed fracture. Recognition of the primary or secondary origin of fluid inclusions is enhanced by using crystallographically oriented sections. Microthermometric measurements of primary inclusions indicate that the second pyrite generation was deposited at maximum P-T conditions of 400 °C and 430 bar and from a fluid of low bulk salinity (3.5-4.6 wt%), possibly KCl-dominant. There are large ranges for homogenisation temperatures in secondary inclusions because of necking-down processes. Decrepitation features of some of pyrite-hosted inclusions and of all inclusions in associated quartz indicate reheating of the veins to 500-550 °C. The late cobalt-rich quartz-pyrite vein assemblage in the Radka deposit may be the shallow manifestation of deeper and genetically related porphyry copper mineralisation. This is a common observation of many intermediate- to high-sulfidation epithermal replacement-type ore bodies in this ore district and possibly the Cretaceous Banat-Srednogorie metallogenic belt in general.

Modified Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy for Hepatoblastoma in a Small Infant: How Far Can We Push the Envelope?

PubMed

Hong, Johnny C; Kim, Joohyun; Browning, Meghen; Wagner, Amy; Lerret, Stacee; Segura, Annette D; Zimmerman, Michael A

2017-08-01

: For patients with hepatoblastoma, a timely and complete resection of the tumor is critical to the patient's tumor recurrence-free survival. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), a 2-stage hepatectomy procedure, has revolutionized the surgical management of large hepatic tumors with insufficient future liver remnant (FLR) at presentation. Although existing data support the utility of ALPPS in adults with primary and metastatic hepatobiliary malignancy, the literature in children is scarce. To our knowledge, this is the first report showing clinical applicability and safety of the modified ALPPS procedure in a small infant (54 days old) with hepatoblastoma who presented with insufficient FLR. Our report suggests the modified ALPPS could potentially expand the surgical treatment alternative for small infants with large hepatoblastoma.

Epidemiology of venous thromboembolism

PubMed Central

Heit, John A.

2015-01-01

Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and—in women—pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing. PMID:26076949

Epidemiology of venous thromboembolism.

PubMed

Heit, John A

2015-08-01

Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and-in women-pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing.

Dating native gold by noble gas analyses

NASA Technical Reports Server (NTRS)

Niedermann, S.; Eugster, O.; Hofmann, B.; Thalmann, CH.; Reimold, W. U.

1993-01-01

Our recent work on He, Ne, and Ar in Alpine gold samples has demonstrated that gold is extremely retentive for He and could thus, in principle, be used for U/Th-He-4 dating. For vein-type gold from Brusson, Northern Italy, we derived a U/Th-He-4 age of 36 Ma, in agreement with the K-Ar formation age of associated muscovites and biotites. However, in placer gold from the Napf area, Central Switzerland, we observed large excesses of both He-4 and radiogenic Ar-40 (Ar-40 sub rad, defined as Ar-40-295.5-Ar-.36). The gas release systematics indicate two distinct noble gas components, one of which is released below about 800 C and the other one at the melting point of gold (1064 C). We now present results of He and Xe measurements in a 1 g placer gold sample from the river Kruempelgraben, as well as He and Ar data for Brusson vein-type gold and for gold from the Lily Gold Mine, South Africa. We calculate reasonable U/Th-He-4 as well as U-Xe ages based on those gases which are released at approximately 800 C. Probably the low-temperature components represent in-situ-produced radiogenic He and fission Xe, whereas the gases evolving when gold melts have been trapped during gold formation. Therefore, only the low-temperature components are relevant for dating purposes.

[Value of preserved saphenous vein graft for the creation of access ports in hemodialyzed patients: report of 309 cases].

PubMed

Schneider, Marc; Barrou, Benoît; Cluzel, Philippe; Hamani, Aziz; Bitker, Marc-Olivier; Richard, François

2003-09-01

Biological grafts are rarely used for the creation of vascular access, despite their many advantages. Our group prefers to use distal vascular accesses with interposition of a biological graft when direct access cannot be achieved. The objective of this study was to determine the long-term patency and the complication rate of a series of 309 vascular access procedures using a preserved saphenous (PS) vein homograft. 410 (27%) of the 1,500 vascular access procedures performed by our group required the use of a graft, including 376 PS vein homografts (25%). This retrospective study comprised complete data collection for 309 arteriovenous fistulas (AVF) using preserved saphenous (PS) vein graft in the forearm performed in 267 patients between 1985 and 2000. Primary patency was defined as the interval between creation of the vascular access and the first complication requiring surgical or radiological correction; secondary patency was defined as the interval between creation and loss of the graft, with or without revision of the fistula. Survival rates were calculated according to the Kaplan-Meier method. Inter-group comparison was performed by the Logrank test and analysis of variance was performed by logistic regression. Primary patency rates were 77%, 40% and 27% at 1,2 and 5 years, respectively. Secondary patency rates were 79% and 47% at 1 year and 5 years, respectively. The thrombosis rate was 42%. Two episodes of thrombosis occurred in 25% of grafts and 3 episodes were observed in 10% of cases. Infection rates were 1.9% postoperatively and 5% after dialysis, respectively. An aneurysm occurred on 10% of grafts. The operator's experience (RR = 1.58; p < 0.05) and diabetic nephropathy (RR = 1.89; p = 0.059) significantly influenced graft patency. In contrast, the position of the graft, the fact that it crossed the elbow joint, and the site of the arterial anastomosis did not have any negative impact on graft patency. Preservation of the patient's vascular capital is an essential objective in patients with chronic renal insufficiency, which is sometimes difficult to reconcile with the need to create vascular accesses with a long life span. The strategic choice between a distal access requiring a graft and a direct proximal access depends on the clinical context: cardiac function, waiting list for renal transplantation. Our preferred material in the case of bypass graft is the PS graft, as it presents the same resistance and the same patency rates as synthetic grafts, without the associated septic complications. The PS vein graft is a good material for the creation of vascular accesses with similar patency rates to those of prosthetic grafts. Vein grafts present a number of advantages, particularly a greater ease of use facilitating distal implantation of the graft and a low infection rate.

Cardiovascular tissues contain independent circadian clocks

NASA Technical Reports Server (NTRS)

Davidson, A. J.; London, B.; Block, G. D.; Menaker, M.

2005-01-01

Acute cardiovascular events exhibit a circadian rhythm in the frequency of occurrence. The mechanisms underlying these phenomena are not yet fully understood, but they may be due to rhythmicity inherent in the cardiovascular system. We have begun to characterize rhythmicity of the clock gene mPer1 in the rat cardiovascular system. Luciferase activity driven by the mPer1 gene promoter is rhythmic in vitro in heart tissue explants and a wide variety of veins and arteries cultured from the transgenic Per1-luc rat. The tissues showed between 3 and 12 circadian cycles of gene expression in vitro before damping. Whereas peak per1-driven bioluminescence consistently occurred during the late night in the heart and all arteries sampled, the phases of the rhythms in veins varied significantly by anatomical location. Varying the time of the culture procedure relative to the donor animal's light:dark cycle revealed that, unlike some other rat tissues such as liver, the phases of in vitro rhythms of arteries, veins, and heart explants were affected by culture time. However, phase relationships among tissues were consistent across culture times; this suggests diversity in circadian regulation among components of the cardiovascular system.

Taspine downregulates VEGF expression and inhibits proliferation of vascular endothelial cells through PI3 kinase and MAP kinase signaling pathways.

PubMed

Zhao, Jing; Zhao, Le; Chen, Wei; He, Langchong; Li, Xu

2008-01-01

Taspine is an active component isolated from Radix et Rhizoma Leonticis with inhibiting tumor angiogenic properties. The molecular mechanism(s) of taspine on tumor angiogenic inhibition have not been well documented. The aim of this study was to elucidate in detail the effects of taspine on genetic expressions of VEGF in human umbilical vein endothelial cells, and on VEGFR2-mediated intracellular signaling of human umbilical vein endothelial cells. The genetic expression of vascular endothelial growth factor (VEGF) in the human umbilical vein endothelial cells (HUVECs) treated with taspine in vitro was measured by the ELISA and RT-PCR methods. The effects of taspine on cell proliferation of HUVECs and HUVECs induced by VEGF165 were considered by using MTT assay. And also, a western blot was used to detect Akt and Erk1/2 expressions and their phosphorylation levels in HUVECs treated with taspine. Our results show that VEGF protein and mRNA expressions in the cells treated with taspine were significantly decreased. Taspine also significantly inhibited cell proliferation of HUVECs induced by VEGF165. HUVECs treated with taspine showed decreased Akt and Erk1/2 activities.

Portal vein embolization for induction of selective hepatic hypertrophy prior to major hepatectomy: rationale, techniques, outcomes and future directions

PubMed Central

Li, David; Madoff, David C.

2016-01-01

The ability to modulate the future liver remnant (FLR) is a key component of modern oncologic hepatobiliary surgery practice and has extended surgical candidacy for patients who may have been previously thought unable to survive liver resection. Multiple techniques have been developed to augment the FLR including portal vein embolization (PVE), associating liver partition and portal vein ligation (ALPPS), and the recently reported transhepatic liver venous deprivation (LVD). PVE is a well-established means to improve the safety of liver resection by redirecting blood flow to the FLR in an effort to selectively hypertrophy and ultimately improve functional reserve of the FLR. This article discusses the current practice of PVE with focus on summarizing the large number of published reports from which outcomes based practices have been developed. Both technical aspects of PVE including volumetry, approaches, and embolization agents; and clinical aspects of PVE including data supporting indications, and its role in conjunction with chemotherapy and transarterial embolization will be highlighted. PVE remains an important aspect of oncologic care; in large part due to the substantial foundation of information available demonstrating its clear clinical benefit for hepatic resection candidates with small anticipated FLRs. PMID:28154774

Characterization of frictional melting processes in subduction zone faults by trace element and isotope analyses

NASA Astrophysics Data System (ADS)

Ishikawa, T.; Ujiie, K.

2017-12-01

Pseudotachylytes found in exhumed accretionary complexes, which are considered to be formed originally at seismogenic depths, are of great importance for elucidating frictional melting and concomitant dynamic weakening of the fault during earthquake in subduction zones. However, fluid-rich environment of the subduction zone faults tends to cause extensive alteration of the pseudotachylyte glass matrix in later stages, and thus it has been controversial that pseudotachylytes are rarely formed or rarely preserved. Chemical analysis of the fault rocks, especially on fluid-immobile trace elements and isotopes, can be a useful means to identify and quantify the frictional melting occurred in subduction zone faults. In this paper, we report major and trace element and Sr isotope compositions for pseudotachylyte-bearing dark veins and surrounding host rocks from the Mugi area of the Shimanto accretionary complex (Ujiie et al., J. Struct. Geol. 2007). Samples were collected from a rock chip along the microstructure using a micro-drilling technique, and then analyzed by ICP-MS and TIMS. Major element compositions of the dark veins showed a clear shift from the host rock composition toward the illite composition. The dark veins, either unaltered or completely altered, were also characterized by extreme enrichment in some of the trace elements such as Ti, Zr, Nb and Th. These results are consistent with disequilibrium melting of the fault zone. Model calculations revealed that the compositions of the dark veins can be produced by total melting of clay-rich matrix in the source rock, leaving plagioclase and quartz grains almost unmolten. The calculations also showed that the dark veins are far more enriched in melt component than that expected from the source rock compositions, suggesting migration and concentration of frictional melt during the earthquake faulting. Furthermore, Sr isotope data of the dark veins implied the occurrence of frictional melting in multiple stages. These results demonstrate that trace element and isotope analyses are useful not only to detect preexistence of pseudotachylytes but also to evaluate the frictional melting in subduction zone faults quantitatively.

phenoVein—A Tool for Leaf Vein Segmentation and Analysis1[OPEN

PubMed Central

Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; Jahnke, Siegfried

2015-01-01

Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates for local brightness inhomogeneities. The most important traits being calculated are total vein length, vein density, piecewise vein lengths and widths, areole area, and skeleton graph statistics, like the number of branching or ending points. For the determination of vein widths, a model-based vein edge estimation approach has been implemented. Validation was performed for the measurement of vein length, vein width, and vein density of Arabidopsis (Arabidopsis thaliana), proving the reliability of phenoVein. We demonstrate the power of phenoVein on a set of previously described vein structure mutants of Arabidopsis (hemivenata, ondulata3, and asymmetric leaves2-101) compared with wild-type accessions Columbia-0 and Landsberg erecta-0. phenoVein is freely available as open-source software. PMID:26468519

Uranium deposits of the northern part of the Boulder Batholith, Montana

USGS Publications Warehouse

Becraft, George E.

1955-01-01

Uranium minerals and radioactivity anomalies occur in many silver-lead veins and chalcedony veins and vein zones in the Boulder batholith of southwestern Montanao Pitchblende has been identified in a few silver-lead veins. These veins occupy shear zones along which there is no evidence of large-scale lateral displacement. The wall rock adjacent to the veins is intensely silicified and sencitized quartz monzonite and granodiortte. The veins have yielded substantial quantities of lead, silver, zinc, and gold. The silver-lead veins consist principal1y of galena, spha1erite, tetrahedrite, cha1copyrite and pyrite in a gangue of light to dark gray quartz, altered rock, gouge, and subordinate chalcedony and carbonate minerals. No anomalous radioactivity nor uranium minerals have been found in similar veins in pre-batholithic rocks of the area. Chalcedony veins and vein zones, some of which are ttraniferous, are distinctly different from the silver-lead veins and, with a single except1on, are known only in the batholith. The chalcedony vein zones consist of one or more discontinuous stringers or veins of cha1cedony and microcrystalline quartz in silicified and sericitized quartz monzonite and granodiorite, and in less strongly altered alaskite. On1y small amounts of silver ore have been produced from these chalcedony veins and vein zones. All of the veins are ear1y Tertiary in age, but the silver-lead veins probably are older than the chalcedony veins. Uranium is closely associated with chalcedory and microcrystalline quartz in both types of veins. This association suggests that all of the uranium in the area is of the same age. If so, some of the silver-lead veins must have been reopened during the period of chalcedony vein formation.

Endovascular Radiofrequency Ablation for Varicose Veins

PubMed Central

2011-01-01

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 radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (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 back pain and arthritis. Lower limb VV is a very common disease affecting adults – estimated to be the 7th most common reason for physician referral in the US. There is a very strong familial predisposition to VV. The risk in offspring is 90% if both parents affected, 20% when neither affected and 45% (25% boys, 62% girls) if one parent affected. The prevalence of VV worldwide ranges from 5% to 15% among men and 3% to 29% among women varying by the age, gender and ethnicity of the study population, survey methods and disease definition and measurement. The annual incidence of VV estimated from the Framingham Study was reported to be 2.6% among women and 1.9% among men and did not vary within the age range (40-89 years) studied. Approximately 1% of the adult population has a stasis ulcer of venous origin at any one time with 4% at risk. The majority of leg ulcer patients are elderly with simple superficial vein reflux. Stasis ulcers are often lengthy medical problems and can last for several years and, despite effective compression therapy and multilayer bandaging are associated with high recurrence rates. Recent trials involving surgical treatment of superficial vein reflux have resulted in healing and significantly reduced recurrence rates. Endovascular Radiofrequency Ablation for Varicose Veins RFA is an image-guided minimally invasive treatment alternative to surgical stripping of superficial venous reflux. RFA does not require an operating room or general anaesthesia and has been performed in an outpatient setting by a variety of medical specialties including surgeons and interventional radiologists. Rather than surgically removing the vein, RFA works by destroying or ablating the refluxing vein segment using thermal energy delivered through a radiofrequency catheter. Prior to performing RFA, color-flow Doppler ultrasonography is used to confirm and map all areas of venous reflux to devise a safe and effective treatment plan. The RFA procedure involves the introduction of a guide wire into the target vein under ultrasound guidance followed by the insertion of an introducer sheath through which the RFA catheter is advanced. Once satisfactory positioning has been confirmed with ultrasound, a tumescent anaesthetic solution is injected into the soft tissue surrounding the target vein along its entire length. This serves to anaesthetize the vein, insulate the heat from damaging adjacent structures, including nerves and skin and compresses the vein increasing optimal contact of the vessel wall with the electrodes or expanded prongs of the RF device. The RF generator is then activated and the catheter is slowly pulled along the length of the vein. At the end of the procedure, hemostasis is then achieved by applying pressure to the vein entry point. Adequate and proper compression stockings and bandages are applied after the procedure to reduce the risk of venous thromboembolism and to reduce postoperative bruising and tenderness. Patients are encouraged to walk immediately after the procedure. Follow-up protocols vary, with most patients returning 1 to 3 weeks later for an initial follow-up visit. At this point, the initial clinical result is assessed and occlusion of the treated vessels is confirmed with ultrasound. Patients often have a second follow-up visit 1 to 3 months following RFA at which time clinical evaluation and ultrasound are repeated. If required, additional procedures such as phlebectomy or sclerotherapy may be performed during the RFA procedure or at any follow-up visits. Regulatory Status The Closure System® radiofrequency generator for endovascular thermal ablation of varicose veins was approved by Health Canada as a class 3 device in March 2005, registered under medical device license 67865. The RFA intravascular catheter was approved by Health Canada in November 2007 for the ClosureFast catheter, registered under medical device license 16574. The Closure System® also has regulatory approvals in Australia, Europe (CE Mark) and the United States (FDA clearance). In Ontario, RFA is not an insured service and is currently being introduced in private clinics. Methods Literature Search The MAS evidence–based review was performed to support public financing decisions. The literature search was performed on March 9th, 2010 using standard bibliographic databases for studies published up until March, 2010. Inclusion Criteria English language full-reports and human studies Original reports with defined study methodologyReports including standardized measurements on outcome events such as technical success, safety, effectiveness, durability, quality of life or patient satisfaction Reports involving RFA for varicose veins (great or small saphenous veins)Randomized controlled trials (RCTs), systematic reviews and meta-analysesCohort and controlled clinical studies involving ≥ 1 month ultrasound imaging follow-up Exclusion Criteria Non systematic reviews, letters, comments and editorials Reports not involving outcome events such as safety, effectiveness, durability, or patient satisfaction following an intervention with RFAReports not involving interventions with RFA for varicose veinsPilot studies or studies with small samples (< 50 subjects) Summary of Findings The MAS evidence search on the safety and effectiveness of endovascular RFA ablation of VV identified the following evidence: three HTAs, nine systematic reviews, eight randomized controlled trials (five comparing RFA to surgery and three comparing RFA to ELT), five controlled clinical trials and fourteen cohort case series (four were multicenter registry studies). The majority (12⁄14) of the cohort studies (3,664) evaluating RFA for VV involved treatment with first generation RFA catheters and the great saphenous vein (GSV) was the target vessel in all studies. Major adverse events were uncommonly reported and the overall pooled major adverse event rate extracted from the cohort studies was 2.9% (105⁄3,664). Imaging defined treatment effectiveness of vein closure rates were variable ranging from 68% to 96% at post-operative follow-up. Vein ablation rate at 6-month follow-up was reported in four studies with rates close to 90%. Only one study reported vein closure rates at 2 years but only for a minority of the eligible cases. The two studies reporting on RFA ablation with the more efficient second generation catheters involved better follow-up and reported higher ablation rates close to 100% at 6-month follow-up with no major adverse events. A large prospective registry trial that recruited over 1,000 patients at thirty-four largely European centers reported on treatment success in six overlapping reports on selected patient subgroups at various follow-up points up to 5 year. However, the follow-up for eligible recruited patients at all time points was low resulting in inadequate estimates of longer term treatment efficacy. The overall level of evidence of randomized trials comparing RFA with surgical ligation and vein stripping (n = 5) was graded as low to moderate. In all trials RFA ablation was performed with first generation catheters in the setting of the operating theatre under general anaesthesia, usually without tumescent anaesthesia. Procedure times were significantly longer after RFA than surgery. Recovery after treatment was significantly quicker after RFA both with return to usual activity and return to work with on average a one week less of work loss. Major adverse events occurring after surgery were higher [(1.8% (n=4) vs. 0.4% (n = 1) than after RFA but not significantly. Treatment effectiveness measured by imaging defined vein absence or vein closure was comparable in the two treatment groups. Significant improvements in vein symptoms and quality of life over baseline were reported for both treatment groups. Improvements in these outcomes were significantly greater in the RFA group than the surgery group in the peri-operative period but not in later follow-up. Follow-up in these trials was inadequate to evaluate longer term recurrence for either treatment. Patient satisfaction was reported to be high for both treatments but was higher for RFA. The studies comparing endovascular treatment approaches for VV (RFA and ELT) were more limited. Three RCT studies compared RFA (two with the second generation catheter) with ELT but mainly focused on peri-procedural outcomes such as pain, complications and recovery. Vein ablation rates were not evaluated in the trials, except for one small trial involving bilateral VV. Pain responses in patients undergoing ablation were extremely variable and up to 2 weeks, mean pain levels were significantly less with RFA than ELT ablation but differences were not significant at one month. Recovery, evaluated as return to usual activity or return to work, however, was similar in the treatment groups. Vein symptom and QOL improvements were improved in both groups but were significantly better in the RFA group than the ELT group at 2 weeks, but not at one month. Vein ablation rates were evaluated in several controlled clinical studies comparing the treatments between centers or within centers between individuals or over time. Comparisons in these studies were inconsistent with vein ablation rates for RFA reported to be similar to, higher than and lower than those with ELT. Economic Analysis RFA and surgical vein stripping, the main comparator reimbursed by the public system, are comparable in clinical benefits. Hence a cost-analysis was conducted to identify the differences in resources and costs between both procedures and a budgetary impact analysis (BIA) was conducted to project costs over a 5- year period in the province of Ontario. The target population of this economic analysis was patients with symptomatic varicose veins and the primary analytic perspective was that of the Ministry of Health and Long-Term Care. The average case cost (based on Ontario hospital costs and medical resources) for surgical vein stripping was estimated to be $1,799. In order to calculate a procedural cost for RFA it was assumed that the hospital cost and physician labour fees, excluding anaesthesia and surgical assistance, were the same as vein stripping surgery. The manufacturer also provided details on the generator with a capital cost of $27,500 and a lifespan of 5 years and the disposables (catheter, sheath, guidewire) with a cost of $673 per case. The average case cost for RFA was therefore estimated to be $1,356. One-way sensitivity analysis was also conducted with hospital cost of RFA varied to 60% that of vein stripping surgery (average cost per case = $627.08) to calculate an impact to the province. Historical volumes of vein stripping surgeries in Ontario were used to project surgeries in a linear fashion up to five years into the future. Volumes for RFA and ELT were calculated based on share capture from the surgery market based on discussion with clinical expert opinion and existing private data based on discussion with the manufacturer. RFA is expected to compete with ELT and capture some of the market. If ELT is reimbursed by the public sector then numbers will continue to increase from previous private data and share capture from the conventional surgical treatment market. Therefore, RFA cases will also increase since it will be capturing a share of the ELT market. A budget impact to the province was then calculated by multiplying volumes by the cost of the procedure. RFA is comparable in clinical benefits to vein stripping surgery. It has the extra upfront cost of the generator and cost per case for disposables but does not require an operating theater, anaesthetist or surgical assistant fees. The impact to the province is expected to be 5 M by Year 5 with the introduction of new ELT and RFA image guided endovascular technologies and existing surgery for varicose veins. Conclusion The conclusions on the comparative outcomes between endovascular RFA and surgical ligation and saphenous vein stripping and between endovascular RFA and laser ablation for VV treatment are summarized in the table below (ES Table 1). ES Table 1 Outcome comparisons of RFA vs. surgery and RFA vs ELT for varicose veins Outcome Comparisons RFA vs Surgery RFA vs ELT Post procedural pain, minor complications RFA < Surgery RFA < ELT Recovery RFA < Surgery RFA ~ ELT Major adverse events RFA < Surgery RFA ~ ELT Effectiveness - Imaging vein occlusion/ absence RFA ~ Surgery RFA ? ELT Effectiveness -Vein symptom improvement RFA ~ Surgery RFA ~ ELT Effectiveness - Quality Of Life RFA ~ Surgery RFA ~ ELT Recurrence RFA ? Surgery RFA ? ELT Patient satisfaction RFA > Surgery RFA ? ELT Patient preference RFA > Surgery RFA ? ELT Procedure costs RFA < Surgery RFA ~ ELT Budget impact RFA < Surgery RFA ~ ELT ELT refers to endovascular laser ablation; RFA, radiofrequency ablation The outcomes of the evidence-based review on these treatments for VV based on different perspectives are summarized below: RFA First versus Second Generation Catheters and Segmental Ablation Ablation with second generation catheters and segmental ablation offered technical advantages with improved ease and significant decreases in procedure time. RFA ablation with second generation catheters is also no longer restricted to smaller (< 12 mm diameter) saphenous veins. The safety profile with the new device and method of energy delivery is as good as or improved over the first generation device. No major adverse events were reported in two multicenter prospective cohort studies in 6 month follow-up with over 500 patients. Post-operative complications such as bruising and pain were significantly less with RFA ablation with second generation catheters than ELT in two RCT trials.RFA treatment with second generation catheters has ablation rates that are higher than with first generation catheters and are more comparable with the consistently high rates of ELT. Endovascular RFA versus Surgery RFA has a quicker recovery attributable to decreased pain and lower minor complications.RFA, in the short term was comparable to surgery in treatment effectiveness as assessed by imaging defined anatomic outcomes such as vein closure, flow or reflux. Other treatment outcomes such as symptomatic relief and HRQOL were significantly improved in both groups and between group differences in the early peri-operative period were likely influenced by pain experiences. Longer term follow-up was inadequate to evaluate recurrence after either treatment.Patient satisfaction was high after both treatments but was higher for RFA than surgery. Endovascular RFA versus ELT RFA has significantly less post-operative pain than ELT but differences were not significant when pain was adjusted for analgesic use and pain differences between groups did not persist at 1 month follow-up.Treatment effectiveness, measured as symptom relief and QOL improvement were similar between the endovascular treatments in the short term (within 1 month) Treatment effectiveness measured as imaging defined vein ablation was not measured in any RCT trials (only for bilateral VV disease) and results were inconsistently reported in observational trials.Longer term follow-up was not available to assess recurrence after either treatment. System Outcomes – RFA Replacing Surgery or Competing with ELT RFA may offer system advantages in that the treatment can be offered by several medical specialties in outpatient settings and because it does not require an operating theatre or general anaesthesia. The treatment may result in decanting of patients from OR with decreased pre-surgical investigations, demand on anaesthetists’ time, hospital stay and wait time for VV treatment. It may also provide more reliable outpatient scheduling. Procedure costs may be less for endovascular approaches than surgery but the budget impact may be greater with insurance of RFA because of the transfer of cases from the private market to the public payer system.Competition between RFA and ELT endovascular approaches is likely to continue to stimulate innovation and technical changes to advance patient care and result in competitive pricing. PMID:23074413

Morphological variability in leaves and molecular characterization of novel table grape candidate cultivars (Vitis vinifera L.).

PubMed

Alba, Vittorio; Bergamini, Carlo; Cardone, Maria Francesca; Gasparro, Marica; Perniola, Rocco; Genghi, Rosalinda; Antonacci, Donato

2014-06-01

The present work report the characterization of twenty-one table grapes candidate cultivars plus five registered ones included as reference, by means of 47 ampelographic traits, 23 ampelometric measurements and six microsatellite loci. The final goal of the research was to analyse the possibility of reducing the number of morphological and molecular tools required for a precise and effective description of a grape genotype or cultivar. This would be of great help for future biodiversity description on a larger sample of more than 300 table grapes accessions today grown at the 'Consiglio per la Ricerca e la sperimentazione in Agricoltura (C.R.A.)-Unità di ricerca per l'uva da tavola e la vitivinicoltura in ambiente mediterraneo (Bari-Italy)'. OIV ampelographic traits showed a clear distinction among all twenty-six genotypes analysed, suggesting the relevant morphological variability investigated. Principal component analysis based on ampelometric traits revealed main veins ON(3), ON(4) and O(3)N(4); ratios between main veins; angles between main veins and of petiolar sinus, to be the most effective records in differentiating cultivars, for a total variation of 69.9 % described by the first three components. Molecular analysis based on six microsatellite loci was performed on all genotypes, providing a detailed molecular profile and a dendrogram of genetic similarity, in which all genotypes were clearly distinguishable. Finally, with the goal of using the minimum possible number of markers to differentiate genotypes, microsatellites VVMD5 and VVMD27 were selected to be sufficient to distinguish among all the candidate cultivars included in the analysis, representing a possible 'step by step' approach when a molecular characterization has to be undertaken on a large number of genotypes, by first testing few markers and increasing their number only if necessary.

Constraints on lithosphere-asthenosphere melt mixing in basaltic intraplate volcanism from olivine melt inclusions from southern Payenia, Argentina

NASA Astrophysics Data System (ADS)

Søager, Nina; Portnyagin, Maxim; Hoernle, Kaj; Holm, Paul Martin; Garbe-Schönberg, Dieter

2018-06-01

We present major and trace element compositions of melt inclusions from three alkali basalts from the Río Colorado volcanic field in the Payenia backarc province, Argentina. Modeling of diffusion profiles around the inclusions showed that most inclusions equilibrated <14 days after formation, indicating a short crustal residence time for the magmas and nearly direct ascent through the crust. Despite overlapping host rock isotopic compositions, the inclusions show a large variation in their degree of enrichment, and display trends that we interpret as mixing between asthenospheric OIB-type low K2O-high Nb/U melts and enriched high K2O-low Nb/U lithospheric mantle melts similar in composition to alkaline lamprophyres. The low Nb/U magmas are excessively enriched in the elements Cs, Rb, Ba, Th, U, K, Pb and Cl relative to Nb, Ta and REEs. The enriched low Nb/U components are interpreted to have formed by percolative fractional crystallization of asthenospheric high Nb/U melts in the lithospheric mantle involving crystallization of clinopyroxene, apatite and rutile. The residual fluid-rich melts either mixed directly with new batches of high Nb/U melts or metasomatized and veined the lithospheric mantle which later re-melted during continued volcanism. The major element compositions of the high K2O-low Nb/U components are distinct for the whole rocks and melt inclusions, and most enriched inclusions have lower SiO2 and higher TiO2 contents indicating derivation by melting of amphibole-bearing veins. In contrast, most whole rock low Nb/U basalts have higher SiO2 and lower TiO2 and were most likely formed by melting of pyroxenitic veins or peridotitic metasomatized lithospheric mantle.

Late-Hercynian intrusion-related gold deposits: An integrated model on the Tighza polymetallic district, central Morocco

NASA Astrophysics Data System (ADS)

Éric, Marcoux; Khadija, Nerci; Yannick, Branquet; Claire, Ramboz; Gilles, Ruffet; Jean-Jacques, Peucat; Ross, Stevenson; Michel, Jébrak

2015-07-01

Gold have been recently recognized in the Tighza (formerly Jebel Aouam) district, in the Hercynian belt of central Morocco. This district has long been known for its W mineralization, as well as major Pb-Ag-Zn, and minor Sb-Ba deposits, all geographically associated with late-Hercynian calc-alkaline magmatism. Gold mineralization in the district is mainly hosted by thick W-Au quartz veins located around the "Mine granite" small granitic plug. Within the veins, gold grade is highest (up to 70 g/t) close to the granite but rapidly decreases going outward from the granite, defining a perigranitic zoning. Anomalous gold grades have also been measured in hydrothermal skarn layers close to two other granitic plugs (Kaolin granite and Mispickel granite), associated with disseminated As-Fe sulfides. The paragenetic sequence for the W-Au quartz veins shows three stages: (1) an early oxidized stage with wolframite-scheelite associated with early quartz (Q1), (2) an intermediate Bi-As-Te-Mo-Au sulfide stage with loellingite, bismuth minerals and native gold with a later quartz (Q2), restricted to a narrow distance from the granite, and (3) a late lower temperature As-Cu-Zn-(Pb) stage with abundant massive pyrrhotite, arsenopyrite and sphalerite, locally forming independent veins ("pyrrhotite vein"). Both Q1 hyaline and Q2 saccharoidal gold-bearing quartz display aqua-carbonic fluids with minor H2S and Cu and an homogeneous composition (81 mole% H2O, 18 mole% CO2 and about 1 mole% NaCl). The trapping pressure is estimated to 1.5-2 kbar with temperature ranging from 300 to 350 °C. Q1 inclusions have exploded indicating an uplift of the Tighza block, that lead to saccharoidal Q2 quartz deposition with multiphase NaCl-saturated fluid inclusions. 40Ar/39Ar dating demonstrates that the "Mine granite", tungsten skarnoid, scheelite-molybdenite veins, and very likely gold-bearing veins are coeval, emplaced at 286 ± 1 Ma. Multiple and widespread metal sources are indicated by radiogenic isotope studies. Nd and Sr isotope compositions of scheelite and granites suggest the participation of a juvenile component while lead isotopes demonstrate a major participation of the basement. Both gold mineralization and zoning suggest that the system developed at the end of the magmatic activity, accompanying a major transition in magmatic fluid composition. The morphology of the gold-bearing mineralization is dependent of the permeability and the reactivity of host-rocks: focus circulation of fluids through pre-existing tectonic corridors, reactivated by late-Hercynian intrusions favor the formation of large W-type gold veins, while infiltration of fluid within reactive stratigraphic layers gives rise to skarn mineralization. A 40Ar/39Ar date (W1 north vein: 291.8 ± 0.3 Ma) indicates that hydrothermal circulation predates gold and tungsten deposition in open fractures as well as Mine granite emplacement. The W-Au mineralization preceded the onset of a large convective hydrothermal cell around the intrusion that led to the formation of the Pb-Ag-Zn mined veins. The Tighza polymetallic district displays numerous similarities with the R-IRG model that was defined in the American Cordillera, such as thermal and zonation patterns, carbonic hydrothermal fluids and chronology of intrusion and related deposits, but also provides new insight to the R-IRG model such as wide Au-quartz veins instead of sheeted Au-veins, oxidation state of the magma, and Sr-Nd isotopic data. These results establish a major magmatic contribution and discard a direct genetic relationship between gold mineralization and major neighboring Pb-Ag-Zn veins. A large number of classic Pb-Zn district of the Western Hercynides belong to the same clan.

Chemistry and Ni-isotope composition of ureilites and their components

NASA Astrophysics Data System (ADS)

Gabriel, A. D.; Quitté, G.; Pack, A.

2008-09-01

Ureilites are olivine-pigeonite bearing achondrites with interstitial carbonaceous material and metal. The latter is present as <1 μm metal inclusions in reduced rims of silicate grains, 5-20 μm spherical inclusions in clear silicate grains, and in association with interstitial carbonaceous material. We have studied the composition of metal and silicates in 9 ureilites with a fayalite content of Fa2 to Fa21. Vein metal contains 3.7 to 5.4 wt% Ni and 0.35 to 0.54 wt% Co. Cobalt and Ni contents in vein metal and fayalite in olivine do not correlate. Mass balance calculations assuming a chondritic parent body yield a metal core with 7 to 11 wt% Ni and 0.3 to 0.55 wt% Co. Thermodynamic calculations of Fe-Ni and Fe-Co exchange between olivine and vein metal show that vein metal cannot be in equilibrium with the olivine at any temperature. We conclude that the vein metal is genetically not linked to the ureilite olivine and may have been injected into the parent body by an impactor. Recently published data show a deficit in 60Ni of - 0.24+/-0.02 ɛ-units for various achondrites including ureilites [1]. This has been interpreted as evidence for a late injection of 60Fe after formation of these achondrites. However, our chemical data for vein metal, which is the dominant Ni host in ureilites, demonstrate that bulk Ni isotope data have little meaning with respect to the formation of ureilite silicates. In this work we present Ni isotope data for bulk samples but also vein material and the silicate phase of 4 ureilites (ALHA77257, EET87157, EET96041, Kenna). Bulk ureilites have a ɛ60 between -0.05+/-0.12 and 0.08+/-0.12; the vein metal gives ɛ60 = -0.05+/-0.13 to 0.11+/-0.16. No resolvable deficit in ɛ60 was found, in disagreement with results reported in Bizzarro et al. (2007). The vein material and the bulk samples have, within uncertainty, the same isotopic composition, confirming that the global Ni budget is controlled by the vein material. In ureilite silicates ɛ60 varies from -0.77+/-0.31 to -0.12+/-0.21. Due to the high Fe/Ni ratio of silicates, clear excesses of 60Ni (at least several ɛ-units) are expected if they formed early in the solar system. This is not observed. There is thus no evidence for life 60Fe in ureilites, which may be interpreted in different ways: either 60Fe was injected at a later time into the protoplanetary disk as suggested by [1] (but this is difficult to reconcile with data obtained in other meteorites [2]), or several isotopically distinct reservoirs co-existed at the beginning of the solar system. The isotopic difference between vein material and silicates rather supports the second hypothesis, even if further studies are required to confirm it. It may also be that the Fe-Ni system has been disturbed at a later stage after formation of ureilites. References [1] Bizzarro M. et al. 2007. Science 316 (5828), 1178- 1181. [2] Quitté G. et al. 2007. LPSC 38, abstract #1900.

The Effect of Stenting on Venous Hypertension: Results Using a Treadmill Stress Test with Invasive Pressure Measurements in Patients with Iliofemoral Venous Obstruction.

PubMed

Kurstjens, Ralph L M; de Wolf, Mark A F; Konijn, Helena W; Toonder, Irwin M; Nelemans, Patricia J; van Laanen, Jorinde H H; de Graaf, Rick; Wittens, Cees H A

2018-06-01

The primary aim was to investigate whether stenting of post-thrombotic iliofemoral obstruction reduces venous hypertension. The secondary aim was to establish whether improvement in haemodynamic parameters impacts on quality of life. In this prospective observational study, 12 participants with unilateral post-thrombotic obstruction of the iliac and/or common femoral veins (CFVs) underwent a treadmill stress test with invasive pressure measurements in the CFVs and dorsal foot veins of both affected and non-affected limbs. This was performed the day before and 3 months after stenting the obstructed tract. Paired sample t-tests were used to compare the treatment effect and univariable linear regression analysis to determine the association with improvement in quality of life. Before treatment, CFV pressure increased 34.8 ± 23.1 mmHg during walking in affected limbs compared with 3.9 ± 5.8 mmHg in non-affected limbs. This pressure rise decreased to 22.3 ± 24.8 mmHg after 3 months follow up compared with a 4.0 ± 6.0 mmHg increase in non-affected limbs (-26.2 mmHg difference; 95% CI -41.2 to -11.3). No such effect was found in the dorsal foot veins. The VEINES-QOL increased 25.3 ± 11.3 points after stenting and was significantly associated with a decrease in CFV pressure rise during walking (regression coefficient 0.4; 95% CI 0.1-0.6). Stenting of post-thrombotic iliofemoral obstruction significantly reduces venous hypertension in the common femoral vein and correlates with an improvement in the quality of life. Larger studies with a broader range of degree of obstruction need be performed to assess whether pre-stenting pressure measurements can predict post stenting clinical success. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akahane, Akio, E-mail: a.akahane@gmail.com; Sone, Miyuki; Ehara, Shigeru

2011-12-15

Purpose: This study was designed to compare central venous ports (CVP) from two different routes of venous access-the subclavian vein and arm vein-in terms of safety for patients with head and neck cancer (HNC). Methods: Patients with HNC who underwent image-guided implantations of CVPs were retrospectively evaluated. All CVPs were implanted under local anesthesia. Primary outcome measurements were rates and types of adverse events (AEs). Secondary outcomes included technical success and rate and reason of CVP removal. Results: A total of 162 patients (subclavian port group, 47; arm port group, 115) were included in this study. Technical success was achievedmore » in all patients. The median follow-up period was 94 (range, 1-891) days. Two patients in the subclavian port group experienced periprocedural complications. Postprocedural AEs were observed in 8.5 and 22.6% of the subclavian port and arm port group patients, respectively (P = 0.044). Phlebitis and system occlusions were observed only in the arm port group. The rate of infection was not significantly different between the two groups. The CVP was removed in 34 and 39.1% of the subclavian port and arm port patients, respectively. Conclusions: Both subclavian and arm CVPs are feasible in patients with HNC. AEs were more frequent in the arm port group; thus, the arm port is not recommended as the first choice for patients with HNC. However, further experience is needed to improve the placement technique and the maintenance of CVPs and a prospective analysis is warranted.« less

Concurrent Angioplasty Balloon Placement for Stent Delivery through Jugular Venous Bulb for Treating Cerebral Venous Sinus Stenosis. Technical Report.

PubMed

Qureshi, Adnan I; Khan, Asif A; Capistrant, Rachel; Qureshi, Mushtaq H; Xie, Kevin; Suri, M Fareed K

2016-10-01

To report upon technique of concurrent placement of angioplasty balloon at the internal jugular vein and sigmoid venous sinus junction to facilitate stent delivery in two patients in whom stent delivery past the jugular bulb was not possible. A 21-year-old woman and a 41-year-old woman with worsening headaches, visual obscuration or diplopia were treated for pseudotumor cerebri associated with transverse venous stenosis. Both patients had undergone primary angioplasty, which resulted in improvement in clinical symptoms followed by the recurrence of symptoms with restenosis at the site of angioplasty. After multiple attempts at stent delivery through jugular venous bulb were unsuccessful, a second guide catheter was placed in the ipsilateral internal jugular vein through contralateral femoral venous approach. A 6 mm × 20 mm (left) or 5 × 15 mm (right) angioplasty balloon was placed across the internal jugular vein and sigmoid sinus junction and partially inflated until the inflation and relative straightening of the junction was observed. In both patients, the internal jugular vein and sigmoid sinus junction was successfully traversed by the stent delivery system in a parallel alignment to inflated balloon. Balloon mounted stent was deployed at the site of restenosis with near complete resolution of lumen narrowing delivery and improvement in clinical symptoms. We report a technique for realignment and diameter change with concurrent placement and partial inflation of angioplasty balloon at the jugular venous bulb to facilitate stent delivery into the sigmoid and transverse venous sinuses in circumstances where multiple attempts at stent delivery are unsuccessful.

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.

Pathophysiology of Venous Thromboembolism with Respect to the Anatomical Features of the Deep Veins of Lower Limbs: A Review.

PubMed

Ro, Ayako; Kageyama, Norimasa; Mukai, Toshiji

2017-06-25

Here the pathophysiology of venous thromboembolism is reviewed with respect to the anatomical features of the deep veins of lower limbs. A thrombus is less likely to form in the thigh veins compared with that in the calf veins; however, clinical symptoms are more likely to appear in the thigh veins owing to vascular occlusion. When a patient is bedridden, thrombosis is more likely to occur in the intramuscular vein, which mainly depends on muscular pumping and the venous valve, rather than in the three crural branches, which mainly depends on the pulsation of the accompanying artery. Thrombi are prone to be generated in the soleal vein compared with those in the gastrocnemius vein because of the vein and muscle structures. A soleal vein thrombosis grows toward the proximal veins along the drainage veins. To prevent a sudden pulmonary thromboembolism-related death in bedridden patients, preventing soleal vein thrombus formation and observing the thrombus proximal propagation via the drainage veins are clinically important. When deep vein thrombosis occurs, avoiding embolization and sequela caused by the thrombus organization is necessary.

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.

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

An observational study comparing the prototype device with the existing device for the effective visualization of invisible veins in elderly patients in Japan.

PubMed

Kimori, Keiko; Sugama, Junko; Nakatani, Toshio; Nakayama, Kazuya; Miyati, Tosiaki; Sanada, Hiromi

2015-01-01

To compare the performance on the detection of the invisible veins between our modified prototype device and an existing device in elderly hospitalized patients. A prospective, cross-sectional, and observational study was performed in the invisible veins in elderly patients. The major variables, skin color near the invisible veins, and diameter and depth of the invisible veins were measured. The vein visualization rate was calculated as the ratio of the visualized veins to the invisible veins by the visualization device. We analyzed 53 invisible veins in the cubital fossa and 56 invisible veins in the forearm in a total of 72 patients (median age, 73 years). The visualization rate for our prototype device was higher than that for an existing device in the cubital fossa and the forearm sites. The visualized veins of the prototype device had a higher intensity ratio than that of an existing device. No significant differences were observed in the body mass index, vein depth, and vein diameter of the visualized veins at the cubital fossa and forearm sites. The prototype surpassed the existing device in visualizing the invisible veins. However, the prototype was unable to visualize all the invisible veins. We need to look for ways to reduce noise and to visualize the invisible veins, and the visualization rate of devices needs to be investigated in further association with the percentage of success with actual intravenous access and locating time to vein.

Geology of the Devils Hole area, Nevada

USGS Publications Warehouse

Carr, W.J.

1988-01-01

Detailed and reconnaissance mapping of the Devils Hole, Nevada, area has improved definition of the local geologic structure within a regional carbonate aquifer near its primary discharge points -- the springs of Ash Meadows. Several formerly unmapped calcite veins, and other young calcite-lined paleo-spring feeder zones were found, as well as a number of previously unknown small collapse areas in the limestone. Although the predominant structural grain of the area is oriented northwest, the importance of the very subordinate northeast-striking faults and fractures is underscored by their association with Devils Hole itself, with most of the collapse depressions, and with many of the calcite veins in ' lake beds ' and alluvium. Probable channeling of groundwater flow may occur along one important northeast-striking fault zone. The persistent tendency for openings may have been facilitated by underlying low-angle faults that separate brittle carbonate rocks from underlying, less-competent clastic rocks. (Author 's abstract)

Extrahepatic portal obstruction without hepatopetal pathway associated with congenital arterioportal fistula: a case report.

PubMed

Maeda, N; Horie, Y; Koda, M; Suou, T; Andachi, H; Nakamura, K; Kawasaki, H

1997-01-01

Extrahepatic portal obstruction is one of the causes of portal hypertension, in which well-developed hepatopetal pathways are commonly recognized. Herein an extremely rare case of extrahepatic portal obstruction without hepatopetal pathway, probably caused by arterioportal fistula, is reported. The patient was a normally matured 16-year-old girl admitted for further evaluation of jaundice, presenting with the clinical manifestations of the portal hypertension associated with hypersplenism and portosystemic venous shunt. Celiac angiography clearly demonstrated an intrahepatic arterial aneurysm fed by the right hepatic artery shunting to the superior mesenteric vein, and portography disclosed complete obstruction of the portal trunk with conspicuous hepatofugal pathway but no hepatopetal collateral veins. The exact mechanism of this phenomenon is not known and whether the extrahepatic portal obstruction was primary or secondary is still obscure. However, this is the first case report in the world literature describing extrahepatic portal obstruction with absence of hepatopetal pathway.

Supportive care for children with cancer. Guidelines of the Childrens Cancer Study Group. The use of nutritional therapy.

PubMed

Lukens, J N

1984-01-01

Nutritional support for children with cancer is predicated on the belief that optimal nutrition promotes tolerance of anti-neoplastic therapy and preserves immunologic responsiveness. The use of nutritional support is based on the assumption that there is effective therapy for the primary disease and that there will be a predictable period of nutritional stress. The most common nutritional problem is posed by the failure of sick children willingly to eat enough to maintain nutritional homeostasis. Supplementation of oral intake with a nutritional formula given by a small-bore nasogastric tube is simple, effective, and economical. If the sum of oral and tolerated nasogastric tube feedings is less than that required for optimal nutrition, unmet needs may be satisfied by nutrients given into a peripheral vein. Total parenteral nutrition, given by central vein, is reserved for situations in which the combination of enteral and peripheral venous alimentation is inadequate.

[Venous thromboembolic disease: presentation of a case].

PubMed

Mirpuri-Mirpuri, P G; Álvarez-Cordovés, M M; Pérez-Monje, A

2013-01-01

Venous thromboembolic disease in its clinical spectrum includes both deep vein thrombosis and pulmonary thromboembolism, which is usually a complication of deep vein thrombosis. It is a relatively common disease with significant morbidity and requires an accurate diagnosis. They are numerous risk factors for venous thromboembolism, and there is evidence that the risk of thromboembolic disease increases proportionally to the number of predisposing risk factors present. The primary care physician should know the risk factors and suspect the presence of venous thromboembolic disease when there is a compatible clnical picture. The treatment for this pathology is anticoagulation. We report a patient with cardiovascular risk factors who was seen with pain in the right leg and shortness of breath and referred to the hospital with suspected venous thromboembolism, atrial fibrillation and pleural effusion. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp

Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopymore » guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.« less

Advances in the management of childhood portal hypertension.

PubMed

McKiernan, Patrick; Abdel-Hady, Mona

2015-05-01

Portal hypertension is one of the most serious complications of childhood liver disease, and variceal bleeding is the most feared complication. Most portal hypertension results from cirrhosis but extra hepatic portal vein obstruction is the single commonest cause. Upper gastrointestinal endoscopy endoscopy remains necessary to diagnose gastro-esophageal varices. Families of children with portal hypertension should be provided with written instructions in case of gastrointestinal bleeding. Children with large varices should be considered for primary prophylaxis on a case-by-case basis. The preferred method is variceal band ligation. Children with acute bleeding should be admitted to hospital and treated with antibiotics and pharmacotherapy before urgent therapeutic endoscopy. All children who have bled should then receive secondary prophylaxis. The preferred method is variceal band ligation and as yet there is little evidence to support the use of β-blockers. Children with extrahepatic portal vein obstruction should be assessed for suitability of mesoportal bypass.

Pathophysiology of Venous Thromboembolism with Respect to the Anatomical Features of the Deep Veins of Lower Limbs: A Review

PubMed Central

Ro, Ayako; Kageyama, Norimasa; Mukai, Toshiji

2017-01-01

Here the pathophysiology of venous thromboembolism is reviewed with respect to the anatomical features of the deep veins of lower limbs. A thrombus is less likely to form in the thigh veins compared with that in the calf veins; however, clinical symptoms are more likely to appear in the thigh veins owing to vascular occlusion. When a patient is bedridden, thrombosis is more likely to occur in the intramuscular vein, which mainly depends on muscular pumping and the venous valve, rather than in the three crural branches, which mainly depends on the pulsation of the accompanying artery. Thrombi are prone to be generated in the soleal vein compared with those in the gastrocnemius vein because of the vein and muscle structures. A soleal vein thrombosis grows toward the proximal veins along the drainage veins. To prevent a sudden pulmonary thromboembolism-related death in bedridden patients, preventing soleal vein thrombus formation and observing the thrombus proximal propagation via the drainage veins are clinically important. When deep vein thrombosis occurs, avoiding embolization and sequela caused by the thrombus organization is necessary. PMID:29034034

Major element compositions of fluid inclusions from hydrothermal vein-type deposits record eroded sedimentary units in the Schwarzwald district, SW Germany

NASA Astrophysics Data System (ADS)

Walter, Benjamin F.; Burisch, Mathias; Marks, Michael A. W.; Markl, Gregor

2017-12-01

Mixing of sedimentary formation fluids with basement-derived brines is an important mechanism for the formation of hydrothermal veins. We focus on the sources of the sediment-derived fluid component in ore-forming processes and present a comprehensive fluid inclusion study on 84 Jurassic hydrothermal veins from the Schwarzwald mining district (SW Germany). Our data derive from about 2300 fluid inclusions and reveal differences in the average fluid composition between the northern, central, and southern Schwarzwald. Fluids from the northern and southern Schwarzwald are characterised by high salinities (18-26 wt% NaCl+CaCl2), low Ca/(Ca+Na) mole ratios (0.1-0.4), and variable Cl/Br mass ratios (30-1140). In contrast, fluids from the central Schwarzwald show even higher salinities (23-27 wt% NaCl+CaCl2), higher Ca/(Ca+Na) mole ratios (0.2-0.9), and less variable Cl/Br mass ratios (40-130). These fluid compositions correlate with the nature and thickness of the now eroded sedimentary cover rocks. Compared to the northern and the southern Schwarzwald, where halite precipitation occurred during the Middle Triassic, the sedimentary basin in the central Schwarzwald was relatively shallow at this time and no halite was precipitated. Accordingly, Cl/Br ratios of fluids from the central Schwarzwald provide no evidence for the reaction of a sedimentary brine with halite, whereas those from the northern and southern Schwarzwald do. Instead, elevated Ca/(Ca+Na), high SO4 contents, and relatively low Cl/Br imply the presence of a gypsum dissolution brine during vein formation in the central Schwarzwald which agrees with the reconstructed regional Triassic geology. Hence, the information archived in fluid inclusions from hydrothermal veins in the crystalline basement has the potential for reconstructing sedimentary rocks in the former overburden.

Petrography and geochemistry of granitoids from the Samphire Pluton, South Australia: Implications for uranium mineralisation in overlying sediments

NASA Astrophysics Data System (ADS)

Domnick, Urs; Cook, Nigel J.; Bluck, Russel; Brown, Callan; Ciobanu, Cristiana L.

2018-02-01

The Blackbush uranium deposit (JORC Inferred Resource: 12,580 tonnes U), located on the north-eastern Eyre Peninsula, is currently the only sediment-hosted U deposit investigated in detail in the Gawler Craton. Uranium is hosted within Eocene sandstone of the Kanaka Beds, overlying Mesoproterozoic granites of the Samphire pluton, affiliated with the Hiltaba Intrusive Suite ( 1.6 Ga). These are considered the most probable source rocks for uranium mineralisation. By constraining the petrography and mineralogy of the granites, insights into the post-emplacement evolution can be gained, which may provide an exploration indicator for other sediment-hosted uranium systems. Three geochemically distinct granite types were identified in the Samphire Pluton and correspond to domains interpreted from geophysical data. All granites show complex alteration overprints and textures with increasing intensity closer to the deposit, as well as crosscutting veining. Alkali feldspar has been replaced by porous K-feldspar and albite, and plagioclase is overprinted by an assemblage of porous albite + sericite ± calc-silicates (prehnite, pumpellyite and epidote). This style of feldspar alteration is regionally widespread and known from Hiltaba-aged granites associated with iron-oxide copper-gold mineralisation at Olympic Dam and in the Moonta-Wallaroo region. In two granite types biotite is replaced by calcic garnet. Calc-silicates are indicative of Ca-metasomatism, sourced from the anorthite component of altered plagioclase. Minor clay alteration of feldspars is present in all samples. Mineral assemblages in veins include quartz + hematite, hematite + coffinite, fluorite + quartz, and clay minerals. Minor chlorite and sericite are found in all vein types. All granite types are anomalously rich in U (concentrations between 10 and 81 ppm). Highly variable Th/U ratios, as well as hydrothermal U minerals (mostly coffinite) in granites and veins, are clear evidence for U mobility. Uranium may have been preconcentrated in veins in the upper parts of the pluton, and was subsequently leached after deposition of the sediment.

Randomized Study Comparing the Effect of Carbon Dioxide Insufflation on Veins Using 2 Types of Endoscopic and Open Vein Harvesting.

PubMed

Krishnamoorthy, Bhuvaneswari; Critchley, William R; Nair, Janesh; Malagon, Ignacio; Carey, John; Barnard, James B; Waterworth, Paul D; Venkateswaran, Rajamiyer V; Fildes, James E; Caress, Ann L; Yonan, Nizar

The aim of the study was to assess whether the use of carbon dioxide insufflation has any impact on integrity of long saphenous vein comparing 2 types of endoscopic vein harvesting and traditional open vein harvesting. A total of 301 patients were prospectively randomized into 3 groups. Group 1 control arm of open vein harvesting (n = 101), group 2 closed tunnel (carbon dioxide) endoscopic vein harvesting (n = 100) and Group 3 open tunnel (carbon dioxide) endoscopic vein harvesting (open tunnel endoscopic vein harvesting) (n = 100). Each group was assessed to determine the systemic level of partial arterial carbon dioxide, end-tidal carbon dioxide, and pH. Three blood samples were obtained at baseline, 10 minutes after start of endoscopic vein harvesting, and 10 minutes after the vein was retrieved. Vein samples were taken immediately after vein harvesting without further surgical handling to measure the histological level of endothelial damage. A modified validated endothelial scoring system was used to compare the extent of endothelial stretching and detachment. The level of end-tidal carbon dioxide was maintained in the open tunnel endoscopic vein harvesting and open vein harvesting groups but increased significantly in the closed tunnel endoscopic vein harvesting group (P = 0.451, P = 0.385, and P < 0.001). Interestingly, partial arterial carbon dioxide also did not differ over time in the open tunnel endoscopic vein harvesting group (P = 0.241), whereas partial arterial carbon dioxide reduced significantly over time in the open vein harvesting group (P = 0.001). A profound increase in partial arterial carbon dioxide was observed in the closed tunnel endoscopic vein harvesting group (P < 0.001). Consistent with these patterns, only the closed tunnel endoscopic vein harvesting group demonstrated a sudden drop in pH over time (P < 0.001), whereas pH remained stable for both open tunnel endoscopic vein harvesting and open vein harvesting groups (P = 0.105 and P = 0.869, respectively). Endothelial integrity was better preserved in the open vein harvesting group compared with open tunnel endoscopic vein harvesting or closed tunnel endoscopic vein harvesting groups (P = 0.012) and was not affected by changes in carbon dioxide or low pH. Significantly greater stretching of the endothelium was observed in the open tunnel endoscopic open tunnel endoscopic vein harvesting group compared with the other groups (P = 0.003). This study demonstrated that the different vein harvesting techniques impact on endothelial integrity; however, this does not seem to be related to the increase in systemic absorption of carbon dioxide or to the pressurized endoscopic tunnel. The open tunnel endoscopic harvesting technique vein had more endothelial stretching compared with the closed tunnel endoscopic technique; this may be due to manual dissection of the vein. Further research is required to evaluate the long-term clinical outcome of these vein grafts.

[Analysis of efficacy of radiofrequency obliteration with due regard for the target vein's diameter].

PubMed

Shaĭdakov, E V; Grigorian, A G; Iliukhin, E A; Bulatov, V L; Gal'chenko, M I

2014-01-01

Data concerning the effect of the target vein's diameter on efficacy of radiofrequency obliteration (RFO) in the current literature are limited. To assess efficacy of RFO and stripping, peculiarities of the postoperative period course with due regard for the diameter of the target veins, to compare the outcomes of RFO and classical phlebectomy in treatment of varicose disease during 1-year follow up by a composite end point. A multicenter prospective non-randomized study based on analysing therapeutic outcomes in a total of 218 patients presenting with varicose disease (C2-C3 according to the CEAP). RFO was performed in 108 patients and phlebectomy in 110 subjects. The results were assessed by means of a composite end point including four components: technical outcome at 1-year follow-up, pain, subcutaneous haemorrhage, and paresthesias. The groups of patients who endured RFO and phlebectomy were subdivided into two subgroups according to the target vein's diameter with a border of 14 mm. Statistical analysis. We used the methods of non-parametric statistics (contingency tables, chi squared test), calculating the odds ratio (OR) for a favourable outcome with a 95% confidential interval. Pain dynamics was assessed by means of intellectual data analysis (cluster analysis). «Phelbectomy ≥ 14 mm» and «RFO ≥ 14 mm». The incidence rate of a good outcome in the subgroups amounted to 20 (30.8%) and 61 (95.3%), respectively. The odds ratio for favourable outcome between the subgroups of RFA and phlebectomy amounted to 45.8; 95% CI (44.5-47.0). "RFA ≥ 14 mm" and "RFA < 14 mm". Favourable outcome rate in the subgroups amounted to 25 (39.1%) and 17 (38.6%), respectively. The differences were not statistically significant, p=0.24. The odds ratio for a good outcome between the RFO subgroups amounted to: OR=0.98; 95% CI (0.18-1.77). Comparative analysis of RFO outcomes between the clinics. Favourable outcome rate in the first clinic was 50 (92.6%), in the second 34 (87.2%), and in the third 13 (86.6%), with the difference being statistically insignificant, p=0.7. The cluster analysis of the pain dynamics after the intervention. The clusters with moderate pain were composed of the patients after phlebectomy. These clusters showed association of pain intensity with increased BMI and greater vein diameter. 1) RFA of great-diameter veins by a favourable outcome by the composite end point (CED) turned out to be superior to the classic phlebectomy. 2) For RFA the incidence rate of a favourable outcome by the CED does not depend on the target vein's diameter. 3) A pronounced pain syndrome after phlebectomy was associated with excessive body weight or obesity and greater diameter of the vein.

[Results of the percutaneous retrograde embolization as the first choice in the treatment of varicocele].

PubMed

Piñera, J Gonzálvez; Fernández-Córdoba, M S; Anselmi, E Hernández; Mollá, E Juliá; Jiménez, M J Pedrosa; Cabañero, A G Blanco; Baró, A Palma

2009-07-01

There is evidence that early varicocele treatment decreases testicular damage. The minimally invasive techniques such as laparoscopic varicocelectomy, antegrade sclerotherapy and percutaneous retrograde embolisation, are acquiring greater significance in the treatment of this disease. Since 1994, a series of 51 children, aged 7-16 years (mean, 12.9 years), with left-sided varicocele grades 2 (47%) and 3 (53%) were treated in our institution by percutaneous retrograde embolisation using coils. The right basilica vein was the most widely used (70%) followed by the right femoral vein. Seven children (13.7%) had complications: perforation of internal spermatic vein was the most frequent and treated conservatively. No child presented hydrocele after radiological procedures. Embolisation was accomplished succesfully at the first attempt in 35 (68.6%) of the 51 children and in 45 (88.2%) after a second embolisation. The follow-up ranges from 7 months to 5 ? years (mean, 1.8 years). The patients were monitored with clinical and doppler ultrasound examination 3, 6 and 12 months after the treatment. Retrograde embolisation is a safe and efficient minimally invasive treatment for correcting varicoceles in children. We performed retrograde embolisation as first choice of varicocele treatment in children; a second embolisation or conventional surgery for primary failure or late recurrence should be considered.

The quest for durable lesions in catheter ablation of atrial fibrillation - technological advances in radiofrequency catheters and balloon devices.

PubMed

Maurer, Tilman; Kuck, Karl-Heinz

2017-08-01

Atrial fibrillation is the most common cardiac arrhythmia and represents a growing clinical, social and economic challenge. Catheter ablation for symptomatic atrial fibrillation has evolved from an experimental procedure into a widespread therapy and offers a safe and effective treatment option. A prerequisite for durable PVI are transmural and contiguous circumferential lesions around the pulmonary veins. However, electrical reconnection of initially isolated pulmonary veins remains a primary concern and is a dominant factor for arrhythmia recurrence during long-term follow up. Areas covered: This article discusses the physiology of lesion formation using radiofrequency-, cryo- or laser- energy for pulmonary vein isolation and provides a detailed review of recent technological advancements in the field of radiofrequency catheters and balloon devices. Finally, future directions and upcoming developments for the interventional treatment of atrial fibrillation are discussed. Expert commentary: Durable conduction block across deployed myocardial lesions is mandatory not only for PVI but for any other cardiac ablation strategy as well. A major improvement urgently expected is the intraprocedural real-time distinction of durable lesions from interposed gaps with only transiently impaired electrical conduction. Furthermore, a simplification of ablation tools used for PVI is required to reduce the high technical complexity of the procedure.

Effects of defibrotide in patients with chronic deep insufficiency. The PROVEDIS study.

PubMed

Coccheri, S; Andreozzi, G M; D'Addato, M; Gensini, G F

2004-06-01

In the present study the effect of defibrotide, an antithrombotic and profibrinolytic agent, was investigated in patients with chronic venous insufficiency (CVI) due to deep vein obstruction and/or reflux (chronic deep vein insufficiency, CDVI). The study was a multicenter, randomized, double blind placebo controlled trial in which only patients with CDVI confirmed by ultrasound were enrolled. All patients were treated with adequate elastic compression and randomized to receive either oral defibrotide (800 mg/die) or matching placebo for 1 year. Patients with active or previous leg ulcer were excluded. A total of 288 patients were randomized and 159 completed the study. At baseline ultrasound investigation, obstructive changes were found in 2/3 of all patients thus ascertaining a post-thrombotic syndrome (PTS). The primary endpoint, ankle circumference, was significantly reduced under defibrotide from day 120 throughout 360. Scores for pain and edema were improved. The number of episodes of superficial thrombophlebitis and deep vein thrombosis was significantly lower under defibrotide (n=2) than under placebo (n=10). The majority of these events occurred in the subset of patients with documented PTS. Treatment with defibrotide in addition to elastic compression in patients with objectively assessed CDVI, mostly due to PTS, resulted in clinical benefits and prevented thrombotic complications harmful to the limb conditions.

Relationship between peripheral insertion site and catheter-related phlebitis in adult hospitalized patients: a systematic review.

PubMed

Comparcini, Dania; Simonetti, Valentina; Blot, Stijn; Tomietto, Marco; Cicolini, Giancarlo

2017-01-01

To explore the relationship between the anatomical site of peripheral venous catheterization and risk of catheter-related phlebitis. Peripheral venous catheterization is frequently associated with phlebitis. Recent guidelines, recommend the use of an upper-extremity site for catheter insertion but no univocal consensus exists on the anatomical site with lower risk of phlebitis. Systematic review. We searched Medline (PubMed) and CINAHL (EBSCOhost) databases until the end of January 2017. We also reviewed the reference lists of retrieved articles and gray literature was excluded. Searches were limited to articles published in English with no restriction imposed to date of publication. The primary outcome was the incidence of phlebitis associated with anatomical site of peripheral catheterization. We included randomized controlled trials and observational studies on adult patients who required a peripheral catheter for the administration of medi- cation, intermittent or continuous fluid infusion. Antecubital fossa veins are associated with lower phlebitis rates, while hands veins are the most risky sites to develop phlebitis. There is no consensus regarding vein in forearm. Choosing the right anatomical site to insert a peripheral venous catheter is important to decrease phlebitis rate. Further studies should compare indwelling time in different anatomical sites with phlebitis rate. A more standardized approach in defining and assessing phlebitis among studies is recommended.

Varix of the vortex vein ampulla simulating choroidal melanoma: report of four cases.

PubMed

Gündüz, K; Shields, C L; Shields, J A

1998-01-01

Varix of the vortex vein ampulla is a condition that can cause diagnostic confusion with choroidal melanoma. A case series review was performed from the Ocular Oncology Service, Wills Eye Hospital. In all four cases, the patients were referred with the diagnosis of a small choroidal melanoma. The lesions were located in the nasal quadrant of the fundus near the equator. One patient had two lesions in the same quadrant. In all cases, the fundus lesion became more prominent when the eye gazed in the direction of the lesion and diminished in primary gaze. The mass measured up to 6.0 mm in base diameter and 2.5 mm in thickness in proper gaze. B-scan ultrasonography showed acoustic solidity and gaze-evoked dynamic enlargement of the lesion. Indocyanine green angiography demonstrated early pooling of dye and gaze-evoked fluctuation of the hyperfluorescence in the lesion. Color Doppler imaging, performed in one patient, showed a vascular lesion of venous origin that filled when the eye was placed in the direction of the lesion. Varix of the vortex vein is a condition that should be considered in the differential diagnosis of equatorial small choroidal melanoma. The dynamic nature of the lesion is characteristic and diagnostic.

Case report of a modified Meso-Rex bypass as a treatment technique for late-onset portal vein cavernous transformation with portal hypertension after adult deceased-donor liver transplantation.

PubMed

Han, Dongdong; Tang, Rui; Wang, Liang; Li, Ang; Huang, Xin; Shen, Shan; Dong, Jiahong

2017-06-01

Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein. Here we report about an adult patient who was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. An adult male patient with post-liver transplantation portal vein cavernous transformation suffered from hypersplenism and elevated hepatic enzymes. The last follow up revealed irregular and obvious hypersplenism, and splenomegaly had occurred, while an enhanced CT scan revealed serious esophagogastric varices and CTPV in addition to occluded right and common PV trunks. The patient was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. After the operation, a satisfactory velocity was confirmed 1 month postoperatively and the shunt still remained patent at the 6-month postoperation follow-up. A Meso-Rex bypass intervention connecting the left portal vein to the splenic vein instead of the superior mesenteric vein after liver transplantation in an adult patient with right and common portal vein occlusions has been successfully performed as an alternative approach.

Locating difficult veins for venepuncture and cannulation.

PubMed

Shaw, Sally Jane

2017-02-15

Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation. Practitioners should be experienced and skilled in the assessment of veins, and they are encouraged to revisit how they locate and assess veins.

The heritability of vessel size of the pampiniform plexus as a means to assess the genetic component of varicocele

USDA-ARS?s Scientific Manuscript database

Ultrasonography of each testicle was used to capture a coronal-saggital image of the veins of the pampiniform plexus (PP) and the testicular artery of 239 boars at approximately 6 months of age. Three to 10 vessels of the PP were used to derive the average area of right PP vessels (AAR) and the aver...

Influence of homeobox B2 antisense oligodeoxynucleotides on the biological characteristics of in vitro cultured primary human umbilical vein endothelial cells.

PubMed

Liu, X S; Zhang, X Q; Tian, T; Liu, L; Ming, J

2008-01-01

This study aims to explore the influence of homeobox B2 (HOXB2) antisense oligodeoxynucleotides (asodn) on the biological characteristics of in vitro cultured primary human umbilical vein endothelial cells (HUVECs). The distribution of HOXB2 asodn in the HUVECs was observed by fluorescent labelling, and the influence of different concentrations of HOXB2 asodn on the DNA synthesis of HUVECs was assessed. Flow cytometry and a reverse transcriptase-polymerase chain reaction (RT- PCR) method were employed to observe the influence of HOXB2 asodn on HOXB2 expression and the HUVEC cell cycle. After the induction of liposome, the nuclear fluorescent staining of HOXB2 asodn was weaker 15 min after transfection and the staining reached the strongest level at 4-8 h but then weakened and disappeared by 16 h after transfection. This indicated that endothelial DNA synthesis could be inhibited by HOXB2 asodn in a dose-dependent manner. Furthermore, the HUVECs could be delayed in their passage from G1 to S. Simultaneously, expression of HOXB2 mRNA had decreased significantly by 24-48 h after transfection. Clearly, HOXB2 plays important roles in the proliferation of endothelial cells and also affects the cell cycle.

Percutaneous Creation of Bare Intervascular Tunnels for Salvage of Thrombosed Hemodialysis Fistulas Without Recanalizable Outflow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Matt Chiung-Yu, E-mail: jjychen@gmail.com; Wang, Yen-Chi; Weng, Mei-Jui

2015-08-15

PurposeThis study aimed to retrospectively assess the efficacy of a bare intervascular tunnel for salvage of a thrombosed hemodialysis fistula. We examined the clinical outcomes and provided follow-up images of the bare intervascular tunnel.Materials and MethodsEight thrombosed fistulas lacked available recanalizable outflow veins were included in this study. These fistulas were salvaged by re-directing access site flow to a new outflow vein through a percutaneously created intervascular tunnel without stent graft placement. The post-intervention primary and secondary access patency rates were calculated using the Kaplan–Meier method.ResultsThe procedural and clinical success rates were 100 %. Post-intervention primary and secondary access patency atmore » 300 days were 18.7 ± 15.8 and 87.5 ± 11.7 %, respectively. The mean follow-up period was 218.7 days (range 10–368 days). One patient died of acute myocardial infarction 10 days after the procedure. No other major complications were observed. Minor complications, such as swelling, ecchymosis, and pain around the tunnel, occurred in all of the patients.ConclusionsPercutaneous creation of a bare intervascular tunnel is a treatment option for thrombosed hemodialysis fistulas without recanalizable outflow in selected patients.« less

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

Chemical and biotechnological processing of collagen-containing raw materials into functional components of feed suitable for production of high-quality meat from farm animals

NASA Astrophysics Data System (ADS)

Baburina, M. I.; Ivankin, A. N.; Stanovova, I. A.

2017-09-01

The process of chemical biotechnological processing of collagen-containing raw materials into functional components of feeds for effective pig rearing was studied. Protein components of feeds were obtained as a result of hydrolysis in the presence of lactic acid of the animal collagen from secondary raw materials, which comprised subcutaneous collagen (cuticle), skin and veined mass with tendons from cattle. For comparison, a method is described for preparing protein components of feeds by cultivating Lactobacillus plantarum. Analysis of the kinetic data of the conversion of a high-molecular collagen protein to an aminolyte polypeptide mixture showed the advantage of microbiological synthesis in obtaining a protein for feeds. Feed formulations have been developed to include the components obtained, and which result in high quality pork suitable for the production of quality meat products.

Low-Dimensional Models for Physiological Systems: Nonlinear Coupling of Gas and Liquid Flows

NASA Astrophysics Data System (ADS)

Staples, A. E.; Oran, E. S.; Boris, J. P.; Kailasanath, K.

2006-11-01

Current computational models of biological organisms focus on the details of a specific component of the organism. For example, very detailed models of the human heart, an aorta, a vein, or part of the respiratory or digestive system, are considered either independently from the rest of the body, or as interacting simply with other systems and components in the body. In actual biological organisms, these components and systems are strongly coupled and interact in complex, nonlinear ways leading to complicated global behavior. Here we describe a low-order computational model of two physiological systems, based loosely on a circulatory and respiratory system. Each system is represented as a one-dimensional fluid system with an interconnected series of mass sources, pumps, valves, and other network components, as appropriate, representing different physical organs and system components. Preliminary results from a first version of this model system are presented.

Splanchnic vein thrombosis as a first manifestation of Primary myelofibrosis

PubMed

Campos-Cabrera, Gregorio; Campos-Cabrera, Virginia; Campos-Cabrera, Salvador; Campos-Villagómez, José-Luis; Romero-González, Alejandra

2017-01-01

Myeloproliferative neoplasms are chronic disorders of clonal hematopoietic stem cells, characterized by an overproduction of functional granulocytes, red blood cells and / or platelets, and one of the major complications is the occurrence of venous and arterial thrombotic problems caused by increased platelet aggregation and thrombin generation. In this study 11 cases of primary myelofibrosis (PM) were evaluated and 2 debuted with splanchnic venous thrombosis (SVT); so after seeing the results of this study and of world literature, it is suggested that in patients with SVT, diagnostic methods for PM like the JAK2V617F mutation should be included. Copyright: © 2017 SecretarÍa de Salud

Episodic formation of the world-class Waihi epithermal Au-Ag vein system, Hauraki Goldfield, New Zealand

USGS Publications Warehouse

Gasston, Erin; Mauk, Jeffrey L.; Cosca, Michael A.; Morgan, Leah; Hall, Chris M.

2017-01-01

The world-class Waihi vein system in New Zealand has produced more than 248,400 kg Au and 1.43 million kg Ag. New high-precision 40Ar/39Ar dates of adularia from different veins show that some veins formed at different times (6.15 Ma Martha vs. 5.83 and 5.85 Ma Empire and Welcome, respectively), even though they have similar mineralogy. The Martha vein formed over a period of approximately 150,000 years. The Moonlight vein, which has a different ore mineral assemblage, appears to have formed over a longer time interval that spanned formation of the Martha, Welcome, and Empire veins. These dates suggest that some veins in the Waihi vein system formed relatively quickly during only part of the lifetime of the hydrothermal system, whereas other veins may have formed over longer periods of time. However, the Au endowment of the Martha vein exceeds the Au endowment of the Moonlight vein, indicating that the total lifetime of the vein-forming hydrothermal system does not determine metal endowment.

The Genesis of Precious and Base Metal Mineralization at the Miguel Auza Deposit, Zacatecas, Mexico

NASA Astrophysics Data System (ADS)

Findley, A. A.; Olivo, G. R.; Godin, L.

2009-05-01

The Miguel Auza mine located in Zacatecas State, Mexico, is a vein-type polymetallic epithermal deposit hosted in deformed argillite, siltstone and, greywacke of the Cretaceous Caracol Formation. Silver-rich base metal veins (0.2 m to >1.5 m wide) are spatially associated with the NE-striking, steeply SE- dipping (70-80°) Miguel Auza fault over a strike length of 1.6 km and a depth of 460 m. A 2 km2 monzonitic stock located in the proximity of the mineralized zones, has previously been interpreted as the source of the mineralizing fluids. Four distinct structural stages are correlated with hydrothermal mineral deposition: (I) The Pre-ore stage is characterized by normal faulting, fracturing of host rock, and rotation of bedding planes. This stage consists of quartz, illite, chlorite, +/- pyrite alteration of sedimentary wall rocks. (II) The Pyrite-vein stage is associated with reverse-sense reactivation of early normal faults, dilation of bedding planes/fractures, and deposition of generally barren calcite + pyrite veinlets. (III) The Main-ore stage is related to the development of reverse-fault- hosted massive sulphide veins. During this stage three phases of mineral deposition are recorded: early pyrite and arsenopyrite, intermediate chalcopyrite, pyrite, arsenopyrite, and base metals, and late base metals and Ag-bearing minerals. Associated gangue minerals during the main ore stage are quartz, muscovite, calcite and chlorite. (IV) The Post-ore stage involves late NW-SE striking block faulting, brecciation and calcite veining. Later supergene oxidation of veins led to deposition of Fe-oxides and hydroxides, commonly filling fractures or replacing early-formed sulphide assemblages. The various vein types display classic epithermal textures including open space filling, banding, comb quartz and brecciation. The Ag-bearing minerals comprise pyrargyrite [Ag3(Sb,As)S3], argentotennantite [(Cu,Ag)10(Zn,Fe)2(Sn,As)4S13], polybasite-pearceite [(Ag,Cu)16(Sb,As)2S11], and acanthite [AgS2]; associated sulphides include galena, sphalerite, chalcopyrite, arsenopyrite and pyrite. In the main ore zone, base metal sulphides are commonly intergrown with the Ag-bearing sulfosalts. Analyses of galena show no significant silver values indicating that silver grades are exclusively associated with the Ag-bearing sulfosalts and sulphides. The distribution of the Sb/(Sb + As) ratios in the silver sulfosalts indicate that the ore forming fluid(s) was consistently antimony-rich during the Ag-rich ore deposition with no significant variation laterally, vertically, or along strike of the vein systems. However, Ag/(Ag + Cu) values in argentotennantite decrease along-strike from NE to SW and with depth. Compositions of argentotennantite + pyrargyrite + sphalerite indicate a primary depositional temperature around 325-350° C for the late phase of the Main-ore stage. Compositions of sphalerite also show an increasing trend in FeS (mol %) along strike of the deposit from NE to SW. The geometric relationship between the various structures, vein types, and the regional Miguel Auza fault zone suggest episodic reverse-sense reactivation of normal faults. It is argued that the structural evolution of the area, and, in particular, the Main-ore stage, provided transport pathways for metal-rich fluids and controlled the orientations of ore-bearing veins. Variations in mineral chemistry suggest that the rocks in the NE sector interacted with hotter fluids than in the SW part of the deposit.

Mineralogical, textural, geochemical and thermometric characteristics of Central Anatolian fluorites (Turkey): Tracing the origin of post-magmatic fluids

NASA Astrophysics Data System (ADS)

Cosanay, Pelin; Mutlu, Halim; Koc, Sükrü; Cevik, Nihal; Oztürk, Ceyda; Varol, Ece

2016-04-01

In this study, we investigate the spatial distribution of fluorite veins in Central Anatolia with emphasis on mineralogical, textural, geochemical and thermometric variations. The studied fluorite mineralizations (Kaman, Akçakent, Pöhrenk and Şefaatli mineralizations from west to east) are located on northern part of Kırşehir Massif which is a part of Central Anatolian Crystalline Complex that is bordered by the İzmir-Ankara-Erzincan Suture Zone. The Kaman, Akçakent and Şefaatli fluorite deposits are formed in association with magmatic rocks such as syenite and monzonite / monzodiorite in composition which are of Upper Cretaceous age. Fluorite in these deposits occurs as purple- and green-colored stockwork veins and/or disseminations along fault/fracture systems and is accompanied by quartz and rare pyrite. The Pöhrenk ore, however, is precipitated as space filling-breccia type within karstic voids of Eocene limestones and marl levels. The silicification/carbonatization and barite occurrences are found as the main alteration and secondary products of mineralization. Thickness of fluorite veins is between 2 and 30 cm. ΣREE contents of host rocks and fluorite veins are in the range of 2-806 ppm and 20-390 ppm, respectively. In element variation diagrams constructed for both host rocks and fluorite mineralizations, LREE concentrations are found to be greater than HREEs. REE contents of green-colored fluorites are about 10-fold higher than those of purple-colored ones. Negative Ce and Eu anomalies indicate high oxygen fugacity for the mineralizing fluids. Fluid inclusion studies indicated three different types of inclusions: 1) two-phase (liquid-vapor) primary and secondary inclusions, 2) single-phase (liquid) primary and secondary inclusions and 3) two-phase (liquid-vapor) and single-phase (liquid) pseudo-secondary inclusions. Results of homogenization temperatures from a number of about 200 measurements chiefly on fluorite and less often quartz and barite crystals point to a temperature range of 90-210°C and a salinity range of 0.2 to 23.0 NaCl equivalent wt%. Our ongoing survey which has been further focused on the time of mineralization and Sr-Nd isotope compositions of fluorites and host rocks as well as stable isotope systematics of accessory minerals will lead to a better understanding of the origin of mineralizing fluids that precipitated Central Anatolian fluorites.

Rationale, design, and methodology of the observational INSIGHTS-SVT study on the current state of care and outcomes of patients with superficial vein thrombosis.

PubMed

Bauersachs, Rupert; Gerlach, Horst Eberhard; Heinken, Andreas; Hoffmann, Ulrich; Langer, Florian; Noppeney, Thomas; Pittrow, David; Klotsche, Jens; Rabe, Eberhard

2017-07-01

Superficial vein thrombosis (SVT) is a common disease in clinical practice. In terms of pathophysiology and outcomes, the condition is related to venous thromboembolism, bearing a potential for severe thromboembolic complications if it is not treated adequately. A wide range of treatment approaches (including oral and injectable anticoagulants, pain medication, nondrug therapy including compression therapy, and no treatment at all) are applied in clinical practice, but there is sparse information about selection of patients for therapies, current treatment pathways, and drug use as well as outcomes. The INvestigating SIGnificant Health TrendS in the management of Superficial Vein Thrombosis (INSIGHTS-SVT) study aims to close this gap by collecting representative data on the current treatment of SVT. The observational prospective study of about 1200 patients is carried out by up to 120 clinical and office-based physicians who regularly treat patients with SVT and are capable of conducting appropriate compression ultrasound diagnostics, such as vascular physicians, phlebologists, internists, vascular surgeons, and general practitioners. Patients are eligible for inclusion if they have ultrasound-confirmed acute, isolated SVT of the lower extremities. Documentation about the characteristics of the patients, diagnostics, comorbidities, and medical and nonmedical treatment is collected at baseline, at 10 ± 3 days or at approximately 45 days (depending on treatment), at approximately 3 months, and at approximately 12 months. Patients are requested to fill in quality of life questionnaires (on pain, Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms [VEINES-QOL/Sym], EuroQol-5 Dimension 5-Level [EQ-5D-5L]) at baseline and at approximately 3 months. Interventions are not stipulated by the trial protocol. The primary efficacy outcome is the incidence of venous thromboembolism at 3 months; the primary safety outcome is the combined incidence of major and clinically relevant bleeding events at 3 months. As quality measures, plausibility checks at data entry, queries based on statistical analyses that focus on outliers and distribution of values, monitoring visits, and adjudication procedures will be applied. This large study is expected to provide a comprehensive picture of patients with SVT under clinical practice conditions in Germany. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Venous drainage of the face.

PubMed

Onishi, S; Imanishi, N; Yoshimura, Y; Inoue, Y; Sakamoto, Y; Chang, H; Okumoto, T

2017-04-01

The venous anatomy of the face was examined in 12 fresh cadavers. Venograms and arteriovenograms were obtained after the injection of contrast medium. In 8 of the 12 cadavers, a large loop was formed by the facial vein, the supratrochlear vein, and the superficial temporal vein, which became the main trunk vein of the face. In 4 of the 12 cadavers, the superior lateral limb of the loop vein was less well developed. The loop vein generally did not accompany the arteries of the face. Cutaneous branches of the loop vein formed a polygonal venous network in the skin, while communicating branches ran toward deep veins. These findings suggest that blood from the dermis of the face is collected by the polygonal venous network and enters the loop vein through the cutaneous branches, after which blood flows away from the face through the superficial temporal vein, the facial vein, and the communicating branches and enters the deep veins. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Transformation of Serpentinite to Listvenite as Recorded in the Vein History of Rocks From Oman Drilling Project Hole BT1B

NASA Astrophysics Data System (ADS)

Manning, C. E.; Kelemen, P. B.; Michibayashi, K.; Harris, M.; Urai, J. L.; de Obeso, J. C.; Jesus, A. P. M.; Zeko, D.

2017-12-01

Oman Drilling Project Hole BT1B intersected 191 m of listvenite (magnesite + quartz rock) and serpentinite in the hanging wall of the basal thrust of the Oman ophiolite. Recovery was 100%. Listvenite is the dominant lithology in the upper plate rocks (166 m). Its shows wide color and textural variation, including pseudomorphic replacement of serpentinized peridotite. Serpentinite was encountered in two main contiguous intervals totaling 25 m. In light of the strongly metasomatic nature for the origin of listvenite, a substantial portion of the core description effort was dedicated to characterization of the complex veining history recorded in the hole. Dense veining is recorded in both lithologies. The density of <1 mm veins is >200/m. The density of veins >1 mm was 50-100/m, with somewhat higher densities recorded in serpentinite than in listvenite. In order of oldest to youngest, the main vein types in serpentinite are microscopic mesh-textured serpentine veins, macroscopic serpentine veins, carbonate-oxide veins, and carbonate veins. The vein paragenesis in listvenite is: early carbonate-oxide veins, followed by carbonate and carbonate-quartz veins, then late carbonate veins. The carbonate-oxide and carbonate veins are shared by the lithologies and hold clues to the transformation of ultramafic rocks to listvenite. Carbonate-oxide veins form a distinctive set that is interpreted to be the earliest record of carbonate formation in serpentinite. They contain Fe-oxide, usually hematite, on a medial line, with antitaxial magnesite crystals growing outward and showing terminations against wall rock minerals. Antitaxial textures may be evidence of positive reaction volumes. In serpentinite, secondary serpentine after earlier serpentine is common at vein margins. Carbonate-oxide veins are the earliest observed in listvenite, where they may form isolated veins to dense, aligned networks that impart a foliated texture. In some cases, they appear to predate replacement of serpentine by microcrystalline quartz. Both lithologies record later, coarser, through going carbonate ± quartz veins. Preliminary vein petrology in BT1B rocks indicates that fracture formation and filling by secondary minerals is integral to the metasomatic replacement of altered peridotite by listvenite.

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux.

PubMed

Holdstock, J M; Dos Santos, S J; Harrison, C C; Price, B A; Whiteley, M S

2015-03-01

To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Impact of operative time on early joint infection and deep vein thrombosis in primary total hip arthroplasty.

PubMed

Wills, B W; Sheppard, E D; Smith, W R; Staggers, J R; Li, P; Shah, A; Lee, S R; Naranje, S M

2018-03-22

Infections and deep vein thrombosis (DVT) after total hip arthroplasty (THA) are challenging problems for both the patient and surgeon. Previous studies have identified numerous risk factors for infections and DVT after THA but have often been limited by sample size. We aimed to evaluate the effect of operative time on early postoperative infection as well as DVT rates following THA. We hypothesized that an increase in operative time would result in increased odds of acquiring an infection as well as a DVT. We conducted a retrospective analysis of prospectively collected data using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2015 for all patients undergoing primary THA. Associations between operative time and infection or DVT were evaluated with multivariable logistic regressions controlling for demographics and several known risks factors for infection. Three different types of infections were evaluated: (1) superficial surgical site infection (SSI), an infection involving the skin or subcutaneous tissue, (2) deep SSI, an infection involving the muscle or fascial layers beneath the subcutaneous tissue, and (3) organ/space infection, an infection involving any part of the anatomy manipulated during surgery other than the incisional components. In total, 103,044 patients who underwent THA were included in our study. Our results suggested a significant association between superficial SSIs and operative time. Specifically, the adjusted odds of suffering a superficial SSI increased by 6% (CI=1.04-1.08, p<0.0001) for every 10-minute increase of operative time. When using dichotomized operative time (<90minutes or >90minutes), the adjusted odds of suffering a superficial SSI was 56% higher for patients with prolonged operative time (CI=1.05-2.32, p=0.0277). The adjusted odds of suffering a deep SSI increased by 7% for every 10-minute increase in operative time (CI=1.01-1.14, p=0.0335). No significant associations were detected between organ/space infection, wound dehiscence, or DVT and operative time either as continuous or as dichotomized. Prolonged operative times (>90min) are associated with increased rates of superficial SSIs, but not deep SSIs, organ/space infections, wound dehiscence, or DVT. III. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography.

PubMed

Mukai, Kanae; Nakajima, Yukari; Nakano, Tomotaka; Okuhira, Manami; Kasashima, Aya; Hayashi, Rina; Yamashita, Misaki; Urai, Tamae; Nakatani, Toshio

2017-11-15

The aim of the present observational study was to identify safe and suitable venipuncture sites for nursing in the clinical setting using ultrasonography to measure the depth and cross-sectional area of each superficial vein before and after tourniquet application as well as the distance between each superficial vein and the median nerve or brachial artery. Twenty healthy volunteers (21.8 [0.6] y) were recruited. The visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. The cross-sectional area of the median cubital vein after tourniquet application was significantly larger than that of the basilic vein and cephalic vein. The distance between the basilic vein or median cubital vein and median nerve was significantly smaller than that between the cephalic vein and median nerve. The distance between the basilic vein or median cubital vein and brachial artery was significantly smaller than that between the cephalic vein and brachial artery. These results demonstrated that the cephalic vein at the cubital fossa is a relatively safe venipuncture site because of its distance from the median nerve and brachial artery. When puncturing the cephalic vein is difficult because it is not visible, the median cubital vein at the cubital fossa may be selected for venipuncture due to its cross-sectional area and visibility; however, care is needed to avoid penetrating the vein because the median nerve and brachial artery are located underneath.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Genesis of the Assif El Mal Zn-Pb (Cu, Ag) vein deposit. An extension-related Mesozoic vein system in the High Atlas of Morocco. Structural, mineralogical, and geochemical evidence

USGS Publications Warehouse

Bouabdellah, M.; Beaudoin, G.; Leach, D.L.; Grandia, F.; Cardellach, E.

2009-01-01

The Assif El Mal Zn-Pb (Cu-Ag) vein system, located in the northern flank of the High Atlas of Marrakech (Morocco), is hosted in a Cambro-Ordovician volcaniclastic and metasedimentary sequence composed of graywacke, siltstone, pelite, and shale interlayered with minor tuff and mudstone. Intrusion of synorogenic to postorogenic Late Hercynian peraluminous granitoids has contact metamorphosed the host rocks giving rise to a metamorphic assemblage of quartz, plagioclase, biotite, muscovite, chlorite, amphibole, chloritoid, and garnet. The Assif El Mal Zn-Pb (Cu-Ag) mineralization forms subvertical veins with ribbon, fault breccia, cockade, comb, and crack and seal textures. Two-phase liquid-vapor fluid inclusions that were trapped during several stages occur in quartz and sphalerite. Primary inclusion fluids exhibit Th mean values ranging from 104??C to 198??C. Final ice-melting temperatures range from -8.1??C to -12.8??C, corresponding to salinities of ???15 wt.% NaCl equiv. Halogen data suggest that the salinity of the ore fluids was largely due to evaporation of seawater. Late secondary fluid inclusions have either Ca-rich, saline (26 wt.% NaCl equiv.), or very dilute (3.5 wt.% NaCl equiv.) compositions and homogenization temperatures ranging from 75??C to 150??C. The ??18O and ??D fluid values suggest an isotopically heterogeneous fluid source involving mixing between connate seawater and black-shale-derived organic waters. Low ??13CVPDB values ranging from -7.5??? to -7.7??? indicate a homogeneous carbon source, possibly organic matter disseminated in black shale hosting the Zn-Pb (Cu-Ag) veins. The calculated ??34SH2S values for reduced sulfur (22.5??? to 24.3???) are most likely from reduction of SO42- in trapped seawater sulfate or evaporite in the host rocks. Reduction of sulfate probably occurred through thermochemical sulfate reduction in which organic matter was oxidized to produce CO2 which ultimately led to precipitation of saddle dolomite with isotopically light carbon. Lead isotope compositions are consistent with fluid-rock interaction that leached metals from the immediate Cambro-Ordovician volcaniclastic and metasedimentary sequence or from the underlying Paleo-Neoproterozoic crustal basement. Geological constraints suggest that the vein system of Assif El Mal formed during the Jurassic opening of the central Atlantic Ocean. ?? Springer-Verlag 2009.

Shear localization in the shallow part of megathrusts: understanding active megathrusts trough the study of fossil analogues.

NASA Astrophysics Data System (ADS)

Cerchiari, Anna; MIttempergher, Silvia; Remitti, Francesca; Festa, Andrea

2017-04-01

The shallowest part of active megathrusts has an intriguing behaviour, characterized by the coexistence of coseismic slips and aseismic creep, slow slip events, low and very low frequency earthquakes. Origins and interplays of these phenomena are actually little known. In this respect, the study of exhumed shallow parts of fossil megathrusts is an advantageous approach in terms of accessibility, costs and resolution. The Sestola-Vidiciatico tectonic Unit in the Northern Apennines has been interpreted as a possible analogue of a shallow, hectometer scale megathrust shear zone, which accommodated subduction of the Adria plate under the Ligurian prism during early-middle Miocene by involving sediments from the seafloor to burial depth corresponding to 150° C maximum temperature. Performing detailed microstructural analysis on samples through optical, cathodoluminescence and scanning electron microscopy, we studied a 5 m thick fault zone marking the base of the SVU. Here, more or less competent marls make up a heterogeneous fault zone assemblage, with a strongly deformed tectonic fabric characterized by mesoscopic cleavage, boudinage, faults and low-angle thrusts coated by calcite veins. At the top of the shear zone, a sharp and continuous shear vein, 20 cm thick cuts all other structures. At the microscale, we identified a primary sedimentary layering, consisting of alternating fine and coarse marly or shaly laminae that are crosscut by "soft-sediment"-type deformation bands derived from the reorientation of mineral grains without fracturing. Parallel to the sedimentary laminae, oriented phyllosilicates define a pervasive foliation in clay-rich domains. More competent calcareous portions are strongly boudinaged and cut by calcite shear veins displaying crack-and-seal texture and locally implosion breccias. Multiple mutually crosscutting generations of extensional veins are recognizable, with dispersed orientations and complex relations with shear veins. Calcite veins appear also to be partially dissolved by pressure-solution processes. Our microstructural findings suggest that deformation started acting on not completely lithified sediments, with a progressive and differential embrittlement of the shear zone, depending on lithology (i. e. competence contrast) and fluid pressure cycles. Features described point out also for thrusting under low differential stress, with decoupling from the footwall and progressive migration and thinning of the shear zone.

Hydrothermal Alteration of the Lower Oceanic Crust: Insight from OmanDP Holes GT1A and GT2A.

NASA Astrophysics Data System (ADS)

Harris, M.; Zihlmann, B.; Mock, D.; Akitou, T.; Teagle, D. A. H.; Kondo, K.; Deans, J. R.; Crispini, L.; Takazawa, E.; Coggon, J. A.; Kelemen, P. B.

2017-12-01

Hydrothermal circulation is a fundamental Earth process that is responsible for the cooling of newly formed ocean crust at mid ocean ridges and imparts a chemical signature on both the crust and the oceans. Despite decades of study, the critical samples necessary to resolve the role of hydrothermal circulation during the formation of the lower ocean crust have remained poorly sampled in the ocean basins. The Oman Drilling Project successfully cored 3 boreholes into the lower crust of the Semail ophiolite (Holes GT1A layered gabbros, GT2A foliated gabbros and GT3A dike/gabbro transition). These boreholes have exceptionally high recovery ( 100%) compared to rotary coring in the oceans and provide an unrivalled opportunity to quantitatively characterise the hydrothermal system in the lower oceanic crust. Hydrothermal alteration in Holes GT1A and GT2A is ubiquitous and manifests as secondary minerals replacing primary igneous phases and secondary minerals precipitated in hydrothermal veins and hydrothermal fault zones. Hole GT1A is characterised by total alteration intensities between 10 -100%, with a mean alteration intensity of 60%, and shows no overall trend downhole. However, there are discrete depth intervals (on the scale of 30 -100 m) where the total alteration intensity increases with depth. Alteration assemblages are dominated by chlorite + albite + amphibole, with variable abundances of epidote, clinozoisite and quartz. Hole GT1A intersected several hydrothermal fault zones, these range from 2-3 cm up to >1m in size and are associated with more complex secondary mineral assemblages. Hydrothermal veins are abundant throughout Hole GT1A, with a mean density of 37 vein/m. Hole GT2A is characterised by total alteration intensities between 6-100%, with a mean alteration intensity of 45%, and is highly variable downhole. Alteration halos and patches are slightly more abundant than in Hole GT1A. The secondary mineral assemblage is similar to Hole GT1A, but Hole GT2A has higher abundances of epidote, clinozoisite, quartz, laumontite and iron-oxydroxides. Vein density in Hole GT2A is 61 veins/m. In both holes, cross cutting vein relationships indicate a relative timing from earliest to latest of: amphibole; epidote + zoisite + qtz; chlorite + prehnite + qtz, calcite-laumontite-anhydrite; gypsum.

Mineral resources prospecting by synthetic application of TM/ETM+, Quickbird and Hyperion data in the Hatu area, West Junggar, Xinjiang, China

PubMed Central

Liu, Lei; Zhou, Jun; Jiang, Dong; Zhuang, Dafang; Mansaray, Lamin R.; Hu, Zhijun; Ji, Zhengbao

2016-01-01

The Hatu area, West Junggar, Xinjiang, China, is situated at a potential gold-copper mineralization zone in association with quartz veins and small granitic intrusions. In order to identify the alteration zones and mineralization occurrences in this area, the Landsat Thematic Mapper (TM) and Enhanced Thematic Mapper (ETM+), Quickbird, Hyperion data and laboratory measured spectra were combined in identifying structures, alteration zones, quartz veins and small intrusions. The hue-saturation-intensity (HSI) color model transformation was applied to transform principal component analysis (PCA) combinations from R (Red), G (Green) and B (Blue) to HSI space to enhance faults. To wipe out the interference of the noise, a method, integrating Crosta technique and anomaly-overlaying selection, was proposed and implemented. Both Jet Propulsion Laboratory Spectral Library spectra and laboratory-measured spectra, combining with matched filtering method, were used to process Hyperion data. In addition, high-resolution Quickbird data were used for unraveling the quartz veins and small intrusions along the alteration zones. The Baobei fault and a SW-NE-oriented alteration zone were identified for the first time. This study eventually led to the discovery of four weak gold-copper mineralized locations through ground inspection and brought new geological knowledge of the region’s metallogeny. PMID:26911195

Evolutionary Association of Stomatal Traits with Leaf Vein Density in Paphiopedilum, Orchidaceae

PubMed Central

Sun, Mei; Zhang, Juan-Juan; Cao, Kun-Fang; Hu, Hong

2012-01-01

Background Both leaf attributes and stomatal traits are linked to water economy in land plants. However, it is unclear whether these two components are associated evolutionarily. Methodology/Principal Findings In characterizing the possible effect of phylogeny on leaf attributes and stomatal traits, we hypothesized that a correlated evolution exists between the two. Using a phylogenetic comparative method, we analyzed 14 leaf attributes and stomatal traits for 17 species in Paphiopedilum. Stomatal length (SL), stomatal area (SA), upper cuticular thickness (UCT), and total cuticular thickness (TCT) showed strong phylogenetic conservatism whereas stomatal density (SD) and stomatal index (SI) were significantly convergent. Leaf vein density was correlated with SL and SD whether or not phylogeny was considered. The lower epidermal thickness (LET) was correlated positively with SL, SA, and stomatal width but negatively with SD when phylogeny was not considered. When this phylogenetic influence was factored in, only the significant correlation between SL and LET remained. Conclusion/Significance Our results support the hypothesis for correlated evolution between stomatal traits and vein density in Paphiopedilum. However, they do not provide evidence for an evolutionary association between stomata and leaf thickness. These findings lend insight into the evolution of traits related to water economy for orchids under natural selection. PMID:22768224

In Vitro Endothelialization Test of Biomaterials Using Immortalized Endothelial Cells.

PubMed

Kono, Ken; Hiruma, Hitomi; Kobayashi, Shingo; Sato, Yoji; Tanaka, Masaru; Sawada, Rumi; Niimi, Shingo

2016-01-01

Functionalizing biomaterials with peptides or polymers that enhance recruitment of endothelial cells (ECs) can reduce blood coagulation and thrombosis. To assess endothelialization of materials in vitro, primary ECs are generally used, although the characteristics of these cells vary among the donors and change with time in culture. Recently, primary cell lines immortalized by transduction of simian vacuolating virus 40 large T antigen or human telomerase reverse transcriptase have been developed. To determine whether immortalized ECs can substitute for primary ECs in material testing, we investigated endothelialization on biocompatible polymers using three lots of primary human umbilical vein endothelial cells (HUVEC) and immortalized microvascular ECs, TIME-GFP. Attachment to and growth on polymer surfaces were comparable between cell types, but results were more consistent with TIME-GFP. Our findings indicate that TIME-GFP is more suitable for in vitro endothelialization testing of biomaterials.

Iliac Vein Interrogation Augments Venous Ulcer Healing in Patients Who Have Failed Standard Compression Therapy along with Pathological Venous Closure.

PubMed

Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F

2016-07-01

Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15.3 weeks, P = 0.055). The final VCCS score was not significantly different (IVI = 7.9 ± 9.5 vs. NIVI = 10.0 ± 6.5, P = 0.578). However, compared with the NIVI group, the healing time for patients who actually received IVAS was marginally lower (5.8 ± 3.6 weeks, P = 0.075) and final VCCS was significantly lower (2.4 ± 2.9, P = 0.031). Veins that received IVI and IVAS remained patent and the associated ulcers were healed (100%). The small sample size and retrospective design limit the strength of the conclusions but the findings suggest that further studies are needed to define the exact role of IVI including angioplasty/stenting for patients with chronic venous ulcers. Copyright © 2016 Elsevier Inc. All rights reserved.

Can a Satellite-Derived Estimate of the Fraction of PAR Absorbed by Chlorophyll (FAPAR(sub chl)) Improve Predictions of Light-Use Efficiency and Ecosystem Photosynthesis for a Boreal Aspen Forest?

NASA Technical Reports Server (NTRS)

Zhang, Qingyuan; Middleton, Elizabeth M.; Margolis, Hank A.; Drolet, Guillaume G.; Barr, Alan A.; Black, T. Andrew

2009-01-01

Gross primary production (GPP) is a key terrestrial ecophysiological process that links atmospheric composition and vegetation processes. Study of GPP is important to global carbon cycles and global warming. One of the most important of these processes, plant photosynthesis, requires solar radiation in the 0.4-0.7 micron range (also known as photosynthetically active radiation or PAR), water, carbon dioxide (CO2), and nutrients. A vegetation canopy is composed primarily of photosynthetically active vegetation (PAV) and non-photosynthetic vegetation (NPV; e.g., senescent foliage, branches and stems). A green leaf is composed of chlorophyll and various proportions of nonphotosynthetic components (e.g., other pigments in the leaf, primary/secondary/tertiary veins, and cell walls). The fraction of PAR absorbed by whole vegetation canopy (FAPAR(sub canopy)) has been widely used in satellite-based Production Efficiency Models to estimate GPP (as a product of FAPAR(sub canopy)x PAR x LUE(sub canopy), where LUE(sub canopy) is light use efficiency at canopy level). However, only the PAR absorbed by chlorophyll (a product of FAPAR(sub chl) x PAR) is used for photosynthesis. Therefore, remote sensing driven biogeochemical models that use FAPAR(sub chl) in estimating GPP (as a product of FAPAR(sub chl x PAR x LUE(sub chl) are more likely to be consistent with plant photosynthesis processes.

Estimation of Right-Lobe Graft Weight From Computed Tomographic Volumetry for Living Donor Liver Transplantation.

PubMed

Yang, X; Chu, C W; Yang, J D; Yang, K H; Yu, H C; Cho, B H; You, H

2017-03-01

The objective of the study was to establish a right-lobe graft weight (GW) estimation formula for living donor liver transplantation (LDLT) from right-lobe graft volume without veins (GV w/o_veins ), including portal vein and hepatic vein measured by computed tomographic (CT) volumetry, and to compare its estimation accuracy with those of existing formulas. Right-lobe GW estimation formulas established with the use of graft volume with veins (GV w_veins ) sacrifice accuracy because GW measured intra-operatively excludes the weight of blood in the veins. Right-lobe GW estimation formulas have been established with the use of right-lobe GV w/o_veins , but a more accurate formula must be developed. The present study developed right-lobe GW estimation formulas based on GV w/o_veins as well as GV w_veins , using 40 cases of Korean donors: GW = 29.1 + 0.943 × GV w/o_veins (adjusted R 2  = 0.94) and GW = 74.7 + 0.773 × GV w_veins (adjusted R 2  = 0.87). The proposed GW estimation formulas were compared with existing GV w_veins - and GV w/o_veins -based models, using 43 cases additionally obtained from two medical centers for cross-validation. The GV w/o_veins -based formula developed in the present study was most preferred (absolute error = 21.5 ± 16.5 g and percentage of absolute error = 3.0 ± 2.3%). The GV w/o_veins -based formula is preferred to the GV w_veins -based formula in GW estimation. Accurate CT volumetry and alignment between planned and actual surgical cutting lines are crucial in the establishment of a better GW estimation formula. Copyright © 2016 Elsevier Inc. All rights reserved.

Hydrothermal Evolution of the Giant Cenozoic Kadjaran porphyry Cu-Mo deposit, Tethyan metallogenic belt, Armenia, Lesser Caucasus: mineral paragenetic, cathodoluminescence and fluid inclusion constraints

NASA Astrophysics Data System (ADS)

Hovakimyan, Samvel; Moritz, Robert; Tayan, Rodrik; Rezeau, Hervé

2016-04-01

The Lesser Caucasus belongs to the Central segment of the Tethyan metallogenic belt and it is a key area to understand the metallogenic evolution between the Western & Central parts of the Tethyan belt and its extension into Iran. Zangezur is the most important mineral district in the southernmost Lesser Caucasus. It is a component of the South Armenian block, and it was generated during the convergence and collision of the southern margin of the Eurasian plate and the northern margin of the Arabian plate, and terranes of Gondwana origin (Moritz et al., in press). The Zangezur ore district consists of the Tertiary Meghri-Ordubad composite pluton, which is characterized by a long-lasting Eocene to Pliocene magmatic, tectonic and metallogenic evolution. It hosts major porphyries Cu-Mo and epithermal Au - polymetallic deposits and occurrences, including the giant world class Kadjaran porphyry Cu-Mo deposit (2244 Mt reserves, 0.3% Cu, 0.05% Mo and 0.02 g/t Au). The Kadjaran deposit is hosted by a monzonite intrusion (31.83±0.02Ma; Moritz et al., in press). Detailed field studies of the porphyry stockwork and veins of the different mineralization stages, their crosscutting and displacement relationships and the age relationship between different paragenetic mineral associations were the criteria for distinction of the main stages of porphyry mineralization at the Kadjaran deposit. The economic stages being: quartz- molybdenite, quartz-molybdenite-chalcopyrite, and quartz-chalcopyrite. The main paragenetic association of the Kadjaran porphyry deposit includes pyrite, molybdenite, chalcopyrite, bornite, chalcocite, pyrrhotite, covellite, sphalerite, and galena. Recent field observations in the Kadjaran open pit revealed the presence of epithermal veins with late vuggy silica and advanced argillic alteration in the north-eastern and eastern parts of the deposit. They are distributed as separate veins and have also been recognized in re-opened porphyry veins and in stockwork. One of them is the east-west-oriented 6th vein zone in the northern part of the deposit, which contains quartz-molybdenite veins and late quartz-galena-sphalerite veins. This is interpreted as a telescoping between porphyry and epithermal environments. It is supported by microscopic studies of mineral paragenesis, which reveal the presence of enargite and tennantite-tetrahedrite, luzonite, sphalerite, and galena, generally in a gangue of quartz, followed by a late carbonate and gypsum stage. On-going fluid inclusion studies are being carried out on quartz samples from the different mineralization stages. Five types of fluid inclusions were distinguished according to their nature, bubble size, and daughter mineral content: vapor-rich, aqueous-carbonic, brine, polyphase brine and liquid-rich inclusions. Cathodoluminescence images from the porphyry veins reveal four generations of quartz. Molybdenite and chalcopyrite are associated with two different dark luminescent quartz generations, which contain typical brine, aqueous-carbonic and vapour-rich H2O fluid inclusions, with some of them coexisting locally as boiling assemblages. Epithermal veins are mainly characterized by liquid-rich H2O fluid inclusions. Microthermometric studies of fluid inclusions reveal a major difference in homogenisation temperatures between the early quartz-molybdenite- chalcopyrite stage (Thtotal between 3600 and 4250C) and the late quartz-galena-sphalerite vein stage (Thtotal 300-2700C), which is attributed to the transition from a porphyry to an epithermal environment in the Kadjaran deposit.

Aggressive venous invasion in the area of carcinoma correlates with liver metastasis as an index of metastasis for invasive ductal carcinoma of the pancreas.

PubMed

Hamada, Yoshihiro; Nakayama, Yoshifuku

Invasive ductal carcinoma of the pancreas (IDCP) predominantly causes death through liver metastasis (LM) and peritoneal dissemination with local recurrence. However, whether its venous invasion is from the enlarged carcinoma accompanied by tumor growth, or from a distinct carcinoma group, for which venous invasion is facilitated by proximity to the origin, is unclear. We analyzed the correlation between LM and venous invasion in patients with small IDCP tumors. Of 388 patients who were diagnosed with IDCP, 20 (5.2%) had tumors with diameters <2 cm. The follow-up period of the 20 patients with smaller tumors was 1-24 years. The small-tumor group (n = 20) included 11 men and 9 women, aged 51-80 years. Five died of liver metastasis (LM group, n = 5) and 15 patients (non-LM group, n = 15) were either alive without recurrence (n = 11) or died of peritonitis carcinomatosa following local recurrence, subarachnoid hemorrhage, primary lung cancer, or old age (n = 1 for each cause of death). The LM and non-LM groups did not significantly differ in numbers of venous invasion by the carcinoma in IDCP and non-IDCP area of the pancreas. However, median numbers of invaded veins in the area of IDCP and percentage of invaded vein/total number of vein in IDCP area were significantly higher in the LM group. Among patients with small IDCP tumors, the LM group showed more aggressive venous invasion by IDPC. Patients in whom ≥60% of veins were invaded by IDCP should be prepared for LM. Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

ART 3.5D: an algorithm to label arteries and veins from three-dimensional angiography.

PubMed

Barra, Beatrice; De Momi, Elena; Ferrigno, Giancarlo; Pero, Guglielmo; Cardinale, Francesco; Baselli, Giuseppe

2016-10-01

Preoperative three-dimensional (3-D) visualization of brain vasculature by digital subtraction angiography from computerized tomography (CT) in neurosurgery is gaining more and more importance, since vessels are the primary landmarks both for organs at risk and for navigation. Surgical embolization of cerebral aneurysms and arteriovenous malformations, epilepsy surgery, and stereoelectroencephalography are a few examples. Contrast-enhanced cone-beam computed tomography (CE-CBCT) represents a powerful facility, since it is capable of acquiring images in the operation room, shortly before surgery. However, standard 3-D reconstructions do not provide a direct distinction between arteries and veins, which is of utmost importance and is left to the surgeon's inference so far. Pioneering attempts by true four-dimensional (4-D) CT perfusion scans were already described, though at the expense of longer acquisition protocols, higher dosages, and sensible resolution losses. Hence, space is open to approaches attempting to recover the contrast dynamics from standard CE-CBCT, on the basis of anomalies overlooked in the standard 3-D approach. This paper aims at presenting algebraic reconstruction technique (ART) 3.5D, a method that overcomes the clinical limitations of 4-D CT, from standard 3-D CE-CBCT scans. The strategy works on the 3-D angiography, previously segmented in the standard way, and reprocesses the dynamics hidden in the raw data to recover an approximate dynamics in each segmented voxel. Next, a classification algorithm labels the angiographic voxels and artery or vein. Numerical simulations were performed on a digital phantom of a simplified 3-D vasculature with contrast transit. CE-CBCT projections were simulated and used for ART 3.5D testing. We achieved up to 90% classification accuracy in simulations, proving the feasibility of the presented approach for dynamic information recovery for arteries and veins segmentation.

Weight-based enoxaparin dosing and deep vein thrombosis in hospitalized trauma patients: A double-blind, randomized, pilot study.

PubMed

Kay, Annika Bickford; Majercik, Sarah; Sorensen, Jeffrey; Woller, Scott C; Stevens, Scott M; White, Thomas W; Morris, David S; Baldwin, Margaret; Bledsoe, Joseph R

2018-04-23

Venous thromboembolism is a cause of morbidity and mortality in trauma patients. Chemoprophylaxis with low-molecular-weight heparin at a standardized dose is recommended. Conventional chemoprophylaxis may be inadequate. We hypothesized that a weight-adjusted enoxaparin prophylaxis regimen would reduce the frequency of venous thromboembolism in hospitalized trauma patients and at 90-day follow-up. This prospective, randomized pilot study enrolled adult patients admitted to a level 1 trauma center between July 2013 and January 2015. Subjects were randomized to receive either standard (30 mg subcutaneously every 12 hours) or weight-based (0.5mg/kg subcutaneously every 12 hours) enoxaparin. Surveillance duplex ultrasound for lower extremity deep vein thrombosis was performed on hospital days 1, 3, and 7, and weekly thereafter. The primary outcome was deep vein thrombosis during hospitalization. Secondary outcomes included venous thromboembolism at 90 days and significant bleeding events. Two hundred thirty-four (124 standard, 110 weight-based) subjects were enrolled. There was no difference between standard and weight-based regarding age, body mass index, percentage female gender, injury severity score, or percentage that had surgery. There was a trend toward less in-hospital deep vein thrombosis in weight-based (12 [9.7%] standard vs 4 [3.6%] weight-based, P = .075). At 90 days, there was no difference in venous thromboembolism (12 [9.7%] standard vs 6 [5.5%] weight-based, P =.34). There was 1 bleeding event, which occurred in a standard subject. Weight-based enoxaparin dosing for venous thromboembolism chemoprophylaxis in trauma patients may provide better protection against venous thromboembolism than standard. A definitive study is necessary to determine whether weight-based dosing is superior to standard. Copyright © 2018 Elsevier Inc. All rights reserved.

Temporal Changes in Microscale Colonization of the Phylloplane by Aureobasidium pullulans

PubMed Central

McGrath, Molly J.; Andrews, John H.

2006-01-01

Colonization of apple leaves by the yeastlike fungus Aureobasidium pullulans was followed quantitatively and spatially at a microscale level throughout two growing seasons. Ten field leaves were sampled on 11 dates in 2003 and 15 dates in 2004. Using an A. pullulans-specific fluorescence in situ hybridization probe and epifluorescence microscopy, we enumerated total cells, swollen-cells and chlamydospores (SCC), and blastospores/mm2 on leaf features, including the midvein, other (smaller) veins, and the interveinal regions. By 7 July 2003 and 7 June 2004, the total numbers of A. pullulans cells/mm2 were significantly higher (P < 0.05) on the midvein and other veins than in the interveinal regions. This pattern remained consistent thereafter. The primary colonizing morphotype in all regions at all dates was the SCC form, although blastospores always occurred in low numbers. Occupancy was quantified based on the percentage of microscope fields of a particular leaf feature containing ≥1 A. pullulans cell. In general, as seasons progressed, the percent occupancy of features increased and, for most midvein and veinal features, approximated 100% at the end of both growing seasons. Except for early collections, when A. pullulans cell numbers were low, the percent occupancy of interveinal regions was lower than that of the midvein or other veinal regions. A. pullulans was distributed primarily as single cells throughout the seasons in interveinal regions. On the midvein and other veins, colonies of ≥4 cells developed over time, and more cells occurred in colonies than as singletons by August. Our results demonstrate that A. pullulans primarily colonizes veins, where populations appear to increase by growth in situ. This pattern is established early in the growing season and persists. PMID:16957250

The chronology for the d18O record from Devils Hole, Nevada, extended into the Mid-Holocene

USGS Publications Warehouse

Landwehr, J.M.; Sharp, W.D.; Coplen, T.B.; Ludwig, K. R.; Winograd, I.J.

2011-01-01

This report presents the numeric values for the chronology of the paleoclimatically relevant mid-to-late Pleistocene record of the ratios of stable oxygen isotope (delta18O) in vein calcite from Devils Hole, Nev., which recently had been extended into the mid-Holocene. Dating was obtained using 230Th-234U-238U thermal ionization mass spectrometry. Devils Hole is a subaqueous cave of tectonic origin, which developed in the discharge zone of a regional aquifer in south-central Nevada. The primary groundwater recharge source area is the Spring Mountains, the highest mountain range in southern Nevada [altitude 3,630 meters (m)], approximately 80 kilometers to the east of the cavern. The walls of the open fault zone comprising the cave system are coated with dense vein calcite precipitated from the through-flowing groundwater. The calcite, up to 40 centimeters (cm) thick, contains a continuous record of the sequential variation of the composition of stable oxygen isotopes in the ground water over time. The vein calcite has also proven to be a suitable material for precise uranium-series dating via thermal ionization mass spectrometry utilizing the 230Th-234U-238U decay clock. Earlier work has presented data from the Devils Hole core DH-11, a 36-cm-long core of vein calcite recovered from a depth of about 30 m below the water table (about 45 m beneath the ground surface). The DH-11 core provided a continuous record of isotopic oxygen variation from 567,700 to 59,800 years before present. Recent work has extended this record up to 4,500 years before present, into the mid-Holocene epoch.

A Portal Vein Injection Model to Study Liver Metastasis of Breast Cancer.

PubMed

Goddard, Erica T; Fischer, Jacob; Schedin, Pepper

2016-12-26

Breast cancer is the leading cause of cancer-related mortality in women worldwide. Liver metastasis is involved in upwards of 30% of cases with breast cancer metastasis, and results in poor outcomes with median survival rates of only 4.8 - 15 months. Current rodent models of breast cancer metastasis, including primary tumor cell xenograft and spontaneous tumor models, rarely metastasize to the liver. Intracardiac and intrasplenic injection models do result in liver metastases, however these models can be confounded by concomitant secondary-site metastasis, or by compromised immunity due to removal of the spleen to avoid tumor growth at the injection site. To address the need for improved liver metastasis models, a murine portal vein injection method that delivers tumor cells firstly and directly to the liver was developed. This model delivers tumor cells to the liver without complications of concurrent metastases in other organs or removal of the spleen. The optimized portal vein protocol employs small injection volumes of 5 - 10 μl, ≥ 32 gauge needles, and hemostatic gauze at the injection site to control for blood loss. The portal vein injection approach in Balb/c female mice using three syngeneic mammary tumor lines of varying metastatic potential was tested; high-metastatic 4T1 cells, moderate-metastatic D2A1 cells, and low-metastatic D2.OR cells. Concentrations of ≤ 10,000 cells/injection results in a latency of ~ 20 - 40 days for development of liver metastases with the higher metastatic 4T1 and D2A1 lines, and > 55 days for the less aggressive D2.OR line. This model represents an important tool to study breast cancer metastasis to the liver, and may be applicable to other cancers that frequently metastasize to the liver including colorectal and pancreatic adenocarcinomas.

Long-term follow-up of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy.

PubMed

Jacobowitz, G R; Kalish, J A; Lee, A M; Adelman, M A; Riles, T S; Landis, R

2001-05-01

To determine whether choice of material used for patch closure following carotid artery endarterectomy (CAE) influences rates of early or late restenosis, stroke, and death, 274 consecutive CAEs were retrospectively reviewed. Saphenous vein (SV) was used in 159 (58.0%) procedures; everted, double-thickness jugular vein (JV) was used in 25 (9.1%); and knitted Dacron (KD) was used in 90 (32.9%). Primary closure was not used in this series. There were four perioperative strokes: two (1.3%) in SV, one (4%) in JV, and one (1.1%) in KD (NS). Follow-up was obtained on 263 (96%) operated arteries (mean 41.5 months). Duplex scan results were available for 236 (89.7%) of these arteries (mean follow-up time 33.7 months). There were three (2%) late strokes in SV and two (2.2%) in KD (NS). In long-term follow-up, one patient (0.7%) in SV and two (2.4%) in KD developed > 80% stenosis (NS). One patient (0.7%) in SV, one (5.3%) in JV, and one (1.2%) in KD had total occlusion of the operated vessel (NS). Three procedures (2.2%) in SV, 1 (5.3%) in JV, and 7 (8.5%) in KD demonstrated moderate stenosis (50-79%) (NS). Three-year follow-up shows that choice of patch material does not affect early or late stroke rate, stroke-related death rate, rate of high-grade (> 80%) restenosis, or rate of total occlusion. There is a higher incidence of moderate stenosis in KD. Although our results and a review of the literature do not indicate that these patients are at increased risk for symptoms or progression of stenosis, they should be followed by duplex scanning to ensure that this is the case.

Technical considerations in percutaneous hepatic perfusion--a multi-center experience.

PubMed

Antoine, Radcliffe A

2011-03-01

Patients diagnosed with primary or metastatic liver cancer face a daunting future that is complicated by limited treatment options. Percutaneous hepatic perfusion is a novel approach to chemotherapy delivery that offers significant benefits over contemporary modalities. Percutaneous hepatic perfusion is a procedure in which a chemotherapeutic agent is administered at high doses via the hepatic artery where it perfuses the liver, is extracted and filtered using a veno-veno bypass circuit, a fenestrated multi-lumen double-balloon catheter, and two biocompatible hemoperfusion filters. Venous access is gained at the groin through the femoral vein after which the catheter is advanced and positioned in the inferior vena cava just below the right atrium.The catheter's proximal and distal balloons are inflated to occlude the inferior vena cava above and below the hepatic veins. The occlusion isolated the chemo-rich venous outflow of the liver from the systemic venous circulation. This maneuver also diverts venous blood returning to the heart from lower extremities of the azygos vein. Once the patient is on bypass, the agent is infused through the hepatic artery where it saturates the liver. The chemo-rich venous outflow is extracted through the double-balloon catheter by the bypass circuit. The blood is continuously filtered and cleared of the agent as it passes through the filters and returned to the patient through a catheter placed in the right internal jugular vein. A phase I study demonstrated efficacy with an overall radiographic response rate of 30% observed in treated patients. In 10 patients with ocular melanoma, a 50% overall response rate was observed, including two complete responses. The technique is minimally invasive and can be performed safely by a well-trained multi-disciplinary team. It offers significant benefits including multiple procedures without risks commonly associated with open abdominal surgery.

Technical Considerations in Percutaneous Hepatic Perfusion—A Multi-Center Experience

PubMed Central

Antoine, Radcliffe A.

2011-01-01

Abstract: Patients diagnosed with primary or metastatic liver cancer face a daunting future that is complicated by limited treatment options. Percutaneous hepatic perfusion is a novel approach to chemotherapy delivery that offers significant benefits over contemporary modalities. Percutaneous hepatic perfusion is a procedure in which a chemotherapeutic agent is administered at high doses via the hepatic artery where it perfuses the liver, is extracted and filtered using a veno-veno bypass circuit, a fenestrated multi-lumen double-balloon catheter, and two biocompatible hemoperfusion filters. Venous access is gained at the groin through the femoral vein after which the catheter is advanced and positioned in the inferior vena cava just below the right atrium. The catheter’s proximal and distal balloons are inflated to occlude the inferior vena cava above and below the hepatic veins. The occlusion isolated the chemo-rich venous outflow of the liver from the systemic venous circulation. This maneuver also diverts venous blood returning to the heart from lower extremities of the azygos vein. Once the patient is on bypass, the agent is infused through the hepatic artery where it saturates the liver. The chemorich venous outflow is extracted through the double-balloon catheter by the bypass circuit. The blood is continuously filtered and cleared of the agent as it passes through the filters and returned to the patient through a catheter placed in the right internal jugular vein. A phase I study demonstrated efficacy with an overall radiographic response rate of 30% observed in treated patients. In 10 patients with ocular melanoma, a 50% overall response rate was observed, including two complete responses. The technique is minimally invasive and can be performed safely by a well-trained multi-disciplinary team. It offers significant benefits including multiple procedures without risks commonly associated with open abdominal surgery. PMID:21449232

A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery

PubMed Central

Morimoto, R; Satani, N; Iwakura, Y; Ono, Y; Kudo, M; Nezu, M; Omata, K; Tezuka, Y; Seiji, K; Ota, H; Kawasaki, Y; Ishidoya, S; Nakamura, Y; Arai, Y; Takase, K; Sasano, H; Ito, S; Satoh, F

2016-01-01

Primary aldosteronism due to unilateral aldosterone-producing adenoma (APA) is a surgically curable form of hypertension. Bilateral APA can also be surgically curable in theory but few successful cases can be found in the literature. It has been reported that even using successful adrenal venous sampling (AVS) via bilateral adrenal central veins, it is extremely difficult to differentiate bilateral APA from bilateral idiopathic hyperaldosteronism (IHA) harbouring computed tomography (CT)-detectable bilateral adrenocortical nodules. We report a case of bilateral APA diagnosed by segmental AVS (S-AVS) and blood sampling via intra-adrenal first-degree tributary veins to localize the sites of intra-adrenal hormone production. A 36-year-old man with marked long-standing hypertension was referred to us with a clinical diagnosis of bilateral APA. He had typical clinical and laboratory profiles of marked hypertension, hypokalaemia, elevated plasma aldosterone concentration (PAC) of 45.1 ng dl−1 and aldosterone renin activity ratio of 90.2 (ng dl−1 per ng ml−1 h−1), which was still high after 50 mg-captopril loading. CT revealed bilateral adrenocortical tumours of 10 and 12 mm in diameter on the right and left sides, respectively. S-AVS confirmed excess aldosterone secretion from a tumour segment vein and suppressed secretion from a non-tumour segment vein bilaterally, leading to the diagnosis of bilateral APA. The patient underwent simultaneous bilateral sparing adrenalectomy. Histopathological analysis of the resected adrenals together with decreased blood pressure and PAC of 5.2 ng dl−1 confirmed the removal of bilateral APA. S-AVS was reliable to differentiate bilateral APA from IHA by direct evaluation of intra-adrenal hormone production. PMID:26538381

Natural history of deep vein thrombosis in children.

PubMed

Spentzouris, G; Gasparis, A; Scriven, R J; Lee, T K; Labropoulos, N

2015-07-01

To determine the natural history of deep vein thrombosis in children presented with a first episode in the lower extremity veins. Children with objective diagnosis of acute deep vein thrombosis were followed up with ultrasound and clinical examination. Risk factors and clinical presentation were prospectively collected. The prevalence of recurrent deep vein thrombosis and the development of signs and symptoms of chronic venous disease were recorded. There were 27 children, 15 males and 12 females, with acute deep vein thrombosis, with a mean age of 4 years, range 0.1-16 years. The median follow-up was 23 months, range 8-62 months. The location of thrombosis involved the iliac and common femoral vein in 18 patients and the femoral and popliteal veins in 9. Only one vein was affected in 7 children, two veins in 14 and more than two veins in 6. Recurrent deep vein thrombosis occurred in two patients, while no patient had a clinically significant pulmonary embolism. Signs and symptoms of chronic venous disease were present at last follow-up in 11 patients. There were nine patients with vein collaterals, but no patient developed varicose veins. Reflux was found in 18 veins of 11 patients. Failure of recanalization was seen in 7 patients and partial recanalization in 11. Iliofemoral thrombosis (p = 0.012) and failure to recanalize (p = 0.036) increased significantly the risk for developing signs and symptoms. Children with acute proximal deep vein thrombosis develop mild chronic venous disease signs and symptoms at mid-term follow-up and are closely related with iliofemoral thrombosis and failure to recanalization. © The Author(s) 2014.

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.

A case report: a young waiter with Paget-Schroetter syndrome.

PubMed

Drakos, Nicholas; Gausche-Hill, Marianne

2013-03-01

Paget-Schroetter syndrome (PSS) is a rare presentation of primary axillary subclavian vein thrombosis that classically occurs in young men with a degree of underlying thoracic outlet syndrome after a period of upper extremity exertion. The primary complication of PSS is post-thrombotic syndrome, a result of chronic venous hypertension. To educate Emergency Physicians on this condition to potentiate timely diagnosis and appropriate disposition. A 29-year-old right-handed restaurant waiter presented with 3 days of non-painful, gradual-onset right upper extremity swelling with normal vital signs. The patient's history was otherwise notable for subjective fevers and a right forearm abrasion. Upon examination, the right upper extremity was neurovascularly intact and remarkable for uniform edema and erythema extending distally from the level of the mid-humerus. The primary differential diagnoses were deep venous thrombosis (DVT) vs. soft tissue infection. Venous phase contrast computed tomography did not reveal evidence of underlying soft tissue infection and was inconclusive regarding a DVT. Ultrasound demonstrated a right subclavian vein DVT. The patient was admitted and underwent thrombolysis, venolysis, and first rib resection and initiation of warfarin. PSS is a rare presentation of upper-extremity DVT occurring classically in patients without commonly recognized pro-thrombotic risk factors. PSS carries the potential of significant morbidity in the form of post-thrombotic syndrome and pulmonary embolism. Current literature suggests that optimal outcomes are achieved when treatment is initiated within 6 weeks of onset. The treatment paradigm calls for thrombolysis and, frequently, a first rib resection. Copyright © 2013 Elsevier Inc. All rights reserved.

Two-stage hepatectomy: who will not jump over the second hurdle?

PubMed

Turrini, O; Ewald, J; Viret, F; Sarran, A; Goncalves, A; Delpero, J-R

2012-03-01

Two-stage hepatectomy uses compensatory liver regeneration after a first noncurative hepatectomy to enable a second curative resection in patients with bilobar colorectal liver metastasis (CLM). To determine the predictive factors of failure of two-stage hepatectomy. Between 2000 and 2010, 48 patients with irresectable CLM were eligible for two-stage hepatectomy. The planned strategy was a) cleaning of the left hepatic lobe (first hepatectomy), b) right portal vein embolisation and c) right hepatectomy (second hepatectomy). Six patients had occult CLM (n = 5) or extra-hepatic disease (n = 1), which was discovered during the first hepatectomy. Thus, 42 patients completed the first hepatectomy and underwent portal vein embolisation in order to receive the second hepatectomy. Eight patients did not undergo a second hepatectomy due to disease progression. Upon univariate analysis, two factors were identified that precluded patients from having the second hepatectomy: the combined resection of a primary tumour during the first hepatectomy (p = 0.01) and administration of chemotherapy between the two hepatectomies (p = 0.03). An independent association with impairment to perform the two-stage strategy was demonstrated by multivariate analysis for only the combined resection of the primary colorectal cancer during the first hepatectomy (p = 0.04). Due to the small number of patients and the absence of equivalent conclusions in other studies, we cannot recommend performance of an isolated colorectal resection prior to chemotherapy. However, resection of an asymptomatic primary tumour before chemotherapy should not be considered as an outdated procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

The risk of recurrent thromboembolic disorders in patients with unprovoked venous thromboembolism: new scenarios and opportunities.

PubMed

Prandoni, Paolo; Barbar, Sofia; Milan, Marta; Vedovetto, Valentina; Pesavento, Raffaele

2014-01-01

The risk of recurrent thromboembolic disorders in the 10-year period following an episode of unprovoked venous thromboembolism (VTE) ranges between 30 and 50%, the rate being higher in patients with primary deep venous thrombosis (DVT) than in those with primary pulmonary embolism (PE). The clinical presentation with primary PE increases by more than three times the risk of a new PE episode over that with isolated DVT. Baseline parameters that increase this risk are the proximal location of DVT, obesity, old age and male sex, whereas the role of thrombophilia is controversial. An increasing role is played by post-baseline parameters such as the ultrasound assessment of residual vein thrombosis and the determination of D-dimer. While the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, new scenarios are being offered by the identification of risk stratification models and by strategies that have the potential to help identify patients in whom anticoagulation can be safely discontinued, such as those that incorporate the assessment of D-dimer and residual vein thrombosis. New opportunities are being offered by low-dose aspirin, which has recently been reported to decrease by more than 30% the risk of recurrent events without increasing the bleeding risk; and especially by a few emerging anti-Xa and anti-IIa oral compounds, which are likely to induce fewer haemorrhagic complications than vitamin K antagonists while preserving at least the same effectiveness, do not require laboratory monitoring, and can be used immediately after the thrombotic episode. © 2013.

Concerns and Discomforts of Pregnancy - Varicose Veins

MedlinePlus

Concerns and Discomforts of Pregnancy - Varicose Veins Varicose veins are enlarged veins you may see on your ... Healthy Roads Media project www. healthyroadsmedia. org English - Concerns and Discomforts of Pregnancy (Varicose Veins) Last reviewed ...

Deep Vein Thrombosis

MedlinePlus

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

Pelvic Vein Embolisation in the Management of Varicose Veins

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.

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 47more » (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.« less

Metamorphism Near the Dike-Gabbro Transition in the Ocean Crust Based on Preliminary Results from Oman Drilling Project Hole GT3A

NASA Astrophysics Data System (ADS)

Manning, C. E.; Nozaka, T.; Harris, M.; Michibayashi, K.; de Obeso, J. C.; D'Andres, J.; Lefay, R.; Leong, J. A. M.; Zeko, D.; Kelemen, P. B.; Teagle, D. A. H.

2017-12-01

Oman Drilling Project Hole GT3A intersected 400 m of altered basaltic dikes, gabbros, and diorites. The 100% recovery affords an unprecedented opportunity to study metamorphism and hydrothermal alteration near the dike-gabbro transition in the ocean crust. Hydrothermal alteration is ubiquitous; all rocks are at least moderately altered, and mean alteration intensity is 54%. The earliest alteration in all rock types is background replacement of igneous minerals, some of which occurred at clinopyroxene amphibolite facies, as indicated by brown-green hornblende, calcic plagioclase, and secondary cpx. In addition, background alteration includes greenschist, subgreenschist, and zeolite facies minerals. More extensive alteration is locally observed in halos around veins, patches, and zones related to deformation. Dense networks of hydrothermal veins record a complex history of fluid-rock alteration. During core description, 10,727 individual veins and 371 vein networks were logged in the 400 m of Hole GT3A. The veins displayed a range of textures and connectivities. The total density of veins in Hole GT3A is 26.8 veins m-1. Vein density shows no correlation with depth, but may be higher near dike margins and faults. Vein minerals include amphibole, epidote, quartz, chlorite, prehnite, zeolite (chiefly laumontite) and calcite in a range of combinations. Analysis of crosscutting relations leads to classification of 4 main vein types. In order of generally oldest to youngest these are: amphibole, quartz-epidote-chlorite (QEC), zeolite-prehnite (ZP), and calcite. QEC and ZP vein types may contain any combination of minerals except quartz alone; veins filled only by quartz may occur at any relative time. Macroscopic amphibole veins are rare and show no variation with depth. QEC vein densities appear to be higher (>9.3 veins m-1) in the upper 300 m of GT3A, where dikes predominate. In contrast, there are 5.5 veins m-1 at 300-400 m, where gabbros and diorites are abundant. ZP veins increase in density downhole; the highest density of 17.5 ZP veins/m occurs in the lowest 100 m where substantial faulting is observed. Equilibrium coexistence of laumontite and prehnite in ZP veins implies formation at 100-250 °C, lower than amphibole and QEC veins. Calcite veins are abundant only in the uppermost 100 m of the hole.

Improvements of deep vein reflux following radiofrequency ablation for saphenous vein incompetence.

PubMed

Kim, Suh Min; Jung, In Mok; Chung, Jung Kee

2017-02-01

Objectives The aim of this study was to describe the changes of deep vein reflux after radiofrequency ablation for great saphenous vein incompetence. Method The data on 139 limbs which were treated with radiofrequency ablation for great saphenous vein incompetence were prospectively collected and reviewed. Results Deep vein reflux was present in 43 of 139 limbs (30.9%). There were no significant differences in the rate of successful closure, the incidence of procedure-related complications, and the improvements of symptoms and quality of life between the limbs with or without deep vein reflux. With a mean follow-up of 5.9 months, the peak reflux velocity and duration of reflux were improved in all limbs with deep vein reflux and it was completely corrected in 13 limbs (30.2%) after radiofrequency ablation. Conclusions The presence of deep vein reflux does not affect the treatment outcomes of radiofrequency ablation for great saphenous vein incompetence and is improved in all patients. Deep vein reflux is not a barrier to performing radiofrequency ablation.

Enriched and depleted characters of the Amnay Ophiolite upper crustal section and the regionally heterogeneous nature of the South China Sea mantle

NASA Astrophysics Data System (ADS)

Perez, Americus d. C.; Faustino-Eslava, Decibel V.; Yumul, Graciano P.; Dimalanta, Carla B.; Tamayo, Rodolfo A.; Yang, Tsanyao Frank; Zhou, Mei-Fu

2013-03-01

The volcanic section of the Middle Oligocene Amnay Ophiolite in Mindoro, Philippines has previously been shown to be of normalmid-oceanic ridge basalt (NMORB) composition. Here we report for the first time an enriched mantle component that is additionally recorded in this crustal section. New whole rock major and trace element data are presented for nine mafic volcanic rocks from a section of the ophiolite that has not been previously examined. These moderately evolved tholeiitic basalts were found to have resulted from the bulk mixing of ˜10% ocean island basalt components with depleted mantle. Drawing together various geochemical characteristics reported for different rock suites taken as representatives of the South China Sea crust, including the enriched MORB (EMORB) and NMORB of the East Taiwan Ophiolite, the NMORB from previous studies of the Amnay Ophiolite and the younger ocean floor eruptives of the Scarborough Seamount-Reed Bank region, a veined mantle model is proposed for the South China Sea mantle. The NMORB magmatic products are suggested to have been derived from the more depleted portions of the mantle whereas the ocean island basalt (OIB) and EMORB-type materials from the mixing of depleted and veined/enriched mantle regions.

Determining the origin of superficial venous reflux in the groin with duplex ultrasound and implications for varicose vein surgery.

PubMed

Zollmann, Paul; Zollmann, Christine; Zollmann, Philipp; Veltman, Juergen; Kerzig, Dennis; Doerler, Martin; Stücker, Markus

2017-01-01

The purpose of this paper was to describe patterns of superficial reflux in the groin with respect to the terminal valve (TV), which is located at the saphenous opening to the common femoral vein, the great saphenous vein, and its tributary veins. This study included 2019 legs with chronic venous insufficiency that received endoluminal varicose vein treatment because of varicosities with insufficiency of the saphenofemoral junction (SFJ). In a preoperative duplex ultrasound investigation of the superficial vein system, reflux after provocation in the SFJ, great saphenous vein, cranial veins (superficial external pudendal vein, superficial epigastric vein, superficial circumflex iliac vein), and anterior and posterior accessory saphenous veins was recorded and classified on the basis of the origin of reflux. In 1348 legs (66.8%), the reflux had its origin exclusively in the common femoral vein. In 170 legs (8.4%), the reflux had its origin in the common femoral and cranial veins. In 430 legs (21.3%), the insufficiency was due to saphenocranial reflux only. In 71 legs (3.5%), the origin of reflux could not be determined. Reflux in the SFJ does not involve the TV in 24.8% of the legs, implying that routine high ligation and ablation close to the TV might be overtreatment in these patients. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Evidence for de-sulfidation to form native electrum in the Fire Creek epithermal gold-silver deposit, north-central Nevada

NASA Astrophysics Data System (ADS)

Perez, J.; Day, J. M.; Cook, G. W.

2012-12-01

The Fire Creek property is a newly developed and previously unstudied epithermal Au-Ag deposit located in the Northern Shoshone range of north central Nevada. The mineralization occurs within and above en echelon N-NW trending basaltic dykes that are hosted within a co-genetic and bimodal suite of mid-Miocene basalts and andesites formed in association with the Yellowstone hotspot-track. Previous studies of Au-Ag mineralization in the Great Basin have focused primarily on extensively mined and/or low-grade deposits. Therefore, the ability for unrestricted sampling of a major Au-Ag deposit early in its exploration and development represents an opportunity for refined understanding of epithermal ore genesis processes. New petrology reveals at least two distinct pulses of mineralization that in relative order of timing are: 1) S-rich veins which are associated with initial host-rock alteration; 2) quartz- and/or calcite-rich veins which vary from fine-grained to lath-like quartz crystals with large calcite crystals in vein centers. Native electrum occurs only within the second phase of mineralization and typically occurs within quartz and adjacent to cross-cut first-phase S-rich veins. In places the electrum appears to replace or form overgrowths around existing sulfide phases. High levels of gold and silver are found in both the first (0.8 g Au/tonne) and second-phase pulses (37 g Au/tonne). Fire Creek shares many similarities with its northern neighbor, the Mule Canyon Au-Ag deposit, with high Fe sulfide contents for some of the ores, altered wall-rocks and the presence of narrow and discontinuous gold-bearing siliceous veins. Like Fire Creek, Mule Canyon possesses two distinct mineralizing phases, a sulfide rich and a late stage calcite/silica assemblage. The first pulse appears to be identical in both locations with a variation of disseminated to euhedral iron-sulfides and associated intense alteration of host rock. However, Fire Creek differs from Mule Canyon in that the second phase of mineralization shows spatial and petrographic association with coarser silica and carbon phases. Conversely associations of electrum in Mule Canyon are typically with chalcedony or opal veins and hydrothermal breccia matrices (John et al. Econ. Geol. 98, 425-463, 2003). Opal and chalcedony phases do not appear within fracture-filled veins in Fire Creek, but occur as cap rocks on the surface. These associations are likely driven by impingement of basaltic dikes into ground waters in both the Fire Creek and Mule Canyon deposits. However, in the case of Fire Creek, our study demonstrates that there is a clear spatial dependence between the electrum, primary S-rich mineralized veins and phases of coarse carbonate and silica. We postulate that this occurs through increased brecciation and sub-surface boiling of hydrothermal fluids leading to de-sulfidation and a marked change in alteration and mineral assemblage.

Stable-isotope studies of rocks and secondary minerals in a vapor-dominated hydrothermal system at The Geysers, Sonoma County, California

NASA Astrophysics Data System (ADS)

Lambert, Steven J.; Epstein, Samuel

1992-11-01

The Geysers, a vapor-dominated hydrothermal system, is developed in host rock of the Franciscan Formation, which contains veins of quartz and calcite whose δ 18O values record the temperatures and isotopic compositions of fluids prevailing during at least two different episodes of rock-fluid interaction. The first episode took place at about 200°C, during which marine silica and carbonate apparently interacted with ocean water entrapped in the sediments to form veins of quartz and calcite whose δ 18O values were around +19 and +16%, respectively. The calculated water/mineral ratios were less than unity. The water may have profoundly influenced the δ 18O values of spilitic basalts during their metamorphism to greenstones. Serpentinization and structural emplacement of ophiolite slabs were isotopically unrelated to this episode, which was essentially a low-grade (post-Cretaceous?) burial metamorphism. D/H ratios of actinolite, chlorite, and micas in host rocks were more profoundly altered during this episode than were 18O/ 16O ratios. A paleogeothermal gradient of about 53°C/km has been inferred for this episode, from δ 18O-depth distributions of vein minerals. The second episode, in part recorded by cogenetic vein quartz and calcite δ 18O values of +4 to +6% and +1 to +3%, respectively, began with large quantities of meteoric water circulating in fractures in the rock at temperatures of 160-180°C in response to the initiation of the Pliocene-Pleistocene Clear Lake magmatism. The temperature rose, and with the restricted circulation of fluids the ancestral hot-water system evolved into the presently active vapor-dominated system, which according to the cogenetic vein quartz and calcite δ 18O values involved temperatures as high as 320°C and fluid/mineral ratios near unity. The change in the oxygen-isotopic composition of the serpentinite within the host rock during this later activity was negligible. The δ 13C values of vein calcite at The Geysers reflect both a marine carbonate and organic component of carbon, but carbon-isotope exchange has been facilitated by the vapor-dominated hydrothermal fluid to a greater degree than in any other episode or in other hot-water systems.

Origin of ore-forming fluids of the Haigou gold deposit in the eastern Central Asian Orogenic belt, NE China: Constraints from H-O-He-Ar isotopes

NASA Astrophysics Data System (ADS)

Zeng, Qingdong; He, Huaiyu; Zhu, Rixiang; Zhang, Song; Wang, Yongbin; Su, Fei

2017-08-01

The Haigou lode deposit contains 40 t of gold at an average grade of 3.5 g/t, and is one of the largest deposits in the Jiapigou gold belt located along the eastern segment of the northern margin of the North China Craton. The deposit comprises 15 gold-bearing quartz veins hosted in a Carboniferous monzonite-monzogranite stock. Cretaceous dikes consisting of diorite, diabase, and granodiorite porphyries are well developed in the deposit. The diorite porphyry dikes (130.4 ± 6.3 Ma) occur together with gold-bearing quartz veins in NNE- and NE-striking faults. Gold-bearing quartz veins crosscut the diorite porphyry dikes, and the veins are in turn crosscut by E-W-striking 124.6 ± 2.2 Ma granodiorite porphyry dikes. The mineralization mainly occurs as auriferous quartz veins with minor amounts of sulfide minerals, including pyrite, galena, chalcopyrite, and molybdenite. Gold occurs as either native gold or calaverite. Common gangue minerals in the deposit include quartz, sericite, and calcite. The deposit is characterized by various types of hydrothermal alteration, including silicification, sericitization, chloritization, potassic alteration, and carbonatization. Three stages of hydrothermal activity have been recognized in the deposit: (1) a barren quartz stage; (2) a polymetallic sulfide (gold) stage; (3) a calcite stage. Fluid inclusions in hydrothermal pyrites have 3He/4He ratios of 0.3 to 3.3 Ra and 40Ar/36Ar ratios of 351 to 1353, indicating mixing of fluids of mantle and crustal origin. Hydrothermal quartz yielded δ18O values of -1.3‰ to +7.2‰ and δD values of fluid inclusions in the quartz vary between -80‰ and -104‰. These stable isotope data also suggest mixing of magmatic and meteoric fluids. Noble gas and stable isotopic data suggest that the ore fluids have a predominant mantle source with a significant crustal component. Based on the spatial association of gold-bearing quartz veins with early Cretaceous intrusions, and the H-O-He-Ar isotopic data from the deposit and intrusions, we propose that gold mineralization in the Haigou deposit was formed in an extensional setting and was related to the early Cretaceous, mantle-derived intrusions.

Global variations in abyssal peridotite compositions

NASA Astrophysics Data System (ADS)

Warren, Jessica M.

2016-04-01

Abyssal peridotites are ultramafic rocks collected from mid-ocean ridges that are the residues of adiabatic decompression melting. Their compositions provide information on the degree of melting and melt-rock interaction involved in the formation of oceanic lithosphere, as well as providing constraints on pre-existing mantle heterogeneities. This review presents a compilation of abyssal peridotite geochemical data (modes, mineral major elements, and clinopyroxene trace elements) for > 1200 samples from 53 localities on 6 major ridge systems. On the basis of composition and petrography, peridotites are classified into one of five lithological groups: (1) residual peridotite, (2) dunite, (3) gabbro-veined and/or plagioclase-bearing peridotite, (4) pyroxenite-veined peridotite, and (5) other types of melt-added peridotite. Almost a third of abyssal peridotites are veined, indicating that the oceanic lithospheric mantle is more fertile, on average, than estimates based on residual peridotites alone imply. All veins appear to have formed recently during melt transport beneath the ridge, though some pyroxenites may be derived from melting of recycled oceanic crust. A limited number of samples are available at intermediate and fast spreading rates, with samples from the East Pacific Rise indicating high degrees of melting. At slow and ultra-slow spreading rates, residual abyssal peridotites define a large (0-15% modal clinopyroxene and spinel Cr# = 0.1-0.6) compositional range. These variations do not match the prediction for how degree of melting should vary as a function of spreading rate. Instead, the compositional ranges of residual peridotites are derived from a combination of melting, melt-rock interaction and pre-existing compositional variability, where melt-rock interaction is used here as a general term to refer to the wide range of processes that can occur during melt transport in the mantle. Globally, 10% of abyssal peridotites are refractory (0% clinopyroxene, spinel Cr# > 0.5, bulk Al2O3 < 1 wt.%) and some ridge sections are dominated by harzburgites while lacking a significant basaltic crust. Abyssal ultramafic samples thus indicate that the mantle is multi-component, probably consisting of at least three components (lherzolite, harzburgite, and pyroxenite). Overall, the large compositional range among residual and melt-added peridotites implies that the oceanic lithospheric mantle is heterogeneous, which will lead to the generation of further heterogeneities upon subduction back into the mantle.

Anatomy of the inferior petro-occipital vein and its relation to the base of the skull: application to surgical and endovascular procedures of the skull base.

PubMed

Tubbs, R Shane; Watanabe, Koichi; Loukas, Marios; Cohen-Gadol, Aaron A

2014-07-01

Although the inferior petro-occipital vein has been recently used for vascular access to the cavernous sinus, few detailed descriptions of its anatomy are in the literature. We aimed to investigate the morphology and relationships of this vessel. Twelve latex-injected cadaveric heads (24 sides) were dissected to identify the inferior petro-occipital vein and anatomic details documented. The petro-occipital vein was identified on 83.3% of sides. Generally this vein united the internal carotid venous plexus to the superior jugular bulb. However, on 10% of sides, the anterior part of this vein communicated directly with the cavernous sinus, and on 15%, the posterior vein drained into the inferior petrosal sinus at its termination into the superior jugular bulb. The petro-occipital vein was separated from the overlying inferior petrosal sinus by a thin plate of bone. On 40% of sides, small venous connections were found between these two venous structures. The vein was usually larger if a nondominant transverse sinus was present. The overlying inferior petrosal sinus was smaller in diameter when an underlying inferior petro-occipital vein was present. On 20% of sides, the posterior aspect of the vein communicated with the hypoglossal canal veins. On three sides, diploic veins from the clivus drained into the inferior petro-occipital vein. The inferior petro-occipital vein is present in most humans. This primarily extracranial vessel communicates with intracranial venous sinuses and should be considered an emissary vein. Knowledge of this vessel's exact anatomy may be useful to cranial base surgeons and endovascular specialists. Copyright © 2013 Wiley Periodicals, Inc.

Pregnancy causes diminished myogenic tone and outward hypotrophic remodeling of the cerebral vein of Galen.

PubMed

van der Wijk, Anne-Eva; Schreurs, Malou P H; Cipolla, Marilyn J

2013-04-01

Pregnancy increases the risk of several complications associated with the cerebral veins, including thrombosis and hemorrhage. In contrast to the cerebral arteries and arterioles, few studies have focused on the effect of pregnancy on the cerebral venous side. Here, we investigated for the first time the effect of pregnancy on the function and structure of the cerebral vein of Galen in rats. Our major finding was that cerebral veins from late-pregnant (LP, n=11) rats had larger lumen diameters and thinner walls than veins from nonpregnant (NP, n=13) rats, indicating that pregnancy caused outward hypotrophic remodeling of the vein of Galen. Moreover, veins from NP animals had a small amount of myogenic tone at 10 mm Hg (3.9±1.0%) that was diminished in veins during pregnancy (0.8±0.3%; P<0.01). However, endothelium-dependent and -independent vasodilation of the veins was unchanged during pregnancy. Using immunohistochemistry, we show that the vein of Galen receives perivascular innervation, and that serotonergic innervation of cerebral veins is significantly higher in veins from LP animals. Outward hypotrophic remodeling and diminished tone of cerebral veins during pregnancy may contribute to the development of venous pathology through elevated wall tension and wall stress, and possibly by promoting venous blood stasis.

Macrolides for KCNJ5-mutated aldosterone-producing adenoma (MAPA): design of a study for personalized diagnosis of primary aldosteronism.

PubMed

Maiolino, Giuseppe; Ceolotto, Giulio; Battistel, Michele; Barbiero, Giulio; Cesari, Maurizio; Amar, Laurence; Caroccia, Brasilina; Padrini, Roberto; Azizi, Michel; Rossi, Gian Paolo

2018-02-06

Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA. Thus, we aimed at investigating if clarithromycin and roxithromycin, two macrolides that potently blunt mutated Kir3.4 channel function in vitro, affect plasma aldosterone concentration in adrenal vein blood during AVS and in peripheral blood, respectively, in PA patients with a mutated APA. We designed two proof of concept studies. In study A: consecutive patients with an unambiguous biochemical evidence of PA will be exposed to a single dose of 250 mg clarithromycin during AVS, to assess its effect on the relative aldosterone secretion index in adrenal vein blood from the gland with and without APA. In study B: consecutive hypertensive patients submitted to the work-up for hypertension will receive a single oral dose of 150 mg roxithromycin. The experimental endpoints will be the change induced by roxithromycin of plasma aldosterone concentration and other steroids, direct active renin concentration, serum K + , systolic and diastolic blood pressure. We expect to prove that: (i) clarithromycin allows identification of mutated APA before adrenalectomy and sequencing of tumour DNA; (ii) the acute changes of plasma aldosterone concentration, direct active renin concentration, and blood pressure in peripheral venous blood after roxithromycin can be a proxy for the presence of an APA with somatic mutations.

Kinematics of Cone-In-Cone Growth, with Implications for Timing and Formation Mechanism

NASA Astrophysics Data System (ADS)

Hooker, J. N.; Cartwright, J. A.

2015-12-01

Cone-in-cone is an enigmatic structure. Similar to many fibrous calcite veins, cone-in-cone is generally formed of calcite and present in bedding-parallel vein-like accumulations within fine-grained rocks. Unlike most fibrous veins, cone-in-cone contains conical inclusions of host-rock material, creating nested, parallel cones throughout. A long-debated aspect of cone-in-cone structures is whether the calcite precipitated with its conical form (primary cone-in-cone), or whether the cones formed afterwards (secondary cone-in-cone). Trace dolomite within a calcite cone-in-cone structure from the Cretaceous of Jordan supports the primary hypothesis. The host sediment is a siliceous mud containing abundant rhombohedral dolomite grains. Dolomite rhombohedra are also distributed throughout the cone-in-cone. The rhombohedra within the cones are randomly oriented yet locally have dolomite overgrowths having boundaries that are aligned with calcite fibers. Evidence that dolomite co-precipitated with calcite, and did not replace calcite, includes (i) preferential downward extension of dolomite overgrowths, in the presumed growth-direction of the cone-in-cone, and (ii) planar, vertical borders between dolomite crystals and calcite fibers. Because dolomite overgrows host-sediment rhombohedra and forms fibers within the cones, it follows that the host-sediment was included within the growing cone-in-cone as the calcite precipitated, and not afterward. The host-sediment was not injected into the cone-in-cone along fractures, as the secondary-origin hypothesis suggests. This finding implies that cone-in-cone in general does not form over multiple stages, and thus has greater potential to preserve the chemical signature of its original precipitation. Because cone-in-cone likely forms before complete lithification of the host, and because the calcite displaces the host material against gravity, this chemical signature can preserve information about early overpressures in fine-grained sediments.

A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with observation to treat vision loss associated with macular edema secondary to central retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 5.

PubMed

Ip, Michael S; Scott, Ingrid U; VanVeldhuisen, Paul C; Oden, Neal L; Blodi, Barbara A; Fisher, Marian; Singerman, Lawrence J; Tolentino, Michael; Chan, Clement K; Gonzalez, Victor H

2009-09-01

To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with observation for eyes with vision loss associated with macular edema secondary to perfused central retinal vein occlusion (CRVO). Multicenter, randomized, clinical trial of 271 participants. Gain in visual acuity letter score of 15 or more from baseline to month 12. Seven percent, 27%, and 26% of participants achieved the primary outcome in the observation, 1-mg, and 4-mg groups, respectively. The odds of achieving the primary outcome were 5.0 times greater in the 1-mg group than the observation group (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.8-14.1; P = .001) and 5.0 times greater in 4-mg group than the observation group (OR, 5.0; 95% CI, 1.8-14.4; P = .001); there was no difference identified between the 1-mg and 4-mg groups (OR, 1.0; 95% CI, 0.5-2.1; P = .97). The rates of elevated intraocular pressure and cataract were similar for the observation and 1-mg groups, but higher in the 4-mg group. Intravitreal triamcinolone is superior to observation for treating vision loss associated with macular edema secondary to CRVO in patients who have characteristics similar to those in the SCORE-CRVO trial. The 1-mg dose has a safety profile superior to that of the 4-mg dose. Application to Clinical Practice Intravitreal triamcinolone in a 1-mg dose, following the retreatment criteria applied in the SCORE Study, should be considered for up to 1 year, and possibly 2 years, for patients with characteristics similar to those in the SCORE-CRVO trial. Trial Registration clinicaltrials.gov Identifier: NCT00105027.

Recommended Practices for Measurement of Gas Path Pressures and Temperatures for Performance Assessment of Aircraft Turbine Engines and Components (Les Methodes Recommandees pour la Mesure de la Pression et de la Temperature de la Veine Gazeuse en Vue de l’Evaluation des Performances des Turbines Aeronautiques et de leurs Composants

DTIC Science & Technology

1990-06-01

reduction software , prior to converting all remaining test which requires internal compensation. T he r sidual effect is pressures to engineering units...Reduction Conversion of Millivolts to Engineering Units. Carrying out numerical integrations to obtain area and mass weighted averages for various...Performance Assessment of Aircraft Turbine Engines and Components (Les MWthodes Recommande’es pour la Mesure de la Pression et de ]a Temperature de la

Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy - Case report.

PubMed

Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B

2014-12-01

62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

PubMed Central

Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

2014-01-01

62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. Conclusion The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival. PMID:25568802

Numerical modelling of the formation of fibrous bedding-parallel veins

NASA Astrophysics Data System (ADS)

Torremans, Koen; Muchez, Philippe; Sintubin, Manuel

2014-05-01

Bedding-parallel veins with a fibrous infill oriented orthogonal to the vein wall, are often observed in fine-grained metasedimentary sequences. Several mechanisms have been proposed for their formation, mostly with respect to effects of fluid overpressures and anisotropy of the host-rock fabric in order to explain the inferred extensional failure with sub-vertical opening. Abundant pre-folding, bedding-parallel fibrous dolomite veins are found associated with the Nkana-Mindola stratiform Cu-Co deposit in Zambia. The goal of this study is to better understand the formation mechanisms of these veins and to explain their particular spatial and thickness distribution, with respect to failure of transversely isotropic rocks. The spatial distribution and thickness variation of these veins was quantified during a field campaign in thirteen line transects perpendicular to undeformed veins in underground crosscuts. The fibrous dolomite veins studied are not related to lithological contrasts, but to a strong bedding-parallel shaly fabric, typical for the black shale facies of the Copperbelt Orebody Member. The host rock can hence be considered as transversely isotropic. Growth morphologies vary from antitaxial with a pronounced median surface to asymmetric syntaxial, always with small but quantifiable growth competition. A microstructural fabric study reveals that the undeformed dolomite veins show low-tortuosity vein walls and quantifiable growth competition. Here, we use a Discrete Element Method numerical modelling approach with ESyS-Particle (http://launchpad.net/esys-particle) to simulate the observed properties of the veins. Calibrated numerical specimens with a transversely isotropic matrix are repeatedly brought to failure under constant strain rates by changing the effective strain rates at model boundaries. After each fracture event, fractures in the numerical model are filled with cohesive vein material and the experiment is repeated. By systematically varying stress states, fluid pressures and mechanical properties of materials (host rock, vein infill and interface), we attempt to reproduce the characteristics of spatial distribution and thickness variation of the veins. Four parameter sets of mechanical micro-properties are defined in the models, essentially yielding (1) a competent and (2) incompetent matrix, (3) a vein material and (4) a vein-matrix interface. Each combination of parameters and particle packings is calibrated to fit a predetermined Mohr-Coulomb type failure envelope, via an automated calibration procedure. Preliminary tests already show that by varying these parameters, we are able to simulate realistically distributed cracking through crack-seal processes. Different types of veins and vein generations can be modelled, ranging from single veins, over crack-seal veins to anastomosing veins, by varying the mechanical strength of competent and incompetent matrix, vein and interface material. Further results of this approach will be presented. We will discuss our results with respect to mechanisms proposed in the literature for bedding-parallel, fibrous veins in metasedimentary rock sequences.

Double external jugular vein and other rare venous variations of the head and neck.

PubMed

Shenoy, Varsha; Saraswathi, Perumal; Raghunath, Gunapriya; Karthik, Jayakumar Sai

2012-12-01

Superficial veins of the head and neck are utilised for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Hence, although variations in these vessels are common, a sound knowledge of such variations becomes clinically important to surgeons, radiologists and interventional anaesthetists. We report a rare case of a left-sided double external jugular vein where the common facial vein continued as the second external jugular vein, and where there was a communicating channel between the internal jugular vein on the same side and the anterior jugular vein.

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

Morphology of congenital portosystemic shunts involving the left colic vein in dogs and cats.

PubMed

White, R N; Parry, A T

2016-05-01

To describe the anatomy of congenital portosystemic shunts involving the left colic vein in dogs and cats. Retrospective review of a consecutive series of dogs and cats managed for congenital portosystemic shunts. For inclusion a shunt involving the left colic vein with recorded intraoperative mesenteric portovenography or computed tomography angiography along with direct gross surgical observations at the time of surgery was required. Six dogs and three cats met the inclusion criteria. All cases had a shunt which involved a distended left colic vein. The final communication with a systemic vein was variable; in seven cases (five dogs, two cats) it was via the caudal vena cava, in one cat it was via the common iliac vein and in the remaining dog it was via the internal iliac vein. In addition, two cats showed caudal vena cava duplication. The morphology of this shunt type appeared to be a result of an abnormal communication between either the left colic vein or the cranial rectal vein and a pelvic systemic vein (caudal vena cava, common iliac vein or internal iliac vein). This information may help with surgical planning in cases undergoing shunt closure surgery. © 2016 British Small Animal Veterinary Association.

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.

Anatomical study of the accessory axillary vein in cadavers: a contribution to the axillary surgical approach.

PubMed

Felix, Valtuir Barbosa; Dos Santos, José André Bernardino; Fernandes, Katharina Jucá de Moraes; Cabral, Dhayanna Rolemberg Gama; Dos Santos, Carlos Adriano Silva; Rodrigues, Célio Fernando de Sousa; Lima, Jacqueline Silva Brito; Ramalho, Antônio José Casado

2016-01-01

The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path. The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel's topography. In this study, axillary dissections were carried out on twenty-four (24) human cadavers of both sexes that had been fixed with 10% formaldehyde. The upper limbs of the cadavers were still attached to the bodies and the axillary structures were preserved. Data collection was carried out and the axillary structures of the cadavers were compared. The incidence of accessory axillary veins was 58.3%, with no significant preference for sex or for side of the body. The accessory axillary vein originated from the lateral brachial vein in 39.28% of cases, from the common brachial vein in 35.71% of cases, and from the deep brachial vein in 25% of cases. Its high incidence and clinical relevance make the accessory axillary vein important for provision of collateral circulation in the event of traumatic injury to the axillary vein.

TrapEase inferior vena cava filter placement: use of the subclavian vein.

PubMed

Stone, Patrick A; Aburahma, Ali F; Hass, Stephen M; Hofeldt, Matthew J; Zimmerman, William B; Deel, John T; Deluca, John A

2004-01-01

The purpose of this paper was to evaluate the safety and technical success of TrapEase inferior vena cava filter placement via the subclavian vein. As of yet, no reports in the literature have specifically investigated the use of the subclavian vein as a route for deploying TrapEase vena cava filters. Retrospective chart review was conducted of 135 patients with attempted TrapEase inferior vena cava filter placement over a 2-year period. In a majority of cases, the choice of subclavian vein approach was based primarily on surgeon preference. Other circumstances for subclavian vein deployment included cervical immobilization secondary to trauma, desire for concomitant placement of a subclavian long-term central venous access catheter, and patient body habitus limiting exposure to the internal jugular vein. One hundred and thirty-five filters were placed over this 2-year period. The internal jugular vein approach was used in 56 patients, the femoral vein approach in 39 patients, and the subclavian vein approach in 40 patients. Thirty-nine of the 40 TrapEase filter placements using the subclavian vein were successful. Twenty-six were deployed through the right subclavian vein and 14 through the left subclavian vein. The single failed subclavian deployment was due to the inability to pass the guidewire adequately into the inferior vena cava after successful cannulation of the right subclavian vein. The average deployment time for subclavian vein placement was 26 minutes when TrapEase filter placement was the only procedure performed. No insertional complications were encountered, specifically no pneumothoraces confirmed by chest radiography or fluoroscopy. The subclavian vein provides an alternative site of access for the TrapEase inferior vena cava filter. This route is comparable to other alternative methods evaluated both in average deployment time and complication occurrence. Furthermore, the subclavian vein route is valuable in patients with limited central access and where combined long-term central venous catheter placement using the subclavian vein is desirable.

Susceptibility-weighted imaging of the venous networks around the brain stem.

PubMed

Cai, Ming; Zhang, Xiao-Fen; Qiao, Hui-Huang; Lin, Zhong-Xiao; Ren, Chuan-Gen; Li, Jian-Ce; Chen, Cheng-Chun; Zhang, Nu

2015-02-01

The venous network of the brainstem is complex and significant. Susceptibility-weighted imaging (SWI) is a practical technique which is sensitive to veins, especially tiny veins. Our purpose of this study was to evaluate the visualization of the venous network of brainstem by using SWI at 3.0 T. The occurrence rate of each superficial veins of brainstem was evaluated by using SWI on a 3 T MR imaging system in 60 volunteers. The diameter of the lateral mesencephalic vein and peduncular vein were measured by SWI using the reconstructed mIP images in the sagittal view. And the outflow of the veins of brainstem were studied and described according to the reconstructed images. The median anterior pontomesencephalic vein, median anterior medullary vein, peduncular vein, right vein of the pontomesencephalic sulcus, and right lateral anterior pontomesencephalic vein were detected in all the subjects (100%). The outer diameter of peduncular vein was 1.38 ± 0.26 mm (range 0.8-1.8 mm). The lateral mesencephalic vein was found in 75% of the subjects and the mean outer diameter was 0.81 ± 0.2 mm (range 0.5-1.2 mm). The inner veins of mesencephalon were found by using SWI. The venous networks around the brain stem can be visualized by SWI clearly. This result can not only provide data for anatomical study, but also may be available for the surgical planning in the infratentorial region.

Varicose Veins

MedlinePlus

... This causes the veins to swell, which can lead to varicose veins. Varicose veins are very common. You are more at risk if you are older, are female, have obesity, don't exercise, or have a family history of varicose veins. They can also be more ...

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 vein therapy

Internal jugular and vertebral vein volume flow in patients with clinically isolated syndrome or mild multiple sclerosis and healthy controls: results from a prospective sonographer-blinded study.

PubMed

Chambers, Brian; Chambers, Jayne; Churilov, Leonid; Cameron, Heather; Macdonell, Richard

2014-09-01

We evaluated internal jugular vein and vertebral vein volume flow using ultrasound, in patients with clinically isolated syndrome or mild multiple sclerosis and controls, to determine whether volume flow was different between the two groups. In patients and controls, internal jugular vein volume flow increased from superior to inferior segments, consistent with recruitment from collateral veins. Internal jugular vein and vertebral vein volume flow were greater on the right in supine and sitting positions. Internal jugular vein volume flow was higher in the supine posture. Vertebral vein volume flow was higher in the sitting posture. Regression analyses of cube root transformed volume flow data, adjusted for supine/sitting, right/left and internal jugular vein/vertebral vein, revealed no significant difference in volume flow in patients compared to controls. Our findings further refute the concept of venous obstruction as a causal factor in the pathogenesis of multiple sclerosis. Control volume flow data may provide useful normative reference values. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Circulating tumor cells in patients with testicular germ cell tumors.

PubMed

Nastały, Paulina; Ruf, Christian; Becker, Pascal; Bednarz-Knoll, Natalia; Stoupiec, Małgorzata; Kavsur, Refik; Isbarn, Hendrik; Matthies, Cord; Wagner, Walter; Höppner, Dirk; Fisch, Margit; Bokemeyer, Carsten; Ahyai, Sascha; Honecker, Friedemann; Riethdorf, Sabine; Pantel, Klaus

2014-07-15

Germ cell tumors (GCTs) represent the most frequent malignancies among young men, but little is known about circulating tumor cells (CTCs) in these tumors. Considering their heterogeneity, CTCs were investigated using two independent assays targeting germ cell tumor and epithelial cell-specific markers, and results were correlated with disease stage, histology, and serum tumor markers. CTCs were enriched from peripheral blood (n = 143 patients) and testicular vein blood (TVB, n = 19 patients) using Ficoll density gradient centrifugation. For CTC detection, a combination of germ cell tumor (anti-SALL4, anti-OCT3/4) and epithelial cell-specific (anti-keratin, anti-EpCAM) antibodies was used. In parallel, 122 corresponding peripheral blood samples were analyzed using the CellSearch system. In total, CTCs were detected in 25 of 143 (17.5%) peripheral blood samples, whereas only 11.5% of patients were CTC-positive when considering exclusively the CellSearch assay. The presence of CTCs in peripheral blood correlated with clinical stage (P < 0.001) with 41% of CTC positivity in patients with metastasized tumors and 100% in patients with relapsed and chemotherapy-refractory disease. Histologically, CTC-positive patients suffered more frequently from nonseminomatous primary tumors (P < 0.001), with higher percentage of yolk sac (P < 0.001) and teratoma (P = 0.004) components. Furthermore, CTC detection was associated with elevated serum levels of α-fetoprotein (AFP; P = 0.025), β-human chorionic gonadotropin (βHCG; P = 0.002), and lactate dehydrogenase (LDH; P = 0.002). Incidence and numbers of CTCs in TVB were much higher than in peripheral blood. The inclusion of germ cell tumor-specific markers improves CTC detection in GCTs. CTCs occur frequently in patients with more aggressive disease, and there is a gradient of CTCs with decreasing numbers from the tumor-draining vein to the periphery. ©2014 American Association for Cancer Research.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schellhammer, Frank, E-mail: frank.schellhammer@med.uni-duesseldorf.d; Esch, Jan Schulte am; Hammerschlag, Sascha

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.

Fluid fractionation of tungsten during granite-pegmatite differentiation and the metal source of peribatholitic W quartz veins: Evidence from the Karagwe-Ankole Belt (Rwanda)

NASA Astrophysics Data System (ADS)

Hulsbosch, Niels; Boiron, Marie-Christine; Dewaele, Stijn; Muchez, Philippe

2016-02-01

The identification of a magmatic source for granite-associated rare metal (W, Nb, Ta and Sn) mineralisation in metasediment-hosted quartz veins is often obscured by intense fluid-rock interactions which metamorphically overprinted most source signatures in the vein system. In order to address this recurrent metal sourcing problem, we have studied the metasediment-hosted tungsten-bearing quartz veins of the Nyakabingo deposit of the Karagwe-Ankole belt in Central Rwanda. The vein system (992 ± 2 Ma) is spatiotemporal related to the well-characterised B-rich, F-poor G4 leucogranite-pegmatite suite (986 ± 10 Ma to 975 ± 8 Ma) of the Gatumba-Gitarama area which culminated in Nb-Ta-Sn mineralisation. Muscovite in the Nyakabingo veins is significantly enriched in granitophile elements (Rb, Cs, W and Sn) and show alkali metal signatures equivalent to muscovite of less-differentiated pegmatite zones of the Gatumba-Gitarama area. Pegmatitic muscovite records a decrease in W content with increasing differentiation proxies (Rb and Cs), in contrast to the continuous enrichment of other high field strength elements (Nb and Ta) and Sn. This is an indication of a selective redistribution for W by fluid exsolution and fluid fractionation. Primary fluid inclusions in tourmaline of these less-differentiated pegmatites demonstrate the presence of medium to low saline, H2O-NaCl-KCl-MgCl2-complex salt (e.g. Rb, Cs) fluids which started to exsolve at the G4 granite-pegmatite transition stage. Laser ablation inductively coupled plasma mass-spectrometry shows significant tungsten enrichment in these fluid phases (∼5-500 ppm). Fractional crystallisation has been identified previously as the driving mechanism for the transition from G4 granites, less-differentiated biotite, biotite-muscovite towards muscovite pegmatites and eventually columbite-tantalite mineralised pegmatites. The general absence of tungsten mineralisation in this magmatic suite, including the most differentiated columbite-tantalite mineralised pegmatites of the Gatumba-Gitarama area, emphasises the efficiency of fluid saturation to extract crystal-melt incompatible tungsten from the differentiating melt phase. Fluid-melt-crystal partitioning calculations support the concept of a magmatic-hydrothermal fluid source for tungsten and constrain the range of permissible crystal-melt and fluid-melt partition coefficients together with realistic values for water solubility in the parental G4 granitic melt. Consequently, we propose that for highly-differentiated B-rich, F-poor granite systems fluid saturation started prior to or at the granite-pegmatite transition stage resulting in apical to peribatholitic tungsten veins systems that are paragenetically older than the final pegmatite stage.

Anatomical variations in the pattern of the right hepatic veins draining the posterior segment of the right lobe of the liver.

PubMed

Shilal, Poonam; Tuli, Anita

2015-03-01

The pattern of drainage in the right posterior lobe of liver varies considerably. The knowledge of this variation is very important while performing various surgeries on the right posterior lobe. A study was conducted to see the variations in the pattern of drainage of posterior segment of the right lobe of liver. The aim was to see the variations of right hepatic vein and small accessory hepatic veins draining the posterior segment, the presence of which led to modifications in drainage of posterior segment. Sixty formalin fixed adult human liver specimens were dissected manually. According to the pattern of drainage of tributaries of right hepatic vein, the right hepatic vein was classified into type I, type II, type III and type IV. According to presence of inferior right hepatic vein, three types of drainage of posterior lobe were seen: Type I, (76.36%) right hepatic vein was large, draining wide area of posterior segment. A small inferior right hepatic vein drained the small area of posterior segment. In Type II, (19.92%) both right hepatic and inferior right hepatic veins were medium sized draining the posteroinferior segment of the right lobe concomitantly. In Type III, (32%) accessory veins, the middle right hepatic vein drained the posterosuperior (VII) as well as the posteroinferior (VI) segment. In one specimen, there were numerous middle right hepatic veins draining the right posterior segment. The knowledge of anatomic relationship of veins draining right lobe, is important in performing right posterior segmentectomy. For safe resection of the liver, the complex anatomy of the distribution of the tributaries of the right hepatic vein and the accessory veins have to be studied prior to any surgery done on liver.

Use of PTFE Stent Grafts for Hemodialysis-related Central Venous Occlusions: Intermediate-Term Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kundu, Sanjoy, E-mail: sanjoy_kundu40@hotmail.com; Modabber, Milad; You, John M.

2011-10-15

Purpose: To assess the safety and effectiveness of a polytetrafluoroethylene (PTFE) encapsulated nitinol stents (Bard Peripheral Vascular, Tempe, AZ) for treatment of hemodialysis-related central venous occlusions. Materials and Methods: Study design was a single-center nonrandomized retrospective cohort of patients from May 2004 to August 2009 for a total of 64 months. There were 14 patients (mean age 60 years, range 50-83 years; 13 male, 1 female). All patients had autogenous fistulas. All 14 patients had central venous occlusions and presented with clinical symptoms of the following: extremity swelling (14%, 2 of 14), extremity and face swelling (72%, 10 of 14),more » and face swelling/edema (14%, 2 of 14). There was evidence of access dysfunction with decreased access flow in 36% (5 of 14) patients. There were prior interventions or previous line placement at the site of the central venous lesion in all 14 patients. Results were assessed by recurrence of clinical symptoms and function of the access circuit (National Kidney Foundation recommended criteria). Results: Sixteen consecutive straight stent grafts were implanted in 14 patients. Average treated lesion length was 5.0 cm (range, 0.9-7 cm). All 14 patients had complete central venous occlusion (100% stenosis). The central venous occlusions were located as follows: right subclavian and brachiocephalic vein (21%, 3 of 14), right brachiocephalic vein (36%, 5 of 14), left brachiocephalic vein (36%, 5 of 14), and bilateral brachiocephalic vein (7%, 1 of 14). A total of 16 PTFE stent grafts were placed. Ten- or 12-mm-diameter PTFE stent grafts were placed. The average stent length was 6.1 cm (range, 4-8 cm). Technical (deployment), anatomic (<30% residual stenosis), clinical (resolution of symptoms), and hemodynamic (resolution of access dysfunction) success were 100%. At 3, 6, and 9 months, primary patency of the treated area and access circuit were 100% (14 of 14). Conclusions: This PTFE encapsulated stent graft demonstrates encouraging intermediate-term patency results for central vein occlusions. Further prospective studies with long-term assessment and larger patient populations will be required.« less

Constitutive modeling of jugular vein-derived venous valve leaflet tissues.

PubMed

Kaul, Nayyan; Huang, Hsiao-Ying Shadow

2017-11-01

Venous valve tissues, though used in vein reconstruction surgeries and bioprosthetic valves with moderate success, have not been extensively studied with respect to their structure. Their inherent anisotropic, non-linear behavior combined with severe diseases which affect veins, such as chronic venous insufficiency, warrant understanding the structure and material behavior of these tissues. Hence, before any bioprosthetic grafts may be used in place of tissues, it is of the utmost importance to understand the mechanical and structural properties of these tissues as this may lead to higher success rates for valve replacement surgeries. The longevity of the bioprosthetics may also increase if the manufactured grafts behave the same as native valves. Building on the scant information about the uniaxial and biaxial mechanical properties of jugular venous valves and wall tissues from previous studies, the current focus of our investigation lies in understanding the material behavior by establishing a phenomenological strain energy-based constitutive relation for the tissues. We used bovine veins to study the behavior of valve leaflet tissue and adjoining wall tissue (from the proximal and distal ends of the veins) under different biaxial testing protocols. We looked at the behavior of numerical partial derivatives of the strain energy to select a suitable functional form for the strain energy for wall and valve tissues. Using this strain energy descriptor, we determined the Cauchy stress and compared it with experimental results under additional sets of displacement-controlled biaxial testing protocols to find material specific model parameters by the Powell's method algorithm. Results show that whereas wall tissue strain energy can be explained using a polynomial non-linear function, the valve tissue, due to higher non-linearities, requires an exponential function. This study may provide useful information for the primary stages of bioprosthetic designs and replacement surgeries and may support future studies investigating structural models. It may also support the study of valvular diseases by providing a way to understand material properties and behavior and to form a continuum model when required for numerical analyses and computational simulations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autogenous forearm loop arteriovenous fistula creation.

PubMed

Tang, Weng Jun; Mat Saad, Arman Zaharil

2018-03-01

Arteriovenous fistula is a lifeline for end-stage kidney disease patients on dialysis. The quality of the vein and artery to be used plays a crucial role in attaining a functioning, reliable and long-lasting arteriovenous fistula. The aim of the study is to present an alternative for haemodialysis access to preserve the upper arm vasculature for future use - the forearm loop arteriovenous fistula. From October 2015 to September 2016, 202 patients with chronic kidney disease (CKD), stages 4 and 5, underwent arteriovenous fistula creation at the Universiti Sains Malaysia Hospital, Malaysia. Nine patients, with severe atherosclerosis of the distal artery, but with satisfactory veins, underwent forearm loop arteriovenous fistula creation. Maturation of the fistula was based on the classification by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI). All nine patients who underwent forearm loop arteriovenous fistula have had diabetes mellitus for more than 10 years. Only one fistula failed to mature within 6 weeks. Two arteriovenous fistulas thrombosed at 3 and 5 months, respectively, after the commencement of haemodialysis. However, the other six matured fistulas are still functioning well after a year of regular usage. Distal forearm arteries in diabetics may be severely atherosclerotic. Forearm loop arteriovenous fistula can be considered as the primary access for cases decided as inconvenient for fistula creation due to severe occlusive atherosclerotic disease of the forearm arteries; in order to preserve upper arm veins for future access procedures.

Central vein stenosis: current concepts.

PubMed

Agarwal, Anil K

2009-09-01

Central vein stenosis (CVS) is a common complication of the central venous catheter (CVC) placement. The prevalence of CVS has mostly been studied in those who present with symptoms such as swelling of the extremity, neck and breast. CVS compromises arteriovenous access and can be resistant to treatment. A previous history of CVC placement is the most important risk factor for the development of CVS later. Pacemaker and defibrillator wires are associated with a high incidence of CVS. Increasingly liberal use of peripherally inserted central catheters (PICC) is likely to increase the incidence of CVS. The trauma and inflammation related to the catheter placement is thought to result in microthrombi formation, intimal hyperplasia and fibrotic response, with development of CVS. Treatment of CVS by endovascular procedures involves angioplasty of the stenosis. An elastic or recurrent stenosis may require a stent placement. The long-term benefits of the endovascular procedures, although improved with newer technology, remain modest. Surgical options are usually limited. Future studies to explore the pathogenesis and the use of novel therapies to prevent and treat CVS are needed. The key to reducing the prevalence of CVS is in reducing CVC placement and placement of arteriovenous accesses prior to initiating dialysis. Early referral of the patients to the nephrologists by the primary care physicians is important. Timely vein mapping and referral to the surgeon for fistula creation can obviate the need for a CVC and decrease incidence of CVS.

Percutaneous Portal Vein Access and Transhepatic Tract Hemostasis

PubMed Central

Saad, Wael E. A.; Madoff, David C.

2012-01-01

Percutaneous portal vein interventions require minimally invasive access to the portal venous system. Common approaches to the portal vein include transjugular hepatic vein to portal vein access and direct transhepatic portal vein access. A major concern of the transhepatic route is the risk of postprocedural bleeding, which is increased when patients are anticoagulated or receiving pharmaceutical thrombolytic therapy. Thus percutaneous portal vein access and subsequent closure are important technical parts of percutaneous portal vein procedures. At present, various techniques have been used for either portal access or subsequent transhepatic tract closure and hemostasis. Regardless of the method used, meticulous technique is required to achieve the overall safety and effectiveness of portal venous procedures. This article reviews the various techniques of percutaneous transhepatic portal vein access and the various closure and hemostatic methods used to reduce the risk of postprocedural bleeding. PMID:23729976

Vein rupture by Arrow-Trerotola percutaneous thrombolytic device in a treatment of thrombosed arteriovenous graft.

PubMed

Hong, Yong Kook; Kang, Kyung Hoon; Kim, Tae Hwan; Yang, Hee Chul

2018-03-01

We report a case of vein rupture by Arrow-Trerotola percutaneous thrombolytic device (Trerotola PTD) during a treatment of thrombosed arteriovenous graft (AVG). A 77-year-old woman with a problem of thrombosed AVG underwent an endovascular treatment including a procedure of angioplasty of axillary vein. After angioplasty of axillary vein, we found a newly developed thrombus in axillary vein and performed thrombolysis using an over-the-wire 7F Trerotola PTD. When the rotating cage of the device arrived at axillary vein, it suddenly stopped, fixed at the angioplasty site, and didn't move at all. Venogram showed an extravasation of contrast media at axillary vein, suggesting vein rupture. The patient underwent an emergency operation. It could be dangerous to use Trerotola PTD in a native vein immediately after angioplasty.

A proof-of-concept study of the VeinScrew: A new percutaneous venous closure device.

PubMed

Boersma, Doeke; de Borst, Gert Jan; Moll, Frans L

2017-02-01

Objective This study evaluated the concept of percutaneous closure of insufficient veins using the VeinScrew principle. Methods The VeinScrew is designed to place a spring-shaped implant that contracts and clamps around the vein. The ability of the device to occlude adequately was tested in a bench model experiment. The feasibility of accurate placement and adequate venous occlusion was evaluated in an animal experiment and in a human cadaveric experiment. Results The VeinScrew implant occluded up to a pressure of 135 mmHg. In vivo studies confirmed that deployment was challenging but technically feasible, and subsequent phlebography showed closure of the vein. The cadaveric study showed that percutaneous placement of the evolved VeinScrew around the great saphenous vein was feasible and accurate. Conclusions The current studies show the feasibility of the VeinScrew concept. Future developments and translational studies are necessary to determine the potential of this technique as a new option in the phlebologist's toolbox.

Decoding leaf hydraulics with a spatially explicit model: principles of venation architecture and implications for its evolution.

PubMed

McKown, Athena D; Cochard, Hervé; Sack, Lawren

2010-04-01

Leaf venation architecture is tremendously diverse across plant species. Understanding the hydraulic functions of given venation traits can clarify the organization of the vascular system and its adaptation to environment. Using a spatially explicit model (the program K_leaf), we subjected realistic simulated leaves to modifications and calculated the impacts on xylem and leaf hydraulic conductance (K(x) and K(leaf), respectively), important traits in determining photosynthesis and growth. We tested the sensitivity of leaves to altered vein order conductivities (1) in the absence or (2) presence of hierarchical vein architecture, (3) to major vein tapering, and (4) to modification of vein densities (length/leaf area). The K(x) and K(leaf) increased with individual vein order conductivities and densities; for hierarchical venation systems, the greatest impact was from increases in vein conductivity for lower vein orders and increases in density for higher vein orders. Individual vein order conductivities were colimiting of K(x) and K(leaf), as were their densities, but the effects of vein conductivities and densities were orthogonal. Both vein hierarchy and vein tapering increased K(x) relative to xylem construction cost. These results highlight the important consequences of venation traits for the economics, ecology, and evolution of plant transport capacity.

A Rabbit Model for Testing Helper-Dependent Adenovirus-Mediated Gene Therapy for Vein Graft Atherosclerosis.

PubMed

Bi, Lianxiang; Wacker, Bradley K; Bueren, Emma; Ham, Ervin; Dronadula, Nagadhara; Dichek, David A

2017-12-15

Coronary artery bypass vein grafts are a mainstay of therapy for human atherosclerosis. Unfortunately, the long-term patency of vein grafts is limited by accelerated atherosclerosis. Gene therapy, directed at the vein graft wall, is a promising approach for preventing vein graft atherosclerosis. Because helper-dependent adenovirus (HDAd) efficiently transduces grafted veins and confers long-term transgene expression, HDAd is an excellent candidate for delivery of vein graft-targeted gene therapy. We developed a model of vein graft atherosclerosis in fat-fed rabbits and demonstrated long-term (≥20 weeks) persistence of HDAd genomes after graft transduction. This model enables quantitation of vein graft hemodynamics, wall structure, lipid accumulation, cellularity, vector persistence, and inflammatory markers on a single graft. Time-course experiments identified 12 weeks after transduction as an optimal time to measure efficacy of gene therapy on the critical variables of lipid and macrophage accumulation. We also used chow-fed rabbits to test whether HDAd infusion in vein grafts promotes intimal growth and inflammation. HDAd did not increase intimal growth, but had moderate-yet significant-pro-inflammatory effects. The vein graft atherosclerosis model will be useful for testing HDAd-mediated gene therapy; however, pro-inflammatory effects of HdAd remain a concern in developing HDAd as a therapy for vein graft disease.

Anatomical study of the accessory axillary vein in cadavers: a contribution to the axillary surgical approach

PubMed Central

Felix, Valtuir Barbosa; dos Santos, José André Bernardino; Fernandes, Katharina Jucá de Moraes; Cabral, Dhayanna Rolemberg Gama; dos Santos, Carlos Adriano Silva; Rodrigues, Célio Fernando de Sousa; Lima, Jacqueline Silva Brito; Ramalho, Antônio José Casado

2016-01-01

Abstract Background The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path. Objectives The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel’s topography. Methods In this study, axillary dissections were carried out on twenty-four (24) human cadavers of both sexes that had been fixed with 10% formaldehyde. The upper limbs of the cadavers were still attached to the bodies and the axillary structures were preserved. Data collection was carried out and the axillary structures of the cadavers were compared. Results The incidence of accessory axillary veins was 58.3%, with no significant preference for sex or for side of the body. The accessory axillary vein originated from the lateral brachial vein in 39.28% of cases, from the common brachial vein in 35.71% of cases, and from the deep brachial vein in 25% of cases. Conclusions Its high incidence and clinical relevance make the accessory axillary vein important for provision of collateral circulation in the event of traumatic injury to the axillary vein.

Conditions for veining and origin of mineralizing fluids in the Alpi Apuane (NW Tuscany, Italy): Evidence from structural and geochemical analyses on calcite veins hosted in Carrara marbles

NASA Astrophysics Data System (ADS)

Vaselli, Luca; Cortecci, Gianni; Tonarini, Sonia; Ottria, Giuseppe; Mussi, Mario

2012-11-01

This work deals with structural and geochemical (chemical and isotopic) analyses of calcite veins hosted in Carrara marbles in the Alpi Apuane, NW Tuscany, Italy. Geometric features and spatial distribution of veins provided estimations of stress ratio (Φ = (σ2 - σ3)/(σ1 - σ3)), driving stress ratio (R' = (Pf - σ3)/(σ1 - σ3)) and fluid overpressure (Δsi = Pf - σ3) at the time of vein formation. The obtained values of Φ = 32 and R' = 0.43 reveal that fluid pressure was higher than the intermediate principal stress at the time of veins formation, whereas the estimated Δsi ranging from 129 to 207 MPa indicates that veins formed under supra-hydrostatic to lithostatic pressure conditions. Carbon (δ13CV-PDB = 1.81-2.10‰ for veins and 1.95-2.51‰ for host marbles), oxygen (δ18OV-SMOW = 28.71-29.57‰ for veins and 28.90-29.36‰ for host marbles) and strontium (87Sr/86Sr = 0.707716-0.707985 for veins and 0.0707708-0.707900 for host marbles) isotope compositions in vein/host marble pairs were internally quite consistent. Combining our structural and geochemical data, a modeling approach was performed to investigate the compositional features and temperatures of calcite depositing fluids. The results of our studies give evidence that (1) pore-fluids in Carrara marble, consisting of metamorphic formation waters, were re-mobilized during veining event and migrated within the veins in closed system conditions, (2) veins formed after ductile folding phases and before high-angle brittle faulting events, at temperature and pressure around 250 °C and 210 MPa, and finally (3) about 12 g H2O/m3 marble are calculated to have been available as vein parental fluid at the time of vein formation.

Incidence of deep vein thrombosis in patients undergoing breast reconstruction with autologous tissue transfer.

PubMed

Konoeda, Hisato; Yamaki, Takashi; Hamahata, Atsumori; Ochi, Masakazu; Osada, Atsuyoshi; Hasegawa, Yuki; Kirita, Miho; Sakurai, Hiroyuki

2017-05-01

Background Breast reconstruction is associated with multiple risk factors for venous thromboembolism. However, the incidence of deep vein thrombosis in patients undergoing breast reconstruction is uncertain. Objective The aim of this study was to prospectively evaluate the incidence of deep vein thrombosis in patients undergoing breast reconstruction using autologous tissue transfer and to identify potential risk factors for deep vein thrombosis. Methods Thirty-five patients undergoing breast reconstruction were enrolled. We measured patients' preoperative characteristics including age, body mass index (kg/m 2 ), and risk factors for deep vein thrombosis. The preoperative diameter of each venous segment in the deep veins was measured using duplex ultrasound. All patients received intermittent pneumatic pump and elastic compression stockings for postoperative thromboprophylaxis. Results Among the 35 patients evaluated, 11 (31.4%) were found to have deep vein thrombosis postoperatively, and one patient was found to have pulmonary embolism postoperatively. All instances of deep vein thrombosis developed in the calf and were asymptomatic. Ten of 11 patients underwent free flap transfer, and the remaining one patient received a latissimus dorsi pedicled flap. Deep vein thrombosis incidence did not significantly differ between patients with a free flap or pedicled flap (P = 0.13). Documented risk factors for deep vein thrombosis demonstrated no significant differences between patients with and without deep vein thrombosis. The diameter of the common femoral vein was significantly larger in patients who developed postoperative deep vein thrombosis than in those who did not ( P < 0.05). Conclusions The morbidity of deep vein thrombosis in patients who underwent breast reconstruction using autologous tissue transfer was relatively high. Since only the diameter of the common femoral vein was predictive of developing postoperative deep vein thrombosis, postoperative pharmacological thromboprophylaxis should be considered for all patients undergoing breast reconstruction regardless of operative procedure.

Component Control System for a Vehicle

NASA Technical Reports Server (NTRS)

Lee, Chunhao J. (Inventor); Fraser-Chanpong, Nathan (Inventor); Vitale, Robert L. (Inventor); Akinyode, Akinjide Akinniyi (Inventor); Dawson, Andrew D. (Inventor); Guo, Raymond (Inventor); Waligora, Thomas M. (Inventor); Spain, Ivan (Inventor); Bluethmann, William J. (Inventor); Reed, Ryan M. (Inventor)

2016-01-01

A vehicle includes a chassis, a modular component, and a central operating system. The modular component is supported by the chassis. The central operating system includes a component control system, a primary master controller, and a secondary master controller. The component control system is configured for controlling the modular component. The primary and secondary master controllers are in operative communication with the component control system. The primary and secondary master controllers are configured to simultaneously transmit commands to the component control system. The component control system is configured to accept commands from the secondary master controller only when a fault occurs in the primary master controller.

Effects of gestational hypertension and pre-eclampsia in mRNA expression of fibrinolysis genes in primary cultured human umbilical vein endothelial cells.

PubMed

Poblete-Naredo, Irais; Rodríguez-Yáñez, Yury; Corona-Núñez, Rogelio O; González-Monroy, Stuart; Salinas, Juan E; Albores, Arnulfo

2018-05-17

Hypertension disorders (HD) and pre-eclampsia (PRE) are leading causes of maternal deaths worldwide. PRE is associated with vascular endothelial dysfunction and with deregulation of the fibrinolysis pathway genes. Fibrinolysis is the fibrin clot hydrolysis process catalyzed by plasmin, a proteolytic enzyme formed from plasminogen. Plasminogen is cleaved by tissue-type (tPA) and urokinase-type (uPA) activators and inhibited by the plasminogen activator inhibitors type-1 (PAI-1) and type-2 (PAI-2). The whole process maintains blood hemostasis. This study aims to assess PAI-1, PAI-2, tPA and uPA mRNA expression in primary cultured human umbilical vein endothelial cells (HUVEC) isolated and cultured from healthy, HD and PRE women. Results show that PAI-1 and PAI-2 mRNA decreased in HD-HUVEC, whereas PAI-1 and uPA decreased in PRE-HUVEC cultures compared to control ones. Notably, the expression ratio between pro- and anti-fibrinolytic actors remained unchanged among the studied groups. It seems that newborn's hemostasis is maintained balanced probably by a compensatory mechanism that involves changes in the fibrinolysis gene expression profile. The real impact of these changes in mRNA expression is unknown, however, it is suggested that these changes could be associated with an increased predisposition to vascular disease development in the progeny. Copyright © 2018. Published by Elsevier Ltd.

A CONTROLLED TECHNIQUE FOR VEIN STRIPPING

PubMed Central

Gordon, Milton; Payne, Robert D.

1953-01-01

A number of difficulties encountered in vein stripping operations for varicose veins in the legs have been overcome by use of a technique evolved by adaptation and modifications of various reported methods. The stripping instrument is passed from below upward, the valves or branches offering less impediment to its passage in that direction. Inserting the tip of the instrument at the ankle through an incision in the vein while it is still in continuity is easier than introducing it into the end of a transected vein. Ligation of major superficial branches or subfascial division of communicating veins can be readily carried out while the stripper is still in place in the vein. Applying pressure bandages to the entire length of the leg before removing the stripper and the telescoped vein diminishes the chances of ecchymosis yet does not hinder withdrawal of the instrument and the vein. PMID:13106726

Ore mineralogy and textural zonation in the world-class epithermal Waihi Vein System, Hauraki Goldfield

USGS Publications Warehouse

Mauk, Jeffrey L.; Skinner, Erin G; Fyfe, Sarah J; Menzies, Andrew H; Lowers, Heather A.; Koenig, Alan E.

2016-01-01

The Waihi district in the Hauraki Goldfield of New Zealand contains adularia-sericite epithermal gold-silver veins that have produced more than 7.7 Moz gold. The outermost veins of the district (Martha, Favona, Moonlight, and Cowshed) contain abundant colloform, cherty, and black quartz fill textures, with minor crustiform and massive quartz. The central veins (Amaranth, Trio, and Union) contain predominantly massive and crustiform textures, and these veins are also commonly coarser grained than outermost veins. Pyrite, sphalerite, galena, chalcopyrite, electrum, and acanthite occur in both outermost and central veins; base metal sulfide minerals typically increase in abundance in deeper samples. Antimony-, arsenic-, and selenium-bearing minerals are most abundant in the Favona and Moonlight veins, whereas base metal sulfide minerals are more abundant in the central veins at Correnso. Throughout the Waihi vein system, electrum is by far the most widespread, abundant, and significant gold-bearing mineral, but LA-ICP-MS analyses show that arsenian pyrite also contains some gold. Mineralogical and textural data are consistent with the central veins forming at a deeper structural level, or from hydrothermal fluids with different chemistry, or both.

Patterns and Rates of Supplementary Venous Drainage to the Internal Jugular Veins.

PubMed

Qureshi, Adnan I; Ishfaq, Muhammad Fawad; Herial, Nabeel A; Khan, Asif A; Suri, M Fareed K

2016-07-01

Several studies have found supplemental venous drainage channels in addition to bilateral internal jugular veins for cerebral venous efflux. We performed this study to characterize the supplemental venous outflow patterns in a consecutive series of patients undergoing detailed cerebral angiography with venous phase imaging. The venographic phase of the arteriogram was reviewed to identify and classify supplemental cerebral venous drainage into anterior (cavernous venous sinus draining into pterygoid plexus and retromandibular vein) and posterior drainage pattern. The posterior drainage pattern was further divided into plexiform pattern (with sigmoid venous sinus draining into the paravertebral venous plexus), and solitary vein pattern (dominant single draining deep cervical vein) drainage. The posterior plexiform pattern was further divided into 2 groups: posterior plexiform with or without prominent solitary vein. Supplemental venous drainage was seen ipsilateral to internal jugular vein in 76 (43.7%) of 174 venous drainages (87 patients) analyzed. The patterns were anterior (n = 23, 13.2%), posterior plexiform without prominent solitary vein (n = 40, 23%), posterior plexiform with prominent solitary vein (n = 62, 35.6%), and posterior solitary vein alone (n = 3, 1.7%); occipital emissary veins and/or transosseous veins were seen in 1 supplemental venous drainage. Concurrent ipsilateral anterior and posterior supplemental drainage was seen in 6 of 174 venous drainages analyzed. We provide an assessment of patterns and rates of supplementary venous drainage to internal jugular veins to improve our understanding of anatomical and physiological aspects of cerebral venous drainage. Copyright © 2016 by the American Society of Neuroimaging.

Episodic vein formation in Gale crater, Mars: evidence for an extended history of liquid water

NASA Astrophysics Data System (ADS)

Kronyak, R. E.; Fedo, C.; Banham, S.; Edgett, K. S.; Newsom, H. E.; Nachon, M.; Kah, L. C.

2017-12-01

The sedimentary rock record of Gale crater is consistent with deposition in an ancient lake basin. These strata represent aqueous and potentially habitable past conditions that existed over a relatively small part of Mars' geologic history. Post-depositional fluid migration is recorded by the presence of veins, which have been prevalent features throughout Curiosity's mission. These veins record later episodes of fluid flow and represent an extended history of liquid water stability, and perhaps habitability. White Ca-sulfate veins are observed in the Bradbury (Yellowknife Bay), Mount Sharp (Murray formation), and Siccar Point (Stimson formation) groups across a range of lithologies. At Yellowknife Bay and in the Stimson, Ca-sulfate veins characteristically exhibit mm-scale thicknesses. In the Pahrump Hills (PH) area, 62% of measured veins in the Murray formation are <3 mm thick. However, PH also contains a population of veins that range from 1-5 cm thick that commonly contain gray inclusions and are crosscut by thinner white veins. Similar gray material occurs along the interface between wall rock and Ca-sulfate and is interpreted as a precursor vein fill. Gray veins at PH are more erosionally resistant relative to Ca-sulfate and average 1 mm in width. Additionally, gray veins exhibit elevated Mg and depleted Ca, distinguishing them compositionally from Ca-sulfate veins. Veins continue locally throughout the stratigraphic section. The lowermost Stimson sandstones at the Missoula outcrop contain white clasts and elevated Ca-sulfate, suggesting the formation of Murray veins prior to the deposition of the Stimson formation. Near the Old Soaker outcrop, bedding-parallel sulfate may represent syndepositional gypsum precipitation. In the context of time, the multiple vein systems identified in the Gale crater sedimentary fill shed light on the sequence and evolution of fluids responsible for their deposition. It is envisioned that sulfates first precipitated contemporaneously with the deposition of the Murray formation, followed by burial, lithification, and fracturing to form the earliest gray and sulfate veins. The Murray was then exhumed and eroded, followed by deposition and lithification of the Stimson formation, fracturing, and precipitation of the latest sulfate veins.

[Liver segment anatomy in ultrasound--examinations to define the frontier between segment II/III and literature review].

PubMed

Wolf, H; Gross, F; Merz, A; Schuler, A

2013-03-01

Liver segment definition due to Couinaud is the basis for localisation of focal liver lesions in imaging, in the follow-up or for planning operations. A literature review shows variety in segment definition and the frontier between segment II and III in the left liver lobe, in the course of the portal vein level and in variations of liver veins. The aim of this study is to demonstrate liver segment anatomy in sonography compared to anatomic preparations and the literature. This leads to a proposal for a unique nomenclature and illustration. 152 liver healthy persons (77 F, 75 M, mean age 63.3 years (18 - 91 years) were examined with standardised abdominal ultrasound in longitudinal, transversal and axis planes. (Angle) measurements were taken to define the left hepatic vein (Fissura sinistra), the Ramus umbilicalis of the portal vein (Fissura umbilicalis), the portal vein level and the amount and variations of the liver veins. The left hepatic vein was found with a mean angle of 24° (0 - 70°) left to the median axis, the Pars umbilicalis of the portal vein wasalmost strictly in the mid axis. The portal vein level was located with a mean angle of 61° (5 - 110°) right to the median with no variations of the two main branches. 27 (18 %) out of the remaining 151 patients showed variations of the liver veins: 7 × (4.6 %) a doubled mid hepatic vein, 12 × (8 %) a doubled left hepatic vein, 4 × (2.7 %) 3 left liver veins were found with a short (≤ 1 cm) common trunk, 1 × each (0.7 %) four left liver veins with a short common trunk, one trifurcation of the mid hepatic vein, one doubled right liver vein and one common trunk (2 cm) of all 3 main liver veins leading to the inferior V. cava. The surgical functional liver segment definition by Couinaud is the basis for localisation of focal liver lesions. The frontier between segment II and III is mainly described as a horizontal plane in the literature. The course of the left liver vein (fissura sinistra) has a mean angle of 24° left to the median and not like the umbilical fissure, which is found almost strictly in the median plane. The left hepatic vein(s), their course and liver vein variations are well demonstrated by sonography (99.3 % in this study). Anatomic landmarks as well as variations and a unique nomenclature should be well known and considered in the localisation of focal liver lesions, their feeding vessels and liver segment anatomy. © Georg Thieme Verlag KG Stuttgart · New York.

Numerical study on static component generation from the primary Lamb waves propagating in a plate with nonlinearity

NASA Astrophysics Data System (ADS)

Wan, Xiang; Tse, Peter W.; Zhang, Xuhui; Xu, Guanghua; Zhang, Qing; Fan, Hongwei; Mao, Qinghua; Dong, Ming; Wang, Chuanwei; Ma, Hongwei

2018-04-01

Under the discipline of nonlinear ultrasonics, in addition to second harmonic generation, static component generation is another frequently used nonlinear ultrasonic behavior in non-destructive testing (NDT) and structural health monitoring (SHM) communities. However, most previous studies on static component generation are mainly based on using longitudinal waves. It is desirable to extend static component generation from primary longitudinal waves to primary Lamb waves. In this paper, static component generation from the primary Lamb waves is studied. Two major issues are numerically investigated. First, the mode of static displacement component generated from different primary Lamb wave modes is identified. Second, cumulative effect of static displacement component from different primary Lamb wave modes is also discussed. Our study results show that the static component wave packets generated from the primary S0, A0 and S1 modes share the almost same group velocity equal to the phase velocity of S0 mode tending to zero frequency c plate . The finding indicates that whether the primary mode is S0, A0 or S1, the static components generated from these primary modes always share the nature of S0 mode. This conclusion is also verified by the displacement filed of these static components that the horizontal displacement field is almost uniform and the vertical displacement filed is antisymmetric across the thickness of the plate. The uniform distribution of horizontal displacement filed enables the static component, regardless of the primary Lamb modes, to be a promising technique for evaluating microstructural damages buried in the interior of a structure. Our study also illustrates that the static components are cumulative regardless of whether the phase velocity of the primary and secondary waves is matched or not. This observation indicates that the static component overcomes the limitations of the traditional nonlinear Lamb waves satisfying phase velocity matching condition to achieve cumulative second harmonic generation. This nature also enables the primary Lamb waves excited at a low center frequency to generate static component used for inspecting large-scale structures with micro-scale damages.

Inhibitory effect of indigo naturalis on tumor necrosis factor-α-induced vascular cell adhesion molecule-1 expression in human umbilical vein endothelial cells.

PubMed

Chang, Hsin-Ning; Pang, Jong-Hwei Su; Yang, Sien-Hung; Hung, Chi-Feng; Chiang, Chi-Hsin; Lin, Tung-Yi; Lin, Yin-Ku

2010-09-14

The use of indigo naturalis to treat psoriasis has proved effective in our previous clinical studies. The present study was designed to examine the anti-inflammatory effect of indigo naturalis in primary cultured human umbilical vein endothelial cells (HUVECs). Pretreatment of cells with indigo naturalis extract attenuated TNF-α-induced increase in Jurkat T cell adhesion to HUVECs as well as decreased the protein and messenger (m)RNA expression levels of vascular cell adhesion molecule-1 (VCAM-1) on HUVECs. Indigo naturalis extract also inhibited the protein expression of activator protein-1 (AP-1)/c-Jun, a critical transcription factor for the activation of VCAM-1 gene expression. Since the reduction of lymphocyte adhesion to vascular cells by indigo naturalis extract could subsequently reduce the inflammatory reactions caused by lymphocyte infiltration in the epidermal layer and help to improve psoriasis, this study provides a potential mechanism for the anti-inflammatory therapeutic effect of indigo naturalis extract in psoriasis.

Risk factors, management and primary prevention of thrombotic complications related to the use of central venous catheters.

PubMed

Linnemann, Birgit; Lindhoff-Last, Edelgard

2012-09-01

An adequate vascular access is of importance for the treatment of patients with cancer and complex illnesses in the intensive, perioperative or palliative care setting. Deep vein thrombosis and thrombotic occlusion are the most common complications attributed to central venous catheters in short-term and, especially, in long-term use. In this review we will focus on the risk factors, management and prevention strategies of catheter-related thrombosis and occlusion. Due to the lack of randomised controlled trials, there is still controversy about the optimal treatment of catheter-related thrombotic complications, and therapy has been widely adopted using the evidence concerning lower extremity deep vein thrombosis. Given the increasing use of central venous catheters in patients that require long-term intravenous therapy, the problem of upper extremity deep venous thrombosis can be expected to increase in the future. We provide data for establishing a more uniform strategy for preventing, diagnosing and treating catheter-related thrombotic complications.

SUCCESSFUL TREATMENT OF DIGITAL OSTEITIS BY INTRAVENOUS REGIONAL PERFUSION OF CEFTIOFUR IN AN AFRICAN ELEPHANT (LOXODONTA AFRICANA).

PubMed

Dutton, Christopher J; Delnatte, Pauline G; Hollamby, Simon R; Crawshaw, Graham J

2017-06-01

A 41-yr-old African elephant ( Loxodonta africana ) presented with a swollen third digit of the left forelimb and a 2-cm hole in the pad. Corrective trimming, topical treatments, and an oral antibiotic resulted in apparent resolution; however, it reoccurred after 4 mo. Radiographs suggested bone lysis in the third phalanx, with the primary differential diagnosis being septic osteitis. Flushing with metronidazole solution and intravenous regional perfusion (IVRP) of the foot were commenced. A tourniquet was applied just above the carpus, an interdigital vein was identified by ultrasound, and into this vein 2 g (20 ml) of ceftiofur sodium solution, followed by 60 ml of heparinized saline, was administered. The foot was kept raised for 25 min and then the tourniquet was removed. IVRP was repeated every other day for 70 treatments over 6 mo. Healing occurred, which was confirmed radiographically. IVRP offers an excellent treatment modality in a well-trained elephant.

Future remnant liver function as predictive factor for the hypertrophy response after portal vein embolization.

PubMed

Cieslak, Kasia P; Huisman, Floor; Bais, Thomas; Bennink, Roelof J; van Lienden, Krijn P; Verheij, Joanne; Besselink, Marc G; Busch, Olivier R C; van Gulik, Thomas M

2017-07-01

Preoperative portal vein embolization is widely used to increase the future remnant liver. Identification of nonresponders to portal vein embolization is essential because these patients may benefit from associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), which induces a more powerful hypertrophy response. 99m Tc-mebrofenin hepatobiliary scintigraphy is a quantitative method for assessment of future remnant liver function with a calculated cutoff value for the prediction of postoperative liver failure. The aim of this study was to analyze future remnant liver function before portal vein embolization to predict sufficient functional hypertrophy response after portal vein embolization. Sixty-three patients who underwent preoperative portal vein embolization and computed tomography imaging were included. Hepatobiliary scintigraphy was performed to determine pre-portal vein embolization and post-portal vein embolization future remnant liver function. Receiver operator characteristic analysis of pre-portal vein embolization future remnant liver function was performed to identify patients who would meet the post-portal vein embolization cutoff value for sufficient function (ie, 2.7%/min/m 2 ). Mean pre-portal vein embolization future remnant liver function was 1.80% ± 0.45%/min/m 2 and increased to 2.89% ± 0.97%/min/m 2 post-portal vein embolization. Receiver operator characteristic analysis in 33 patients who did not receive chemotherapy revealed that a pre-portal vein embolization future remnant liver function of ≥1.72%/min/m 2 was able to identify patients who would meet the safe future remnant liver function cutoff value 3 weeks after portal vein embolization (area under the curve = 0.820). The predictive value was less pronounced in 30 patients treated with neoadjuvant chemotherapy (area under the curve = 0.618). A total of 45 of 63 patients underwent liver resection, of whom 5 of 45 developed postoperative liver failure; 4 of 5 patients had a post-portal vein embolization future remnant liver function below the cutoff value for safe resection. When selecting patients for portal vein embolization, future remnant liver function assessed with hepatobiliary scintigraphy can be used as a predictor of insufficient functional hypertrophy after portal vein embolization, especially in nonchemotherapy patients. These patients are potential candidates for ALPPS. Copyright © 2017 Elsevier Inc. All rights reserved.

Injection of Light Material into an Older Dark Vein

NASA Image and Video Library

2015-11-11

Light material emplaced within darker vein material is seen in this view of a mineral vein at the "Garden City" site on lower Mount Sharp, Mars. The Mars Hand Lens Imager (MAHLI) on the arm of NASA's Curiosity Mars Rover took the image on April 4, 2015, during the 946th Martian day, or sol, of Curiosity's work on Mars. The area shown is roughly 0.4 inch (1 centimeter) wide. Differences in textures of light-toned veins in the Garden City complex of crisscrossing mineral veins are clues that these veins may result from distinct fluid events. This example shows where injection of light material into a prior dark vein suggests high fluid pressure. Differences in textures of light-toned veins in the Garden City complex of crisscrossing mineral veins are clues that these veins may result from distinct fluid events. This vein's texture shows indications of crystal growth, suggesting that crystallization may have exerted a force for opening the fracture filled by the vein. Different examples are at PIA19925 and PIA19927. Mineral veins often form where fluids move through fractured rocks, depositing minerals in the fractures and affecting chemistry of the surrounding rock. At Garden City, the veins have been more resistant to erosion than the surrounding host rock. The fluid movement through fractures at Garden City occurred later than wet environmental conditions in which the host rock formed, before it hardened and cracked. Malin Space Science Systems, San Diego, built and operates MAHLI. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology in Pasadena, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington. JPL designed and built the project's Curiosity rover. http://photojournal.jpl.nasa.gov/catalog/PIA19926

Development of the human infrahepatic inferior caval and azygos venous systems

PubMed Central

Hikspoors, Jill P J M; Soffers, Jelly H M; Mekonen, Hayelom K; Cornillie, Pieter; Köhler, S Eleonore; Lamers, Wouter H

2015-01-01

Differences in opinion regarding the development of the infrahepatic inferior caval and azygos venous systems in mammals centre on the contributions of ‘caudal cardinal’, ‘subcardinal’, ‘supracardinal’, ‘medial and lateral sympathetic line’ and ‘sacrocardinal’ veins. The disagreements appear to arise from the use of topographical position rather than developmental origin as criterion to define separate venous systems. We reinvestigated the issue in a closely spaced series of human embryos between 4 and 10 weeks of development. Structures were visualized with the Amira® reconstruction and Cinema4D® remodelling software. The vertebral level and neighbouring structures were used as topographic landmarks. The main results were that the caudal cardinal veins extended caudally from the common cardinal vein between CS11 and CS15, followed by the development of the subcardinal veins as a plexus sprouting ventrally from the caudal cardinal veins. The caudal cardinal veins adapted their course from lateral to medial relative to the laterally expanding lungs, adrenal glands, definitive kidneys, sympathetic trunk and umbilical arteries between CS15 and CS18, and then became interrupted in the part overlaying the regressing mesonephroi (Th12-L3). The caudal part of the left caudal cardinal vein then also regressed. The infrarenal part of the inferior caval vein originated from the right caudal cardinal vein, while the renal part originated from subcardinal veins. The azygos veins developed from the remaining cranial part of the caudal cardinal veins. Our data show that all parts of the inferior caval and azygos venous systems developed directly from the caudal cardinal veins or from a plexus sprouting from these veins. PMID:25496171

[Applied anatomy of small saphenous vein and its distally-based sural nerve nutrient].

PubMed

Zhang, Fahui; Lin, Songqing; Zheng, Heping

2005-07-01

To investigate the origin of small saphenous vein of distally-based of sural nerve nutrient vessels flap and its clinical application. The origins of nutrient vessels of small saphenous vein and communicating branches of superficial-deep vein were observed on specimens of 30 adult cadaveric low limbs by perfusing red gelatin to dissect the artery. The nutrient vessels of small saphenous vein originated from the heel lateral artery, the terminal perforator branches of peroneal artery and intermuscular septum perforating branches of peroneal artery. There were 2 to 5 branches of such distally-based perforating branches whose diameters ranged from 0.6 to 1.0 mm. Those perforating branches included fascia branches, cutaneous branches nerve and vein nutrient branches. Those nutrient vessels formed a longitudinal vessel chain of clinical nerve shaft, vessel chain of vein side and vessel network of deep superficial fascia. The small saphenous vein had 1 to 2 communicating branches of superficial-deep vein whose diameter was 1.7+/-0.5 mm, 3.4+/-0.9 cm to the level of cusp of lateral malleolus, and converged into the fibular vein. Distally-based sural nerve, small saphenous vein, and nutrient vessels of fascia skin have the same region. The communicating branches of superficial-deep vein is 3 to 4 cm to the level of cusp lateral malleolus. These communicating branches could improve the venous drainage of the flap.

Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.

PubMed

Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton

2015-04-01

We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

Association of an alphasatellite with tomato yellow leaf curl virus and ageratum yellow vein virus in Japan is suggestive of a recent introduction.

PubMed

Shahid, Muhammad Shafiq; Ikegami, Masato; Waheed, Abdul; Briddon, Rob W; Natsuaki, Keiko T

2014-01-14

Samples were collected in 2011 from tomato plants exhibiting typical tomato leaf curl disease symptoms in the vicinity of Komae, Japan. PCR mediated amplification, cloning and sequencing of all begomovirus components from two plants from different fields showed the plants to be infected by Tomato yellow leaf curl virus (TYLCV) and Ageratum yellow vein virus (AYVV). Both viruses have previously been shown to be present in Japan, although this is the first identification of AYVV on mainland Japan; the virus previously having been shown to be present on the Okinawa Islands. The plant harboring AYVV was also shown to contain the betasatellite Tomato leaf curl Java betasatellite (ToLCJaB), a satellite not previously shown to be present in Japan. No betasatellite was associated with the TYLCV infected tomato plants analyzed here, consistent with earlier findings for this virus in Japan. Surprisingly both plants were also found to harbor an alphasatellite; no alphasatellites having previously been reported from Japan. The alphasatellite associated with both viruses was shown to be Sida yellow vein China alphasatellite which has previously only been identified in the Yunnan Province of China and Nepal. The results suggest that further begomoviruses, and their associated satellites, are being introduced to Japan. The significance of these findings is discussed.

A global multiscale mathematical model for the human circulation with emphasis on the venous system.

PubMed

Müller, Lucas O; Toro, Eleuterio F

2014-07-01

We present a global, closed-loop, multiscale mathematical model for the human circulation including the arterial system, the venous system, the heart, the pulmonary circulation and the microcirculation. A distinctive feature of our model is the detailed description of the venous system, particularly for intracranial and extracranial veins. Medium to large vessels are described by one-dimensional hyperbolic systems while the rest of the components are described by zero-dimensional models represented by differential-algebraic equations. Robust, high-order accurate numerical methodology is implemented for solving the hyperbolic equations, which are adopted from a recent reformulation that includes variable material properties. Because of the large intersubject variability of the venous system, we perform a patient-specific characterization of major veins of the head and neck using MRI data. Computational results are carefully validated using published data for the arterial system and most regions of the venous system. For head and neck veins, validation is carried out through a detailed comparison of simulation results against patient-specific phase-contrast MRI flow quantification data. A merit of our model is its global, closed-loop character; the imposition of highly artificial boundary conditions is avoided. Applications in mind include a vast range of medical conditions. Of particular interest is the study of some neurodegenerative diseases, whose venous haemodynamic connection has recently been identified by medical researchers. Copyright © 2014 John Wiley & Sons, Ltd.

Portal venous stent placement for treatment of portal hypertension caused by benign main portal vein stenosis.

PubMed

Shan, Hong; Xiao, Xiang-Sheng; Huang, Ming-Sheng; Ouyang, Qiang; Jiang, Zai-Bo

2005-06-07

To evaluate the value of endovascular stent in the treatment of portal hypertension caused by benign main portal vein stenosis. Portal vein stents were implanted in six patients with benign main portal vein stenosis (inflammatory stenosis in three cases, postprocedure of liver transplantation in another three cases). Changes in portal vein pressure, portal vein patency, relative clinical symptoms, complications, and survival were evaluated. Six metallic stents were successfully placed across the portal vein stenotic or obstructive lesions in six patients. Mean portal venous pressure decreased significantly after stent implantation from (37.3+/-4.7) cm H(2)O to (18.0+/-1.9) cm H(2)O. The portal blood flow restored and the symptoms caused by portal hypertension were eliminated. There were no severe procedure-related complications. The patients were followed up for 1-48 mo. The portal vein remained patent during follow-up. All patients survived except for one patient who died of other complications of liver transplantation. Percutaneous portal vein stent placement for the treatment of portal hypertension caused by benign main portal vein stenosis is safe and effective.

New therapeutic possibilities for vein graft disease in the post-edifoligide era.

PubMed

Cai, Xinjiang; Freedman, Neil J

2006-07-01

Vein graft neointimal hyperplasia involves proliferation and migration of vascular smooth muscle cells into the vessel intima, and ultimately engenders accelerated atherosclerosis and vein graft failure. Since a myriad of stimuli provoke smooth muscle cell proliferation, molecular therapies for vein graft disease have targeted mechanisms fundamental to all cell proliferation - the 'cell-cycle' machinery. Preclinically, the most successful of these therapies has been edifoligide (E2F decoy), a double-stranded oligodeoxynucleotide that binds to the transcription factor known as E2F. Recently, PRoject of Ex vivo vein GRaft Engineering via Transfection (PREVENT) III and IV demonstrated that edifoligide failed to benefit human vein grafts employed to treat lower-extremity ischemia and coronary heart disease, respectively. The clinical failure of edifoligide calls into question previous models of vein graft disease and lends credence to recent animal studies demonstrating that vein graft arterialization substantially involves the immigration into the vein graft of a variety of vascular progenitor cells. Future vein graft disease therapies will likely target not only proliferation of graft-intrinsic cells, but also immigration of graft-extrinsic cells.

The influence of branch order on optimal leaf vein geometries: Murray's law and area preserving branching.

PubMed

Price, Charles A; Knox, Sarah-Jane C; Brodribb, Tim J

2013-01-01

Models that predict the form of hierarchical branching networks typically invoke optimization based on biomechanical similitude, the minimization of impedance to fluid flow, or construction costs. Unfortunately, due to the small size and high number of vein segments found in real biological networks, complete descriptions of networks needed to evaluate such models are rare. To help address this we report results from the analysis of the branching geometry of 349 leaf vein networks comprising over 1.5 million individual vein segments. In addition to measuring the diameters of individual veins before and after vein bifurcations, we also assign vein orders using the Horton-Strahler ordering algorithm adopted from the study of river networks. Our results demonstrate that across all leaves, both radius tapering and the ratio of daughter to parent branch areas for leaf veins are in strong agreement with the expectation from Murray's law. However, as veins become larger, area ratios shift systematically toward values expected under area-preserving branching. Our work supports the idea that leaf vein networks differentiate roles of leaf support and hydraulic supply between hierarchical orders.

Reduction of intimal hyperplasia and enhanced reactivity of experimental vein bypass grafts with verapamil treatment.

PubMed Central

el-Sanadiki, M N; Cross, K S; Murray, J J; Schuman, R W; Mikat, E; McCann, R L; Hagen, P O

1990-01-01

Recent studies have shown that calcium antagonists exert an antiatherogenic effect in animals fed cholesterol. Vein graft intimal hyperplasia is believed to be an early event in atherosclerotic lesion formation, which is a significant cause of graft failure. Altered vasoreactivity has also been postulated in the etiology of vein graft failure. Therefore this study examined the effect of verapamil treatment on the development of intimal hyperplasia and the vasoreactivity of experimental vein bypass grafts. The right external jugular vein was grafted into the right carotid artery of 30 male New Zealand white rabbits fed normal rabbit chow. The left external jugular vein was used as the control vein. Fifteen animals received verapamil (1.25 mg/day for 28 days) via the femoral vein by means of an osmotic pump. In 15 control animals the pump contained saline. Plasma verapamil concentration was 50.9 +/- 13.2 ng/mL (x +/- SEM), a dose that showed no effect on either blood pressure, total serum cholesterol, or in vitro platelet aggregation to ADP. Fourteen of fifteen grafts were patent in each group, for a patency rate of 93%. Histologic examination using computer morphometry showed significant reduction of intimal hyperplasia at the proximal, middle, and distal graft segments (p less than 0.05). In addition in vitro isometric tension studies of the vein grafts and control veins showed that verapamil causes enhanced reactivity of both vein grafts and control veins in response to norepinephrine and histamine (p less than 0.05). Reactivity of vein grafts to serotonin was unaltered. While none of the normal veins in the control group responded to serotonin, normal veins treated with verapamil contracted readily in response to serotonin. Endothelial-dependent relaxation to acetylcholine was absent in both control and verapamil-treated vein grafts, while normal veins from both groups responded to the same extent to acetylcholine. Because we could not demonstrate any difference in platelet or endothelium function between untreated and verapamil-treated animals, we examined the direct effect of verapamil on smooth muscle. Verapamil significantly inhibited [3H]-thymidine incorporation into DNA in vascular smooth muscle cells in culture in a dose-dependent manner. Verapamil treatment significantly reduces intimal hyperplasia in experimental vein grafts and inhibits smooth muscle cell proliferation in culture. Furthermore the enhanced reactivity to norepinephrine and histamine in the verapamil-treated vessels has no detrimental effect on the patency rate at 4 weeks. Thus by inhibiting intimal hyperplasia, calcium antagonists may improve the long-term patency of vein bypass grafts. Images Figs. 1A-C. PMID:2363608

Correlation of the flow patterns among the four pulmonary veins as assessed by transesophageal echocardiography: influence of significant mitral regurgitation.

PubMed

Hwang, J J; Lin, J M; Hsu, K L; Lai, L P; Tseng, Y Z; Lee, Y T; Lien, W P

1999-01-01

To evaluate the correlation of the flow patterns of the four pulmonary veins as assessed by transesophageal echocardiography and the influence of significant mitral regurgitation on this correlation. Eighty-eight patients with normal sinus rhythm and variable underlying cardiovascular diseases underwent transthoracic and transesophageal echocardiographic studies. Doppler flow of the four pulmonary veins could not be adequately interpreted in 19 patients (22%). The left atrial dimension of these patients was significantly larger than that of the patients with complete study of the flow in the four pulmonary veins (49 +/- 6 vs. 43 +/- 7 mm; p < 0.05). Of the 69 patients with complete evaluation of the four pulmonary veins, 48 patients without significant mitral regurgitation were analyzed as group A, and the remaining 21 patients as group B. The peak systolic and diastolic forward flow velocities of the four pulmonary veins were measured and the ratio of peak systolic (S) to diastolic (D) flow velocity was calculated. Group A had a significantly larger S/D ratio in all four pulmonary veins than group B (p < 0.05 in each pulmonary vein measurement). There was good correlation of the flow pattern represented as S/D ratio between left upper and lower pulmonary veins (r = 0.90) and between right upper and lower pulmonary veins (r = 0.89) in group A. The correlation of the flow pattern among the four pulmonary veins deteriorated in group B. Pulmonary veins on the same side share rather similar flow patterns in comparison with pulmonary veins on the opposite sides. The correlation of flow patterns among the four pulmonary veins is good in subjects without significant mitral regurgitation, but it worsens in patients with significant mitral regurgitation. Therefore, cautious interpretation of flow patterns of the four pulmonary veins in patients with significant regurgitation is indicated for grading the severity of mitral regurgitation.

Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

PubMed

Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

2017-12-01

Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

Phenotypic heterogeneity in the endothelium of the human vortex vein system.

PubMed

Yu, Paula K; Tan, Priscilla E Z; Cringle, Stephen J; McAllister, Ian L; Yu, Dao-Yi

2013-10-01

The vortex vein system is the drainage pathway for the choroidal circulation and serves an important function in the effective drainage of the exceptionally high blood flow from the choroidal circulation. As there are only 4-6 vortex veins, a large volume of blood must be drained from many choroidal veins into each individual vortex vein. The vortex vein system must also cope with passing through tissues of different rigidity and significant pressure gradient as it transverses from the intrao-cular to the extra-ocular compartments. However, little is known about how the vortex vein system works under such complex situations in both physiological and pathological condition. Endothelial cells play a vital role in other vascular systems, but they have not been studied in detail in the vortex vein system. The purpose of this study is to characterise the intracellular structures and morphology in both the intra-and extra-ocular regions of the human vortex vein system. We hypothesise the presence of endothelial phenotypic heterogeneity through the vortex vein system. The inferior temporal vortex vein system from human donor eyes were obtained and studied histologically using confocal microscopy. The f-actin cytoskeleton and nuclei were labelled using Alexa Fluor conjugated Phalloidin and YO-PRO-1. Eight regions of the vortex vein system were examined with the venous endothelium studied in detail with quantitative data obtained for endothelial cell and nuclei size and shape. Significant endothelial phenotypic heterogeneity was found throughout the vortex vein system with the most obvious differences observed between the ampulla and its downstream regions. Variation in the distribution pattern of smooth muscle cells, in particular the absence of smooth muscle cells around the ampulla, was noted. Our results suggest the presence of significantly different haemodynamic forces in different regions of the vortex vein system and indicate that the vortex vein system may play important roles in regulation of the choroidal circulation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Arabidopsis thaliana Ei-5: Minor Vein Architecture Adjustment Compensates for Low Vein Density in Support of Photosynthesis.

PubMed

Stewart, Jared J; Polutchko, Stephanie K; Demmig-Adams, Barbara; Adams, William W

2018-01-01

An Arabidopsis thaliana accession with naturally low vein density, Eifel-5 (Ei-5), was compared to Columbia-0 (Col-0) with respect to rosette growth, foliar vein architecture, photosynthesis, and transpiration. In addition to having to a lower vein density, Ei-5 grew more slowly, with significantly lower rates of rosette expansion, but had similar capacities for photosynthetic oxygen evolution on a leaf area basis compared to Col-0. The individual foliar minor veins were larger in Ei-5, with a greater number of vascular cells per vein, compared to Col-0. This compensation for low vein density resulted in similar values for the product of vein density × phloem cell number per minor vein in Ei-5 and Col-0, which suggests a similar capacity for foliar sugar export to support similar photosynthetic capacities per unit leaf area. In contrast, the product of vein density × xylem cell number per minor vein was significantly greater in Ei-5 compared to Col-0, and was associated not only with a higher ratio of water-transporting tracheary elements versus sugar-transporting sieve elements but also significantly higher foliar transpiration rates per leaf area in Ei-5. In contrast, previous studies in other systems had reported higher ratios of tracheary to sieve elements and higher transpiration rate to be associated with higher - rather than lower - vein densities. The Ei-5 accession thus further underscores the plasticity of the foliar vasculature by illustrating an example where a higher ratio of tracheary to sieve elements is associated with a lower vein density. Establishment of the Ei-5 accession, with a low vein density but an apparent overcapacity for water flux through the foliar xylem network, may have been facilitated by a higher level of precipitation in its habitat of origin compared to that of the Col-0 accession.

Patterning of leaf vein networks by convergent auxin transport pathways.

PubMed

Sawchuk, Megan G; Edgar, Alexander; Scarpella, Enrico

2013-01-01

The formation of leaf vein patterns has fascinated biologists for centuries. Transport of the plant signal auxin has long been implicated in vein patterning, but molecular details have remained unclear. Varied evidence suggests a central role for the plasma-membrane (PM)-localized PIN-FORMED1 (PIN1) intercellular auxin transporter of Arabidopsis thaliana in auxin-transport-dependent vein patterning. However, in contrast to the severe vein-pattern defects induced by auxin transport inhibitors, pin1 mutant leaves have only mild vein-pattern defects. These defects have been interpreted as evidence of redundancy between PIN1 and the other four PM-localized PIN proteins in vein patterning, redundancy that underlies many developmental processes. By contrast, we show here that vein patterning in the Arabidopsis leaf is controlled by two distinct and convergent auxin-transport pathways: intercellular auxin transport mediated by PM-localized PIN1 and intracellular auxin transport mediated by the evolutionarily older, endoplasmic-reticulum-localized PIN6, PIN8, and PIN5. PIN6 and PIN8 are expressed, as PIN1 and PIN5, at sites of vein formation. pin6 synthetically enhances pin1 vein-pattern defects, and pin8 quantitatively enhances pin1pin6 vein-pattern defects. Function of PIN6 is necessary, redundantly with that of PIN8, and sufficient to control auxin response levels, PIN1 expression, and vein network formation; and the vein pattern defects induced by ectopic PIN6 expression are mimicked by ectopic PIN8 expression. Finally, vein patterning functions of PIN6 and PIN8 are antagonized by PIN5 function. Our data define a new level of control of vein patterning, one with repercussions on other patterning processes in the plant, and suggest a mechanism to select cell files specialized for vascular function that predates evolution of PM-localized PIN proteins.

Contralateral suppression of aldosterone at adrenal venous sampling predicts hyperkalemia following adrenalectomy for primary aldosteronism.

PubMed

Shariq, Omair A; Bancos, Irina; Cronin, Patricia A; Farley, David R; Richards, Melanie L; Thompson, Geoffrey B; Young, William F; McKenzie, Travis J

2018-01-01

We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5.2 mmol/L) after unilateral adreanlectomy were compared with those who remained normokalemic. The contralateral suppression index was defined as the aldosterone-to-cortisol ratio from the nondominant adrenal vein divided by the aldosterone-to-cortisol ratio from the external iliac vein. Of 192 patients who met criteria for inclusion, 12 (6.3%) developed hyperkalemia (median serum potassium 5.5 mmol/L, range 5.2-6.2 mmol/L), with a median time to onset of 13.5 days (range 7-55 days). Five patients had transiently increased serum potassium concentrations that normalized spontaneously. Four patients received mineralocorticoid replacement therapy with fludrocortisone. On univariate analysis, hyperkalemic patients had slightly greater preoperative serum creatinine levels (1.2 vs 1.0 mg/dL, P = .01), higher postoperative creatinine (1.3 vs 1.0 mg/dL, P = .02), lesser median contralateral suppression index (0.14 vs 0.27, P = .03), and larger adenomas (1.9 vs 1.4 cm, P = .02). On multivariable logistic regression, the contralateral suppression index remained the only significant predictor of postoperative hyperkalemia (P = .04) with an optimal cut-off of <0.47. Hyperkalemia after unilateral adrenalectomy for primary aldosteronism is uncommon and usually transient, but may require mineralocorticoid supplementation. Patients with a contralateral suppression index of <0.47 require meticulous follow-up and monitoring of serum potassium concentrations after unilateral adrenalectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Portal vein thrombosis in paroxysmal nocturnal haemoglobinuria.

PubMed

Tomizuka, H; Hatake, K; Kitagawa, S; Yamashita, K; Arai, H; Miura, Y

1999-01-01

A 28-year-old man was hospitalized with nausea, vomiting, abdominal pain and low-grade fever. He had a 6-month history of paroxysmal nocturnal haemoglobinuria (PNH), and laboratory data showed anaemia and liver dysfunction. An abdominal ultrasonography showed ascites and portal vein thrombosis. After receiving antithrombotic treatment, the portal vein thrombosis did not extend. Portal vein thrombosis is very rare but should be considered when we encounter liver dysfunction associated with PNH as well as hepatic vein thrombosis. Ultrasonography is very useful in detecting portal vein thrombosis and facilitating early diagnosis. Warfarin is very effective in preventing exacerbation of portal vein thrombosis in PNH.

S-shaped versus conventional straight skin incision: Impact on primary functional maturation, stenosis and thrombosis of autogenous radiocephalic arteriovenous fistula: Impact of incision on maturation, stenosis & failure of RCAVF. Study design: Prospective observational comparative.

PubMed

Kordzadeh, Ali; Panayiotopolous, Yiannis

2017-10-01

The objective of this study is to test the null hypothesis that an S-shaped surgical incision versus conventional (straight) skin incision in the creation of autogenous radiocephalic arteriovenous fistulas (RCAVFs) have no impact on the primary end-point of primary functional maturation and secondary end points of stenosis and thrombosis. A prospective observational comparative consecutive study with intention-to-treat on individuals undergoing only radiocephalic arteriovenous fistula (RCAVFs) over a period of 12 months was conducted. Variables on patient's demographics, comorbidities, anesthesia type, mean arterial blood pressure, thrill, laterality, cephalic vein and radial artery diameter were collated. The test of probability was assessed through Chi-Square, Kaplan-Meier survival estimator and Log-Rank analysis. Total of n = 83 individuals with median age of 67 years (IQR, 20-89) and male predominance 83% during this period were subjected to RCAVF formation. Total of n = 45 patients in straight skin incision were compared to n = 38 individuals in S-shaped group. Despite equal prevalence of demographics, comorbidities, anesthesia type, mean arterial blood pressure (MAP), thrill, laterality, cephalic vein and radial artery diameter ( p  > 0.05) higher incidence of juxta-anastomotic stenosis was noted in the straight skin incision group ( p  = 0.029) in comparative and survival analysis (Log-Rank, p  = 0.036). The maturation of the entire cohort was 69% (S-shaped 76% vs. straight group 62%) (p > 0.05). The outcome of this study demonstrates that S-shaped surgical skin incision is associated with a lower incidence of stenosis in comparison to straight incision type in RCAVF formation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Raab, Udo, E-mail: udo.raab@klinikum-ingolstadt.de; Lazarus, Friedrich, E-mail: friedrich.lazarus@klinikum-ingolstadt.de

PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft wasmore » the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.« less

Endovascular treatment of post-thrombotic and non-thrombotic iliofemoral venous outflow obstructions with self-expanding nitinol stents.

PubMed

Stuck, Anna K; Reich, Thomas; Engelberger, Rolf P; Sebastian, Tim; Kucher, Nils

2018-06-01

The aim of the study was to investigate venous patency and clinical outcomes for endovascular treatment of iliofemoral venous obstruction in patients with post-thrombotic syndrome (PTS) and non-thrombotic iliac vein lesion (NIVL) with dedicated self-expanding nitinol stents. Data were collected from the prospective Swiss Venous Stent Registry, enrolling consecutive patients with a standardized follow-up procedure since January 2008. Patency was evaluated by duplex sonography and clinical outcome by various scores including the Villalta score at baseline, three, six, and 12 months, and then annually after endovascular therapy. Overall, 93 patients (64 PTS, 29 NIVL) were analysed. Mean follow-up time was 20 ± 16 (range 3-70) months. A total of 11 (12 %) patients had a stent occlusion, all of which occurred in the PTS group, and 13 (14 %) patients had a symptomatic stent stenosis. Primary patency was 79 % (95 % CI 68-87 %) at 12 months and 72 % (95 % CI 59-82 %) at 24 months. In PTS patients, primary patency at 12 months was 75 % (95 % CI 61-84 %) vs. 89 % (95 % CI 63-97 %) in NIVL patients (p = 0.10). Secondary patency at 24 months was 94 % (95 % CI 84-98 %) in PTS and 100 % in NIVL, p = 0.19). Overall, 62 (67 %) patients were free from PTS at the latest follow-up with a Villalta score < 5 points. Predictive factors for the loss of primary patency were stents placed below the inguinal ligament (OR 2.59, 95 % CI, 0.99-6.84, p = 0.05). In symptomatic patients with chronic iliofemoral vein obstruction, endovascular therapy with self-expanding nitinol stents was associated with favourable patency rates and clinical improvement in the majority of patients.

Vdrive Evaluation of Remote Steering and Testing in Lasso Electrophysiology Procedures Study: The VERSATILE Study in Atrial Fibrillation Ablation.

PubMed

Nölker, Georg; Schwagten, Bruno; Deville, J Brian; Burkhardt, J David; Horton, Rodney P; Sha, Qun; Tomassoni, Gery

2016-03-01

Circular mapping catheters (CMC) are an essential tool in most atrial fibrillation ablation procedures. The Vdrive™ with V-Loop™ system enables a physician to remotely manipulate a CMC during electrophysiology studies. Our aim was to compare the clinical performance of the system to conventional CMC navigation according to efficiency and safety endpoints. A total of 120 patients scheduled to undergo a CMC study followed by pulmonary vein isolation (PVI) were included. Treatment allocation was randomized 2:1, remote navigation:manual navigation. The primary effectiveness endpoint was assessed based on both successful navigation to the targeted pulmonary vein (PV) and successful recording of PV electrograms. All PVs were treated independently within and between patients. The primary safety endpoint was assessed based on the occurrence of major adverse events (MAEs) through seven days after the study procedure. Primary effectiveness endpoints were achieved in 295/302 PVs in the Vdrive arm (97.7%) and 167/167 PVs in the manual arm (100%). Effectiveness analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0405; δ = -0.05) per the Cochran-Mantel-Haenszel test adjusted for PV correlation. Five MAEs related to the ablation procedure occurred (three in the Vdrive arm-3.9%; two in the manual arm-2.33%). No device-related MAEs were observed; safety analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0441; δ = 0.07) per the normal Z test. Remote navigation of a CMC is equivalent to manual in PVI in terms of safety and effectiveness. This allows for single-operator procedures in conjunction with a magnetically guided ablation catheter. © 2016 Wiley Periodicals, Inc.

Geology and mineralization at the Ishmas Kabir gold prospect, Ishmas gold district, Kingdom of Saudi Arabia

USGS Publications Warehouse

Walker, B.M.; Ben Talib, Majed; El Komi, Mohamed; Hussain, M.A.; Christian, R.P.

1990-01-01

Quartz veins intersected by drill holes are surrounded by mylonite schist. Quartz and carbonate veins less than 5 mm thick are boudined, whereas thick quartz veins (£ 1.2 m) have disrupted and brecciated margins; mylonitized country rock envelops quartz-vein fragments. Sulfide mineralization associated with vein formation predates this rock-deformation event. Contemporaneous brittle and ductile deformation of quartz veins and country rocks occurred during the Nabitah orogeny. Supergene gold enrichment took place much later.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

Computer-assisted diagnostic tool to quantify the pulmonary veins in sickle cell associated pulmonary hypertension

NASA Astrophysics Data System (ADS)

Jajamovich, Guido H.; Pamulapati, Vivek; Alam, Shoaib; Mehari, Alem; Kato, Gregory J.; Wood, Bradford J.; Linguraru, Marius George

2012-03-01

Pulmonary hypertension is a common cause of death among patients with sickle cell disease. This study investigates the use of pulmonary vein analysis to assist the diagnosis of pulmonary hypertension non-invasively with CT-Angiography images. The characterization of the pulmonary veins from CT presents two main challenges. Firstly, the number of pulmonary veins is unknown a priori and secondly, the contrast material is degraded when reaching the pulmonary veins, making the edges of these vessels to appear faint. Each image is first denoised and a fast marching approach is used to segment the left atrium and pulmonary veins. Afterward, a geodesic active contour is employed to isolate the left atrium. A thinning technique is then used to extract the skeleton of the atrium and the veins. The locations of the pulmonary veins ostia are determined by the intersection of the skeleton and the contour of the atrium. The diameters of the pulmonary veins are measured in each vein at fixed distances from the corresponding ostium, and for each distance, the sum of the diameters of all the veins is computed. These indicators are shown to be significantly larger in sickle-cell patients with pulmonary hypertension as compared to controls (p-values < 0.01).

Bundle sheath lignification mediates the linkage of leaf hydraulics and venation.

PubMed

Ohtsuka, Akihiro; Sack, Lawren; Taneda, Haruhiko

2018-02-01

The lignification of the leaf vein bundle sheath (BS) has been observed in many species and would reduce conductance from xylem to mesophyll. We hypothesized that lignification of the BS in lower-order veins would provide benefits for water delivery through the vein hierarchy but that the lignification of higher-order veins would limit transport capacity from xylem to mesophyll and leaf hydraulic conductance (K leaf ). We further hypothesized that BS lignification would mediate the relationship of K leaf to vein length per area. We analysed the dependence of K leaf , and its light response, on the lignification of the BS across vein orders for 11 angiosperm tree species. Eight of 11 species had lignin deposits in the BS of the midrib, and two species additionally only in their secondary veins, and for six species up to their minor veins. Species with lignification of minor veins had a lower hydraulic conductance of xylem and outside-xylem pathways and lower K leaf . K leaf could be strongly predicted by vein length per area and highest lignified vein order (R 2  = .69). The light-response of K leaf was statistically independent of BS lignification. The lignification of the BS is an important determinant of species variation in leaf and thus whole plant water transport. © 2017 John Wiley & Sons Ltd.

Minimization of skin incisions at stripping by Mayo of large-diameter veins.

PubMed

Tsukanov, Yu

2018-03-15

To study the possibility of minimization of the skin incisions up to a puncture size at stripping by Mayo with the use of the stripper with an oval-ring head for large-diameter veins. The problem is solved due to the geometrical changing of the stripper head from a round to an oval one. The laboratory experiment showed that with a vein diameter of 10-20 mm the total cross-sectional area of its walls constituted 13.61 mm2, with a diameter of more than 20 mm it was 19.98 mm2. There were designed three types of the external dimensions for the stripper: 3.0 х 6.0 mm; 3,5 х 7.0 mm and 4.0 х 8.0 mm. From 1997 to 2017 the stripper with an oval-ring head was used in 1274 patients (male, n=421; female, n=853) for treating 1832 lower limbs. Average age was 46.4±12.3 years (range, 29 to 73). GSV and SSV stripping was performed in 1165 and 137 cases respectively in patients with the trunk diameter of more than 10 mm, severe vein tortuosity, for a vein located immediately under the skin, as well as for patients with the history of thrombophlebitis. The pain level in the 1st evening after the operation was 1.59, on the 7th day it decreased to 0.12 according to VAS-10. The motion activity level in the 1st evening after the operation was 7.24, on the 7th day it decreased to 9.96 according to VAS-10. All patients had primary wound healing. Hematomas along the location of the eliminated veins were of a moderate nature and resolved, on average, within 17 days. With the GSV diameter of 10-20 mm the skin scars were of 2.93 mm (95% CI: 3.09 mm - 4.47 mm), with the GSV diameter of more than 20 mm the skin scars were of 4.10 mm (95% CI: 4.01 mm - 5.07 mm). After 3 months 1102 patients (86,5%) were very satisfied and 172 (13,5%) were just satisfied with the performed operation. The use of the proposed stripper with an oval-ring head in patients with large-diameter subcutaneous trunks leads to the minimization of the skin incisions up to the punctures and, in general, makes the surgery significantly less traumatic, providing a quick recovery and minimization of the skin scars.

Postoperative enlargement and prognostic effects of portal venous bypass grafts in children undergoing Rex shunt.

PubMed

Zhang, Jin-Shan; Li, Long; Cheng, Wei

2018-05-22

Patency of the bypass vein after a Rex shunt is an important indicator of prognosis. However, there is no report about the change of caliber of the bypass vein after a Rex shunt. The aim of this study was to identify postoperative changes of the bypass vein and to assess the relationship with prognosis. Between October 2008 and October 2016 in our center, 114 children were diagnosed with extrahepatic portal venous obstruction. The portal cavernoma-portal bypass with interposition of grafted portal vessels was performed in 31 children, the gastroportal shunt was performed in 54 children, and other Rex shunts were performed in another 29 children. At follow-up, the patency and diameter of the bypass vein were assessed with ultrasound and computed tomography. The intraoperative and postoperative diameters of the bypass vein were compared to identify postoperative changes of the bypass vein. Prognosis was compared between children with and children without an enlarged bypass vein. The caliber of the bypass vein was enlarged in 50% of children (40/80) at 6 months postoperatively. The postoperative incidences of rebleeding and esophageal varices were significantly lower in children with an enlarged bypass vein than in those without (P < .05). Postoperatively, the reduced splenic size was significantly higher in children with an enlarged bypass vein than in those without (P < .05). The postoperative increase in platelet count in children with an enlarged bypass vein was significantly higher than in those without (P = .006). There was no significant difference in the flow velocity of the bypass vein between children with and children without an enlarged bypass vein (P = .133). The portal pressure was significantly reduced after surgery in children with an enlarged bypass vein than in children without an enlarged bypass vein (P = .017). The caliber of the bypass vein increases in 50% of children after a Rex shunt using a grafted portal vessel, which is related to a better prognosis. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.

2003-04-15

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine cathetermore » dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.« less

Possible silica gel in the Olive Fault, Naukluft Nappe Complex, Namibia: A geologic record of dynamic weakening in faults during continental orogenesis

NASA Astrophysics Data System (ADS)

Faber, C.; Rowe, C. D.; Miller, J. A.; Backeberg, N.; Sylvester, F.

2009-12-01

The apparently low frictional strength of faults during earthquake slip is not sufficiently well explained. Dynamic weakening has been observed in recent laboratory experiments at seismic slip rates, even if materials are strong at slow slip rates. Di Toro et al. (2004) performed experiments on crystalline rocks at slip rates of 1m/s and observed frictional strength drops to near zero. Examination of the slip surface revealed an amorophous silica had formed during fast slip and interpreted this as a solidified silica gel. If similar silica gel forms during earthquakes, and solidifies to amorphous silica, it would be expected to slowly crystallize over time. Ujiie et al (2007) reported a microcrystalline silica fault vein from the Shimanto Complex (Japan) which contains colloidal microspheres of silica, consistent with its origin as a silica gel. This vein may have been created during seismic slip, although other explanations are possible. No other natural examples of this potentially important coseismic weakening mechanism have been reported. To investigate whether silica gel actually forms during seismic slip, it will be necessary to discover and fully characterize additional natural examples. The Naukluft Nappe Complex in central Namibia is a foreland thrust stack at the distal southern margin of the Pan-African Damara Orogen (active at ~ 550Ma). A fault vein of microcrystalline silica has been found in an intra-nappe thrust fault . The vein occurs as a mostly continuous, planar, 0.1-1.0cm-thick fault vein within dolomite breccias of the Olive Fault. There are no other veins of silica associated with the fault. The hanging wall and footwall are dolomite and calcareous shales, respectively. The layer is petrographically similar to the microcrystalline silica described by Ujiie et al. (2007). The silica layer is purple-blue to white in color cathodoluminescence, in contrast to the bright turquoise typical of quartz. Although X-ray diffraction spectra show only silica and minor dolomite in the fault vein, SEM revealed the presence of small grains of Ti-oxides which have not been observed in the host rock. The cathodoluminescence has also revealed primary textures in the dolomite breccias which are overprinted by recrystallization and invisible in transmitted light . Transmission Electron Microscopy will be used to determine whether colloidal silica particles are present. The possible finding of the solidified silica gel in the Olive Fault is significant because it may represent a new way to identify fault surfaces which have slipped seismically in the past. In particular, the presence of this unusual silica vein in a carbonate-dominated environment is consistent with the experiments of Di Toro et al (2004) who suggested that quartz need not be present in the source rocks in order to form silica gel. Di Toro, G. et al. (2004) Friction falls towards zero in quartz rock as slip velocity approaches seismic rates. Nature, 427, 436-439 Ujie, K. et al. (2007) Fluidization of granular material in a subduction thrust at seismogenic depths. EPSL, 259, 307-318

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 which no stable phase occurs were largely leached from the rocks. A model has been constructed showing the arrangement of zoned veins and altered rocks in which the minerals produced by alteration are arranged in bands on each side of the vein, similar to the Butte pattern. Along strike from the cores, the inner bands thin and pinch out against the vein so that the vein becomes enclosed successively in the next outer bands. The sequence of alteration minerals along the veins is sericite, kaolinite, and montmorillonite for the aluminum silicates; and pyrite, carbonate, and iron oxides for the iron-bearing minerals. Alteration is thought to be controlled by reactions between wallrock minerals and the pore solution. In the aluminum silicate reactions, H+ was added to the rock and Na+ and Ca++ were removed. Carbon and sulfur from the vein were added to iron of the wallrock to produce pyrite and iron carbonate. Carbon, sulfur, and hydrogen moved into the wallrock, while Ca++, Na+, and some SiO2 moved toward the vein along concentration or activity gradients. Temperatures during mineralization ranged from below 200? C to about 350? C.

Assessment and management of patients with varicose veins.

PubMed

Allen, Louise

Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

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 themore » azygos vein via a transhepatic, retroperitoneal route. At 6 month follow-up the shunt was open and the azygos vein aneurysm had resolved.« less

D’Andrea’s disease (angiomegaly): a currently well-defined nosological entitys.

PubMed

Taurone, S; Spoletini, M; Di Matteo, F M; Mele, R; Tromba, L; Grippaudo, F R; Minni, A; Artico, M

2017-01-01

In 1997 D’Andrea et al. described a new nosological entity the characteristics of which consisted of lengthening, dilation and tortuosity of blood vessels, arteries or veins, less prominent, but also less circumscribed than an aneurysm. This condition does not necessarily imply specific aneurysm formation although aneurysms at multiple sites are a frequent observation. The term used by authors for angiomegaly of the venous system was venomegaly and the analogous condition of the arterial system was termed arteriomegaly. Although tortuosity and dilation of arteries and veins have been widely reported, suggesting a systemic disorder which affects the structural integrity of all vessels, most papers dealing with this intriguing condition did not describe any alterations in the components of vessel walls. In the present paper, the authors describe a well-defined condition, D’Andrea’s Disease (or DD, in this article), analyzing its salient morphological and clinical features and clarifying this pathological condition as a distinct and now well-defined nosological entity.

A new pretest probability score for diagnosis of lower limb deep vein thrombosis in unselected population of outpatients and inpatients.

PubMed

Sermsathanasawadi, Nuttawut; Chaivanit, Trakarn; Suparatchatpun, Pinyo; Chinsakchai, Khamin; Wongwanit, Chumpol; Ruangsetakit, Chanean; Mutirangura, Pramook

2017-03-01

Objective To develop a new pretest probability score for deep vein thrombosis (DVT) in unselected population of outpatients and inpatients. Methods The new score was developed using independent factors from 500 patients clinically suspected of leg DVT. The new score was validated in a second group of 315 patients. Results The score consists of four components: unilateral leg pain, confinement to bed, calf enlargement >3 cm compared with the other side, and previous venous thromboembolism. A score ≥2 indicated a high probability while a score <2 indicated low probability. The sensitivity and specificity of the new score were 71.60% and 79.49%, respectively. The area under the receiver operating characteristic curve for the new score was 0.79. The combination of a new score <2 and D-dimer level <500 µg/L had a negative predictive value of 96.43%. Conclusions Our new score was valid in an unselected population of outpatients and inpatients.

[Primary Malignant Melanoma of the Gallbladder].

PubMed

Ujiie, Daisuke; Miyamoto, Kotaro; Onozawa, Hisashi; Hoshi, Nobuhiro; Nakayama, Koichi; Urazumi, Kojiro; Takenoshita, Seiichi; Kusakabe, Takashi

2016-11-01

Primary malignant melanoma of the gallbladder is a rare disease, and 37 cases have been reported in the literature.The current patient was a 78-year-old man who was admitted with a pelvic tumor and left leg edema due to compression of the external iliac vein by the pelvic tumor.The edema improved following resection of the tumor, which was diagnosed at pathology as a malignant melanoma.After surgery, the patient became anorexic and complained of discomfort in the upper right abdomen.A whole body FDG-PET scan demonstrated significant uptake in the gallbladder and in the lymph nodes of the lower abdomen.The patient underwent open cholecystectomy, and the pathological diagnosis was malignant melanoma. Junctional activity was seen in the gallbladder, suggesting that this was the primary site.No melanocytic lesions of the skin or eyes were detected, further supporting the diagnosis of primary malignant melanoma of the gallbladder.Chemotherapy was initiated, but the patient died on February 28, 2016.

Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein.

PubMed

Mahan, Angel F; McEvoy, Matthew D; Gravenstein, Nikolaus

2016-04-01

In modern practice, real-time ultrasound guidance is commonly employed for the placement of internal jugular vein catheters. With a new tool, such as ultrasound, comes the opportunity to refine and further optimize the ultrasound view during jugular vein catheterization. We describe jugular vein access techniques and use the long-axis view as an alternative to the commonly employed short-axis cross-section view for internal jugular vein access and cannulation. The long-axis ultrasound-guided internal jugular vein approach for internal jugular vein cannulation is a useful alternative technique that can provide better needle tip and guidewire visualization than the more traditional short-axis ultrasound view.

[The effect of emotional stressors on thyroid gland function].

PubMed

Pastukhov, N A

1975-01-01

Response of the normal and goiterous thyroid gland to the information on the forthcoming operation was studied in 12 patients with varicose veins of the lower limbs and in 67 patients with thyrotoxicosis; this was done by determination of protein-bound iodine (PBI). PBI proved to increase before the operation in both groups of the patients. Due to undesirable hyperfunction of the thyroid gland prior to the operation in thyrotoxicosis, the psychodepressive premedication component should be increased.

Histomorphological Assessment of Phlebitis in Renal Allografts

PubMed Central

Jurčić, Vesna; Jeruc, Jera; Marić, Stela; Ferluga, Dušan

2007-01-01

Aim To evaluate the histomorphological features of veins in normal and transplanted kidneys. Methods Between 1992 and 1997 at the Institute of Pathology in Ljubljana, we semiquantitatively evaluated histomorphological changes in veins in nephrectomy specimens of 29 renal allografts with rejection and in 31 control kidneys. The structure of different segments of renal veins was additionally analyzed. Results Small interlobular veins were composed of endothelium and basement membrane, similar to capillaries, while the walls of large interlobular and arcuate veins had smooth muscle cell bundles forming the medial layer, similar to large extrarenal veins. In the control group, only focal mononuclear infiltration around small interlobular veins was found (8/31). In rejected kidney allografts, the veins were frequently infiltrated with inflammatory cells, predominantly T lymphocytes and macrophages (29/29). Other changes included thrombosis (16/29), fibrinoid necrosis (7/29), and sclerosis (9/29), and in one case an intimal lipid deposition. Conclusion This study, performed on whole explanted kidney specimens, revealed that rejection vasculitis often involved extrarenal and intrarenal veins, showing a whole spectrum of histopathological changes similar to those in arteries. Since large intrarenal veins have a muscle wall, we believe that the term »rejection phlebitis« could be used in renal transplant pathology. PMID:17589975

Anatomical variations of the right hepatic veins and their relevance to surgery.

PubMed

Hribernik, Marija; de Cecchis, Lucio; Trotovsek, Blaz; Gadzijev, Eldar M; Ravnik, Dean

2003-01-01

In a morphological study of the right hepatic veins anatomical characteristics of surgical importance were looked for. 110 cadaveric human livers were prepared by the corrosion casts method. The confluence patterns of the superior right hepatic vein, the hepatocaval confluence, the accessory right hepatic veins and the anastomoses between hepatic veins in the right hemiliver were examined. Four types of the superior right hepatic vein, based on the length of its trunk and the confluence pattern of its main tributaries were determined and their frequency was calculated. Type I was found in 20%, type II in 40%, type III in 25% and type IV in 15%. Accessory right hepatic veins with a minimal caliber of 0.4 cm, which were always present in type IV, were also found in other types, all together in 27% of the casts. The tributary-free part of the superior right hepatic vein at hepatocaval confluence was longer than 1 cm in 77%. In the right hemiliver 109 anastomoses were found in 29/110 liver casts. Knowing the characteristics of different superior right hepatic vein types and of the accessory right hepatic veins may be useful in segment-oriented liver resections and in right side living donor resections.

Identification of Beet necrotic yellow vein virus P25 pathogenicity factor-interacting sugar beet proteins that represent putative virus targets or components of plant resistance.

PubMed

Thiel, Heike; Varrelmann, Mark

2009-08-01

Beet necrotic yellow vein virus (BNYVV) induces the most important disease threatening sugar beet. The growth of partially resistant hybrids carrying monogenic dominant resistance genes stabilize yield but are unable to entirely prevent virus infection and replication. P25 is responsible for symptom development and previous studies have shown that recently occurring resistance-breaking isolates possess increased P25 variability. To better understand the viral pathogenicity factor's interplay with plant proteins and to possibly unravel the molecular basis of sugar beet antivirus resistance, P25 was applied in a yeast two-hybrid screen of a resistant sugar beet cDNA library. This screen identified candidate proteins recognized as orthologues from other plant species which are known to be expressed following pathogen infection and involved in plant defense response. Most of the candidates potentially related to host-pathogen interactions were involved in the ubiquitylation process and plants response to stress, and were part of cell and metabolism components. The interaction of several candidate genes with P25 was confirmed in Nicotiana benthamiana leaf cells by transient agrobacterium-mediated expression applying bimolecular fluorescence complementation assay. The putative functions of several of the candidates identified support previous findings and present first targets for understanding the BNYVV pathogenicity and antivirus resistance mechanism.

Proteus mirabilis inhibits cancer growth and pulmonary metastasis in a mouse breast cancer model

PubMed Central

Zhang, Hong; Diao, Hongxiu; Jia, Lixin; Yuan, Yujing; Thamm, Douglas H.; Wang, Huanan; Jin, Yipeng; Pei, Shimin; Zhou, Bin; Yu, Fang; Zhao, Linna; Cheng, Nan; Du, Hongchao; Huang, Ying; Lin, Degui

2017-01-01

A variety of bacteria have been used as agents and vectors for antineoplastic therapy. A series of mechanisms, including native bacterial toxicity, sensitization of the immune system and competition for nutrients, may contribute to antitumor effects. However, the antitumor effects of Proteus species have been minimally studied, and it is not clear if bacteria can alter tumor hypoxia as a component of their antineoplastic effect. In the present study, Proteus mirabilis bacteria were evaluated for the ability to proliferate and accumulate in murine tumors after intravenous injection. To further investigate the efficacy and safety of bacterial injection, mice bearing 4T1 tumors were treated with an intravenous dose of 5×107 CFU Proteus mirabilis bacteria via the tail vein weekly for three treatments. Histopathology, immunohistochemistry (IHC) and western analysis were then performed on excised tumors. The results suggested Proteus mirabilis localized preferentially to tumor tissues and remarkably suppressed the growth of primary breast cancer and pulmonary metastasis in murine 4T1 models. Results showed that the expression of NKp46 and CD11c was significantly increased after bacteria treatment. Furthermore, tumor expression of carbonic anhydrase IX (CA IX) and hypoxia inducible factor-1a (HIF-1a), surrogates for hypoxia, was significantly lower in the treated group than the control group mice as assessed by IHC and western analysis. These findings demonstrated that Proteus mirabilis may a promising bacterial strain for used against primary tumor growth and pulmonary metastasis, and the immune system and reduction of tumor hypoxia may contribute to the antineoplastic and antimetastatic effects observed. PMID:29206859

Proteus mirabilis inhibits cancer growth and pulmonary metastasis in a mouse breast cancer model.

PubMed

Zhang, Hong; Diao, Hongxiu; Jia, Lixin; Yuan, Yujing; Thamm, Douglas H; Wang, Huanan; Jin, Yipeng; Pei, Shimin; Zhou, Bin; Yu, Fang; Zhao, Linna; Cheng, Nan; Du, Hongchao; Huang, Ying; Zhang, Di; Lin, Degui

2017-01-01

A variety of bacteria have been used as agents and vectors for antineoplastic therapy. A series of mechanisms, including native bacterial toxicity, sensitization of the immune system and competition for nutrients, may contribute to antitumor effects. However, the antitumor effects of Proteus species have been minimally studied, and it is not clear if bacteria can alter tumor hypoxia as a component of their antineoplastic effect. In the present study, Proteus mirabilis bacteria were evaluated for the ability to proliferate and accumulate in murine tumors after intravenous injection. To further investigate the efficacy and safety of bacterial injection, mice bearing 4T1 tumors were treated with an intravenous dose of 5×107 CFU Proteus mirabilis bacteria via the tail vein weekly for three treatments. Histopathology, immunohistochemistry (IHC) and western analysis were then performed on excised tumors. The results suggested Proteus mirabilis localized preferentially to tumor tissues and remarkably suppressed the growth of primary breast cancer and pulmonary metastasis in murine 4T1 models. Results showed that the expression of NKp46 and CD11c was significantly increased after bacteria treatment. Furthermore, tumor expression of carbonic anhydrase IX (CA IX) and hypoxia inducible factor-1a (HIF-1a), surrogates for hypoxia, was significantly lower in the treated group than the control group mice as assessed by IHC and western analysis. These findings demonstrated that Proteus mirabilis may a promising bacterial strain for used against primary tumor growth and pulmonary metastasis, and the immune system and reduction of tumor hypoxia may contribute to the antineoplastic and antimetastatic effects observed.

Investigation of adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents in the iliac vein: insights into developing a better iliac vein stent.

PubMed

Shida, Takuya; Umezu, Mitsuo; Iwasaki, Kiyotaka

2018-06-01

We analyzed the adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents for the treatment of iliac venous thromboembolism and investigated their relationships with the anatomical features of the iliac vein, to gain insights into the development of a better iliac vein stent. Reports of adverse events following the use of stents in the iliac vein were retrieved from the Manufacturer and User Facility Device Experience (MAUDE) database that contain suspected device-associated complications reported to the Food and Drug Administration. Data from 2006 to 2016 were investigated. The literature analysis was also conducted using PubMed, Cochrane Library, EMBASE, and Web of Science focusing on English articles published up to 4 October 2016. The analysis of 88 adverse events from the MAUDE database and 182 articles from the literature revealed that a higher number of adverse events had been reported following the use of arterial stents in the iliac vein compared to CE-marked iliac vein stents. While stent migration and shortening were reported only for the arterial stents, stent fracture and compression occurred regardless of the stent type, even though a vein does not pulsate. A study of the anatomical features of the iliac vein implies that bending, compression, and kink loads are applied to the iliac vein stents in vivo. For designing, developing, and pre-clinical testing of stents intended for use in the iliac vein, the above mechanical load environments induced by the anatomical features should be considered.

Apixaban or Dalteparin in Reducing Blood Clots in Patients With Cancer Related Venous Thromboembolism

ClinicalTrials.gov

2017-12-28

Cerebral Vein Thrombosis; Deep Vein Thrombosis; Gonadal Thrombosis; Hepatic Thrombosis; Malignant Neoplasm; Mesenteric Thrombosis; Metastatic Malignant Neoplasm; Portal Vein Thrombosis; Pulmonary Embolism; Renal Vein Thrombosis; Splenic Thrombosis; Venous Thromboembolism

Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure).

PubMed

Dua, Anahita; Heller, Jennifer; Lee, Cheong

2017-11-01

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

Primary Budd-Chiari Syndrome in Children: King's College Hospital Experience.

PubMed

Nobre, Susana; Khanna, Rajeev; Bab, Natalie; Kyrana, Eirini; Height, Sue; Karani, John; Kane, Pauline; Heaton, Nigel; Dhawan, Anil

2017-07-01

Primary Budd-Chiari syndrome is a rare cause of liver disease in children in the western world. Here we present a retrospective review of children with Primary Budd-Chiari syndrome presenting from January 2001 to November 2015 to our hospital. Seven children were identified. Their presentation was mostly chronic. All had predisposing factors for thrombosis and were started on anticoagulation. Radiological interventions (2 transjugular intrahepatic portosystemic shunts and 1 hepatic vein stenting), liver transplant and mesocaval shunt were done in 3, 2, and 1 patients, respectively; 1 child underwent bone marrow transplantation following transjugular intrahepatic portosystemic shunts and 1 child was managed only medically. After liver transplantation, one child died 3 years later as a result of subarachnoid haemorrhage, whereas others remain well at a median follow-up of 6 years. Despite high morbidity, the disease can have a good long-term outcome with a multidisciplinary approach.

Element variations in rhyolitic magma resulting from gas transport

NASA Astrophysics Data System (ADS)

Berlo, K.; Tuffen, H.; Smith, V. C.; Castro, J. M.; Pyle, D. M.; Mather, T. A.; Geraki, K.

2013-11-01

Tuffisite veins are glass-filled fractures formed when magma fragments during degassing within the conduit. These veins form transient channels through which exsolved gases can escape from magma. The purpose of this study is to determine the extent to which chemical heterogeneity within the melt results from gas transport, and assess how this can be used to study magma degassing. Two tuffisite veins from contrasting rhyolitic eruptions at Torfajökull (Iceland) and Chaitén (Chile) were studied in detail. The tuffisite vein from Torfajökull is from a shallow dissected conduit (∼70 ka) that fed a degassed lava flow, while the sample from Chaitén was a bomb ejected during the waning phases of Plinian activity in May 2008. The results of detailed in situ chemical analyses (synchrotron XRF, FTIR, LA-ICP-MS) show that in both veins larger vesiculated fragments are enriched in volatile elements (Torfajökull: H, Li, Cl; Chaitén: Li, Cl, Cu, Zn, As, Sn, Sb) compared to the host, while the surrounding smaller particles are depleted in the Torfajökull vein (Li, Cl, Zn, Br, Rb, Pb), but enriched in the Chaitén vein (K, Cu, Zn, As, Mo, Sb, Pb). The lifespans of both veins and the fluxes of gas and particles through them can be estimated using diffusion profiles and enrichment factors. The Torfajökull vein had a longer lifespan (∼a day) and low particle velocities (∼cm/s), while the Chaitén vein was shorter lived (<1 h) with a high gas velocity (∼m/s). These differences are consistent with the contrasting eruption mechanisms (effusive vs. explosive). The amount of magma that degassed through the Chaitén vein is more than ten times the volume of the vein itself, requiring the vein to tap into pre-exsolved gas pockets. This study highlights that tuffisite veins are highly efficient gas pathways and thereby impart chemical diversity in volatile elements on the melt.

Isolated Deep Venous Thrombosis: Implications for 2-Point Compression Ultrasonography of the Lower Extremity.

PubMed

Adhikari, Srikar; Zeger, Wes; Thom, Christopher; Fields, J Matthew

2015-09-01

Two-point compression ultrasonography focuses on the evaluation of common femoral and popliteal veins for complete compressibility. The presence of isolated thrombi in proximal veins other than the common femoral and popliteal veins should prompt modification of 2-point compression technique. The objective of this study is to determine the prevalence and distribution of deep venous thrombi isolated to lower-extremity veins other than the common femoral and popliteal veins in emergency department (ED) patients with clinically suspected deep venous thrombosis. This was a retrospective study of all adult ED patients who received a lower-extremity venous duplex ultrasonographic examination for evaluation of deep venous thrombosis during a 6-year period. The ultrasonographic protocol included B-mode, color-flow, and spectral Doppler scanning of the common femoral, femoral, deep femoral, popliteal, and calf veins. Deep venous thrombosis was detected in 362 of 2,451 patients (14.7%; 95% confidence interval [CI] 13.3% to 16.1%). Thrombus confined to the common femoral vein alone was found in 5 of 362 cases (1.4%; 95% CI 0.2% to 2.6%). Isolated femoral vein thrombus was identified in 20 of 362 patients (5.5%; 95% CI 3.2% to 7.9%). Isolated deep femoral vein thrombus was found in 3 of 362 cases (0.8%; 95% CI -0.1% to 1.8%). Thrombus in the popliteal vein alone was identified in 53 of 362 cases (14.6%; 95% CI 11% to 18.2%). In our study, 6.3% of ED patients with suspected deep venous thrombosis had isolated thrombi in proximal veins other than common femoral and popliteal veins. Our study results support the addition of femoral and deep femoral vein evaluation to standard compression ultrasonography of the common femoral and popliteal vein, assuming that this does not have a deleterious effect on specificity. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Reproducibility of cerebrospinal venous blood flow and vessel anatomy with the use of phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA.

PubMed

Schrauben, E M; Johnson, K M; Huston, J; Del Rio, A M; Reeder, S B; Field, A; Wieben, O

2014-05-01

The chronic cerebrospinal venous insufficiency hypothesis raises interest in cerebrospinal venous blood flow imaging, which is more complex and less established than in arteries. For accurate assessment of venous flow in chronic cerebrospinal venous insufficiency diagnosis and research, we must account for physiologic changes in flow patterns. This study examines day-to-day flow variability in cerebrospinal veins by use of 4D MR flow and contrast-enhanced MRA under typical, uncontrolled conditions in healthy individuals. Ten healthy volunteers were scanned in a test-retest fashion by use of a 4D flow MR imaging technique and contrast-enhanced MRA. Flow parameters obtained from phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA scoring measurements in the head, neck, and chest veins were analyzed for internal consistency and interscan reproducibility. Internal consistency was satisfied at the torcular herophili, with an input-output difference of 2.2%. Percentages of variations in flow were 20.3%, internal jugular vein; 20.4%, azygos vein; 6.8%, transverse sinus; and 5.1%, common carotid artery. Retrograde flow was found in the lower internal jugular vein (4.8%) and azygos vein (7.2%). Contrast-enhanced MRA interscan κ values for the internal jugular vein (left: 0.474, right: 0.366) and azygos vein (-0.053) showed poor interscan agreement. Phase contrast-vastly undersampled isotropic projection reconstruction blood flow measurements are reliable and highly reproducible in intracranial veins and in the common carotid artery but not in veins of the neck (internal jugular vein) and chest (azygos vein) because of normal physiologic variation. Retrograde flow normally may be observed in the lower internal jugular vein and azygos vein. Low interrater agreement in contrast-enhanced MRA scans was observed. These findings have important implications for imaging diagnosis and experimental research of chronic cerebrospinal venous insufficiency. © 2014 by American Journal of Neuroradiology.

Convolutional Neural Network-Based Finger-Vein Recognition Using NIR Image Sensors

PubMed Central

Hong, Hyung Gil; Lee, Min Beom; Park, Kang Ryoung

2017-01-01

Conventional finger-vein recognition systems perform recognition based on the finger-vein lines extracted from the input images or image enhancement, and texture feature extraction from the finger-vein images. In these cases, however, the inaccurate detection of finger-vein lines lowers the recognition accuracy. In the case of texture feature extraction, the developer must experimentally decide on a form of the optimal filter for extraction considering the characteristics of the image database. To address this problem, this research proposes a finger-vein recognition method that is robust to various database types and environmental changes based on the convolutional neural network (CNN). In the experiments using the two finger-vein databases constructed in this research and the SDUMLA-HMT finger-vein database, which is an open database, the method proposed in this research showed a better performance compared to the conventional methods. PMID:28587269

Convolutional Neural Network-Based Finger-Vein Recognition Using NIR Image Sensors.

PubMed

Hong, Hyung Gil; Lee, Min Beom; Park, Kang Ryoung

2017-06-06

Conventional finger-vein recognition systems perform recognition based on the finger-vein lines extracted from the input images or image enhancement, and texture feature extraction from the finger-vein images. In these cases, however, the inaccurate detection of finger-vein lines lowers the recognition accuracy. In the case of texture feature extraction, the developer must experimentally decide on a form of the optimal filter for extraction considering the characteristics of the image database. To address this problem, this research proposes a finger-vein recognition method that is robust to various database types and environmental changes based on the convolutional neural network (CNN). In the experiments using the two finger-vein databases constructed in this research and the SDUMLA-HMT finger-vein database, which is an open database, the method proposed in this research showed a better performance compared to the conventional methods.

Near-infrared image formation and processing for the extraction of hand veins

NASA Astrophysics Data System (ADS)

Bouzida, Nabila; Hakim Bendada, Abdel; Maldague, Xavier P.

2010-10-01

The main objective of this work is to extract the hand vein network using a non-invasive technique in the near-infrared region (NIR). The visualization of the veins is based on a relevant feature of the blood in relation with certain wavelengths of the electromagnetic spectrum. In the present paper, we first introduce the image formation in the NIR spectral band. Then, the acquisition system will be presented as well as the method used for the image processing in order to extract the vein signature. Extractions of this pattern on the finger, on the wrist and on the dorsal hand are achieved after exposing the hand to an optical stimulation by reflection or transmission of light. We present meaningful results of the extracted vein pattern demonstrating the utility of the method for a clinical application like the diagnosis of vein disease, of primitive varicose vein and also for applications in vein biometrics.

Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

PubMed Central

Ikegami, Akiko; Kondo, Takeshi; Tsukamoto, Tomoko; Ohira, Yoshiyuki; Ikusaka, Masatomi

2015-01-01

We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter), and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case) is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome. PMID:25802794

Stripping without a stripper.

PubMed

Singh, D R; Shrestha, S K; Shretha, S K

2004-01-01

Varicose veins afflict some 10 to 20% of the population in the west. It is believed to be less prevalent in the developing nations. Though there are absolute indications of surgery for varicose veins, people in Nepal come for treatment of the varicose veins either to join the army or to work abroad. Not all hospitals in Nepal are equipped with a vein stripper. In KMCTH, we studied 29 patients who had their long Saphenous veins stripped either with a stripper or by tunnelling around the Saphenous vein. We found that the long Saphenous vein could be stripped via the tunnelling method with an additional incision above the knee joint which is cosmetically accepted by our patients Moreover the patients were much satisfied because of minimal or no bruises in the post operative period as compared to those who had the long Saphenous vein stripped with a stripper.

Primary Pancreatic Head Tuberculosis: Great Masquerader of Pancreatic Adenocarcinoma

PubMed Central

Gupta, Dhaval; Patel, Jatin; Rathi, Chetan; Ingle, Meghraj; Sawant, Prabha

2015-01-01

Isolated pancreatic tuberculosis (TB) is considered an extremely rare condition, even in the developing countries. Most reported cases of pancreatic TB are diagnosed after exploratory laparotomy or autopsy. Pancreatic TB is a potential mimic of invasive pancreatic malignancy and the presence of vascular invasion does not distinguish one condition from the other. Every effort should be made for the earliest diagnosis of this condition as TB is a treatable condition and it avoids unnecessary management of pancreatic carcinoma. Here we report a rare case of primary pancreatic head TB in a 58-year-old male who presented with hypodense lesion in head of pancreas with double duct sign and portal vein invasion mimicking non-resectable pancreatic carcinoma. PMID:27785295

Microchemical evidence for episodic growth of antitaxial veins during fracture-controlled fluid flow

NASA Astrophysics Data System (ADS)

Barker, Shaun L. L.; Cox, Stephen F.; Eggins, Stephen M.; Gagan, Michael K.

2006-10-01

The mechanism by which syntectonic hydrothermal veins form is widely debated, with some workers suggesting that certain vein textures are related to specific fluid flow regimes. Central to the debate is whether vein formation involves advective fluid flow, or occurs by local diffusion of material from the surrounding wall rock. To address this issue, we integrated textural observations and microchemical analyses of a hydrothermal vein from the Lachlan Orogen, southeast Australia, to reveal information about vein growth history, changes in fluid chemistry, and the evolution of fluid flow pathways during vein growth. The study area is part of a regional-scale fault-fracture network in an interbedded limestone-shale sequence, which formed at depths of ˜ 5-10 km (˜ 150-200 °C) during late Devonian crustal shortening. This integrated approach demonstrates that the zonation of textures, Sr isotopes, stable isotopes (C, O), and trace and rare earth elements is distinctly asymmetrical about the median growth-line of the vein. δ 18O values in vein calcite (17.0-18.8‰, VSMOW) are lower than those in surrounding unaltered limestones (23-25‰, VSMOW), and vary systematically across the vein. In contrast, δ 13C values are relatively constant across most of the vein, but become markedly depleted ( ca. 4‰) immediately adjacent to the wall rock. This strong depletion in δ 13C was probably caused by the influx of more oxidised fluids during the latest stages of vein growth. Strontium isotope ratios ( 87Sr/ 86Sr) vary between 0.70912 and 0.70931 across the vein. Abrubt changes in 87Sr/ 86Sr, δ 18O, Ce/Ce *, Eu/Eu * and trace element concentrations indicate that vein growth was accompanied by stepwise changes in the fluid flow pathway and consequent variations in fluid chemistry. Taken together, our findings are not consistent with growth of fibrous antitaxial veins by diffusional transfer of material from the surrounding wall rock. Instead, they suggest that externally sourced fluids migrated along episodically changing fracture-controlled flow pathways. This has implications for the dynamics of crustal permeability and mineralisation.

The Origin of Fibrous Calcite Veins: Aragonite?

NASA Astrophysics Data System (ADS)

Elburg, M. A.; Bons, P. D.

2005-12-01

Truly fibrous calcite veins occur mainly in carbonaceous shales and are characterised by high length:width ratios of their fibres (>10). Previous studies on their Sr isotopic geochemistry (Elburg et al., 2002: Geol. Soc. London Spec. Publ. 200, 103-118; Hilgers and Sindern, 2005: Geofluids, in press) have shown that some of the material could be derived from the local wall rock. These studies also showed that the veins were always enriched in Sr compared to the calcite in the host rocks. Aragonite can contain significantly more Sr than calcite, while it also tends to have a fibrous crystal habit. It is therefore possible that the fibrous habit of these veins, which now consist of calcite, are a reflection of their initial aragonitic mineralogy, rather than of any special tectonic regime during their formation. This idea was investigated by analysing the major and trace element geochemistry of selected fibrous and non-fibrous calcite veins from Arkaroola (northern Flinders Ranges, Australia). The fibrous vein analysed for major elements contains less than 1% MgCO3, whereas calcite in the host rock, with which it is in Sr isotopic equilibrium, contains 18% MgCO3. Calcite can contain significant Mg, whereas the aragonitic structure cannot accomodate this ion, so this result is consistent with the idea of an original aragonitic mineralogy of the veins. The fibrous veins show an enrichment in the middle rare earth elements (REE) compared to the calcite in the host rock and blocky veins. In a Post-Archean Average Shale normalised diagram, Eu is more strongly enriched compared to its neighbouring elements in the fibrous veins, but not in the host calcite, blocky veins, or in the silicate fraction of the host rock, suggesting more reducing conditions during fibrous vein formation. This data cannot be used as direct evidence for the fibrous veins' aragonitic mineralogy. It does, however, show that significant differences exist between calcite in host rocks, blocky and fibrous calcite veins, and this data should be incorporated in any model explaining the origin of fibrous veins.

Hepatic venous pressure gradient after portal vein embolization: An accurate predictor of future liver remnant hypertrophy.

PubMed

Mohkam, Kayvan; Rode, Agnès; Darnis, Benjamin; Manichon, Anne-Frédérique; Boussel, Loïc; Ducerf, Christian; Merle, Philippe; Lesurtel, Mickaël; Mabrut, Jean-Yves

2018-05-09

The impact of portal hemodynamic variations after portal vein embolization on liver regeneration remains unknown. We studied the correlation between the parameters of hepatic venous pressure measured before and after portal vein embolization and future hypertrophy of the liver remnant after portal vein embolization. Between 2014 and 2017, we reviewed patients who were eligible for major hepatectomy and who had portal vein embolization. Patients had undergone simultaneous measurement of portal venous pressure and hepatic venous pressure gradient before and after portal vein embolization by direct puncture of portal vein and inferior vena cava. We assessed these parameters to predict future liver remnant hypertrophy. Twenty-six patients were included. After portal vein embolization, median portal venous pressure (range) increased from 15 (9-24) to 19 (10-27) mm Hg and hepatic venous pressure gradient increased from 5 (0-12) to 8 (0-14) mm Hg. Median future liver remnant volume (range) was 513 (299-933) mL before portal vein embolization versus 724 (499-1279) mL 3 weeks after portal vein embolization, representing a 35% (7.4-83.6) median hypertrophy. Post-portal vein embolization hepatic venous pressure gradient was the most accurate parameter to predict failure of future liver remnant to reach a 30% hypertrophy (c-statistic: 0.882 [95% CI: 0.727-1.000], P < 0.001). A cut-off value of post-portal vein embolization hepatic venous pressure gradient of 8 mm Hg showed a sensitivity of 91% (95% CI: 57%-99%), specificity of 80% (95% CI: 52%-96%), positive predictive value of 77% (95% CI: 46%-95%) and negative predictive value of 92.3% (95% CI: 64.0%-99.8%). On multivariate analysis, post-portal vein embolization hepatic venous pressure gradient and previous chemotherapy were identified as predictors of impaired future liver remnant hypertrophy. Post-portal vein embolization hepatic venous pressure gradient is a simple and reproducible tool which accurately predicts future liver remnant hypertrophy after portal vein embolization and allows early detection of patients who may benefit from more aggressive procedures inducing future liver remnant hypertrophy. (Surgery 2018;143:1-2.). Copyright © 2018 Elsevier Inc. All rights reserved.

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

PubMed Central

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-01-01

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy. PMID:26184226

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex.

PubMed

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-07-14

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy.

Free Flap Survival Despite Internal Jugular Vein Thrombosis in Head and Neck Reconstruction

PubMed Central

Kiya, Koichiro; Seike, Shien; Hosokawa, Ko

2018-01-01

Summary: Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system. PMID:29464172

Factor V Leiden

MedlinePlus

... and where it travels. A clot in a deep vein This is known as deep vein thrombosis (DVT). Deep vein thrombosis may not cause any symptoms. If ... as a pulmonary embolism, this occurs when a deep vein clot breaks free and travels through the ...

Intravitreal triamcinolone acetonide injections in the treatment of retinal vein occlusions.

PubMed

Roth, Daniel B; Cukras, Catherine; Radhakrishnan, Ravi; Feuer, William J; Yarian, David L; Green, Stuart N; Wheatley, Harold M; Prenner, Jonathan

2008-01-01

To report the visual acuity response after intravitreal triamcinolone injection in patients with macular edema due to retinal vein occlusions. Retrospective nonrandomized interventional series of 172 consecutive patients with macular edema due to retinal vein occlusions who were treated with intravitreal triamcinolone acetonide injection. Patients underwent Snellen visual acuity testing and ophthalmoscopic examination at baseline and 1, 3, 6, and 12 months after intravitreal triamcinolone acetonide injection. All subtypes of retinal vein occlusions showed significant improvements in mean visual acuity 1 month after injection. This improvement in visual acuity was maintained over the 12-month period for all but the central retinal vein occlusion group. Seventy-one (41.3%) of the 172 patients received more than one intravitreal triamcinolone injection for unresolved or recurrent macular edema. This study demonstrates a benefit associated with intravitreal triamcinolone acetonide injection for retinal vein occlusions that was maintained by patients with branch retinal vein occlusions and hemiretinal vein occlusions over a 12-month period. Visual acuity improvement was not maintained in patients with central retinal vein occlusions with this course of treatment.

Cell Therapy Applications for Retinal Vascular Diseases: Diabetic Retinopathy and Retinal Vein Occlusion.

PubMed

Park, Susanna S

2016-04-01

Retinal vascular conditions, such as diabetic retinopathy and retinal vein occlusion, remain leading causes of vision loss. No therapy exists to restore vision loss resulting from retinal ischemia and associated retinal degeneration. Tissue regeneration is possible with cell therapy. The goal would be to restore or replace the damaged retinal vasculature and the retinal neurons that are damaged and/or degenerating from the hypoxic insult. Currently, various adult cell therapies have been explored as potential treatment. They include mesenchymal stem cells, vascular precursor cells (i.e., CD34+ cells, hematopoietic cells or endothelial progenitor cells), and adipose stromal cells. Preclinical studies show that all these cells have a paracrine trophic effect on damaged ischemic tissue, leading to tissue preservation. Endothelial progenitor cells and adipose stromal cells integrate into the damaged retinal vascular wall in preclinical models of diabetic retinopathy and ischemia-reperfusion injury. Mesenchymal stem cells do not integrate as readily but appear to have a primary paracrine trophic effect. Early phase clinical trials have been initiated and ongoing using mesenchymal stem cells or autologous bone marrow CD34+ cells injected intravitreally as potential therapy for diabetic retinopathy or retinal vein occlusion. Adipose stromal cells or pluripotent stem cells differentiated into endothelial colony-forming cells have been explored in preclinical studies and show promise as possible therapies for retinal vascular disorders. The relative safety or efficacy of these various cell therapies for treating retinal vascular disorders have yet to be determined.

Strategies of arteriovenous dialysis access.

PubMed

Weiswasser, Jonathan M; Kellicut, Dwight; Arora, Subodh; Sidawy, Anton N

2004-03-01

Surgical management of the patient who requires hemodialysis access, while continuing to demand more attention from the vascular surgeon, suffers from discrepancies of approach and strategy. With the increase in incidence of dialysis dependent renal failure among our population, many have attempted to present a uniform, logical strategy with which the vascular surgeon can most effectively treat the hemodialysis patient in the long term. Most notably, the multidisciplinary Dialysis Outcomes Quality Initiative (DOQI) guidelines present the surgeon with a rough outline of hemodialysis access insertion strategy, and it has become nationally recognized as an acceptable summary of treatment strategy and goals. The decision as to the most appropriate surgical access to offer a patient depends on immediate need for hemodialysis, history and physical examination findings, and suitability of available veins in the extremity. While percutaneous, catheter based access affords the luxury of immediate access, these devices suffer from several complicating factors, such as infection, and damage to large, proximal veins. For long-term access, the autogenous access, while perhaps less successful in the immediate short term, is always the preferred access type given its favorable longevity. The surgeons should focus on sites distally on the extremity, reserving proximal sites for potential future access insertions should the primary access fail. In the absence of suitable vein, prosthetic access may be considered. When both the upper and lower aspects of both upper extremities have been exhausted, the surgeon should consider access insertion elsewhere, such as the lower extremity.

Acute subdural hematoma because of boxing.

PubMed

Kushi, Hidehiko; Saito, Takeshi; Sakagami, Yuichiro; Ohtsuki, Jyoji; Tanjoh, Katsuhisa

2009-02-01

To identify factors determining the clinical characteristics and prognosis of acute subdural hematoma (ASDH) arising from boxing injuries by comparing with ASDH due to any nonboxing cause. Two groups were selected for this study: 10 patients with ASDH because of boxing injuries and 26 patients with nonboxer ASDH. All of the patients underwent neurologic examination by neurosurgeons. Primary resuscitation and stabilization as well as operative therapy were performed to all patients according to the European Brain Injury Consortium Guidelines. Two groups were compared in terms of age, the Glasgow Coma Scale at admission, neurologic findings, craniogram and brain computed tomography scan findings, operative findings, and prognosis. As potential prognostic indicators for boxers, the time interval until surgery, the Glasgow Outcome Scale, hematoma thickness, midline shift, and the site of bleeding were analyzed. The characteristics of patients because of boxing injuries are that patients were younger, had lucid interval, and had no cerebral contusion or contralateral brain injury. There was no significant difference in initial Glasgow Coma Scale, hematoma thickness, midline shift, and their prognosis. The most peculiar clinical presentation of boxers' ASDH was that all bleedings were limited from "bridging veins" or "cortical veins." The prognosis of boxers was most closely correlated with the site of bleeding (r2 = 0.81; p = 0.0001) and the midline shift (r2 = 0.67; p = 0.007). Our study shows that ASDH because of boxing is characterized by bleeding from bridging or cortical veins, and that the site of bleeding is a significant determinant of their prognosis.

Mechanisms of fine extinction band development in vein quartz: new insights from correlative light and electron microscopy

NASA Astrophysics Data System (ADS)

Derez, Tine; Van Der Donck, Tom; Plümper, Oliver; Muchez, Philippe; Pennock, Gill; Drury, Martyn R.; Sintubin, Manuel

2017-07-01

Fine extinction bands (FEBs) (also known as deformation lamellae) visible with polarized light microscopy in quartz consist of a range of nanostructures, inferring different formation processes. Previous transmission electron microscopy studies have shown that most FEB nanostructures in naturally deformed quartz are elongated subgrains formed by recovery of dislocation slip bands. Here we show that three types of FEB nanostructure occur in naturally deformed vein quartz from the low-grade metamorphic High-Ardenne slate belt (Belgium). Prismatic oriented FEBs are defined by bands of dislocation walls. Dauphiné twin boundaries present along the FEB boundaries probably formed after FEB formation. In an example of two sub-rhombohedral oriented FEBs, developed as two sets in one grain, the finer FEB set consists of elongated subgrains, similar to FEBs described in previous transmission electron microscopy studies. The second wider FEB set consists of bands with different dislocation density and fluid-inclusion content. The wider FEB set is interpreted as bands with different plastic strain associated with the primary growth banding of the vein quartz grain. The nanometre-scale fluid inclusions are interpreted to have formed from structurally bounded hydroxyl groups that moreover facilitated formation of the elongate subgrains. Larger fluid inclusions aligned along FEBs are explained by fluid-inclusion redistribution along dislocation cores. The prismatic FEB nanostructure and the relation between FEBs and growth bands have not been recognized before, although related structures have been reported in experimentally deformed quartz.

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

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 . © 2015 John Wiley & Sons Ltd.

Fractal vein distributions within a fault-fracture mesh in an exhumed accretionary mélange, Chrystalls Beach Complex, New Zealand

NASA Astrophysics Data System (ADS)

Fagereng, Åke

2011-05-01

A well developed fault-fracture mesh is observed in the Chrystalls Beach Complex, an accretionary mélange within the Otago Schist on the South Island of New Zealand. In this study, an analysis of vein thicknesses and clustering of veins is presented. Both shear and extension veins have a power-law thickness distribution. Measures of vein spacing best fit a power-law distribution, but a small data set limits this interpretation to a small fractal range. Vein clustering varies from random to moderately clustered between outcrops, and is the greatest where a large proportion of relatively competent blocks occurs within the mélange. Fractures are distributed within the mélange matrix, and this localized deformation requires heterogeneity in rheology and/or fluid pressure distribution, whereas pervasive, distributed deformation occurs in relatively homogeneous rock. The overall trend of this deformation being mainly accommodated by thin veins required that new fractures formed preferentially over refracturing existing veins, which highlights the distributed nature of deformation within a fault-fracture mesh. The predominance of new fractures may result from vein material being stronger than the cleaved wall rock, such that wall rock failure occurred instead of reopening of pre-existing shear and extension veins.

Mechanisms of flexural flow folding of competent single-layers as evidenced by folded fibrous dolomite veins

NASA Astrophysics Data System (ADS)

Torremans, Koen; Muchez, Philippe; Sintubin, Manuel

2014-12-01

Flexural flow is thought unlikely to occur in naturally deformed, competent isotropic single-layers. In this study we discuss a particular case of folded bedding-parallel fibrous dolomite veins in shale, in which the internal strain pattern and microstructural deformation features provide new insights in the mechanisms enabling flexural flow folding. Strain in the pre-folding veins is accommodated by two main mechanisms: intracrystalline deformation by bending and intergranular deformation with bookshelf rotation of dolomite fibres. The initially orthogonal dolomite fibres allowed a reconstruction of the strain distribution across the folded veins. This analysis shows that the planar mechanical anisotropy created by the fibres causes the veins to approximate flexural flow. During folding, synkinematic veins overgrow the pre-folding fibrous dolomite veins. Microstructures and dolomite growth morphologies reflect growth during progressive fold evolution, with evidence for flexural slip at fold lock-up. Homogeneous flattening, as evidenced by disjunctive axial-planar cleavage, subsequently modified these folds from class 1B to 1C folds. Our study shows that the internal vein fabric has a first-order influence on folding kinematics. Moreover, the fibrous dolomite veins show high viscosity contrasts with the shale matrix, essential in creating transient permeability for subsequent mineralising stages in the later synkinematic veins during progressive folding.

Cavernous Transformation of Portal Vein Secondary to Portal Vein Thrombosis: A Case Report

PubMed Central

Ramos, Radhames; Park, Yoojin; Shazad, Ghulamullah; A.Garcia, Christine; Cohen, Ronny

2012-01-01

There are few reported cases of cavernous transformation of the portal vein (CTPV) in adults. We present a case of a 58 year-old male who was found to have this complication due to portal vein thrombosis (PVT). A 58-year old African American male with chronic alcohol and tobacco use presented with a 25-day history of weakness, generalized malaise, nausea and vomiting associated with progressively worsening anorexia and weight loss. The patient was admitted for severe anemia in conjunction with abnormal liver function tests and electrolyte abnormalities, and to rule out end stage liver disease or hepatic malignancy. The work-up for anemia showed no significant colon abnormalities, cholecystitis, liver cirrhosis, or liver abnormalities but could not rule out malignancy. An esophageogastroduodenoscopy (EGD) was suspicious for a mass compressing the stomach and small bowel. After further work-up, the hepatic mass has been diagnosed as a cavernous transformation of the portal vein (CTPV), a very rare complication of portal vein thrombosis (PVT). Cavernous Transformation of the Portal Vein (CTPV) is a rare and incurable complication of portal vein thrombosis (PVT) that should be considered as one of the differential diagnoses of a hepatic mass. Keywords Cavernous transformation of the portal vein; Portal vein thrombosis; Portal hypertension; Hyperbilirubinemia; Hepatic mass PMID:22383935

Development of infectious cDNA clones of citrus yellow vein clearing virus using a novel and rapid strategy.

PubMed

Cui, Tian Tian; Bin, Yu; Yan, Jian Hong; Mei, Peng Ying; Li, Zhong An; Zhou, Chang Yong; Song, Zhen

2018-05-04

Yellow vein clearing disease (YVCD) causes significant economic losses in lemon and other species of citrus. Usually, citrus yellow vein clearing virus (CYVCV) is considered to be the causal agent of YVCD. However, mixed infection of CYVCV and Indian citrus ringspot virus (ICRSV) or other pathogens is often detected in citrus plants with YVCD. In this study, we re-examined the causal agent of YVCD to fulfill Koch's postulates. First, the full-length genome of CYVCV isolate AY (CYVCV-AY) was amplified by long-distance RT-PCR from a Eureka lemon [Citrus limon (L) Brum. f.] tree with typical YVCD symptoms. The genomic cDNAs were then cloned into a ternary Yeast-Escherichia coli-Agrobacterium tumefaciens shuttle vector, pCY, using transformation-associated recombination (TAR) strategy, and 15 full-length cDNA clones of CYVCV-AY were obtained. Subsequently, four of these clones were selected randomly and inoculated on Jincheng [C. sinensis (L) Osbeck] seedlings through Agrobacterium-mediated vacuum-infiltration, and it was found that 80 to 100% of inoculated plants were infected with CYVCV by RT-PCR at 20 to 40 days post inoculation (dpi) and by direct tissue blot immunoassay at 60 dpi. The progeny of CYVCV-AY from cDNA clones caused typical symptoms of YVCD such as yellow vein clearing, leaf distortion, and chlorosis, which were the same as that elicited by wild-type virus. Finally, the regeneration of CYVCV-AY genome was confirmed by long-distance RT-PCR in lemon trees inoculated with the infectious cDNA clone. These results proved that CYVCV was the primary causal agent of YVCD. This is the first report on the development of infectious cDNA clones of CYVCV, which lays the foundation for further studies on viral gene functions and virus-host interactions.

Enhanced pressure in the central retinal vein decreases the perfusion pressure in the prelaminar region of the optic nerve head.

PubMed

Stodtmeister, Richard; Ventzke, Sylvana; Spoerl, Eberhard; Boehm, Andreas G; Terai, Naim; Haustein, Michael; Pillunat, Lutz E

2013-07-12

The pressure in the central retinal vein (CRVP) has been shown to be higher in glaucoma patients than in controls. Until now, these measurements have been performed in arbitrary units or in units of ophthalmodynamometric force. In our study, a contact lens dynamometer, calibrated in mm Hg, was used to calculate the retinal perfusion pressure. A total of 27 patients with primary open angle glaucoma (POAG) and 27 healthy control subjects were included in the study. The IOP measurement included Goldmann applanation tonometry, whereas the pressure enhancement measurement consisted of contact lens dynamometry. results: the pressures are given in mm hg, and are expressed as the mean ± SD for the control subjects versus the POAG patients: IOP 14.4 ± 2.7 vs. 15.4 ± 2.9, systolic blood pressure 141 ± 20.1 vs. 153 ± 16.5 (P = 0.013), central retinal vein threshold pressure (CRVTP) 11.9 ± 3.8 vs. 16.8 ± 5.0, CRVP 15.0 ± 2.7 vs. 17.9 ± 4.2, and retinal perfusion pressure (PPret) standard 84 ± 12.2 vs. 94 ± 9.1 and new 83 ± 12.2 vs. 91 ± 9.6. The differences in PPret between using the new versus the standard method are 0.55 ± 1.33 vs. -2.5 ± 3.89 (P = 0.041 and P = 0.002, respectively). The PPret was at least 5.0 mm Hg lower in 5 of the 27 POAG patients when the new calculation method was used. The perfusion pressure in the retina and prelaminar region of the optic nerve head (ONH) may be lower than expected because the CRVP may be higher. The pressure measurement in the central retinal vein may be a step toward a better understanding of ONH pathophysiology.

A Portal Vein Injection Model to Study Liver Metastasis of Breast Cancer

PubMed Central

Goddard, Erica T.; Fischer, Jacob; Schedin, Pepper

2016-01-01

Breast cancer is the leading cause of cancer-related mortality in women worldwide. Liver metastasis is involved in upwards of 30% of cases with breast cancer metastasis, and results in poor outcomes with median survival rates of only 4.8 - 15 months. Current rodent models of breast cancer metastasis, including primary tumor cell xenograft and spontaneous tumor models, rarely metastasize to the liver. Intracardiac and intrasplenic injection models do result in liver metastases, however these models can be confounded by concomitant secondary-site metastasis, or by compromised immunity due to removal of the spleen to avoid tumor growth at the injection site. To address the need for improved liver metastasis models, a murine portal vein injection method that delivers tumor cells firstly and directly to the liver was developed. This model delivers tumor cells to the liver without complications of concurrent metastases in other organs or removal of the spleen. The optimized portal vein protocol employs small injection volumes of 5 - 10 μl, ≥ 32 gauge needles, and hemostatic gauze at the injection site to control for blood loss. The portal vein injection approach in Balb/c female mice using three syngeneic mammary tumor lines of varying metastatic potential was tested; high-metastatic 4T1 cells, moderate-metastatic D2A1 cells, and low-metastatic D2.OR cells. Concentrations of ≤ 10,000 cells/injection results in a latency of ~ 20 - 40 days for development of liver metastases with the higher metastatic 4T1 and D2A1 lines, and > 55 days for the less aggressive D2.OR line. This model represents an important tool to study breast cancer metastasis to the liver, and may be applicable to other cancers that frequently metastasize to the liver including colorectal and pancreatic adenocarcinomas. PMID:28060292

A multicentre, randomized, double-blind placebo-controlled trial evaluating rosiglitazone for the prevention of atherosclerosis progression after coronary artery bypass graft surgery in patients with type 2 diabetes. Design and rationale of the VeIn-Coronary aTherOsclerosis and Rosiglitazone after bypass surgerY (VICTORY) trial

PubMed Central

Bertrand, Olivier F; Poirier, Paul; Rodés-Cabau, Josep; Rinfret, Stéphane; Title, Lawrence; Dzavik, Vladimir; Natarajan, Madhu; Angel, Juan; Batalla, Nuria; Alméras, Natalie; Costerousse, Olivier; De Larochellière, Robert; Roy, Louis; Després, Jean-Pierre

2009-01-01

BACKGROUND: The number of patients with coronary artery disease and type 2 diabetes will increase dramatically over the next decade. Diabetes has been related to accelerated atherosclerosis and many patients with diabetes will require coronary artery bypass graft (CABG) surgery utilizing saphenous vein grafts. After CABG, accelerated atherosclerosis in saphenous vein grafts leads to graft failure in approximately 50% of cases over a 10-year period. Rosiglitazone, a peroxisome proliferator-activated receptor-gamma agonist, has been shown to improve multiple metabolic parameters in patients with type 2 diabetes. However, its role in the prevention of atherosclerosis progression is uncertain. STUDY DESIGN: VeIn-Coronary aTherOsclerosis and Rosiglitazone after bypass surgerY (VICTORY) is a cardiometabolic trial in which patients with type 2 diabetes, one to 10 years after CABG, will be randomly assigned to receive rosiglitazone (up to 8 mg/day) or a placebo after qualifying angiography and intravascular ultrasound of a segment of one vein graft with or without a native anastomosed coronary artery. A comprehensive set of athero-thrombo-inflammatory markers will be serially assessed during the 12-month follow-up period. Body fat distribution and body composition will be assessed by computed tomography and dual energy x-ray absorptiometry, respectively, at baseline, six months and 12 months follow-up. For atherosclerosis progression evaluation, repeat angiography and intravascular ultrasound will be performed after 12 months follow-up. The primary end point of the study will be the change in atherosclerotic plaque volume in a 40 mm or longer segment of one vein graft. CONCLUSIONS: The VICTORY trial is the first cardiometabolic study to evaluate the antiatherosclerotic and metabolic effects of rosiglitazone in post-CABG patients with type 2 diabetes. PMID:19746240

Complications and Retrieval Data of Vena Cava Filters Based on Specific Infrarenal Location.

PubMed

Tullius, Thomas G; Bos, Aaron S; Patel, Mikin V; Funaki, Brian; Van Ha, Thuong G

2018-02-01

Although recommended placement of IVC filters is with their tips positioned at the level of the renal vein inflow, in practice, adherence is limited due to clinical situation or IVC anatomy. We seek to evaluate the indwelling and retrieval complications of IVC filters based on their specific position within the infrarenal IVC. Retrospective, single institution study of 333 consecutive infrarenal vena cava filters placed by interventional radiologists in patients with an average age of 62.2 ± 15.7 years was performed between 2013 and 2015. Primary indication was venous thromboembolic disease (n = 320, 96.1%). Filters were classified based on location of the apex below the lowest renal vein inflow on the procedural venogram: less than 1 cm (n = 180, 54.1%), 1-2 cm (n = 96, 28.8%), and greater than 2 cm (n = 57, 17.1%). Denali (n = 171, 51.4%) and Celect (n = 162, 48.6%) filters were evaluated. CT follow-up, indwelling complications, and retrieval data were obtained. Follow-up CT imaging performed for symptomatic indications occurred for 38.3% of filters placed < 1 cm below the lowest renal vein, 27.1% of filters placed 1-2 cm, and 36.8% placed > 2 cm (p = .16). There was no difference in caval strut penetration, penetration of adjacent viscera, time to penetration, filter migration, or tilt (p = .15, .27, .41, .57, .93). No filter fractures occurred. There was no difference in the incidence of breakthrough PE or complex filter retrieval (p = .83, .59). Only one retrieval failure occurred. This study suggests filter apex location within the infrarenal IVC, including placement > 2 cm below the level of the renal vein inflow, is not associated with differences in indwelling or retrieval complications. Level 3 non-randomized controlled follow-up study.

Manual calf massage and passive ankle motion reduce the incidence of deep vein thromboembolism after total hip arthroplasty.

PubMed

Imai, Norio; Ito, Tomoyuki; Suda, Ken; Miyasaka, Dai; Endo, Naoto

2017-07-01

Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial. The purpose of this study was to investigate whether manual calf massage and passive ankle motion could lower the risk for venous thromboembolism after total hip arthroplasty. We retrospectively reviewed the data of 126 consecutive patients undergoing elective primary unilateral total hip arthroplasty wherein manual calf massage and passive ankle motion were performed after the surgery at our hospitals between January and October 2014. The 138 patients of the control group underwent total hip arthroplasty using the same surgical approach and pre- and postoperative protocols without this mechanical prophylaxis between January and December 2013. This mechanical prophylaxis was performed simultaneously 30 times during approximately 10 s; these procedures were repeated thrice immediately after total hip arthroplasty. Duplex ultrasonography was performed to observe the veins of both legs in all the patients on postoperative day 7. The incidence of deep vein thrombosis was 6.52% and 0.79% in the control and manual calf massage and passive ankle motion groups, respectively. The odds ratio for the manual calf massage and passive ankle motion groups was 8.72. Performing this mechanical prophylaxis reduced the incidence of venous thromboembolism after total hip arthroplasty. This mechanical prophylaxis is not only simple and easy, but is also safe and inexpensive. We therefore recommend that manual calf massage and passive ankle motion be performed in patients who will undergo total hip arthroplasty, if deep vein thrombosis does not exist before the surgery. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

The caudate lobe of the liver: implications of embryology and anatomy for surgery.

PubMed

Abdalla, Eddie K; Vauthey, Jean-Nicolas; Couinaud, Claude

2002-10-01

The anatomy of the caudate lobe has technical and possibly oncologic implications for surgeons. The complex anatomy of the lobe is clarified by embryologic and anatomic analysis. This posterior sector is embryonically and anatomically independent of the right and left liver and the main portal fissure. The caudate lobe represents the only part of the liver that is in contact with the vena cava, except at the entrance of the main hepatic veins into the vena cava, and provides an anastomosis between the hepatic veins and vena cava. The entire caudate lobe is a single anatomic segment that is defined by the presence of portal venous and hepatic arterial branches, which supply the lobe, draining biliary ducts, and hepatic veins. Because no separate veins, arteries, or ducts can be defined for the right paracaval portion of the posterior liver and because pedicles cross the proposed division between the right and left caudate, the concept of segment IX is abandoned. The significance of caudate anatomy is reflected in the increase in the frequency and safety of major hepatic resection for primary and metastatic tumors in the liver. Right hepatic lobectomy routinely involves resection of the right portion of the caudate lobe (C. Couinaud, unpublished data, 1999). In the case of hilar bile duct cancer, which may extend into the dorsal ducts (especially the right lateral duct), partial or total caudate lobectomy is often necessary for complete extirpation of the tumor. Isolated caudate lobectomy can be performed for hepatocellular carcinoma that arises in the caudate lobe or for other tumors that arise in the lobe. The caudate lobe can be resected as part of the donor liver in preparation for a living related donor transplantation. Knowledge of the surgical anatomy of the caudate lobe is an essential part of the repertoire for surgeons who perform liver transplants or treat hepatobiliary cancer.