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Sample records for abdominal arteries comparison

  1. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    Moloney, M A

    2012-02-01

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  2. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    Moloney, M A

    2010-11-11

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  3. Abdominal CT in acute arterial pathology

    The abdominal arterial pathology as studied by CT imagings is reviewed. The illustrated morphology of aortic aneurysms complications (arterial embolism, dissection and arteriosclerotic ulcer ) are studied. The signs that lead to diagnosis are assessed and the major points on which to base a correct radiological study are reviewed

  4. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    Ming, Zhu; Qian, Wang [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2009-08-15

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  5. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  6. Clinical significance of hepatic artery variations originating from the superior mesenteric artery in abdominal tumor surgery

    HUANG Yuan; LIU Chao; LIN Jin-ling

    2013-01-01

    Background Hepatic artery variations are frequent clinical occurrences.The aim of this study was to investigate the characteristic course of variant hepatic arteries originating from the superior mesenteric artery for the purpose of providing instructions for abdominal tumor surgery.Methods The course of variant hepatic arteries originating from the superior mesenteric artery was studied in 400 patients with liver cancer confirmed by digital subtraction angiography (DSA) and multi-slice spiral computed tomography angiography (MSCTA),and 86 patients with gastric cancer confirmed by preoperative MSCTA between June 2008 and June 2010 in the First Affiliated Hospital of Guangxi Medical University.Results Hepatic artery variations originating from the superior mesenteric artery were noticed in 49 liver cancer patients and 14 gastric cancer patients (total 63 cases),with a variation rate of 12.96%,including two cases (3.17%) where the hepatic arteries ran along the anterior pancreas,and 61 cases (96.83%) where the hepatic arteries ran along the posterior pancreas.Conclusions Hepatic artery variations originating from the superior mesenteric artery present as two types:the pre-pancreas type and the post-pancreas type with the latter predominating.This finding is of clinical significance in abdominal tumor surgeries where clearance of portal lymph nodes is needed.

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

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

    1998-08-01

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

  8. Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome

    2011-01-01

    AIM: To evaluate the therapeutic effects of abdominal decompression plus continuous regional arterial infusion (CRAI) via a drug delivery system (DDS) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).

  9. A practical MRI technique for detecting Abdominal Aorta Aneurism and Peripheral Arterial Disease

    Aykut Aktas

    2014-12-01

    Full Text Available Aim: Peripheral Arterial Disease(PAD and abdominal aorta aneurysm(AAA are frequent problems in geriatric population. In DSA, CTA or MRA techniques contrast agents has to be used for diagnosis that can be nephrotoxic for elderly patients. Magnetic resonans imaging (MRI is the most powerful, non-ionising radiological diagnostic tool that has the highest soft tissue contrast resolution. The aim of our study was to investigate the effectivity of MRI by the means of detecting the AAA and PAD in comparison with DSA. Material and Method: After getting ethical commitee approvel and informed consent, we have performed Balanced turbo field echo(B-TFE MRI technique without contrast agent in 1.5 Tesla MRI device before DSA examination. The luminal diameters of renal arteries, infrarenal abdominal aorta, iliac and femoral arteries was measured by using Philips DICOM Viewer R2.2 application. The intraclass corelation coefficient and reliability used to check if the techniques could be used for each other and the t-test was used to measure the differences between them. Results: There has been a high relationship between B-TFE and DSA in detecting the pathologies of larger arteries like aorta. In the case of small arterial pathologies, there is relatively lower relationship between BTFE and DSA. Discussion: For the diagnosis of AAA and PAD, DSA is the gold standart technique but it is invasive and patients have radiation exposure. In the follow up of geriatric patients with larger arterial pathologies B-TFE can be used instead of contrast enhanced MRA and invasive DSA.

  10. Ruptured Aneurysm of the Splenic Artery: A Rare Cause of Abdominal Pain after Blunt Trauma

    Jalalludin Khoshnevis

    2013-01-01

    Full Text Available Introduction: Splenic artery aneurysms (SAAs are rare (0.2-10.4%; however, they are the most common form of visceral artery aneurysms. Splenic artery aneurysms are important to identify, because up to 25% of the cases are complicated by rupture. Post- rupture mortality rate is 25% -70% based on the underlying cause. Herein we present a young patient with abdominal pain after blunt abdominal trauma due to rupture of an SAA.Case Presentation: A 27-year-old male, without a remarkable medical history, who suffered from abdominal pain for 2 days after falling was admitted to the emergency department with hypovolemic shock. Upon performing emergency laparotomy a ruptured splenic artery aneurysm was found.Conclusions: It is important to consider rupture of a splenic artery aneurysm in patients with abdominal pain and hypovolemic shock.

  11. Emergent interventional therapy for the massive abdominal and pelvic arterial hemorrhage

    Objective: To evaluate the clinical application of interventional therapy in treating massive abdominal and pelvic arterial hemorrhage. Methods: Sixty-seven patients with massive abdominal or pelvic arterial hemorrhage were collected for this study. The bleeding sites included gastroduodenal artery (n=11), superior mesenteric artery (n=15), inferior mesenteric artery (n=6), renal artery (n=12) and internal iliac artery branches (n=23). With Seldinger's technique the femoral artery was punctured, which was followed by angiography in order to visualize and to confirm the bleeding arteries, and then by using the gelatin sponge particles, coils or micro-coil, PVA particles or granules of sodium alginate the bleeding arteries were occluded. All the patients were observed closely after the operation, focusing on the vital signs. And follow-up observation and examine were conducted regularly. Results: Of the 67 patients,successful embolization with single procedure was obtained in 65, with twice procedures in one. The remaining one patient had to receive surgery as there was still small amounts of bleeding after embolization. The total success rate was 98.5%. Fifty patients were followed up for 3 months to 2 years after the arterial embolization (mean 12 months), and no severe complications or recurrence occurred. Conclusion: Interventional embolization is a safe and effective treatment for massive abdominal and pelvic arterial bleeding. It can precisely and instantly occlude the bleeding arteries. The key point of technical success is the proficient super-selective catheterization skill. (authors)

  12. Lateral abdominal wall hematoma as a rare complication after carotid artery stenting: a case report

    Satomi Jyunichiro

    2009-11-01

    Full Text Available Abstract Abdominal wall hematoma is a rare and life-threatening complication after carotid artery stenting (CAS, but it can occur when activated clotting time is prolonged. We report a right lateral abdominal wall hematoma caused by rupture of the superficial circumflex iliac artery after CAS in a 72-year-old man with severe stenosis of the origin of the right internal carotid artery. We performed CAS for the targeted lesion while activated clotting time exceeded 300 seconds. After 2 hours, he complained of right lateral abdominal pain. Abdominal computed tomography revealed an extensive hematoma in the right lateral abdominal wall. Activated clotting time was 180 seconds at this point. Seven hours later, he developed hypotension and hemoglobin level dropped to 11.3 g/dl. Subsequent computed tomography showed enlargement of the hematoma. Emergent selective angiography of the external iliac artery revealed active bleeding from the right superficial circumflex iliac artery. Transcatheter arterial embolization with Gelfoam and microcoils was performed successfully. With more CAS procedures being performed, it is important for endovascular surgeons and radiologists to consider the possibility of abdominal wall hematoma in this situation.

  13. Effects of microcurrents and physical exercise on the abdominal fat: a randomized controlled trial in patients with coronary artery disease

    Noites, Andreia; Pinto, Joana; Freitas, Carla Patrícia; Melo, Cristina; Albuquerque, Aníbal; Teixeira, Madalena; Ribeiro, Fernando; Bastos, José Mesquita

    2015-01-01

    Objectives: Coronary artery disease are associated with decreased levels of physical activity, contributing to increases in abdominal fat and consequently the metabolic risk. The use of microcurrents is an innovative and effective method to increase lipolytic rate of abdominal adipocytes. This study aims to investigate the effects of microcurrents with a homebased exercise program on total, subcutaneous and visceral abdominal adipose tissue in subjects with coronary artery disease. Meth...

  14. Episodic arterial oxygen desaturation and heart rate variations following major abdominal surgery

    Rosenberg, J; Dirkes, W E; Kehlet, H

    1989-01-01

    In 20 patients undergoing elective major abdominal surgery, heart rate and arterial oxygen saturation were monitored continuously during the night 2 days before operation and during the first and second nights after operation (23:00 to 07:30). Mean heart rate increased by 16 beat min-1 (P less th...

  15. Retained intra-abdominal artery forceps – An unusual cause of intestinal strangulation

    Anthony Ikemefuna Ugochukwu

    2011-07-01

    Full Text Available Context: Surgical instruments and materials continue to be retained in the peritoneal cavity despite precautionary measures. Even though uncommon it is also under-reported and carries serious medico-legal consequences. Gauzes and sponges (gossypiboma are the most commonly retained materials and intra-abdominal retained artery forceps are much rarer but when they do occur lead to chronic abdominal pain and can be a rare cause of intestinal obstruction or strangulation with significant morbidity and mortality. Case Report: We present a case of intraabdominal retained artery forceps in a 70-years-old lady who underwent laparotomy with splenectomy for a large spleen in a peripheral hospital. Upon discharge she continued to complain of intermittent abdominal pain of increasing severity. 12 months later she presented to us with an acute (surgical abdomen requiring another laparotomy. At laparotomy she had strangulated/gangrenous lower jejunual and upper ileal bowel loops, the small bowel mesentery of this area being tightly trapped between the jaws of the retained artery forceps. She had gut resection and enteroanastomosis. Unfortunately she died from continuing sepsis on the second post-operative day. Conclusion: Retained instruments in intra-abdominal surgery can cause serious complication and should be treated surgically. High index of suspicion and appropriate investigations like plain abdominal X-ray, abdominal ultrasound and CT and MRI scans should be instituted in patients who develop chronic abdominal symptoms following laparotomy. Preventive measures against retained instruments must follow strict laid down protocols for surgical instruments handling in theatre.

  16. Retained intra-abdominal artery forceps - An unusual cause of intestinal strangulation

    Anthony Ikemefuna Ugochukwu

    2011-01-01

    Full Text Available Context: Surgical instruments and materials continue to be retained in the peritoneal cavity despite precautionary measures. Even though uncommon it is also under-reported and carries serious medico-legal consequences. Gauzes and sponges (gossypiboma are the most commonly retained materials and intra-abdominal retained artery forceps are much rarer but when they do occur lead to chronic abdominal pain and can be a rare cause of intestinal obstruction or strangulation with significant morbidity and mortality. Case Report: We present a case of intraabdominal retained artery forceps in a 70-years-old lady who underwent laparotomy with splenectomy for a large spleen in a peripheral hospital. Upon discharge she continued to complain of intermittent abdominal pain of increasing severity. 12 months later she presented to us with an acute (surgical abdomen requiring another laparotomy. At laparotomy she had strangulated/gangrenous lower jejunual and upper ileal bowel loops, the small bowel mesentery of this area being tightly trapped between the jaws of the retained artery forceps. She had gut resection and enteroanastomosis. Unfortunately she died from continuing sepsis on the second post-operative day. Conclusion: Retained instruments in intra-abdominal surgery can cause serious complication and should be treated surgically. High index of suspicion and appropriate investigations like plain abdominal X-ray, abdominal ultrasound and CT and MRI scans should be instituted in patients who develop chronic abdominal symptoms following laparotomy. Preventive measures against retained instruments must follow strict laid down protocols for surgical instruments handling in theatre.

  17. Chlorogenic Acid Enhances Abdominal Skin Flap Survival Based on Epigastric Artery in Nondiabetic and Diabetic Rats.

    Bagdas, Deniz; Etoz, Betul Cam; Gul, Zulfiye; Ozyigit, Musa Ozgur; Cinkilic, Nilufer; Inan, Sevda; Buyukcoskun, Naciye Isbil; Ozluk, Kasim; Gurun, Mine Sibel

    2016-08-01

    Previous studies showed that chlorogenic acid (CGA) accelerates wound healing via its antioxidant activity. We aimed to investigate the effect of CGA in an experimental epigastric abdominal skin flap model in nondiabetic and diabetic rats. Rats were firstly divided into 2 groups: nondiabetic and diabetic. Diabetes was induced by streptozotocin. Then, 4 subgroups were created for each group: vehicle as well as 0.2 mg/0.5 mL, 1 mg/0.5 mL, and 5 mg/0.5 mL CGA treatments. Right epigastric artery-based abdominal skin flaps were elevated and sutured back into their original position. Chlorogenic acid or vehicle was injected once into the femoral arteries by leaving the epigastric artery as the single artery feeding the flaps during the injection. On postoperative day 7, flap survivals were evaluated, and the rats were killed. Distal flap tissues were collected for histopathological and biochemical assays. Chlorogenic acid showed greater flap survival in both nondiabetic and diabetic rats. Capillary density was increased, and necrosis was reduced in the CGA-treated rats. Chlorogenic acid decreased malondialdehyde levels as well as increased reduced glutathione and superoxide dismutase levels in the flap tissues. This study showed that CGA significantly improved flap survival by its antioxidant activities with intra-arterial local injections. PMID:25356637

  18. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index

    Beckmann, Marianne; Husmann, Marc

    2015-01-01

    Background Central augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures. Aim To assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA). Methods cAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease. Results In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006). Conclusion Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease. PMID:26452151

  19. [Hematoma of the abdominal wall. A case report: pitfall of Seldinger method via femoral artery].

    Hiramatsu, Hisaya; Sugiura, Yasushi; Takeda, Ririko; Nanba, Hiroki

    2009-02-01

    We reported a case of an abdominal wall hematoma which caused by Seldinger method via the femoral artery. A 48-year-old female, suffered from direct carotid cavernous fistula, was treated by transfemoral transvenous embolization (TVE). The whole procedure was completed without difficulty except minor resistance of guide wire manipulation during left femoral artery catheterization. Four hours later, the patient became hypotensive and showed the sign of impending shock without definitive causes. Nine hours after the embolization a huge hematoma of the abdominal wall was found. It required the total 1200 m/ of blood transfusion before her blood pressure returned to normal. She recovered fully from this event and discharged uneventfully. There is a speculation that a deep circumflex iliac artery (DCIA) was injured with an angle-shaped guide wire and bled into the abdominal wall. And subsequent systemic heparinization prevented the coagulation process, resulting a large hematoma. Anatomically, an angle-shaped guide wire is easily able to migrate into DCIA. To prevent a vascular injury, it is very important to manipulate a guide wire under fluoroscopic control and to select a J-shaped guide wire instead of an angle-shaped one. PMID:19227158

  20. An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial

    V. A. Zelinskiy; M. V. Melnikov; A. Ye. Barsukov; Andreev, V. V.

    2014-01-01

    Background. The patients with abdominal aortic calcification have a high risk of cardiocerebral events, but the pathways of them have not been reported so far. The goal of our study was to assess the structure and function of myocardium and to determine the morphological features of carotid artery atherosclerosis in patients with abdominal aortic calcification.Materials and methods. A total of 167 executive patients with peripheral arterial disease were enrolled in study. The study group incl...

  1. The effects of 3-month atorvastatin therapy on arterial inflammation, calcification, abdominal adipose tissue and circulating biomarkers

    18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has the potential to track vascular inflammation and monitor therapeutic response. The purpose of this study was to determine the association between arterial inflammation, calcification and serological biomarkers in subjects with atherosclerosis, and to assess their therapeutic response to 12-week atorvastatin treatment. Forty-three statin-naive subjects with atherosclerosis received atorvastatin (40 mg/day) for 12 weeks and underwent 18F-FDG PET/CT, coronary calcification and abdominal adipose tissue volume measurements. A panel of serological biomarkers was analysed. Arterial inflammation was measured at seven arterial segments and normalized to venous FDG activity to produce target to background ratios (TBR). Thirty-four subjects without cardiovascular disease who repeated PET 1-4 years apart for routine health check-ups were retrospectively evaluated for comparison. The baseline mean TBR values in atherosclerotic patients were positively correlated with age (R = 0.36), body mass index (R = 0.54), abdominal visceral adipose tissue volume (R = 0.65), coronary calcification score (R = 0.40), levels of low-density lipoprotein cholesterol (R = 0.54), matrix metalloproteinase (MMP)-9 (R = 0.46) and fatty acid binding protein 4 (FABP4) (R = 0.67, all p < 0.05). The TBR as well as high-sensitivity C-reactive protein (hsCRP), E-selectin, MMP-9, monocyte chemotactic protein 1, FABP4 and follistatin values were reduced significantly after the 12-week atorvastatin treatment. The TBR reduction marginally correlated with changes in MMP-9 levels (R = 0.56, p = 0.05). The control group, whose median age was younger, by comparison had lower hsCRP and arterial TBR than the subjects with atherosclerosis (all p < 0.05), and moreover had a slight but insignificant increase in mean TBR at their 2.5±0.8 year follow-up. The medium dose of atorvastatin over a 12-week period resulted in a significant reduction of

  2. The effects of 3-month atorvastatin therapy on arterial inflammation, calcification, abdominal adipose tissue and circulating biomarkers

    Wu, Yen-Wen [National Taiwan University Hospital, Department of Internal Medicine, Taipei (China); National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); Kao, Hsian-Li; Chen, Ming-Fong; Lin, Lian-Yu.; Wang, Yi-Chih; Lin, Yen-Hung; Lin, Hung-Ju; Huang, Por-Jau [National Taiwan University Hospital, Department of Internal Medicine, Taipei (China); Huang, Chi-Lun [Tao-Yuan General Hospital, Department of Internal Medicine, Tao-Yuan (China); Tzen, Kai-Yuan; Yen, Ruoh-Fang [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); Chi, Yu-Chiao [National Taiwan University, Graduate Institute of Clinical Medicine, College of Medicine, Taipei (China); Yang, Wei-Shiung [National Taiwan University Hospital, Department of Internal Medicine, Taipei (China); National Taiwan University, Graduate Institute of Clinical Medicine, College of Medicine, Taipei (China)

    2012-03-15

    {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has the potential to track vascular inflammation and monitor therapeutic response. The purpose of this study was to determine the association between arterial inflammation, calcification and serological biomarkers in subjects with atherosclerosis, and to assess their therapeutic response to 12-week atorvastatin treatment. Forty-three statin-naive subjects with atherosclerosis received atorvastatin (40 mg/day) for 12 weeks and underwent {sup 18}F-FDG PET/CT, coronary calcification and abdominal adipose tissue volume measurements. A panel of serological biomarkers was analysed. Arterial inflammation was measured at seven arterial segments and normalized to venous FDG activity to produce target to background ratios (TBR). Thirty-four subjects without cardiovascular disease who repeated PET 1-4 years apart for routine health check-ups were retrospectively evaluated for comparison. The baseline mean TBR values in atherosclerotic patients were positively correlated with age (R = 0.36), body mass index (R = 0.54), abdominal visceral adipose tissue volume (R = 0.65), coronary calcification score (R = 0.40), levels of low-density lipoprotein cholesterol (R = 0.54), matrix metalloproteinase (MMP)-9 (R = 0.46) and fatty acid binding protein 4 (FABP4) (R = 0.67, all p < 0.05). The TBR as well as high-sensitivity C-reactive protein (hsCRP), E-selectin, MMP-9, monocyte chemotactic protein 1, FABP4 and follistatin values were reduced significantly after the 12-week atorvastatin treatment. The TBR reduction marginally correlated with changes in MMP-9 levels (R = 0.56, p = 0.05). The control group, whose median age was younger, by comparison had lower hsCRP and arterial TBR than the subjects with atherosclerosis (all p < 0.05), and moreover had a slight but insignificant increase in mean TBR at their 2.5{+-}0.8 year follow-up. The medium dose of atorvastatin over a 12-week period resulted in a significant

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

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

    2005-01-01

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

  4. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    Blondiaux, Eleonore; Miquel, Julie [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); Thomas, Pascale; Watelet, Jacques [Rouen University Hospital Charles Nicolle, Department of Vascular Surgery, Rouen (France); Laloum, Denis [Caen University Hospital, Pediatric Intensive Care Unit, Department of Neonatal Medicine, Caen (France); Dacher, Jean-Nicolas [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine et Pharmacie, Laboratoire Quant-If, Rouen Cedex 01 (France)

    2008-02-15

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  5. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  6. Evaluation of MR angiography and blood flow measurement in abdominal and peripheral arterial occlusive disease

    To assess the characteristics of blood flow measurement with MR Angiography (MRA) to evaluate the status of vascular stenoses, two or three dimensional time-of-flight MRA and velocity-encoded cine MR were performed in the 230 segments of 35 patients, with abdominal and peripheral arterial occlusive diseases. In 11 of these 35 patients digital subtraction angiography was additionally underwent, and the stenotic findings was compared with MRA. There were 17 segments in which the velocity could not be measured, because the blood flow exceeded the upper limit of peak-encoded velocity (VENC) which was set at 120 cm/sec. Therefore, it is necessary to set the upper limit of VENC at higher than 120 cm/sec. There were 11 stenotic findings in DSA and 20 stenotic findings in MRA. Pulsatility Index (PI=(max velocity-min. velocity)/average velocity) were used for evaluating the blood flow waveform, and there were significant difference between the 11 stenotic findings of DSA and the others'. In summery, MRA was considered as useful examination to assess the degree of the vascular stenoses in abdominal and peripheral arterial occlusive disease. (author)

  7. Evaluation of MR angiography and blood flow measurement in abdominal and peripheral arterial occlusive disease

    Tabuchi, Kenji [Dokkyo Univ. School of Medicine, Mibu, Tochigi (Japan)

    2000-03-01

    To assess the characteristics of blood flow measurement with MR Angiography (MRA) to evaluate the status of vascular stenoses, two or three dimensional time-of-flight MRA and velocity-encoded cine MR were performed in the 230 segments of 35 patients, with abdominal and peripheral arterial occlusive diseases. In 11 of these 35 patients digital subtraction angiography was additionally underwent, and the stenotic findings was compared with MRA. There were 17 segments in which the velocity could not be measured, because the blood flow exceeded the upper limit of peak-encoded velocity (VENC) which was set at 120 cm/sec. Therefore, it is necessary to set the upper limit of VENC at higher than 120 cm/sec. There were 11 stenotic findings in DSA and 20 stenotic findings in MRA. Pulsatility Index (PI=(max velocity-min. velocity)/average velocity) were used for evaluating the blood flow waveform, and there were significant difference between the 11 stenotic findings of DSA and the others'. In summery, MRA was considered as useful examination to assess the degree of the vascular stenoses in abdominal and peripheral arterial occlusive disease. (author)

  8. An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial

    V. A. Zelinskiy

    2014-07-01

    Full Text Available Background. The patients with abdominal aortic calcification have a high risk of cardiocerebral events, but the pathways of them have not been reported so far. The goal of our study was to assess the structure and function of myocardium and to determine the morphological features of carotid artery atherosclerosis in patients with abdominal aortic calcification.Materials and methods. A total of 167 executive patients with peripheral arterial disease were enrolled in study. The study group included 85 patients with abdominal aortic calcification (men – 95.3 %; age median was – 66.6 ± 12. Control group included 82 patients without objective signs of abdominal aortic calcification. Abdominal aortic calcification was detected by CT imaging. All patients have undergone echocardiography and duplex scanning of carotid arteries.Results. Prevalence and severity of ischemic heart disease and cerebrovascular disease were statistically significant higher in patients with abdominal aortic calcification (91.7, 65.8 % vs. 67, 37.3 % (р < 0.01. We have found statistically significant differences between groupsin heart structure and function. A high left ventricular wall thickness (р < 0.01, left atrium dilation (р < 0.01 and enhanced of left ventricular mass (р < 0.05, ejection fraction reduction (р < 0.05 and more common diastolic dysfunction (р < 0.05 were determined inpatients with abdominal aortic calcification. An intima-media thickness of the common carotid artery was significantly higher in study group patients (1.38 ± 0.07 mm vs. 1.14 ± 0.06 mm (р < 0.001.Conclusion. Our findings suggested that abdominal aortic calcification is main reason of hypertrophy and dilation in the left heart due to enhanced peripheral resistance. Hypertrophy and dilation in the left heart is provided a high risk of cardiovascular events in patients withabdominal aortic calcification.

  9. A Case of Ischemic Duodenitis Associated with Superior Mesenteric Artery Syndrome Caused by an Abdominal Aortic Aneurysm

    OKUYAMA, Yusuke; Kawakami, Takumi; Ito, Haruki; Otsuka, Hirotomo; Enoki, Yasuyuki; Nishimura, Masahito; Yoshida, Norimasa; Fujimoto, Sotaro

    2011-01-01

    A 74-year-old woman was admitted to our hospital with upper abdominal pain and bloody vomiting. An abdominal aneurysm compressed the third portion of the duodenum and the second portion of duodenum was distended with thickened walls as in superior mesenteric artery syndrome. Endoscopic examination showed an edematous mucosa with hemorrhagic erosions, shallow longitudinal ulcers, and star-shaped ulcers in the duodenum. We diagnosed this case as ischemic duodenitis associated with superior mese...

  10. The diagnosis of bilateral renal artery thrombosis due to circular rupture of the intima following blunt abdominal trauma

    A case of bilateral renal artery thrombosis due to circular rupture of the intima following blunt abdominal trauma is reported. A further 15 published cases are tabulated. The pathogenetic mechanism, symptoms, course and value of various diagnostic techniques are discussed. The importance of early and specific radiological diagnosis is stressed and the value of angiography is pointed out. The literature is quoted extensively. (orig.)

  11. Comparison between plain abdominal radiographs and CT in patients with blunt abdominal trauma

    Plain abdominal radiographs (PAR) and CT in 186 cases of blunt abdominal trauma were reviewed. In the group of normal PAR, CT was normal in 56 cases (30%) and CT was abnormal in 9 (5%). They were all treated conservatively and had on uneventful course. It can be said that possibility of missing significant injury in cases of normal PAR is minimal. Both PAR and CT were abnormal in 88 cases (47%). All patients treated surgically were included in this group. CT is indicated in this group. False negative CT results were seen in 13 cases (7%). It consisted of minor fractures and had no clinical significance. False positive PAR findings were seen in 32 cases (18%). PAR is suitable as the first modality of choice. Among various findings on PAR, obliteration of organs and intraperitoneal fluid collection suggested abdominal injury most frequently. Thorough work-up is necessary when such findings were recognized on PAR. There was no relationship between abnormal injury and specific fractures as has been described in previous reports. (author)

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

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

    2016-07-01

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

  13. Expanding hematoma of the abdominal walI caused by spontaneous rupture of a deep circumflex iliac artery: report of a case treated by coil embolization

    Baik, Jun Hyun; Park, Young Ha; Jeon, Jung Soo; Hwang, Sung Soo; Ihn, Yon Kwon [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-06-01

    Abdominal wall hematoma is a rare but well-known disease, usually caused by trauma or, on rare occasions, occurring spontaneously. Hematomas of the rectus sheath and the anterolateral abdominal wall are commonly associated with injury to the inferior epigastric artery and the deep circumflex iliac artery, respectively. The diagnosis of spontaneously developed abdominal wall hematoma is sometimes delayed, due its clinical manifestations being similar to those of other causes of the acute abdomen. CT and angiography can be helpful in the diagnosis of the hematoma and the injured vessel. Herein, we report on a rare case of a spontaneously developed anterolateral abdominal wall hematoma treated with microcoil embolization of the left deep circumflex iliac artery.

  14. Expanding hematoma of the abdominal walI caused by spontaneous rupture of a deep circumflex iliac artery: report of a case treated by coil embolization

    Abdominal wall hematoma is a rare but well-known disease, usually caused by trauma or, on rare occasions, occurring spontaneously. Hematomas of the rectus sheath and the anterolateral abdominal wall are commonly associated with injury to the inferior epigastric artery and the deep circumflex iliac artery, respectively. The diagnosis of spontaneously developed abdominal wall hematoma is sometimes delayed, due its clinical manifestations being similar to those of other causes of the acute abdomen. CT and angiography can be helpful in the diagnosis of the hematoma and the injured vessel. Herein, we report on a rare case of a spontaneously developed anterolateral abdominal wall hematoma treated with microcoil embolization of the left deep circumflex iliac artery

  15. The feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization for benign diseases of uterus

    Objective: To investigate the feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization (UAE) for uterine fibroids and adenomyosis. Methods: Trans-abdominal biopsies by ultrasound guiding were performed in 62 cases of uterine fibroids or adenomyosis diagnosed pre-UAE. Multi-points in focus were punctured in single lesion and multi-points in every focus of multiple lesions were punctured. The diagnosis before UAE was made according to clinical symptoms, pelvic ultrasound and pelvic magnetic resonance imaging (MRI). The pathological diagnosis by biopsy was comparative to its clinical diagnosis before biopsy. The complications were also observed. Results: Biopsies were performed successfully in 60 cases with pathological examination, including 52 uterine fibroids and 8 adenomyosis cases. The clinical diagnosis of uterine fibroids or adenomyosis was coincident with the pathology except 2 cases of fibroids diagnosed before biopsy were failed to puncture. Conclusion: Trans-abdominal biopsy by ultrasound guiding in uterine artery embolization for benign diseases of uterus is safe and feasible. (authors)

  16. Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report

    Jaha Luan

    2011-08-01

    Full Text Available Abstract Introduction Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. Case presentation Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. Conclusion In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.

  17. Anatomical description of arterial branches of thoracic and abdominal aorta in the coati (Nasua nasua (Carnivora, Procyonidae

    Daniel Arrais Biihrer

    2015-05-01

    Full Text Available The coati (Nasua nasua is a widely distributed species in South America, also in Brazil. This study aimed to observe and describe the branching morphology of the main arterial branches of thoracic and abdominal aorta in the coati, by comparing the findings with existing literature on the other domestic and wild species. For this study, two adult male specimens were used, collected from highways in the state of Minas Gerais, Brazil, victims of roadkill. The specimens were fixed in formalin solution and their aortic branches were filled with latex for subsequent dissection and analysis. It was observed that the left subclavian artery is a direct branch of the aortic arch, there is no formation of a bicarotid or celiac-mesenteric trunk, facts similarly described in domestic carnivores. Thus, it was noticed that the arterial branches of aorta in the coati, both in the thoracic and abdominal cavities, show a distribution very similar to that observed in domestic carnivores, something which reflects their evolutionary closeness within the Carnivora order. Thus, this study proves to be relevant by deepening anatomical knowledge on this wild species, enabling that aspects already known in canine veterinary medicine are applied to the coati.

  18. Early intestinal changes following abdominal radiotherapy. Comparison of endpoints

    Purpose: To compare tests for intestinal function with clinical scores after abdominal irradiation. Patients and Methods: At the Department of Radiotherapy, Erfurt, Germany, intestinal changes were studied in 91 patients receiving abdominal radiotherapy between 1992 and 1996. Conventional fractionation (1.8-2 Gy per fraction, total doses 30.6-62.5 Gy) was applied. Before and at weekly intervals during radiotherapy, the clinical response was scored according to RTOG/EORTC for the upper and lower gastrointestinal (GI) tract. REsorption tests for vitamin B12 and D-xylose were performed before the onset and immediately after treatment. Results: The clinical response displayed a well-defined dose-effects relationship with grade 1 effects in 5% and 50% of the patients at about 10 Gy and 50 Gy, respectively. For grade 2 reactions, 5%- and 50%-effective doses were 20-30 Gy and 60-80 Gy. Effects in the upper and lower GI tract were highly correlated. Changes in body weight did not show a correlation with other clinical symptoms. Changes in resorption also displayed a significant dose effect. However, no correlation was found with the clinical symptoms in the individual patient. Conclusion: In the present study, the clinical manifestation of intestinal side effects according to RTOG/EORTC criteria was reflected by neither the vitamin B12 nor by the D-xylose resorption test. Hence, these tests cannot be regarded as useful for objective quantitation of intestinal radiation injury. (orig.)

  19. Hepatic arterial pseudoaneurysm: a rare complication of blunt abdominal trauma in children

    We report a child who developed a hepatic artery pseudoaneurysm following blunt hepatic injury. This is a rare complication of hepatic trauma in children. The imaging evaluation and clinical management of hepatic artery pseudoaneurysms are presented. (orig.)

  20. Non-invasive continuous arterial pressure and pulse pressure variation measured with Nexfin(®) in patients following major upper abdominal surgery: a comparative study.

    de Wilde, R B P; de Wit, F; Geerts, B F; van Vliet, A L; Aarts, L P H J; Vuyk, J; Jansen, J R C

    2016-07-01

    We compared the accuracy and precision of the non-invasive Nexfin(®) device for determining systolic, diastolic, mean arterial pressure and pulse pressure variation, with arterial blood pressure values measured from a radial artery catheter in 19 patients following upper abdominal surgery. Measurements were taken at baseline and following fluid loading. Pooled data results of the arterial blood pressures showed no difference between the two measurement modalities. Bland-Altman analysis of pulse pressure variation showed significant differences between values obtained from the radial artery catheter and Nexfin finger cuff technology (mean (SD) 1.49 (2.09)%, p agreement -2.71% to 5.69%). The effect of volume expansion on pulse pressure variation was identical between methods (concordance correlation coefficient 0.848). We consider the Nexfin monitor system to be acceptable for use in patients after major upper abdominal surgery without major cardiovascular compromise or haemodynamic support. PMID:27291598

  1. Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive

    Recio-Rodriguez Jose I

    2012-02-01

    Full Text Available Abstract Background Our aim was to analyze the relationship between abdominal obesity and general obesity, with subclinical atherosclerosis, arterial stiffness and wave reflection in healthy, diabetics and hypertensive subjects. Methods A cross-sectional descriptive study was made of 305 individuals (diabetics 32.8%, hypertensive subjects 37.0% and healthy individuals 30.2%. Measurements: Body mass index (BMI, waist circumference (WC, body fat percentage (BFP and waist/height ratio (WHtR. Arterial stiffness was assessed according to pulse wave velocity (PWV, intima-media thickness of the common carotid artery (C-IMT, augmentation index (central and peripheral, ankle-brachial index (ABI, and central and peripheral pulse pressure. Results WC and WHtR showed a positive correlation to PWV and C-IMT in the studied groups. After adjusting for age, gender, high sensitivity c-reactive protein, serum glucose and the presence of diabetes, hypertension, smoking, dyslipidemia, antidiabetic drugs, lipid-lowering drugs, and atherosclerotic plaques, it was seen that for every 0.1 point increase in WHtR, and for every cm increase in WC, the PWV increased 0.041 and 0.029 m/sec, and C-IMT increased 0.001 mm and 0.001 mm, respectively. Conclusions The measures of abdominal obesity (WHtR and WC correlates better than BMI and BFP with arterial stiffness evaluated by PWV, and with subclinical atherosclerosis evaluated by C-IMT, independently of the presence of diabetes or hypertension. Trial Registration Clinical Trials.gov Identifier: NCT01325064

  2. Endovascular therapy for abdominal aortic aneurysm and iliac artery aneurysm using SEAL aortic stent-graft: A single center experience

    Park, Su Young; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin Mo; Choi, Sang Tae; Park, Jae Hyung [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2015-03-15

    The aim of this study was to evaluate the safety and efficacy of SEAL aortic stent-graft for abdominal aortoiliac aneurysms. Between October 2007 and January 2014, 33 patients with abdominal aortoiliac aneurysms were treated with SEAL aortic stent-graft. We evaluated the technical success rate, clinical and CT follow-up periods, major complications, need for additional interventional treatment, aneurysm-related mortality and clinical success rate. SEAL bifurcated aortic stent-graft was successfully placed in 32 patients (97%). Clinical and CT follow-up periods were 24 and 14 months, respectively. Endoleak developed in 13 patients (41%): spontaneous regression or decrease in 6, need for additional treatment in 4 and follow-up loss in 3. Significant stenosis of stent-graft occurred in 4 patients (12%) and was treated with stenting in 3. Migration of stent-graft was noted in 3 patients (9%) and treated with additional stent-grafting. Aneurysm-related mortality was 9% (3 of 33). The placement of SEAL stent-graft was effective in 26 patients (79%). The placement of SEAL aortic stent-graft was safe and effective in patients with aneurysms of abdominal aorta and iliac arteries. However, complicating endoleaks, stenosis and migration of the stent-graft developed during the follow-up. Therefore, regular CT follow-up seems to be mandatory.

  3. Endovascular therapy for abdominal aortic aneurysm and iliac artery aneurysm using SEAL aortic stent-graft: A single center experience

    The aim of this study was to evaluate the safety and efficacy of SEAL aortic stent-graft for abdominal aortoiliac aneurysms. Between October 2007 and January 2014, 33 patients with abdominal aortoiliac aneurysms were treated with SEAL aortic stent-graft. We evaluated the technical success rate, clinical and CT follow-up periods, major complications, need for additional interventional treatment, aneurysm-related mortality and clinical success rate. SEAL bifurcated aortic stent-graft was successfully placed in 32 patients (97%). Clinical and CT follow-up periods were 24 and 14 months, respectively. Endoleak developed in 13 patients (41%): spontaneous regression or decrease in 6, need for additional treatment in 4 and follow-up loss in 3. Significant stenosis of stent-graft occurred in 4 patients (12%) and was treated with stenting in 3. Migration of stent-graft was noted in 3 patients (9%) and treated with additional stent-grafting. Aneurysm-related mortality was 9% (3 of 33). The placement of SEAL stent-graft was effective in 26 patients (79%). The placement of SEAL aortic stent-graft was safe and effective in patients with aneurysms of abdominal aorta and iliac arteries. However, complicating endoleaks, stenosis and migration of the stent-graft developed during the follow-up. Therefore, regular CT follow-up seems to be mandatory.

  4. Aortoiliac Artery Reconstruction Using Bilateral Reversed Superficial Femoral Veins for an Infected Abdominal Aortic Aneurysm

    Hirai, Hanako; Yasuhara, Kiyomitsu; Hatori, Kyohei; Miki, Takao; Obayashi, Tamiyuki

    2016-01-01

    Surgical treatment of an infected abdominal aortic aneurysm (IAAA) is difficult and the ideal graft material is a subject of debate. A 60-year-old man with untreated diabetes mellitus was referred to our hospital presenting with fever and left lower abdominal pain. The patient was diagnosed with an IAAA by blood culture and computed tomography. We treated the patient surgically for the IAAA using bilateral reversed superficial femoral veins which were shaped into a bifurcated graft. No signs of recurrent infection or aneurysmal dilation were observed for 3 years after the procedure. PMID:27087879

  5. Abdominal Skin Rash After TACE Due to Non-Target Embolization of Hepatic Falciform Artery

    Nagpal, Prashant; Bhalala, Mitesh; Vidholia, Aditi; Sao, Rahul; Sharma, Nisha; Mehta, Dhruv; McCabe, Sam; Bodin, Roxana

    2016-01-01

    Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had sli...

  6. The role of early identification of superior mesenteric artery in a modified technique for retrieval of abdominal organs for transplantation

    Abdominal organ recovery has undergone important changes in concepts and practice in recent years, most importantly in the combined approach to retrieve the liver and pancreas by one surgical team. We studied retrospectively 81 organ donors and their respective recipients that were performed from 1996-1997. We compared the results of organ function, morbidity, mortality and operative time of two different surgical techniques. Besides the standard technique (group1), we used a new technique (group2) that involves pre cross-clamp identification of the superior mesenteric artery (SMA). There was no significant difference in organ function parameters between the two groups supporting the safety of new technique. However, there was a 50% reduction in the time needed to achieve aortic cross clamping with the new technique. We conclude that this new technique is safe to apply, distinct in reducing organ retrieval time and easy to learn. (author)

  7. Clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in the resection of sacral tumors

    Objective: To investigate the clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in performing the surgical resection of sacral tumors. Methods: Conventional surgical excision of sacral tumors was employed in 24 patients with sacral tumors (control group), while preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta was carried out in 32 patients with sacral tumors (study group). The operation time, blood loss during the surgery and the one-year recurrence rate of both groups were documented, and the results were statistically analyzed. Results: Angiography showed that in the study group the sacral tumors were supplied by several vessels, and these feeding arteries were occluded separately. The tumors were successfully removed in all patients with the help of intraoperative balloon occlusion of the abdominal aorta. During the surgery, the surgical area was clearly exposed and the blood loss wa remarkably reduced. After the surgery, no ectopic vascular embolization, renal ischemia, limb ischemia or other complications occurred. Statistically significant difference in the operation time, blood loss during the surgery and the one-year recurrence rate existed between the two groups (P<0.05). Conclusion: Preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta can effectively shorten the operation time, reduce the blood loss during the surgery and provide a clear surgical field, and thus the surgical safety can be significantly ensured. (authors)

  8. Comparison of CAD risk factors in abdominal obesity versus General obesity with normal WC in adult males

    Objective: To compare the presence of coronary artery disease risk factors in patients with abdominal obesity versus generalised obesity and to determine the probability of developing the disease in both groups. Methods: The cross-sectional study was carried out at the Department of Medicine, Combined Military Hospital, Okara, from January 2012 to April 2013. Using consecutive sampling, 785 outdoor healthy adult males were enrolled. Body mass index >25kg/m/sup 2/ and waist circumference >90cm defined obesity and abdominal obesity respectively. Blood pressure >140/90mmHg defined Hypertension. All the subjects underwent BSF, electrocardiogram, Lipid profile, personality and physical activity assessment. Risk estimation was done using Eric Brittain scoring system. Data was analysed using SPSS 16. Results: In patients with abdominal obesity, 583 (99.2 %) individuals had at least 1 risk factor for coronary artery disease, while in those with generalised obesity this prevalence was 96.5% (n=191). In patients with abdominal obesity, 52.9% had more than 4% risk of developing the disease in the next 6 years compared to 36.9% individuals with generalised obesity. Conclusion: Both increasing body mass index and waist circumference are associated with increased risk of developing coronary artery disease, with significantly higher risk prevalence in the latter group. Moreover, those with abdominal obesity had a higher risk of developing CAD in next 6 years as compared to those with generalised obesity. Thus waist circumference offers additional prognostic information beyond body mass index. (author)

  9. CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease

    An, Chansik; Lee, Hye-Jeong; Ahn, Sung Soo; Choi, Byoung Wook; Kim, Myeong-Jin; Chung, Yong Eun [Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, 50 Yonsei-Ro, Seodaemun-Gu, Seoul (Korea, Republic of); Lee, Hye Sun [Yonsei University College of Medicine, Biostatistics Collaboration Unit, Department of Research Affairs, Seoul (Korea, Republic of)

    2014-10-15

    To assess the value of a CT-based abdominal aortic calcification (AAC) score as a surrogate marker for the presence of asymptomatic coronary artery disease (CAD). The AAC scores of 373 patients without cardiac symptoms who underwent both screening coronary CT angiography and abdominal CT within one year were calculated according to the Agatston method. Logistic regression was used to derive two multivariate models from traditional cardiovascular risk factors, with and without AAC scores, to predict the presence of CAD. The AAC score and the two multivariate models were compared by calculating the area under the receiver operating characteristic curve (AUC) and the net reclassification improvement (NRI). The AAC score alone showed a marginally higher AUC (0.823 vs. 0.767, P = 0.061) and significantly better risk classification (NRI = 0.158, P = 0.048) than the multivariate model without AAC. The multivariate model using traditional factors and AAC did not show a significantly higher AUC (0.832 vs. 0.823, P = 0.616) or NRI (0.073, P = 0.13) than the AAC score alone. The optimal cutoff value of the AAC score for predicting CAD was 1025.8 (sensitivity, 79.5 %; specificity, 75.9 %). AAC scores may serve as a surrogate marker for the presence or absence of asymptomatic CAD. (orig.)

  10. CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease

    To assess the value of a CT-based abdominal aortic calcification (AAC) score as a surrogate marker for the presence of asymptomatic coronary artery disease (CAD). The AAC scores of 373 patients without cardiac symptoms who underwent both screening coronary CT angiography and abdominal CT within one year were calculated according to the Agatston method. Logistic regression was used to derive two multivariate models from traditional cardiovascular risk factors, with and without AAC scores, to predict the presence of CAD. The AAC score and the two multivariate models were compared by calculating the area under the receiver operating characteristic curve (AUC) and the net reclassification improvement (NRI). The AAC score alone showed a marginally higher AUC (0.823 vs. 0.767, P = 0.061) and significantly better risk classification (NRI = 0.158, P = 0.048) than the multivariate model without AAC. The multivariate model using traditional factors and AAC did not show a significantly higher AUC (0.832 vs. 0.823, P = 0.616) or NRI (0.073, P = 0.13) than the AAC score alone. The optimal cutoff value of the AAC score for predicting CAD was 1025.8 (sensitivity, 79.5 %; specificity, 75.9 %). AAC scores may serve as a surrogate marker for the presence or absence of asymptomatic CAD. (orig.)

  11. Abdominal Skin Rash After TACE Due to Non-Target Embolization of Hepatic Falciform Artery

    Bhalala, Mitesh; Vidholia, Aditi; Sao, Rahul; Sharma, Nisha; Mehta, Dhruv; McCabe, Sam; Bodin, Roxana

    2016-01-01

    Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had slight skin induration and an excoriated papule at 6-month follow-up. Non-target embolization of HFA is very rare, but clinicians and interventionalists should be aware of this complication, especially in patients predisposed to enlargement of HFA. PMID:27144210

  12. Prevalence and prognosis of asymptomatic coronary artery disease in patients with abdominal aortic aneurysm and minor or no perioperative risks

    According to the American Heart Association (AHA)/ American College of Cardiology (ACC) guideline 2002, patients with abdominal aortic aneurysm (AAA) with minor or no clinical risk for perioperative cardiovascular events require no preoperative coronary assessment if they have functional capacity greater than 4 METS. Further coronary assessment is not often performed, even after the operation, because of absence of symptoms. The aim of this study was to clarify the prevalence, and prognosis of asymptomatic coronary artery disease (CAD) in such AAA patients. From 2002 to 2006, 201 patients (161 men; mean age 73.1±7.7 years) were classified as minor or no clinical risk for perioperative cardiovascular events. Medical history, and physical, laboratory, plus imaging examinations were evaluated. Prognosis was assessed by telephone canvass. Asymptomatic CAD was found in 59 patients (29.4%). By multivariate analysis, advanced age (≥75 years: odds ratio (OR) 2.43, P=0.018) and family history of CAD (OR 5.27, P=0.001) independently predicted asymptomatic CAD. Asymptomatic CAD did not significantly affect death or cardiac events when treated appropriately. A high prevalence of asymptomatic CAD requiring treatment was shown in these AAA patients. Under appropriate therapies, prognosis was as well preserved as in patients without asymptomatic CAD, which underscored the importance of appropriate assessment and management of asymptomatic CAD. (author)

  13. Hybrid treatment of bullet embolism at the abdominal aortic bifurcation, complicated with thoracoabdominal aorta pseudoaneurysm and common iliac artery occlusion: case report

    Patrick Bastos Metzger

    2014-03-01

    Full Text Available Embolization due to a firearm projectile entering the bloodstream is a rare event that is unlikely to be suspected during initial treatment of trauma patients. We describe and discuss a case of bullet embolism of the abdominal aortic bifurcation, complicated by a pseudoaneurysm of the thoracoabdominal aorta and occlusion of the right common iliac artery, but successfully treated using a combination of endovascular methods and conventional surgery.

  14. Effects of a home-based exercise program in body composition, abdominal fat and lipid profile in patients with coronary artery disease

    Pinto, Joana; Noites, Andreia; Freitas, Carla Patrícia; Melo, Cristina; Albuquerque, Aníbal; Teixeira, Madalena

    2015-01-01

    Introduction: Coronary artery disease and aging seems to be associated with a sedentary lifestyle, contributing to increased abdominal fat and consequently metabolic complications. The exercise can break this cycle by stimulating lipolysis and the use of fatty acids. In Europe there is still a lack of cardiac rehabilitation programmes in hospitals, therefore, this study aims to demonstrate the advantages of implementing home-based exercise programmes, as well as, their effects on cardiovascul...

  15. Trans-abdominal monitoring of fetal arterial blood oxygenation using pulse oximetry

    Zourabian, Anna; Siegel, Andrew M.; Chance, Britton; Ramanujam, Nirmala; Rode, Martha; Boas, David A.

    2000-10-01

    Pulse oximetry (oxygen saturation monitoring) has markedly improved medical care in many fields, including anesthesiology, intensive care, and newborn intensive care. In obstetrics, fetal heart rate monitoring remains the standard for intrapartum assessment of fetal well being. Fetal oxygen saturation monitoring is a new technique currently under development. It is potentially superior to electronic fetal heart rate monitoring (cardiotocography) because it allows direct assessment of both the fetal oxygen status and fetal tissue perfusion. Here we present the analysis for determining the most optimal wavelength selection for pulse oximetry. The wavelengths we chose as the most optimal are the first in the range of 670 - 720 nm and the second in the range of 825 - 925 nm. Further, we discuss the possible systematic errors during our measurements and their contribution to the obtained saturation results. We present feasibility studies for fetal pulse oximetry, monitored noninvasively through the maternal abdomen. Our preliminary experiments show that the fetal pulse can be discriminated from the maternal pulse and thus, in principle, the fetal arterial oxygen saturation can be obtained. We present the methodology for obtaining these data, and discuss the dependence of our measurements on the fetal position with respect to the optode assembly.

  16. Multidetector row CT angiography of the abdominal aorta and lower extremities in patients with peripheral arterial occlusive disease: diagnostic accuracy and interobserver agreement

    Romano, Maurizio E-mail: maurizio.romano@mailcmn.area.na.cnr.it; Mainenti, Pier Paolo; Imbriaco, Massimo; Amato, Bruno; Markabaoui, Karim; Tamburrini, Oscar; Salvatore, Marco

    2004-06-01

    Purpose: To evaluate the accuracy of four channel multidetector row CT angiography (MDCTA) of the abdominal aorta and lower extremities arteries compared with digital subtraction angiography (DSA). Materials and methods: In our prospective study 42 patients with peripheral vascular occlusive disease (27 M, 15 F, age range 40-79 years) underwent MDCTA and DSA within 5 days. Images were blindly interpreted by two radiologists. Maximum intensity projections (MIP), multiplanar (MPR) reformations, three-dimensional (3D) reconstructions as well as axial images were available for analysis of MDCTA. DSA were analyzed on hard copies. Results: Overall sensitivity and specificity of MDCTA were 93 and 95%, respectively, with positive and negative predictive values of 90 and 97%. Overall diagnostic accuracy was 94%. Normal arterial segments and 100% occlusions were correctly identified in all cases by MDCTA. Moderately stenotic segments interpretation in the calves appeared to be more controversial, but no statistical difference in accuracy of MDCTA in the infrapopliteal district arteries was noted with respect to accuracy in the more proximal arterial bed. Good to excellent interobserver and intraobserver agreement were observed, with k values greater than 0.80. Conclusions: MDCTA of the abdominal aorta and lower extremities is an accurate imaging modality in clinical practice when compared with DSA.

  17. Detecção de hipertensão arterial em adolescentes através de marcadores gerais e adiposidade abdominal Detección de hipertensión arterial en adolescentes por medio de marcadores generales y adiposidad abdominal High blood pressure detection in adolescents by clustering overall and abdominal adiposity markers

    Diego G. D Christofaro

    2011-06-01

    Full Text Available FUNDAMENTO: A obesidade está ligada à hipertensão arterial (HA na infância. Entretanto, o papel da gordura como preditor de HA em adolescentes permanece desconhecido. OBJETIVO: Investigar a associação entre obesidade geral e abdominal com HA e identificar a sensibilidade e especificidade desses indicadores para detectar HA em adolescentes. MÉTODOS: A amostra consistiu em 1.021 adolescentes com idade de 10-17 anos. Os indivíduos foram classificados como normal, sobrepeso/obesidade, de acordo com as medidas do IMC, e como não-obeso com obesidade abdominal, de acordo com as medidas da circunferência da cintura (CC. A pressão arterial sistólica (PAS e diastólica (PAD foi avaliada através de um dispositivo oscilométrico. Regressão logística e curvas ROC foram usadas na análise estatística. RESULTADOS: A prevalência geral de HA foi 11,8% (13,4% em meninos e 10,2% em meninas. A prevalência de HA em meninos e meninas com sobrepeso/obesidade foi 10% e 11,1%, respectivamente. A prevalência de HA em meninos com obesidade abdominal foi 28,6%. Para ambos os sexos, o odds ratio (OR para HA foi mais alto na obesidade abdominal do que no sobrepeso/obesidade geral (4,09 [OR IC95% = 2,57-6,51] versus 1,83 [OR IC95% = 1,83-4,30]. O OR para HA foi mais alto quando sobrepeso/obesidade geral e obesidade abdominal estavam agrupados (OR = 4,35 [OR IC95% = 2,68 -7,05], do que quando identificados como sobrepeso/obesidade geral ou obesidade abdominal apenas (OR = 1,32 [OR IC95% = 0,65- 2,68]. Entretanto, ambos os tipos de obesidade apresentavam baixo poder preditivo na detecção de HA. CONCLUSÃO: Obesidade geral e obesidade abdominal foram associadas com HA; entretanto, a sensibilidade e especificidade dessas variáveis na detecção de HA são baixas em adolescentes brasileiros.BACKGROUND: Obesity is linked to high blood pressure (HBP in childhood. However, the role of fat as a predictor of HBP in adolescents remains unknown. OBJECTIVE: To

  18. Value of Single-Dose Contrast-Enhanced Magnetic Resonance Angiography Versus Intraarterial Digital Subtraction Angiography in Therapy Indications in Abdominal and Iliac Arteries

    The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committee was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30o, field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses ≥50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies

  19. Detecção de hipertensão arterial em adolescentes através de marcadores gerais e adiposidade abdominal

    Diego G. D Christofaro

    2011-06-01

    Full Text Available FUNDAMENTO: A obesidade está ligada à hipertensão arterial (HA na infância. Entretanto, o papel da gordura como preditor de HA em adolescentes permanece desconhecido. OBJETIVO: Investigar a associação entre obesidade geral e abdominal com HA e identificar a sensibilidade e especificidade desses indicadores para detectar HA em adolescentes. MÉTODOS: A amostra consistiu em 1.021 adolescentes com idade de 10-17 anos. Os indivíduos foram classificados como normal, sobrepeso/obesidade, de acordo com as medidas do IMC, e como não-obeso com obesidade abdominal, de acordo com as medidas da circunferência da cintura (CC. A pressão arterial sistólica (PAS e diastólica (PAD foi avaliada através de um dispositivo oscilométrico. Regressão logística e curvas ROC foram usadas na análise estatística. RESULTADOS: A prevalência geral de HA foi 11,8% (13,4% em meninos e 10,2% em meninas. A prevalência de HA em meninos e meninas com sobrepeso/obesidade foi 10% e 11,1%, respectivamente. A prevalência de HA em meninos com obesidade abdominal foi 28,6%. Para ambos os sexos, o odds ratio (OR para HA foi mais alto na obesidade abdominal do que no sobrepeso/obesidade geral (4,09 [OR IC95% = 2,57-6,51] versus 1,83 [OR IC95% = 1,83-4,30]. O OR para HA foi mais alto quando sobrepeso/obesidade geral e obesidade abdominal estavam agrupados (OR = 4,35 [OR IC95% = 2,68 -7,05], do que quando identificados como sobrepeso/obesidade geral ou obesidade abdominal apenas (OR = 1,32 [OR IC95% = 0,65- 2,68]. Entretanto, ambos os tipos de obesidade apresentavam baixo poder preditivo na detecção de HA. CONCLUSÃO: Obesidade geral e obesidade abdominal foram associadas com HA; entretanto, a sensibilidade e especificidade dessas variáveis na detecção de HA são baixas em adolescentes brasileiros.

  20. Gasometria arterial e inflamação pulmonar de ratos com diferentes tempos de sepse abdominal Arterial gasometry and lung inflammation in rats with different times of abdominal sepsis

    Sérgio Luiz Rocha

    2007-03-01

    Full Text Available RACIONAL: Sepse é a principal causa de morbi-mortalidade nas vítimas de trauma e em pacientes cirúrgico e apesar de toda tecnologia e terapêutica disponível não há diminuição nestas estatísticas. OBJETIVOS: Avaliar as repercussões ácido-básicas e o grau de injúria pulmonar decorrentes de sepse abdominal em ratos após seis e 24 horas de peritonite fecal através da ligadura e punção do ceco. MÉTODOS: Foram utilizados 40 ratos Wistar, machos, adultos. A amostra foi dividida aleatoriamente em quatro grupos: grupo A (sham/6 h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo B (sham/24h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo C (LPC/6 h - n=15 submetidos à ligadura e punção do ceco e grupo D (LPC/24h - n=15 submetidos à ligadura e punção do ceco. Após seis ou 24 horas, conforme o grupo em estudo, os animais foram novamente anestesiados e submetidos as seguintes análises: observação clínica de sinais de sepse, laparotomia através do mesmo acesso anterior e realização de cultura do líquido peritoneal e punção cardíaca para obtenção de amostra sangüínea suficiente para gasometria arterial, hematócrito e leucometria. Procedeu-se eutanásia e os pulmões retirados para análise de edema pulmonar e o infiltrado inflamatório. RESULTADOS: Ocorreram quatro óbitos no grupo D. Verificou-se, em todos os grupos, a presença de acidose mista. Comparando os grupos experimento 6h versus controle 6h foram encontradas duas variáveis significativas - HCO3 (p=0,0015 e BE (p=0,0015 -, demonstrando acidose metabólica mais grave no grupo experimento. Nos grupos controle também se confirmou acidose mista, devido às alterações das variáveis HCO3 (p=0,0079, PO2 (p=0,0079 e SO2 (p=0,0079. A correlação entre o grau de comprometimento pulmonar e o estado metabólico confirma a existência de resposta inflamatória sist

  1. Is prophylactic embolization of the hepatic falciform artery needed before radioembolization in patients with {sup 99m}Tc-MAA accumulation in the anterior abdominal wall?

    Ahmadzadehfar, Hojjat; Sabet, Amir; Muckle, Marianne; Haslerud, Torjan; Biersack, Hans Juergen; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Moehlenbruch, Markus; Meyer, Carsten; Wilhelm, Kai; Schild, Hans Heinz [University Hospital Bonn, Department of Radiology, Bonn (Germany)

    2011-08-15

    While influx of chemoembolic agents into the hepatic falciform artery (HFA) from the hepatic artery can cause supraumbilical skin rash, epigastric pain and even skin necrosis, the significance of a patent HFA in patients undergoing radioembolization is not completely clear. Furthermore, the presence of tracer in the anterior abdominal wall seen in {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) images, which is generally performed prior to radioembolization, has been described as a sign of a patent HFA. The aim of this retrospective study was to evaluate the incidence and consequences of {sup 99m}Tc-MAA accumulation in the anterior abdominal wall, indicating a patent HFA, in patients undergoing radioembolization of liver tumours. A total of 224 diagnostic hepatic angiograms combined with {sup 99m}Tc-MAA SPECT/CT were acquired in 192 patients with different types of cancer, of whom 142 were treated with a total of 214 radioembolization procedures. All patients received a whole-body scan, and planar and SPECT/CT scans of the abdomen. Only patients with extrahepatic {sup 99m}Tc-MAA accumulation in the anterior abdominal wall were included in this study. Posttreatment bremsstrahlung SPECT/CT and follow-up results for at least 3 months served as reference standards. Tracer accumulation in the anterior abdominal wall was present in pretreatment {sup 99m}Tc-MAA SPECT/CT images of 18 patients (9.3%). The HFA was found and embolized by radiologists before treatment in one patient. In the remaining patients radioembolization was performed without any modification in the treatment plan despite the previously mentioned extrahepatic accumulation. Only one patient experienced abdominal muscle pain above the navel, which started 24 h after treatment and lasted for 48 h without any skin changes. The remaining patients did not experience any relevant side effects during the follow-up period. Side effects after radioembolization in patients with tracer accumulation in the

  2. Diagnosis of abdominal mural aortic thrombus following discovery of common femoral artery and vein thrombosis by point-of-care ultrasound.

    Shaukat, Nadia Maria; Taha, Farook; Vortsman, Eugene; Desai, Poonam; Kindschuh, Mark

    2015-12-01

    Acute limb ischemia (ALI) is a limb-threatening and life-threatening disease process. Mural aortic thrombosis (MAT) is a rare cause of ALI. While there is limited evidence on the use of bedside ultrasound for the detection of ALI or MAT, duplex ultrasound remains the standard in the diagnosis and ultimate medical decision-making in patients with acute and chronic limb ischemia. Point-of-care ultrasound may be used in the evaluation of patients with signs and symptoms of this disease entity. This is a case of a 79-year-old female with a complicated medical history, who presented with a pulseless right leg and abdominal tenderness. The patient quickly decompensated requiring intubation for airway protection. A post-intubation arterial blood gas (ABG) was unsuccessfully attempted in the right femoral artery, prompting an ultrasound-guided ABG. On B-mode ultrasound evaluation, echogenic material was visualized in the right common femoral artery without evidence of Doppler flow signal. Additionally, a partially obstructing echogenic material was also noted at the femoro-saphenous vein junction with only partial compressibility by compression sonography. A computed tomography angiography of the aorta was performed indicating extensive infrarenal aortic thrombosis. The patient expired despite the relatively prompt diagnosis, highlighting the importance of early identification of acute arterial occlusion. PMID:26550078

  3. Comparison of Colour Duplex Ultrasound with Computed Tomography to Measure the Maximum Abdominal Aortic Aneurysmal Diameter

    C. Gray

    2014-01-01

    Full Text Available Introduction. Maximum diameter of an abdominal aortic aneurysm (AAA is the main indication for surgery. This study compared colour duplex ultrasound (CDU and computed tomography (CT in assessing AAA diameter. Patients and Methods. Patients were included if they had both scans performed within 90 days. Pearson’s correlation coefficient, paired t-test, and limits of agreement (LOA were calculated for the whole group. Subgroup analysis of small (6.5 cm aneurysms was performed. A P value of <0.05 was considered statistically significant. Results. 389 patients were included, giving 130 pairs of tests for comparison. Excellent correlation was in the whole group (r = 0.95 and in the subgroups (r = 0.94; 0.69; 0.96, resp.. Small LOA between the two imaging modalities was found in all subgroups. Conclusion. Small aneurysms can be accurately measured using CDU. CDU is preferable for small AAAs, but cannot supplant CT for planning aortic intervention.

  4. Color doppler sonography of patients with temporal arteritis: Comparison with normal superficial temporal artery

    To evaluate the color doppler sonographic findings of superficial temporal artery of patients with temporal arteritis in comparison with normal superficial temporal artery. The superficial temporal arteries and their frontal and parietal branches were examined by color doppler sonography in 6 patients with temporal arteritis and 30 normal controls. Vessel diameter, vessel wall thickness, peak systolic velocity, end-diastolic velocity and resistive index in proximal and distal portion of superficial temporal arteries and their frontal and parietal branches were examined. For statistical analysis, Student's t-test was used and a p-value<0.01 was considered significant. Mean vessel wall thickness, peak systolic velocity in patients with temporal arteritis were 0.63 0.08 mm and 49.25 11.93 cm/sec,respectively inproximal superficial temporal arteries; 0.63 0.17 mm and 30.53 11.57 cm/sec in distal superficial temporal arteries. Mean vessel wall thickness of normal branches of superficial temporal arteries in patients with temporal arteries was 0.62 0.11 mm. The vessel wall superficial temporal arteries and their frontal branches in temporal arteries group was thicker than normal control group (p<0.01). The mean peak velocity of main superficial temporal arteries in temporal arteries group was significantly lower than normal control group (p<0.01). The vessel wall was hypoechoic in temporal arteries group. We obtained various color doppler sonographic findings in patients with temporal arteritis for comparison with normal group. The wall thickness, the peak systolic velocity and wall echogenicity of superficial temporal artery could be useful in diagnosis of temporal arteritis.

  5. Comparison of intra-arterial digital subtraction angiography with conventional angiography after transcatheter arterial embolization for hepatic malignancy

    Twenty patients with hepatic malignancy were treated with transcatheter arterial embolization (TAE) under examination by intra-arterial digital subtraction angiography (IA-DSA) and conventional angiography (CA). Comparison of these two angiographies revealed that the time required for confirmation of the embolized portion of the artery was about four-and-a-half times shorter with IA-DSA than CA. Moreover, IA-DSA revealed the obstructed portion more readily and accurately than CA. In particular, confirmation could not be made by CA in 35% of cases because of residual Gelform sponge containing contrast medium in the artery. The visualization of residual tumor stain after TAE was 40% better on IA-DSA than CA, because of residual Gelform sponge containing contrast medium and overlapping shadow with calcified costal cartilage, excretory pyelography, and original tumor stain. However, CA was better than IA-DSA in visualizing accidental obstruction of nonobjective arteries such as the cystic artery because of the poor spatial resolution and misregistration artifacts of IA-DSA. CA was better than IA-DSA in visualizing surrounding nonembolized hepatic parenchyma because of the misregistration artifacts of IA-DSA. For effective TAE without severe complication, we concluded that TAE for HCC should be performed under a combination of IA-DSA and CA. (author)

  6. Comparison of Contraction Rates of Abdominal Muscles of Chronic Low Back Pain Patients in Different Postures

    Cho, Sung-Hak; Kim, Kang Hoon; Baek, Il-Hun; Goo, Bong-Oh

    2013-01-01

    [Purpose] This study examined the contraction rates of abdominal muscles in relation to the posture of chronic lumbar pain patients and normal subjects. [Subjects] The subjects were 17 chronic low back pain (CLBP) patients and 17 normal people between the ages of 20 and 59. [Methods] Experimental postures included a supine position, a sitting position, and a standing position. Measurements were taken at rest and during abdominal contraction. The measurement at rest was taken during expiration...

  7. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome

  8. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    Park, Joon Young, E-mail: pjy1331@hanmail.net; Kim, Shin Jung, E-mail: witdd2@hanmail.net; Kim, Hyoung Ook, E-mail: chaos821209@hanmail.net [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Kim, Yong Tae, E-mail: mono-111@hanmail.net [Chonnam National University Hwasun Hospital, Department of Radiology (Korea, Republic of); Lim, Nam Yeol, E-mail: apleseed@hanmail.net; Kim, Jae Kyu, E-mail: kjkrad@jnu.ac.kr [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Chung, Sang Young, E-mail: sycpvts@jnu.ac.kr; Choi, Soo Jin Na, E-mail: choisjn@jnu.ac.kr; Lee, Ho Kyun, E-mail: mhaha@hanmail.net [Chonnam National University Hospital, Department of Surgery (Korea, Republic of)

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  9. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    Andersen, Lea L; Alling Møller, Lars M; Gimbel, Helga M

    2015-01-01

    OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total......, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group...... (443ml) (P=0.0147) according to the voiding diary. CONCLUSION: Subtotal and total abdominal hysterectomy are comparable regarding long-term objective pelvic organ prolapse and urinary incontinence. The subtotal hysterectomy group had a higher Qmax and voided volume....

  10. Comparison of spirometry and abdominal height as four-dimensional computed tomography metrics in lung

    An important consideration in four-dimensional CT scanning is the selection of a breathing metric for sorting the CT data and modeling internal motion. This study compared two noninvasive breathing metrics, spirometry and abdominal height, against internal air content, used as a surrogate for internal motion. Both metrics were shown to be accurate, but the spirometry showed a stronger and more reproducible relationship than the abdominal height in the lung. The abdominal height was known to be affected by sensor placement and patient positioning while the spirometer exhibited signal drift. By combining these two, a normalization of the drift-free metric to tidal volume may be generated and the overall metric precision may be improved

  11. Associação entre circunferência abdominal e hipertensão arterial em mulheres: Estudo Pró-Saúde Association between abdominal circumference and hypertension among women: the Pró-Saúde Study

    Maria Helena Hasselmann

    2008-05-01

    Full Text Available O objetivo deste estudo foi estimar a prevalência de hipertensão arterial segundo estratos de circunferência abdominal (CA e índice de massa corporal (IMC, em kg/m² em uma população de funcionárias públicas de universidade localizada no Rio de Janeiro, Brasil. Foram analisados dados seccionais de 1.743 mulheres não grávidas de 24 a 69 anos participantes, em 2001, do Estudo Pró-Saúde. Mulheres com baixo peso ou apresentando IMC > 35kg/m² foram excluídas. Mulheres que apresentavam pressão sangüínea sistólica > 140mmHg ou diastólica > 90mmHg ou faziam uso de medicação anti-hipertensiva foram consideradas hipertensas. A análise foi conduzida segundo dois estratos de CA (normal: 88cm e três de IMC (eutrofia: 18,5-24,9kg/m²; sobrepeso: 25,0-29,9kg/m²; e obesidade I: 30,0-34,9kg/m². Entre mulheres eutróficas, participantes com valores elevados de CA apresentaram o dobro da prevalência de hipertensão arterial do que aquelas com CA This study aimed to estimate the prevalence of hypertension according to levels of abdominal circumference (AC and body mass index (BMI, expressed as kg/m² among public employees at a university in Rio de Janeiro, Brazil. Cross-sectional data were obtained for 1,743 non-pregnant women aged 24-69 years participating in the Pró-Saúde Study. Underweight women and those with BMI > 35kg/m² were excluded. Hypertension was defined as systolic blood pressure >140mmHg or diastolic > 90mmHg or the use of anti-hypertensive drugs. Age-adjusted prevalence rates for hypertension were calculated considering two strata of AC (normal: 88cm and three levels of BMI (normal: 18.5-24.9kg/m²; overweight: 25.0-29.9kg/m²; and obesity I: 30.0-34.9kg/m². Among normal-weight women, participants with high AC showed a two-fold higher prevalence of hypertension as compared to those with AC < 88cm (18% vs. 8%, p < 0.05. Routine measurement of AC, in addition to BMI, could contribute to early identification of

  12. Measurement of mean arterial pressure: comparison of the Vasotrac monitor with the finger differential oscillometric device.

    Jagomägi, K; Raamat, R; Talts, J; Ragun, U; Tähepõld, P

    2010-01-01

    The Vasotrac monitor provides non-invasive near-continuous blood pressure monitoring and is designed to be an alternative to direct intra-arterial blood pressure (BP) measurement. As compared to radial artery invasive BP and upper arm non-invasive BP, Vasotrac readings have been found to have a good agreement with them. However, discrepancies have been reported when rapid changes in BP exist. In the present study we compared BP measured by the Vasotrac monitor on the radial artery with that recorded on the finger arteries by the differential oscillometric device allowing measurement on the beat-to-beat basis. Comparisons were performed on the mean arterial pressure (MAP) level. Special attention was paid to the signal conditioning before comparison of pressures of different temporal resolution. Altogether 383 paired MAP measurements were made in 14 healthy subjects. Based on all 383 paired measurements, the MAP values measured at the radial artery at rest were 4.8+/-6.0 mm Hg higher than those measured on fingers. The observed difference between the Vasotrac and differential oscillometric device can be explained by different measurement sites. This result is consistent with previous investigations, and the Vasotrac monitor can be considered to adequately track relatively rapid MAP changes on the radial artery. Attention should be paid to a proper signal conditioning before comparison of results obtained by different devices. PMID:20406039

  13. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain

    Randen, Adrienne van; Stoker, Jaap [Academic Medical Centre, Department of Radiology (suite G1-227), Amsterdam (Netherlands); Lameris, Wytze; Boermeester, Marja A. [Academic Medical Center, Department of Surgery, Amsterdam (Netherlands); Es, H.W. van; Heesewijk, Hans P.M. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Ramshorst, Bert van [St Antonius Hospital, Department of Surgery, Nieuwegein (Netherlands); Hove, Wim ten [Gelre Hospitals, Department of Radiology, Apeldoorn (Netherlands); Bouma, Willem H. [Gelre Hospitals, Department of Surgery, Apeldoorn (Netherlands); Leeuwen, Maarten S. van [University Medical Centre, Department of Radiology, Utrecht (Netherlands); Keulen, Esteban M. van [Tergooi Hospitals, Department of Radiology, Hilversum (Netherlands); Bossuyt, Patrick M. [Academic Medical Center, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam (Netherlands)

    2011-07-15

    Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain. Consecutive patients with abdominal pain for >2 h and <5 days referred for imaging underwent both US and CT by different radiologists/radiological residents. An expert panel assigned a final diagnosis. Ultrasound and CT sensitivity and predictive values were calculated for frequent final diagnoses. Effect of patient characteristics and observer experience on ultrasound sensitivity was studied. Frequent final diagnoses in the 1,021 patients (mean age 47; 55% female) were appendicitis (284; 28%), diverticulitis (118; 12%) and cholecystitis (52; 5%). The sensitivity of CT in detecting appendicitis and diverticulitis was significantly higher than that of ultrasound: 94% versus 76% (p < 0.01) and 81% versus 61% (p = 0.048), respectively. For cholecystitis, the sensitivity of both was 73% (p = 1.00). Positive predictive values did not differ significantly between ultrasound and CT for these conditions. Ultrasound sensitivity in detecting appendicitis and diverticulitis was not significantly negatively affected by patient characteristics or reader experience. CT misses fewer cases than ultrasound, but both ultrasound and CT can reliably detect common diagnoses causing acute abdominal pain. Ultrasound sensitivity was largely not influenced by patient characteristics and reader experience. (orig.)

  14. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain

    Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain. Consecutive patients with abdominal pain for >2 h and <5 days referred for imaging underwent both US and CT by different radiologists/radiological residents. An expert panel assigned a final diagnosis. Ultrasound and CT sensitivity and predictive values were calculated for frequent final diagnoses. Effect of patient characteristics and observer experience on ultrasound sensitivity was studied. Frequent final diagnoses in the 1,021 patients (mean age 47; 55% female) were appendicitis (284; 28%), diverticulitis (118; 12%) and cholecystitis (52; 5%). The sensitivity of CT in detecting appendicitis and diverticulitis was significantly higher than that of ultrasound: 94% versus 76% (p < 0.01) and 81% versus 61% (p = 0.048), respectively. For cholecystitis, the sensitivity of both was 73% (p = 1.00). Positive predictive values did not differ significantly between ultrasound and CT for these conditions. Ultrasound sensitivity in detecting appendicitis and diverticulitis was not significantly negatively affected by patient characteristics or reader experience. CT misses fewer cases than ultrasound, but both ultrasound and CT can reliably detect common diagnoses causing acute abdominal pain. Ultrasound sensitivity was largely not influenced by patient characteristics and reader experience. (orig.)

  15. Not All Abdomens Are the Same: A Comparison of Damage Control Surgery for Intra-abdominal Sepsis versus Trauma.

    Smith, Jason W; Nash, Nick; Procter, Levi; Benns, Matthew; Franklin, Glen A; Miller, Keith; Harbrecht, Brian G; Bernard, Andrew C

    2016-05-01

    Damage control surgery (DCS) was developed to manage exsanguinating trauma patients, but is increasingly applied to the management of peritoneal sepsis and abdominal catastrophes. Few manuscripts compare the outcomes of these surgeries on disparate patient populations. A multi-institutional three group propensity score matched case cohort study comparing penetrating trauma (PT-DCS), blunt trauma (BT-DCS), and intraperitoneal sepsis (IPS-DCS) was performed comparing patients treated with DSC between 2008 and 2013. Propensity scoring was performed using demographic and presenting physiologic data. Four hundred and twelve patients were treated with DCS across two institutions. Propensity matching for age, gender, and initial Acute Physiology and Chronic Health Evaluation II score 80 identified 80 patients per group for comparison. Rate of primary fascial closure was lowest in the IPS-DCS group, and highest in the penetrating trauma DCS group. Intra-abdominal complication rates were highest in the IPS-DCS group. IPS-DCS had increased time to definitive closure compared with the other two groups (RR 1.8; 1.3-2.2; P eight days were more than twice the risk of death at 90 days across all groups. (RR 2.15; 1.2-3.5; P trauma and emergency general surgery are quite different. Despite this difference, prompt abdominal closure at the earliest possible opportunity afforded the best outcome in patients managed via DCS. PMID:27215724

  16. Abdominal fat volume estimation by stereology on CT: a comparison with manual planimetry

    Manios, G.E.; Mazonakis, M.; Damilakis, J. [University of Crete, Department of Medical Physics, Faculty of Medicine, Heraklion, Crete (Greece); Voulgaris, C.; Karantanas, A. [University of Crete, Department of Radiology, Faculty of Medicine, Heraklion, Crete (Greece)

    2016-03-15

    To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes. Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans. Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r = 0.98; SAF: r = 0.98). No statistical differences were found between the two methods (VAF: P = 0.81; SAF: P = 0.83). The 95 % limits of agreement were also acceptable (VAF: -16.5 %, 16.1 %; SAF: -10.8 %, 10.7 %) and the repeatability of stereology was good (VAF: CV = 4.5 %, SAF: CV = 3.2 %). Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique. (orig.)

  17. The diagnosis and management of abdominal aortic aneurysms: a comparison of computed tomography, ultrasound and aortography

    It is suggested that all clinically significant abdominal aneurysms can be shown by infusion C.T. or ultrasound and routine aortography is no longer indicated. These methods give more information about wall thickness and wall thrombus but do not give detailed information about the extent of an aneurysm and its exact relationship to important aortic branches. They should complement rather than replace aortography

  18. A randomized comparison of interfraction and intrafraction prostate motion with and without abdominal compression

    Background and purpose: To quantify inter- and intrafraction prostate motion in a standard VacLok (VL) immobilization device or in the BodyFix (BF) system incorporating a compression element which may reduce abdominal movement. Materials and methods: Thirty-two patients were randomly assigned to VL or BF. Interfraction prostate motion >3 mm was corrected pre-treatment. EPIs were taken daily at the start and end of the first and last treatment beams. Interfraction and intrafraction prostate motion were measured for centre of mass (COM) and individual markers. Results: There were no significant differences in interfraction (p ≥ 0.002) or intrafraction (p ≥ 0.16) prostate motion with or without abdominal compression. Median intrafraction motion was slightly smaller than interfraction motion in the AP (7.0 mm vs. 7.6 mm) and SI direction (3.2 mm vs. 4.7 mm). The final image captured the maximal intrafraction displacement in only 40% of fractions. Our PTV incorporated >95% of total prostate motion. Conclusions: Intrafraction motion became the major source of error during radiotherapy after online correction of interfraction prostate motion. The addition of 120 mbar abdominal compression to custom pelvic immobilization influenced neither interfraction nor intrafraction prostate motion

  19. ASSESSMENT AND COMPARISON OF ABDOMINAL MASSES BY SONOGRAPHY AND COMPUTED TOMOGRAPHY

    Suman

    2014-01-01

    Full Text Available OBJECTIVES: To study the role of ultrasonography and computed tomography in the evaluation of abdominal masses , to compare their diagnostic accuracies , to evaluate the imaging features of lesions and to know the exact site of origin and extension into surrounding structures. MATERIALS AND METHODS: A prospective study of 104 patients with abdominal masses. USG was done with Toshiba SSA and Philips Envisor C machine and CT - Scan examination was performed in all patients on Philips brilliance 6 - slice whole body CT scanner. RESULTS: There were 35(30.62% cases of hepatobilliary masses , renal15(14.40%cases , pancreatic 7(6.72% cases , 5(4.80% cases of splenic masses and 30 ( 28.82% cases of pelvic masses.8 cases with other abdominal masses. Hepatic SOL were detected in 6(5.76% and 8(7.69% , 5(4.80%cases o f gall bladder masses and 4(3.85% , Omental caking was seen in 2(1.92% cases and 4(3.85% , calcification was seen in 2(1.92% cases and 4(3.85% cases , renal calculi were seen in 4(3.84% cases and6(5.77% cases , on sonography and CT examination. Peritone al deposits were seen in 3 ( 2.88% cases of ovarian carcinoma and unknown malignancy on US and in 5(4.88% cases on CT. Ascites and lymphadenopathy was more accurately detected on CT as compared to US.CT detected splenicinfarct s which were missed on ultrasonography. CONCLUSION : CT is more sensitive in evaluation of site and size of lesion , detection of calcification , adjacent organ infiltration and regional lymphadenopathy. The limitations of CT are ionizing radiation , high cost and contras t administration. Hence ultrasound should be the primary screening modality and CT should be used for further characterizing the masses.

  20. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... technique that allows the physician to see and evaluate blood flow through arteries and veins in the ... the procedure? Abdominal ultrasound imaging is performed to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas ...

  1. Comparison of changes in the contraction of the lateral abdominal muscles between the abdominal drawing-in maneuver and breathe held at the maximum expiratory level.

    Ishida, Hiroshi; Hirose, Ryohei; Watanabe, Susumu

    2012-10-01

    The abdominal drawing-in maneuver (ADIM) is commonly used as a fundamental component of lumbar stabilization training programs. One potential limitation of lumbar stabilization programs is that it can be difficult and time consuming to train people to perform the ADIM. The transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles are the most powerful muscles involved in expiration. However, little is known about the differences in the recruitment of the abdominal muscles between the ADIM and breathe held at maximum expiratory level (maximum expiration). The thickness of the TrA and IO muscles was measured by ultrasound imaging, and the activity of the EO muscle was measured by electromyography (EMG) in 33 healthy male performing the ADIM and maximum expiration. Maximum expiration produced a significant increase in the thickness of the TrA and IO muscles compared to the ADIM (p method for training of co-activation of the lateral abdominal muscles. PMID:22595657

  2. A prospective comparison of intestinal sonography and abdominal radiographs in a neonatal intensive care unit

    No study reported in the literature comprehensively compares findings on neonatal abdominal radiographs with sonography. To compare the findings on abdominal radiographs and sonograms in infants in intensive care, to better understand how the various intestinal gas patterns on radiographs relate to the spectrum of appearances on sonography and, second, to evaluate the ability of sonography to differentiate necrotizing enterocolitis from other intestinal pathology. We prospectively evaluated sonograms and radiographs, blinded to the other modality and to clinical information. Patients' charts were reviewed by a third blinded reader and used as a reference standard for diagnosis. We made associations between sonographic findings, radiographic intestinal gas patterns and clinical diagnoses. We included 75 infants with gestational ages between 23 weeks and 41 weeks. Sonographic abnormalities were present in infants with all radiographic intestinal gas patterns, including normal patterns. We only saw absent intestinal perfusion and fluid collections on sonography (suggesting intestinal necrosis and sealed perforation) in infants with intestinal dilatation with elongation on radiographs. Separation of intestinal loops on radiographs was most commonly caused by reasons other than intestinal wall thickening. Increased intestinal echogenicity or free fluid with echoes on sonography correlated with a diagnosis of necrotizing enterocolitis, whereas anechoic free fluid correlated with absence of necrotizing enterocolitis. Sonography is complementary to radiographs in infants with suspected intestinal pathology, with a spectrum of appearances seen on each modality. Some sonographic findings either strongly suggest necrotizing enterocolitis or supply evidence against this diagnosis. (orig.)

  3. A prospective comparison of intestinal sonography and abdominal radiographs in a neonatal intensive care unit

    Silva, Cicero T. [The University of Toronto, The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Yale University School of Medicine, New Haven, CT (United States); Daneman, Alan; Navarro, Oscar M. [The University of Toronto, The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Moineddin, Rahim [The University of Toronto, The Hospital for Sick Children, Department of Family and Community Medicine, Toronto (Canada); Levine, Daniel [The University of Toronto, The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); The Royal Marsden NHS Foundation Trust, London (United Kingdom); Moore, Aideen M. [The University of Toronto, The Hospital for Sick Children, Department of Pediatrics, Toronto (Canada)

    2013-11-15

    No study reported in the literature comprehensively compares findings on neonatal abdominal radiographs with sonography. To compare the findings on abdominal radiographs and sonograms in infants in intensive care, to better understand how the various intestinal gas patterns on radiographs relate to the spectrum of appearances on sonography and, second, to evaluate the ability of sonography to differentiate necrotizing enterocolitis from other intestinal pathology. We prospectively evaluated sonograms and radiographs, blinded to the other modality and to clinical information. Patients' charts were reviewed by a third blinded reader and used as a reference standard for diagnosis. We made associations between sonographic findings, radiographic intestinal gas patterns and clinical diagnoses. We included 75 infants with gestational ages between 23 weeks and 41 weeks. Sonographic abnormalities were present in infants with all radiographic intestinal gas patterns, including normal patterns. We only saw absent intestinal perfusion and fluid collections on sonography (suggesting intestinal necrosis and sealed perforation) in infants with intestinal dilatation with elongation on radiographs. Separation of intestinal loops on radiographs was most commonly caused by reasons other than intestinal wall thickening. Increased intestinal echogenicity or free fluid with echoes on sonography correlated with a diagnosis of necrotizing enterocolitis, whereas anechoic free fluid correlated with absence of necrotizing enterocolitis. Sonography is complementary to radiographs in infants with suspected intestinal pathology, with a spectrum of appearances seen on each modality. Some sonographic findings either strongly suggest necrotizing enterocolitis or supply evidence against this diagnosis. (orig.)

  4. Venous thrombosis after abdominal surgery. A comparison between subcutaneous heparin and antithrombotic stockings, or both

    In an open controlled study, 248 consecutive patients (age more than 40 yrs) admitted for major abdominal surgery were randomized to one of three prophylactic antithrombotic treatments. Eighty-five patients received subcutaneous heparin, 74 patients had graduated compression stockings to the knee (TED stockings), and 89 patients had both subcutaneous heparin and stockings. Treatment began on the evening before operation and continued to complete mobilization, or for not less than five days postoperatively. On the fourth or fifth postoperative day, the patients underwent a /sup 99m/Tc-plasmin test of the lower limbs as a test for deep vein thrombosis. There were 29.7% positive tests in the stocking group, 29.4% in the group with heparin prophylaxis, and 25.8% in the combined group. Differences between treatments were not statistically significant

  5. Comparison of two porcine-derived materials for repairing abdominal wall defects in rats.

    Zhengni Liu

    Full Text Available OBJECTIVE: The purpose of this study was to compare the mechanical properties, host responses and incorporation of porcine small intestine submucosa (PSIS and porcine acellular dermal matrix (PADM in a rat model of abdominal wall defect repair. MATERIALS AND METHODS: Prior to implantation, PSIS and PADM were prepared and evaluated in terms of structure and mechanical properties. Full-thickness abdominal wall defects were created in 50 Sprague-Dawley rats, and were repaired using either PSIS or PADM. Rats were sacrificed 1, 2, 4, 8 and 12 weeks post-repair and examined for herniation, infection, adhesions, contraction, and changes in the thickness and strength of the tissues incorporated at the defect sites. Histopathology and immunohistochemistry were performed to analyze inflammatory responses, collagen deposition and vascularization. RESULTS: PADM showed more dense collagen deposition and stronger mechanical properties than PSIS prior to implantation (P<0.01. However, the mechanical properties observed after integration with the surrounding native tissues was similar for PADM and PSIS. Both PADM and PSIS showed significant contraction by week 12. However, PADM tissue induced less adhesion and increased in thickness more slowly, and showed less infiltration by foreign giant cells, polymorphonuclear cells, and mononuclear cells. Improved remodeling of host tissue was observed after PSIS implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12. CONCLUSION: PSIS showed weaker mechanical properties prior to implantation. However, after implantation PSIS induced more pronounced host responses and showed better incorporation into host tissues than PADM.

  6. Quantitative assessment of lower limb ischemia of arterial occlusive disease utilizing leg scintigraphy by abdominal aortic infusion of {sup 201}Tl chloride

    Hirooka, Noriyuki [Wakayama Medical Univ. (Japan)

    2001-06-01

    We developed leg scintigraphy by abdominal aortic infusion of {sup 201}Tl (111 Mbq, which is equivalent dose in leg scintigraphy by intravenous injection) for diagnosis of ischemic leg. An evaluation of the image by this scintigraphy and a quantitative assessment of ischemic leg by time radioactivity curve (TAC) on calf was preformed among 36 limbs in 18 patients with intermittent claudication. These limbs were divided into 4 groups based on walking distance without calf pain as follows; Group 1 (5 limbs): asymptomatic, Group 2 (13 limbs); over 500 m and less than 1000 m, Group 3 (12 limbs); over 100 m and less than 500 m, Group 4 (6 limbs); less than 100 m. The image of supreme quality for diagnosis of leg ischemia was obtained in all subjects due to a lack of interference from background radioactivity. The relationship between each group and following 3 indicators; peak value, peak time and k value as washout rate obtained from TAC was evaluated. The peak value was 792.6{+-}78.6, 419.4{+-}42.3, 252.6{+-}32.7 and 77.0{+-}21.6 in G1, G2, G3 and G4, respectively (significant difference among each group). The peak time was 11.6{+-}0.6, 14.3{+-}1.2, 16.5{+-}0.85 and 18.6{+-}2.2 in G1, G2, G3 and G4, respectively (G1 vs G2 and G2 vs G3: significant difference, G3 vs G4: not significant). The k value was 1.89{+-}0.32, 1.35{+-}0.33, 0.91{+-}0.12 and 0.56{+-}0.11 in G1, G2, G3 and G4, respectively (significant difference among each group). The peak value is affected by the infused dose of Tl, but the k value is not affected by the dose and is constant indicator in a given leg. These results suggest that lower limb muscle scintigraphy using abdominal aortic infusion of {sup 201}Tl produces a clear image for diagnosis of ischemic leg and k value is one of useful indicators to evaluate the clinical grading of arterial occlusive disease of leg. (author)

  7. Comparison of power Doppler ultrasonographic findings of mesenteric lymphadenopathy between children with and without acute abdominal pain

    Hwangbo, Seal; Lim, Gye Yeon; Jang, Hye Suk; Choi, Byoung Gil; Lee, Jae Mun [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2002-12-15

    To evaluate power Doppler ultrasonographic findings of the enlarged mesenteric lymph nodes, and to compare between patients with and without acute abdominal pain. Thirty seven children with acute abdominal pain and thirty three asymptomatic children all with the enlarged mesenteric lymph nodes in whom power Doppler ultrasonography was performed were included in this study. The enlarged lymph nodes were evaluated for number, size, shape (ratio of long to short axis diameter: L/S ratio), distribution and hilar vascularity on gray scale ultrasonography while the flow pattern (3 types; nonvascular, hilar, peripheral type) of the vascularity was analyzed with power Doppler ultrasonography. The hilar pattern of vascular flow type was graded into I to III depending upon color signal. The comparison between symptomatic group and asymptomatic control group was analyzed with gray scale ultrasonography and power Doppler ultrasonography. The number of enlarged lymph nodes (n{>=}10) was greater in the symptomatic group (29/37, 78%) than in the control group (6/33, 18%) (p<0.01). The mean size of the largest lymph node between two groups was different with a statistical significance; the mean long diameter was 12.4 {+-} 3.1 mm (short diameter 5.8 {+-} 1.6 mm) in the symptomatic group and 11.2 {+-} 2.3 mm (4.5 {+-} 1.3 mm) in the control group (p<0.05). The mean L/S ratio of the largest one was 2.2 {+-} 0.6 in the symptomatic group and 2.7 {+-} 0.8 in the control group (p<0.05). Lymph nodes were detected in both right lower quadrant of the abdomen and periumblical region in 16 (43%) of the symptomatic group and 3 (9%) of the control group (p<0.01). On power Doppler ultrasonography, hilar type of vascularity was noted in 22 (67%) cases of the control group and all of symptomatic group. The prevalence of exuberant hilar flows (grade II/III) in the symptomatic group (28/37, 76%) was significantly higher than that of the control group (4/33,12%) (p<0.01). Enlarged mesenteric lymph

  8. INFLUENCE OF ABDOMINAL OBESITY ON HEART STRUCTURAL AND FUNCTIONAL CHANGES AND POSSIBILITY OF THEIR PHARMACOLOGICAL CORRECTION IN PATIENTS WITH ARTERIAL HYPERTENSION

    V. R. Veber

    2016-01-01

    Full Text Available Aim. To study clinical and epidemiological features of arterial hypertension (HT combined with abdominal obesity (AO and pharmacological correction of left ventricle myocardium structural and functional disorders.Material and methods. Single-stage epidemiological study was conducted in Novgorod region population (n=4840. All patients with HT were revealed and analyzed depending on age and gender. Patients with HT grade 2 were split in two groups. 124 women (aged 49,36±1,2 y.o. and 126 men (aged 50,15±1,8 y.o. with HT and AO were included in the first group. 127 women (aged 50,05±1,7 y.o. and 125 men (aged 49,61±1,6 y.o. with HT and normal body mass index were included in the second group. Anthropometric and echocardiography examination was performed before and after 1, 3 and 6 months of therapy (metoprolol, nebivolol, amlodipine, lisinopril.Results. High prevalence of HT was revealed: 44,4% in men and 48,7% in women. AO was observed 5,4 times more often in women than this in men (18,5% and 3,4%, respectively, р<0,001. Combination of HT and AO was also revealed 5,3 times more often in women than this in men (14,3% and 2,7%, respectively, р<0,001. AO in patients with HT contributes to development of left ventricle concentric hypertrophy and diastolic dysfunction.Conclusion. Antihypertensive therapy does not prevent left ventricle hypertrophy and diastolic dysfunction in hypertensive patients with AO.

  9. A comparison of modelling techniques for computing wall stress in abdominal aortic aneurysms

    McGloughlin Timothy M

    2007-10-01

    Full Text Available Abstract Background Aneurysms, in particular abdominal aortic aneurysms (AAA, form a significant portion of cardiovascular related deaths. There is much debate as to the most suitable tool for rupture prediction and interventional surgery of AAAs, and currently maximum diameter is used clinically as the determining factor for surgical intervention. Stress analysis techniques, such as finite element analysis (FEA to compute the wall stress in patient-specific AAAs, have been regarded by some authors to be more clinically important than the use of a "one-size-fits-all" maximum diameter criterion, since some small AAAs have been shown to have higher wall stress than larger AAAs and have been known to rupture. Methods A patient-specific AAA was selected from our AAA database and 3D reconstruction was performed. The AAA was then modelled in this study using three different approaches, namely, AAA(SIMP, AAA(MOD and AAA(COMP, with each model examined using linear and non-linear material properties. All models were analysed using the finite element method for wall stress distributions. Results Wall stress results show marked differences in peak wall stress results between the three methods. Peak wall stress was shown to reduce when more realistic parameters were utilised. It was also noted that wall stress was shown to reduce by 59% when modelled using the most accurate non-linear complex approach, compared to the same model without intraluminal thrombus. Conclusion The results here show that using more realistic parameters affect resulting wall stress. The use of simplified computational modelling methods can lead to inaccurate stress distributions. Care should be taken when examining stress results found using simplified techniques, in particular, if the wall stress results are to have clinical importance.

  10. Quantitative comparison of cerebral artery development in metatherians and monotremes with non-human eutherians.

    Ashwell, Ken W S; Shulruf, Boaz

    2016-03-01

    A quantitative comparison of the internal diameters of cerebral feeder arteries (internal carotid and vertebral) and the aorta in developing non-human eutherians, metatherians and monotremes has been made, with the aim of determining if there are differences in cerebral arterial flow between the three infraclasses of mammals such as might reflect differences in metabolism of the developing brain. There were no significant differences between eutherians and metatherians in the internal radius of the aorta or the thickness of the aortic wall, but aortic internal radius was significantly smaller in developing monotremes than therians at the body length range. Aortic thickness in the developing monotremes also rose at a slower rate relative to body length than in metatherians or eutherians. The sums of the internal calibres of the internal carotid and vertebral arteries were significantly lower in metatherians as a group and monotremes compared with non-human eutherians at body lengths up to 20 mm and in metatherians at > 20 mm body length. The internal calibre of the internal carotids relative to the sum of all cerebral feeder arteries was also significantly lower in monotremes at body length compared with eutherians. It was noted that dasyurids differed from other metatherians in several measures of cerebral arterial calibre and aortic internal calibre. The findings suggest that: (i) both aortic outflow and cerebral arterial inflow may be lower in developing monotremes than in therians, particularly at small body size (human eutherians; and (iii) dasyurids have unusual features of cerebral arteries possibly related to the extreme immaturity and small size at which they are born. The findings have implications for nutritional sourcing of the developing brain in the three infraclasses of mammals. PMID:26644330

  11. Abdominal Ultrasound

    ... It is used to help diagnose pain or distention and evaluate the kidneys, liver, gallbladder, pancreas, spleen ... variety of conditions, such as: abdominal pain or distention. abnormal liver function. enlarged abdominal organ. stones in ...

  12. Abdominal Adhesions

    ... adhesions? Abdominal adhesions can cause intestinal obstruction and female infertility—the inability to become pregnant after a year of trying. Abdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, ...

  13. Comparison of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque

    Objective: To compare the efficacy of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque. Methods: Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study, and 89 carotid arteries were evaluated by MRI and DSA. MRI examination was acquired with 3.0 T MR scanner and 8 channel phase-array surface coil. The MRI sequences consisted of pre-and post-contrast T1WI, T2WI, PDWI, TOF. Anterior-posterior and lateral views of carotid artery were performed on DSA. The degree of carotid artery stenosis was evaluated by the NASCET standard. Fibrous cap rupture, intraplaque hemorrhage, and calcification were also evaluated on MRI and DSA. Statistical comparison was performed with the Kappa value and paired Chi-square test. Results: The degree of carotid artery stenosis was 50% (16%-78%) on MRI and 47% (7%-73%) on DSA. Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa = 0.882, P2 =20.346, P<0.01). Furthermore, thirty-seven vessels with intraplaque hemorrhage and 71 vessels with calcification in the plaque were found on MRI but none on DSA. Conclusion: MRI is a reliable tool in assessment of the degree of the carotid stenosis and it is superior to DSA in detecting fibrous cap rupture, intraplaque hemorrhage, and calcification. (authors)

  14. Study Design of PROCEDURE Study. A Randomized Comparison of the Dose-Dependent Effects of Pitavastatin in Patients with Abdominal Aortic Aneurysm with Massive Aortic Atheroma: Prevention of Cholesterol Embolization during Endovascular and Open Aneurysm Repair with Pitavastatin (PROCEDURE) Study

    Nemoto, Masaru; Hashimoto, Takuya; Miura, Sumio; Urabe, Go; Nakazawa, Tatsu; Hosaka, Akihiro; Kato, Masaaki; Ohkubo, Nobukazu; Miyairi, Takeshi; Okamoto, Hiroyuki; Shigematsu, Kunihiro; Miyata, Tetsuro

    2013-01-01

    Outcomes of abdominal aortic aneurysm (AAA) repair have improved in the 2 decades since the emergence of endovascular aneurysm repair (EVAR). However, EVAR is considered a contraindication for shaggy aorta because of the high risk of shower embolization. Recently, statins have been implicated in preventing embolization in patients with shaggy aorta via its pleiotropic effects, including atheroma reduction and coronary artery stabilization. We selected pitavastatin, a statin with potent effects, discovered and developed by a Japanese company because it has shown excellent pleiotropic effects on atheromatous arteries in the Japanese population. A randomized comparison study of dose-dependent effects of pitavastatin in patients with AAA with massive atheromatous aortic thrombus (PROCEDURE study) has begun. PROCEDURE has an enrollment goal of up to 80 patients with AAA with massive aortic atheroma (excluding intrasac atheroma), randomly allocated into 2 groups receiving pitavastatin at a dose of 1 or 4 mg/day. The endpoints of the PROCEDURE study include change in atheroma volume, major adverse events related to shower embolization after aneurysm repair, and lipid-lowering effects. When complete, results of the PROCEDURE study should provide objective evidence to use statins preoperatively for AAA with massive aortic atheroma. PMID:23641286

  15. Comparison of the relative contributions of intra-abdominal and liver fat to components of the metabolic syndrome

    Kotronen, Anna; Yki-Järvinen, Hannele; Sevastianova, Ksenia; Bergholm, Robert; Hakkarainen, Antti; Pietiläinen, Kirsi H; Juurinen, Leena; Lundbom, Nina; Sørensen, Thorkild I A

    2011-01-01

    Abdominally obese individuals with the metabolic syndrome often have excess fat deposition both intra-abdominally (IA) and in the liver, but the relative contribution of these two deposits to variation in components of the metabolic syndrome remains unclear. We determined the mutually independent...

  16. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

    Hwang, Shin Hye; You, Je Sung; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of); Song, Mi Kyong [Yonsei University, Biostatistics Collaboration Unit, College of Medicine, Seoul (Korea, Republic of)

    2015-04-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. (orig.)

  17. Celiac Artery Compression Syndrome

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  18. Abdominal Assessment.

    Fritz, Deborah; Weilitz, Pamela Becker

    2016-03-01

    Abdominal pain is one of the most common complaints by patients, and assessment of abdominal pain and associated symptoms can be challenging for home healthcare providers. Reasons for abdominal pain are related to inflammation, organ distention, and ischemia. The history and physical examination are important to narrow the source of acute or chronic problems, identify immediate interventions, and when necessary, facilitate emergency department care. PMID:26925941

  19. The internal thoracic artery skeletonization study: A paired, within-patient comparison [NCT00265499

    Boodhwani Munir

    2006-01-01

    Full Text Available Abstract Background Traditional harvesting of the internal thoracic artery (ITA for use as a conduit in coronary bypass surgery involves the dissection of a rim of tissue surrounding the artery on either side. Recent studies, primarily observational, have suggested that skeletonization of the ITA can improve conduit flow, increase length, and reduce the risk of deep sternal infection in high risk patients. Furthermore, skeletonization of the ITA can potentially preserve intercostal nerves and reduce post-operative pain and dysesthesias associated with ITA harvesting. In order to assess the effects of ITA skeletonization, we report a prospective, randomized, within-patient study design that shares many features of a cross-over study. Methods Patients undergoing bilateral internal thoracic artery harvest will be randomized to having one side skeletonized and the other harvested in a non-skeletonized manner. Outcome measures include ITA flow and length measured intra-operatively, post-operative pain and dysesthesia, evaluated at discharge, four weeks, and three months post-operatively, and sternal perfusion assessed using single photon emission computed tomography. Harvest times as well as safety endpoints of ITA injury will be recorded. Discussion This study design, using within-patient comparisons and paired analyses, minimizes the variability of the outcome measures, which is seldom possible in the evaluation of surgical techniques, with minimal chance of carryover effects that can hamper the interpretation of traditional cross-over studies. This study will provide a valid evaluation of clinically relevant effects of internal thoracic artery skeletonization in improving outcomes following coronary artery bypass surgery.

  20. Non-enhanced MR angiography of renal arteries - Comparison with contrast-enhanced MR angiography

    Angeretti, M. G.; Lumia, D.; Cani, A.; Barresi, M.; Cardim, L Nocchi; Piacentino, F.; Genovese, E. A.; Fugazzola, C. [Dept. of Radiology, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)], e-mail: laranocchi@gmail.com; Maresca, A. M. [Dept. of Internal Medicine, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy); Novario, R. [Dept. of Medical Physics, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)

    2013-09-15

    Background: The main causes of renal artery stenosis (RAS) are atherosclerosis and fibromuscular dysplasia. Despite contrast-enhanced magnetic resonance angiography (CE-MRA) being a safe and reliable method for diagnosis of RAS especially in young individuals, recently it has been possible to adopt innovative technologies that do not require paramagnetic contrast agents. Purpose: To assess the accuracy of steady-state free-precession (SSFP) non-contrast-enhanced magnetic resonance angiography (NC-MRA) by using a 1.5 T MR scanner for the detection of renal artery stenosis, in comparison with breath-hold CE-MRA as the reference standard. Material and Methods: Sixty-three patients (33 men, 30 women) with suspected renovascular hypertension (RVHT) were examined by a 1.5T MR scanner; NC-MRA with an electrocardiography (ECG)-gated SSFP sequence was performed in 58.7% (37/63) of patients; in 41.3% (26/63) of patients a respiratory trigger was used in addition to cardiac gating. CE-MRA, with a three-dimensional gradient echo (3D-GRE) T1-weighted sequence, was performed in all patients within the same session. Maximum intensity projection (MIP) image quality, number of renal arteries, and the presence of stenosis were assessed by two observers (independently for NC-MRA and together for CE-MRA). The agreement between NC-MRA and CE-MRA as well as the inter-observer reproducibility were calculated with Bland-Altman plots. Results: MIP image quality was considered better for NC-MRA. NC-MRA identified 143 of 144 (99.3%) arteries detected by CE-MRA (an accessory artery was not identified). Fourteen stenoses were detected by CE-MRA (11 atherosclerotic, 3 dysplastic) with four of 14 (28.5%) significant stenosis. Bland-Altman plot demonstrated an excellent concordance between NC-MRA and CE-MRA; particularly, the reader A evaluated correctly all investigated arteries, while over-estimation of two stenoses occurred for reader B. Regarding NC-MRA, inter-observer agreement was excellent

  1. Comparison of Intraperitoneal Honey and Sodium Hyaluronate-Carboxymethylcellulose (Seprafilm™) for the Prevention of Postoperative Intra-Abdominal Adhesions

    Arif Emre; Murat Akin; Ipek Isikgonul; Osman Yuksel; Ahmet Ziya Anadol; Cagatay Cifter

    2009-01-01

    BACKGROUND: Abdominal surgery can lead to postoperative intra-abdominal adhesions (PIAAs) with significant morbidity and mortality. This study compares the use of honey with a standard bioresorbable membrane (Seprafilm tm) to prevent the formation of PIAAs in rats. METHODS: Thirty rats underwent laparotomy, and PIAAs were induced by scraping the cecum. The animals were divided into three groups, each containing ten rats. Group 1 (control) represented the cecal abrasion group, with no intraper...

  2. Comparison of ramosetron's and ondansetron's preventive anti-emetic effects in highly susceptible patients undergoing abdominal hysterectomy

    Lee, Jae-Woo; Park, Hye Jin; Choi, Juyoun; Park, So Jin; Kang, Hyoseok; Kim, Eu-Gene

    2011-01-01

    Background This study compared the preventive effects of ramosetron and ondansetron on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing abdominal hysterectomy. Methods In a prospective, randomized, double-blinded study, a total of 120 highly susceptible women (nonsmokers, those receiving opioid-based IV patient-controlled analgesia [PCA]) undergoing abdominal hysterectomy were included in the study. Patients were divided into 2 groups and each group received ...

  3. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  4. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    Kitase, M.; Mizutani, M.; Tomita, H.; Kono, T.; Sugie, C.; Shibamoto, Y. [Nagoya City University, Nagoya, (Japan). Graduate School of Medical Sciences. Dept. of Radiology

    2007-07-15

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  5. DIEP breast reconstruction following multiple abdominal liposuction procedures

    Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the ter...

  6. Coronary artery abnormalities in Kawasaki disease - Comparison between CT and MR coronary angiography

    Kim, Jong Woo; Goo, Hyun Woo [Dept. of Radiology and Research Inst. of Radiology, Univ. of Ulsan Coll. of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], e-mail: hwoogoo@amc.seoul.kr

    2013-03-15

    Background: Although CT coronary angiography (CTCA) and MR coronary angiography (MRCA) are increasingly used in patients with Kawasaki disease, comparison of coronary artery assessability and diagnostic performance between the two imaging modalities has been rarely performed. Purpose: To investigate which imaging modality, CTCA or MRCA, is better for evaluating coronary artery abnormalities in patients with Kawasaki disease. Material and Methods: Between 2003 and 2011, 56 patients (38 boys/men; age range, 1-24 years) with Kawasaki disease underwent CTCA or MRCA (group A). Of these, 17 underwent both CTCA and MRCA (group B). Visibility of 11 coronary arterial segments in each patient was graded on a four-point scale. Coronary artery aneurysm, stenosis, and occlusion were evaluated by CTCA and MRCA, based on a reference standard obtained from cardiac catheterization, echocardiography, follow-up CTCA and MRCA, and clinical history. Coronary artery assessability and diagnostic performance were compared between CTCA and MRCA. Results: In per-segment analysis, more segments were assessable on CTCA than on MRCA in both groups. In per-patient analysis of group B, no significant difference in the assessability was found between CTCA (95.0%, 128.3/135 segments) and MRCA (92.4%, 124.8/135 segments) (P > 0.05). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTCA vs. MRCA were 93.1% vs. 77.9% (P < 0.001), 99.2% vs. 99.7% (P = 0.65), 96.8% vs. 98.7% (P = 0.65), 98.2% vs. 94.1% (P < 0.001), and 98.0% vs. 94.9% (P = 0.008), respectively, in group A, and 91.8% vs. 70.4% (P < 0.001), 99.5% vs. 99.5% (P = 1.000), 98.5% vs. 98.0% (P = 1.000), 97.2% vs. 91.1% (P = 0.006), and 97.6% vs. 92.3% (P = 0.004), respectively, in group B. Conclusion: Although CTCA and MRCA show comparable assessability in per-patient analysis, CTCA shows higher diagnostic performance than MRCA for evaluating coronary artery abnormalities in patients with Kawasaki

  7. Functional comparison of endothelin receptors in human and rat pulmonary artery smooth muscle.

    Bialecki, R A; Fisher, C S; Murdoch, W W; Barthlow, H G; Bertelsen, D L

    1997-02-01

    The receptors mediating arterial smooth muscle contraction to endothelins (ET) differ among species and origin of vascular bed. We characterized ET receptors mediating contraction of endothelium-denuded human intralobar pulmonary artery (hIPA) and rat intralobar (rIPA) and extralobar left branch (rLPA) pulmonary artery with ET-1, ET-2, ET-3, sarafotoxin S6c, sarafotoxin S6b, and ET receptor antagonists in vitro. Rat aorta was studied for comparison. Each vascular segment showed concentration-dependent contraction with a rank order sensitivity (pD2) profile of ET-1 > or = ET-2 = sarafotoxin S6b > ET-3. Maximum contraction to ET-1 was greater than to sarafotoxin S6c in all preparations. Responses of rIPA and rLPA to sarafotoxin S6c were conspicuous when compared with hIPA or aorta. The ET(A) receptor blockers BQ-123 and BMS-182874 competitively antagonized ET-1 responses of hIPA and aorta, but not rLPA. The ET(B) receptor antagonist BQ-788 attenuated contractions of rIPA and rLPA to ET-3 and sarafotoxin S6c, respectively. In conclusion, ET(B)-mediated contraction of endothelium-denuded conduit pulmonary arteries varies among species and may contribute more to contraction of rIPA and rLPA than of hIPA and aorta, although maximum ET(B)-mediated contraction is smaller than that mediated by the ET(A) receptor. PMID:9124371

  8. A Comparison of Complications between Open Abdominal Sacrocolpopexy and Laparoscopic Sacrocolpopexy for the Treatment of Vault Prolapse

    Anne-Lotte W. M. Coolen

    2013-01-01

    Full Text Available Introduction. Sacrocolpopexy is a generally applied treatment for vault prolapse which can be performed laparoscopically or by open laparotomy. Methods. Between October 2007 and December 2012, we performed a multicenter prospective cohort study in 2 university and 4 teaching hospitals in the Netherlands. We included patients with symptomatic posthysterectomy vaginal vault prolapse requiring surgical treatment, who either had abdominal or laparoscopic sacrocolpopexy. We studied surgery related morbidity, which was divided in pre-, peri-, and postoperative characteristics. Results. We studied 85 patients, of whom 42 had open abdominal and 43 laparoscopic sacrocolpopexy. In the laparoscopic sacrocolpopexy group, estimated blood loss was significantly less compared to the abdominal group: 192 mL (±126 versus 77 mL (±182, respectively (P≤.001. Furthermore, hospital stay was significantly shorter in the laparoscopic group (4.2 days as compared to the abdominal group (2.4 days (P≤.001. The overall complication rate was not significantly different (P=.121. However there was a significant difference in favor of the laparoscopic group in peri- and postoperative complications requiring complementary (conservative treatment and/or extended admittance (RR 0.24 (95%-CI 0.07–0.80, P=.009. Conclusion. Laparoscopic sacrocolpopexy reduces blood loss and hospital stay as compared to abdominal sacrocolpopexy and generates less procedure related morbidity.

  9. Abdominal trauma

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  10. Abdominal trauma

    The potential for multiple intraperitoneal and retroperitoneal organ injuries often makes accurate clinical evaluation of abdominal trauma patients difficult. Additionally, patients may be unresponsive, have unreliable abdominal physical examinations, or have concurrent serious head and cervical spine injuries which delay diagnosis of and attention to abdominal problems. In these situations radiologic abdominal imaging is often requested. To expedite patient evaluation, close cooperation between the emergency physician and the radiologist is essential. It is the clinical stability of the traumatized patient that dictates the extent of radiologic imaging. Life-threatening hypotension, positive peritoneal signs, or clear evidence of penetrating abdominal injury are indications for immediate surgery. Stable patients with signs suggesting intra-abdominal injury will benefit by further radiologic evaluation with appropriate imaging modalities. The selection of an appropriate modality in any one clinical situation depends upon many criteria including accessibility to diagnostic equipment, the sensitivity and specificity of each technique, and the expertise and preference of the attending radiologist. A suggested scheme for evaluating abdominal trauma patients is presented. Most aspects of this evaluation scheme will be discussed in depth

  11. Comparison of primary and delayed primary closure in dirty abdominal wounds in terms of frequency of surgical site infection

    Objective: Objective of this study was to compare primary and delayed primary wound closure for dirty abdominal wounds in terms of frequency of surgical site infection. Study Design: Randomized Controlled Trial. Place and Duration of Study: Combined Military Hospital, Multan. From 16 Sep 2010 to 15 Mar 2011. Patients and Methods: A total of 110 patients were randomly divided into two groups of 55 patients each using random numbers table. Abdominal wounds of one group were closed primarily and of other group were subjected to delayed primary wound closure. The wounds were then checked for surgical site infection for seven post operative days. Results: A higher frequency of surgical site infection was observed in primary closure group (27.3%) as compared to delayed primary closure group (9.1%) which was statistically significant (p=0.013). Conclusion: Delayed primary closure is superior to primary closure in dirty abdominal wounds in terms of frequency of surgical site infection. (author)

  12. Diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma

    We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery. (orig.)

  13. Comparison of Coronary Artery Bypass Grafting with Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease

    Kawecki, Damian; Morawiec, Beata; Fudal, Marcin; Milejski, Wojciech; Jacheć, Wojciech; Nowalany-Kozielska, Ewa

    2011-01-01

    Purpose Coronary artery bypass grafting (CABG) is the optimal treatment option for left main coronary artery disease (LMCAD). However, LMCAD remains a constant topic of discussion between cardiac surgeons and interventional cardiologists. The aim of this study was to assess the efficacy of LMCAD treatments by comparing the mid-term outcomes of CABG and percutaneous coronary intervention (PCI) using bare metal stents or drug-eluting stents (DESs). Materials and Methods The study population was...

  14. Abdominal sounds

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  15. Early inflammatory response following elective abdominal aortic aneurysm repair: A comparison between endovascular procedure and conventional, open surgery

    Marjanović Ivan

    2011-01-01

    Full Text Available Background/Aim. Abdominal aorta aneurysm (AAA represents a pathological enlargment of infrarenal portion of aorta for over 50% of its lumen. The only treatment of AAA is a surgical reconstruction of the affected segment. Until the late XX century, surgical reconstruction implied explicit, open repair (OR of AAA, which was accompanied by a significant morbidity and mortality of the treated patients. Development of endovascular repair of (EVAR AAA, especially in the last decade, offered another possibility of surgical reconstruction of AAA. The preliminary results of world studies show that complications of such a procedure, as well as morbidity and mortality of patients, are significantly lower than with OR of AAA. The aim of this paper was to present results of comparative clinical prospective study of early inflammatory response after reconstruction of AAA between endovascular and open, conventional surgical technique. Methods. A comparative clinical prospective study included 39 patients, electively operated on for AAA within the period of December 2008 - February 2010, divided into two groups. The group I counted 21 (54% of the patients, 58-87 years old (mean 74.3 years, who had been submited to EVAR by the use of excluder stent graft. The group II consisted of 18 (46% of the patients, 49-82 (mean 66.8 years, operated on using OR technique. All of the treated patients in both groups had AAA larager than 50 mm. The study did not include patients who have been treated as urgent cases, due to the rupture or with simptomatic AAA. Clinical, biochemical and inflamatory parameters in early postoperative period were analyzed, in direct postoperative course (number of leucocytes, thrombocytes, serum circulating levels of cytokine - interleukine (IL-2, IL-4, IL-6 and IL-10. Parameters were monitored on the zero, first, second, third and seventh postoperative days. The study was approved by the Ethics Commitee of the Military Medical Academy. Results

  16. Feasibility of simultaneous PET/MR of the carotid artery: first clinical experience and comparison to PET/CT

    Ripa, Rasmus Sejersten; Knudsen, Andreas; Hag, Anne Mette Fisker;

    2013-01-01

    min after injection. Subsequently, PET/CT was performed. Regions of interest (ROI) were drawn slice by slice to include the carotid arteries and standardized uptake values (SUV) were calculated from both datasets independently. Quantitative comparison of 18F-FDG uptake revealed a high congruence...

  17. Abdominal Sepsis.

    De Waele, Jan J

    2016-08-01

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

  18. Upper abdominal gadoxetic acid-enhanced and diffusion-weighted MRI for the detection of gastric cancer: Comparison with two-dimensional multidetector row CT

    Aim: To evaluate the diagnostic performance of abdominal magnetic resonance imaging (MRI) for the detection of gastric cancer in comparison with that of two-dimensional (2D) multidetector row computed tomography (CT). Materials and methods: The study included 189 patients with 170 surgically confirmed gastric cancers and 19 patients without gastric cancer, all of whom underwent gadoxetic acid-enhanced MRI with diffusion-weighted (DW) imaging, and multidetector contrast-enhanced abdominal CT imaging. Two observers independently analysed three sets of images (CT set, conventional MRI set, and combined conventional and DW MRI set). A five-point scale for likelihood of gastric cancer was used. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were evaluated. Quantitative [apparent diffusion coefficient (ADC) analyses with Mann–Whitney U-test were conducted for gastric cancers and the nearby normal gastric wall. Results: The diagnostic accuracy and sensitivity for detection of gastric cancer were significantly higher on combined conventional and DW MRI set (77.8–78.3%; 75.3–75.9%) than the CT imaging set (67.7–71.4%; 64.1–68.2%) or the conventional MRI set (72–73%; 68.8–70%; p < 0.01). In particular, for gastric cancers with pT2 and pT3, the combined conventional and DW MRI set (91.6–92.6%) yielded significantly higher sensitivity for detection of gastric cancer than did the CT imaging set (76.8–81.1%) by both observers (p < 0.01). The mean ADC of gastric cancer lesions (1 ± 0.23 × 10−3mm2/s) differed significantly from that of normal gastric wall (1.77 ± 0.25 × 10−3 mm2/s; p < 0.01). Conclusion: Abdominal MRI with DW imaging was more sensitive for the detection of gastric cancer than 2D-multidetector row CT or conventional MRI alone. - Highlights: • The sensitivity for detection of gastric cancer is high on abdominal MR imaging. • DW imaging is helpful for detection of

  19. Study Design of PROCEDURE Study. A Randomized Comparison of the Dose-Dependent Effects of Pitavastatin in Patients with Abdominal Aortic Aneurysm with Massive Aortic Atheroma: Prevention of Cholesterol Embolization during Endovascular and Open Aneurysm Repair with Pitavastatin (PROCEDURE) Study

    Hoshina, Katsuyuki; Nemoto, Masaru; Hashimoto, Takuya; Miura, Sumio; Urabe, Go; Nakazawa, Tatsu; Hosaka, Akihiro; Kato, Masaaki; Ohkubo, Nobukazu; Miyairi, Takeshi; Okamoto, Hiroyuki; Shigematsu, Kunihiro; Miyata, Tetsuro

    2013-01-01

    Outcomes of abdominal aortic aneurysm (AAA) repair have improved in the 2 decades since the emergence of endovascular aneurysm repair (EVAR). However, EVAR is considered a contraindication for shaggy aorta because of the high risk of shower embolization. Recently, statins have been implicated in preventing embolization in patients with shaggy aorta via its pleiotropic effects, including atheroma reduction and coronary artery stabilization. We selected pitavastatin, a statin with potent effect...

  20. Comparison of the Multidetector-row Computed Tomographic Angiography Axial and Coronal Planes' Usefulness for Detecting Thoracodorsal Artery Perforators

    Jong Gyu Kim

    2012-07-01

    Full Text Available Background During the planning of a thoracodorsal artery perforator (TDAP free flap,preoperative multidetector-row computed tomographic (MDCT angiography is valuablefor predicting the locations of perforators. However, CT-based perforator mapping of thethoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thickMDCT images in multiple planes to search for reliable perforators accurately.Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6females who underwent MDCT prior to TDAP free flap operations were enrolled in this study.Patients ranged in age from 10 to 75 years (mean, 39.3 years. MDCT images were acquired ata thickness of 1 mm in the axial, coronal, and sagittal planes.Results The thoracodorsal artery perforators were detected in all 19 cases. The reliableperforators originating from the descending branch were found in 14 cases, of which 6 hadtransverse branches. The former were well identified in the coronal view, and the latter in theaxial view. The location of the most reliable perforators on MDCT images corresponded wellwith the surgical findings.Conclusions Though MDCT has been widely used in performing the abdominal perforatorfree flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap.The results of this study suggest that multiple planes of MDCT may increase the probabilityof detecting the most reliable perforators, along with decreasing the probability of missingavailable vessels.

  1. Automated segmentation and tracking of coronary arteries in cardiac CT scans: comparison of performance with a clinically used commercial software

    Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Patel, Smita; Hadjiiski, Lubomir M.; Sahiner, Berkman; Wei, Jun; Kazerooni, Ella A.

    2010-03-01

    Coronary CT angiography (cCTA) has been reported to be an effective means for diagnosis of coronary artery disease. We are investigating the feasibility of developing a computer-aided detection (CADe) system to assist radiologists in detection of non-calcified plaques in coronary arteries in ECG-gated cCTA scans. In this study, we developed a prototype vessel segmentation and tracking method to extract the coronary arterial trees which will define the search space for plaque detection. Vascular structures are first enhanced by 3D multi-scale filtering and analysis of the eigenvalues of Hessian matrices using a vessel enhancement response function specifically designed for coronary arteries. The enhanced vascular structures are then segmented by an EM estimation method. The segmented coronary arteries are tracked using a 3D dynamic balloon tracking (DBT) method. For this preliminary study, two starting seed points were manually identified at the origins of the left and right coronary artery (LCA and RCA). The DBT method automatically moves a sphere along the vessel whose diameter is adjusted dynamically based on the local vessel size, tracks the vessels, and identifies its branches to generate the left and right coronary arterial trees. The algorithm was applied to 20 cCTA scans that contained various degrees of coronary artery diseases. To evaluate the performance of vessel segmentation and tracking, the rendered volume of coronary arteries tracked by our algorithm was displayed on a PC, placed next to a GE Advantage workstation on which the coronary arterial trees tracked by the GE software and the original cCTA scan were displayed. Two experienced thoracic radiologists visually examined the coronary arteries on the cCTA scan and the segmented vessels to count untracked false-negative (FN) segments and false positives (FPs). The comparison was made by radiologists' visual judgment because the digital files for the segmented vessels were not accessible on the

  2. Abdominal Pain

    ... relaxation. Guided imagery for abdominal pain About self-hypnosis and kids See YourChild : Pain and Your Child or Teen for more detail ... how to help your baby cope with the pain of medical procedures, circumcision, and teething. ... Helping Kids YourChild : A Look at Biofeedback YourChild : ...

  3. The efficacy of unenhanced MR imaging for the diagnosis of acute appendicitis: a performance comparison versus abdominal ultrasonography

    To evaluate the efficacy of unenhanced MR imaging compared to the diagnostic accuracy, advantage, and limitations of abdominal ultrasonography in the diagnosis of acute appendicitis. The study included 40 patients suspected of having acute appendicitis and who were subjected to an unenhanced MR image, as well as an abdominal ultrasonography. A T1 FLASH in an axial image, a chemical shift-selective fat suppressed T2 HASTE in an axial image, as well as a T2 HASTE in an axial and coronal image were obtained as unenhanced MR images. The diagnosis was established based on a surgical or clinical follow-up of the unenhanced MR results, which were then statistically compared to the ultrasonographic results. The surgical or clinical follow-up results revealed that 25 patients were positively diagnosed with appendicitis. Of these, 7 patients had symptoms of acute appendicitis with no pathologic diagnoses, whereas the 8 remaining patients were diagnosed with another condition. The sensitivity and accuracy of the unenhanced MR imaging was 92% and 90%, compared to ultrasonography which was 68% and 72.5% accurate, respectively. The differences in sensitivity and accuracy between the two methods were found to be statistically significant (ρ < 0.05, chi-square test). Based on these results, unenhanced MR imaging was superior to sonography for the diagnosis of appendicitis. Unenhanced MR imaging may be a useful modality for the diagnosis of acute appendicitis, especially for suboptimal or nondiagnostic sonographies, as well as patients that are particularity sensitive to radiation exposure

  4. Comparison of deep and superficial abdominal muscle activity between experienced Pilates and resistance exercise instructors and controls during stabilization exercise.

    Moon, Ji-Hyun; Hong, Sang-Min; Kim, Chang-Won; Shin, Yun-A

    2015-06-01

    Pilates and resistance exercises are used for lumbar stabilization training. However, it is unclear which exercise is more effective for lumbar stabilization. In our study, we aimed to compare surface muscle activity and deep muscle thickness during relaxation and spinal stabilization exercise in experienced Pilates and resistance exercise instructors. This study is a retrospective case control study set in the Exercise Prescription Laboratory and Sports Medicine Center. The participants included Pilates instructors (mean years of experience, 3.20±1.76; n=10), resistance exercise instructors (mean years of experience, 2.53±0.63; n=10), and controls (n=10). The participants performed 4 different stabilization exercises: abdominal drawing-in maneuver, bridging, roll-up, and one-leg raise. During the stabilization exercises, surface muscle activity was measured with electromyography, whereas deep muscle thickness was measured by ultrasound imaging. During the 4 stabilization exercises, the thickness of the transverse abdominis (TrA) was significantly greater in the Pilates-trained group than the other 2 other groups. The internal oblique (IO) thickness was significantly greater in the Pilates- and resistance-trained group than the control group, during the 4 exercises. However, the surface muscle activities were similar between the groups. Both Pilates and resistance exercise instructors had greater activation of deep muscles, such as the TrA and IO, than the control subjects. Pilates and resistance exercise are both effective for increasing abdominal deep muscle thickness. PMID:26171383

  5. The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma: a prospective comparison with computed tomography

    Purpose: In this prospective study we aimed to investigate the diagnostic value of ultrasonography (US) in hemodynamically stable children after blunt abdominal trauma (BAT) using computed tomography (CT) as the gold standard. Materials and methods: Between 1997 and 2001, 96 children with BAT were evaluated prospectively. CT was performed first, followed by US. US and CT examinations were independently evaluated by two radiologists for free fluid and organ injury. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US were assessed regarding CT as the gold standard. Results: Overall 128 organ injuries were determined in 96 patients with CT; however, 20 (15.6%) of them could not be seen with US. Free intraabdominal fluid (FIF) was seen in 82 of 96 patients by CT (85.4%) and eight of them (9.7%) could not be seen by US. We found that sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of the US for free intra-abdominal fluid were 90.2, 100, 100, 63.6 and 91.7%, respectively. Conclusions: US for BAT in children is highly accurate and specific. It is highly sensitive in detecting liver, spleen and kidney injuries whereas its sensitivity is moderate for the detection of gastrointestinal tract (GIT) and pancreatic injuries

  6. Comparison of the effects of semicarbazide and β-aminopropionitrile on the arterial extracellular matrix in the Brown Norway rat

    To investigate a putative role for semicarbazide-sensitive amine oxidase (SSAO) in arterial extracellular matrix (ECM) organization, we compared arteries of growing Brown Norway (BN) rats after chronic administration of semicarbazide (SCZ) and β-aminopropionitrile (BAPN), two inhibitors with different properties and relative specificities for SSAO and lysyl oxidase (LOX). The BN model is particularly well adapted to evaluating effects of toxic compounds on the arterial elastic network. We measured aortic LOX and SSAO activities and quantified several ECM parameters. After a pilot study comparing doses previously studied and testing for additivity, we studied low and high equimolar doses of SCZ and BAPN. Both compounds similarly inhibited LOX, whereas SCZ inhibited SSAO far more effectively than BAPN. Both decreased carotid wall rupture pressure, increased tail tendon collagen solubility, decreased aortic insoluble elastin (% dry weight) and dose-dependently increased defects in the internal elastic lamina of abdominal aorta, iliac and renal arteries. Our results suggest that either these effects are mediated by LOX inhibition, SCZ being slightly more effective than BAPN in our conditions, or SSAO acts similarly to and in synergy with LOX on ECM, the greater SCZ effect reflecting the simultaneous inhibition of both enzymes. However, the high SCZ dose increased aortic collagen and ECM proteins other than insoluble elastin markedly more than did equimolar BAPN, possibly revealing a specific effect of SSAO inhibition. To discriminate between the two above possibilities, and to demonstrate unequivocally a specific effect of SSAO inhibition on ECM formation or organization, we must await availability of more specific inhibitors.

  7. Pharmacological and molecular comparison of K(ATP) channels in rat basilar and middle cerebral arteries

    Ploug, Kenneth Beri; Edvinsson, Lars; Olesen, Jes; Jansen-Olesen, Inger

    ATP-sensitive potassium (K(ATP)) channels play an important role in the regulation of cerebral vascular tone. In vitro studies using synthetic K(ATP) channel openers suggest that the pharmacological profiles differ between rat basilar arteries and rat middle cerebral arteries. To address this issue...... basilar and middle cerebral arteries using quantitative real-time PCR (Polymerase Chain Reaction) and Western blotting, respectively. In the perfusion system, we found no significant responses after luminal application of three K(ATP) channel openers to rat basilar and middle cerebral arteries. In...... arteries. Densitometric measurements of the Western blot signals further showed higher expression levels of Kir6.1 and SUR2B proteins in rat middle cerebral arteries than was found in rat basilar arteries. In conclusion, our in vitro pharmacological studies showed no evidence for functional endothelial K...

  8. Detection of abdominal bleeding in blunt abdominal trauma

    Arterial hemorrhage is the most serious immediate complication of blunt abdominal trauma. This paper discusses the detection and localization of active hemorrhage in nonpenetrating injury, as a modification of the technique using technetium-99m sulfur colloid to localize the site of active bleeding in the gastrointestinal tract. Any imaging protocol for suspected hepatosplenic injury can be easily modified to search for active intra-abdominal hemorrhage. The timely detection of unsuspected bleeding improves patient management by allowing the surgeon to reorder his or her treatment priorities. The early detection of clinically unsuspected intra-abdominal, retroperitoneal, or pelvic hemorrhage will identify those patients who may need more definitive diagnostic procedures, interventional angiography for control of bleeding, or surgical intervention. The 500,000-count view of the abdomen and pelvis can be easily incorporated into any existing trauma protocol using technetium-99m sulfur colloid, is of proven value, and adds little additional time to the study

  9. Spiral Computed Tomographic Angiography of the Renal Arteries: A Prospective Comparison with Intravenous and Intraarterial Digital Subtraction Angiography

    Purpose: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). Methods: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation, 2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. Results: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. Conclusion: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA

  10. Acute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.

    Manzar Vakili

    2015-01-01

    Full Text Available Acute Respiratory Distress Syndrome (ARDS is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2 less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 % in the 24 hours and 4 (1.33% patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937 and sex (P

  11. Evaluation of renal artery stenosis on CT-angiography: Comparison of various rendering techniques (AXIAL, MPR, MIP, SSD)

    Purpose: To evaluate the various reconstruction methods of helical-CT angiography for the assessment of hemodynamically relevant renal artery stenoses in comparison to i.a. DSA. Methods: In 76 renal arteries the reconstruction modalities AXIAL, MRP, MIP and SSD of helical-CT angiography were compared with the results of i.a. DSA for the determination of the grade and location of the stenosis. Results: The highest accuracy of stenosis grading was 76% with AXIAL reconstruction. In 8% of the cases grading of the stenosis was not evaluable by the AXIAL reconstruction. In these cases, a higher sensitivity in the detection of hemodynamically relevant stenoses (>grade II, >50%) was achieved with the reconstruction mode MPR (96%) than with MIP (92%). In 51% of the cases the reconstruction mode SSD was not suitable for any diagnosis of renal artery stenosis because of overlying calcified plaques. Conclusions: The evidence of hemodynamically relevant stenosis in helical-CT angiography in comparison to i.a. DSA succeeds most reliably by using the reconstruction modality AXIAL in combination with MRP. The MIP reconstruction provides information about the anatomy of the renal arteries within one image. (orig.)

  12. Comparison of Intravoxel Incoherent Motion Parameters across MR Imagers and Field Strengths: Evaluation in Upper Abdominal Organs.

    Barbieri, Sebastiano; Donati, Olivio F; Froehlich, Johannes M; Thoeny, Harriet C

    2016-06-01

    Purpose To determine the reproducibility of intravoxel incoherent motion (IVIM) parameters measured in upper abdominal organs with magnetic resonance (MR) imagers from different vendors and with different field strengths. Materials and Methods This prospective study was approved by the independent ethics committees of Kanton Bern and Kanton Zurich, and signed informed consent was obtained from all participants. Abdominal diffusion-weighted images in 10 healthy men (mean age, 37 years ± 8 [standard deviation]) were acquired by using 1.5- and 3.0-T MR imagers from three different vendors. Two readers independently delineated regions of interest that were used to measure IVIM parameters (diffusion coefficient [Dt], perfusion fraction [Fp], and pseudodiffusion coefficient [Dp]) in the left and right lobes of the liver, and in the pancreas, spleen, renal cortex, and renal medulla. Measurement reproducibility between readers was assessed with intraclass correlation coefficients (ICCs). Variability across MR imagers was analyzed by using between- and within-subject coefficients of variation (CVs) and analysis of variance (ANOVA). Results Between-reader reproducibility was high for Dt (ICC, 94.6%), intermediate for Fp (ICC, 81.7%), and low for Dp (ICC, 69.5%). Between- and within-subject CVs of Dt were relatively high (>20%) in the left lobe of the liver and relatively low (<10%) in the renal cortex and renal medulla. CVs generally exceeded 15% for Fp values and 20% for Dp. ANOVA indicated significant differences (P < .05) between MR imagers. Conclusion IVIM parameters in the upper abdomen may differ substantially across MR imagers. (©) RSNA, 2015 Online supplemental material is available for this article. PMID:26678455

  13. Multidetector-row CT angiography of hepatic artery: comparison with conventional angiography

    To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MD-CT) for delineating the arterial anatomy of the liver. Hepatic arterial three-dimensional CT angiography was performed using MDCT (lightspeed Qx/I; GE medical systems, milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regrading a patient's hepatic arterial anatomy

  14. A ruptured dissecting aneurysm of the vertebral artery: comparison of angiographic and histological findings

    We present autopsy findings in a patient with a dissecting aneurysm of the vertebral artery causing subarachnoid haemorrhage. We sectioned the artery longitudinally and compared it with the angiogram, which showed the ''pearl-and-string''. Histological examination showed a pseudoaneurysm covered by adventitia alone, forming the ''pearl''. Internal elastic lamina and media were destroyed, and haematoma extended in the subadventitial space of the wall of the pseudoaneurysm. Media thickened by haematoma caused the ''string'', narrowing the parent artery. Alcian blue staining showed that stratified internal elastic lamina in the aneurysm and the parent artery, had undergone marked mucoid degeneration, which may have been responsible for the dissection. (orig.)

  15. COMPARISON OF ANTIEMETIC EFFICACY OF ONDANSETRON, GRANISETRON AND PALONOSETRON IN HIGH-RISK PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY UNDER GENERAL ANAESTHESIA

    Rakesh Kumar

    2016-03-01

    Full Text Available BACKGROUND Postoperative nausea and vomiting is (PONV a very distressing complication and preventive measures are justified when the risk of PONV is very high. Ondansetron is the first 5-HT3 antagonist used alone or in combination for prophylaxis of PONV due to its lower cost. Granisetron and palonosetron are recently introduced 5-HT3 antagonists with greater affinity for 5-HT3 receptor and having longer half-life. Aim of the present study is to compare the antiemetic efficacy of ondansetron, granisetron and palonosetron in high-risk patients undergoing abdominal hysterectomy under general anaesthesia. METHODS After obtaining Institutional Ethical Committee approval and written informed consent from all the participants, 150 patients of ASA grade I & II, aged between 20-50 years and weight between 30-60 kg undergoing abdominal hysterectomy under general anaesthesia were assigned randomly in to three groups of 50 patients each using random number table receiving either ondansetron 4 mg (Group O or granisetron 2 mg (Group G or palonosetron 0.75 mg (Group P intravenously just before the induction of anaesthesia. Incidence and severity of nausea and frequency of retching and vomiting were recorded in each group at the end of 2-hour and then at 24-hour and 48-hour intervals. RESULTS The incidence of nausea during first two hours postoperatively was found to be 14(28% in Group O, which was found to be significantly higher than 6(12% in group G and 4(8% in group P (p value = 0.016. The incidence of vomiting was found to be 6(12% in group O, which was found to be significantly higher than 2(4% in both group G and group P (p value = 0.018. Number of complete responders was significantly higher in Group P and group G as compared to group O. Number of patients requiring rescue antiemetic treatment was significantly high in group O{10(20%} as compared to 3(6% in both the group G and group P. CONCLUSIONS Newly introduced 5-HT3 antagonists, granisetron and

  16. Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

    To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

  17. ASSESSMENT OF VERTEBRAL ARTERIES BLOOD FLOW SPECTRAL DOPPLER INDICES IN COMPARISON WITH INTERNAL AND COMMON CAROTID ARTERIES BLOOD FLOW SPECTRAL DOPPLER INDICES

    H. Mazaher

    2007-05-01

    Full Text Available Vertebrobasilar insufficiency is the cause of cerebrovascular accidents in 20% of cases. There are few reports regarding spectral Doppler indices (SDIs of vertebral arteries (VAs normal blood flow. The objective of this study was to provide basic reference data about SDIs of VAs normal blood flow separately and in comparison with internal carotid arteries (ICAs and common carotid arteries (CCAs normal blood flows SDIs. This cross-sectional study performed on 70 normal patients. Color Doppler sonography (CDS and spectral Doppler sonography (SDS of right and left VAs (RVA and LVA, right and left CCAs (RCCA and LCCA, right and left ICAs (RICA and LICA, were performed. The mean PSV, EDV, and RI values of RVA blood flow were as 41.60 ± 9.6 cm/s, 14.60 ± 3.7 cm/s and 0.65 ± 0.06, and the mean PSV, EDV and RI values of LVA blood flow were as 42.20 ± 10.2 cm/s, 15.20 ± 4.2 cm/s, and 0.64 ± 0.05, respectively. There was not statistically significant difference between the mean PSV, EDV and RI values of RVA and LVA blood flows. The mean PSV and EDV values of VAs blood flows were significantly lower than the values of CCAs and ICCAs blood flows, respectively. The mean RI value of VAs blood flows was significantly lower than the mean RI Value of CCAs blood flows, but there was not statistically significant difference between the mean RI value of VAs blood flows and the mean RI value of ICAs blood flows.

  18. Power doppler ultrasound findings of renal infarct after experimental renal artery occlusion: comparison with spiral CT

    To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction in rabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CT scanning. In 28 rabbits weighing 2.5 4kg, the segmental renal artery was occluded through the left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography and spiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of the segmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, was evaluated by two radiologists. In all cases, as seen on power Doppler ultrasonography, infarcted areas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. The location of the lesion closely corresponded to the location seen during CT scanning. After renal arterial occlusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% of rabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Doppler ultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterial occlusion. Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congested capsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition, as seen on power Doppler ultrasonography

  19. MRI of the carotid artery at 7 Tesla: Quantitative comparison with 3 Tesla

    Koning, Wouter; De Rotte, Alexandra A J; Bluemink, Johanna J.; Van Der Velden, Tijl A.; Luijten, Peter R.; Klomp, DWJ; Zwanenburg, Jaco J M

    2015-01-01

    Purpose: To evaluate the 7 Tesla (T) MRI of the carotid arteries, as quantitatively compared with 3T. Materials and Methods: The 7T MRI of the carotid arteries was performed in six healthy subjects and in two patients with carotid stenosis. The healthy group was scanned at 3T and at 7T, using curren

  20. Pharmacological and molecular comparison of K(ATP) channels in rat basilar and middle cerebral arteries

    Ploug, Kenneth Beri; Edvinsson, Lars; Olesen, Jes;

    2006-01-01

    ATP-sensitive potassium (K(ATP)) channels play an important role in the regulation of cerebral vascular tone. In vitro studies using synthetic K(ATP) channel openers suggest that the pharmacological profiles differ between rat basilar arteries and rat middle cerebral arteries. To address this issue......, we studied the possible involvement of endothelial K(ATP) channels by pressurized arteriography after luminal administration of synthetic K(ATP) channel openers to rat basilar and middle cerebral arteries. Furthermore, we examined the mRNA and protein expression profile of K(ATP) channels to rat...... basilar and middle cerebral arteries using quantitative real-time PCR (Polymerase Chain Reaction) and Western blotting, respectively. In the perfusion system, we found no significant responses after luminal application of three K(ATP) channel openers to rat basilar and middle cerebral arteries. In...

  1. Comparison of levosimendan and nitroglycerine in patients undergoing coronary artery bypass graft surgery

    Sahu, Manoj K.; Das, Anupam; Malik, Vishwas; Subramanian, Arun; Singh, Sarvesh Pal; Hote, Milind

    2016-01-01

    Background: Levosimendan a calcium ion sensitizer improves both systolic and diastolic functions. This novel lusitropic drug has predictable antiischemic properties which are mediated via the opening of mitochondrial adenosine triphosphate-sensitive potassium channels. This action of levosimendan is beneficial in cardiac surgical patients as it improves myocardial contractility, decreases systemic vascular resistance (SVR), and increases cardiac index (CI) and is thought to be cardioprotective. We decided to study whether levosimendan has any impact on the outcomes such as the duration of ventilation, the length of Intensive Care Unit (ICU) stay, and the hospital stay when compared with the nitroglycerine (NTG), which is the current standard of care at our center. Materials and Methods: Forty-seven patients undergoing elective coronary artery bypass surgery were randomly assigned to two groups receiving either levosimendan or NTG. The medications were started before starting surgery and continued until 24 h in the postoperative period. Baseline hemodynamic parameters were evaluated before beginning of the operation and then postoperatively at 3 different time intervals. N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) levels were also measured in both groups. Results: In comparison to the NTG group, the duration of ventilation and length of ICU stay were significantly less in levosimendan group (P < 0.05, P = 0.02). NT-proBNP level analysis showed a slow rising pattern in both groups and a statistically significant rise in the levels was observed in NTG group (P = 0.03, P = 0.02) in postoperative period when compared to levosimendan group of patients. Conclusion: Levosimendan treatment in patients undergoing surgical revascularization resulted in improved CI, decreased SVR and lower heart rate. And, thereby the duration of ventilation and length of ICU stay were significantly less in this group of patients when compared with NTG group. PMID:26750674

  2. Coronary artery bypass graft imaging using ECG-gated multislice computed tomography: Comparison with catheter angiography

    AIM: To compare the value of multislice computerized tomography (MSCT) in imaging coronary artery bypass grafts (CABGs) by direct quantitative comparison with standard invasive angiography. METHODS: Using MSCT, 50 consecutive patients who had previously undergone CABG surgery and had recently undergone invasive angiography for recurrent angina pectoris, were studied further using MSCT after intravenous injection of non-ionic contrast agent; cardiac imaging was performed during a single breath-hold. Graft anatomy was quantified, using both quantitative coronary angiography (QCA) and MSCT, by different investigators blinded to each other. Reproducibility was quantified using the standard error of the measurement expressed as a percentage in log-transformed values (CV%) and intraclass correlation (ICC). RESULTS: All 150 grafts were imaged using MSCT; only 4 patent grafts were not imaged using selective angiography. Good agreement was achieved between MSCT and QCA on assessment of proximal anastomoses (CV% 25.2, ICC 0.84), mid-vessel luminal diameter (CV% 15.5, ICC 0.91) and aneurysmal dilations (CV% 14.3). Reasonable agreement was reached on assessment of distal anastomoses (CV% 26.7, ICC 0.66) and categorization of distal run-off (ICC 0.73). Good agreement was observed for stenoses of over 50% luminal loss (CV% 8.7, ICC 0.97) but agreement on assessment of less severe lesions was poor (CV% 208.7, ICC 0.51). CONCLUSION: This study demonstrates that CABGs can be quantitatively evaluated using MSCT, and that significant lesions present in all CABG segments can be reliably identified. Agreement between MSCT and QCA for lesions of less than 50% luminal loss was poor

  3. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

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

  4. Abdominal cancer during early childhood: A dosimetric comparison of proton beams to standard and advanced photon radiotherapy

    Purpose: Evaluation of dosimetric benefits of advanced radiotherapy techniques for the treatment of abdominal lesions during early childhood. Patients and methods: Treatment planning was performed for five Neuroblastoma (NBL) and four Wilms Tumor (WT) patients. Opposing fields (2F), photon intensity modulated radiotherapy (IMXT) and two proton techniques (passively scattered (PT) and scanned beams (IMPT)) were considered. Averaged dose-volume histograms, associated dosimetric parameters and a radiobiological model for the estimation of the therapy related carcinogenic effect were evaluated. Results: With respect to the 2F technique, both proton techniques enabled to reduce mean liver and kidney dose by 40-60%; Organ fractions irradiated at the level of the tolerance dose were reduced by 65% for kidneys and 75% for the liver in NBL patients and by additional 10% for WT patients. IMXT enabled to reduce parameters related to the steep high-dose gradient, e.g., V15Gy for the kidneys was reduced by a factor 2-3 compared to 2F. V12Gy was reduced by 40% in the liver. On the other side, the improvement of those parameters characterizing the low isodose domain was limited for IMXT. The risk for radiation-induced secondary cancer was doubled for IMXT and even more increased for PT if secondary neutrons were taken into account, while this risk remained the same or was reduced by IMPT with respect to 2F. Conclusions: Proton beams improved all dosimetric parameters for NBL and WT patients compared to photon techniques. This improvement was limited for IMXT mainly to parameters related to the steep high-dose gradient. Further research is needed to minimize uncertainties for secondary cancer estimations

  5. Comparison of clinical curative effect between open surgery and endovascular repair of abdominal aortic aneurysm in China

    WANG Si-wen; LIN Ying; YAO Chen; LIN Pei-liang; WANG Shen-ming

    2012-01-01

    Objective To compare clinical curative effects of open surgery (OS) or endovascular repair (EVAR) for patients with abdominal aortic aneurysm (AAA) in China.Data sources We performed a comprehensive search of both English and Chinese literatures involving case studies on retrograde OS or EVAR of AAA in China from January 1976 to December 2010.Study selection According to the inclusion criteria,76 articles were finally analyzed to compare patient characteristics,clinical success,complications,and prognosis.Results We analyzed a total of 2862 patients with 1757 undergoing OS (OS group) and 1105 undergoing EVAR (EVAR group).There was no significant difference in the success rate of the procedures.Operative time,length of ICU stay,fasting time,duration of total postoperative stay,blood loss,and blood transfusion requirements during the procedure were significantly lower in the EVAR group.A 30-day follow up revealed more cardiac,renal,pulmonary,and visceral complications in the OS group (P<0.01).Low-limb ischemia,however,was more common in the EVAR group (P<0.05).The 30-day mortality rate,including aorta-related and non-aorta related mortality,was significantly lower in the EVAR group (P<0.01).In the follow-up period,there were more patients with occlusions of artificial vessel and late endoleak in the EVAR group (P<0.01).The overall late mortality rate was higher in the OS group (P <0.01),especially non-aorta-related late mortality and mortality during the fourth to the sixth year (P<0.01).Conclusions EVAR was safer and less invasive for AAA patients.Patients suffered fewer complications and recovered sooner.However,complications such as artificial vessel occlusion,low-limb ischemia,and endoleak were common in EVAR.Clinicians should carry out further research to solve these complications and improve the efficacy of EVAR.

  6. Initial experience with single-source dual-energy CT abdominal angiography and comparison with single-energy CT angiography: image quality, enhancement, diagnosis and radiation dose

    To assess image quality of virtual monochromatic spectral (VMS) images, compared to single-energy (SE) CT, and to evaluate the feasibility of material density imaging in abdominal aortic disease. In this retrospective study, single-source (ss) dual-energy (DE) CT of the aorto-iliac system in 35 patients (32 male, mean age 76.5 years) was compared to SE-CT. By post-processing the data from ssDECT, VMS images at different energies and material density water (WD) images were generated. The image quality parameters were rated on 5-point scales. The aorto-iliac attenuation and contrast-to-noise ratio (CNR) were recorded. Quality of WD images was compared to true unenhanced (TNE) images. Radiation dose was recorded and statistical analysis was performed. Image quality and noise were better at 70 keV (P < 0.01). Renal artery branch visualisation was better at 50 keV (P < 0.005). Attenuation and CNR were higher at 50 and 70 keV (P < 0.0001). The WD images had diagnostic quality but higher noise than TNE images (P < 0.0001). Radiation dose was lower using single-phase ssDECT compared to dual-phase SE-CT (P < 0.0001). 70-keV images from ssDECT provide higher contrast enhancement and improved image quality for aorto-iliac CT when compared to SE-CT at 120 kVp. WD images are an effective substitute for TNE images with a potential for dose reduction. (orig.)

  7. Comparison of epidural butorphanol and fentanyl as adjuvants in the lower abdominal surgery: A randomized clinical study

    Jasleen Kaur

    2014-01-01

    Full Text Available Background: Epidural opioids acting through the spinal cord receptors improve the quality and duration of analgesia along with dose-sparing effect with the local anesthetics. The present study compared the efficacy and safety profile of epidurally administered butorphanol and fentanyl combined with bupivacaine (B. Materials and Methods: A total of 75 adult patients of either sex of American Society of Anesthesiologist physical status I and II, aged 20-60 years, undergoing lower abdominal under epidural anesthesia were enrolled into the study. Patients were randomly divided into three groups of 25 each: B, bupivacaine and butorphanol (BB and bupivacaine + fentanyl (BF. B (0.5% 20 ml was administered epidurally in all the three groups with the addition of 1 mg butorphanol in BB group and 100 μg fentanyl in the BF group. The hemodynamic parameters as well as various block characteristics including onset, completion, level and duration of sensory analgesia as well as onset, completion and regression of motor block were observed and compared. Adverse events and post-operative visual analgesia scale scores were also noted and compared. Data was analyzed using ANOVA with post-hoc significance, Chi-square test and Fisher′s exact test. Value of P < 0.05 was considered significant and P < 0.001 as highly significant. Results: The demographic profile of patients was comparable in all the three groups. Onset and completion of sensory analgesia was earliest in BF group, followed by BB and B group. The duration of analgesia was significantly prolonged in BB group followed by BF as compared with group B. Addition of butorphanol and fentanyl to B had no effect on the time of onset, completion and regression of motor block. No serious cardio-respiratory side effects were observed in any group. Conclusions: Butorphanol and fentanyl as epidural adjuvants are equally safe and provide comparable stable hemodynamics, early onset and establishment of sensory

  8. Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction

    Jung, Halim; Jung, SangWoo; Joo, Sunghee; Song, Changho

    2016-01-01

    [Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility...

  9. Abdominal Aortic Aneurysms: Treatments

    ... access catheters Vertebroplasty Women and vascular disease Women's health Social Media Facebook Twitter ... Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists are vascular ...

  10. Outcome of Coronary Artery Bypass Grafts: Comparison between on Pump and off Pump

    Rasoul Ibrahim Abdulrahman; Rezayat Parvizi

    2010-01-01

    The present study was undertaken to compare the in hospital results of coronary artery bypass graft (CABG) with (on pump) or without (off pump) cardiopulmonary bypass (CPB). Data were collected on all first-time isolated CABGs with saphenous vein and/or artery grafts at Shahid Madani Hospital in Tabriz-Iran, between 2006 and 2009. Age and clinical profile were marched between on pump and off pump group patients. Patients with concomitant cardiac operations or beating pump technique were exclu...

  11. Comparison of the Windkessel model and structured-tree model applied to prescribe outflow boundary conditions for a one-dimensional arterial tree model.

    Guan, Debao; Liang, Fuyou; Gremaud, Pierre A

    2016-06-14

    One-dimensional (1D) modeling is a widely adopted approach for studying wave propagation phenomena in the arterial system. Despite the frequent use of the Windkessel (WK) model to prescribe outflow boundary conditions for 1D arterial tree models, it remains unclear to what extent the inherent limitation of the WK model in describing wave propagation in distal vasculatures affect hemodynamic variables simulated at the arterial level. In the present study, a 1D model of the arterial tree was coupled respectively with a WK boundary model and a structured-tree (ST) boundary model, yielding two types of arterial tree models. The effective resistances, compliances and inductances of the WK and ST boundary models were matched to facilitate quantitative comparisons. Obtained results showed that pressure/flow waves simulated by the two models were comparable in the aorta, whereas, their discrepancies increased towards the periphery. Wave analysis revealed that the differences in reflected waves generated by the boundary models were the major sources of pressure wave discrepancies observed in large arteries. Additional simulations performed under aging conditions demonstrated that arterial stiffening with age enlarged the discrepancies, but with the effects being partly counteracted by physiological aortic dilatation with age. These findings suggest that the method adopted for modeling the outflow boundary conditions has considerable influence on the performance of a 1D arterial tree model, with the extent of influence varying with the properties of the arterial system. PMID:27062594

  12. Giant superior mesenteric artery aneurysm

    Temiz, Ahmet; Bostan, Mehmet; Şatıroğlu, Ömer; Çetin, Mustafa; Bozkurt, Engin

    2011-01-01

    Aneurysm of the superior mesenteric artery (SMA) is a rare condition and most of them are symptomatic. Gradu­ally increasing abdominal pain, intestinal ischemic symp­toms and rupture are the most common symptoms. We herein report a giant SMA aneurysm detected in a patient with complaint of abdominal discomfort.

  13. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h

  14. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hirzel, Florian C. [Kantonsspital Winterthur, Department of Gynecology (Switzerland); Gutzeit, Andreas; Zollikofer, Christoph L. [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hess, Thomas [Kantonsspital Winterthur, Department of Gynecology (Switzerland)

    2015-10-15

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h.

  15. Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease.

    Patterson, R E; Eng, C; Horowitz, S F; Gorlin, R; Goldstein, S R

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes' theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%, for example, asymptomatic people with no risk factors. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV). One advantage of this quantitative model is that it estimates a

  16. Abdominal trauma

    Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemo-dynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed. (authors). 26 refs., 11 figs., 1 tab

  17. Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children

    Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

  18. Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children

    Ayyala, Rama S.; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

    2015-11-15

    Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

  19. Contrast Enhanced Abdominal Ultrasound in the Assessment of Ileal Inflammation in Crohn's Disease: A Comparison with MR Enterography.

    C S Horjus Talabur Horje

    Full Text Available To prospectively examine the feasibility and accuracy of Contrast Enhanced Ultrasound (CEUS in the assessment of Crohn's disease (CD activity in the terminal ileum in comparison to Magnetic Resonance Enterography (MRE, using endoscopy as a reference standard.105 consecutive patients with alleged clinically active CD were assessed by MRE and CEUS. CEUS of the terminal ileum was performed using an intravenous microbubble contrast enhancer. Accuracy values of CEUS and MRE for the presence of active terminal ileitis were evaluated using the Receiver Operating Characteristic method, using endoscopic findings as a reference standard. Sensitivity and specificity values of MRE and CEUS were compared by the McNemar test.CEUS was feasible in 98% of patients, MRE in all. Optimal diagnostic accuracy in CEUS was obtained at a peak intensity value of 10%, showing 100% sensitivity, 92% specificity and an accuracy of 99% in demonstrating ileal mucosal inflammation. For MRE, overall sensitivity, specificity and accuracy were, 87%, 100%, and 88%, respectively. CEUS and MRE were highly correlated in assessing length and wall thickness of the terminal ileum. CEUS identified 11 of 16 MRE-detected strictures, but no fistulae.The accuracy of CEUS is comparable to that of MRE in the assessment of active, uncomplicated terminal ileal CD and therefore a valuable bedside alternative to MRE in the follow-up of these patients.

  20. Sequence Comparison for Non-Enhanced MRA of the Lower Extremity Arteries at 7 Tesla

    Sören Johst; Stephan Orzada; Anja Fischer; Lena C Schäfer; Kai Nassenstein; Lale Umutlu; Lauenstein, Thomas C.; Ladd, Mark E.; Stefan Maderwald

    2014-01-01

    In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE) sequence and a variant of the Quiescent-Interval Single-Shot (QISS) sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE) sequence. For image ...

  1. New abdominal CT angiography protocol on a 16 detector-row CT scanner - first results

    Purpose. Purpose of this study was the implementation of a new abdominal CT angiography protocol on a 16 detector-row CT scanner and the comparison to selective catheter angiography.Methods. 76 patients with various vascular disorders underwent abdominal CT angiography on a recently developed 16 detector-row CT scanner using submillimeter slice collimation (16 x 0.75 mm). Results were compared with mesenteric and/or hepatic angiography in 17 patients performed during tumor embolization. Opacification was provided using individually tailored contrast application with a test bolus setting. To evaluate the contrast injection protocol density measurements within the vessel lumen were performed.Results. Diagnostic image quality was achieved in all patients with angiographic comparison (n = 17). Within the hepatic and mesenteric vasculature up to 4th generation vessels could be identified. Compared to selctive angiography CT angiography provided equivalent morphologic information up to the detectable vessel generation. With the applied contrast application regimen there were no significant differences in vessel enhancement along the abdominal aorta and iliac arteries.Conclusion. 16 detector-row CT enables whole abdominal angiographic studies with submillimeter resolution in a single breath-hold. The improved spatial resolution enables for high quality 3D visualization. Compared to invasive angiography, 16 detector-row CT reveals equivalent morphologic information. (orig.)

  2. High prevalence of vertebral artery tortuosity of Loeys-Dietz syndrome in comparison with Marfan syndrome

    Loeys-Dietz syndrome (LDS) is a connective tissue disease caused by mutations in the genes encoding the transforming growth factor-β receptor (TGFBR). LDS is associated with aneurysms or dissections of the aorta similar to Marfan syndrome (MFS) as well as arterial tortuosity and aneurysms in the peripheral arteries. The purpose of this study was to evaluate the arterial diseases of LDS to differentiate it from MFS. A total of 10 LDS patients with an identified mutation in TGFBR (6 male, 4 female; mean age 36.3 years) and 20 MFS patients with an identified mutation in fibrilin-1 who were age- and sex-matched to the LDS subjects (12 male, 8 female; mean age 37.1 years) were reviewed. The prevalence of vertebral arterial tortuosity (VAT) and peripheral aneurysm (PAN) was studied using computed tomography angiography. In all, 9 of the 10 LDS patients had VAT, and five PANs were observed in 3 patients. In contrast, 8 (40%) of the MFS patients had VAT, and 1 patient had a PAN. LDS had a higher prevalence of VAT (P=0.017) by Fisher's exact test. The VAT was highly prevalent among LDS patients. Thus, the presence of VAT has the potential to differentiate LDS from MFS. (author)

  3. Comparison of pulseoximetry oxygen saturation and arterial oxygen saturation in open heart intensive care unit

    Alireza Mahoori

    2013-08-01

    Full Text Available Background: Pulseoximetry is widely used in the critical care setting, currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SPO2 (puls-eoximetry oxygen saturation in intensive care unit after cardiac surgery. Our objective was to compare pulseoximetry with arterial oxygen saturation (SaO2 during clinical routine in such patients, and to examine the effect of mild acidosis on this relationship.Methods: In an observational prospective study 80 patients were evaluated in intensive care unit after cardiac surgery. SPO2 was recorded and compared with SaO2 obtained by blood gas analysis. One or serial arterial blood gas analyses (ABGs were performed via a radial artery line while a reliable pulseoximeter signal was present. One hundred thirty seven samples were collected and for each blood gas analyses, SaO2 and SPO2 we recorded.Results: O2 saturation as a marker of peripheral perfusion was measured by Pulseoxim-etry (SPO2. The mean difference between arterial oxygen saturation and pulseoximetry oxygen saturation was 0.12%±1.6%. A total of 137 paired readings demonstrated good correlation (r=0.754; P<0.0001 between changes in SPO2 and those in SaO2 in samples with normal hemoglobin. Also in forty seven samples with mild acidosis, paired readings demonstrated good correlation (r=0.799; P<0.0001 and the mean difference between SaO2 and SPO2 was 0.05%±1.5%.Conclusion: Data showed that in patients with stable hemodynamic and good signal quality, changes in pulseoximetry oxygen saturation reliably predict equivalent changes in arterial oxygen saturation. Mild acidosis doesn’t alter the relation between SPO2 and SaO2 to any clinically important extent. In conclusion, the pulse oximeter is useful to monitor oxygen saturation in patients with stable hemodynamic.

  4. Dual phase spiral CT of the pancreas : comparison of arterial and portal phase

    Chung, Myung Jin; Choi, Byung Ihn; Han, Joon Koo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To compare the images of arterial phase (AP) and portal venous phase (PVP) in the evaluation of conspicuousness of lesion and peripancreatic arterial and venous opacification in pancreatic diseases. Dual-phase spiral CT was performed in 37 patients with pancreatic adenocarcinoma and 21 patients with pancreatitis. CT scans were performed with 5 mm collimation at 1:1 pitch table feed. Images of AP and PVP were obtained at 30 and 65 seconds after administration of contrast material, was initiated. Using a grading system, images were analalysed for conspicuousness of lesion and vascular opacification(grade 1=good, grade 2=fair, grade 3=poor). In pancreatic adenocarcinoma, 35 and 36 of 37 cases showed low attenuation on AP and PVP, respectively. With regard to conspicuousness of tumour, PVP(mean grade:1.24) was superior AP(mean grade:1.43), but not significantly(p=0.0745). In arterial opacification, AP(mean grade:1.03) was significantly superior to PVP(mean grade:1.30, ; p=0.0051). In venous opacification, PVP(mean grade:1.19) was significautly to AP(mean grade:2.41;p<0.0001). In pancreatitis, 14 and 15 of 21 cases showed localized hypo-attenuating lesion indicating necrosis or fluid collection, on AP and PVP, respectively. With regard to conspicuousness of lesion, PVP(mean grade:1.61) was superior to AP(mean grade:1.81), but not significantly(p=0.1088). In arterial opacification, AP(mean grade:1.05) was significantly superior to PVP(mean grade:1.38;p=0.0180). In venous opacification, PVP(mean grade:1.10) was significantly superior to AP(mean grade:2.33;p=0.0005). For the diagnosis and staging of pancreatic disease, dual-phase spiral CT in arterial and portal venous phase may be recommendable. The portal venous phase of spiral CT seems, however, to be superior to the arterial phase because the lesion is more conspicuous and there is venous opacification.

  5. Dual phase spiral CT of the pancreas : comparison of arterial and portal phase

    To compare the images of arterial phase (AP) and portal venous phase (PVP) in the evaluation of conspicuousness of lesion and peripancreatic arterial and venous opacification in pancreatic diseases. Dual-phase spiral CT was performed in 37 patients with pancreatic adenocarcinoma and 21 patients with pancreatitis. CT scans were performed with 5 mm collimation at 1:1 pitch table feed. Images of AP and PVP were obtained at 30 and 65 seconds after administration of contrast material, was initiated. Using a grading system, images were analalysed for conspicuousness of lesion and vascular opacification(grade 1=good, grade 2=fair, grade 3=poor). In pancreatic adenocarcinoma, 35 and 36 of 37 cases showed low attenuation on AP and PVP, respectively. With regard to conspicuousness of tumour, PVP(mean grade:1.24) was superior AP(mean grade:1.43), but not significantly(p=0.0745). In arterial opacification, AP(mean grade:1.03) was significantly superior to PVP(mean grade:1.30, ; p=0.0051). In venous opacification, PVP(mean grade:1.19) was significautly to AP(mean grade:2.41;p<0.0001). In pancreatitis, 14 and 15 of 21 cases showed localized hypo-attenuating lesion indicating necrosis or fluid collection, on AP and PVP, respectively. With regard to conspicuousness of lesion, PVP(mean grade:1.61) was superior to AP(mean grade:1.81), but not significantly(p=0.1088). In arterial opacification, AP(mean grade:1.05) was significantly superior to PVP(mean grade:1.38;p=0.0180). In venous opacification, PVP(mean grade:1.10) was significantly superior to AP(mean grade:2.33;p=0.0005). For the diagnosis and staging of pancreatic disease, dual-phase spiral CT in arterial and portal venous phase may be recommendable. The portal venous phase of spiral CT seems, however, to be superior to the arterial phase because the lesion is more conspicuous and there is venous opacification

  6. Comparison of oscillometric and intra-arterial blood pressure and pulse measurement.

    Rithalia, S V; Edwards, D

    1994-01-01

    Non-invasive oscillometric blood pressure and pulse measured by an Omron HEM-703CP monitor were compared with arterial values obtained from direct measurements of the radial artery. An excellent correlation and agreement was found between the two methods (systolic r = 0.99; diastolic r = 0.97; pulse r = 0.99), although there was some variability among individual subjects. The range of difference between them was 0 to 10 mmHg for systolic and -6 to +5 mmHg for diastolic pressures. When tested on the bench using the Metron QA-1280 non-invasive blood pressure analyser the HEM-703CP monitor rarely exhibited errors exceeding 2-3 mmHg over a measurement range of 50-200 mmHg. PMID:7776359

  7. Contrast-enhanced MR angiography of abdominal vessels: Is there still a role for angiography?

    Vosshenrich, R.; Fischer, U. [Department of Radiology, Georg-August-Universitaet Goettingen (Germany)

    2002-01-01

    The purpose of this review article is to describe recent advantages in contrast-enhanced (CE) three-dimensional (3D) magnetic resonance angiography (MRA) in comparison with other vascular imaging techniques, and to discuss their current clinical applications for the imaging of abdominal vessels. Principles and technical considerations are presented and clinical applications are reviewed for different vascular diseases. In ruptured aortic aneurysms and acute dissections CT is the method of first choice. Contrast-enhanced 3D MRA can be well used for therapeutic planning and follow-up in patients with stable disease. A comprehensive MR examination including CE 3D MRA, MR urography and MR nephrogram has the potential to replace the conventional studies for the evaluation of renal vascular disease. It is an accurate method for imaging the origins of coeliac and superior mesenteric arteries, although the image resolution is too low for reliable assessment of the inferior mesenteric artery. Contrast-enhanced 3D MRA has emerged as the method of choice for studying the portal venous system in liver transplant recipients, in patients with portal hypertension and in cases with abdominal tumours for preoperative evaluation. Additional non-invasive flow measurements are useful in monitoring portal hypertension. The abdominal veins can be well imaged using unenhanced MR techniques. Imaging may be facilitated with intravascular contrast media. Contrast-enhanced 3D MRA can replace intra-arterial DSA for diagnosis, therapy planning and follow-up in patients with abdominal vascular disease. Catheter-based arteriography will still be used for interventional procedures such as percutaneous transluminal angioplasty, stent placement and embolisation. (orig.)

  8. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    Zhou M; Huang D; Liu C; Liu Z.; Zhang M; Qiao T; Liu CJ

    2014-01-01

    Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular) procedures (HYBRID) with open surgical reconstructions (OPEN) in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of pro...

  9. Risk factors for peripheral arterial disease in the tropics and its comparison with the western population

    Myla Yacob; Edwin Stephen; Nupur Bit; Mazda Turel; David Sadhu; Sunil Agarwal

    2010-01-01

    Objective:To identify and compare the existence of similar and other risk factors in the perspective of an Indian population. Methods:It was designed as a case control study and was conducted in the Department of General and Vascular Surgery Unit 2 of Christian Medical College, Vellore, India between the periods July 2003 to June 2005. 100 patients with an ABPI<0.9 and 100 controls were studied. Results:Peripheral arterial disease (PAD) was found to be commoner among males (87%). While atherosclerosis was the commonest aetiology (54%), the incidence of Thromboangiitis Obliterans was also not uncommon (38%). Smoking was the main risk factor in the Indian context (83%) as compared to hypercholesterolemia (60%) in the West. The patients with atherosclerotic PAD were middle-aged and had concomitant diabetes (50%) and hypertension (30%). Conclusions:Peripheral arterial disease occurs in a relatively younger age group in India as compared to their Western counterparts. Thromboangiitis Obliterans was found to be a significant aetiology for arterial occlusive disease, with smoking as the primary risk factor followed by diabetes, hypertension and hypercholesterolemia.

  10. Elasticity assessment of electrospun nanofibrous vascular grafts: a comparison with femoral ovine arteries.

    Bagnasco, D Suarez; Ballarin, F Montini; Cymberknop, L J; Balay, G; Negreira, C; Abraham, G A; Armentano, R L

    2014-12-01

    Development of successful small-diameter vascular grafts constitutes a real challenge to biomaterial engineering. In most cases these grafts fail in-vivo due to the presence of a mechanical mismatch between the native vessel and the vascular graft. Biomechanical characterization of real native vessels provides significant information for synthetic graft development. Electrospun nanofibrous vascular grafts emerge as a potential tailor made solution to this problem. PLLA-electrospun nanofibrous tubular structures were prepared and selected as model bioresorbable grafts. An experimental setup, using gold standard and high resolution ultrasound techniques, was adapted to characterize in vitro the poly(L-lactic acid) (PLLA) electrospun structures. The grafts were subjected to near physiologic pulsated pressure conditions, following the pressure-diameter loop approach and the criteria stated in the international standard for cardiovascular implants-tubular vascular prostheses. Additionally, ovine femoral arteries were subjected to a similar evaluation. Measurements of pressure and diameter variations allowed the estimation of dynamical compliance (%C, 10(-2) mmHg) and the pressure-strain elastic modulus (E(Pε), 10(6) dyn cm(-2)) of the abovementioned vessels (grafts and arteries). Nanofibrous PLLA showed a decrease in %C (1.38±0.21, 0.93±0.13 and 0.76±0.15) concomitant to an increase in EPε (10.57±0.97, 14.31±1.47 and 17.63±2.61) corresponding to pressure ranges of 50 to 90 mmHg, 80 to 120 mmHg and 100 to 150 mmHg, respectively. Furthermore, femoral arteries exhibited a decrease in %C (8.52±1.15 and 0.79±0.20) and an increase in E(Pε) (1.66±0.30 and 15.76±4.78) corresponding to pressure ranges of 50-90 mmHg (elastin zone) and 100-130 mmHg (collagen zone). Arterial mechanics framework, extensively applied in our previous works, was successfully used to characterize PLLA vascular grafts in vitro, although its application can be directly extended to in vivo

  11. Abdominal Pain or Cramping

    ... Body & lifestyle changes > Abdominal pain or cramping Abdominal pain or cramping E-mail to a friend Please ... signs of severe pain. What causes mild belly pain in pregnancy? There are different causes for mild ...

  12. Case report: Varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein mimicking a renal artery aneurysm: Report of an unusual site of varicose veins and a novel hypothesis to explain its association with abdominal pain

    Sandeep G Jakhere

    2011-01-01

    Full Text Available A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and nephrectomies as it may pose technical difficulties during surgery or cause life-threatening retroperitoneal hemorrhage. Varicosity of this venous channel may be mistaken for paraaortic lymphadenopathy, adrenal pseudo-mass, or renal artery aneurysm. We report a case of a patient with varicosity of this communicating vein, which mimicked a left renal artery aneurysm. A novel hypothesis is also proposed to explain the relationship with abdominal pain.

  13. Comparison of Novel Coronary Artery Disease Risk Factors between Obese and Normal Adolescent

    Kouzehgaran, Samaneh; Vakili, Rahim; Nematy, Mohsen; Safarian, Mohamad; Ghayour-Mobarhan, Majid; Khajedaluee, Mohamad

    2015-01-01

    Background Coronary artery disease is considered as the most common cause of death in all societies including Iran. This study seeks to compare the new risk factors of coronary-artery diseases in obese adolescents and control group. Methods In this cross-sectional study, amongst the obese adolescents registered in the nutrition clinic of Ghaem Hospital, 80 individuals were selected. As the control group, additional 80 adolescent students having the same gender and age as the obese group, but with normal weight were selected. These two groups were selected randomly and their serum level of vitamin D, anti-heat shock protein27 (HSP27), balance of oxidants and antioxidants, and homocysteine were determined and compared. Results In this study, 42 (53.2%) and 37 (46.8%) of the obese and normal weight groups were male, respectively. The mean value of triglyceride, cholesterol, and LDL in the obese group was higher than the normal group, but the mean value for HDL, vitamin D, homocysteine, PAB (Preoxidant and Antioxidants Balance), and anti-HSP27 was not significantly different between the groups. In the base of homocysteine >15 µmol/l, 26.6% of the obese group had hyperhomocysteinemia, therefore homocysteine may be a new risk factor for coronary artery disease in obese adolescents (χ2=4.072; P value=0.091). Conclusion The findings of this study showed that despite the presence of obesity in adolescence and adolescents, new risk factors are not present among them more than the control group. This was in contrast to what was seen in adults. PMID:26170518

  14. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  15. Automated tube potential selection for standard chest and abdominal CT in follow-up patients with testicular cancer: comparison with fixed tube potential

    Gnannt, Ralph; Winklehner, Anna; Frauenfelder, Thomas; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Eberli, Daniel [University Hospital Zurich, Clinic for Urology, Zurich (Switzerland); Knuth, Alexander [University Hospital Zurich, Clinic for Oncology, Zurich (Switzerland)

    2012-09-15

    To evaluate prospectively, in patients with testicular cancer, the radiation dose-saving potential and image quality of contrast-enhanced chest and abdominal CT with automated tube potential selection. Forty consecutive patients with testicular cancer underwent contrast-enhanced arterio-venous chest and portal-venous abdominal CT with automated tube potential selection (protocol B; tube potential 80-140 kVp), which is based on the attenuation of the CT topogram. All had a first CT at 120 kVp (protocol A) using the same 64-section CT machine and similar settings. Image quality was assessed; dose information (CTDI{sub vol}) was noted. Image noise and attenuation in the liver and spleen were significantly higher for protocol B (P < 0.05 each), whereas attenuation in the deltoid and erector spinae muscles was similar. In protocol B, tube potential was reduced to 100 kVp in 18 chest and 33 abdominal examinations, and to 80 kVp in 5 abdominal CT examinations; it increased to 140 kVp in one patient. Image quality of examinations using both CT protocols was rated as diagnostic. CTDI{sub vol} was significantly lower for protocol B compared to protocol A (reduction by 12%, P < 0.01). In patients with testicular cancer, radiation dose of chest and abdominal CT can be reduced with automated tube potential selection, while image quality is preserved. (orig.)

  16. Comparison of the effect of alpha1- and alpha2-adrenoceptor agonists and antagonists on muscle contractility of the rabbit abdominal aorta in vitro.

    Gnus, Jan; Rusiecka, Agnieszka; Czerski, Albert; Zawadzki, Wojciech; Witkiewicz, Wojciech; Hauzer, Willy

    2013-01-01

    The aim of the study was to demonstrate the effect of selected agonists and antagonists of alpha-adrenergic receptors on muscle contractility of the rabbit abdominal aorta in vitro with particular emphasis on alpha2-adrenergic receptor subtypes. The study was conducted on 30 New Zealand breed rabbits from which specimens of the abdominal aorta were collected. The sections were set up in an automatic water bath in a Krebs-Henseleit buffer at 37 degrees C. The experiments showed that alpha1-adrenergic receptors played the main role in the contractile response ofthe rabbit abdominal aorta. Stimulation of alpha1-adrenergic receptor by administration ofphenylephrine resulted in an increase in smooth muscle tonus ofthe rabbit abdominal aorta by an average of 4.75 mN. The reaction after stimulation of alpha2-adrenergic receptors by similar doses of their agonists was much weaker. Prolonged tissue response time and time needed to reach maximum tonus for alpha2-adrenergic receptor agonists were observed. The obtained results confirm the thesis that the alpha1-adrenergic receptor is the most important factor controlling the contractility of the rabbit abdominal aorta, but the alpha2-adrenergic receptor is also involved in maintaining muscle tissue tonus. PMID:23767297

  17. Radiological evaluation of abdominal trauma

    Simple abdomen film has played an important role in decision of emergency operations in patients with the abdominal trauma. Nowadays, it still acts as a primary and inevitable processes in emergency condition. At the Department of Radiology, Hanil Hospital, 70 patients, who were laparotomied due to penetrating or nonpernetraing abdominal trauma, were observed and analyzed with simple abdomen film after comparison with the operative findings. The results are as follows: 1. Most frequent age distribution was 10 to 39 years and marked 70%. Male was in 90% incidence. 2. Penetrating injury largely involved the small bowel and abdominal wall. Non-penetrating injury usually involved the spleen, small bowel, liver, kidney, pancreas, duodenum. 3. Single organ injury occurred in higher incidence at the small bowel and abdominal wall. Multiple organ injury occurred in higher incidence at the spleen, liver, kidney and pancreas. 4. Organ distribution was 26% in spleen, 22% in small bowel, 14% in liver, 11% in abdominal wall. 7% in pancreas, 7% in kidney. 5% in duodenum, 4% in GB and CBD, 2% in diaphragm, 2% in colon, and 1% in stomach. 5. The specific roentgen findings and their frequency which useful in differential diagnosis at abdominal trauma, were as follows: a) flank fluid; Detectable possibility was 71% in liver laceration, 69% in spleen laceration and 57% in pancreas laceration. b) ipsilateral psoas shadow obliteration; Detectable possibility was 57% in liver laceration, 57% in kidney laceration and 46% in spleen laceration. c) free air; Detactable possibility was 60% in duodenal perforation, and 36% in peroration of upper part of small bowel. d) Reflex ileus; Detectable possibility was 64% in small bowel, 50% in liver laceration and 35% in spleen laceration. e) rib fracture; Detactable possibility was 36% in liver laceration and 23% in spleen laceration. f) pleural effusion; Detectable possibility was 29% in liver laceration and 27% in spleen laceration

  18. Comparison of the antagonistic effects of different angiotensin II receptor blockers in human coronary arteries

    Pantev, Emil; Stenman, Emelie; Wackenfors, Angelica;

    2002-01-01

    undertaken to evaluate the inhibitory effects of ARBs on vasoconstriction in humans. METHODS: Vasomotor tone was analyzed in endothelium denuded, human coronary artery (HCA) segments. Ang II type 1 (AT(1)) and type 2 (AT(2)) receptor mRNA expression was examined by reverse transcriptase-polymerase chain...... presence of 100 nM losartan elicited a depression of the Ang II response to 32%. Its active metabolite, EXP 3174 (1 nM),abolished the Ang II contraction. The AT(1) receptor antagonists had the following order of blocking effect; EXP 3174 > candesartan = valsartan > losartan. The AT(2) receptor antagonist...

  19. COMPARISON OF ENALAPRIL AND PERINDOPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION AND LEFT VENTRICLE SYSTOLIC DYSFUNCTION

    Yu. I. Grinshtein; O. L. Barbarash; D. A. Yakhontov; A. E. Popelysheva; V. V. Shabalin; N. B. Osetrova

    2016-01-01

    Aim. To compare efficacy of enalapril and perindopril in patients with arterial hypertension (HT) and left ventricle systolic dysfunction.Material and methods. Patients (n=51) with HT and left ventricle systolic dysfunction (ejection fraction<45%) were included in the prospective open randomized comparative study. Patients were randomized into 2 groups of therapy with enalapril 10-20 mg BID (n=25) or with perindopril 4-8 mg OD (n=26). Hydrochlorothiazide (12,5-25 mg OD) was added in case o...

  20. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    A.A. Anderzhanova; J. V. Gavrilov; V. A. Sulimov

    2016-01-01

    Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate) in patients with arterial hypertension (HT) of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o.) with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2). G1 patients were treated with betaxolol, and G2 patients – with metoprol...

  1. Comparison of flow capacities of arterial and venous grafts for coronary artery bypass grafting: evaluation with exercise thallium-201 single-photon emission tomography

    Stress thallium-201 tomography was performed to compare the flow capacities of arterial and saphenous vein grafts in patients with coronary artery bypass grafting (CABG). One hundred and seven consecutive patients (95 male and 12 female; mean age 58±9.1 years) underwent exercise-redistribution 201Tl myocardial single-photon emission tomography 4-5 weeks after CABG. When a reversible perfusion defect was present in the area covered by a patent bypass graft, the flow capacity of the graft was defined as insufficient. Of all 285 grafts, 211 were considered as complete bypass. Reversible perfusion defects were present in 29 (27%) of 108 myocardial areas supplied by patent arterial grafts but in only 5 (5%) of 103 myocardial areas supplied by patent saphenous vein grafts (P<0.0001). In the LAD area reversible defects were observed in 22 of 82 areas covered by arterial grafts, in contrast to only 1 of 29 areas covered by venous grafts (P<0.01); in the RCA area reversible defects were observed in 7 of 17 and 4 of 41 areas respectively (P<0.01). There was no difference between the native coronary artery stenosis bypassed by patent arterial and venous grafts (88%±12% vs 86%±14% respectively, P=0.27). In conclusion, flow capacities during peak myocardial demand were more frequently insufficient in arterial bypass grafts than in saphenous vein grafts. (orig.)

  2. Sequence comparison for non-enhanced MRA of the lower extremity arteries at 7 Tesla.

    Sören Johst

    Full Text Available In this study three sequences for non-contrast-enhanced MRA of the lower extremity arteries at 7T were compared. Cardiac triggering was used with the aim to reduce signal variations in the arteries. Two fast single-shot 2D sequences, a modified Ultrafast Spoiled Gradient Echo (UGRE sequence and a variant of the Quiescent-Interval Single-Shot (QISS sequence were triggered via phonocardiogram and compared in volunteer examinations to a non-triggered 2D gradient echo (GRE sequence. For image acquisition, a 16-channel transmit/receive coil and a manually positionable AngioSURF table were used. To tackle B1 inhomogeneities at 7T, Time-Interleaved Acquisition of Modes (TIAMO was integrated in GRE and UGRE. To compare the three sequences quantitatively, a vessel-to-background ratio (VBR was measured in all volunteers and stations. In conclusion, cardiac triggering was able to suppress flow artifacts satisfactorily. The modified UGRE showed only moderate image artifacts. Averaged over all volunteers and stations, GRE reached a VBR of 4.18±0.05, UGRE 5.20±0.06, and QISS 2.72±0.03. Using cardiac triggering and TIAMO imaging technique was essential to perform non-enhanced MRA of the lower extremities vessels at 7T. The modified UGRE performed best, as observed artifacts were only moderate and the highest average VBR was reached.

  3. Continuous blood pressure measurement using the pulse transit time: Comparison to intra-arterial measurement.

    Patzak, Andreas; Mendoza, Yuri; Gesche, Heiko; Konermann, Martin

    2015-01-01

    Continuous blood pressure (BP) measurement allows the investigation of transient changes in BP and thus may give insights into mechanisms of BP control. We validated a continuous, non-invasive BP measurement based on the pulse transit time (PTT), i.e., BP(PTT), by comparing it with the intra-arterial BP (BP(i.a.)) measurement. Twelve subjects (five females and seven males) were included. BP(i.a.) was obtained from the radial artery using a system from ReCor Medical. Systolic and diastolic BP were calculated using the PTT (BP(PTT), SOMNOscreen). (PTT) was determined from the electrocardiogram and the peripheral pulse wave. The BP was modulated by application of increasing doses of dobutamine (5, 10, 20 μg/kg body mass). Systolic BP(PTT) and systolic BP(i.a.) correlated significantly (R = 0.94). The limits of agreement in the Bland-Altman plot were ± 19 mmHg; the mean values differed by 1 mmHg. The correlation coefficient for the diastolic BP measurements was R = 0.42. The limits of agreement in the Bland-Altman plot were ± 18 mmHg, with a mean difference of 5 mmHg in favour of the BP(PTT). The study demonstrates a significant correlation between the measurement methods for systolic BP. The results encourage the application of PTT-based BP measurement for the evaluation of BP dynamics and pathological BP changes. PMID:25857601

  4. Ventricular function following coronary artery bypass grafting: comparison between Gated SPECT and cardiac magnetic resonance imaging

    Mesquita, Claudio Tinoco [Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Instituto Nacional de Cardiologia, Rio de Janeiro, RJ (Brazil); Pessoa, Maria Carolina Pinheiro [Pro-Echo Hospital Samaritano, Rio de Janeiro, RJ (Brazil); Vasconcelos, Paulo Pontes [Centro de Diagnostico por Imagens (CDPI), Rio de Janeiro, RJ (Brazil); Oliveira Junior, Amarino Carvalho [Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil). Servico de Radiologia; Dohmann, Hans Fernando Rocha [Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil). Servico de Radiologia; Instituto Nacional de Cardiologia, Rio de Janeiro, RJ (Brazil); Reis, Adair Gomes dos [Nuclear Diagnosticos, SP (Brazil); Fonseca, Lea Mirian Barbosa da [Pro-Echo Hospital Samaritano, Rio de Janeiro, RJ (Brazil); Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil)

    2009-04-15

    Background: The assessment of left ventricular function may be impaired by the abnormal interventricular septal motion frequently found after coronary artery bypass grafting (CABG). Studies on the validation of gated SPECT as a tool for the assessment of left ventricular function in this patient group are scarce. Objective: We investigated the agreement and correlation between left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) as obtained using electrocardiogram-gated myocardial perfusion scintigraphy (gated SPECT) and cardiac magnetic resonance imaging in 20 patients undergoing coronary artery bypass grafting. Methods: Correlation was measured using Spearman's correlation coefficient ({rho}). Agreement was assessed using Bland-Altman analysis. Results: A good correlation was found between gated SPECT and cardiac magnetic resonance imaging in patients after CABG with regard to left ventricular ejection fraction ({rho} = 0.85; p =0.0001), moderate correlation for end-diastolic volume ({rho} = 0.51; p = 0.02), and non-significant correlation for end-diastolic volume ({rho} = 0.13; p = 0.5). Agreement ranges for LVEF, ESV and EDV were: -20% to 12%; -38 to 54 ml and; -96 to 100 ml, respectively. Conclusion: A reliable correlation was found for left ventricular ejection fraction as obtained by gated SPECT and magnetic resonance imaging in patients undergoing CABG. For ventricular volumes, however, the correlation is not adequate. (author)

  5. Skeletonization of the internal thoracic artery: a randomized comparison of harvesting methods.

    Urso, Stefano; Alvarez, Luis; Sádaba, Rafael; Greco, Ernesto

    2008-02-01

    We performed a randomized study to compare internal thoracic artery (ITA) flow response to two harvesting methods used in the skeletonization procedure: ultrasonic scalpel and bipolar electrocautery. Sixty patients scheduled for CABG were randomized to receive either ultrasonically (n=30 patients) or electrocautery (n=30 patients) skeletonized ITAs. Intraoperative ITA graft mean flows were obtained with a transit-time flowmeter. ITA flows were evaluated at the beginning (Time 1) and at the end (Time 2) of the harvesting procedure. Post-cardiopulmonary bypass (CPB) flow measurement (Time 3) was obtained in the ITA grafts anastomosed to the left anterior descending artery. Intraoperative mean flow decreased significantly within ultrasonic group (Group U) and electrocautery group (Group E) at the end of the harvesting procedure (P<0.0001 in both cases). Within both groups the final mean flow measured on anastomosed ITAs (Time 3) was significantly higher than the beginning ITA flow value (Time 1). No statistical difference was noted comparing ITA flows between the two groups at any time of evaluation. Skeletonization harvesting of the ITA produces a modification of the mean flow. The quantity and the reversibility of this phenomenon, probably related to vasospasm, are independent from the energy source used in the skeletonization procedure. PMID:17998305

  6. Evaluation of the graft flow reserve after coronary artery bypass grafting by stress 201Tl myocardial SPECT. Comparison between arterial grafts and venous grafts

    We performed stress 201Tl myocardial SPECT to evaluate ischemia and perfusion reserve after coronary artery bypass grafting (CABG). A total of 103 patients was performed stress 201Tl myocardial SPECT one month after CABG. Each patient's myocardium was divided into 9 segments and visually evaluated using five grade scoring system (0=defect, 1=severe decrease, 2=moderate decrease, 3=mild decrease, 4=normal uptake). Eleven of 133 (8.27%) segments covered by patent venous grafts showed reversible 201Tl defect, however, 36 of 117 (30.8%) segments which covered by patent arterial grafts showed reversible 201Tl defect. This finding was observed more significantly in arterial grafts than in venous grafts (p<0.001). These finding suggests that arterial grafts have lower flow capacity than venous grafts at peak exercise. (author)

  7. Evaluation of the graft flow reserve after coronary artery bypass grafting by stress {sup 201}Tl myocardial SPECT. Comparison between arterial grafts and venous grafts

    Ichikawa, Akihiro; Taki, Junichi; Nakajima, Kenichi; Kawasuji, Michio; Tonami, Norihisa [Kanazawa Univ. (Japan). School of Medicine

    1997-01-01

    We performed stress {sup 201}Tl myocardial SPECT to evaluate ischemia and perfusion reserve after coronary artery bypass grafting (CABG). A total of 103 patients was performed stress {sup 201}Tl myocardial SPECT one month after CABG. Each patient`s myocardium was divided into 9 segments and visually evaluated using five grade scoring system (0=defect, 1=severe decrease, 2=moderate decrease, 3=mild decrease, 4=normal uptake). Eleven of 133 (8.27%) segments covered by patent venous grafts showed reversible {sup 201}Tl defect, however, 36 of 117 (30.8%) segments which covered by patent arterial grafts showed reversible {sup 201}Tl defect. This finding was observed more significantly in arterial grafts than in venous grafts (p<0.001). These finding suggests that arterial grafts have lower flow capacity than venous grafts at peak exercise. (author)

  8. Value of downstream circulation in renal artery stenosis with arterial hypertension: comparison between color Doppler flow and digital renal angiography in 123 patients

    Digital renal angiography and color Doppler flow were compared for diagnosis of renal artery stenosis in 123 hypertensive patients with a prevalence of renal artery stenosis ≥75% of 21 %. Only color Doppler flow signs found downstream from the stenosis could be quantified. A rising time (RT) >0.07 s was the best marker for renal artery stenosis ≥ 75 % according to a receiver operating characteristic curve with a specificity of 97 %, a sensitivity of 88 %, a positive predictive value of 86 %, a negative predictive value of 98 % and an accuracy of 96 %. Digital renal angiography and color Doppler flow findings for renal artery lesions were classified into 4 degrees with agreement for 86 % of the kidneys. (authors). 13 refs., 5 figs., 8 tabs

  9. Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction

    Feridoun Sabzi; Hossein Karim; Shahrokh Chaghazardi; Atefeh Asadmobini

    2016-01-01

    Introduction: Heart failure is a major hazard for public health. Despite recent advance in medical therapy, there is not enough information on the outcome of off-pump coronary artery bypass (OPCAB) and medical therapy on the patients with severe ventricular dysfunction and triple-vessel (CAD). This study aimed to compare treatment outcomes and mortality rate in patients undergoing off-pump coronary artery bypass (OPCAB) surgery and medical therapy who presented with severe ventricular dysfunc...

  10. Comparison of clinical characteristics and survival on patients with idiopathic pulmonary arterial hypertension and familial pulmonary arterial hypertension during conventional therapy era and targeted therapy era

    徐希奇

    2014-01-01

    Objective To compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension(IPAH)and familiar pulmonary arterial hypertension(FPAH)during conventional therapy era and targeted therapy era.Methods IPAH and FPAH patients who were referred between Jan 1999and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group(before 2005 no PAH-specific drug was available in China).All patients in this group

  11. Assesment of perfusion in glial tumors with arterial spin labeling; comparison with dynamic susceptibility contrast method

    Cebeci, H, E-mail: hcebeci16@gmail.com [Department of Radiology, Uludag University Medical School, Bursa (Turkey); Aydin, O [Department of Radiology, Uludag University Medical School, Bursa (Turkey); Ozturk-Isik, E; Gumus, C [Department of Biomedical Engineering, Yeditepe University, Istanbul (Turkey); Inecikli, F [Department of Radiology, Kanuni Sultan Suleyman Educational and Research Hospital, Istanbul (Turkey); Bekar, A; Kocaeli, H [Department of Neurosurgery, Uludag University Medical School, Bursa (Turkey); Hakyemez, B [Department of Radiology, Uludag University Medical School, Bursa (Turkey)

    2014-10-15

    Highlights: • We compared the perfusion parameters obtained with both DSC and ASL perfusion imaging methods. • In ASL perfusion imaging, we also created quantitative CBF maps. • All patients included in the study had histopathological diagnose. • All MR examinations are done with 3T MR imaging system. - Abstract: Purpose: Arterial spin labeling perfusion imaging (ASL-PI) is a non-invasive perfusion imaging method that can be used for evaluation and quantification of cerebral blood flow (CBF). Aim of our study was to evaluating the efficiency of ASL in histopathological grade estimation of glial tumors and comparing findings with dynamic susceptibility contrast perfusion imaging (DSC-PI) method. Methods: This study involved 33 patients (20 high-grade and 13 low-grade gliomas). Multiphase multislice pulsed ASL MRI sequence and a first-passage gadopentetate dimeglumine T2*-weighted gradient-echo single-shot echo-planar sequence were acquired for all the patients. For each patient, perfusion relative signal intensity (rSI), CBF and relative CBF (rCBF) on ASL-PI and relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) values on DSC-PI were determined. The relative signal intensity of each tumor was determined as the maximal SI within the tumor divided by SI within symetric region in the contralateral hemisphere on ASL-PI. rCBV and rCBF were calculated by deconvolution of an arterial input function. Relative values of the lesions were obtained by dividing the values to the normal appearing symmetric region on the contralateral hemisphere. For statistical analysis, Mann–Whitney ranksum test was carried out. Receiver operating characteristic curve (ROC) analysis was performed to assess the relationship between the rCBF-ASL, rSI-ASL, rCBV and rCBF ratios and grade of gliomas. Their cut-off values permitting best discrimination was calculated. The correlation between rCBV, rCBF, rSI-ASL and rCBF-ASL and glioma grade was assessed using

  12. Assesment of perfusion in glial tumors with arterial spin labeling; comparison with dynamic susceptibility contrast method

    Highlights: • We compared the perfusion parameters obtained with both DSC and ASL perfusion imaging methods. • In ASL perfusion imaging, we also created quantitative CBF maps. • All patients included in the study had histopathological diagnose. • All MR examinations are done with 3T MR imaging system. - Abstract: Purpose: Arterial spin labeling perfusion imaging (ASL-PI) is a non-invasive perfusion imaging method that can be used for evaluation and quantification of cerebral blood flow (CBF). Aim of our study was to evaluating the efficiency of ASL in histopathological grade estimation of glial tumors and comparing findings with dynamic susceptibility contrast perfusion imaging (DSC-PI) method. Methods: This study involved 33 patients (20 high-grade and 13 low-grade gliomas). Multiphase multislice pulsed ASL MRI sequence and a first-passage gadopentetate dimeglumine T2*-weighted gradient-echo single-shot echo-planar sequence were acquired for all the patients. For each patient, perfusion relative signal intensity (rSI), CBF and relative CBF (rCBF) on ASL-PI and relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) values on DSC-PI were determined. The relative signal intensity of each tumor was determined as the maximal SI within the tumor divided by SI within symetric region in the contralateral hemisphere on ASL-PI. rCBV and rCBF were calculated by deconvolution of an arterial input function. Relative values of the lesions were obtained by dividing the values to the normal appearing symmetric region on the contralateral hemisphere. For statistical analysis, Mann–Whitney ranksum test was carried out. Receiver operating characteristic curve (ROC) analysis was performed to assess the relationship between the rCBF-ASL, rSI-ASL, rCBV and rCBF ratios and grade of gliomas. Their cut-off values permitting best discrimination was calculated. The correlation between rCBV, rCBF, rSI-ASL and rCBF-ASL and glioma grade was assessed using

  13. Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography

    Zhao, Lei; Ma, Xiaohai; Zhang, Chen; Liu, Yi; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); DeLano, Mark C. [Michigan State University, Division of Radiology and Biomedical Imaging, College of Human Medicine, Lancing, MI (United States); Jiang, Tengyong [Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing (China)

    2013-04-15

    We sought to determine the feasibility and accuracy of dual-source computed tomography (DSCT) in assessing coronary artery disease and myocardial fibrosis of hypertrophic cardiomyopathy (HCM) compared with cardiac magnetic resonance (CMR) imaging and coronary angiography (CA). Forty-seven consecutive patients with HCM were prospectively enrolled. DSCT images were acquired in the arterial and late phases following intravenous contrast medium. The CMR and CA were performed within 7 days. Independent blinded readers read each study. Patients were classified according to myocardial delayed enhanced (MDE) CMR, coronary artery stenosis by CA, and arterial and MDE-DSCT. The diagnostic accuracy of DSCT in detecting coronary stenosis and MDE was analysed. Wall thickness determined by DSCT was strongly correlated with MR results (r = 0.91). DSCT and CMR MDE showed substantial agreement for the detection of myocardial fibrosis on per-patient and per-segment levels. The CT classification of patients by arterial stenosis and delayed enhancement had excellent agreement with MR and CA methods. The comprehensive cardiac CT examination provides reliable coronary artery and myocardial assessments. MDE-DSCT is a robust alternative method to MDE-CMR in assessing myocardial fibrosis in HCM particularly in patients with pacemakers or other contraindications to CMR. (orig.)

  14. Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography

    We sought to determine the feasibility and accuracy of dual-source computed tomography (DSCT) in assessing coronary artery disease and myocardial fibrosis of hypertrophic cardiomyopathy (HCM) compared with cardiac magnetic resonance (CMR) imaging and coronary angiography (CA). Forty-seven consecutive patients with HCM were prospectively enrolled. DSCT images were acquired in the arterial and late phases following intravenous contrast medium. The CMR and CA were performed within 7 days. Independent blinded readers read each study. Patients were classified according to myocardial delayed enhanced (MDE) CMR, coronary artery stenosis by CA, and arterial and MDE-DSCT. The diagnostic accuracy of DSCT in detecting coronary stenosis and MDE was analysed. Wall thickness determined by DSCT was strongly correlated with MR results (r = 0.91). DSCT and CMR MDE showed substantial agreement for the detection of myocardial fibrosis on per-patient and per-segment levels. The CT classification of patients by arterial stenosis and delayed enhancement had excellent agreement with MR and CA methods. The comprehensive cardiac CT examination provides reliable coronary artery and myocardial assessments. MDE-DSCT is a robust alternative method to MDE-CMR in assessing myocardial fibrosis in HCM particularly in patients with pacemakers or other contraindications to CMR. (orig.)

  15. A comparison of the priming properties of two central venous catheters and one pulmonary artery catheter.

    Sanderson, P M

    1995-01-01

    The time taken to prime the individual lumina of two multilumen central venous catheters (Viggo-Spectramed 14G 20 cm Hydrocath and Vialon 14G 20 cm Deltacath) and one pulmonary artery catheter (Viggo-Spectramed 110 cm 7.5F Pentacath) at flows between 5 ml.h-1 and 99 ml.h-1 is reported. The catheters supplied by different manufacturers but of identical length and gauge have significantly different priming times (p < 0.001). A protocol which may be used to prime the individual lumina of the three catheters studied is described. By means of an in vitro test the accuracy of this protocol is validated. PMID:7702147

  16. Magnetic resonance angiography of intracranial aneurysms: comparison with intra-arterial digital subtraction angiography

    Magnetic resonance angiography (MRA) with flow rephased gradient-echo sequences is a new non-invasive method for vascular imaging. We compared MRA and intra-arterial digital subtraction angiography in 18 patients with intracranial aneurysms to test whether MRA presently provides an alternative to cerebral angiography for the diagnosis of these anomalies. MRA showed 19 of the 22 aneurysms detected (86.4%). However, problems, especially with turbulent or slow flow, resulted in 6 studies (27.3%) with limited and 2 with questionable demonstration of an aneurysm, and 1 false negative study. At present, MRA is definitely inferior to angiography for the demonstration of intracranial aneurysms, due to its lower resolution and other limitations. (orig.)

  17. Comparison of three dose regimens of aprotinin in infants undergoing the arterial switch operation

    Verma Yashwant

    2010-01-01

    Full Text Available To determine the most effective dose regimen of aprotinin for infants undergoing arterial switch operation for transposition of the great arteries in reducing blood loss and postoperative packed red blood cell (PRBC requirements. A total of 24 infants scheduled for arterial switch operation for transposition of the great arteries were included in the study. The infants were randomly assigned to one of the three groups. Group I (n = 8 patients received aprotinin in a dose of 20,000 kallikrein inhibiting units (KIU/kg after induction of anesthesia, 20,000 KIU/kg was added to the pump prime, and 20,000 KIU/kg/hour infusion for three hours after weaning from bypass; group II (n = 8 patients received aprotinin 30,000 KIU/kg after induction of anesthesia, 30,000 KIU/kg was added to the pump prime and 30,000 KIU/Kg/hour infusion for three hours after weaning from bypass; group III patients (n = 8 received aprotinin 40,000 KIU/kg after induction of anesthesia, 40,000 KIU/kg was added to the pump prime and 40,000 KIU/kg/hour infusion for three hours after weaning from bypass. Postoperatively, the cumulative hourly blood loss and PRBC requirements were noted up to 24 hours from the time of admission in the intensive care unit (ICU. Use of blood and blood products were noted. Coagulation parameters such as hematocrit, activated clotting time (ACT, fibrinogen, prothrombin time (PT, international normalized ratio (INR, platelet count, and fibrin degradation products (FDP were investigated before cardiopulmonary bypass (CPB, after protamine administration, and at four hours postoperatively in the ICU. The number of infants reexplored for increased mediastinal drainage was recorded. Renal functions were monitored by measuring urine output (hourly and serum urea (mg% and serum creatinine (mg% at 24 hours. The sternal closure time was comparable in all the three groups. Cumulative blood loss (ml/kg/24 hours was greatest in group I (17.30 ± 7.7, least in group

  18. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm2. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone

  19. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  20. Half-dose abdominal CT with sinogram-affirmed iterative reconstruction technique in children - comparison with full-dose CT with filtered back projection

    Iterative reconstruction can be helpful to reduce radiation dose while maintaining image quality. However, this technique has not been fully evaluated in children during abdominal CT. To compare objective and subjective image quality between half-dose images reconstructed with iterative reconstruction at iteration strength levels 1 to 5 (half-S1 to half-S5 studies) and full-dose images reconstructed with filtered back projection (full studies) in pediatric abdominal CT. Twenty-one children (M:F = 13:8; mean age 8.2 ± 5.7 years) underwent dual-source abdominal CT (mean effective dose 4.8 ± 2.1 mSv). The objective image quality was evaluated as noise. Subjective image quality analysis was performed comparing each half study to the full study for noise, sharpness, artifact and diagnostic acceptability. Both objective and subjective image noise decreased with increasing iteration strength. Half-S4 and -S5 studies showed objective image noise similar to or lower than that of full studies. The half-S2 and -S3 studies produced the greatest sharpness and the half-S5 studies were the worst from a blocky appearance. Full and half studies did not differ in artifacts. Half-S3 studies showed the best diagnostic acceptability. Half-S4 and -S5 studies objectively and half-S3 studies subjectively showed comparable image quality to full studies in pediatric abdominal CT. (orig.)

  1. Abdominal aorta calcification score can be used to estimate the calcification degree of coronary artery in hemodialysis patients%腹主动脉钙化评分可预估血液透析患者的冠状动脉钙化程度

    蔡宏; 严玉澄; 陆任华; 张敏芳; 颜佳毅; 庞慧华; 朱铭力; 张伟明; 倪兆慧

    2013-01-01

    目的 观察维持性血液透析患者腹主动脉钙化与冠状动脉钙化之间的关系,探讨应用腹主动脉钙化评分预估冠状动脉钙化情况的可能性. 方法 选择维持性血液透析患者,腹部侧位平片检测腹主动脉钙化情况,应用Kauppila半定量积分法计算腹主动脉钙化(AAC)积分.应用多层螺旋CT(MSCT)评估冠状动脉钙化情况,运用Agaston评分进行量化,Pearson相关性分析腹主动脉钙化和冠状动脉钙化之间的相关性,运用受试者工作特征曲线(ROC)评价腹主动脉钙化评分预估冠状动脉钙化的准确性. 结果 共入选66例患者,平均年龄57.65±13.10岁,透析龄95.50(28.00~143.00)月,30.3%的患者合并糖尿病,透析的Kt/V 1.61(1.41~1.88).72.7%的患者存在腹主动脉钙化,中位AAC为8.5(0,15.00); 78.3%的患者存在冠状动脉钙化,中位冠状动脉钙化积分(CACs)为400.8(4.2,1476.23).相关性分析显示CACs与AAC呈显著正相关(r=0.664,P<0.001).AAC积分诊断各种程度冠状动脉钙化的曲线下面积在0.852~0.902.当AAC≥8时,其诊断冠状动脉重度钙化(CACs>400)的敏感性和特异性分别为84.4%和81.2%.Logistic回归分析显示随着腹主动脉钙化程度的升高,患者发生重度冠状动脉钙化的风险也显著升高.传统心血管危险因素和CKD相关危险因素联合AAC积分具有更强的预测维持性血液透析患者冠状动脉重度钙化的能力. 结论 维持性血液透析患者腹主动脉钙化和冠状动脉钙化之间存在显著相关性,应用腹部侧位平片对腹主动脉钙化情况进行评分可以较好地预估患者冠状动脉的钙化程度.%Objective To determine the relationship between abdominal aorta calcification and coronary artery calcification in maintenance hemodialysis (MHD) patients, and to explore the possibility of diagnosing coronary artery calcification (C AC) by using abdominal aorta calcification (AAC) score. Methods MHD patients were

  2. Entrance surface dose and image quality: Comparison of adult chest and abdominal X-ray examinations in general practitioner clinics, public and private hospitals in Malaysia

    This study was undertaken to compare the entrance surface dose (ESD) and image quality of adult chest and abdominal X-ray examinations conducted at general practitioner (GP) clinics, and public and private hospitals in Malaysia. The surveyed facilities were randomly selected within a given category (28 GP clinics, 20 public hospitals and 15 private hospitals). Only departmental X-ray units were involved in the survey. Chest examinations were done at all facilities, while only hospitals performed abdominal examinations. This study used the x-ray attenuation phantoms and protocols developed for the Nationwide Evaluation of X-ray Trends (NEXT) survey program in the United States. The ESD was calculated from measurements of exposure and clinical geometry. An image quality test tool was used to evaluate the low-contrast detectability and high-contrast detail performance under typical clinical conditions. The median ESD value for the adult chest X-ray examination was the highest (0.25 mGy) at GP clinics, followed by private hospitals (0.22 mGy) and public hospitals (0.17 mGy). The median ESD for the adult abdominal X-ray examination at public hospitals (3.35 mGy) was higher than that for private hospitals (2.81 mGy). Results of image quality assessment for the chest X-ray examination show that all facility types have a similar median spatial resolution and low-contrast detectability. For the abdominal X-ray examination, public hospitals have a similar median spatial resolution but larger low-contrast detectability compared with private hospitals. The results of this survey clearly show that there is room for further improvement in performing chest and abdominal X-ray examinations in Malaysia. (authors)

  3. Comparison of streamlined liner of the pharynx airway (SLIPA TM with the laryngeal mask airway Proseal TM for lower abdominal laparoscopic surgeries in paralyzed, anesthetized patients

    Ashraf Abualhassan Abdellatif

    2011-01-01

    Full Text Available Context: Supraglottic airway devices have been used as an alternative to tracheal intubation during laparoscopic surgery. Aims: The study was designed to compare the efficacy of Streamlined Liner of the Pharynx Airway (SLIPA for positive pressure ventilation and postoperative complications with the Laryngeal Mask Airway ProSeal (PLMA for patients undergoing lower abdominal laparoscopies under general anesthesia with controlled ventilation. Settings and Design: Prospective, crossover randomized controlled trial performed on patients undergoing lower abdominal laparoscopic surgeries. Methods: A total of 120 patients undergoing lower abdominal laparoscopic surgeries were randomly allocated into two equal groups; PLMA and SLIPA groups. Number of intubation attempts, insertion time, ease of insertion, and fiberoptic bronchoscopic view were recorded. Lung mechanics data were collected 5 minutes after securing the airway, then after abdominal insufflation. Blood traces and regurgitation were checked for; postoperative sore throat and other complications were recorded. Statistical Analysis: Arithmetic mean and standard deviation values were calculated and statistical analyses were performed for each group. Independent sample t-test was used to compare continuous variables exhibiting normal distribution, and Chi-squared test for noncontinuous variables. P value <0.05 was considered significant. Results: Insertion time, first insertion success rate, and ease of insertion were comparable in both groups. Fiberoptic bronchoscopic view was significantly better and epiglottic downfolding was significantly lower in SLIPA group. Sealing pressure and lung mechanics were similar. Gastric distension was not observed in both groups. Postoperative sore throat was significantly higher in PACU in PLMA group. Blood traces on the device were significantly more in SLIPA group. Conclusions: SLIPA can be used as a useful alternative to PLMA in patients undergoing lower

  4. Value of helical computed tomography in diagnosis abdominal aorta aneurysms

    Civilization progress and achievements of medicine makes the human life longer. The exposure on vessel injuring factors such as smoking and improper diet is still growing. For those reasons the number of abdominal aorta aneurysms also increased. Early detection of this pathology, its therapy and follow up considering the most sophisticated diagnostic methods is very important. In years 2000-2002 2989 helical computed tomography (HCT) examinations of the abdomen were performed in Dolnoslaski Osrodek Diagnostyki Obrazowej. In 173 patients (141 M and 32 F) aneurysms of abdominal aorta have been found. From this group 127 (101 M and 26 F) were patients of Surgical Ward of our hospital. 73 (63 M and 10 F) underwent the surgical operation of prosthesis implantation. 13 persons (11M and 2 F) were primarily qualified for endovascular stent-graft implantation, in 7 male this procedure was performed. In 159 patients AAA was primarily diagnosed in ultrasound (USG) examination (100%). In 10 cases additional MR examination was performed. In 13 patients qualified for stent-grafting we also performed DSA. USG examination revealed high sensitivity in establishing aneurysm diameter. HCT is characterized by significantly higher sensitivity and specificity in evaluation of renal and iliac pervasion, in comparison to USG. HCT allows for detection of concomitant pathologies and complications. HCT is necessary before stent-graft implantation and in the follow-up. There is no significant prevalence of MR over HCT. It should be performed in cases with doubtful renal arteries location, or when HCT is contraindicated. (author)

  5. Discussion of indication for selecting ectopic pregnancy treated by trans-uterine artery embolization

    Objective: To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods: Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum β-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preproceduralty. Results: Forty eight of the 51 cases were cured by this method, when the ectopic mass size ≥5 cm, the cure rate was low, 33.33% (P<0.01), although the serum β-HCG concentration was ≤10 000 mIU/ml with no abdominal hemorrhage; otherwise, with mass size ≤5 cm, without consideration of the serum β-HCG concentration and abdominal bleeding, the cure rate was 97.92%. Conclusion: The technique of trans-uterine artery MTX perfusion and embolization selection of close clinical could result in satisfactory treatment for tubal pregnancy. Careful selection of indication, close clinical observation and neady for any emergency should always be on alert. (authors)

  6. Importância relativa do Índice de Massa Corporal e da circunferência abdominal na predição da hipertensão arterial Relative importance of body mass index and waist circumference for hypertension in adults

    Flávio Sarno

    2007-10-01

    Full Text Available OBJETIVO: Avaliar a importância relativa do Índice de Massa Corporal (IMC e da circunferência abdominal na determinação da hipertensão arterial em adultos. MÉTODOS: Estudo transversal com amostra de funcionários (N=1.584, entre 18 e 64 anos de idade, de hospital geral privado do município de São Paulo. A coleta de dados envolveu questionário estruturado, medida da pressão arterial, peso, altura e circunferência abdominal. A hipertensão foi diagnosticada com pressão arterial > 140/90 mmHg ou uso de medicação anti-hipertensiva. A importância relativa do IMC e da circunferência abdominal foi calculada pela fração atribuível de hipertensão correspondente a cada indicador antropométrico, empregando-se níveis de cortes usuais e baseados na distribuição observada na população estudada. Adicionalmente, foi desenvolvido um indicador que combinou simultaneamente valores de IMC e circunferência abdominal. RESULTADOS: A prevalência de hipertensão foi de 18,9% (26,9% em homens e 12,5% em mulheres. Em homens, a fração de hipertensão atribuível ao IMC superou aquela atribuível à circunferência abdominal segundo níveis de corte usuais (56% x 48%, respectivamente e quartis da distribuição observada (73% x 69%, respectivamente. Para mulheres, a fração de hipertensão atribuível à circunferência abdominal superou ligeiramente aquela atribuível ao IMC nos níveis de corte usuais (44% x 41%, respectivamente; mas se observou situação inversa empregando a classificação em quartis (41% x 57%, respectivamente. Somente em mulheres a fração de hipertensão atribuível ao indicador que combinou IMC e circunferência abdominal (64% superou a fração atribuível a cada medida isolada. CONCLUSÕES: Tanto o IMC quanto a circunferência abdominal se associaram positiva e independentemente com a ocorrência de hipertensão arterial, sendo superior a influência exercida pelo IMC em homens.OBJECTIVE: To assess the relative

  7. Comparison of Neonatal Arterial Blood Oxygen Saturation Rate Immediately After Birth in Normal and Elective Cesarean Delivery

    Mahmoodi Fatemeh

    2016-01-01

    Full Text Available Objective: Ninety percent of neonates pass the transition from fetal life to outside uterus successfully, and only 1% needs intensive support for survival. The quantity of oxygen saturation immediately after birth shows the need for resuscitation immediately after birth. The present research was carried out with the objective of comparing saturation rate of arterial blood hypoxia in neonates born with normal vaginal delivery and cesarean method. Materials and Methods: 220 neonates born with elective cesarean section and normal delivery were studied in an analytical-descriptive study. Demographic questionnaire was completed. Then a pulse oxymeter with its sensor fixed on the right wrist of the neonates was used. Heart rate was recorded and the level of oxygen saturation (SaO2 under 90% was considered as hypoxia. To compare the quantitative and qualitative variable between the two groups, paired t test and chi-square test was used, respectively. Pearson correlation test was used to study the correlation between the variables. Results: The age range of mothers was 16-38 years. The mothers’ average age, gestational age and neonates’ weight were not significantly different between groups. The average SaO2 in minutes 1, 3 and 5 was 72%, 81% and 89%, respectively in vaginal delivery, which showed a significant difference compared to cesarean neonates with average of 65%, 75% and 83%, respectively. No significant difference was observed after10 minutes. Also there were not significant statistical correlation between mothers age, number of pregnancies, sex and weight of neonate with SaO2 of arterial blood after 1, 3, 5 and 10 minutes after birth. Conclusion: With respect to the results of the present research SaO2 was higher in neonates of vaginal delivery in comparison to cesarean neonates. Encouraging mothers to delivery vaginally and also using aid-oxygen is proposed for the cesarean neonates at birth.

  8. Comparison of BMSs with SES for Symptomatic Intracranial Disease of the Middle Cerebral Artery Stenosis

    This study was designed to compare the clinical and angiographic outcomes of patients with symptomatic atherosclerotic middle cerebral artery stenosis treated with balloon-mounted stents (BMS) and self-expandable Wingspan system (SES). We reviewed the 69 consecutive stent placement procedures for symptomatic atherosclerotic stenosis (≥70) in M1 segment of middle cerebral artery in 67 patients in 3 years. According to the stent types, the patients were classed as BMS and SES groups. The demographic characteristics, conventional risk factors of ischemic stroke, degree of stenosis, periprocedural complications, stent types, and clinical and angiographic outcomes were analyzed. There were 39 patients in the BMS group and 28 patients in the SES group. The demographic characteristics, conventional risk factors, and periprocedural complications were similar but different in residual stenosis after stenting in both groups (5.9% ± 9.9% vs. 14.4% ± 14.6%; P = 0.01). For the overall cohort, the rate of stroke or death and restenosis was 10.9% (7/66) and 24.5% (14/57), respectively. The frequency of restenosis was higher in the SES group than in the BMS group (log-rank, P = 0.04; crude hazard ratio = 3.03; 95% confidence interval (CI), 1.01–9.15; P = 0.049; and adjusted hazard ratio = 3.61; 95% CI, 1.06–12.27; P = 0.04); however, there was no difference in clinical outcomes (log-rank, P = 0.51; crude hazard ratio = 1.66; 95% CI, 0.36–7.61; P = 0.51; and adjusted hazard ratio = 0.59; 95% CI, 0.04–7.89; P = 0.69). The corrected degree of restenosis was higher in the SES than the BMS group. The prevalence of restenosis was higher in the SES than the BMS group, but the perioperative complications and follow-up clinical outcomes had no significant difference.

  9. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    Zhou M

    2014-09-01

    Full Text Available Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular procedures (HYBRID with open surgical reconstructions (OPEN in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of prospectively collected nonrandomized data.Methods: Between 2008 and 2012, 64 patients underwent OPEN and 43 underwent HYBRID. Patient characteristics, technique success, clinical improvement, and procedure-related morbidity were reviewed and compared. Patency rates and limb salvages were analyzed and compared using Kaplan–Meier life tables. Cox regression analyses were used to assess the influence of various risk factors on primary patency.Results: HYBRID patients were older and presented with worse New York Heart Association function compared with OPEN patients. The increase in the ankle-brachial index and improvement of Ruthford category after procedures were equivalent between two groups, but HYBRID patients had shorter hospital length of stay (7.6±12.0 versus 15.5±17.3; P= 0.018 and less overall perioperative morbidity (12% versus 28%; P=0.042 compared with OPEN patients. No statistically significant difference in 36-month primary (47.1%±7.1% versus 50.1%±9.4%; P=0.418, assisted primary (57.0%±7.9% versus 62.4%±9.2%; P=0.517, or secondary (82.0%±6.8% versus 83.1%±7.3%; P=0.445 patency was seen between the two groups. Limb salvage rates of HYBRID vs OPEN at 3 years were similar (76.3%±9.3% versus 80.4%±8.2%; P=0.579. Critical limb ischemia was a negative predictor of long-term patency of patients in both the HYBRID and OPEN groups (P=0.012 and P<0.001, respectively, and the presence of diabetes and renal insufficiency were another two independent predictors

  10. Iodixanol in intra-arterial cerebral digital subtraction angiography: a comparison with iohexol

    We randomised 86 patients undergoing intra-arterial cerebral digital subtraction angiography (IADSA) to receive iodixanol (Visipaque; Nycomed, Oslo, Norway) 150 mgI/ml or iohexol (Omnipaque; Nycomed) 140 mgI/ml. The efficacy and safety of these two contrast media were compared: Efficacy by evaluating the diagnostic information and radiographic density yielded by the angiograms, safety by recording all discomfort connected with thee injections, and all adverse events up to 24 h after the investigation. Diagnostic information was optimal in all patients and the overall radiographic density optimal in all but one (iohexol) (P=0.49). A feeling of warmth, the only discomfort reported, was experienced by 43% and 54% of patients receiving iodixanol and iohexol, respectively (P=0.26). Two patients in the iodixanol group and five in the iohexol group reported one adverse event (nausea, dizziness, visual disturbance or paraesthesia) (P=0.30); all were of mild severity except for one moderate adverse event in each group. Iodixanol 150 mgI/ml and iohexol 140 mgI/ml were demonstrated to be suitable for IADSA, with no clinically or statistically significant differences in efficacy, discomfort or adverse events. (orig.)

  11. COMPARISON OF ENALAPRIL AND PERINDOPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION AND LEFT VENTRICLE SYSTOLIC DYSFUNCTION

    Yu. I. Grinshtein

    2010-01-01

    Full Text Available Aim. To compare efficacy of enalapril and perindopril in patients with arterial hypertension (HT and left ventricle systolic dysfunction.Material and methods. Patients (n=51 with HT and left ventricle systolic dysfunction (ejection fraction<45% were included in the prospective open randomized comparative study. Patients were randomized into 2 groups of therapy with enalapril 10-20 mg BID (n=25 or with perindopril 4-8 mg OD (n=26. Hydrochlorothiazide (12,5-25 mg OD was added in case of ineffective therapy. Routine clinical examination, ambulatory blood pressure (BP monitoring, an electrocardiogram, an echocardiography were performed in all patients.Results. The 24-hour and night antihypertensive effect of enalapril was more prominent than this of perindopril. Target BP level was reached in 21 patients (84% of enalapril group and in 20 patients (76,9% of perindopril group. 8 (30,8% patients of perindopril group did not reach night target BP level vs 3 (12% patients of enalapril group. Similar improvement of the left ventricle systolic function was observed in both groups.Conclusion. Enalapril and perindopril demonstrated comparable antihypertensive and cardioprotective effect.

  12. Comparison between Adventitial and Intimal Inflammation of Ruptured and Nonruptured Atherosclerotic Plaques in Human Coronary Arteries

    Higuchi Maria L.

    2002-01-01

    Full Text Available OBJECTIVE: To verify the possible role of adventitial inflammation in atherosclerotic plaque vulnerability and coronary artery remodelling. METHODS: We compared the mean numbers of lymphocytes in the adventitia and in the plaque of ruptured thrombosed and stable equi-stenotic coronary segments of 34 patients who died due to acute myocardial infarction. We also analysed adventitial microvessels, adventitial fibrosis and the external elastic membrane. RESULTS: In the adventitia, the numbers of lymphocytes and microvessels/mm² were 69.5±88.3 and 60.9± 32.1 in culprit lesions and 16.4 ± 21.1 and 44.3±16.1 in stable lesions (p<0.05; within the plaques, the mean number of lymphocytes was 24±40.8 in culprit lesions and 10.9±13.2 in stable ones (p=0.17. The mean percent area of adventitial fibrosis/cross-sectional area of the vessel was significantly lower in unstable plaques (p<0.001. The confocal images showed holes in the external elastic membrane. CONCLUSION: Unstable plaques exhibit chronic pan-arteritis, accompanied by enlargement, medial thinning, and less fibrosis than in stable lesions, which is compatible with vessel aneurysm. Adventitial inflammation may contribute significantly to atheroma instability.

  13. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    A. A. Anderzhanova

    2016-01-01

    Full Text Available Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate in patients with arterial hypertension (HT of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o. with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2. G1 patients were treated with betaxolol, and G2 patients – with metoprolol tartrate. Ambulatory BP and electrocardiogram monitoring, exercise stress-test, echocardiography, evaluating of respiratory function, blood analysis was performed initially and in 30 and 90 days of treatment.Results. Target BP level was reached in 44 (88% patients treated with betaxolol (average daily dose 10±4 mg. 34 patients of G1 took 10 mg daily. Target BP level was reached in 41 (82% patients treated with metoprolol tartrate (average daily dose 150±27 mg. 30 patients of G2 took 150 mg daily. Exercise tolerance increased and a number of ischemic ST segment depressions reduced significantly in both groups. There were no significant differences in antihypertensive, antianginal, and antiischemic efficacy between groups.Conclusion. Betaxolol advantage is an ability to maintain target BP level more than 24 hours. A possibility to take betaxolol once a day raises patient’s compliance with therapy.

  14. Uterine artery embolization - inpatient and outpatient therapy: a comparison of cost, safety, and patient satisfaction

    To determine whether uterine artery embolization (UAE) can be safely performed as an outpatient procedure without increased complications and readmission rates or decreased patient satisfaction rates and to determine the Canadian cost difference between performing UAE as an outpatient, compared with inpatient, procedure. We performed a retrospective chart review and patient survey of 2 groups of patients, 132 patients who underwent inpatient UAE and 20 patients who underwent outpatient UAE. Of these, 82 and 18, respectively, were successfully surveyed by telephone. Variables examined included presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also performed a detailed Canadian cost analysis comparing inpatient with outpatient UAE. We did not find any statistically significant difference between inpatient and outpatient UAE on any of the patient variables measured, including presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also found that outpatient UAE costs significantly less than inpatient UAE, primarily owing to decreased hospital overhead costs for overnight admission. In Ontario, inpatient UAE costs per patient totalled $3216.22, whereas outpatient costs totalled $2194.53 - a saving of $1021.69, which represents a 31.8% cost reduction. Given these results, we recommend that centres consider performing UAE as an outpatient procedure. A key enabling factor is the ability to have several hours of close nursing supervision of the patient postprocedure, prior to discharge. (author)

  15. Therapeutic comparison of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer

    Objective: To compare the short-term and long-term therapeutic response of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer. Methods: One hundred and fifty-one patients with stages I b2-II a cervical cancer were treated with preoperative intra-arterial chemotherapy before radical hysterectomy was carried out. Patients in study group (n = 113) received uterine artery chemoembolization (UACE), while patients control group(n = 38) received internal iliac anterior trunk arterial chemotherapy. Radical hysterectomy was carried out in all patients within 2-4 weeks after UACE or chemotherapy. The tumor size was measured before and after the procedure,and the survival rate at 2 and 5 years after treatment was calculated. Results: The mean maximum diameter of the tumors was (4.58 ± 0.37) cm before interventional therapy, and it was (2.11 ± 0.24) cm in two weeks after interventional therapy. The complete response rate of study group and control group was 31.9% and 21.1% respectively. The total effective rate of study group and control group was 94.7% (107/113) and 76.3% (29/38) respectively. The effective rate of study group two weeks after therapy was significantly higher than that of control group. No surgical margin infiltration was observed in both groups. Pathological findings in study group included vascular invasion around surgical margin (n = 3), parametrial invasion (n = 5) and pelvic lymph node metastasis (n = 6), while in control group vascular invasion around surgical margin, parametrial invasion and pelvic lymph node metastasis were found in one, two and one cases respectively. The two-year and five-year survival rate in study group were 80.9% (68/84) and 73.4% (47/64) respectively, while the two-year and five-year survival rate in control group were 81.3% (26/32) and 75.0% (18/24) respectively. No significant difference in survival

  16. Abdominal MRI in childhood

    MRI provides diagnostic information in multiple abdominal diseases in childhood. Additional information to sonographic findings can be achieved in the diagnosis of abdominal malformation as well as in several inflammatory processes. In childhood cancer imaging MRI is essential at the beginning as well as during therapy to assess response to therapy. Because of radiation protection MRI has to replace CT in abdominal imaging in children. Some technical details have to be considered when children are examined. (orig.)

  17. Comparison of amiodarone vs magnesium sulphate in the prevention of atrial fibrillation after coronary artery bypass grafting surgery

    Background: Atrial fibrillation (AF) is common in patients after coronary artery bypass grafting (CABG) and can result in increased morbidity and mortality, increased length of hospital stay, and increased cost. In this study we compared the efficacy of amiodarone versus magnesium sulphate in the prophylaxis of post-CABG atrial fibrillation. Objective: This study was carried out to assess the efficacy of amiodarone in comparison to magnesium sulphate in the prevention of atrial fibrillation after coronary artery bypass grafting. Study Design: Randomized controlled trials. Place and duration of study: The study was carried out at Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi from July 2010 to December 2011 Patients and Methods: Total 240 patients were included in the study and randomly divided in two groups of 120 each using random number table. Patients in Group A (Amiodarone group) were given a loading dose of amiodarone 5 mg/Kg after induction of anesthesia which was then continued as infusion at 5 micro gm/Kg/minute on first postoperative day. This was followed by an oral dose of 600 mg/day postoperatively for 5 days. Those in Group B (Magnesium Sulphate group) received 2 g of magnesium sulphate in 100 ml of isotonic 0.9% solution intravenously over 1 hour at following times: preoperatively, immediately following the operation, and on postoperative days 1, 2, and 3. Results: Thirteen patients (10.8%) developed AF in Amiodarone group, compared to 31 patients (25.8%) in magnesium sulphate group. The results proved amiodarone to be more effective than magnesium sulphate in preventing post-CABG AF (p<0.001). Thirty one patients who developed AF postoperatively in the magnesium group were treated with amiodarone, and all patients recovered normal sinus rhythm. In the amiodarone prophylaxis group, 9 patients regained sinus rhythm in 6 - 8 hours, while for 4 remaining patients cardioversion was attempted out of which 2

  18. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    Stagnitti, Franco

    2009-01-01

    a critical clinical condition of Polycompartment Syndrome. The monitoring of Abdominal Perfusion Pressure (APP) is more correct than the measurement of IAP because it reveals hydrodynamic alterations in the abdominal compartment. The APP (MAP-IAP) depends on arterial flow, venous outflow and capacity of the abdominal compartments response to increased internal volumes. The medical therapy used to decrease IAH and to contrast ACS is intestinal decompression with gastric and rectal tube; colonic endoscopic detention; correction of electrolytic abnormalities and prokinetic agents. Surgery, besides being decompressive and resolutive, must prevent a recurrence of ACS through the "tension-free closure" procedure. PMID:20476671

  19. Circumaortic Left Renal Vein Associated with Juxtarenal Abdominal Aortic Aneurysm

    Hashizume, Koji; Taniguchi, Shinichiro; Ariyoshi, Tsuneo; Hisata, Yoichi; Tanigawa, Kazuyoshi; Miura, Takashi; Sumi, Mizuki; Eishi, Kiyoyuki

    2013-01-01

    The patient was an 82-year-old man who was found to have a juxtarenal abdominal aortic aneurysm accompanied by a circumaortic left renal vein (CLRV). During dissection of the proximal anastomosis site the CLRV was injured, but was successfully repaired. A graft implantation was performed below the renal arteries. The incidence of CLRV is thought to be rare, however it is found in 7% of cadavers donated for anatomy. CLRV may cause unexpected bleeding by inadvertent dissection of the abdominal ...

  20. Comparison of intraperitoneal honey and sodium hyaluronate-carboxymethylcellulose (SeprafilmTM for the prevention of postoperative intra-abdominal adhesions

    Arif Emre

    2009-04-01

    Full Text Available BACKGROUND: Abdominal surgery can lead to postoperative intra-abdominal adhesions (PIAAs with significant morbidity and mortality. This study compares the use of honey with a standard bioresorbable membrane (Seprafilm tm to prevent the formation of PIAAs in rats. METHODS: Thirty rats underwent laparotomy, and PIAAs were induced by scraping the cecum. The animals were divided into three groups, each containing ten rats. Group 1 (control represented the cecal abrasion group, with no intraperitoneal administration of any substance. Group 2 (honey group underwent cecal abrasion and intraperitoneal administration of honey. Group 3 (Seprafilm tm group underwent cecal abrasion and intraperitoneal Seprafilm tm application. RESULTS: Group 1 exhibited higher adhesion scores for adhesions between the abdominal wall and the organs. Groups 2 and 3 had decreased adhesive attachments to the intra-abdominal structures. Compared to group 1, the incidence of adhesion formation was lower in both group 2 (p=0.001 and group 3 (p=0.001. The incidence of fibrosis was also lower in group 2 (p=0.016 and group 3 (p=0.063 compared to group 1. There was no significant difference between the histopathological fibrosis scores for the rats in group 2 and those in group 3 (p= 0.688. CONCLUSION: This study suggests that both honey and Seprafilm tm decrease the incidence of PIAAs in the rat cecal abrasion model. Although the mechanism of action is not clear, intraperitoneal administration of honey reduced PIAAs. The outcome of this study demonstrates that honey is as effective as Seprafilm tm in preventing PIAAs.

  1. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design

    Yue Jiao; Ying Han; Xin Li; Yi-gong Fang; Zhao-hui Liu; Wen-na Zhou; Jin-cao Zhou; Zhong-chao Wu; Jin-hong Yang; Shao-yuan Li; Fan-ying Meng; Wei-wei Xu

    2015-01-01

    Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols) and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture). The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality...

  2. Comparison of models for predicting outcomes in patients with coronary artery disease focusing on microsimulation

    Masoud Amiri

    2012-01-01

    Full Text Available Background: Physicians have difficulty to subjectively estimate the cardiovascular risk of their patients. Using an estimate of global cardiovascular risk could be more relevant to guide decisions than using binary representation (presence or absence of risk factors data. The main aim of the paper is to compare different models of predicting the progress of a coronary artery diseases (CAD to help the decision making of physician. Methods: There are different standard models for predicting risk factors such as models based on logistic regression model, Cox regression model, dynamic logistic regression model, and simulation models such as Markov model and microsimulation model. Each model has its own application which can or cannot use by physicians to make a decision on treatment of each patient. Results: There are five main common models for predicting of outcomes, including models based on logistic regression model (for short-term outcomes, Cox regression model (for intermediate-term outcomes, dynamic logistic regression model, and simulation models such as Markov and microsimulation models (for long-term outcomes. The advantages and disadvantages of these models have been discussed and summarized. Conclusion: Given the complex medical decisions that physicians face in everyday practice, the multiple interrelated factors that play a role in choosing the optimal treatment, and the continuously accumulating new evidence on determinants of outcome and treatment options for CAD, physicians may potentially benefit from a clinical decision support system that accounts for all these considerations. The microsimulation model could provide cardiologists, researchers, and medical students a user-friendly software, which can be used as an intelligent interventional simulator.

  3. Comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MRI in patients with acute stroke.

    Yen-Chu Huang

    Full Text Available BACKGROUND: The aim of this study was to evaluate whether arterial spin labeling (ASL perfusion magnetic resonance imaging (MRI can reliably quantify perfusion deficit as compared to dynamic susceptibility contrast (DSC perfusion MRI. METHODS: Thirty-nine patients with acute ischemic stroke in the anterior circulation territory were recruited. All underwent ASL and DSC MRI perfusion scans within 30 hours after stroke onset and 31 patients underwent follow-up MRI scans. ASL cerebral blood flow (CBF and DSC time to maximum (T(max maps were used to calculate the perfusion defects. The ASL CBF lesion volume was compared to the DSC Tmax lesion volume by Pearson's correlation coefficient and likewise the ASL CBF and DSC T(max lesion volumes were compared to the final infarct sizes respectively. A repeated measures analysis of variance and least significant difference post hoc test was used to compare the mean lesion volumes among ASL CBF, DSC T(max >4-6 s and final infarct. RESULTS: Mean patient age was 72.6 years. The average time from stroke onset to MRI was 13.9 hours. The ASL lesion volume showed significant correlation with the DSC lesion volume for T(max >4, 5 and 6 s (r = 0.81, 0.82 and 0.80; p5 s (29.2 ml, p6 s (21.8 ml, p5 or 6 s were close to mean final infarct size. CONCLUSION: Quantitative measurement of ASL perfusion is well correlated with DSC perfusion. However, ASL perfusion may overestimate the perfusion defects and therefore further refinement of the true penumbra threshold and improved ASL technique are necessary before applying ASL in therapeutic trials.

  4. Carotid artery wall thickness: comparison between sonography and multi-detector row CT angiography

    Saba, Luca [University of Cagliari, Department of Radiology, Policlinico Universitario, Cagliari (Italy); Sanfilippo, Roberto; Montisci, Roberto [Policlinico Universitario, Department of Vascular Surgery, Cagliari (Italy); Mallarini, Giorgio [University of Cagliari, Department of Radiology, Policlinico Universitario, Cagliari (Italy); Ospedale San Giovanni di Dio, Institute of Radiology, Cagliari (Italy)

    2010-02-15

    Prospective studies have shown that an increased thickness of the carotid wall is a significant predictor of coronary and cerebrovascular complications. Our purpose was to assess the agreement between multi-detector row computed tomography (CT) angiography (MDCTA) and colour Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and the intima-media thickness (IMT). Altogether, 97 subjects (age range 64-84 years) were prospectively analysed using a four-detector row CT and a sonographic scanner. In total, 46 subjects had shown cerebral ischaemic symptoms. CAWT and IMT were measured in each patient using MDCTA and CD-US (by applying a digital calliper), respectively. Continuous data were described as the mean value {+-} standard deviation and were compared using the Mann-Whitney U test. A p value <0.05 was considered significant. Bland-Altman statistics was employed to measure the agreement between MDCTA and CD-US. CAWT ranged from 0.5 to 1.53 mm, with a mean value of 0.9072 mm. IMT ranged from 0.46 to 1.5 mm, with a mean value of 0.8839 mm. By analysing the Bland-Altman plot, we observed an excellent agreement between CD-US and MDCTA with a bias between methods of 0.023 {+-} 0.0424 mm. A limit of agreement from -0.06 to 0.106 was recorded. Correlation coefficient r was 0.9855 (95% confidence interval 0.9808-0.989). Mann-Whitney U test indicated a p value of 0.377. Obtained results indicated a significant agreement between MDCTA and CD-US in the measurement of CAWT and IMT. (orig.)

  5. Carotid artery wall thickness: comparison between sonography and multi-detector row CT angiography

    Prospective studies have shown that an increased thickness of the carotid wall is a significant predictor of coronary and cerebrovascular complications. Our purpose was to assess the agreement between multi-detector row computed tomography (CT) angiography (MDCTA) and colour Doppler ultrasound (CD-US) in measuring carotid artery wall thickness (CAWT) and the intima-media thickness (IMT). Altogether, 97 subjects (age range 64-84 years) were prospectively analysed using a four-detector row CT and a sonographic scanner. In total, 46 subjects had shown cerebral ischaemic symptoms. CAWT and IMT were measured in each patient using MDCTA and CD-US (by applying a digital calliper), respectively. Continuous data were described as the mean value ± standard deviation and were compared using the Mann-Whitney U test. A p value <0.05 was considered significant. Bland-Altman statistics was employed to measure the agreement between MDCTA and CD-US. CAWT ranged from 0.5 to 1.53 mm, with a mean value of 0.9072 mm. IMT ranged from 0.46 to 1.5 mm, with a mean value of 0.8839 mm. By analysing the Bland-Altman plot, we observed an excellent agreement between CD-US and MDCTA with a bias between methods of 0.023 ± 0.0424 mm. A limit of agreement from -0.06 to 0.106 was recorded. Correlation coefficient r was 0.9855 (95% confidence interval 0.9808-0.989). Mann-Whitney U test indicated a p value of 0.377. Obtained results indicated a significant agreement between MDCTA and CD-US in the measurement of CAWT and IMT. (orig.)

  6. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design.

    Jiao, Yue; Han, Ying; Li, Xin; Fang, Yi-Gong; Liu, Zhao-Hui; Zhou, Wen-Na; Zhou, Jin-Cao; Wu, Zhong-Chao; Yang, Jin-Hong; Li, Shao-Yuan; Meng, Fan-Ying; Xu, Wei-Wei

    2015-01-01

    Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols) and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture). The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality index (PSQI), Hamilton Depression Scale (HAMD) scores, and Hamilton Anxiety Scale (HAMA) scores of patients before treatment, after one course of treatment, and after two courses of treatment as well as one month after treatment. Results. Body, auricular, and abdominal acupuncture treatments all alleviated symptoms of insomnia, depression, and anxiety, but body and auricular acupuncture had stronger therapeutic effects. Conclusions. Body acupuncture at basic points shall be given priority in protocol selection for insomnia. The second-best choice is auricular acupuncture with basic points combined with points based on Traditional Chinese Medicine (TCM) theories. Abdominal needling with very quick effect can be an alternative protocol with basic points combined with syndrome differentiation points. PMID:26640498

  7. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design

    Yue Jiao

    2015-01-01

    Full Text Available Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture. The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality index (PSQI, Hamilton Depression Scale (HAMD scores, and Hamilton Anxiety Scale (HAMA scores of patients before treatment, after one course of treatment, and after two courses of treatment as well as one month after treatment. Results. Body, auricular, and abdominal acupuncture treatments all alleviated symptoms of insomnia, depression, and anxiety, but body and auricular acupuncture had stronger therapeutic effects. Conclusions. Body acupuncture at basic points shall be given priority in protocol selection for insomnia. The second-best choice is auricular acupuncture with basic points combined with points based on Traditional Chinese Medicine (TCM theories. Abdominal needling with very quick effect can be an alternative protocol with basic points combined with syndrome differentiation points.

  8. Multiple vascular anomalies involving testicular, suprarenal arteries and lumbar veins

    P Jyothsna

    2012-01-01

    Full Text Available Testicular arteries arise from the abdominal aorta and the inferior suprarenal artery from the renal artery. There are reports about variant origin and course of these arteries. Accessory testicular artery is also a common finding but its providing origin to inferior suprarenal artery is an important observation. During a routine dissection of abdomen of approximately 55-year-old male cadaver, unique vascular abnormality was observed. On the left side, a common arterial trunk originating from abdominal aorta immediately branched to give rise to superior testicular and inferior suprarenal arteries, the former after a short course hooked by the left suprarenal vein. In addition, the left suprarenal vein, second left lumbar vein, and left testicular vein joined to form a common trunk which drained into the left renal vein. A sound knowledge of vascular variations in relation to the kidney and suprarenal gland is important to surgeons dissecting the abdominal cavity.

  9. Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization

    Arnold, Raoul [University Hospital, Department of Paediatric Cardiology, Heidelberg (Germany); University Hospital, Department of Paediatric Cardiology, Freiburg (Germany); Ley, Sebastian [Department of Radiology, German Cancer Research Centre, Heidelberg (Germany); University Hospital, Department of Paediatric Radiology, Heidelberg (Germany); Ley-Zaporozhan, Julia; Kauczor, Hans-Ulrich [Department of Radiology, German Cancer Research Centre, Heidelberg (Germany); Eichhorn, Joachim; Ulmer, Herbert [University Hospital, Department of Paediatric Cardiology, Heidelberg (Germany); Schenk, Jens-Peter [University Hospital, Department of Paediatric Radiology, Heidelberg (Germany)

    2007-10-15

    After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI - one stenosis was missed. MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS. (orig.)

  10. Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization

    After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI - one stenosis was missed. MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS. (orig.)

  11. Bilateral popliteal arterial dissection.

    Chen, Po-Liang; Ko, Shih-Yu; Tan, Ken-Hing

    2012-01-01

    A clinical feature of bilateral popliteal arterial dissection without involving the descending aorta, bilateral iliac, as well as femoral arteries has never been reported in the past literature. We report a 56-year-old man with hypertension and coronary artery disease who presented to our emergency department with complaints of bilateral knee pain after long-distance walking. Physical examination was notable for elevated blood pressure, but there was no palpable pulsation over dorsalis pedis arteries on his feet. Laboratory evaluation revealed a d-dimer level of 35.2 mg/L (FEU) on the day of the test and 1.2 mg/L one and a half months ago (normal level, <0.55). These findings were suggestive of a recent-onset peripheral arterial occlusive disorder. Computed tomography of the aorta showed bilateral popliteal arterial dissection with arterial intimal flap. Abdominal aorta, bilateral iliac, and femoral arteries remained intact with only arteriosclerotic change. Minimally invasive endovascular stent grafting was then performed. The patient had an uneventful recovery. PMID:21106320

  12. [Cognitive dysfunction following anterior communicating artery aneurysm rupture. Comparison with alcoholic Korsakoff syndrome on neuropsychological performance].

    Mimura, M; Kato, M; Yoshimasu, H; Kashima, H

    1995-08-01

    The present study aims to compare neuropsychological performance of patients following anterior communicating artery aneurysm rupture (ACoA) with that of patients with alcoholic Korsakoff syndrome (AKS). Fifteen ACoA patients and ten age-and education-matched AKS patients were included in the study. All the patients were tested at least one year post onset of their illness at a stable condition. The WAIS and forward digit span scores of AKS were also matched to ACoA, and simple attention and general intelligence were well preserved both in ACoA and AKS. Frontal function as measured by the Wisconsin card sorting test (Keio version) (KWCST) was equivalently impaired in the two groups. Anterograde memory as measured by Wechsler memory scale subtests, serial seven word learning test, Rey auditory verbal learning test, and logical memorizing test (Luria's paired word-picture association), was more severely impaired in AKS than ACoA in contrast to the comparable attention, intelligence, and frontal function: (1) memory tasks with low correlations to KWCST (serial word learning tasks and paired verbal associates), reflecting primary simple serial memorizing, and (2) memory tasks with high correlations to KWCST (logical memory and logical memorizing), reflecting higher and complicated strategic mnemonic activities. However, the correlations between these anterograde memory subtests and KWCST were substantially equivalent in ACoA and AKS. This suggests that the differences in anterograde amnesia demonstrated in ACoA and AKS may be of quantitative, not of qualitative property. The extent of deficits in semantic encoding as measured by Wickens' release from proactive interference paradigm (PI release) was also milder in ACoA than AKS. Both AKS and ACoA failed to show PI release in contrast to normal PI release demonstrated in age-matched ten healthy subjects. PI release in ACoA, however, was in between AKS and healthy subjects. The results were interpreted in the light of a

  13. Diagnostic value of adenosine-triphosphate radionuclide ventriculography in coronary artery disease. Comparison with conventional exercise stress method

    The purpose of this study was to assess the effect of adenosine-triphosphate (ATP) on hemodynamics and left ventricular (LV) function, and to examine the value of ATP radionuclide-ventriculography (RNVG) for detecting coronary artery disease (CAD) in comparison with standard exercise RNVG. Thirty-eight consecutive patients with suspected CAD underwent ATP (0.18 mg/Kg/min) RNVG and symptom-limited exercise RNVG. Coronary angiography revealed 27 patients with CAD (Group S) and 11 without CAD (Group N). In group S, exercise induced an increase in LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV), and a decrease in LV ejection fraction (LVEF). In contrast, ATP infusion caused LVESV to decrease in both groups, improving LVEF. Only 14 of 39 segments whose wall motion was deteriorated by exercise showed worsening regional wall motion during ATP infusion. The sensitivity and specificity of ATP RNVG for detecting CAD were 22. 2% and 100%, while those of exercise RNVG were 77.8% and 81.8%, respectively. Although ATP induced a depression of peak filling rate in group S as compared with group N, the deterioration of systolic function was not apparent with this method. ATP RNVG was not adequate for detecting CAD because of its lower sensitivity compared with exercise RNVG. (author)

  14. Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

    In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE

  15. Transluminar catheter angioplasty of abdominal aorta in Takayasu's arteritis

    Nine patients with Takayasu's arteritis and a long stenotic segment of the abdominal aorta were treated by percutaneous transluminal angioplasty (PTA). Intermittent claudication dissappeared in six of seven cases, the femoral pulse reappeared in all five; ankle/arm indices increased in seven cases; elevated blood pressure normalized in seven of eight cases. Seven patients were followed for 3 to 28 months. They were all free of symptoms from the lower extremities. In three patients with or without renal artery stenosis and with hypertension, the blood pressure decreased after PTA of the abdominal aorta only. PTA may be a valuable treatment in Takayasu's arteritis and stenosis of the abdominal aorta. (orig.)

  16. Celiaco-Mesenterial Arterial Aberrations in Patients Undergoing Extended Pancreatic Resections: Correlation of CT Angiography with Findings at Surgery

    Viacheslav I Egorov

    2010-07-01

    Full Text Available Context It is important to recognize arterial variants in the preoperative planning of extended pancreatic resections. The absence of surgical confirmation of radiological data is a limitation of the majority of angiographic or CT-angiographic studies of celiac and mesenteric arterial anatomy. Objective The purpose of this study was to test the accuracy of CT angiography in delineating the arterial architecture by comparing the resultant 3D images with findings at surgery and determining the frequency of different celiac and mesenteric arterial anatomy variants. Methods Abdominal CT angiographies of 350 patients were performed on a 64- and 256- MDCT scanner prior to major pancreatic or hepatobiliary surgery. Variants of celiac and mesenteric arterial anatomy were documented as 3D reconstructions. Radiological data were compared to operative photographs during extended pancreaticoduodenectomies and extended distal pancreatectomies in 59 cases. Results Only 197 patients (56.3% had the classic arterial anatomy identified at CT angiography. The most common variants were a replaced or accessory right hepatic artery originating from the superior mesenteric artery (62 cases, 17.7% and a replaced or accessory left hepatic artery (43 cases, 12.3% originating from the left gastric artery. According to a comparison with operative photographs, CT angiography demonstrated 100% accuracy in identifying celiac and mesenteric arterial anatomy variants, stenoses, obstructions and aneurysms of the celiac and mesenteric branches, including those which were hemodynamically significant and which influence the choice and sequence of operative procedures. Conclusion The celiac and mesenteric arterial anatomy variants are fairly common and are of great significance in planning extended pancreatic resections. Radiological findings were fully corroborated by operative data, which means that CT angiography is a reliable tool for identifying celiac and mesenteric arterial

  17. [Abdominal pregnancy, institutional experience].

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  18. Imaging in abdominal trauma

    Imaging in abdominal trauma with special regard to the value of abdominal X-ray, ultrasound and computed tomography is described. The introduction to each organ focusses on the clinical situation, special mechanism of trauma, symptoms and the pathological staging of trauma. (orig.)

  19. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (P<0.05) and male (P<0.05) values, and returned to initial perioperative readings four hours after surgery. Tomcats and pregnant females (P<0.05) showed an increase in MAP and APP immediately after surgery decreasing back to initial perioperative values four hours later. A significant decrease in RT was appreciated immediately after laparotomy in both pregnant and non-pregnant queens. IAP was affected by abdominal surgery in this study, due likely to factors, such as postoperative pain and hypothermia. Pregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy. PMID:23118052

  20. Computer-aided diagnosis of osteoporosis using abdominal X-ray CT images. Preliminary study of automated region extraction and comparison between BMD values and CT features

    The purpose of this study was to develop an algorithm that can be used to distinguish the central part of the vertebral body in an abdominal X-ray CT image, and to use that algorithm to automatically calculate three measures that are used to diagnose osteoporosis. In addition, the correlation between the BMD (bone mineral density) and these measures was investigated. We also examined whether the CT images obtained could be used to aid in diagnosing osteoporosis. The abdominal region contained in the third lumbar vertebra was scanned using spiral CT equipment (CT-W950SR: Hitachi). We judged whether female patients had osteoporosis using the diagnostic criteria available (Year 2000 revision, published by the Japanese Society for Bone and Mineral Research: only female data available). Twenty-two female patients, with an age range of 35-79 years (average age: 61.8), were examined. The mean CT number, coefficient of variation, and the first moment of the power spectrum were calculated as measures representing specific features of osteoporosis disease in the recognized vertebral body. We classified three measures obtained from the CT images for normal and abnormal groups using discriminant analysis, and the results obtained from the diagnosis criteria for the two groups were then compared. Our results showed that the algorithm could be used to distinguish the central part of the vertebral body in all cases, and to calculate these measures automatically. When the results of the discriminant analysis were applied to the three measures obtained from the CT images, the ratio usable for diagnosing a patient as osteoporotic (sensitivity) was 0.79 (11/14), and the ratio usable for diagnosing a patient as normal (specificity) was 0.63 (5/8). Therefore, in conclusion, we believe that this algorithm can be used to aid physicians in diagnosing osteoporosis, utilizing the measures obtained from abdominal X-ray CT images. (author)

  1. Five years' experience of transverse groin incision for femoral artery access in arterial reconstructive surgery: parallel observational longitudinal group comparison study.

    Beirne, Christopher

    2008-07-01

    Vertical groin incisions (VGIs) have been used to access femoral vessels, but reports allude to wound complications. Our aim was to compare VGI with transverse groin incision (TGI) for femoral artery exposure. Over a 5-year interval, 196 patients with 284 femoral artery exposures for supra- and infrainguinal procedures were studied. Primary endpoints were surgical skin site wound infection, seroma, haematoma formation, and major lower limb amputation. Secondary endpoints were graft patency, wound paresthesias, and length of hospital stay. There were 160 TGIs and 124 VGIs. The demographics and risk factor profile were not statistically different between groups. Seroma developed in 4.4% of TGIs and 13.7% of VGIs (p= .005). The complicated skin and soft tissue infection rate was five times greater with VGI (p= .001). The VGI group had a significantly higher rate of major amputation (p= .0005). Significantly higher graft failure rates were observed in the VGI group (p= .011). No paresthesia was reported in any TGI wound. The mean hospital stay was also significantly shorter in the TGI group (p= .006). The study data support and expound on the theory that an alternative incision to VGI offers lower short- and long-term morbidity. Our findings sustain the selection of the TGI in femoral artery surgery for both supra- and infrainguinal procedures without compromise of vessel exposure.

  2. Characterization of plaque in the internal carotid artery. Comparison neuroradiological findings with pathological findings

    We evaluate the morphology of the carotid plaque using echogram, CT scan and MRI and compare those neuroradiological findings with histological findings of the plaque. We evaluated 14 cases operated with carotid endoarterectomy for carotid stenosis. We estimated the findings of the echogram, enhanced CT scan and black blood MRI (BB MRI), in comparison with the histological findings of the carotid plaque. Echogram, enhanced CT scan and MRI clearly demonstrated the plaque in cervical carotid stenosis. In most cases, echograms could show the plaque, but in some cases could not due to the back shadow caused by plaque calcification. Enhanced CT scan clearly demonstrated the calcification and the neovasculization in plaque. BB MRI clearly showed the carotid plaque. Low-intensity lesions in T1 and T2 weighted images showed hard and fibrous plaque. High-intensity lesions in T1 and T2 weighted images showed soft plaque with lipoprotein and/or hemorrhage. This study demonstrates the potential of a systemic approach to atherosclerotic plaque with enhanced CT scan and BB MRI compared with histological findings of the carotid plaque. These estimations elucidate the growth mechanism of carotid plaque. (author)

  3. Breath-hold two-dimensional MR angiography of coronary arteries. Comparison with conventional coronary angiography in ten cases

    Purpose: To assess the diagnostic value of two-dimensional coronary magnetic resonance (MR) angiography in patients evaluated for ischemic heart disease. Materials and methods: Ten patients who underwent selective cardiac catheterization with coronary MR angiography were evaluated with two-dimensional coronary MR angiography. Coronary MR angiography was performed with breath-hold fat-suppressed ECG-gated Turbo-FLASH with K-space segmentation using a 1.5 T imager. Results: The left main coronary artery, proximal left anterior descending artery, circumflex artery and right coronary artery were demonstrated in all cases. Continuous segments (mean) of left anterior descending, circumflex and right coronary arteries visualized on MRA were 6.72 +- 3.16 cm, 3.67 +- 4.81 cm and 7.93 +- 3.12 cm respectively. The overall sensitivity for detection of hemodynamically significant coronary artery lesion (≥50%) was 62.5% respectively. Conclusion: Breath-hold two-dimensional coronary MR angiography was useful in showing relatively long segments of the main coronary arteries and also has potential in depicting hemodynamically significant coronary artery lesions

  4. Comparison of low dose with standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer under surveillance

    O' Malley, Martin E. [Joint Department of Medical Imaging, Toronto, ON (Canada); Chung, Peter; Warde, Padraig [Princess Margaret Hospital, Department of Radiation Oncology, Toronto, ON (Canada); Haider, Masoom; Jhaveri, Kartik; Khalili, Korosh [Princess Margaret Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Jang, Hyun-Jung [Toronto General Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Panzarella, Tony [Princess Margaret Hospital, Department of Biostatistics, Toronto, ON (Canada)

    2010-07-15

    To compare the image quality and acceptability of a low dose with those of standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer managed by surveillance. One hundred patients (median age 31 years; range 19-83 years), 79 with seminoma and 21 with non-seminoma, underwent abdominal/pelvic imaging with low and standard dose protocols on 64-slice multidetector CT. Three reviewers independently evaluated images for noise and diagnostic quality on a 5-point scale and for diagnostic acceptability. On average, each reader scored noise and diagnostic quality of standard dose images significantly better than corresponding low dose images (p < 0.0001). One reader found all CT examinations acceptable; two readers each found 1/100 (1%) low dose examinations unacceptable. Median and mean dose-length product for low and standard dose protocols were 416.0 and 452.2 (range 122.9-913.4) and 931.9 and 999.8 (range 283.8-1,987.7) mGy cm, respectively. The low dose protocol provided diagnostically acceptable images for at least 99% of patients and achieved mean dose reduction of 55% compared with the standard dose protocol. (orig.)

  5. Comparison of radiation doses between newborns and 6-y-old children undergoing head, chest and abdominal CT examinations-A phantom study

    Radiation doses in paediatric computed tomography (CT) were investigated for various types of recent CT scanners with newborn and 6-y-old phantoms in which silicon-photodiode dosemeters were implanted at various organ positions. In the head, chest and abdominal CT for the newborn phantom, doses for organs within the scan region were 21-40, 3-8 and 3-12 mGy, respectively. The corresponding doses for the child phantom were 20-37, 2-11 and 4-17 mGy, respectively. In the head, chest and abdominal CT, the effective doses were respectively 2.1-3.3, 2.0-6.0 and 2.2-10.0 mSv for the newborn, and 1.0-2.0, 1.2-6.6 and 2.9-11.8 mSv for the child. Radiation doses for the newborn were at the same levels as those for the child, excepting effective doses in head CT for the newborn, which were 1.8 times higher than those for the child. (authors)

  6. Arterial Catheterization

    ... version AMERICAN THORACIC SOCIETY Patient Information Series Arterial Catheterization An arterial catheter is a thin, hollow tube ... PHYSICIANS: AND COPY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ■ ...

  7. Morphological description of collateral branches from the abdominal aorta of lesser anteater (Tamandua tetradactyla

    Breno Costa Macedo

    2013-03-01

    Full Text Available Tamandua tetradactyla, Xenarthra, is a native species from South America which, due to the few number of studies on its biology, still has many unknown aspects in its morphology. Taking into account the importance of morphological data for various studies, this paper aimed to elucidate the branching of the abdominal aorta in this species to foster the development of further studies. To do this, 4 specimens were used, 2 male and 2 female, all young, from the Bauxite Mine – Paragominas, Para, Brazil, donated after death due to running over to the Animal Morphology Research Laboratory (LaPMA of Universidade Federal Rural da Amazonia (UFRA. The arterial system was filled with contrasted latex and the animals were fixed in a formaldehyde solution (10%, and then dissected, in order to evidence the abdominal aorta and its collateral branches. The parietal branches consisted of 1 pair of caudal phrenic arteries, 2 pairs of intercostal arteries, and 3 pairs of lumbar arteries. Among the visceral branches, stood out: celiac artery; cranial mesenteric artery; adrenal arteries; renal arteries; caudal mesenteric artery; and external, internal, and median sacral iliac arteries, formed from the final portion of the abdominal aorta. Testicular and ovarian arteries originated from the renal arteries, differing from that described in various species.

  8. Abdominal manifestations of autoimmune disorders

    carcinomatosis; lymph nodes: With Castelman disease like features: abdominal, mediastinal, hilar and cervical lymphadenopathy have been reported. Peripancreatic and paraortic lymphadenopathy are common; Blood vessels: With various arterial (central, peripheral or visceral cases) or venous presentations; inflammatory aortic aneurysms predominantly affecting the abdominal aorta and occasionally aortic arch and noninfectious aortitis

  9. Comparison of the safety of simultaneous bilateral carotid artery stenting versus unilateral carotid artery stenting: 30-day and6-month results

    DONG Hui; JIANG Xiong-jing; PENG Meng; JI Wei; WU Hai-ying; HUI Ru-tai; XU Bo; YANG Yue-jin; GAO Run-lin

    2012-01-01

    Background Severe bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly.Such patients have high stroke risk.Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis.However,the optimal procedural strategy of bilateral carotid stenosis remains unclear.The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).Methods In this single-center retrospective study,we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009.Thirty-nine patients (16.7%) of them underwent SBCAS,and the others (n=195) underwent UCAS.Indication for CAS was defined as carotid artery diameter reduction >60% (symptomatic) or >80% (asymptomatic).Six-month and 30-day hemodynamic depression (HD),hyperperfusion syndrome (HPS),stroke,death and myocardial infarction (MI) after carotid stenting were assessed.Results SBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD:28.2% vs.20.0%,P=0.396; HPS:2.6% vs.2.1%,P=0.262).Moreover,there was no statistically significant difference between SBCAS group and UCAS group in major stroke,death,MI and their combinations within 30 days (major stroke:0 vs.3.6%,P=0.604; death:2.6% vs.1.5%,P=0.520; MI:2.6% vs.0.5%,P=0.306; and their combinations:5.1% vs.4.6%,P=1.000)and 6 months (major stroke:0 vs.3.6%,P=0.604; death:5.1% vs.2.1%,P=0.262; MI:5.1% vs.1.0%,P=0.130 and their combinations:7.7% vs.5.1%,P=0.459).Conclusions The patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up.Our finding suggests that SBCAS appears to be as safe as UCAS.

  10. Evaluation of the pedal artery: comparison of three-dimensional gadolinium-enhanced MR angiography with digital subtraction angiography

    Lee, Jeong Min; Kang, Sung Gwon; Byun, Joo Nam; Kim, Young Cheol; Choi, Jeong Yeol; Kim, Dong Hyun [College of Medicine, Chosun Univ., Kwangju (Korea, Republic of)

    2002-07-01

    To compare the three-dimensional gadolinium-enhanced MR angiography with digital subtraction angiography (DSA) for evaluation of the pedal artery. In 12 extremities of 11 patients, both digital subtraction angiography (DSA) and contrast-enhanced MR angiography (CE-MR angiography) were performed during the same week. Among ten of the 11 patients, the following conditions were present: atherosclerosis (n=4), diabetic foot (n=3), Buerger's disease (n=1), calciphylactic arteriopathy (n=1) and arteriovenous malformation of the foot (n=1). The remaining patient underwent angiography prior to flap surgery. For MR angiography, a 1.5T system using an extremity or head coil was used. A three-dimensional FISP (fast imaging with steady state precession) sequence was obtained before enhancement, followed by four sequential acquisitions (scan time, 20 secs, scan interval time, 10 secs) 10 seconds after intravenous bolus injection of normal saline (total 10 cc), following intravenous administration of gadolinium (0.02 mmol/kg, 3 ml/sec). Arterial segments of the ankle and foot were classified as the anterior or posterior tibial artery, the distal peroneal artery, the medial or lateral plantar artery, the pedal arch, and the dorsalis pedis artery. Two radiologists independently analysed visualization of each arteraial segment and the mean of visible arterial segments in one extreminty using CE-MR angiography and DSA. Among 84 arterial segments, 16 were invisible at both CE-MR angiography and DSA, while 39 were demonstrated by both modalities. Twenty-six segments were visible only at CE-MR angiography and three only at DSA. CE-MR angiography displayed a higher number of arterial segments than DSA (mean, 5.42 vs. mean 3.50, respectively), a difference which was statistically significant (p<0.000). The difference between each arterial segment was not statistically significant, except for the dorsalis pedis artery (t test, p<0.000). In that it provides additional information for