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Sample records for veia jugular interna

  1. Ultrasound evaluation of techniques for internal jugular vein puncture in children / Avaliação ultra-sonográfica das técnicas de punção da veia jugular interna em crianças

    Scientific Electronic Library Online (English)

    Sérgio Tomaz, Schettini; Luiz Fernando Ybarra Martins de, Oliveira; Harold Ruiz, Henao; Henrique Manoel, Lederman.

    2008-10-01

    Full Text Available OBJETIVO: Determinar pelo ultra-som qual o melhor acesso e posicionamento da criança com o intuito de se obter a melhor secção transversal da veia jugular interna direita (VJID), permitindo uma punção com maior segurança. MÉTODOS: Três possíveis acessos a VJID, anterior, lateral e posterior foram an [...] alisados pela ultrassonografia em uma sequência de diferentes posições da cabeça, estando o paciente em posição supina com ou sem um coxim sob a escápula; cabeça na posição neutra; (NPP E NP); rotação lateral da cabeça (CLRP e CLR), posição neutra com o paciente em posição de Trendlemburg a 30(0) (TDG). Para analisar os resultados foi aplicado um método estatístico com análise variada sobre os mesmos indivíduos. Procedimentos básicos: Avaliação ultrassonográfica em cada uma das posições propostas. RESULTADOS: Pela análise estatística dos resultados observou-se que a punção lateral estando o paciente em posição neutra, em Trendlemburg sem a colocação de coxim sob a escápula oferece uma área maior em comparação a todas as outras opções de punção e posicionamento do paciente (p Abstract in english PURPOSE: To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV) allowing a safer puncture. METHODS: Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were [...] analyzed through ultrasound images in a sequence of positions of the head, in supine position, with or without a roll under the scapula: head centered in neutral position with and without a roll (NPP and NP); contra lateral rotation with and without a roll (CLRP and CLR), neutral position and the patient raised in 30° in Trendelenburg position (TDG). To analyze the results it was applied one statistic method, with variation analysis to the same individuals. Basic Procedures: Ultrasound evaluation in each one of the proposed positions. RESULTS: The statistical analysis of the results observed that the lateral puncture with the patient in the neutral position, in Trendelemburg without a roll, offers a bigger area in comparison to all the other options of puncture and positioning of the patient (p

  2. Ultrasound evaluation of techniques for internal jugular vein puncture in children Avaliação ultra-sonográfica das técnicas de punção da veia jugular interna em crianças

    Directory of Open Access Journals (Sweden)

    Sérgio Tomaz Schettini

    2008-10-01

    Full Text Available PURPOSE: To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV allowing a safer puncture. METHODS: Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were analyzed through ultrasound images in a sequence of positions of the head, in supine position, with or without a roll under the scapula: head centered in neutral position with and without a roll (NPP and NP; contra lateral rotation with and without a roll (CLRP and CLR, neutral position and the patient raised in 30° in Trendelenburg position (TDG. To analyze the results it was applied one statistic method, with variation analysis to the same individuals. Basic Procedures: Ultrasound evaluation in each one of the proposed positions. RESULTS: The statistical analysis of the results observed that the lateral puncture with the patient in the neutral position, in Trendelemburg without a roll, offers a bigger area in comparison to all the other options of puncture and positioning of the patient (pOBJETIVO: Determinar pelo ultra-som qual o melhor acesso e posicionamento da criança com o intuito de se obter a melhor secção transversal da veia jugular interna direita (VJID, permitindo uma punção com maior segurança. MÉTODOS: Três possíveis acessos a VJID, anterior, lateral e posterior foram analisados pela ultrassonografia em uma sequência de diferentes posições da cabeça, estando o paciente em posição supina com ou sem um coxim sob a escápula; cabeça na posição neutra; (NPP E NP; rotação lateral da cabeça (CLRP e CLR, posição neutra com o paciente em posição de Trendlemburg a 30(0 (TDG. Para analisar os resultados foi aplicado um método estatístico com análise variada sobre os mesmos indivíduos. Procedimentos básicos: Avaliação ultrassonográfica em cada uma das posições propostas. RESULTADOS: Pela análise estatística dos resultados observou-se que a punção lateral estando o paciente em posição neutra, em Trendlemburg sem a colocação de coxim sob a escápula oferece uma área maior em comparação a todas as outras opções de punção e posicionamento do paciente (p<0,0001. CONCLUSÃO: A melhor técnica para a punção da VJID em crianças foi a posição neutra em Trendlemburg, por punção lateral , sem a colocação de um coxim sob a escápula.

  3. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

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    Severino Lourenço da Silva Júnior

    2013-04-01

    Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carried out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or partial thrombosis. RESULTS: There was a significant weight gain of pigs in the time interval between the manufacture of the aneurysm and angiography (p = 0.04. Aneurysmal patency was observed in ten pigs (83%. Operative wound infections occurred in two animals (16.6%, both with early onset, three days after the making of the aneurysm. Histological analysis showed aneurysm thrombus partially occluding the light in nine pigs (75%. In these animals, it was observed that on average 9% of the aneurysmal diameter was filled with thrombi. CONCLUSION: It was possible to develop a stable experimental model of saccular aneurysms in pig carotid artery by use of the internal jugular vein.

  4. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna / Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

    Scientific Electronic Library Online (English)

    Severino Lourenço da, Silva Júnior; Guilherme Benjamin Brandão, Pitta; Adamastor Humberto, Pereira; Aldemar de Araújo, Castro; Maria Helena Tavares de, Matos; Fábio Duque, Silveira; Leonardo Torres, Magalhães; José Adolfo Hurt Almeida de, Moraes; Emmylena Karina Cordeiro, Machado; Carlos Wagner de Souza, Wanderley; Camila Meirelles de Souza, Silva; Luciana da Paz dos, Santos; João Nicolle Tupiná, Nogueira.

    2013-04-01

    Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotom [...] ia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04). Foi observada perviedade aneurismática em dez suínos (83%). Ocorreram infecções de feridas operatórias em dois animais (16,6%), ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%). Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. Abstract in english OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carrie [...] d out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or partial thrombosis. RESULTS: There was a significant weight gain of pigs in the time interval between the manufacture of the aneurysm and angiography (p = 0.04). Aneurysmal patency was observed in ten pigs (83%). Operative wound infections occurred in two animals (16.6%), both with early onset, three days after the making of the aneurysm. Histological analysis showed aneurysm thrombus partially occluding the light in nine pigs (75%). In these animals, it was observed that on average 9% of the aneurysmal diameter was filled with thrombi. CONCLUSION: It was possible to develop a stable experimental model of saccular aneurysms in pig carotid artery by use of the internal jugular vein.

  5. Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

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    Felippe Leopoldo Dexheimer Neto

    2011-08-01

    Full Text Available OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU. Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118, 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5 and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12 of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01 and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02. CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experienceOBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complicações graves. RESULTADOS: No período entre maio de 2008 e novembro de 2009 foram avaliados 118 pacientes. A taxa de sucesso da punção guiada por ultrassom foi 90% (106/118, 77% dessas na primeira tentativa. Complicações graves ocorreram em 4% dos casos (n = 5 e não foram associadas às variáveis analisadas. Incapacidade de progredir o fio-guia foi a razão de 58% (7/12 das falhas. Operadores com mais de 15 punções guiadas por ultrassom obtiveram uma maior taxa de sucesso (95% vs. 79%, p = 0,01 e pacientes com cateterização prévia apresentaram um maior número de falhas (26% vs. 7%, p = 0,02. CONCLUSÃO: O aprendizado da técnica de punção de veia jugular interna guiada por ultrasssom é seguro e efetivo em pacientes críticos. Este processo não esteve associado a um aumento da taxa de complicações e melhores resultados são obtidos à medida que aumenta a experiência do operador

  6. Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients / Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

    Scientific Electronic Library Online (English)

    Felippe Leopoldo, Dexheimer Neto; Cíntia, Roehrig; Paola, Morandi; Roselaine Pinheiro de, Oliveira; Cassiano, Teixeira; Juçara Gasparetto, Maccari; Andre Luiz da Silva, Alencastro; Régis Bueno, Albuquerque; Eubrando Silvestre, Oliveira.

    2011-08-01

    Full Text Available OBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. O [...] s médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complicações graves. RESULTADOS: No período entre maio de 2008 e novembro de 2009 foram avaliados 118 pacientes. A taxa de sucesso da punção guiada por ultrassom foi 90% (106/118), 77% dessas na primeira tentativa. Complicações graves ocorreram em 4% dos casos (n = 5) e não foram associadas às variáveis analisadas. Incapacidade de progredir o fio-guia foi a razão de 58% (7/12) das falhas. Operadores com mais de 15 punções guiadas por ultrassom obtiveram uma maior taxa de sucesso (95% vs. 79%, p = 0,01) e pacientes com cateterização prévia apresentaram um maior número de falhas (26% vs. 7%, p = 0,02). CONCLUSÃO: O aprendizado da técnica de punção de veia jugular interna guiada por ultrasssom é seguro e efetivo em pacientes críticos. Este processo não esteve associado a um aumento da taxa de complicações e melhores resultados são obtidos à medida que aumenta a experiência do operador Abstract in english OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU). Catheter placement was [...] performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118), 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5) and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12) of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01) and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02). CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experience

  7. Infecção de corrente sanguínea relacionada a cateter venoso central (ICSRC) em enfermarias: estudo prospectivo comparativo entre veia subclávia e veia jugular interna / Catheter-associated bloodstream infections (CA-BSI) in wards: a prospective comparative study between subclavian and jugular access

    Scientific Electronic Library Online (English)

    Gustavo Lopes Gomes, Siqueira; Walkiria, Hueb; Rodrigo, Contreira; Maria Aparecida, Nogueron; Daniela Muniz, Cancio; Roberto Augusto, Caffaro.

    2011-09-01

    Full Text Available CONTEXTO: Hemocultura positiva associada a cateter venoso central tem sido estudada em unidades de terapia intensiva (UTI), mas ainda é controverso se o acesso jugular tem maior incidência de complicações infecciosas que o acesso na veia subclávia. OBJETIVO: Comparar índice de infecção entre os aces [...] sos na jugular interna e os na veia subclávia em pacientes internados nas enfermarias de cirurgia. MÉTODOS: Estudo prospectivo, descritivo e comparativo com 114 cateteres em 96 pacientes admitidos nas enfermarias de cirurgia de um Hospital Quaternário, tendo como variáveis o local de inserção, número de lumens, tempo de uso, comparando-os com o índice de complicações infecciosas. RESULTADOS: O índice de infecção foi de 9,64% (11 cateteres), sem significância estatística quando comparados o número de lumens (mono versus duplo) e infecção (p=0,274); também sem significância estatística a comparação entre o tempo de uso (>14 dias) e infecção (p=0,156). Comparando os acessos jugular e subclávia, encontramos significância estatística tendo infecção em 17,2% na subclávia e 1,8% na jugular, com p=0,005. Índice de Hemocultura positivo associado a cateter venoso central foi maior no acesso subclávia quando comparado com jugular interna, com OR 11,2, IC95% (1,4-90,9; p=0,023). CONCLUSÕES: O acesso venoso central na jugular interna tem menor risco de infecção se comparado com subclávia em enfermarias. Abstract in english BACKGROUND: Positive hemoculture associated with central venous catheters has been studied in intensive care units (ICU), but is still controversial if the internal jugular vein access has a higher incidence of infection than subclavian or femoral vein access. OBJECTIVE: To compare catheter-related [...] bloodstream infection (CABSI) rates between internal jugular and subclavian vein access in patients admitted to surgical wards. METHODS: This is a prospective, descriptive and comparative study of 114 central venous catheters placed in 96 patients admitted to the surgical wards of a tertiary-care hospital. The following parameters were studied: local of insertion of the catheter (internal jugular versus subclavian), number of lumens (single versus double) and duration of use (longer or shorter than 14 days), in order to determine their influence in CABSI rates. RESULTS: The CABSI rate was 9,64% (11 catheters), with no significant statistical differences regarding the number of lumens (p=0.274), and duration of use (p=0.156). The CABSI rate was higher in the subclavian vein than in the internal jugular vein access (OR 11.2, 95%CI 1.4-90.8; p=0.023). CONCLUSIONS: The internal jugular vein access has a lesser incidence of CABSI than subclavian vein access in patients admitted to surgical wards.

  8. Ressecção de aneurisma venoso em veia jugular externa direita Resection of right external jugular vein aneurysm

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    Eduardo Pereira Savi

    2010-12-01

    Full Text Available O aneurisma venoso é uma anomalia rara, cujo diagnóstico pode ser realizado a partir de exames físicos e complementares. Sua raridade justifica a necessidade de investigação e de publicações de estudos de caso, objetivo maior deste estudo. Relata-se aqui o caso de uma paciente que apresentava um abaulamento cervical anterior assintomático, progressivo e com seis meses de evolução. A paciente foi submetida à cervicotomia anterior, sob anestesia geral, com ressecção do segmento venoso acometido e ligadura da veia jugular externa. Realizado o estudo, verificou-se que aneurismas venosos podem causar tromboflebite, embolia pulmonar ou rotura. Cirurgia profilática, quando oferece baixo risco, é cuidadosamente recomendada para pacientes com aneurismas abdominais e altamente recomendada para aneurismas do sistema venoso profundo dos membros inferiores. Outros aneurismas venosos devem ser tratados cirurgicamente quando sintomáticos, desfigurantes ou se apresentarem aumento progressivo.Venous aneurysms are a rare abnormality, usually found in physical or complementary exams. We report a case of a 43-year old female with an asymptomatic and progressive enlarging mass in the neck. She had no history of trauma or cervical puncture. Vascular ultrasound showed a right jugular veins aneurysm with 1,81 x 1,62 cm of diameter. She was undergone resection and ligation of right external jugular vein, under general anesthesia. Venous aneurysm can cause thrombophlebitis, pulmonary embolism or spontaneous rupture. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring

  9. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso

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    Utida Hélio; Abreu Mariza Toledo de; Manso Paulo Góis; Koller Karine; Wang Stephen; Leite Carla Reichert

    2002-01-01

    Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de ...

  10. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

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    Hélio Utida

    2002-06-01

    Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

  11. Experiencia Clínica de Enfermería: Canalización de Vena Yugular Externa / Nursing Clinical Experience: Catheterization of External Jugular Vein / Experiência Clínica de Enfermagem: Cateterização da Veia Jugular Externa

    Scientific Electronic Library Online (English)

    José Manuel, Flórez Ramos; María Moraima, Arias Restrepo; Andrés Felipe, Tirado Otálvaro.

    2013-06-01

    Full Text Available Objetivo: identificar as complicações que se apresentam e a normativa na gestão do acesso venoso jugular externo, em doentes em estado crítico ou precisando de cuidados intermédios de saúde, hospitalizados nas unidades de cuidados intensivos e cuidados especiais de uma clínica de terceiro nível na c [...] idade de Medellín, 2010. Metodologia: estudo descritivo, prospectivo realizado em 104 doentes; as informações foram coletadas através da observação direta desses doentes e o preenchimento de formulário para coleta de dados. As informações foram analisadas mediante medidas de frequência absoluta e relativa. Resultados: a incidência de complicações foi 26%, das quais a retirada não programada teve a maior frequência (51.9%). O sucesso da cateterização da veia jugular externa foi de (91.3%). 81.7% dos doentes estiveram com o acesso venoso jugular externo canulado até por cinco dias não apresentando complicações na sua estadia. Conclusão: o acesso jugular externo deve ser considerado em doentes difíceis de canalizar podendo ser usado para administrar medicamentos e soluções potencialmente vesicantes ou hiperosmolares. A baixa incidência de complicações permite que esse procedimento seja desenvolvido pelo profissional de enfermagem corretamente treinado; o sucesso da cateterização depende do treinamento prévio do pessoal de cuidados de saúde, porém esse procedimento foi fundamentado na experiência clínica e na formação da graduação sem curso prévio específico para tal técnica. Abstract in spanish Objetivo: Identificar las complicaciones que se presentan y las normas en el manejo del acceso venoso yugular externo, en pacientes en estado crítico o que ameriten cuidados intermedios de salud, hospitalizados en las unidades de cuidados intensivos y cuidados especiales de una clínica de tercer niv [...] el de la ciudad de Medellín, 2010. Metodología: Estudio descriptivo, prospectivo realizado en 104 pacientes; la información se recolectó a través de la observación directa de los mismos y el diligenciamiento de un formulario para la recolección de datos. Se analizó la información a través de medidas de frecuencia absoluta y relativa. Resultados: La incidencia de complicaciones fue del 26%, de las cuales, el retiro no programado tuvo la mayor frecuencia (51.9%). El éxito de canalización de la vena yugular externa fue de (91.3%). El 81.7% de los pacientes estuvo con el acceso venoso yugular externo canulado hasta por cinco días sin presentar complicaciones por su estancia. Conclusión: El acceso yugular externo se debe considerar en pacientes que son difíciles de canalizar y se puede utilizar para la administración de medicamentos y soluciones potencialmente vesicantes o hiperosmolares. La baja incidencia en las complicaciones, permiten que este procedimiento lo pueda realizar el profesional de enfermería debidamente entrenado; el éxito de la canalización depende del entrenamiento previo del personal asistencial, sin embargo este procedimiento tuvo como fundamento la experiencia clínica y la formación de pregrado sin previo curso especifico para dicha técnica. Abstract in english Objective: To identify the complications that arise and management standards external jugular venous access in patients in critical care or intermediate health warrant hospitalized in intensive care units and special care from a clinic in third level Medellin, 2010. Methods: Prospective descriptive [...] study conducted in 104 patients, information was collected through direct observation of them and filling out a form for data collection. Data was analyzed through measures of absolute and relative frequency. Results: The incidence of complications was 26%, with unscheduled withdrawal being the most common (51.9%). The success of external jugular vein catheterization was 91.3%. 81.7% of patients with venous access were external jugular cannulated up to 5 days without complications for your stay. Conclusion: external jugular access should be considered in patients who

  12. Trombose de veia jugular em paciente com anticorpo anticardiolipina e lúpus eritematoso sistêmico / Thrombosis in jugular vein in patient with anticardiolipin antibody and systemic lupus erythematosus

    Scientific Electronic Library Online (English)

    Marcel Antônio, Camarosano; Augusto Pereira do, Nascimento Júnior; Marcelo, Casagrande; José Maria Pereira de, Godoy; Domingo Marcolino, Braile; Roberto Acayaba de, Toledo.

    2003-08-01

    Full Text Available Os autores relatam o caso de uma paciente com 19 anos de idade, portadora de lúpus eritematoso sistêmico, que apresentou edema súbito e progressivo em membro superior esquerdo e dor e circulação colateral visível em região supraclavicular esquerda. Foi realizado diagnóstico de trombose venosa em vei [...] a jugular externa esquerda por meio do dúplex scan. Nos exames laboratoriais, evidenciou-se a presença de anticorpo anticardiolipina. Abstract in english The authors report the case of a 19-year-old patient with systemic lupus erythematosus who presented with sudden and progressive edema in the left upper limb. She suffered from pain and visible collateral circulation in the left supra-clavicle region. Using a duplex scan, a diagnosis of venous throm [...] bosis in the external left jugular vein was made. Laboratory tests proved the existence of anticardiolipin antibody.

  13. Trombosis de la vena yugular interna secundaria a faringoamigdalitis aguda / Thrombosis of the internal jugular vein secondary to acute pharyngotonsillitis

    Scientific Electronic Library Online (English)

    Giselle, Cuestas; Yesica, Lijdens; María Victoria, Demarchi; María Pía, Martínez Corvalán; Juan, Razetti; Carlos, Boccio.

    2014-12-01

    Full Text Available La faringoamigdalitis aguda es una de las enfermedades más comunes en niños y adolescentes. La etiología más frecuente es la viral, seguida por la bacteriana. Entre las causas bacterianas, el principal agente es el estreptococo beta hemolítico del grupo A. Una complicación infrecuente de los proceso [...] s infecciosos faríngeos es la tromboflebitis séptica de la vena yugular interna. El diagnóstico se sospecha ante la tumefacción laterocervical unilateral de carácter inflamatorio. Se confirma mediante tomografía computada con contraste. El tratamiento consiste en la administración prolongada de antibióticos; el uso de anticoagulantes es controvertido. El diagnóstico precoz y el tratamiento apropiado son esenciales para evitar la oclusión vascular persistente y la progresión del trombo, que puede ocasionar émbolos pulmonares. Presentamos a una adolescente con tromboflebitis de la vena yugular interna secundaria a faringoamigdalitis aguda estreptocócica, con el objetivo de describir las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara complicación vascular. Abstract in english Acute pharyngotonsillitis is one of the most common diseases in children and adolescents. The most frequent etiology is virus, followed by bacteria. The main bacterial agent is beta hemolytic Streptococcus group A. A rare complication of pharyngeal infectious processes is septic thrombophlebitis of [...] the internal jugular vein. The diagnosis is suspected in the presence of an inflammatory unilateral neck swelling. The diagnosis is confirmed by contrast computed tomography. Treatment consists of prolonged administration of antibiotics, being the use of anticoagulants controversial. Early diagnosis and appropriate treatment are essential to prevent persistent vascular occlusion and progression of the thrombus, which can cause pulmonary emboli. In the present study, we present a teenager with thrombophlebitis of the internal jugular vein secondary to acute streptococcal pharyngotonsillitis. Clinical manifestations, diagnostic methods and treatment of this rare vascular complication are described herein.

  14. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Directory of Open Access Journals (Sweden)

    Cristina Ribeiro Riguetti Pinto

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço inoxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA. Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%. CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA. Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%. CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

  15. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos / Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Scientific Electronic Library Online (English)

    Cristina Ribeiro Riguetti, Pinto; Celso Luiz Muhlethaler, Chouin; Gaudencio, Espinosa Lopez.

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço i [...] noxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA). Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%). CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso. Abstract in english OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used [...] the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA). Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%). CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

  16. Communication of the External and Internal Jugular Veins: A Case Report / Comunicación entre las Venas Yugulares Externa e Interna: Reporte de Caso

    Scientific Electronic Library Online (English)

    Rekha, Lalwani; Kum Kum, Rana; Srijit, Das; Riyazul Qamar, Khan.

    2006-12-01

    Full Text Available La vena yugular externa, cruza transversal y superficialmente al músculo esternocleidomastoideo presentando variaciones en su curso y formación, existiendo algunos repórters en las comunicaciones entre ambas venas yugulares externa e interna. Durante ua disección de rutina, detectamos una anormal co [...] municación entre ambas venas, en una cadáver de sexo masculino de 45 años. El conocimiento de la anatomía normal y de las variaciones de las venas superficiales del cuello es importante en los procedimientos de cateterización tanto para clínicos como para cirujanos que operan en esta región. La presencia de estas variaciones de comunicación venosa es importante además, para imagenólogos y estudios sonográficos Abstract in english The external jugular vein, which traverses the sternocleidomastoid muscle superficially, is known to exhibit variations in its formation and course. There are less reports on the communication of the external and internal jugular vein. During routine cadaveric dissection, we detected an abnormal com [...] munication of the external jugular vein and the internal jugular vein, in a 45 year male cadaver. The knowledge of both normal and abnormal anatomy of the superficial veins of the neck may be important for clinicians performing catheterization and surgeons operating in the region of the neck. The presence of such anomalous communications may also be important for radiologists performing angiographic and sonographic studies

  17. Central venous access through the external jugular vein in children submitted to bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    José Luiz de Godoy

    2005-01-01

    Full Text Available Establishment of long-term central venous access is a sine qua non step for bone marrow transplantation in children. Most frequently, long-term central venous access has been obtained via blind percutaneous cannulation of subclavian and internal jugular veins or via internal jugular vein cutdown. In order to avoid some potential minor and major complications associated with the subclavian or internal jugular approaches, the authors describe an easy, simple and safe method for central venous access through an external jugular vein cutdown that should be of interest to readers involved in the field of bone marrow transplantation. It should be also considered for children as well as adults needing central venous access via an external catheter - or totally implantable port - for reasons other than bone marrow transplantation, such as total parenteral nutrition and administration of chemotherapeutic agents.O estabelecimento de um acesso venoso central de longa duração é uma condição sine qua non para realizar o transplante de medula óssea em crianças. Com frequência, este acesso tem sido obtido através da punção percutânea das veias subclávia e jugular interna ou via dissecção da jugular interna. Com o objetivo de evitar algumas complicações maiores e menores associadas com a subclávia e a jugular interna, os autores descrevem um método simples, fácil e seguro para o acesso venoso central através de dissecção da veia jugular externa. Este método deveria ser de interesse dos leitores envolvidos com o transplante de medula óssea e ser considerado também para crianças e/ou adultos que necessitem de cateter venoso central de longa permanência (externo ou totalmente implantável devido a outras razões, como a nutrição parenteral ou a administração de agentes quimioterápicos.

  18. Correction of carotid-jugular traumatic fistula using a bovine pericardial patch / Correção de fístula traumática carotídeo-jugular com pericárdio bovino

    Scientific Electronic Library Online (English)

    Werther Souza, Sales; Fabio Augusto Cypreste, Oliveira; Fabio Henrique Ribeiro de, Souza; Handel Meireles, Borges Filho; Juliano Ricardo Santana, Santos; Marcelo Luiz, Brandão; Paula Sabrina Araujo, Milhomem; Rodrigo Alves, Riemma.

    2014-03-01

    Full Text Available A fístula carotídeo-jugular é de ocorrência rara, porém habitualmente causa morbimortalidade. Está associada frequentemente a trauma penetrante, principalmente em razão de lesão por projétil de arma de fogo. Relata-se o caso de um paciente vítima de lesão por projétil de arma de fogo na região cervi [...] cal esquerda, o que provocou fístula arteriovenosa carotídeo-jugular com oclusão da artéria carótida comum. Foi realizada correção da fístula com ligadura da veia jugular interna e arteriorrafia com remendo de pericárdio bovino na artéria carótida comum esquerda. Abstract in english Carotid-jugular fistulae are rare, but habitually cause morbidity and mortality. They are often linked with penetrating trauma, primarily caused by gunshots. This report describes the case of a patient who was the victim of a gunshot wound to the left cervical area, provoking a carotid-jugular arter [...] iovenous fistula and occlusion of the common carotid artery. The fistula was corrected by ligature of the internal jugular vein and arteriorrhaphy of the left common carotid artery with a bovine pericardium patch.

  19. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos / Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

    Scientific Electronic Library Online (English)

    Celso Luiz Muhlethaler, Chouin; Cristina Ribeiro Riguetti, Pinto; Gaudencio Espinosa, Lopez.

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L- [...] hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA) na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar), mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso. Abstract in english BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delive [...] red by Taheri-Leonhardt system (Florida, USA) . The implants were done in the descending thoracic aorta, and in the infra-renal vena cava of 10 swines. Sixty days after, the endoprosthesis were removed and analyzed under macro and microscopic view. The following parameters were analyzed: patency, incorporation to the vessel wall, type of inflammatory reaction, tissue response concerning the layer of the vessel as for the contact with the ring steel. RESULTS: All implanted stent-grafts were patent, and incorporated to the vessel wall. Six presented fibrous bars, and four presented perivascular fibrosis at the venous section. At the arterial section, only one prosthesis developed a very small stenosis, without perivascular fibrosis. We observed chronic inflammatory reaction with a foreign body granulomatous response in 100% of the samples, the medium layer was the more prevalent at the vein section, while the intima layer was more constant at the artery, venous incorporation was stronger than artery incorporation, and tissue response was enhanced in the inner contact between the vessel wall and the ring steel. CONCLUSION: The prosthesis in study presented low thrombogenicity in both systems. It was also present, larger tissue response and low biocompatibility at the venous system, and better biocompatibility at the arterial system.

  20. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

    Directory of Open Access Journals (Sweden)

    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida, USA . The implants were done in the descending thoracic aorta, and in the infra-renal vena cava of 10 swines. Sixty days after, the endoprosthesis were removed and analyzed under macro and microscopic view. The following parameters were analyzed: patency, incorporation to the vessel wall, type of inflammatory reaction, tissue response concerning the layer of the vessel as for the contact with the ring steel. RESULTS: All implanted stent-grafts were patent, and incorporated to the vessel wall. Six presented fibrous bars, and four presented perivascular fibrosis at the venous section. At the arterial section, only one prosthesis developed a very small stenosis, without perivascular fibrosis. We observed chronic inflammatory reaction with a foreign body granulomatous response in 100% of the samples, the medium layer was the more prevalent at the vein section, while the intima layer was more constant at the artery, venous incorporation was stronger than artery incorporation, and tissue response was enhanced in the inner contact between the vessel wall and the ring steel. CONCLUSION: The prosthesis in study presented low thrombogenicity in both systems. It was also present, larger tissue response and low biocompatibility at the venous system, and better biocompatibility at the arterial system.

  1. Trombosis yugular interna bilateral asociada a trombofilia después de la inducción ovárica por infertilidad Bilateral internal jugular thrombosis associated with thrombophilia after ovarian induction for infertility

    Directory of Open Access Journals (Sweden)

    Fernando Vázquez

    2002-08-01

    Full Text Available Los eventos tromboembólicos son complicaciones poco frecuentes del tratamiento hormonal de la infertilidad y generalmente están asociados al síndrome de hiperestimulación ovárico (SHO. La trombosis venosa yugular es infrecuente y ante su presencia se debería sospechar la existencia de algún factor predisponente. Describimos una paciente de 31 años, sin antecedentes de importancia, no fumadora, a la cual se le realizó un único ciclo de estimulación hormonal para fertilización in vitro por esterilidad primaria con factor masculino. Durante la octava semana de embarazo gemelar desarrolló una trombosis yugular interna bilateral, en ausencia de SHO u otros factores predisponentes aparentes. En la evaluación para trombofilia se detectó la presencia del Factor V Leiden y la mutación del gen de la protrombina G 20210, que junto con el estímulo hormonal, se interpretaron como los factores predisponentes. Se anticoaguló con heparina de bajo peso molecular. No está recomendado el rastreo sistemático de trombofilia antes del tratamiento hormonal, pero podría ser considerado en pacientes de alto riesgo o en quienes desarrollan trombosis en ausencia de un factor predisponente claro.Thromboembolic events are an infrequent complication of hormonal treatment for infertility and are generally related to the hyperstimulated ovarian syndrome (HOS. Jugular vein thrombosis is an unusual site of thrombosis and when present one should look for a predisposing factor. We describe a 31-year-old woman, with no previous medical history, non-smoker, who received a single cycle of hormonal stimulation for in vitro fertilisation due to primary infertility. During her eighth week of a twin pregnancy, she consulted the emergency room where the diagnosis of bilateral jugular thrombosis was confirmed, in absence of HOS or any known predisposing factor. In subsequent studies, the presence of Factor V Leyden and a mutation of G 20210 prothrombin were found. These, in association to the hormonal stimulus, were considered the risk factors. She received anticoagulation treatment with low molecular weight heparin. Screening tests for thrombophilias before hormonal treatment is not recommended, but one could consider this possibility in high-risk patients or in those who develop thrombosis in the absence of any predisposing factors.

  2. Trombosis yugular interna bilateral asociada a trombofilia después de la inducción ovárica por infertilidad / Bilateral internal jugular thrombosis associated with thrombophilia after ovarian induction for infertility

    Scientific Electronic Library Online (English)

    Fernando, Vázquez; Diana, Penchasky; Inés, De la Parra; Astrid, Pavlovsky; Yolanda, Adamczuk.

    2002-08-01

    Full Text Available Los eventos tromboembólicos son complicaciones poco frecuentes del tratamiento hormonal de la infertilidad y generalmente están asociados al síndrome de hiperestimulación ovárico (SHO). La trombosis venosa yugular es infrecuente y ante su presencia se debería sospechar la existencia de algún factor [...] predisponente. Describimos una paciente de 31 años, sin antecedentes de importancia, no fumadora, a la cual se le realizó un único ciclo de estimulación hormonal para fertilización in vitro por esterilidad primaria con factor masculino. Durante la octava semana de embarazo gemelar desarrolló una trombosis yugular interna bilateral, en ausencia de SHO u otros factores predisponentes aparentes. En la evaluación para trombofilia se detectó la presencia del Factor V Leiden y la mutación del gen de la protrombina G 20210, que junto con el estímulo hormonal, se interpretaron como los factores predisponentes. Se anticoaguló con heparina de bajo peso molecular. No está recomendado el rastreo sistemático de trombofilia antes del tratamiento hormonal, pero podría ser considerado en pacientes de alto riesgo o en quienes desarrollan trombosis en ausencia de un factor predisponente claro. Abstract in english Thromboembolic events are an infrequent complication of hormonal treatment for infertility and are generally related to the hyperstimulated ovarian syndrome (HOS). Jugular vein thrombosis is an unusual site of thrombosis and when present one should look for a predisposing factor. We describe a 31-ye [...] ar-old woman, with no previous medical history, non-smoker, who received a single cycle of hormonal stimulation for in vitro fertilisation due to primary infertility. During her eighth week of a twin pregnancy, she consulted the emergency room where the diagnosis of bilateral jugular thrombosis was confirmed, in absence of HOS or any known predisposing factor. In subsequent studies, the presence of Factor V Leyden and a mutation of G 20210 prothrombin were found. These, in association to the hormonal stimulus, were considered the risk factors. She received anticoagulation treatment with low molecular weight heparin. Screening tests for thrombophilias before hormonal treatment is not recommended, but one could consider this possibility in high-risk patients or in those who develop thrombosis in the absence of any predisposing factors.

  3. Comparação entre o laser endovenoso e a fleboextração total da veia safena interna: resultados em médio prazo Comparison of endovenous laser therapy vs. conventional stripping of the great saphenous vein: midterm results

    Directory of Open Access Journals (Sweden)

    Charles Angotti Furtado de Medeiros

    2006-12-01

    Full Text Available OBJETIVO: Comparar a fotocoagulação endovenosa com laser diodo e a fleboextração total da veia safena interna. MÉTODOS: Trata-se de um estudo prospectivo, controlado e cego de 20 pacientes com varizes sintomáticas e insuficiência bilateral da veia safena interna que foram operados entre março de 2002 e fevereiro de 2004. Para cada caso, foram realizadas aleatoriamente (sorteio as duas técnicas, sendo uma em cada lado. A avaliação pós-operatória consistiu na aplicação de questionários, exame físico e fotografia digital em todos os pacientes desde o 7º dia de pós-operatório. Também foi realizado controle ultra-sonográfico no 30º dia de pós-operatório e pletismografia a ar no 60º dia após a cirurgia. Este projeto foi aprovado pela comissão de ética, e os pacientes foram incluídos ao assinarem o consentimento pós-informação. Os dados foram submetidos a análise estatística com os programas SPSS e SAS. RESULTADOS: A técnica que utilizou o laser endovenoso apresentou dor semelhante, mas menos edema e menos hematoma durante o pós-operatório. O índice de melhora estética e de satisfação com a cirurgia foi de 100% para as duas técnicas, mas a maioria dos pacientes respondeu que o membro operado com o laser foi o mais beneficiado. Houve melhora do tempo de enchimento venoso nos dois grupos, mas sem diferença significativa entre eles. Durante o seguimento (média de 26 meses, houve um caso de parestesia leve e transitória do lado convencional e somente uma recanalização do lado laser. CONCLUSÃO: A fotocoagulação endovenosa para o tratamento da veia safena interna em pacientes com varizes de membros inferiores é segura e apresenta resultados comparáveis aos da fleboextração convencional.OBJECTIVE: To compare endovenous diode laser photocoagulation and conventional stripping of the great saphenous vein. METHODS: A controlled and blind prospective study of 20 patients with symptomatic varicose veins and bilateral great saphenous vein insufficiency who underwent surgery between March 2002 and February 2004. For each case, both techniques were randomly performed, one at each side. The postoperative assessment consisted of questionnaires, physical examination and digital photography of all patients since the 7th postoperative day. Patients also underwent examination with duplex scan at the 30th postoperative day and air plethysmography 60 days after the surgery. This project was approved by the ethics committee, and the patients were included after signing the consent form. All data were submitted to statistical analysis using the software SPSS and SAS. RESULTS:: The endovenous laser technique presented similar pain, but less edema and less hematoma during the postoperative period. The index of esthetic improvement and satisfaction with the surgery was 100% for both techniques, but a minority of patients reported that the limb operated with the laser had better results. There was improvement in venous filling time in both groups, but with no significant difference. During the follow-up (average of 26 months, there was one case of mild and transient paresthesia at the conventional side and only one recanalization at the laser side. CONCLUSION: The endovenous photocoagulation for the treatment of the great saphenous vein in patients with lower limb varicose veins is safe and presents results comparable with the conventional stripping.

  4. Comparação entre o laser endovenoso e a fleboextração total da veia safena interna: resultados em médio prazo / Comparison of endovenous laser therapy vs. conventional stripping of the great saphenous vein: midterm results

    Scientific Electronic Library Online (English)

    Charles Angotti Furtado de, Medeiros.

    2006-12-01

    Full Text Available OBJETIVO: Comparar a fotocoagulação endovenosa com laser diodo e a fleboextração total da veia safena interna. MÉTODOS: Trata-se de um estudo prospectivo, controlado e cego de 20 pacientes com varizes sintomáticas e insuficiência bilateral da veia safena interna que foram operados entre março de 200 [...] 2 e fevereiro de 2004. Para cada caso, foram realizadas aleatoriamente (sorteio) as duas técnicas, sendo uma em cada lado. A avaliação pós-operatória consistiu na aplicação de questionários, exame físico e fotografia digital em todos os pacientes desde o 7º dia de pós-operatório. Também foi realizado controle ultra-sonográfico no 30º dia de pós-operatório e pletismografia a ar no 60º dia após a cirurgia. Este projeto foi aprovado pela comissão de ética, e os pacientes foram incluídos ao assinarem o consentimento pós-informação. Os dados foram submetidos a análise estatística com os programas SPSS e SAS. RESULTADOS: A técnica que utilizou o laser endovenoso apresentou dor semelhante, mas menos edema e menos hematoma durante o pós-operatório. O índice de melhora estética e de satisfação com a cirurgia foi de 100% para as duas técnicas, mas a maioria dos pacientes respondeu que o membro operado com o laser foi o mais beneficiado. Houve melhora do tempo de enchimento venoso nos dois grupos, mas sem diferença significativa entre eles. Durante o seguimento (média de 26 meses), houve um caso de parestesia leve e transitória do lado convencional e somente uma recanalização do lado laser. CONCLUSÃO: A fotocoagulação endovenosa para o tratamento da veia safena interna em pacientes com varizes de membros inferiores é segura e apresenta resultados comparáveis aos da fleboextração convencional. Abstract in english OBJECTIVE: To compare endovenous diode laser photocoagulation and conventional stripping of the great saphenous vein. METHODS: A controlled and blind prospective study of 20 patients with symptomatic varicose veins and bilateral great saphenous vein insufficiency who underwent surgery between March [...] 2002 and February 2004. For each case, both techniques were randomly performed, one at each side. The postoperative assessment consisted of questionnaires, physical examination and digital photography of all patients since the 7th postoperative day. Patients also underwent examination with duplex scan at the 30th postoperative day and air plethysmography 60 days after the surgery. This project was approved by the ethics committee, and the patients were included after signing the consent form. All data were submitted to statistical analysis using the software SPSS and SAS. RESULTS:: The endovenous laser technique presented similar pain, but less edema and less hematoma during the postoperative period. The index of esthetic improvement and satisfaction with the surgery was 100% for both techniques, but a minority of patients reported that the limb operated with the laser had better results. There was improvement in venous filling time in both groups, but with no significant difference. During the follow-up (average of 26 months), there was one case of mild and transient paresthesia at the conventional side and only one recanalization at the laser side. CONCLUSION: The endovenous photocoagulation for the treatment of the great saphenous vein in patients with lower limb varicose veins is safe and presents results comparable with the conventional stripping.

  5. Trombosis de la vena yugular interna y mediastinitis aguda necrosante descendente debido a una faringoamigdalitis aguda / Thrombosis of the internal jugular vein and descending necrotizing mediastinitis due to acute pharyngotonsilitis

    Scientific Electronic Library Online (English)

    Celia, Sánchez Acedo; Pedro Luis, Martos Díaz; Mario F., Muñoz Guerra; Luis, Naval Gías; Francisco J., Rodríguez Campo; Emilio, Martín Díaz.

    2010-09-01

    Full Text Available El síndrome de Lemierre es una patología muy infrecuente en la época actual, pero muy grave, y siempre debe considerarse ante un cuadro de fiebre con antecedente de infección orofaríngea, tumefacción laterocervical a lo largo del músculo esternocleidomastoideo y signos de sepsis. El diagnóstico de e [...] ste síndrome es fundamentalmente clínico, y las pruebas complementarias tan sólo ayudan a confirmar el cuadro. Presentamos el caso de un varón de 31 años que acudió a urgencias con clínica de faringoamigdalitis junto con tumefacción en la región submandibular izquierda e importante dolor cervical ipsilateral, que mostró un deterioro rápido y progresivo del estado general pese al tratamiento antibiótico intravenoso. Finalmente tuvo que ser intervenido debido al desarrollo de mediastinitis aguda necrosante descendente desde la región pretiroidea hasta el diafragma, con trombosis de la vena yugular interna izquierda. Se le realizó toracotomía urgente y cervicotomía izquierda con drenaje de abundante material purulento y ligadura de la vena yugular interna. Abstract in english Lemierre syndrome is a potentially fatal condition after an oropharyngeal infection. It is characterized by thrombophlebitis of head and neck veins with systemic dissemination of septic emboli. The diagnosis of this syndrome is mainly clinical and complementary test only serve as aid to confirm it. [...] We report an unusual case of Lemierre syndrome in a 31-year-old man caused by Gemella spp. and Streptococcus pyogenes. It developed following a pharyngotonsillitis infection, which deteriorated rapidly and progressively despite intravenous antibiotic treatment. He finally had to be intervened due to developing acute descending necrotizing mediastinitis from the pre-thyroid region to the diaphragm, with thrombosis of the internal jugular vein. An urgent thoracotomy and left cervicotomy was performed, with drainage of abundant purulent material and ligature of the internal jugular vein. We also discuss its atypical clinical presentation, the crucial role of imaging in the early diagnosis, and the different treatment options of this life-threatening syndrome.

  6. Transposition of cephalic vein to rescue hemodialysis access arteriovenous fistula and treat symptomatic central venous obstruction / Transposição de veia cefálica para salvamento de fístula arteriovenosa de hemodiálise e tratamento de obstrução venosa central sintomática

    Scientific Electronic Library Online (English)

    Felipe Jose, Skupien; Ricardo Zanetti, Gomes; Emerson Hideyoshi, Shimada; Rafael Inacio, Brandao; Suellen Vienscoski, Skupien.

    2014-03-01

    Full Text Available Sabemos que estenose ou obstrução venosa central ocorre em 20 a 50% dos pacientes que são submetidos à colocação de cateter em veias centrais. Nos pacientes que realizam hemodiálise pelos membros superiores, este problema causa sintomas debilitantes e um grande risco de perda do acesso para hemodiál [...] ise. Relatamos um caso atípico de tratamento em um paciente dialítico com múltiplas comorbidades, queixa de dor e edema severo do membro superior direito (MSD), escassas alternativas de acessos vasculares para hemodiálise e fístula braquiobasílica funcionante do MSD associada à severa hipertensão venosa deste membro, secundária à oclusão venosa central da veia jugular interna e do tronco braquiocefálico direito. O tratamento cirúrgico alternativo foi a transposição da veia cefálica do MSD, formando colar venoso na região cervical anterior, resultando em um bypass sobre o sítio venoso ocluído. Para isso, realizamos a dissecção da veia cefálica no braço direito até a sua junção com a veia axilar, devalvulamos e anastomosamos a veia cefálica na veia jugular externa contralateral, permitindo a drenagem venosa do MSD, aliviando os sintomas da hipertensão venosa e mantendo a fístula braquiobasílica funcionante. Abstract in english It is known that stenosis or central venous obstruction affects 20 to 50% of patients who undergo placement of catheters in central veins. For patients who are given hemodialysis via upper limbs, this problem causes debilitating symptoms and increases the risk of loss of hemodialysis access. We repo [...] rt an atypical case of treatment of a dialysis patient with multiple comorbidities, severe swelling and pain in the right upper limb (RUL), few alternative sites for hemodialysis vascular access, a functioning brachiobasilic fistula in the RUL and severe venous hypertension in the same limb, secondary to central vein occlusion of the internal jugular vein and right brachiocephalic trunk. The alternative surgical treatment chosen was to transpose the RUL cephalic vein, forming a venous necklace at the anterior cervical region, bypassing the site of venous occlusion. In order to achieve this, we dissected the cephalic vein in the right arm to its junction with the axillary vein, devalved the cephalic vein and anastomosed it to the contralateral external jugular vein, providing venous drainage to the RUL, alleviating symptoms of venous hypertension and preserving function of the brachiobasilic fistula.

  7. Internal jugular vein cannulation: How much safety can we offer? / Canalización venosa yugular interna: que tanta seguridad podemos llegar a ofrecer?

    Scientific Electronic Library Online (English)

    William F, Amaya Zuñiga; Fernando, Raffán Sanabria; Claudia, Niño de Mejía; Eduardo, Hermida; Jorge, Alvarado Sánchez; María, Conchita Solórzano; Raphael Hernando, Parrado Rodriguez; Leonardo José, León Nuñez.

    2015-01-01

    Full Text Available Introducción: La canulación venosa central por técnica de reparos anatómicos presenta complicaciones mecánicas entre 5-19%, por tal motivo se han modificado e implementado técnicas buscando disminuir los riesgos para el paciente. La introducción de la ultrasonografía en la práctica clínica y más rec [...] ientemente en la colocación de catéteres venosos centrales, ha disminuido la incidencia de complicaciones. Objetivo: Evaluar la aplicación clínica del algoritmo "Adecuada inserción de catéteres venosos yugulares internos guiados por ultrasonografía". Metodología: Estudio descriptivo prospectivo de serie de casos. Se seleccionaron pacientes mayores de 18 anos de edad, con el consentimiento informado completamente diligenciado. Los criterios de exclusión fueron pacientes con masas, alteraciones anatómicas o infecciones en el sitio de punción, trastornos de coagulación (Índice Normalizado Internacional INR ? 2,0 y conteo plaquetario ?50.000). La canulación venosa central fue realizada con técnica ultrasonofigura considerando las recomendaciones de seguridad que se tienen en el departamento de anestesia del Hospital Universitario Fundación Santa Fe de Bogotá (HUFSFB), los ajustes y validación del algoritmo guía se realizaron según el consenso de expertos en procedimientos invasivos y ultrasonografía. Se realizó análisis descriptivo uni-variado y la eficacia fue determinada por el número de punciones necesarias para una adecuada canulación vascular y la incidencia de complicaciones. Resultados: La serie de casos fue de 38 pacientes con una edad promedio de 62 años. En el 97,4% de los casos el paso fue realizado en el primer intento. En un paciente se evidenció desplazamiento inadecuado de la guía por lo que fue necesario repetir la punción. En 2 pacientes (5,2%) se presentó punción de la pared posterior del vaso sin que esto se hubiese correlacionado con presencia de lesión vascular arterial o neumotórax. Conclusiones: La implementación del algoritmo guía, permitió una alta tasa de éxito en el primer intento y la prevención de complicaciones potenciales, mejorando los estándares operacionales, brindando una mayor calidad en el cuidado y atención de los pacientes. Abstract in english Introduction: Central venous catheterization, performed by the anatomical landmark technique, has a mechanical complication rate between 5% and 19%. This technique has been modified and new approaches have been implemented aiming to improve patient safety. With the introduction of ultrasonography in [...] the clinical practice, and recently in central venous catheter insertion, the rate of complications has dropped over time. Objective: To measure the clinical application of the algorithm "Successful ultrasound-guided internal jugular vein cannulation". Methods: A descriptive, prospective, case series study. Patients over 18 years of age were selected, and the informed consent documentation was filled out appropriately. Patients with masses, anatomical abnormalities, insertion site infections and coagulopathy (International Normalized Ratio [INR] ? 2.0, platelet count ?50.000) were excluded. Central venous cannulation was performed under ultrasound guidance in accordance with safety of the Fundación Santa Fe de Bogotá University Hospital (HUFSFB). Adjustment and validation of the algorithm was done according to an expert consensus in our department. A descriptive univariate analysis was conducted, and efficacy was determined on the basis of the number of attempts to achieve successful venous cannulation, and the incidence of complications. Results: This series included 38 patients with a mean age of 62 years. In 97.4% of the cases, successful venous cannulation was achieved on the first attempt. Guidewire displacement was observed in one case, requiring a second attempt. The posterior jugular vein wall was punctured in two patients (5.2%), with no associated arterial vascular injury or pneumoth-orax. Conclusions: This algorithm resulted in a high rate of successful f

  8. Persistência da veia ciática / Persistent sciatic vein

    Scientific Electronic Library Online (English)

    Bárbara Borges, Cardoso; Camila Oliveira, Alvarenga; Maíra de Souza, Miyahara; Marcelo Calil, Burihan; Maria Raphaella Queiroz Alves de, Lima; Mariana Cardoso, Kuwahara; Rafael Capobianco Maia e, Silva.

    2010-09-01

    Full Text Available CONTEXTO: Durante um período da vida embrionária, a veia ciática é a principal coletora do membro inferior. Na embriogênese vascular, há diferenciação dos angioblastos em um plexo vascular primitivo, com posterior remodelagem e expansão. Consequentemente, durante esse processo, podem ocorrer anomali [...] as. Quando ocorre persistência da veia ciática, esta pode se comunicar com a veia safena parva ou com a veia poplítea durante seu percurso, anastomosando-se com a veia perfurante superior e com a veia circunflexa medial do fêmur. OBJETIVO: Relatar o caso da persistência bilateral de veia ciática nos membros inferiores, comparando à literatura. MÉTODOS: Foram dissecados 32 membros inferiores de 16 cadáveres formolizados no Laboratório de Anatomia pela Disciplina de Anatomia Topográfica da Faculdade de Medicina da Universidade de Santo Amaro (Unisa), durante 2006 e 2007, observando-se em 2 membros inferiores de um único cadáver, a presença de veia ciática. RESULTADOS: No membro inferior esquerdo de um cadáver que apresentou a anomalia bilateralmente, a veia media 37 cm, tinha origem na região da veia poplítea, acompanhava o nervo ciático, perfurava o músculo adutor magno e desembocava na veia femoral profunda. No membro inferior direito, ela media 36 cm, originava-se recebendo as veias do compartimento tibial anterior, acompanhava o nervo ciático, perfurava o músculo adutor magno e desembocava na veia ilíaca interna. CONCLUSÃO: As variações anatômicas do sistema venoso do membro inferior são as mais prevalentes. A persistência da veia ciática pode causar insuficiência venosa crônica no membro inferior e, dessa forma, deve ser investigada para uma melhor conduta clínica ou cirúrgica. Abstract in english BACKGROUND: During a period of the embryonic life, the sciatic vein is the main lower limb collector. In vascular embryogenesis, there is a differentiation of the angioblasts in a primitive vascular plexus, with posterior remodeling and expansion. Consequently, anomalies may occur during this proces [...] s. When there is persistence of the sciatic vein, it may communicate with the small saphenous vein or with the popliteal vein during its route, being anastomosed to the superior perforating vein and to the medial circumflex femoral vein. OBJECTIVE: To report a case of bilateral persistent sciatic vein on the lower limbs in comparison to the literature. METHODS: Thirty-two lower limbs from 16 corpses preserved in formaldehyde were dissected at the Laboratory of Anatomy of the discipline of Topographic Anatomy of the Medical School of Universidade Santo Amaro (Unisa), during 2006 and 2007, and the sciatic vein was observed in 2 lower limbs of one single corpse. RESULTS: On the left lower limb of a corpse that presented bilateral anomaly, the vein had 37 cm, emerging on the popliteal vein, accompanying the sciatic nerve, perforating the long adductor muscle and leading into the deep femoral vein. On the right lower limb, it measured 36 cm, emerged receiving the veins of the anterior tibial compartment, accompanied the sciatic nerve, perforated the long adductor muscle and led into the internal iliac vein. CONCLUSION: The anatomical variations of the lower limb venous system are the most common ones. The persistent sciatic vein may cause chronic venous failure in the lower limbs and, in this manner, must be investigated aiming at a better clinical or surgical management.

  9. Doença de Behçet cursando com trombose de veia cava superior / Behçet's disease presenting with superior vena cava thrombosis

    Scientific Electronic Library Online (English)

    Otacílio Figueiredo da, Silva Júnior; Ricardo Henrique de Sousa, Araújo; Eutília Andrade Medeiros, Freire; Ronaldo Rangel, Travassos Júnior; Thiago Emanuel Rodrigues, Cavalcante; Tarcísio José Pinheiro, Lucena; Norberto de Castro, Nogueira Neto; Alessandra Vanessa de Albuquerque, Melo.

    2006-03-01

    Full Text Available A trombose venosa é o principal acometimento do sistema vascular na doença de Behçet, sendo uma complicação freqüente na evolução clínica dessa patologia, e está mais associada ao sexo masculino. Os autores relatam o caso de uma paciente do sexo feminino que apresentou início da doença há 3 anos com [...] úlceras orais, além de úlceras genitais, e que vem cursando com episódios recorrentes de trombose venosa, sendo a primeira uma trombose venosa profunda no membro inferior direito; a segunda, de jugular interna esquerda; e, por último, uma trombose da veia cava superior. Abstract in english Venous thrombosis is the main hazard to the vascular system in Behçet's disease. It is a frequent complication throughout the clinical evolution of this illness, which is more associated with the male gender. The authors report the case of a female patient with disease onset 3 years ago, showing ora [...] l and genital ulcers presenting with recurring episodes of venous thrombosis. The first one was a deep venous thrombosis in the right leg; the second was in the left internal jugular vein; and finally a superior vena cava thrombosis.

  10. Distancia a introducir un catéter venoso central al puncionar la vena yugular interna por vía anterior derecha en pacientes pediátricos / Distance measured to introduce a central-venous catheter in internal jugular vein via right anterior in children

    Scientific Electronic Library Online (English)

    Junior M., Lima Aguiar; Antolín, Romero Suárez; Manuel, Lima Montero; Abel, Facenda Mederos; Néstor, Sánchez Nogueira; Jacqueline, Barrial Moreno.

    2011-08-01

    Full Text Available Introducción: La colocación correcta del extremo distal del catéter venoso centrales es de gran importancia para la obtención de información hemodinámica. Objetivo: Determinar la distancia existente desde la piel hasta la unión atriocava según edad, peso y talla e identificar las complicaciones. Mét [...] odo: Se incluyeron en un estudio prospectivo, analítico, descriptivo y observacional 72 pacientes pediátricos programados para cirugía cardiaca electiva previo consentimiento informado y aprobación del Comité de Ética. Posterior a la inducción de la anestesia general se colocó un calzo interescapular de 3-5 cm, la cabeza se colocó en posición central y extendida, Trendelemburg 15 grados. A nivel del cartílago cricoideo se localizó el pulso carotídeo derecho y lateral a este se procedió a puncionar la vena yugular interna. El trocar se dirigió con un ángulo de 45º hacia la mama ipsilateral, se introdujo el catéter por técnica de Seldinger clásica, se midió la distancia en centímetro desde el sitio de inserción hasta la articulación esternoclavicular, se confirmó la posición en la unión atriocava del catéter durante la apertura de la aurícula derecha, se determinó la distancia introducida del catéter según su escala. Las complicaciones se recogieron hasta la entrega del paciente en la terapia intensiva donde se realizó una radiografía de tórax anteroposterior. Resultados: en pacientes menores de 1 año y 10 kg se necesita introducir 6 cm, de 1 a 10 años y peso entre 11 y 50 kg, 8 cm y para mayores de 10 años y 50 kg necesitan solo 10 cm con un bajo índice de complicaciones. Conclusiones: Determinamos la distancia a introducir el catéter en la vena cava superior con pocas complicaciones. Abstract in english Introduction: The appropriate placement of distal end of the central venous catheter is very important for the achievement of hemodynamic information. Objective: To determine the distance measured from the skin up to atriocaval joint according to age, weight and height and to identify the complicati [...] ons. Method: In an observational, descriptive, analytical and prospective study were included 72 children programmed for elective cardiac surgery previous informed consent and the approval of Ethical Committee. After induction of general anesthesia a 3-5 cm interscapular wedge was placed, head was in central and outstretched position, Trendelemburg position of 15°. At cricoids cartilage level the right carotid pulse was felt and lateral to it the internal jugular vein was punctured. Trocar was directed with an angle of 45° towards the ipsilateral breast introducing the catheter using the classic Seldinger technique measuring the distance in centimeters from the insertion site up to sternoclavicular joint to confirm the position en the atriocaval joint of the catheter during the opening of the right atrium and to determine the distance of the introduced catheter according to its scale. Complications were registered at arrival of patient to intensive therapy unit obtaining anteroposterior thorax radiography. Results: In patients aged under 1 and weighing 10kg it is necessary to introduce 6 cm, from 1 to 10 years and weighing 11 and 50 kg the distance is of 6 cm and for those over 10 years and weighing 50kg are needed only 10 cm with a low rate of complications. Conclusions: Distance to introduce the catheter into the superior vena cava was determined achieving a low rate of complications.

  11. Enxertos vasculares homólogos e heterólogos conservados em glicerina na fleboplastia da jugular em eqüinos Arterial homograft and venous heterograft conserved in glycerin in the phleboplasty of the jugular in equines

    OpenAIRE

    D.R. Stainki; G.E.S Alves; A. C. VASCONCELOS; Barbosa, M. P.; de Oliveira, H. P.

    2005-01-01

    Doze eqüinos foram divididos aleatoriamente em dois grupos de seis animais (grupos I e II), com a finalidade de estudar a compatibilidade tecidual e a propriedade de indução de trombos de dois tecidos biológicos conservados em glicerina a 98%. Esses tecidos foram usados na restauração da jugular externa e se constituíram de artéria carótida comum homóloga (ACCHo), no grupo I, e veia jugular externa heteróloga (VJEHe), no grupo II. Para a restauração, utilizaram-se duas técnicas de anastomose ...

  12. The jugular bulb diverticulum

    International Nuclear Information System (INIS)

    Two hundred and forty-five temporal bone specimens were examined radiographically. Subsequently the topographic relationship between the jugular fossa and surrounding structures was evaluated in plastic casts of the specimens. Fifty-eight casts showed a high jugular fossa and in 17 a jugular bulb diverticulum was found. A diverticulum is regarded as an anomaly of the high jugular bulb and presumably has a potential for expansion. Most frequently a diverticulum was directed medially into the space between the internal acoustic meatus, the vestibular aqueduct and the posterior cranial fossa. Seven diverticula reached the level of the internal acoustic meatus. Encroachment upon the vestibular aqueduct was seen in 4 casts and both the internal acoustic meatus and the cochlear aqueduct were very close to the diverticulum. A few diverticula were directed postero-laterally close to the facial canal and the stapedius muscle. The investigation was supplemented with a selected clinical material of radiographs of temporal bones with high fossae. The results corresponded to those of the experimental investigation. The jugular bulb diverticulum is a relatively common feature and should be regarded as an anomaly with a potential to give rise to clinical symptoms consequent to its intrusion upon surrounding structures. (orig.)

  13. Neurinoma of the jugular foramen

    International Nuclear Information System (INIS)

    The complementary predications of modern imaging techniques, CT, MRI and intraarterial digital subtraction angiography (i.a. DSA), in the differential diagnosis of a neutrinoma of the jugular foramen are described. (orig.)

  14. Fenestrated Internal Jugular Vein: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ju Young; Lee, In Ho; Song, Chang June [Dept. of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of)

    2011-05-15

    A 54-year-old woman presented with a submental mass for 10 days. She underwent neck CT and a fenestrated internal jugular vein was incidentally found. We report a case of fenestrated internal jugular vein.

  15. Fenestrated Internal Jugular Vein: Case Report

    International Nuclear Information System (INIS)

    A 54-year-old woman presented with a submental mass for 10 days. She underwent neck CT and a fenestrated internal jugular vein was incidentally found. We report a case of fenestrated internal jugular vein.

  16. Metastatic thyroid carcinoma of jugular foramen simulating glomus jugulare tumor : a case report

    International Nuclear Information System (INIS)

    We report a case of hypervascular metastatic thyroid carcinoma of the jugular foramen simulating a glomus jugulare tumor. Computed tomography(CT) revealed areas of irregular lytic bony destruction of the left jugular foramen, as well as characteristic invasion routes of a glomus jugulare tumor. Magnetic resonance(MR) imaging and angiography demonstrated a hypervascular mass similar to a glomus tumor

  17. Contemporary management of jugular paragangliomas.

    Science.gov (United States)

    Wanna, George B; Sweeney, Alex D; Haynes, David S; Carlson, Matthew L

    2015-04-01

    Jugular paragangliomas are generally benign slow-growing tumors that can cause pulsatile tinnitus, hearing loss, and cranial nerves neuropathy. Progressive growth can also lead to intracranial extension. Historically, the treatment of choice for these lesions has been gross total resection. However, over the last 15 years, many groups have adopted less invasive management strategies including stereotactic radiation therapy, subtotal resection, and primary observation in order to reduce treatment-associated morbidity. The focus of this article is to review the modern management of jugular paraganglioma, highlighting the evolving treatment paradigm at the Otology Group of Vanderbilt. PMID:25769354

  18. Computed tomography of jugular foramen neurinomas

    International Nuclear Information System (INIS)

    Four jugular foramen neurinomas studied by computed tomography and verified by surgery originated from the glossopharyngeal nerve. Characteristic CT findings were a mixed low- and isodense extraaxial mass with ring-like enhancement in the cerebellopontine angle; enlargement of the jugular foramen, with smooth margins and a normal internal auditory canal; and an extracranial soft tissue mass extending through the jugular foramen. (author)

  19. Thyrocervical artery - jugular fistula following internal jugular venous catheterization

    OpenAIRE

    Zachariah, P. P.; Unni, V. N.; Kurian, G.; Nair, R R; Mathew, A.

    2014-01-01

    Arteriovenous fistula (AVF) is an anomalous communication between an artery and a vein, caused by an iatrogenic or traumatic etiology. Surgically created upper limb AVF remains the preferred vascular access for patients on maintenance hemodialysis. Nonetheless central vein cannulation for hemodialysis is a common procedure done in patients who need hemodialysis. We incidentally detected a thyrocervical artery - jugular fistula in a patient on maintenance hemodialysis. He underwent a successfu...

  20. Jugular vein thrombosis associated with distant malignancy.

    OpenAIRE

    Carrington, B. M.; Adams, J E

    1988-01-01

    We describe two patients who developed internal jugular vein thrombosis associated with primary malignant disease arising outside the neck, and in one patient it was the presenting feature. Computed tomography was performed and the findings characteristic of internal jugular vein thrombosis are illustrated. We conclude that malignant disease should be considered in patients presenting with spontaneous internal jugular vein thrombosis with no other predisposing factors and that computed tomogr...

  1. Slit-like jugular foramen due to abnormal bone growth at jugular fossa

    OpenAIRE

    Budhiraja V; Rastogi R

    2010-01-01

    An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narro...

  2. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    International Nuclear Information System (INIS)

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman

  3. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seog Wan [College of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

    2004-12-01

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman.

  4. Embolia pulmonar séptica secundária à tromboflebite jugular: um caso de síndrome de Lemierre Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2008-12-01

    Full Text Available A síndrome de Lemierre é caracterizada pela infecção aguda da orofaringe, complicada por trombose venosa jugular interna secundária à tromboflebite séptica, e por infecções metastáticas a vários órgãos distantes-mais freqüentemente os pulmões. Relatamos um caso de síndrome de Lemierre em uma mulher de 56 anos que se apresentou com massa cervical à direita e febre. Trombose venosa jugular interna foi demonstrada na ecografia. A tomografia computadorizada de tórax revelou múltiplas opacidades em ambos os pulmões. Uma biópsia pulmonar cirúrgica foi realizada por suspeita de metástases pulmonares. O exame anatomopatológico revelou êmbolos sépticos em parênquima pulmonar. Retrospectivamente, a paciente relatou história de faringite duas semanas antes da hospitalização. Após o diagnóstico, foi tratada com antibióticos de amplo espectro (cefuroxima por 7 dias e azitromicina por 5 dias e, posteriormente, devido à persistência de febre, cefepime por 7 dias. A tomografia computadorizada de tórax, realizada um mês após, mostrou resolução das opacidades.Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old female who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days. One month later, a computed tomography scan of the chest revealed resolution of the opacities.

  5. Embolia pulmonar séptica secundária à tromboflebite jugular: um caso de síndrome de Lemierre / Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome

    Scientific Electronic Library Online (English)

    Denise Rossato, Silva; Marcelo Basso, Gazzana; Ricardo, Albaneze; Paulo de Tarso Roth, Dalcin; Josi, Vidart; Nei, Gulcó.

    1079-10-01

    Full Text Available A síndrome de Lemierre é caracterizada pela infecção aguda da orofaringe, complicada por trombose venosa jugular interna secundária à tromboflebite séptica, e por infecções metastáticas a vários órgãos distantes-mais freqüentemente os pulmões. Relatamos um caso de síndrome de Lemierre em uma mulher [...] de 56 anos que se apresentou com massa cervical à direita e febre. Trombose venosa jugular interna foi demonstrada na ecografia. A tomografia computadorizada de tórax revelou múltiplas opacidades em ambos os pulmões. Uma biópsia pulmonar cirúrgica foi realizada por suspeita de metástases pulmonares. O exame anatomopatológico revelou êmbolos sépticos em parênquima pulmonar. Retrospectivamente, a paciente relatou história de faringite duas semanas antes da hospitalização. Após o diagnóstico, foi tratada com antibióticos de amplo espectro (cefuroxima por 7 dias e azitromicina por 5 dias e, posteriormente, devido à persistência de febre, cefepime por 7 dias). A tomografia computadorizada de tórax, realizada um mês após, mostrou resolução das opacidades. Abstract in english Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old f [...] emale who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days). One month later, a computed tomography scan of the chest revealed resolution of the opacities.

  6. Anatomic study of portal vein: transpancreatic vessels injuries approach Estudo anatômico da veia porta-hepática: abordagem cirúrgica portal transpancreática

    Directory of Open Access Journals (Sweden)

    Mario Mantovani

    2002-08-01

    Full Text Available Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.Introdução: No trauma abdominal, o comprometimento dos grandes vasos constitui uma situação de grande complexidade com altos índices de complicações e mortalidade. Nestes pacientes, a lesão da veia porta-hepática tem interesse em razão da dificuldade no diagnóstico e na abordagem cirúrgica. Objetivo: Padronizar o plano de transecção do pâncreas visando o acesso cirúrgico mais seguro para os reparos das lesões da veia porta-hepática. Métodos: Procedeu-se à uma análise quantitativa para caracterizar a relação anatômica da veia porta-hepática e suas tributárias relacionando-as com o pâncreas. Nestes cadáveres, estudou-se as medidas de um triângulo anatômico que tem como base o limite superior da veia mesentérica superior e porção inicial da veia porta; como ápice, um ponto localizado no limite superior da confluência das veias esplênica e mesentérica superior, situado na linha média da veia mesentérica superior. Resultados: A veia porta-hepática é formada a 3.24cm da borda interna do arco duodenal numa localização que dista 1.61cm e 1.07 das bordas inferior e superior do pâncreas, respectivamente. Conclusão: O presente estudo nos permite concluir que, para se fazer o acesso à origem da veia porta-hepática, em caso de trauma deste vaso, deve-se proceder a secção do colo do pâncreas junto à veia mesentérica superior, pois a confluência entre ela e a veia esplênica ocorre, em média, a 1.07cm da borda superior da glândula, e a 1.61cm de sua borda inferior.

  7. Anatomic study of portal vein: transpancreatic vessels injuries approach / Estudo anatômico da veia porta-hepática: abordagem cirúrgica portal transpancreática

    Scientific Electronic Library Online (English)

    Mario, Mantovani; Raquel Franco, Leal; Mauro José, Fontelles.

    2002-08-01

    Full Text Available Introdução: No trauma abdominal, o comprometimento dos grandes vasos constitui uma situação de grande complexidade com altos índices de complicações e mortalidade. Nestes pacientes, a lesão da veia porta-hepática tem interesse em razão da dificuldade no diagnóstico e na abordagem cirúrgica. Objetivo [...] : Padronizar o plano de transecção do pâncreas visando o acesso cirúrgico mais seguro para os reparos das lesões da veia porta-hepática. Métodos: Procedeu-se à uma análise quantitativa para caracterizar a relação anatômica da veia porta-hepática e suas tributárias relacionando-as com o pâncreas. Nestes cadáveres, estudou-se as medidas de um triângulo anatômico que tem como base o limite superior da veia mesentérica superior e porção inicial da veia porta; como ápice, um ponto localizado no limite superior da confluência das veias esplênica e mesentérica superior, situado na linha média da veia mesentérica superior. Resultados: A veia porta-hepática é formada a 3.24cm da borda interna do arco duodenal numa localização que dista 1.61cm e 1.07 das bordas inferior e superior do pâncreas, respectivamente. Conclusão: O presente estudo nos permite concluir que, para se fazer o acesso à origem da veia porta-hepática, em caso de trauma deste vaso, deve-se proceder a secção do colo do pâncreas junto à veia mesentérica superior, pois a confluência entre ela e a veia esplênica ocorre, em média, a 1.07cm da borda superior da glândula, e a 1.61cm de sua borda inferior. Abstract in english Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To [...] set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.

  8. Differential Diagnosis of Jugular Foramen Lesions

    OpenAIRE

    Vogl, Thomas J.; Bisdas, Sotirios

    2009-01-01

    The anatomy of the jugular foramen is complex. It contains the lower cranial nerves and major vascular structures. Tumors that develop within it, or extend into it, provide significant diagnostic and surgical challenges. In this article, we describe the anatomy of the jugular foramen and outline an imaging protocol that can differentiate between lesions, thereby aiding diagnosis and facilitating management.

  9. Multiple gunshot carotico-jugular fistulas

    OpenAIRE

    Unal, Orcun; Citgez, Bulent; Battal, Muharrem; KARATEPE, OGUZHAN

    2012-01-01

    The development of post-traumatic fistula between the carotid artery and jugular vein is an extremely rare clinical condition. The authors present a 28-year-old patient, who sustained a gunshot injury to the right side of the neck 6 years ago, with undiagnosed contralateral carotico-jugular fistula.

  10. Jugular foramen: anatomic and computed tomographic study

    International Nuclear Information System (INIS)

    The computed tomographic (CT) appearance of the jugular foramen was examined in detail, and anatomic and CT sections were correlated. The pars nervosa and pars vascularis were identified, and, with intravenous contrast enhancement, a rapid sequence of scans at a gantry angle of +300 to the canthomeatal line demonstrated cranial nerves IX, X, and XI. The osseous margins of the jugular foramen were best shown by CT at planes of sections parallel and positive (00-300) to the canthomeatal line. CT can be used to evaluate osseous anatomy and the jugular foramen with precision sufficient to confidently exclude an intracanalicular mass

  11. Trans-jugular intrahepatic portosystemic shunt

    International Nuclear Information System (INIS)

    Authors deal in this article with the trans-jugular intrahepatic portosystemic shunt. The indications, technique of examinations, anatomic considerations, complications, contraindications, long-term results as well as comparison with endoscopic therapy are discussed

  12. External jugular venous aneurysm: A clinical curiosity

    OpenAIRE

    Mohanty, Debajyoti; Jain, Bhupendra Kumar; GARG, Pankaj Kumar; Tandon, Anupama

    2013-01-01

    Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is co...

  13. CURTEA PENAL? INTERNA?IONAL?

    OpenAIRE

    Sorin Ciutureanu

    2007-01-01

    Experien?a jurisdic?iilor ad-hoc a f?cut posibil? adoptarea, în cadrul conferin?ei diplomatice dela Roma din 1998, a Statutului Cur?ii Penale Interna?ionale, prima jurisdic?ie interna?ional? penal?permanent?, creat? printr-un tratat multilateral.Formula cre?rii jurisdic?iei interna?ionale penale printr-un tratat multilateral nu este nou?.Aceast? formul? a ap?rut odat? cu ideea de jurisdic?ie interna?ional? penal? permanent?, înc? de laînceputul secolului ?i a fo...

  14. Glomus jugulare tumors: effects of radiotherapy

    International Nuclear Information System (INIS)

    Twenty glomus jugulare tumors which received x-ray therapy are analyzed. Postirradiation angiography showed persistent tumor vessels and abnormal channels in eight patients. Histologic study of five postirradiation specimens showed that tumor cells persisted after treatment in a significant proportion of the patients. Vascular response was nonuniform and consisted of endothelial hyperplasia and subendothelial hyalinization. Radiotherapy is not always effective in the permanent eradication of the tumor when used as the only modality of treatment in patients with large glomus jugulare tumors. Because of the frequent recurrence after irradiation or surgical resection, a combination of both modalities offers the patient the best probability of cure. (U.S.)

  15. The structure and function of giraffe jugular vein valves

    OpenAIRE

    Mitchell, Graham; Sittert, Sybrand J.; Skinner, J. D.

    2009-01-01

    When a giraffe (Giraffa camelopardalis) lowers its head to drink, blood could enter the jugular vein from the inferior vena cava or regurgitate from the jugular veins into the cranial veins. We investigated the anatomy of jugular valves in giraffes to establish if they could prevent either of these regurgitations. Jugular vein length and intervalve distances of 396 valves (192 left, 204 right) were measured in 60 veins from 25 adult (11 males and 14 females) and five foetal giraffes. The aver...

  16. Asymmetry of jugular veins on neck computed tomography

    International Nuclear Information System (INIS)

    Authors measured the long and the short diameters of both internal jugular veins on the neck computed tomogram of 70 normal subjects. Asymmetry of the diameter of both internal jugular veins was common. The diameter of the right internal jugular vein was greater than that of the left vein in 43% and vice versa in 14%. The diameter of the jugular veins increased with aging. There was no sex difference

  17. Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos Equine experimental thrombophlebitis: clinical, ultrasonographic and venographic evaluation

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Hussni

    2012-07-01

    Full Text Available A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mórbidos associados à iatrogenia, podendo levar a perda de função, edema cefálico, diminuição do desempenho atlético e ainda causar o óbito. Esta enfermidade nos equinos apesar de frequente é pouco conhecida quanto à sua evolução e tratamentos. O objetivo deste trabalho foi avaliar a evolução da tromboflebite jugular experimental em equinos, quanto às alterações clínicas e estruturais envolvidas na enfermidade, observando-se os aspectos clínicos, ultra-sonográficos e venográficos no contexto do trombo e do vaso, quanto à possibilidade de recanalização do trombo produzido e da vascularização compensatória. A tromboflebite da veia jugular foi induzida, unilateralmente, em 05 equinos nos quais previamente à indução da tromboflebite e diariamente após foram observadas manifestações clínicas e realizados exames ultra-sonográficos. Venografias foram feitas nos momentos pré-indução, na indução e a cada seis dias após a indução da tromboflebite, verificando-se a recanalização do trombo oclusivo e a presença de vasos na drenagem sanguínea compensatória. Observou-se a ocorrência de edema moderado das regiões parotídea, massetérica e supra-orbitária e discreto edema submandibular que reduziram até o 6º dia, permanecendo apenas discreto aumento parotídeo. O ingurgitamento da jugular cranial a região da indução permaneceu durante todo o período de avaliação. A porção caudal à tromboflebite mostrou ingurgitamento frente ao garrote na entrada do tórax desde o primeiro dia após a indução. Os exames ultra-sonográficos mostraram formação de trombo oclusivo total durante todo o período de observação em 3 animais e o restabelecimento parcial do fluxo na jugular em 2 animais e a presença de vasos colaterais conduzindo o sangue da porção cranial para a porção caudal à obstrução. As venografias revelaram fluxo sanguíneo "linear" normal no momento pré-operatório, constatando nos momentos pós-operatórios a presença oclusiva do trombo, com o contraste preenchendo os vasos tributários compensatórios direcionados à porção caudal à oclusão da veia ou ainda estagnado cranialmente ao trombo. Conclui-se que a trombose oclusiva na tromboflebite jugular experimental e unilateral sofre recanalização e compensação vascular por vasos tributários de drenagem, com redução gradativa dos sinais decorrentes da estase sanguínea de retorno, especificamente as regiões cefálicas com edema. Estudos envolvendo a tromboflebite jugular nos equinos devem evoluir nos aspectos experimental e clínico.Jugular thrombophlebitis is a common complication of disease processes associated with repeated venipuncture, injection of irritant solutions, and the use of indwelling catheters, especially with bacterial contamination. Bilateral thrombophlebitis may result in edema of the soft tissues of the head, reduction of athletic performance and even death of the animal. This disease, although common in horses, is not much known regarding its evolution and treatment. The aim of this study was to evaluate the clinical and structural changes of experimentally induced jugular thrombophlebitis in horses, through clinical examination, ultrasound and venography of the thrombus and the vessel, verifying the possibility of thrombus recanalization and compensatory produced blood flow. The jugular thrombophlebitis was induced unilaterally into 5 horses, monitored by clinical (general, regional and local and ultrassonographycs exams. Venographs were made at pre-induction, induction and every 6 days after induction of thrombophlebitis, in order to observe recanalization of the occlusive thrombus and presence of blood vessels in the drainage allowance. Occurrence of moderate edema was observed in the parotid, masseter and supra orbital regions, and mild edema in the submandibular region. The jugular engorgement of the cranial region of induction persisted throughout the period of ev

  18. Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos / Equine experimental thrombophlebitis: clinical, ultrasonographic and venographic evaluation

    Scientific Electronic Library Online (English)

    Carlos Alberto, Hussni; Roberta Galvano, Barbosa; Alexandre Correa, Borghesan; Hamilton Almeida, Rollo; Ana Liz Garcia, Alves; Marcos Jun, Watanabe; Vania Maria de Vasconcelos, Machado; Nereide Freire, Cerqueira.

    2012-07-01

    Full Text Available A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mórbidos associados à iatrogenia, podendo levar a perda de função, edema cefálico, diminuição do desempenho atlético e ainda causar o óbito. Esta enfermidade nos equinos apesar de frequente é pouco conhecida [...] quanto à sua evolução e tratamentos. O objetivo deste trabalho foi avaliar a evolução da tromboflebite jugular experimental em equinos, quanto às alterações clínicas e estruturais envolvidas na enfermidade, observando-se os aspectos clínicos, ultra-sonográficos e venográficos no contexto do trombo e do vaso, quanto à possibilidade de recanalização do trombo produzido e da vascularização compensatória. A tromboflebite da veia jugular foi induzida, unilateralmente, em 05 equinos nos quais previamente à indução da tromboflebite e diariamente após foram observadas manifestações clínicas e realizados exames ultra-sonográficos. Venografias foram feitas nos momentos pré-indução, na indução e a cada seis dias após a indução da tromboflebite, verificando-se a recanalização do trombo oclusivo e a presença de vasos na drenagem sanguínea compensatória. Observou-se a ocorrência de edema moderado das regiões parotídea, massetérica e supra-orbitária e discreto edema submandibular que reduziram até o 6º dia, permanecendo apenas discreto aumento parotídeo. O ingurgitamento da jugular cranial a região da indução permaneceu durante todo o período de avaliação. A porção caudal à tromboflebite mostrou ingurgitamento frente ao garrote na entrada do tórax desde o primeiro dia após a indução. Os exames ultra-sonográficos mostraram formação de trombo oclusivo total durante todo o período de observação em 3 animais e o restabelecimento parcial do fluxo na jugular em 2 animais e a presença de vasos colaterais conduzindo o sangue da porção cranial para a porção caudal à obstrução. As venografias revelaram fluxo sanguíneo "linear" normal no momento pré-operatório, constatando nos momentos pós-operatórios a presença oclusiva do trombo, com o contraste preenchendo os vasos tributários compensatórios direcionados à porção caudal à oclusão da veia ou ainda estagnado cranialmente ao trombo. Conclui-se que a trombose oclusiva na tromboflebite jugular experimental e unilateral sofre recanalização e compensação vascular por vasos tributários de drenagem, com redução gradativa dos sinais decorrentes da estase sanguínea de retorno, especificamente as regiões cefálicas com edema. Estudos envolvendo a tromboflebite jugular nos equinos devem evoluir nos aspectos experimental e clínico. Abstract in english Jugular thrombophlebitis is a common complication of disease processes associated with repeated venipuncture, injection of irritant solutions, and the use of indwelling catheters, especially with bacterial contamination. Bilateral thrombophlebitis may result in edema of the soft tissues of the head, [...] reduction of athletic performance and even death of the animal. This disease, although common in horses, is not much known regarding its evolution and treatment. The aim of this study was to evaluate the clinical and structural changes of experimentally induced jugular thrombophlebitis in horses, through clinical examination, ultrasound and venography of the thrombus and the vessel, verifying the possibility of thrombus recanalization and compensatory produced blood flow. The jugular thrombophlebitis was induced unilaterally into 5 horses, monitored by clinical (general, regional and local) and ultrassonographycs exams. Venographs were made at pre-induction, induction and every 6 days after induction of thrombophlebitis, in order to observe recanalization of the occlusive thrombus and presence of blood vessels in the drainage allowance. Occurrence of moderate edema was observed in the parotid, masseter and supra orbital regions, and mild edema in the submandibular region. The jugular engorgement of the cranial region of induction per

  19. Schwannoma de forame jugular: relato de caso

    Directory of Open Access Journals (Sweden)

    Tavares, Joana R. P

    2009-03-01

    Full Text Available Introdução: As lesões do forame jugular são raras, sendo os paragangliomas os tumores mais comuns desta região seguidos pelos schwannomas. Os schwannomas são tumores benignos de crescimento lento e origem principalmente nos nervos cranianos sensitivos. Quando localizados no forame jugular, apresentam-se clinicamente com perda auditiva, ataxia e cefaleia, sendo comuns as alterações dos nervos cranianos IX, X e XI. A excisão cirúrgica é a opção terapêutica de escolha. Relato do Caso: Relatamos o caso de um paciente adulto jovem que procurou o serviço de Otorrinolaringologia do Hospital Universitário de Brasília com quadro de otalgia e otorreia piossanguinolenta no ouvido esquerdo, associada a zumbido, hipoacusia e tumor no conduto auditivo externo. Iniciada investigação diagnóstica com tomografia computadorizada e biópsia, ambas com resultados inconclusivos. Realizadas então nova biópsia e ressonância nuclear magnética, com diagnóstico definitivo de schwannoma do foram jugular. Na ocasião a lesão foi definida como tipo D pela classificação de Kaye-Pellet, por envolver o forame jugular, apresentar formato de halter e componentes intra e extracraniano. Realizada cirurgia por craniotomia com excisão parcial do tumor. Não houve sequelas do procedimento, apesar da persistência dos sintomas otológicos. Comentários Finais: O caso é um exemplo de uma doença rara, com pouco mais de duzentos casos relatados na literatura, e apresentação clínica incomum. O desafio diagnóstico e terapêutico é enfrentado pelas equipes de Otorrinolaringologia e Neurocirurgia, que programam para breve nova abordagem cirúrgica combinada para extirpação completa do tumor.

  20. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear

    International Nuclear Information System (INIS)

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value. (orig.)

  1. Radiologic approach to jugular bulb paragangliomas

    International Nuclear Information System (INIS)

    Paragangliomas are highly vascular neoplasms that derive from neuroendocrine tissue. They account for about 0.6% of all head and neck tumors and most commonly occur in the carotid bifurcation, tympanic cavity, jugular foramen and in the area of vagal ganglia below the skull base. The aim of the study was retrospective evaluation of radiological features of jugular bulb paragangliomas in the group of 22 patients. In the analyzed group, there were 16 females and 7 males, aged 14-81. All the patients underwent CT and MRI, in 12 cases carotid angiography and in 3 cases Doppler sonography was performed. We evaluated typical radiological features of jugular bulb paragangliomas and usefulness of various imaging methods in diagnosis and assessment of this pathology. Computed tomography in all patients showed widening of the jugular foramen. MR images in 19 cases revealed the presence of intra-tumoral signal-void areas representing tumor vessels. Both methods showed intensive post-contrast enhancement of all tumors. Carotid angiography presented high vascularity and arterio-venous fistulas in all tumors. In the performed Doppler ultrasound studies, the tumors were not visible. In all cases, increased blood flow in the ipsilateral carotid artery and vein was observed, and in 2 patients with a coexisting carotid body paraganglioma was diagnosed. CT and MRI allow best evaluation of tumor extension and present features characteristic of jugular bulb paraganglioma. Carotid angiogragular bulb paraganglioma. Carotid angiography confirms the diagnosis of a vascular tumor and is used for its preoperative embolization. Ultrasonography is a useful technique for exclusion of coexisting carotid body paraganglioma. (author)

  2. Isolated thrombosis of the external jugular vein.

    Science.gov (United States)

    Colomina, M J; Godet, C; Bagó, J; Pellisé, F; Puig, O; Villanueva, C

    2000-08-01

    Thrombosis of the external jugular vein (EJV) is an infrequent clinical condition that has been associated with central venous catheterization, head and neck infections, intravenous drug abuse, and compression at the affected site. The authors report a case of thrombotic obstruction of the EJV in the late postoperative period after laparoscopic anterior lumbar interbody fusion. A 40-year-old morbidly obese woman with a depressive syndrome was diagnosed with L5-S1 discopathy and was submitted to laparoscopic anterior isthmic fusion. The operation lasted approximately 6 hours, during which the patient remained in a supine decubitus and Trendelenburg position. The left radial artery, peripheral veins, and right internal jugular vein were canalized. The internal jugular vein catheter was electively withdrawn 24 hours after the intervention. The postoperative period was satisfactory, and the patient was started on prophylaxis with low-molecular-weight heparin. She sat up and began walking at 24 hours and was discharged to her home 4 days after the procedure. Eight days after discharge she returned, experiencing right cervical pain. Palpation revealed a painful induration and erythematous area under the anterior edge of the sternocleidomastoid muscle. Results of otoscopy and laryngoscopy were normal. Cervical echo-Doppler disclosed an image consistent with EJV thrombosis. The most frequent causes of jugular vein thrombosis are mentioned above. A higher incidence has been described after upper abdomen and pelvic surgery; other contributing factors are age, obesity, and associated illness. There are few references in the literature to position-induced EJV thrombosis in the late postoperative period. The authors' patient presented signs and symptoms of EJV thrombosis (probably because of various factors), which was confirmed by echo-Doppler study and treated with 10 days of calcic heparin. PMID:10961761

  3. Jugular phlebectasia: clinical scenario in India.

    Science.gov (United States)

    Yaadhavakrishnan, Rajprakash Dharmapuri; Navaneethan, Nagendran

    2015-03-01

    Jugular phlebectasia is fusiform dilatation of internal jugular vein seen in childrens. It usually occurs in children but can occur at any age. It usually presents as unilateral swelling in the neck found during coughing and shouting. It is usually asymptomatic, so it is often ignored or misdiagnosed. Differential diagnosis include laryngocele, cavernous hemangioma, cystic hygroma, branchial cyst. Treatment is usually conservative as complications like thrombosis and horners syndrome are very rare. Non invasive investigations like Doppler sonogram and are usually done to diagnose this condition. We report two cases of jugular phlebectasia, who presented to our out patient department with history of swelling in the right side of neck which increases on crying and shouting. Doppler sonogram and ultrasound was done to diagnose the condition. There seems be lack of knowledge among medical fraternity in various specialities. So a questionnaire was prepared to assess the knowledge among resident doctors, general practitioners, Otorhinolaryngologists, paediatricians. Questionnaire was posted in social networking sites and the feedback was obtained. Out of the 150 interns in our hospital, only one (0.66 %) was able to explain about the condition. In general practitioners group containing 369 respondents, only 4 (1.08 %) knew the condition and have seen patients. A pediatricians group containing 312 respondents only 23 (7.37 %) pediatricians knew the condition, 289 (92.62 %) persons had no idea about the treatment. Otorhinolaryngologists group containing 328 respondents. 21 (6.40 %) knew the condition, 293 (89.3 %) have no idea. The Chi square test shows that the specialty of the respondent like pediatrician and ENT practitioner have more knowledge than the other for jugular phlebectasia at p < 0.0001. PMID:25621225

  4. Agenesis of Internal Jugular Vein a Cause for Concern

    OpenAIRE

    Majeed, Tanveer Abdul; Deshpande, Ramakant K.; Upadhaya, Sanjay; Deshmukh, Shilpa A.

    2010-01-01

    Internal jugular vein is one of the major contributors to the venous drainage from the intracranial structures. Neck dissections which necessitates ligation of internal jugular vein leads to significant alteration of cerebrospinal fluid pressures in the range of three times for unilateral ligation to five times in cases of bilateral ligation. Agenesis of internal jugular vein merits concern prior to central venous cannulation and ligation during radical neck dissection for metastatic nodes in...

  5. External Jugular Vein Aneurysm Presenting as a Cervical Mass

    OpenAIRE

    Eleni E. Drakonaki; SYMVOULAKIS, Emmanouil K.; Anthoula Fachouridi; Dimitrios Kounalakis; Emmanouil Tsafantakis

    2011-01-01

    Venous aneurysms are rare causes of neck mass. Among neck veins, aneurysms of the external jugular vein are extremely uncommon. We present a case of a woman with a history of prior internal jugular vein catheterization who presented at a rural primary health care unit with a nontender progressively enlarging swelling in the right supraclavicular region. B-mode and Doppler ultrasound examination revealed a saccular dilatation of the external jugular vein, suggesting a posttraumatic venous aneu...

  6. Analysis of Jugular Foramen Exposure in the Fallopian Bridge Technique

    OpenAIRE

    Satar, Bulent; YAZAR, Fatih; Aykut CEYHAN; Arslan, Hasan Huseyin; AYDIN, Sedat

    2009-01-01

    Objective: To analyze the exposure of the jugular foramen afforded by the fallopian bridge technique. Method: The jugular foramen exposure was obtained using the jugular foramen approach combined with the fallopian bridge technique. We applied this technique using 10 temporal bone specimens at a tertiary referral center. The exposure was assessed by means of depth of the dissection field and two separate dissection spaces that were created anteriorly and posteriorly to the facial nerve. Anter...

  7. Compton scatter image simulating jugular venous reflux

    International Nuclear Information System (INIS)

    In a radionuclide cerebral angiographic study, Tc-99m photons from the subclavian vein may scatter in the superficial tissues of the neck and head, resulting in an image simulating the jugular venous reflux. In a scintillation camera peaked at 140 keV with a 20% window, any scattered photons with a scatter angle of less tha 53.5 degrees may be counted in the Tc-99m window. This scatter angle is large enough to allow counting of many secondary photons from Compton collisions in an area quite distant from the radioactive source to be counted, provided the scatter area and source are separated by air

  8. Magnetic resonance images resembling jugular venous thrombosis

    International Nuclear Information System (INIS)

    Juglar venous blood flow resembled venous thrombosis on magnetic resonance images (MRI) in three cases. We present these cases together with MRI of juglar venous thrombosis and also discuss on flow signals and thrombus through the clinical cases and the experimental study. Left jugular angiography showed hemostasis in two of three cases and normal venous flow in one. In clinical cases and experimental study the blood clot appeared high intense on spin echo image (SE) and inversion recovery image (IR). Water flow appeared high intense at a certain range of velocity on SE and IR. Consequently the normal venous flow as well as hemostasis can look like thrombus on MRI. (author)

  9. Fibrin Sealant Injection: An Aid to Reduce Venous Bleeding during Jugular Bulb and Sigmoid Sinus Dissection in Glomus Jugulare (Jugulotympanic Paraganglioma) Surgery

    OpenAIRE

    List, Richard James; Thomas, Sebastien Philippe Henry; Shenouda, Emad; LANG, DOROTHY; Davis, Anne; Mathad, Nijaguna

    2011-01-01

    Glomus jugulare (jugulotympanic paraganglioma) surgery requires tumor dissection in the region of the jugular bulb, upper internal jugular vein, and sigmoid sinus. Despite ligation or external compression of the sigmoid sinus proximally and ligation of the internal jugular vein distally, troublesome venous bleeding can arise from the inferior petrosal sinus or condylar veins at the medial wall of the jugular bulb. Excessive packing in this area can place the integrity of the lower cranial ner...

  10. One-stage tomography of the jugular foramens

    International Nuclear Information System (INIS)

    A tomographic method for the jugular foramens that makes it possible to get their one-stage image with minimum projection distortions is proposed. The recommended arrangement of the patients is indicated in tumors of the jugular glome, neurinomas of the 9 and 10 cranial nerves, intracranial hypertension and fractures of the posterior cranial fossa

  11. Traumatic Common Carotid—Jugular Fistula: Report of 2 Cases

    OpenAIRE

    Ezemba, Ndubueze; Ekpe, Eyo E; Ezike, Humphrey A.; Anyanwu, Chijioke H.

    2006-01-01

    Traumatic common carotid artery-to-internal jugular vein fistula is a rare entity that is not usually detected during the acute injury phase. We present 2 cases of traumatic carotid–jugular fistula. Both involved the right side of the neck, and both were due to injury from a firearm. The patients exhibited signs of high cardiac output.

  12. Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

    OpenAIRE

    Prince Cheriyan Modayil; Howlett, David C.; Sathyan Panthakalam

    2009-01-01

    Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

  13. INTERNAL JUGULAR VEIN PHLEBECTASIA PRESENTING WITH HOARSENESS OF VOICE

    OpenAIRE

    Sohini Chakraborty; Pranab Kumar Dey; Amrita Roy

    2014-01-01

    Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present case of a 7 year old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image diagnosis of right internal jugular phlebectasia was made.

  14. Aneurysm of External Jugular Vein Mimicking Hemangioma of Neck

    OpenAIRE

    Aiyappan, Senthil Kumar; Ranga, Upasana; Veeraiyan, Saveetha

    2012-01-01

    Venous aneurysms are one of the rare causes of neck swellings. Among neck veins, external jugular vein aneurysms are uncommon. We present a case of a woman who presented with a nontender compressible swelling in the left lower neck region, which initially thought to be hemangioma, was later found to be external jugular vein aneurysm on Doppler ultrasound and CT angiography.

  15. Internal Jugular Vein Phlebectasia Presenting with Hoarseness of Voice

    OpenAIRE

    Sohini Chakraborty; Pranab Kumar Dey; Amrita Roy; Nilay Ranjan Bagchi; Debalina Sarkar; Sumita Pal

    2013-01-01

    Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present a case of a 7-year-old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image, diagnosis of right internal jugular phlebectasia was made.

  16. Saccular Aneurysm of the External Jugular Vein: A Case Report

    OpenAIRE

    Lee, Hae Young; Cho, Sung Ho; Ko, Taek Yong; Kim, Hyun Su; Kim, Jong In; Park, Sung Dal; Cho, Sung Rae; Chun, Bong Kwon

    2014-01-01

    Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer.

  17. A Limited Approach to the Jugular Bulb: Anatomical Considerations in a Rare Jugular Foramen Tumour

    OpenAIRE

    Fernandes, Carmen Lee; Fernandes, C. M. C.

    2013-01-01

    We report a case of a rare schwannoma of the jugular foramen and removed it by a limited transjugular approach. A limited surgical approach was performed for removal of the tumour, with preservation of surrounding structures. A thorough understanding of the anatomy of the region is necessary for our limited transjugular approach. The schwannoma was successfully removed. Through a detailed understanding of the anatomy of the region and adequate classification of the tumour, a limited surgical ...

  18. Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis

    International Nuclear Information System (INIS)

    Purpose: During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors. Methods and Materials: To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was 36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions: The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.ment of glomus jugulare tumors.

  19. Glomus jugulare tumor with intra- and extracranial extension

    International Nuclear Information System (INIS)

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C2. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very usee tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension. (author)

  20. Comunicación Interna y formación profesional

    Scientific Electronic Library Online (English)

    Marisa, Cuervo.

    2011-03-01

    Full Text Available O artigo aborda a importância da orientação docente na apertura de novas opções disponíveis no campo profissional das Comunicações Internas para os estudantes de Relaçõoes Públicas. Por outro lado, se indicam as atuais necessidades de atualização e incorporação de novas técnicas e ferramentas profis [...] sionais para o trabalho no campo real da disciplina. Esta permanente interação entre prática e teoria deve ser um estímulo para que os docentes atualizem a bibliografa e incorporem casos nos planos de estudo e para a apresentação de ensaios acadêmicos e presentem livros para a hierarquização das Relações Públicas como disciplina acadêmica. Em síntese, o artigo convida à reflexão pessoal sobre a situação atual da comunicação interna nas organizações e sus principais desafíos em vista a um futuro atravessado pela globalização e os avances tecnológicos. Abstract in spanish El artículo aborda en su desarrollo la importancia de la orientación docente en la apertura de nuevas opciones disponibles en el campo profesional de las Comunicaciones Internas para los estudiantes de la carrera de Relaciones Públicas. Por otra parte, se señalan las actuales necesidades de actualiz [...] ación e incorporación de nuevas técnicas y herramientas profesionales con vistas al trabajo en el campo real de la disciplina. Esta permanente interacción entre práctica y teoría debe ser un estímulo para que los docentes no sólo mantengan actualizada la bibliografía e incorporen casos en los planes de estudio sino, para que presenten ensayos académicos o publiquen textos que le den jerarquía a las Relaciones Públicas como disciplina académica. En síntesis, el artículo invita a la reflexión profesional sobre la situación actual de la comunicación interna en las organizaciones y sus principales desafíos en vistas de un futuro atravesado por la globalización y los avances tecnológicos. Abstract in english The article approaches the importance of educational guidance in the offering of new options within the professional feld of Internal Communications for the students of Public Relations careers. In addition, present professional needs of being updated in new communication techniques and tools are po [...] inted out. This permanent interaction between practice and theory must be a stimulus so that professors could update bibliography and incorporate study cases in the subjects curricula. Likewise, the article enhances the value of academic research in order to generate publications that contribute to reinforce relevance of Public Relations as a discipline. The article appeals to professional refection about internal communication in the organizations and their main challenges looking forward a future crossed by globalisation and technological changes.

  1. Massive jugular and dural sinus reflux associated with cerebral death

    International Nuclear Information System (INIS)

    Radionuclide cerebral angiograms demonstrated massive jugular venous reflux in two children with clinical and electroencephalographic evidence of cerebral death. With an antecubital injection, the tracer flowed up the jugular vein, through the transverse dural sinus, and down the contralateral jugular vein. No arterial flow was seen. We hypothesize that this unusual pattern reflects the absence of normal antegrade flow through the venous system. The appearance of jugular reflux is distinct from arterial flow and should not be confused with it. These cases illustrate communication between the systemic venous system and the dural sinuses. Although this pattern is not diagnostic of cerebral death, the appearance of radiotracer in the dural sinuses does not establish the presence of cerebral perfusion. (orig.)

  2. Jugular Foramen Syndrome as Initial Presentation of Metastatic Lung Cancer

    OpenAIRE

    Hayward, Dustin; Morgan, Christopher; Emami, Bahman; Biller, Jose; Prabhu, Vikram C.

    2012-01-01

    Metastatic involvement of the cranial base and jugular foramen generally presents with headache and lower cranial neuropathy but may escape early diagnosis. In this report, a patient developed a jugular foramen syndrome as the initial presentation of metastatic lung cancer soon after being diagnosed and treated surgically for extracranial atherosclerotic internal carotid artery disease. With the appropriate diagnosis established, he underwent local fractionated radiation therapy and systemic ...

  3. Clinical Importance of Duplication of Internal Jugular Vein

    OpenAIRE

    Kapre, Madan; Mangalgiri, Ashutosh S.

    2011-01-01

    Duplication of internal jugular vein (IJV) is rare. It is the larger channel draining the cranial cavity. We encountered duplication of the IJV while cervical node clearance in a patient with squamous cell carcinoma of left margin of the tongue. IJV divides into two parts anterior and posterior after descending about 2.5 cm from the jugular foramen. IJV is an important landmark in neck surgery. Knowledge of its variations is essential to avoid complications during surgery and to avoid misinte...

  4. Applications of contrast enhanced CT through external jugular access

    International Nuclear Information System (INIS)

    Objective: A retrospective analysis and evaluation for the effects of contrast enhanced computed tomography through external jugular access. Methods: 1250 cases (male 692 and female 558) underwent CT contrast enhanced examination were retrospectively reviewed from May, 2002 to Oct, 2002. The patients aged from 12 to 86 years, averagely 49 years. Contrast agent (Ultravist) was given through an intravenous catheter placed in the cubital vein. Precise injection rates were ensured by a power injector (Medrad MCT310, USA). Excellent enhancement was achieved with this protocol in most of the patients, while external jugular access was established in 96 cases because it was unable to setup a cubital venous access. Results: Good enhancement were acquired when 96 cases of contrast agent injected through external jugular vein. And the external jugular access was setup successfully with a single puncture. Conclusion: It is a common occasion when patient undergoing contrast enhanced CT scan is in poor conditions: debility, cachexia, or with complication of chemotherapy or radiation therapy, which often results in invalidity of cabital venous access, and consequently, making bolus injection impossible. The external jugular vein is a large and central blood vessel, which is easy to setup an access. In our experience, an external jugular access should be recommended as a substitution if the cubital venous access is not available. (authors)

  5. Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Guss, Zachary D.; Batra, Sachin [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States); Limb, Charles J. [Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, MD (United States); Li, Gordon [Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA (United States); Sughrue, Michael E. [Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, CA (United States); Redmond, Kristin [Department of Radiation Oncology, Johns Hopkins Hospital, Baltimore, MD (United States); Rigamonti, Daniele [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States); Parsa, Andrew T. [Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, CA (United States); Chang, Steven [Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA (United States); Kleinberg, Lawrence [Department of Radiation Oncology, Johns Hopkins Hospital, Baltimore, MD (United States); Lim, Michael, E-mail: mlim3@jhmi.edu [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States)

    2011-11-15

    Purpose: During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors. Methods and Materials: To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was <25%. Bias was assessed using the Egger funnel plot test. Results: Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions: The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.

  6. Salvage of clotted jugular vein hemodialysis catheters.

    Science.gov (United States)

    Shrivastava, D; Lundin, A P; Dosunmu, B; Rao, T K; Beyer, M M; Friedman, E A

    1994-01-01

    Jugular venous catheters (JVC) provide rapid, vascular access for both emergency and maintenance hemodialysis in both acute and end-stage renal disease. Clotting and occlusion of JVC is a common problem necessitating alternate vascular access. Urokinase will declot 80-90% of central venous catheters; however, recurrence of catheter occlusion is frequent. We successfully employed a guide wire insertion technique to salvage occluded JVC after failed urokinase infusion. In 24 patients JVCs, inserted for either temporary or permanent vascular access, clotted within 6-55 days of initiating hemodialysis. Urokinase (5,000 IU) instilled into both arterial and venous limbs of the catheter had been unsuccessful in restoring patency. In these patients, we inserted a soft-tipped guide wire into both lumina. In 21 of 24 patients (87.5%), guide wire insertion opened the occluded JVC, permitting immediate initiation of hemodialysis. We conclude that for clotted JVC unresponsive to urokinase infusion, guide wire insertion can salvage most catheters thereby facilitating hemodialysis. PMID:7991044

  7. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation

    Energy Technology Data Exchange (ETDEWEB)

    Wadin, K.; Thomander, L.; Wilbrand, H.

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

  8. Desvios porta-jugular e cava-jugular passivos em cães: Investigação de pressões sangüíneas

    Directory of Open Access Journals (Sweden)

    Coelho Antônio Roberto Barros

    1999-01-01

    Full Text Available Os principais objetivos dos desvios veno-venosos durante o transplante ortotópico de fígado são: atenuação da estase venosa subdiafragmática, manutenção do retorno satisfatório de sangue ao coração e perfusão tissular eficiente. Investigações sobre PP, PVCIIH, PVC, PAM e PPR, bem como D PP e D PVCIIH foram conduzidas em seis cães, sob anestesia geral, com fígados perfundidos pela Artéria Hepática, submetidos a desvios porta-jugular e cava-jugular passivos durante 2 horas. Estes desvios não foram capazes de evitar estagnação de sangue na VP e VCIIH, acarretando estase e menor retorno sangüíneo ao coração, sugeridos por aumentos significativos de PP e PVCIIH e quedas significantes nos níveis de PVC. Os valores de PAM não apresentaram diferenças significativas em relação ao tempo T0, na maior parte dos tempos avaliados, enquanto que os valores de PPR foram significativamente menores que os verificados no tempo T0, na maioria dos tempos estudados. Tais pressões mantiveram-se, respectivamente, acima de 100 e 50 mm de Hg, atribuindo-se tais resultados, em parte, à vasoconstricção arteriolar generalizada. Incrementos de pressão na VP (D PP foram significativamente menos elevados que aqueles verificados na VCIIH (D PVCIIH, atribuindo-se tal diferença à complacência esplâncnica. Decréscimos ulteriores dos níveis de PP e PVCIIH sugerem queda do fluxo arterial para os territórios esplâncnico e sistêmico, decorrente de diminuição do retorno sangüíneo ao coração. Determinações de PP, PVCIIH, PVC, PAM e PPR podem constituir meio prático de avaliação hemodinâmica do desvio veno-venoso.

  9. Electromagnetic needle tracking during simulated right internal jugular cannulation.

    Science.gov (United States)

    Faulke, D J; Hall, T H; Nixon, C

    2015-07-01

    This study used three-dimensional information from Stealth navigation technology during simulated right internal jugular vein cannulation to define the initial needle trajectory taken when using three approaches: landmark (LM), short-axis (SAX) ultrasound and long-axis (LAX) ultrasound. Nineteen volunteers indicated the entry site and needle direction (track) they would use in performing right internal jugular vein cannulation by the three approaches. The likelihood of cannulation success, arterial puncture and needle direction were recorded. Volunteers were asked to assess the suitability of the simulation system for validity and educational benefit. The SAX track crossed the jugular vein more frequently than the LAX and LM tracks (SAX: 94%; LAX: 80%; LM: 47% [SAX versus LM, P jugular cannulation was considered realistic (16/19) and of benefit for 18 of 19 (95%) respondents. The SAX track was associated with the highest likelihood of successful jugular cannulation and the lowest cross rate of the carotid artery. The simulation model using Stealth was considered to be valuable and realistic by participants despite some limitations. PMID:26099763

  10. Diagnosis of jugular paraganglioma by radionuclide angiography: concise communication

    International Nuclear Information System (INIS)

    Jugular paraganglioma is a highly vascular tumor, slowly growing, extending into the surrounding stuctures and causing otologic and /or neurologic symptoms according to its location in the jugular bulb region or the middle-ear. In our study, modified vertex and posterior head scintiangiography was used in seven cases. Scintiangiography was positive in all seven, whereas concomitant radiographic studies were limited: four of the seven gave positive findings by transmission computerized tomography (TCT). Only four patients underwent angiography, with positive results in two. Hypocycloidal tomography was positive in three cases. However, some radiographic studies, particularly TCT, may be useful in detecting local extension, bone destruction, and soft-tissue infiltration. Radionuclide angiography proved highly reliable and should be used initially whenever a jugular paraganglioma is suspected

  11. Blood pressure normalization post-jugular venous balloon angioplasty

    Science.gov (United States)

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee

    2015-01-01

    Objective This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. Methods The criteria for eligibility for balloon angioplasty intervention included ?50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ?3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Results Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ?105?mmHg, diastolic ?70?mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ?130?mmHg, diastolic???80?mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. Discussion The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the association between blood pressure deviation and internal jugular veins narrowing, and whether blood pressure normalization affects Patient's clinical outcomes. PMID:24255092

  12. Use of radiotherapy in tumour of jugular glomus

    International Nuclear Information System (INIS)

    Tumours of the jugular glomus are an infrequent proliferative process originating in the chemoreceptor bodies, located in the temporal region. These tumours are histologically bening, rarely extend to distant sites, but they have a local aggressive growing. The clinical presentation is secondary to local progression, with paralysis of the craneal nerves and otic symptoms. Tumours of this origin are able to produce symptoms secondary to catecholamine release into the blood stream as cyclic hypertension. We report a 63 years old woman, with a jugulare glomus tumour, treated repeteady with incomplete surgey, and finally treated with radiotherapy. (Author) 14 refs

  13. Calcium micro-depositions in jugular truncular venous malformations revealed by Synchrotron-based XRF imaging

    OpenAIRE

    Pascolo, Lorella; Gianoncelli, Alessandra; Rizzardi, Clara; Tisato, Veronica; Salomé, Murielle; Calligaro, Carla; Salvi, Fabrizio; Paterson, David; Zamboni, Paolo

    2014-01-01

    It has been recently demonstrated that the internal jugular vein may exhibit abnormalities classified as truncular venous malformations (TVMs). The investigation of possible morphological and biochemical anomalies at jugular tissue level could help to better understand the link between brain venous drainage and neurodegenerative disorders, recently found associated with jugular TVMs. To this end we performed sequential X-ray Fluorescence (XRF) analyses on jugular tissue samples from two TVM p...

  14. Observations on the bony bridging of the jugular foramen in man.

    OpenAIRE

    Dodo, Y

    1986-01-01

    The anatomical nature and pattern of incidence of bony bridging of the jugular foramen was investigated using 64 fetal crania aged nine months to term and 222 adult crania of Japanese. In addition, the region of the jugular foramen of an adult cadaver was carefully dissected in order to clarify the relationship between the cranial nerves passing through the jugular foramen and the intrajugular processes of the jugular foramen. The general conclusions concerning the anatomical nature of the bo...

  15. External Jugular Vein Aneurysm with Thrombus Presenting as Painful Neck Mass: A Case Report

    OpenAIRE

    Roshan Kumar Verma; Darwin Kaushal; Panda, Naresh K

    2013-01-01

    External jugular vein aneurysm with thrombosis presenting as neck swelling is a rare clinical entity and rarely encountered in routine clinical practice. We present a case of a 45-year-old female with external jugular vein aneurysm presenting as a painful lump in the neck. Ultrasound of the neck and CT angiography showed saccular dilation of the lower end of the external jugular vein with thrombosis within the aneurysm. Saccular aneurysm of the external jugular vein is very uncommon and can l...

  16. Anomalous formation of the portal vein: a case report / Formação anômala da veia porta: relato de caso

    Scientific Electronic Library Online (English)

    Vasavi Rakesh, Gorantla; Bhagath Kumar, Potu; Thejodhar, Pulakunta; Venkata Ramana, Vollala; Pavan Kumar, Addala; Soubhagya Ranjan, Nayak.

    2007-12-01

    Full Text Available O conhecimento sobre a formação e as relações da veia porta é importante para cirurgiões e radiologistas. As variações no nível de formação e o padrão de formação da veia porta podem causar confusões durante procedimentos cirúrgicos e radiológicos. Neste relato, apresentamos uma variação na formação [...] da veia porta encontrada durante as dissecções cadavéricas. A veia porta foi formada pela união da veia esplênica, veia mesentérica superior e veias mesentéricas inferiores. A terminação anormal da veia gástrica esquerda na veia mesentérica superior antes da formação da veia porta também foi observada no mesmo cadáver. A identificação dessas variações é útil para tratar a ruptura traumática do mesentério. Abstract in english The knowledge about the formation and relations of the portal vein is important for surgeons and radiologists. The variations in the level of formation and the pattern of formation of portal vein might lead to confusions during radiological and surgical procedures. Here we present a rare variation i [...] n the formation of the portal vein as found during the cadaveric dissections. The portal vein was formed by the union of splenic vein, superior mesenteric vein and inferior mesenteric veins. The abnormal termination of left gastric vein into superior mesenteric vein before the formation of portal vein was also seen in the same cadaver. Identification of these variations is useful in managing traumatic rupture of the mesentery.

  17. Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement / Anatomia tomográfica da veia cava e das veias renais: aspectos relevantes para implante de filtro de veia cava

    Scientific Electronic Library Online (English)

    Thiago Melo do, Espírito Santo; Fernando, Bacalhau; Adilson Ferraz, Paschôa; Bonno, van Bellen; Igor, Austin; Douglas, Raci.

    2015-03-01

    Full Text Available CONTEXTO: Há uma demanda crescente por procedimentos invasivos que abordam a veia cava inferior, especialmente o implante de filtros de veia cava. A identificação da veia renal mais caudal para a liberação segura do filtro nem sempre é fácil durante a cavografia. OBJETIVOS: Estabelecer parâmetros d [...] a relação das veias renais e da cava infrarrenal com o corpo vertebral correspondente, sua relação com a biotipologia, presença de variações anatômicas, relação dos corpos vertebrais com a bifurcação das veias ilíacas comuns para a veia cava e distância desta bifurcação até a desembocadura da veia renal mais caudal, visando à implantação de filtro de veia cava. MÉTODOS: Foram analisadas 150 tomografias computadorizadas de abdome no período entre outubro e novembro de 2011, tendo sido agrupadas de acordo com o biotipo apresentado (ângulo de Charpy). As tomografias forem realizadas na MEDIMAGEM e analisadas no Serviço de Cirurgia Vascular Integrada, ambas da Beneficência Portuguesa de São Paulo. RESULTADOS: Dos 150 exames analisados, 127 (84,66%) apresentaram a emergência da veia renal mais caudal desde a projeção do primeiro espaço intervertebral lombar (L1-L2) até o corpo de L2, independentemente do biotipo do paciente. Somente 23 pacientes (15,33%) apresentaram a desembocadura da veia renal mais caudal abaixo do corpo de L2, ou seja, na projeção do espaço entre L2 e L3. CONCLUSÕES: A correlação radiológica da confluência da veia renal mais distal em relação aos corpos vertebrais apresenta pouca variação, independentemente do biotipo do paciente. Abstract in english BACKGROUND: There is a growing demand for invasive procedures involving the inferior vena cava, in particular for placement of vena cava filters. It is not always easy to identify the more distal renal vein with cavography, for safe release of filters. OBJECTIVES: To determine parameters for the re [...] lationships between the renal veins and the infrarenal vena cava and their corresponding vertebral bodies, their relationships with biotype and the occurrence of anatomic variations, the relationships between vertebral bodies and the bifurcation of the common iliac veins and the distance from this bifurcation to the outflow of the more distal renal vein, with reference to placement of vena cava filters. METHODS: A total of 150 abdominal computed tomography scans conducted from October to November 2011 were analyzed and classified according to the biotype exhibited (using Charpy's angle). Scans were performed at MEDIMAGEM and analyzed at the Integrated Vascular Surgery Service, both part of Hospital da Beneficência Portuguesa in São Paulo, Brazil. RESULTS: In 127 of the 150 scans analyzed (84.66%), the more distal renal vein emerged between the first lumbar intervertebral space (L1-L2) and the body of L2, irrespective of patient biotype. Just 23 patients (15.33%) exhibited a more distal renal vein with outflow below the body of L2, i.e. in the projection of the space between L2 and L3. CONCLUSIONS: The radiological correlation between the confluence of the more distal renal vein and vertebral bodies exhibits little variation, irrespective of the biotype of the patient.

  18. Isolamento das veias pulmonares para tratamento da fibrilação atrial paroxística: resultados clínicos após um único procedimento

    OpenAIRE

    Scanavacca Mauricio; Sartini Raul; Tondato Fernando; D'Ávila André; Hachul Denise; Darrieux Francisco; Lara Sissy; Sosa Eduardo

    2004-01-01

    OBJETIVO: Avaliar a evolução clínica dos pacientes com fibrilação atrial paroxística submetidos a um único procedimento de isolamento das veias pulmonares. MÉTODOS: Estudados 49 pacientes consecutivos (36 homens; idade média de 53±10 anos) com episódios freqüentes e sintomáticos de fibrilação atrial paroxística de difícil controle clínico. Para mapeamento da junção do átrio esquerdo com as veias pulmonares, foi utilizado o cateter decapolar circular Lasso e para ablação 30 watts e 50ºC, um ca...

  19. Oclusão de ramo da veia central da retina Retinal vein branch occlusion

    OpenAIRE

    Alexandre Antonio Marques Rosa

    2003-01-01

    As oclusões venosas retinianas são a segunda causa mais comum de doenças vasculares da retina, atrás apenas da retinopatia diabética. A obstrução venosa de ramo é definida como a oclusão focal de uma veia retiniana em nível de um cruzamento arteriovenoso, no qual a artéria passa anteriormente à veia. Serão revisto o estudo multicêntrico sobre o tratamento com fotocoagulação a "laser" para esta doença, bem como abordadas as novas terapêuticas cirúrgicas propostas.Retinal ven...

  20. Neovascularization after surgical exposure of rat external jugular vein endothelium

    Scientific Electronic Library Online (English)

    José Francimário Bezerra do, Nascimento; Guilherme Brandão Benjamin, Pitta; Fausto, Miranda Junior.

    2013-12-01

    Full Text Available PURPOSE: To investigate the neovascularization after exposure of the external jugular venous endothelium in an experimental model. METHODS: The sample was composed of 60 male rats of Wistar OUT B breed provided by animal colony of the Medicine College of Juazeiro do Norte, weighing 250 to 350g, aged [...] 90-120 days. Randomized study in OUT B Wistar rats, open, with 60 days duration. The animals were distributed into three groups of 20 specimens and were subjected to the following: Group 1: neck incision with dissection, ligation and section of the external jugular vein. Group 2: neck incision with dissection and ligation of the external jugular vein. Group 3: cervicotomy without dissection of the external jugular vein without ligation or section. The animals were sacrificed, half of them in 30 days and the other half within 60 days. The material in block harvested from the operated site were sectioned and stained for immunohistochemistry with CD34 marker. RESULTS: Neovascularization occurred with level of significance when compared group 1 to group 3 at 30 days (p=0.0076) and the same occurred at 60 days (p=0.0001) (Newman-Keuls test). CONCLUSION: The group with exposure of the venous endothelium showed a significant increase of neovascularization when compared with other groups.

  1. Tumors around the jugular foramen - diagnosis and clinical findings

    International Nuclear Information System (INIS)

    Tumors can originate in the jugular foramen itself or invade it from the intra- or extracranial space. Their identification by radiological techniques is difficult due to their location in the base of the skull. Computed tomography offers superior diagnostic possibilities as compared with other non invasive X-ray procedures. Our clinical and radiological findings will be presented. (orig.)

  2. Clinical application of preoperative endovascular management for jugular paraganglioma

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of preoperative angiography and embolization managements for jugular paraganglioma. Methods: Fourteen patients with jugular paraganglioma were carefully evaluated with CT, MRI and clinical ENT exams. Bilateral carotid and affected-side vertebral angiography together with embolization of the feeding arteries and tumor nidi were performed in all 14 patients before surgery. Internal carotid artery balloon occlusive test was employed to check the function of Willis' circle in 7 patients. The tumors were excised within 48 hours after embolization. Results: Preoperative angiographic and embolization procedures of jugular paraganglioma were successfully accomplished in all patients. The mean blood loss during the surgery was obviously less than usual. Of seven cases who passed the internal carotid artery balloon occlusive test,carotid artery ligation was adopted in 3. No new symptoms and signs of nervous system developed after the surgery and during the follow-up period. Conclusion: The angiography and embolization of feeding-arteries and tumor nidi, and the preoperative balloon occlusive test of carotid artery performed before the surgery of jugular paraganglioma are safe and reliable, which can be regarded as a routine preoperative preparation. (authors)

  3. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

    Directory of Open Access Journals (Sweden)

    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus.

  4. Tratamento cirúrgico da conexão anômala parcial das veias pulmonares em veia cava superior / Surgical treatment of partial anomalous pulmonary venous connection to the superior vena cava

    Scientific Electronic Library Online (English)

    Marcelo Dagola, Paulista; Paulo Henrique Dagola, Paulista; Ana Luiza Paulista, Guerra; Paulo Paredes, Paulista.

    2009-06-01

    Full Text Available OBJETIVO: O tratamento cirúrgico da conexão anômala das veias pulmonares em veia cava superior, associada ao defeito septal atrial tipo seio venoso, é bem estabelecido e transcorre com baixa mortalidade e morbidade. Com a finalidade de diminuir a incidência de estenose ou oclusão da veia cava superi [...] or direita, especialmente quando associada à presença de veia cava superior esquerda, o apêndice atrial direito foi utilizado para ampliar a veia cava superior direita, após o desvio das veias pulmonares para o átrio esquerdo. MÉTODOS: No período entre junho de 1986 e setembro de 2008, foram operados 95 pacientes, consecutivos, portadores desta anomalia com drenagem em veia cava superior direita e porção alta do átrio direito. A idade variou de 6 meses a 68 anos e o sexo feminino predominou com 50 casos. RESULTADOS: No material apresentado, não ocorreu nenhum óbito na fase de pós-operatório imediato ou tardio. O ritmo cardíaco permaneceu sempre sinusal e não ocorreram complicações na evolução. CONCLUSÃO: O presente trabalho demonstra a aplicabilidade da técnica descrita, com resultados favoráveis em relação a mortalidade, distúrbios de ritmo e complicações na região da veia cava superior direita. Abstract in english OBJECTIVE: Surgical treatment of anomalous pulmonary venous connection to the superior vena cava, associated with sinus venous atrial septal defect, is well established and correlates with low mortality and morbidity. In order to reduce the incidence of stenosis or occlusion of the right superior ve [...] na cava, especially when associated with the presence of left superior vena cava, the right atrial appendage was used to enlarge the right superior vena cava, after the diversion of the anomalous pulmonary veins for the left atrium. METHODS: Between June 1986 and September 2008, 95 consecutive patients were operated with anomalous drainage in the superior right vena cava and high right atrium. Ages ranged from 6 months to 68 years and females predominated with 50 cases. RESULTS: There was no death in the immediate or late post operative care. The sinus cardiac rhythm was preserved in all cases and there was no complications in the late follow up. CONCLUSION: This paper demonstrates the applicability of the technique described, with favorable results on mortality, rhythm disturbances and complications in the right superior vena cava.

  5. As diferenças entre comunicação interna e endomarketing

    Directory of Open Access Journals (Sweden)

    Carolina Girotto Ochoa

    2014-01-01

    Full Text Available Atualmente, a comunicação empresarial é algo imprescindível no mundo dos negócios. Em busca de crescimento e melhores resultados, as empresas sempre investiram na comunicação destinada aos clientes, o público externo. Porém, há algum tempo, percebeu-se a necessidade de conquistar o público interno, basicamente composto por empregados e familiares, para que os bons resultados e qualidade de produtos e serviços sejam mantidos. As empresas passaram a investir em ações de comunicação interna e de endomarketing para estreitar relacionamento e motivar os empregados, com o objetivo de obter os resultados esperados. Muitos profissionais costumam, erroneamente, conceituar comunicação interna e endomarketing como sinônimos. Este artigo tem por objetivo diferenciá-los.

  6. Left Internal Jugular Vein Thrombosis Due to a Lung Tumor

    Directory of Open Access Journals (Sweden)

    Kuan-Hsing Chen

    2003-06-01

    Full Text Available Deep vein thrombosis is a common disease among Caucasians but is rare in Asia.Venous thrombosis may be fatal, for example by a pulmonary embolism and right or leftatrial thrombosis. Alternatively, deep vein thrombosis may follow a benign pattern such asfemoral and popliteal vein thrombosis. Theories abound regarding the causes of deep veinthrombosis, with the most common theories being long-term stasis and lack of exercise.Internal jugular vein thrombosis is a rare but potentially fatal disease with various causes. Inthe pre-antibiotics era, this disease was frequently associated with deep neck infection.Recently however, local trauma, central catheterization, and repeated intravenous injectionswith drugs have become the leading causes of thrombosis. Spontaneous internal jugularvein thrombosis may occur in connection with a neoplasm, termed Trousseau's syndrome.This investigation reports a case of lung cancer associated with internal jugular vein thrombosis.

  7. Comparação entre os efeitos da mistura gelatina-resorcina-formaldeído e do N-butil-cianoacrilato em angiorrafias de veia jugular externa de coelhos (Oryctolagus cuniculus

    Directory of Open Access Journals (Sweden)

    Ferrigno Cassio Ricardo Auada

    2003-01-01

    Full Text Available OBJETIVO: Estudar comparativamente os efeitos de dois adesivos cirúrgicos adjutórios à técnica clássica de venorrafia, Colagel® e Histoacryl® no reforço da linha de sutura. MÉTODOS: Os procedimentos, conduzidos em 18 leporinos da raça Nova Zelândia, buscaram investigar a cicatrização de venorrafias pela evolução clínica dos animais, bem como a evolução da cicatrização das feridas cirúrgicas, macroscópica e microscopicamente. RESULTADOS: Os resultados obtidos mostraram, clínica e macroscopicamente, alterações de maior significado e, microscopicamente, predomínio de maior reação inflamatória nas suturas recobertas pelo Colagel®, comparativamente às mantidas como controle e às "protegidas'' pelo Histoacryl®. CONCLUSÕES: Houve retardo na cicatrização das feridas que receberam o Colagel® e similitude de resultados entre o grupo controle e as suturas recobertas pelo Histoacryl®.

  8. Jugular Foramen Schwannomas: Diagnosis and Suggestions for Surgical Management

    OpenAIRE

    Graham, Malcolm D.; LaRouere, Michael J.; Kartush, Jack M.

    1991-01-01

    Schwannomas arising in the parapharyngeal space are rare lesions; however, those originating in the jugular foramen are even less common. Two cases, each with marked intra- and extracranial extensions, are discussed. Clinical presentation and preoperative evaluation emphasizing computerized tomographic and magnetic resonance imaging will be presented. An aggressive two-stage surgical approach consisting of a retrosigmoid craniectomy combined with infratemporal removal is advocated for those l...

  9. MONITORIZACIÓN DE LA OXIMETRÍA DEL BULBO DE LA YUGULAR Oximetry monitoring of the jugular vein bulb

    Directory of Open Access Journals (Sweden)

    Oscar Illodo Hernández

    2007-09-01

    Full Text Available La monitorización de sangre de la yugular interna para determinar la oxigenación cerebral ha recobrado interés, pues permite una estimación global del balance entre aporte y demanda de oxígeno del cerebro. La medida directa de la presión arterial se considera como una necesidad. Sin embargo, no siempre es posible lograr un acceso arterial o incluso monitorizar la presión arterial no invasiva. La importancia clínico fisiológica y las técnicas descritas en este trabajo, así como las experiencias nacionales e internacionales al respecto, nos permiten conocer que la mayor utilidad de la monitorización de la SvyO2 es la detección de isquemia cerebral y la implementación de un tratamiento adecuado y temprano. La introducción de la oximetría del bulbo yugular permite la estimación del balance entre el aporte y la demanda de O2 del cerebro. Esta monitorización en tiempo real posibilita la mejoría del entorno fisiológico del cerebro y puede mejorar el resultado final del paciente; sin embargo, deben considerarse sus limitaciones.Monitoring internal jugular vein blood to determine cerebral oxygenation has regained interest because it allows a global assessment of the balance between demand and supply resources of oxygen in the brain. The direct measurement of arterial pressure is considered as a necessity. However it's not always possible to neither achieve an arterial access nor even monitor the arterial pressure with a non invasive technique. The clinical and physiological importance of the techniques described in this review, as well as the national and international experiences in the topic, allow us to know that the main utility of the SvyO 2 is the detection of cerebral ischemia and the implementation of an adequate and early treatment. This monitoring in real time makes possible the brain's fisological environment and it can also improve the final clinical results however, its limitations must be known and assessed.

  10. A veia ázigos direita na cutia (Dasyprocta aguti, rodentia) / The right azygos vein in agouti (Dasyprocta aguti, rodentia)

    Scientific Electronic Library Online (English)

    Paola Franssinetti Nunes Machado, OLIVEIRA; Maria Acelina Martins, CARVALHO; Wilson Machado, SOUZA; Maria Angélica, MIGLINO.

    Full Text Available O comportamento da veia ázigos, sua formação e topografia foram estudados em 10 cutias (Dasyprocta aguti, rodentia) adultas (6 machos e 4 fêmeas, capturadas no estado do Piauí, Brasil). Este trabalho tem por objetivo constituir a base de outras investigações, particularmente aquelas referentes à exp [...] loração zootécnica desta espécie. O sistema de veia ázigos foi injetado com látex - Neoprene 671, e os animais foram colocados em solução aquosa de formol a 10%, e dissecados. Em todas as espécies foi observado que a veia ázigos sempre chega na veia cava cranial em nível do quarto espaço intercostal. A veia ázigos recebe em (50%) dos casos as veias intercostais à direita e (50%) à esquerda. As tributárias da veia ázigos são: as veias frênicas (100%) e a veia bronco esofágica (30%). A veia hemiázigos aparece em todos os casos à esquerda e em 60% dos casos à direita. A veia ázigos comunica-se com a veia hemiázigos esquerda (90%), e com a direita (100%), com a veia cava caudal e veias intervertebrais, com igual freqüência (30%). Abstract in english The behaviour of the azygos vein, its formation and topography were studied in 10 cutias (Dasyprocta aguti, rodentia) adults (6 males and 4 females) captured in the State of Piauí, Brazil. This research intends to be a base for other investigations, particularly those with reference to zootechnical [...] exploration of this species. The azygos venous system was injected with latex (Neoprene 671), then the animals were put in watery solution of formol 10%, and dissected. In all specimens it was observed that the azygos vein always arrives in the cranial vena cava on a level with fourth intercostal space. The azygos vein receives more frequently (50%), the intercostal veins on the right side and 5 (50%) on the left one. The tributaries of the azygos vein are the phrenic veins (l00%), and the broncoesophagea vein (30%). The hemiazygos vein is in all cases on the left side and in 60% of the cases on the right side. The azygos vein communicates with the left hemiazygos vein (90%), with the right one (100%), and with the vena cava caudal and intervertebral veins, with equal frequency (30%).

  11. Aspectos ultra-sonográficos da trombose da veia porta Ultrasonographic features of portal vein thrombosis

    Directory of Open Access Journals (Sweden)

    Márcio Martins Machado

    2006-04-01

    Full Text Available A trombose da veia porta pode estar associada a várias alterações, como a presença de tumores (por exemplo: hepatocarcinoma, doença metastática hepática e carcinoma do pâncreas, pancreatite, hepatite, septicemia, trauma, esplenectomia, derivações porto-cava, estados de hipercoagulabilidade (por exemplo: gravidez, em neonatos (por exemplo: onfalite e cateterização da veia umbilical e desidratação aguda. Os autores discutem, neste artigo, os aspectos ultra-sonográficos da trombose de veia porta e alguns aspectos de relevância clínica.Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy, in neonates (for example, omphalitis and umbilical vein catheterization and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.

  12. Veia gástrica posterior: hipertensão porta Posterior gastric vein: portal hipertension

    Directory of Open Access Journals (Sweden)

    Alcino Lázaro da Silva

    1999-10-01

    Full Text Available A veia gástrica posterior não é muito citada nos livros de anatomia e nos trabalhos sobre hipertensão porta. Estudou-se sua anatomia, freqüência e desembocadura. Ela foi encontrada em 54% dos casos e, em 100%, desembocava na veia esplênica. Discute-se a vantagem ou não de sua ligadura ou preservação no tratamento cirúrgico da hipertensão porta.The posterior gastric vein has not been mentioned very often neither in anatomy textbooks nor in portal hypertension papers. The authors studied the anatomy, frequency and confluence of this vein because is a huge variety in the presentation of esophageal varices. Twenty-six adult preserved corpses (twenty females and six males had a wide abdominal incision allowing the dissection of the portal system, identifying the frequency and confluence of its tributaries, notably the posterior gastric vein. The portal vein, in all cases, was formed by the confluence of the superior mesenteric vein with the splenic vein and had a mean length of 6.4 cm. The splenic vein had a mean length of 6.5 cm. The left gastric vein was tributary of the portal vein in 50% of the cases and in 30% of the cases in the splenic vein. The right gastric vein had it's confluence to portal vein in 30 % of the cases and to the splenic vein in 4 %. The inferior mesenteric vein was tributary of the splenic vein in 54% of the cases and in the superior mesenteric vein in 46%. The left gastro-omental vein had its confluence to the splenic vein in 50% of the cases and to the inferior polar vein in 34 %. The middle colic vein had its confluence to superior mesenteric vein in 42% of the cases, to inferior mesenteric vein in 12% and to splenic vein in 8%. The posterior gastric vein was found in 54% of the corpses, and in all cases it was a tributary of the splenic vein, in retropancreatic position, coming from the esophageal-gastric junction. These findings agree with previous papers describing a prevalence of 60% of posterior gastric vein in patients submitted to surgery in portal hypertension, and in all cases, this vein was tributary of the splenic vein. The identification of this vein may influence the treatment, because if left untied during cases of portal-azigos disconnection, they may predispose to postoperative bleeding, but in cases of splenorenal anastomosis may preserve its patency in cases of anastomosis occlusion, or can lead again to postoperative bleeding feeding the esophageal varices. To ligate or not this vein will depends on the surgeon 's experience and common sense. Regarding to previous papers and to this data presented here, the authors believe that the prevalence of this vein is between 50 and 60% in the population.

  13. Anatomía quirúrgica del drenaje venoso en la región del triángulo carotídeo Surgical anatomy of jugular vein tributaries

    Directory of Open Access Journals (Sweden)

    JOSÉ GONZÁLEZ R

    2010-06-01

    Full Text Available Los principales afl uentes de la vena yugular interna se incorporan a nivel cervical por medio del tronco venoso tirolinguofacial. Clásicamente se ha descrito su formación por la unión de la vena facial, lingual y tiroidea superior. El objetivo de este estudio fue determinar las variaciones en la presentación del tronco tirolinguofacial en cadáveres humanos de la región del Maule, Chile. Se disecaron 30 hemicuellos pertenecientes a 15 cadáveres humanos de ambos sexos, con un rango de edad entre 29 y 50 años, y se analizaron mediante observación directa. Se observó la formación de tronco venoso en la totalidad de los casos, siendo 53,3% correspondiente al tronco de tipo tirolinguofacial, 23,3% linguofacial, 20% tirolingual y sólo un 3,3% el tronco tirolinguofaringofacial. No se encontró la formación del tronco venoso de tipo tirofacial. Además se encontró una correlación significativa entre el diámetro de la vena yugular interna y el tronco venoso conformado por estas venas. Por lo tanto, existen variaciones morfológicas en los patrones de conformación de las venas facial, lingual y tiroidea superior, siendo estos datos de importancia para áreas de cirugía oncológica, cirugía plástica, cirugía de cabeza y cuello y radiología.Background: The main tributaries of the internal jugular vein join at cervical level through the venous thyrolinguofacial trunk. This trunk is classically described as formed by the union of the facial, superior thyroid and lingual veins. Aim: To evaluate variations in the formation of the thyrolinguofacial trunk in human cadavers. Material and Methods: Thirty hemi-necks were dissected in human cadavers of nine men and six women, with ages ranging between 29 and 50 years, and analyzed by direct observation. Results: In 16 hemi-necks (53.3%, the trunk was thyrolinguofacial; in seven (23.3%, it was linguofacial; in six (20%, it was thyrolingual and in one case (3.3% it was thyrolinguo pharyngofacial. No thyrofacial trunk formation was found. There was a correlation between the diameter of the internal jugular vein and of the venous trunk formed by these veins. Conclusions: There are morphological changes in the formation patterns of facial, lingual and superior thyroid veins. This information is useful for surgical oncology, plastic surgery, head and neck surgery and radiology.

  14. Anatomía quirúrgica del drenaje venoso en la región del triángulo carotídeo / Surgical anatomy of jugular vein tributaries

    Scientific Electronic Library Online (English)

    JOSÉ, GONZÁLEZ R; MARIO, CANTÍN L; CÉSAR, CORONADO G; IVÁN, SUAZO G.

    2010-06-01

    Full Text Available Los principales afl uentes de la vena yugular interna se incorporan a nivel cervical por medio del tronco venoso tirolinguofacial. Clásicamente se ha descrito su formación por la unión de la vena facial, lingual y tiroidea superior. El objetivo de este estudio fue determinar las variaciones en la pr [...] esentación del tronco tirolinguofacial en cadáveres humanos de la región del Maule, Chile. Se disecaron 30 hemicuellos pertenecientes a 15 cadáveres humanos de ambos sexos, con un rango de edad entre 29 y 50 años, y se analizaron mediante observación directa. Se observó la formación de tronco venoso en la totalidad de los casos, siendo 53,3% correspondiente al tronco de tipo tirolinguofacial, 23,3% linguofacial, 20% tirolingual y sólo un 3,3% el tronco tirolinguofaringofacial. No se encontró la formación del tronco venoso de tipo tirofacial. Además se encontró una correlación significativa entre el diámetro de la vena yugular interna y el tronco venoso conformado por estas venas. Por lo tanto, existen variaciones morfológicas en los patrones de conformación de las venas facial, lingual y tiroidea superior, siendo estos datos de importancia para áreas de cirugía oncológica, cirugía plástica, cirugía de cabeza y cuello y radiología. Abstract in english Background: The main tributaries of the internal jugular vein join at cervical level through the venous thyrolinguofacial trunk. This trunk is classically described as formed by the union of the facial, superior thyroid and lingual veins. Aim: To evaluate variations in the formation of the thyroling [...] uofacial trunk in human cadavers. Material and Methods: Thirty hemi-necks were dissected in human cadavers of nine men and six women, with ages ranging between 29 and 50 years, and analyzed by direct observation. Results: In 16 hemi-necks (53.3%), the trunk was thyrolinguofacial; in seven (23.3%), it was linguofacial; in six (20%), it was thyrolingual and in one case (3.3%) it was thyrolinguo pharyngofacial. No thyrofacial trunk formation was found. There was a correlation between the diameter of the internal jugular vein and of the venous trunk formed by these veins. Conclusions: There are morphological changes in the formation patterns of facial, lingual and superior thyroid veins. This information is useful for surgical oncology, plastic surgery, head and neck surgery and radiology.

  15. Jugular foramen neurilemmoma mimicking an intra-axial brainstem tumor--a case report.

    OpenAIRE

    Lee, Y. B.; Kim, S. H.; Kim, H. T.; Kim, J. H.; Kim, M. H.; Ko, Y.

    1996-01-01

    Jugular foramen neurilemmoma is frequently manifested as a jugular foramen syndrome or extraaxial mass. Neurilemmoma arising from the cranial nerves of the foramen, although rare, may be manifestated as an intracranial or extracranial mass lesion. When the tumor is located only in the intracranium, it is often misdiagnosed as an acoustic neurinoma or a brainstem tumor because of their similarity in clinical or radiological findings. We present a rare case of jugular foramen neurilemmoma with ...

  16. Therapeutic embolization of the dural arteriovenous malformation involving the jugular bulb.

    OpenAIRE

    J.Y. Park; Ahn, J Y; Lee, B. H.; Huh, R.; H. K. Choi; Shin, M.S.

    2001-01-01

    Pulsatile tinnitus is a rarely occurring symptom of vascular origin. Most frequently, the symptoms are due to an arteriovenous malformation, to a tumor of the jugular glomus or to a local arterial stenosis. A 39-yr-old Korean male suffering from pulsatile tinnitus of the left ear was diagnosed to have dural arteriovenous malformation of the jugular bulb. Magnetic resonance imaging and angiography revealed a high-velocity vascular lesion encroaching the internal jugular vein and sigmoid sinuse...

  17. Unusual Intracranial Parasagittal Meningioma Extending into the Internal Jugular Vein through the Sinuses

    OpenAIRE

    Seo, Eui-Kyo; Cho, Yong-jae; Koo, Heasoo; Lim, Soo-Mee

    2008-01-01

    Meningiomas frequently invade cerebral venus sinuses, especially parasagittal meningioma to superior sagittal sinus. However, most invasions do not reach internal jugular vein. We present a case of parasagittal meningioma extending into the internal jugular vein through the sinuses. Radiological investigation revealed that the tumor was invading the sagittal, transverse, sigmoid sinus and junction of the internal jugular vein to subclavian vein, which was filled with tumor. The histopathologi...

  18. A Rare Carotid-Basilar Anastomosis Traversing the Jugular Foramen: Origin and Clinical Implications

    OpenAIRE

    Ranchod, A.I.; Gora, S.; Swartz, R.N.; Andronikou, S.; Mngomezulu, V.

    2011-01-01

    This report describes imaging in a patient with a unique unnamed carotid-basilar anastomosis, where the entry into the skull was via the jugular foramen. There were associated findings of absent right and hypoplastic left vertebral arteries and an aberrant right subclavian artery. We speculate that the persistent anastomosis is developmentally related to the jugular branch of the ascending pharyngeal artery. Clinical implications of the course via the jugular foramen are also discussed.

  19. Effect of feeding on jugular venous blood flow in the normal newborn infant.

    OpenAIRE

    Dear, P. R.

    1980-01-01

    Jugular venous occlusion plethysmography was used to measure jugular blood flow in 47 infants; this was done at varying times after the end of a feed. Jugular blood flow was found to be lower, by about 30%, during the first postprandial half hour than at any other time up to 2 hours postprandially. In 2 infants longitudinal studies were performed in relation to several feeds, and postprandial reductions in blood flow of a similar magnitude were found. Aspects of the venous occlusion technique...

  20. Internal jugular phlebectasia as an incidental finding in cervical spine surgery

    OpenAIRE

    Thulasiraman V; Ramesh Pandian T; Cheralathan S; Ashok S

    2010-01-01

    Idiopathic internal jugular phlebectasia, occurs either unilaterally or bilaterally affecting the internal jugular vein is a rare congenital variation often diagnosed during childhood. It usually presents with a benign swelling over the lateral side of neck on the affected side, seen on exertion. A-30-year old male was operated for anterior cervical dissectomy from right lateral approach and was diagnosed per-operatively as internal jugular phlebectasia. The surgery was abandoned at this stag...

  1. Central venous access through the external jugular vein in children submitted to bone marrow transplantation

    OpenAIRE

    José Luiz de Godoy; Edson Keity Otta; Ricardo Atsumori Miyazaki; Marco Antonio Bitencourt; Ricardo Pasquini

    2005-01-01

    Establishment of long-term central venous access is a sine qua non step for bone marrow transplantation in children. Most frequently, long-term central venous access has been obtained via blind percutaneous cannulation of subclavian and internal jugular veins or via internal jugular vein cutdown. In order to avoid some potential minor and major complications associated with the subclavian or internal jugular approaches, the authors describe an easy, simple and safe method for central venous a...

  2. Pattern of inner retinal layers involvement in pigmented paravenous retinochoroidal atrophy as determined by SD-OCT: case report / Padrão de envolvimento das camadas retinianas internas na atrofia retinocoroidiana pigmentada paravenosa determinado pelo SD-OCT: relato de caso

    Scientific Electronic Library Online (English)

    Daniela Laura Melo, Junqueira; Flavio Siqueira Santos, Lopes; Luís Gustavo, Biteli; Tiago Santos, Prata.

    2013-12-01

    Full Text Available Atrofia retinocoroidiana pigmentada paravenosa é uma doença ocular caracterizada por atrofia localizada da coroide e da retina externa associada a áreas de pigmentação em espícula óssea depositada ao longo das veias retinianas. Como é uma condição rara, há pouca informação na literatura sobre o padr [...] ão de envolvimento das camadas mais internas da retina. Relatamos o caso de um homem branco, de 41 anos, encaminhado incialmente para avaliação de glaucoma. Apresentava à fundoscopia áreas de atrofia retinocoroidiana com pigmentação leve sobrejacente, estendendo-se desde o disco óptico e seguindo ao longo da veia temporal inferior da retina em ambos os olhos. Por meio de diferentes protocolos da tomografia de coerência óptica de domínio espectral (SD-OCT) identificamos um afinamento significante das camadas internas da retina ao longo da veia temporal inferior, mas com uma área de intervalo lúcido ao redor do disco óptico. A perimetria automatizada acromática revelou um escotoma arqueado superior absoluto, poupando a fixação central em ambos os olhos e correspondendo às áreas de atrofia ao longo das veias retinianas (boa correlação anátomo-funcional). Este padrão de envolvimento das camadas retinianas internas não havia sido descrito anteriormente. Acreditamos que o SD-OCT contribuiu significativamente para a descrição anatômica desse caso e que estes novos achados devam ser considerados e correlacionados com o estado funcional ao avaliar esses pacientes. Abstract in english Pigmented paravenous retinochoroidal atrophy is an ocular disease characterized by outer retina and choroidal atrophy often with overlying intraretinal bone spicule pigment deposition along the retinal veins. As a rare condition, there is scant information in the literature regarding the pattern of [...] inner retinal layers involvement. We present a case of a 41-year-old white man initially referred for a glaucoma evaluation. Fundoscopy revealed patches of retinochoroidal atrophy and light pigmentation extending from the optic nerve head along the inferior-temporal retinal veins in both eyes. Using different spectral-domain optical coherence tomography (SD-OCT) protocols we identified a significant thinning of the inner retinal layers along the inferior-temporal veins, but with a lucid interval surrounding the optic nerve head. Standard automated perimetry revealed a superior absolute arcuate scotoma sparing the central fixation (good structure-functional correlation). This pattern of inner retinal layers involvement was not previously described. We believe SD-OCT added significantly to the anatomical description of this case. Physicians should consider these new anatomical findings and correlate them with functional status while assessing these patients.

  3. Variations in the structure of the jugular foramen of the human skull.

    OpenAIRE

    Sturrock, R R

    1988-01-01

    The jugular foramina were examined in 156 skulls. In 69% of cases the right was larger than the left and in 23% the left was larger, with the remainder being of equal size. An obvious dome caused by a superior jugular bulb was present bilaterally in 54%, on the right only in 30%, on the left only in 6% and was absent bilaterally in 10%. Of the 312 jugular foramina examined there was no evidence of an enlargement due to a superior jugular bulb in 28%.

  4. Endovascular treatment of traumatic carotid-jugular fistula: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Han Won; Byun, Woo Mok; Kim, Jae Woon; Chang, Chul Hoon [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2007-02-15

    We report 2 patients with a traumatic carotid-jugular fistula. The first patient suffered a deep neck penetrating injury. The external carotid-jugular fistula was demonstrated by 3-dimension CT angiography (3D-CTA) and digital subtraction angiography (DSA). The patient was treated with coil embolization. The second patient suffered a gun shot injury to the neck. 3D CTA and DSA revealed a common carotid-jugular fistula and a pseudoaneurysm. The common carotid-jugular fistula was treated with coil embolization in the fistula and the pseudoaneurysm was treated with stent assisted coil embolization.

  5. Internal Jugular/Subclavian Venous Access In Electrophysiology Study And Ablation

    OpenAIRE

    Shomu Bohora; Jaganmohan Tharakan

    2009-01-01

    Multiple venous accesses are required for catheter placement during electrophysiology study and ablation. Internal jugular/subclavian venous access, though restricted nowadays, can be important in difficult situations.

  6. Endovascular treatment of traumatic carotid-jugular fistula: report of two cases

    International Nuclear Information System (INIS)

    We report 2 patients with a traumatic carotid-jugular fistula. The first patient suffered a deep neck penetrating injury. The external carotid-jugular fistula was demonstrated by 3-dimension CT angiography (3D-CTA) and digital subtraction angiography (DSA). The patient was treated with coil embolization. The second patient suffered a gun shot injury to the neck. 3D CTA and DSA revealed a common carotid-jugular fistula and a pseudoaneurysm. The common carotid-jugular fistula was treated with coil embolization in the fistula and the pseudoaneurysm was treated with stent assisted coil embolization

  7. External Jugular Vein Aneurysm with Thrombus Presenting as Painful Neck Mass: A Case Report

    Directory of Open Access Journals (Sweden)

    Roshan Kumar Verma

    2013-07-01

    Full Text Available External jugular vein aneurysm with thrombosis presenting as neck swelling is a rare clinical entity and rarely encountered in routine clinical practice. We present a case of a 45-year-old female with external jugular vein aneurysm presenting as a painful lump in the neck. Ultrasound of the neck and CT angiography showed saccular dilation of the lower end of the external jugular vein with thrombosis within the aneurysm. Saccular aneurysm of the external jugular vein is very uncommon and can lead to thrombotic complications with serious consequence.

  8. Estudo da regeneração de nervos tibiais de ratos Wistar em sutura primária com "gap" e sem "gap", cobertos por segmentos de veia / Study of tibial nerve regenration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments

    Scientific Electronic Library Online (English)

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

    Full Text Available OBJETIVO: O presente estudo comparou, em ratos da raça Wistar, a regeneração nervosa nas suturas epineurais com espaçamento de 1,0mm (com "gap") e sem espaçamento (sem "gap"), ambos cobertos com tubo de veia jugular externa, através da contagem de motoneurônios no nível da medula espinhal entre L3 e [...] S1, marcados por meio de exposição do nervo tibial ao Fluoro - Goldâ (FG). MÉTODO: Os nervos tibias de ambos os lados foram seccionados e foram realizadas suturas epineurais com "gap" e, no lado contralateral, sem "gap" sendo que as suturas foram cobertas com tubo de veia. Após quatro meses do procedimento cirúrgico, os nervos tibias foram expostos ao FG, perfundidos e realizada a contagem dos motoneurônios na medula espinhal. RESULTADOS: Para a análise estatística foi utilizado o teste de Wilcoxon pareado, onde obtivemos um resultado estatisticamente significante entre o número de motoneurônios do grupo com "gap" em relação ao sem "gap" (p= 0,013). CONCLUSÃO: Obtivemos melhores resultados na contagem de motoneurônios daqueles nervos onde haviam sido realizadas as suturas primárias sem "gap", quando comparados com as suturas com "gap". Nível de Evidência: Estudo Experimental. Abstract in english OBJECTIVE: This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Go [...] ld (FG). METHOD: The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. RESULTS: The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the motor neuron count (p=0.013). CONCLUSION: The epineural neurorraphy without gap wrapped with jugular vein showed better results for nerve regeneration than the same procedure with gap. Level of Evidence: Experimental Study.

  9. Estudo comparativo entre enxerto autógeno e enxerto muscular coberto com tubo de veia autógeno em nervos tibiais de ratos wistar, utilizando o fluoro-gold® como marcador neuronal / Comparative study between autogenous graft and muscular graft covered with autogenous vein tube in wistar rats' tibial nerves using the fluoro-gold® as a neuronal marker

    Scientific Electronic Library Online (English)

    Marcela, Fernandes; Sandra Gomes, Valente; Débora, Amado; Maria José da Silva, Fernandes; Maria da Graça, Naffah-Mazzacoratti; João Baptista Gomes dos, Santos; Flávio, Faloppa; Vilnei Mattioli, Leite.

    Full Text Available Este trabalho teve como objetivo o estudo da regeneração nervosa através da contagem de neurônios comparando duas técnicas cirúrgicas no tratamento da perda de substância nervosa nos membros inferiores em 15 ratos. Inicialmente obteve-se tubo de veia de 12mm de comprimento retirado da jugular extern [...] a esquerda. A seguir, opera-se os dois membros inferiores, expondo o nervo tibial de cada lado e ressecando um segmento de 8 mm do nervo, simulando, ao mesmo tempo, a perda de substância e a obtenção do enxerto nervoso autógeno. A reparação da perda de substância do lado esquerdo consistiu numa enxertia convencional simples para a reparação de lesão nervosa por meio de sutura microcirúrgica. A do membro inferior direito foi pela tubulização com 8 mm de enxerto de músculo quadríceps denaturado com nitrogênio líquido coberto com veia jugular. Após quatro meses, os animais foram submetidos à nova cirurgia para exposição dos nervos tibiais ao marcador neuronal Fluoro Gold®. Após 48 horas, foram perfundidos e o segmento medular entre L3 e S1 foi removido e posteriormente cortado em secções de 40 µm. Houve contagem neuronal de todos os cortes e não foram verificadas diferenças estatísticas entre as duas técnicas cirúrgicas. Abstract in english The purpose of this work was to study nervous regeneration through neurons counts by comparing two surgical techniques for addressing nervous gaps on 15 rats' lower limbs. Initially, a 12-mm long vein tube from the left outer jugular was obtained, and then both lower limbs are operated, exposing the [...] tibial nerve at each side and performing a resection of an 8-mm nerve segment, at the same time simulating a gap and an autogenous nerve graft. Left gap repair consisted of a usual conventional graft for nervous injury repair by means of microsurgical suture. The gap repair on right lower limbs was made through quadriceps muscle, treated with liquid nitrogen, covered with an 8-mm tube of jugular vein. After four months, the animals were submitted to a new surgery for exposing tibial nerves to the Fluoro-Gold® neuronal marker. After 48 hours, the rats were perfused and medullar segment between L3 and S1 was removed and subsequently cut into 40µm sections. Neurons on all sections were counted, and no statistical differences were found between both surgical techniques.

  10. Arterialização seletiva da veia interventricular anterior: opção de revascularização miocárdica / Selective arterialization of the anterior interventricular vein: a choice for myocardial revascularization

    Scientific Electronic Library Online (English)

    Luiz Fernando, Kubrusly; Márcio, Escorsin; Antonio Carlos, Zavelinski; Paulo Henrique, Stahlke; Sérgio, Savytzky; Denise Bermudez, Kubrusly.

    1992-12-01

    Full Text Available O objetivo deste trabalho é referir dois casos cirúrgicos, onde, após ressecção de aneurisma de ventrículo esquerdo, a revascularização do miocárdio através da artéria interventricular anterior (AIA) não foi possível. Utilizando-se a artéria torácica interna (ATI) esquerda, optou-se pela anatomose c [...] om a veia interventricular anterior (VIA) com ligadura próxima, para estabelecimento do fluxo retrógrado e evitar a formação de fístula artenovenosa. Não houve mortalidade e os resultados a curto prazo são encorajadores. Testes de perfusão miocárdica com radioisótopos no pré e no pós-operatório, assim como angiografia do sistema coronário e da artéria torácica interna esquerda pré e pós-operatória são apresentados e discutidos. O objetivo da cirurgia de aneurisma ventricular é a recomposição geométrica do ventrículo esquerdo e revascularização de possíveis áreas isquémicas. Na impossibilidade de revascularização direta da artéria interventricular anterior, a técnica citada demonstra ser facilmente exeqüível e, a curto prazo, com bons resultados. Abstract in english The purpose of this study is to report two surgical cases, whereby after the repair of the left ventricular aneurysm, the myocardial revascularization of the interventricular anterior artery (IAA) was not possible. Using the left internal thoracic artery it was decided to perform anastomosis with th [...] e interventricular anterior (IAA) and its cephalad ligation, in order to obtain a retrograde flow and to avoid an arteriovenous fistula formation. There was no mortality and the results are optimistic in a short follow-up of these two patients. Myocardial perfusion tests and pre and post-operative angiography of the coronary system and the left internal thoracic artery are assessed and discussed. The geometrical reconstruction of the left ventricle and the revascularization of the ischemic areas play major role in the repair of postinfarction ventricular aneurysm. When it is not possible to access diretly the revascularization of the IAV this technique is safely and easily perfomed and shows satisfactory results in a short period of time.

  11. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications

    International Nuclear Information System (INIS)

    Purpose: To retrospectively compare immediate and long-term outcome of central venous infusion port inserted via right high versus low jugular vein approaches. Materials and methods: The study included 163 patients (125 women patients, 38 men patients; age range, 18-79 years; mean age, 53 years); 142 patients underwent port insertion with low jugular vein approach and 21 patients with high jugular vein approach. The causes of high jugular vein puncture were metastatic lymphadenopathy (n = 7), operation scar (n = 6), radiation scar (n = 5), failure of low jugular vein puncture (n = 2), and abnormal course of right subclavian artery (n = 1). Medical records and radiologic studies were reviewed retrospectively to determine and compare the outcome and the occurrence of complication related to port. Results: The procedure-related complications were all minor (n = 14, 8.6%) in both groups; hematoma (n = 4, 2.8% in low jugular puncture group and n = 1, 4.8% in high jugular puncture group, p = 0.6295), air embolism (n = 2, 1.4% in low jugular puncture group and n = 0 in high jugular puncture group, p = 0.5842) and minor bleeding (n = 5, 3.5% in low jugular vein puncture group and n = 2, 9.5% in high jugular vein puncture group, p = 0.2054). The average length of follow-up was 431 days for low jugular vein puncture group and 284 days for high jugular vein puncture group. The difference between two groups was significant (p = 0.0349). The reasons for catheter removal were patiehe reasons for catheter removal were patients' death (59 in low jugular puncture group and 14 in high jugular puncture group, p = 0.0465), suspected infection (11 in low jugular vein puncture group and 2 in high jugular vein puncture group, p = 0.8242), catheter occlusion (four in low jugular vein puncture group and one in high jugular vein puncture group, p = 0.6583). The catheter tip migrated upward an average of 1.86 cm (range, -0.5 to 5.0 cm) in low jugular vein puncture group and 1.56 cm (range, 0-3.6 cm) in high jugular vein puncture group and there was no significant difference (p = 0.4232). Conclusions: Right high jugular vein approach can be a feasible alternative to right low jugular vein approach.

  12. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk [Research Institute and Hospital, National Cancer Center, 809 Madu 1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-764 (Korea, Republic of); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)], E-mail: hpark@dreamwiz.com; Kim, Young Il; Lee, Sang Hyun; Kim, Jung Im; Seo, Hyobin; Lee, Sang Min; Lee, Youkyung; Lim, Min Kyung [Research Institute and Hospital, National Cancer Center, 809 Madu 1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-764 (Korea, Republic of); Park, Young Suk [Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    Purpose: To retrospectively compare immediate and long-term outcome of central venous infusion port inserted via right high versus low jugular vein approaches. Materials and methods: The study included 163 patients (125 women patients, 38 men patients; age range, 18-79 years; mean age, 53 years); 142 patients underwent port insertion with low jugular vein approach and 21 patients with high jugular vein approach. The causes of high jugular vein puncture were metastatic lymphadenopathy (n = 7), operation scar (n = 6), radiation scar (n = 5), failure of low jugular vein puncture (n = 2), and abnormal course of right subclavian artery (n = 1). Medical records and radiologic studies were reviewed retrospectively to determine and compare the outcome and the occurrence of complication related to port. Results: The procedure-related complications were all minor (n = 14, 8.6%) in both groups; hematoma (n = 4, 2.8% in low jugular puncture group and n = 1, 4.8% in high jugular puncture group, p = 0.6295), air embolism (n = 2, 1.4% in low jugular puncture group and n = 0 in high jugular puncture group, p = 0.5842) and minor bleeding (n = 5, 3.5% in low jugular vein puncture group and n = 2, 9.5% in high jugular vein puncture group, p = 0.2054). The average length of follow-up was 431 days for low jugular vein puncture group and 284 days for high jugular vein puncture group. The difference between two groups was significant (p = 0.0349). The reasons for catheter removal were patients' death (59 in low jugular puncture group and 14 in high jugular puncture group, p = 0.0465), suspected infection (11 in low jugular vein puncture group and 2 in high jugular vein puncture group, p = 0.8242), catheter occlusion (four in low jugular vein puncture group and one in high jugular vein puncture group, p = 0.6583). The catheter tip migrated upward an average of 1.86 cm (range, -0.5 to 5.0 cm) in low jugular vein puncture group and 1.56 cm (range, 0-3.6 cm) in high jugular vein puncture group and there was no significant difference (p = 0.4232). Conclusions: Right high jugular vein approach can be a feasible alternative to right low jugular vein approach.

  13. Jugular bulb abnormalities in patients with Meniere's disease using high-resolution computed tomography.

    Science.gov (United States)

    Park, Jonas J-H; Shen, Anmin; Keil, Sebastian; Kuhl, Christiane; Westhofen, Martin

    2015-08-01

    Temporal bone abnormalities such as hypoplasia of the vestibular aqueduct or hypopneumatization of the mastoid have been described in Meniere's disease (MD). Jugular bulb abnormalities (JBA) are one of the most common temporal bone abnormalities. The aim of this study was to evaluate the frequency of JBA in MD. Radiological data obtained by temporal bone high-resolution computed tomography of 200 ears of 167 MD patients (MD group) and 218 ears of 109 patients with normal inner ear function (control group) were analyzed retrospectively. The frequencies of high jugular bulb (HJB), jugular bulb diverticulum (JBD), inner ear adjacent jugular bulb (IAJB) and jugular bulb related inner ear dehiscence (JBID) were evaluated and compared between MD group and control group. IAJB was differentiated into vestibular aqueduct adjacent jugular bulb (VAAJB), cochlear aqueduct adjacent jugular bulb and posterior semicircular canal adjacent jugular bulb. JBID was further analyzed by differentiating into jugular bulb related vestibular aqueduct dehiscence (JBVAD), jugular bulb related cochlear aqueduct dehiscence and jugular bulb related posterior semicircular canal dehiscence. The frequencies of HJB, JBD and IAJB were higher in MD group compared to control group (21, 13.3 %, p = 0.036; 8.5, 3.7 %, p = 0.037; 13.5, 4.6 %, p = 0.001). No differences between both groups were seen in JBID (4.0, 2.3 %, p = 0.315). Most IAJB and JBID were seen in VAAJB and JBVAD. There is a higher frequency of JBA in patients with MD than in patients without inner ear symptoms. Temporal bones of MD patients might be constituted anatomically different, carrying predisposing factors for the development of clinically apparent MD. PMID:24647494

  14. High-Flow Traumatic Carotico-Jugular Fistula Manifesting as Venous Hypertensive Encephalopathy: A Case Report

    OpenAIRE

    A. K Gupta; Purkayastha, S; Varma, D R; Kapilamoorthy, T.R.; Thomas, B.

    2005-01-01

    We report the clinical and angiographic findings in a patient who presented with venous hypertensive encephalopathy secondary to a traumatic carotico-jugular fistula. Endovascular entrapment of the fistula by occluding the common carotid artery and internal jugular vein at the base of the skull resulted in near total improvement of the patient's neurological status.

  15. Anatomical study of the superior jugular bulb by use of high-resolution computed tomography

    International Nuclear Information System (INIS)

    Using high-resolutiion computed tomography, the relationship between the superior jugular bulb and the tympanic cavity was analysed in 40 subjects. Until now, the superior jugular bulb was thought to lie below the floor of the hypotympanum, however, the following observations were made from this study: In 48 (60%) out of 80 temporal bones (40 cases), the top of the superior jugular bulb was situated in the higher level than the floor of the hypotympanum. In 9 cases, the jugular bulb was separated from the tympanic cavity by only thin bony wall. This finding was noticed on the right side in 8 cases and was bilateral in a case. In 21 cases (52.5%), the right jugular bulb was situated in higher level than the left, and the reverse finding was noticed only in 4 cases (10.0%). The reason why the right jugular bulb is frequently higher than the left was thought to be related to its function. Namely, the jugular bulb is useful to absorb the pulsation of the carotid artery, therefore, it was considerd that the anatomical and physiological differences between the right and left carotid arteries induce the asymmetry of the jugular bulbs. (author)

  16. Las Cuatro Dimensiones de la Comunicación Interna

    Scientific Electronic Library Online (English)

    Julio, Reyes.

    2012-06-01

    Full Text Available Cada dia são mais as consultoras globais que se interesam nas comunicações internas, devido ao impacto que têm em quatro grandes âmbitos da gestão organizacional. Existe amplo consenso sobre o papel das comunicações internas para alinhar aos funcionários de uma organização. Esto implica orienta-los [...] sobre as condutas necessárias para fazer real os objetivos estratégicos da organização; e, ao tempo, fortalecer os comportamentos que constituem a identidade e tangibilizam os valores corporativos. Também sobre a importância de ter colaboradores comprometidos, que não só conheçam, senão também valorem a proposta que a organização faz para retê-los e mantê-los motivados. Finalmente, cada dia é mais evidente e relevante que uma organização se vincule com seu entorno e faça participar a seus colaboradores de sua responsabilidade corporativa. Abstract in spanish Cada día son más las consultoras globales que se interesan en las comunicaciones internas, dado el impacto que tienen en cuatro grandes ámbitos de la gestión organizacional. Existe amplio consenso sobre el rol de las comunicaciones internas para alinear a los integrantes de una organización. Esto im [...] plica, orientarlos sobre las conductas necesarias para hacer real los objetivos estratégicos de la organización; y, al mismo tiempo, fortalecer aquellos comportamientos que constituyen la identidad y tangibilizan los valores corporativos. También sobre la importancia de tener colaboradores comprometidos, que no sólo conozcan, sino también valoren la propuesta que la organización hace para retenerlos y mantenerlos motivados. Finalmente, cada día es más evidente y relevante que una organización se vincule con su entorno y haga partícipes a sus colaboradores de su responsabilidad corporativa. Abstract in english : Global communications consultants interest in internal communications has dramatically increased in the past few years, due to the impact that they have in four great scopes of the organizational management. It exists a wide consensus on the role of the internal communications to align to the memb [...] ers of an organization. This implies, to orient them on which behaviors are necessary to make real the strategic goals of the organization; and, at the same time, to fortify those behaviors that constitute the identity and shaped the corporate values. The article focuses also on the importance of having colleagues who not only know, but also value the organization offers that aim to retain and get them motivated. Finally, every day is more evident and relevant than an organization ties with its environment and makes their colleagues become contributors of its corporate responsibility.

  17. Cirurgia Endoscópica Subfascial de veias Perfurantes Insuficientes (CESPI): experiência inicial / Subfascial endoscopic perforator venous surgery: initial experience

    Scientific Electronic Library Online (English)

    Eduardo Toledo de, Aguiar; Alex, Lederman; Marina A., Farjallat; Mônica A., Rudner.

    2003-06-01

    Full Text Available OBJETIVO: Estudar os resultados imediatos e a médio prazo da cirurgia endoscópica subfascial de perfurantes. MÉTODO: Estudo clínico, prospectivo e descritivo. Critérios de inclusão: insuficiência venosa crônica primária ou secundária, sistema venoso profundo pérvio e índice tornozelo/braço maior que [...] 0,8. Critérios de exclusão: ocorrência da trombose venosa profunda, ou trauma ou cirurgia ortopédica e cirurgia sobre o sistema venoso profundo durante o período de seguimento pós-operatório. Todos doentes foram examinados pelo ecodoppler colorido antes da operação. RESULTADOS: Foram operados 43 membros a partir de junho/1997. Eram 27 doentes com média de idade 56,5 anos. A insuficiência venosa crônica era secundária à trombose venosa em dois membros. Três membros foram classificados como C3, 15 como C4, 11 como C5 e 14 como C6. A retirada das veias safena interna, safena externa e tributárias foi associada em 35 membros. Foram ligadas três a cinco perfurantes por membro; não houve óbitos no pós-operatório imediato; houve três infecções e as úlceras cicatrizaram em períodos variáveis de duas a 15 semanas. Dezenove doentes obtiveram alta hospitalar no primeiro dia de pós-operatório, seis no segundo e dois no terceiro. Houve uma recidiva de úlcera (4,0%) durante o período de seguimento de 25 meses (média) por causa de perfurante não-ligada. CONCLUSÕES: A cirurgia endoscópica subfascial de veias perfurantes insuficientes associada à cirurgia radical de varizes é segura, acompanha-se de baixo índice de complicações, pode ser adaptada aos instrumentos comuns da cirurgia laparoscópica, indicada para doentes classificados como C4, C5 e C6 e se acompanha de bons resultados imediatos e a médio prazo. Abstract in english BACKGROUND: Prevalence of varicose ulcers in Brazil has been estimated as high as 3.6%. Perforator vein insufficiency is the main source for the development of these ulcers. The recently proposed SEPS technique is regarded as minimally invasive approach followed by low complication rates and short i [...] n-hospital stay. Our objective is to study the results of subfascial endoscopic perforator surgery associated or not to superficial venous system surgery. METHODS: Prospective, non-controlled ,clinical study. Inclusion criteria were patent deep venous system, patient with primary or secondary venous insufficiency (congenital not included) and an ankle/arm index higher than 0.8; exclusion criteria were: deep vein thrombosis, trauma or orthopedic surgery and deep venous system surgery occurring during post-operative follow-up. All patients had a duplex-scan perfomed before operation. RESULTS: Forty-three lower limbs were operated on since june/97; there were 27 patients with mean age 56.6 years; great saphenous vein, lesser saphenous vein and tributaries stripping were associated in 29 limbs; three limb were classified as C3, 15 as C4, 11 as C5 and 14 as C6. Venous insufficiency was secondary to deep venous thrombosis in 2 limbs. There were no immediate deaths; three to five perforators per limb were ligated; all ulcers healed during a period from two to 15 weeks; there were three infections (6.9%); 19 patients left hospital on 1st, six on 2nd and two on 3rd post-operative day. There was one ulcer recurrence (4.0%) after 10 months (perforator vein left in place). CONCLUSION: the procedure is safe, the hospitalization time is short, ulcer healing occurs mostly within two weeks and recurrence rate depends on a follow-up period at least of five years.

  18. A thin-slice radioanatomic study of jugular foramen

    International Nuclear Information System (INIS)

    Objective: To observe and analyze the CT and MR imaging of the structures in the region of the jugular foramen (JF) on the base of thin-slice anatomic study. Methods: Having been scanned by multislice CT and 1.5T MR scanner, two formalin-preserved adult cadavers were dissected into 1.0 mm thickness contiguous sections in transverse plane. Twenty cases without skull base and nasopharyngeal history received routine and post-contrast CT examinations with spiral and HQ mode. Twenty healthy volunteers received MR scanning, including SE T1WI, FSE T2WI, and 3D RF-FAST (3D Radio-Frequency Fourier Acquired Steady-State) sequences. Results: JF region was divided into three levels, which included inner aperture, the jugular cavity, and the outer aperture. At the entrance of JF, there were glossopharyngeal canal and vagal canal, which wrapped the IX nerve and X and XI nerves, respectively. CT images could display these canals in 20 cases (100%). Furthermore, the IX, X and XI nerves could be identified on different MR sequences. 17 cases (85%) were displayed on 3D RF-FAST, 14 cases (70%) on SE T1WI, and 10 cases (50%) on FSE T2WI, respectively. From the anterior to the posterior compartment within the JF cavity, the structures ranged as follows: the IX nerve, the inferior petrosal sinus, the X and XI nerves, and the jugular bulb. These neuro-vessel structures could not be distinguished on CT, SE T1WI, and FSE T2WI iT1WI, and FSE T2WI images, except for 3D RF-FAST (16 cases, 80%). The outer aperture of JF was adjacent to the hypoglossal canal. The shape of JF outer aperture could be evaluated on CT images. On the oblique plane, which was parallel to the hypoglossal canal, the posterior cranial nerves could be detected to enter/exit the skull through the JF and hypoglossal canal separately. Conclusion: The complement of CT and MR imaging would be helpful to distinguish the structures in the region of JF

  19. Glomus jugulare tumor with intra- and extracranial extension. A case report with MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Morisako, Toshitaka; Goya, Tomokazu; Wakisaka, Shinichiro; Kinoshita, Kazuo

    1987-11-01

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C/sub 2/. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension

  20. Adequate irradiation of the internal jugular lymph node chain: technical considerations

    International Nuclear Information System (INIS)

    Purpose: This research aimed to study the anatomic relationship between the internal jugular vein with the surrounding internal jugular lymph node chain and the underlying bony anatomical structures which are commonly used as landmarks for radiation therapy planning. Methods and Materials: Twelve patients with carcinoma of the head and neck region were studied prospectively. Using our three-dimensional planning system, a beam's-eye view of the internal jugular vein was projected onto a lateral and anterior simulation film. Quantitative measurements were made in every case of the anatomic relationship between the internal jugular vein and the posterior border of the cervical vertebrae and sagittal midline. Results: The distance between the posterior border of the internal jugular vein and the posterior border of the cervical vertebrae ranged between 0 and 2.5 cm. The distances between the sagittal midline and the medial border of the internal jugular veins ranged between 2 and 4 cm. Conclusion: To ensure adequate irradiation of the internal jugular lymph nodes, the posterior border of the lateral radiation therapy upper-neck fields should be placed at least 1 cm posterior to the posterior aspect of the cervical vertebrae. The midline block used in the lower neck anterior field should not exceed 2 cm in width

  1. Two cases of jugular vein thrombosis in severely burned patients

    Directory of Open Access Journals (Sweden)

    Cen H

    2013-07-01

    Full Text Available Hanghui Cen, Xiaojie HeDepartment of Burn, The Second Affiliated Hospital, Zhejiang University Medical College, Hangzhou, People’s Republic of ChinaAbstract: Here we present two cases of jugular vein thrombosis in burn patients, with diagnosis, risk factor analysis, and treatment approaches. Severely burned patients have high risk of deep vein thrombosis occurrence due to multiple surgeries. The deep vein catheter should be carefully performed. Once deep vein thrombosis is detected, a wide ultrasonography helps to find other thrombosis sites. During the acute phase, low molecular weight heparin can be used. Upon long-term anti-thrombosis treatment, combined use of herbal medicine during rehabilitation is helpful.Keywords: burn, heparin, combined treatment

  2. Duplication of the right internal jugular vein: A case report.

    Science.gov (United States)

    Bathala, Srinivasalu; Makura, Zvoru G

    2015-06-01

    We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy detected a transglottic tumor that had extended beyond the vocal folds. The patient underwent a total laryngectomy and bilateral selective neck dissection at levels II-VI. Intraoperatively, the right IJV was noted to be duplicated. The duplicate segment was approximately 10 cm in length, and it rejoined the normal vein before the normal vein joined the subclavian vein. PMID:26053982

  3. Jugular foramen meningiomas. Review of the major surgical series

    International Nuclear Information System (INIS)

    Primary jugular foramen meningiomas are uncommon, with 96 previous cases published between 1992 and 2007. Exact location and extent of tumor were determined on the basis of radiologic and operative findings and used to develop a staging system. The mean age of patients was 39.4 years. The lesion was located on the right in 14 patients and on the left in 11 patients. The series identified 23 males and 58 females. The most common presenting clinical symptoms were hearing loss and tinnitus. Most clinical findings were middle ear mass and neck mass. Most meningiomas were World Health Organization grade I. The most common postoperative complications were lower cranial nerve paresis and facial nerve paresis. Surgical planning should consider that meningiomas usually invade the dura mater, cranial nerves, and surrounding bone. The surgeon should carefully collect detailed data about the tumor, and consult an otolaryngologist preoperatively for lower cranial nerve functions and hearing levels.(author)

  4. Internal jugular venous abnormalities in transient monocular blindness

    Science.gov (United States)

    2013-01-01

    Background The etiology of transient monocular blindness (TMB) in patients without carotid stenosis has been linked to ocular venous hypertension, for their increased retrobulbar vascular resistance, sustained retinal venule dilatation and higher frequency of jugular venous reflux (JVR). This study aimed to elucidate whether there are anatomical abnormalities at internal jugular vein (IJV) in TMB patients that would contribute to impaired cerebral venous drainage and consequent ocular venous hypertension. Methods Contrast-enhanced axial T1-weighted magnetic resonance imaging (MRI) was performed in 23 TMB patients who had no carotid stenosis and 23 age- and sex-matched controls. The veins were assessed at the upper IJV (at C1–3 level) and the middle IJV (at C3–5 level). Grading of IJV compression/stenosis was determined bilaterally as follows: 0 = normal round or ovoid appearance; 1 = mild flattening; 2 = moderate flattening; and 3 = severe flattening or not visualized. Results There was significantly more moderate or severe IJV compression/stenosis in the TMB patients at the left upper IJV level and the bilateral middle IJV level. Defining venous compression/stenosis scores ? 2 as a significant cerebral venous outflow impairment, TMB patients were found to have higher frequency of significant venous outflow impairment at the upper IJV level (56.5% vs. 8.7%, p = 0.0005) and the middle IJV level (69.6% vs. 21.7%, p=0.0011). Conclusions TMB Patients with the absence of carotid stenosis had higher frequency and greater severity of IJV compression/stenosis which could impair cerebral venous outflow. Our results provide evidence supporting that the cerebral venous outflow abnormality is one of the etiologies of TMB. PMID:23876171

  5. An adult case of idiopathic internal carotid-internal jugular vein arteriovenous fistula.

    Science.gov (United States)

    Puca, Aniello E; Pignatelli, Francesco

    2015-05-01

    Carotid-jugular fistula is an abnormal connection between the carotid artery and/or its branches and jugular vein. It can develop either because of trauma or spontaneous causes. Traumatic fistula may occur after head injuries and can range from minor falls to severe penetrating wounds. Traumatic fistula may also result from endovascular therapy; however, these fistulas may be congenital arteriovenous connections that open spontaneously in the setting of collagen vascular disease, atherosclerotic disease, hypertension, or childbirth. Spontaneous fistulas between internal carotid artery and internal jugular vein are very exceptional diseases; therefore, this case is presented for its rare incidence in literature. PMID:25749610

  6. Oclusão de ramo da veia central da retina Retinal vein branch occlusion

    Directory of Open Access Journals (Sweden)

    Alexandre Antonio Marques Rosa

    2003-12-01

    Full Text Available As oclusões venosas retinianas são a segunda causa mais comum de doenças vasculares da retina, atrás apenas da retinopatia diabética. A obstrução venosa de ramo é definida como a oclusão focal de uma veia retiniana em nível de um cruzamento arteriovenoso, no qual a artéria passa anteriormente à veia. Serão revisto o estudo multicêntrico sobre o tratamento com fotocoagulação a "laser" para esta doença, bem como abordadas as novas terapêuticas cirúrgicas propostas.Retinal venous occlusions are the second most common retinal vascular diseases, behind diabetic retinopathy. The retinal vein branch occlusion is defined as a retinal vein focal occlusion at the level of an arteriovenous crossing, where the artery lies anterior to vein. The clinical trial with laser photocoagulation for this disease, as well as new proposed surgical therapeutic techniques will be reviewed.

  7. Oclusão de ramo da veia central da retina / Retinal vein branch occlusion

    Scientific Electronic Library Online (English)

    Alexandre Antonio Marques, Rosa.

    2003-12-01

    Full Text Available As oclusões venosas retinianas são a segunda causa mais comum de doenças vasculares da retina, atrás apenas da retinopatia diabética. A obstrução venosa de ramo é definida como a oclusão focal de uma veia retiniana em nível de um cruzamento arteriovenoso, no qual a artéria passa anteriormente à veia [...] . Serão revisto o estudo multicêntrico sobre o tratamento com fotocoagulação a "laser" para esta doença, bem como abordadas as novas terapêuticas cirúrgicas propostas. Abstract in english Retinal venous occlusions are the second most common retinal vascular diseases, behind diabetic retinopathy. The retinal vein branch occlusion is defined as a retinal vein focal occlusion at the level of an arteriovenous crossing, where the artery lies anterior to vein. The clinical trial with laser [...] photocoagulation for this disease, as well as new proposed surgical therapeutic techniques will be reviewed.

  8. Trombose da veia de Galeno: relato de caso Galen vein thrombosis: case report

    OpenAIRE

    Marcio Chaves Pedro Marques; Leopoldo Antônio Pires; Carlos Augusto Damasceno; André Carvalho Felício; Ângelo Atala; Franco, Gla?ucio M.

    2003-01-01

    A trombose venosa cerebral (TVC) é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas). A trombose da veia de Galeno (TVG) é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente de 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico c...

  9. Methods for the development of architecture models in the VEIA reference process

    OpenAIRE

    Große-rhode, M.

    2008-01-01

    The reference process for the development of automotive product lines formulated in the project VEIA introduces different kinds of models for the representation of architectural views of the system family under development. The purpose of this report is to present methods and guidelines on how such models can be developed in the course of the process. Thereby mainly early models are considered, which in this case means the derivation of a function interface model and an executable hierarchica...

  10. Aneurisma da veia femoral simulando uma hérnia inguinal / Femoral vein aneurysm simulating an inguinal hernia

    Scientific Electronic Library Online (English)

    Victor Assad, Buffara-Jr; Júlio Cezar. Uili, Coelho; Mateus Martinelli de, Oliveira.

    2009-12-01

    Full Text Available INTRODUÇÃO: Somente seis casos de aneurismas da veia femoral simulando hérnia inguinal foram descritos na literatura. RELATO DO CASO: Um caso de aneurisma da veia femoral comum direita que simulava uma hérnia inguinal é descrito em jovem de 19 anos de idade com uma massa dolorosa de consistência mol [...] e na região inguinal direita de seis meses de duração. Durante a consulta médica, o paciente morreu durante em episódio de convulsão generalizada. Na necropsia, tromboembolismo pulmonar maciço e um aneurisma da veia femoral comum de 8x8x7 cm com trombos foram diagnosticados. Abstract in english BACKGROUND: Only six cases of femoral vein aneurysm are related on medical literature. CASE REPORT: A case of a right common femoral vein aneurysm simulating an inguinal hernia in a 19 year-old male. He had a soft and painful mass in the right inguinal area of six months of duration. At medical cons [...] ultation, the patient died during a generalized convulsive episode. At necropsy, massive pulmonary thromboembolism and an 8x8x7 cm common femoral vein aneurysm with thrombus were recognized.

  11. Comportamento anatômico da veia hepática esquerda de fetos de búfalos (Bubalus bubalis ? Linnaeus, 1758.

    Directory of Open Access Journals (Sweden)

    A. E. F. S. Almeida

    2005-03-01

    Full Text Available RESUMO: Foram estudados em 31 fígados de fetos de búfalos (Bubalus bubalis sem especificidade de raça, o comportamento da veia hepática esquerda e seus respectivos setores de drenagem, sendo o material injetado com látex corado em azul, fixado em formol a 20% e em seguida dissecado pela face visceral do fígado. Nessas peças foi observado que a veia hepática esquerda muito calibrosa e responsável por amplo território, drena os diferentes setores do lobo esquerdo e o setor supraportal do lobo caudado e, eventualmente também, parte do lobo quadrado, desembocando, em todos os casos, diretamente na veia cava caudal. PALAVRAS CHAVE: Anatomia de Búfalos; Fígado; Circulação Venosa SUMMARY: Here have been studied in 31 livers of buffalo fetuses (Bubalus bubalis, without specified breed, the behaviour of the left hepatic vein and respective draining sectors. This material was injected with coloured latex, fixed in 20% formaldehyde and dissected. It was observed that the left hepatic vein, greatly calibrous, responsible for a wide region, drains distinct sectors of left lobe, supraportalis sector of lobus caudatus and eventually it also drains part of lobus quadratus (41.93% and goes, in all cases, directly into vena cava caudalis. KEYWORDS: Anatomy of Buffalo; Liver; Circulation Venosa

  12. Primary hyperparathyroidism in a child. Use of jugular venous catheterization in diagnosis.

    Science.gov (United States)

    Gluckman, P D; Ferguson, R S; Osborne, D; Evans, M

    1977-06-01

    A 10-year-old boy with a parathyroid ademona is reported. Parathyroid hormone estimations of samples obtained by selective jugular venous catheterization were useful in diagnosis and for localizing the tumour before operation. PMID:879837

  13. Internal jugular vein access for the interventional management of nonfunctioning artero-venous haemodialysis fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Basile, A. E-mail: antodoc@yahoo.com; Garcia Medina, J.; Lupattelli, T.; Garcia Medina, V.; Leal, R

    2004-12-01

    We report our experience and results with the use of internal jugular vein as secondary approach for the endovascular treatment of twelve nonfunctioning artero-venous (AV) fistulas in haemodialysis patients.

  14. High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies

    International Nuclear Information System (INIS)

    In high-resolution computed tomographic (HRCT) images of dry skulls and patients, the anatomy of the jugular foramen and its neighboring structures was demonstrated to excellent advantage. Among those structures visualized were the cortical margins of the jugular compartments, which are important in evaluating tumor involvement, the anatomic relationship between the jugular fossa and hypotympanum, and the adjacent basal foramina. The inferior tympanic canaliculus, which transmits the inferior tympanic artery and nerve and houses one fifth of the glomus formation, thereby playing a role in arterial anomalies as well as glomus tumors, was occasionally recognizable. In addition, subtle bone findings associated with vascular anomalies in and around the jugular foramen, critically important in the differential diagnosis of glomus tumors, were visualized. Examples of these findings are presented

  15. Internal jugular phlebectasia as an incidental finding in cervical spine surgery

    Directory of Open Access Journals (Sweden)

    Thulasiraman V

    2010-01-01

    Full Text Available Idiopathic internal jugular phlebectasia, occurs either unilaterally or bilaterally affecting the internal jugular vein is a rare congenital variation often diagnosed during childhood. It usually presents with a benign swelling over the lateral side of neck on the affected side, seen on exertion. A-30-year old male was operated for anterior cervical dissectomy from right lateral approach and was diagnosed per-operatively as internal jugular phlebectasia.The surgery was abandoned at this stage on the advice of cardiothoracic surgeon to investigate the patient for the secondary etiological factors for internal jugular vein dilatation. The patient was reassured without any active intervention for the phlebectasia and cervical dissectomy was performed in the second surgery through the lateral approach from left side. This case is presented in view of rarity and suggested that during preoperative workup the nearby structures like carotid sheath should be evaluated by magnetic resonance imaging to avoid such per-operative surprises.

  16. Internal jugular vein access for the interventional management of nonfunctioning artero-venous haemodialysis fistulas

    International Nuclear Information System (INIS)

    We report our experience and results with the use of internal jugular vein as secondary approach for the endovascular treatment of twelve nonfunctioning artero-venous (AV) fistulas in haemodialysis patients

  17. Jugular versus subclavian totally implantable access ports: Catheter position, complications and intrainterventional pain perception

    International Nuclear Information System (INIS)

    Purpose: To determine the safest and most tolerable method for totally implantable access ports (TIAPs) particularly in regard to patient's pain perception and catheter-related complications. Materials and methods: From January 2007 to October 2008 a subcutaneous TIAP (Bardport, Bard Access System, UT, USA) was implanted in 138 oncological patients (60 male, 78 female; 18-85 years old; mean age of 56 ± 6 years) by experienced interventional radiologists. 94 TIAP were implanted through the subclavian vein (subclavian group) and 44 TIAP were implanted through the internal jugular vein (jugular group). Intrainterventional pain perception (visual analogue scale from 1 to 10), postinterventional catheter tip migration and radiation dose were documented for each method and implantation side and differences were compared with Wilcoxon t-test. For ordinal variables, comparison of two groups was performed with the Fisher's exact test. Results: No severe periinterventional complication occurred. Inadvertent arterial punctures without serious consequences were reported in one case for the jugular group versus four cases in the subclavian group. Significantly (p < 0.05) lower pain perception, radiation dose and tip migration rate were observed in the jugular group. Catheter occlusions occurred in 4% (n = 4) of the subclavian group versus 2% (n = 1) of the jugular group. The corresponding values for vein thrombosis and catheter dislocation were 3% (n = 3) and 1% (n = 1) in the su were 3% (n = 3) and 1% (n = 1) in the subclavian group, while none of those complications occurred in the jugular group. Conclusion: Both techniques, the TIAP implantation via fluoroscopy-guided subclavian vein puncture and via ultrasound-guided jugular vein puncture, are feasible and safe. Regarding intrainterventional pain perception, radiation dose, postinterventional catheter tip position and port function the jugular vein puncture under ultrasound guidance seems to be advantageous.

  18. Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement

    OpenAIRE

    Leila Aghaghazvini; Nahid Sedighi; Parisa Karami; Omid Yeganeh

    2012-01-01

    Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe e...

  19. A case of huge neurofibroma expanding extra- and intracranially through the enlarged jugular foramen

    International Nuclear Information System (INIS)

    The surgical approach to the jugular foramen has been considered to be very difficult and troublesome, because of the location in which important structures, such as the internal jugular vein, internal carotid artery and lower cranial nerves, converge in the narrow deep space. A case of huge neurofibroma, which extended from the tentorium cerebelli through the dilated jugular foramen to the level of the vertebral body of C3 was presented. A 12-year-old girl was admitted with complaints of visual disturbance and palsy of the V-XII cranial nerves of the left side. Plain skull film showed prominent widening of the cranial sutures and enlargement of the sella turcica. Horizontal CT scan with contrast showed symmetrical ventricular dilatation and a heterogeneously enhanced mass, which was situated mainly in the left CP angle. Coronal CT scan with contrast revealed a huge mass and enlarged jugular foramen, through which the tumor extended to the level of the vertebral body of C3. Occlusion of the sigmoid sinus and the internal jugular vein of the left side was noticed in the vertebral angiography. Two-stage approach, the first one for removal of the intracranial tumor and the second one for extracranial tumor, was performed for its huge tumor. Several authors have reported excellent surgical approaches for the tumors situated in the jugular foramen. By our approach, modifying Gardner's original one, a wide operative field was obtained to remove the tumative field was obtained to remove the tumor around the jugular foramen with success. Our approach for the jugular foramen was described with illustrations. (author)

  20. Study of the Jugular Foramen of the Human Skull in South Indian Region

    OpenAIRE

    Anitha.M.R.; Rekha G; Deepti Shasthri; Rajitha V; Panneer Selvi

    2013-01-01

    The Jugular Foramen is situated at the posterior end of the Petro-occipital fissure, which descendsantero-laterally to the exterior. Through this foramen the ninth, tenth and eleventh cranial nervespass and sigmoid sinus continues below with the internal jugular vein and the meningeal branches ofoccipital and ascending pharyngeal arteries enter through the foramen. The increasing use of moderndiagnostic procedures and new surgical approaches has created a need for much more detailedanatomical...

  1. Internal jugular vein vascular malformation presenting as mass at root of neck: a case report

    OpenAIRE

    Nair Deepa; Pai Prathamesh S; Chaturvedi Pankaj; Duggal Prahlad; Juvekar SL; Rekhi Bharat

    2009-01-01

    Abstract Background We report a case of vascular malformation arising from internal jugular vein presenting as mass at root of neck with no clinical stigmata which to the best of our knowledge is the first reported case of an intrinsic vascular malformation arising from the internal jugular vein. Magnetic resonance imaging features of this new entity have been described. Case presentation A 27 year male presented with a gradually enlarging, asymptomatic swelling on left supraclavicular region...

  2. Jugular versus subclavian totally implantable access ports: Catheter position, complications and intrainterventional pain perception

    Energy Technology Data Exchange (ETDEWEB)

    Plumhans, Cedric, E-mail: plumhans@rad.rwth-aachen.de [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany); Mahnken, Andreas H. [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany); Applied Medical Engineering, Helmholtz Institute, RWTH-Aachen University (Germany); Ocklenburg, Christina [Institute of Medical Statistics, University Hospital, RWTH-Aachen University (Germany); Keil, Sebastian; Behrendt, Florian F.; Guenther, Rolf W.; Schoth, Felix [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany)

    2011-09-15

    Purpose: To determine the safest and most tolerable method for totally implantable access ports (TIAPs) particularly in regard to patient's pain perception and catheter-related complications. Materials and methods: From January 2007 to October 2008 a subcutaneous TIAP (Bardport, Bard Access System, UT, USA) was implanted in 138 oncological patients (60 male, 78 female; 18-85 years old; mean age of 56 {+-} 6 years) by experienced interventional radiologists. 94 TIAP were implanted through the subclavian vein (subclavian group) and 44 TIAP were implanted through the internal jugular vein (jugular group). Intrainterventional pain perception (visual analogue scale from 1 to 10), postinterventional catheter tip migration and radiation dose were documented for each method and implantation side and differences were compared with Wilcoxon t-test. For ordinal variables, comparison of two groups was performed with the Fisher's exact test. Results: No severe periinterventional complication occurred. Inadvertent arterial punctures without serious consequences were reported in one case for the jugular group versus four cases in the subclavian group. Significantly (p < 0.05) lower pain perception, radiation dose and tip migration rate were observed in the jugular group. Catheter occlusions occurred in 4% (n = 4) of the subclavian group versus 2% (n = 1) of the jugular group. The corresponding values for vein thrombosis and catheter dislocation were 3% (n = 3) and 1% (n = 1) in the subclavian group, while none of those complications occurred in the jugular group. Conclusion: Both techniques, the TIAP implantation via fluoroscopy-guided subclavian vein puncture and via ultrasound-guided jugular vein puncture, are feasible and safe. Regarding intrainterventional pain perception, radiation dose, postinterventional catheter tip position and port function the jugular vein puncture under ultrasound guidance seems to be advantageous.

  3. Functional Deficits of Cranial Nerves in Patients with Jugular Foramen Lesions

    OpenAIRE

    Raquet, F.; Mann, W; Amedee, R.; Maruer, J.; Gilsbach, J

    1991-01-01

    Lower cranial neuropathies are a leading presenting symptom in patients with tumors involving the jugular foramen. The purpose of this study is to assess acute and chronic functional deficits along with neurologic findings in 31 patients who underwent resection of a tumor involving the jugular foramen. Preoperative nerve dysfunction made intraoperative preservation unlikely, while postoperative lower cranial nerve dysfunction was found to be transient in many patients. Compensation of permane...

  4. Incidental Detection of Internal Jugular Vein Thrombosis Secondary to Undiagnosed Benign Substernal Goiter

    OpenAIRE

    Knut Sverre Andersen; Jan Erik Varhaug; Mai Tone Lønnebakken; Ole Martin Pedersen

    2010-01-01

    Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right ...

  5. A Case of Jugular Bulb Diverticulum Invading the Internal Auditory Canal

    OpenAIRE

    Park, Jae Hong; Son, Seung Beom; Hong, Hyun Pyo; Lee, Hyun-Seok

    2012-01-01

    Jugular bulb diverticulum (JBD) is a rarely reported vascular anomaly, which is an extraluminal outpouching from the jugular bulb. Especially, there exists a lack of reported cases involving JBD encroaching the internal auditory canal (IAC) in Korea. Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size. In this article, we report a unique case of JBD eroding into the IAC that was presented as sudden sensorineural hearing loss with vertigo.

  6. Sonographic findings of the internal jugular vein valve in normal children

    International Nuclear Information System (INIS)

    To describe the sonographic findings of the valve in the internal jugular vein in normal children. Seventy children (5-15 years, average age 10.8 years, 36 boys and 34 girls) were recruited for the study. The number of cusps, length and insertion sites of the valve in the internal jugular vein was examined. Sex differences were investigated, in addition to the symmetry of the valves found in both of the veins. In all children, valve was found in either one or both internal jugular veins. Sixteen percents of the children had valve on one side only, while eighty four percents showed on both sides. All the one side were found on the right side only. Nine percents of the valves in the internal jugular veins of the children were bicuspid and ninety one percents were unicuspid. The length of the cusps was on the average, 7.59 ± 2.77 mm. The insertion of the cusps was on the average, 6.75 ± 2.59 mm (range: 0-12.0 mm), proximal to the confluence of the subclavian and internal jugular veins to form the brachiocephalic vein. There was no significant statistical difference of the number of cusps, length and insertion sites of the valves on both sides and sex distinction. A valve in internal jugular vein is identified in all cases on ultrasonography. There was no significant statistical difference of the number of cusps, length and insertion sites of the valves on both sides and sex distinction.

  7. Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas / Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

    Scientific Electronic Library Online (English)

    Herbert Coelho, Hortmann; Homero Geraldo de, Oliveira; Renato Rocha, Rabello; Eduardo Augusto Victor, Rocha; Sérgio Caporali de, Oliveira.

    2010-06-01

    Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM). MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre [...] os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI), artéria radial (AR) e veia safena (VS), e foram estratificados segundo a gravidade das lesões: sem lesão grave ( Abstract in english OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG). METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospit [...] al in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV), and they were stratified according to the severity of injury: uninjured or patent (

  8. Two Rare Anatomical Variations of External Jugular Vein: an Embryological Overview Dos Raras Variaciones Anatómicas de la Vena Yugular Externa: una Visión Embriológica

    Directory of Open Access Journals (Sweden)

    Susmita Ghosh

    2012-09-01

    Full Text Available Human anatomy is an ocean of unending variations and its mysteries are being unravelled since ages. Knowledge of variations in the superficial veins of head and neck is essential to carry out successful surgical procedures. During routine dissection of head and neck of two middle aged male cadavers, in the Department of Anatomy, Calcutta National Medical College, Kolkata, India, we came out with some interesting venous architecture. The retromandibular vein on the left side of both the cadavers was found to be undivided and joined with the facial vein in the neck at an acute angle to form a common venous trunk at variable distances from the angle of the mandible. That trunk ultimately drained into the left subclavian vein. This might be the result of disappearance of the cephalic part of the external jugular vein and formation of an additional communication between common facial vein and the external jugular vein in foetal life. In one case, we also came across an extra transverse communication between that common trunk and the internal jugular vein. A detail of those cases with embryological explanation is attempted.La anatomía humana tiene un sin fin de variaciones y sus misterios se han develado desde el inicio de los tiempos. El conocimiento de las variaciones anatómicas de las venas superficiales de la cabeza y del cuello es fundamental para llevar a cabo con éxito los procedimientos quirúrgicos. Durante una disección de rutina de cabeza y cuello encontramos una arquitectura venosa interesante en dos cadáveres de hombres de mediana edad en el Departamento de Anatomía de la Facultad de Medicina Nacional Calcuta, Calcuta, India. En el lado izquierdo del cuello de ambos cadáveres, la vena retromandibular no se encontraba dividida, y se unía a la vena facial en un ángulo agudo, para formar un tronco venoso común a una distancia variable desde el ángulo de la mandíbula. Ese tronco finalmente drenaba en la vena subclavia izquierda. Esto podría ser el resultado de la desaparición de la parte cefálica de la vena yugular externa y la formación de una comunicación adicional entre la vena facial común y la vena yugular externa en la vida fetal. En un caso, también se encontró con una comunicación adicional transversal entre ese tronco común y la vena yugular interna. Se realiza una descripción en detalle de los casos junto a una explicación embriológica.

  9. Two Rare Anatomical Variations of External Jugular Vein: an Embryological Overview / Dos Raras Variaciones Anatómicas de la Vena Yugular Externa: una Visión Embriológica

    Scientific Electronic Library Online (English)

    Susmita, Ghosh; Lopamudra, Mandal; Sanchita, Roy; Manimay, Bandyopadhyay.

    2012-09-01

    Full Text Available La anatomía humana tiene un sin fin de variaciones y sus misterios se han develado desde el inicio de los tiempos. El conocimiento de las variaciones anatómicas de las venas superficiales de la cabeza y del cuello es fundamental para llevar a cabo con éxito los procedimientos quirúrgicos. Durante un [...] a disección de rutina de cabeza y cuello encontramos una arquitectura venosa interesante en dos cadáveres de hombres de mediana edad en el Departamento de Anatomía de la Facultad de Medicina Nacional Calcuta, Calcuta, India. En el lado izquierdo del cuello de ambos cadáveres, la vena retromandibular no se encontraba dividida, y se unía a la vena facial en un ángulo agudo, para formar un tronco venoso común a una distancia variable desde el ángulo de la mandíbula. Ese tronco finalmente drenaba en la vena subclavia izquierda. Esto podría ser el resultado de la desaparición de la parte cefálica de la vena yugular externa y la formación de una comunicación adicional entre la vena facial común y la vena yugular externa en la vida fetal. En un caso, también se encontró con una comunicación adicional transversal entre ese tronco común y la vena yugular interna. Se realiza una descripción en detalle de los casos junto a una explicación embriológica. Abstract in english Human anatomy is an ocean of unending variations and its mysteries are being unravelled since ages. Knowledge of variations in the superficial veins of head and neck is essential to carry out successful surgical procedures. During routine dissection of head and neck of two middle aged male cadavers, [...] in the Department of Anatomy, Calcutta National Medical College, Kolkata, India, we came out with some interesting venous architecture. The retromandibular vein on the left side of both the cadavers was found to be undivided and joined with the facial vein in the neck at an acute angle to form a common venous trunk at variable distances from the angle of the mandible. That trunk ultimately drained into the left subclavian vein. This might be the result of disappearance of the cephalic part of the external jugular vein and formation of an additional communication between common facial vein and the external jugular vein in foetal life. In one case, we also came across an extra transverse communication between that common trunk and the internal jugular vein. A detail of those cases with embryological explanation is attempted.

  10. An Unusual Anatomic Variation of the Jugular Foramen with Doubled Posterior Condylar Canal / Una Variación Anatómica Inusual del Foramen Yugular con Canal Condilar Posterior Duplicado

    Scientific Electronic Library Online (English)

    Samet, Kapakin.

    2011-12-01

    Full Text Available Es reportado el caso de una inusual variación anatómica del foramen yugular (FY), con el canal condilar posterior duplicado (CCP). De acuerdo con la presencia de los puentes, el FY se puede definir como Tipo I (una tabicación, dos compartimientos) en el lado derecho y Tipo IV (tres tabiques, cuatro [...] compartimientos) en el lado izquierdo. El domo de la fosa yugular está presente en el lado derecho, y ausente en el izquierdo. El foramen yugular mostró una estructura igual a un canal con una apertura externa y otra interna. Las longitudes de los ejes más largos y anchos de la FY fueron 21,93x16,56mm al lado derecho y 16,75x15,14mm al lado izquierdo. El FY derecho fue más grande. El CCP se observó duplicado en el lado derecho y único en el lado izquierdo. Es esencial no sólo conocer los compartimientos en sí, sino también las estructuras que pasan a través de los compartimientos con el fin de lograr los resultados deseados y evitar las complicaciones quirúrgicas. Abstract in english A case of unusual anatomical variation of the jugular foramen (JF) with doubled posterior condylar canal (PCC) is reported. According to the presence of bridging, the JF can be defined as Type I (one septation, two compartments) on the right side and Type IV (three septations, four compartments) on [...] the left side. The dome of the jugular fossa is present on the right, absent on the left. The jugular foramen shows a canal-like structure with an external and an internal opening. The lengths of the longest and widest axes of the JFs are measured as 21.93 x 16.56 mm on the right and 16.75 x 15.14 mm on the left side. The right JF is larger. The PCC is doubled on the right side and there is only one on the left side. It is essential not only to know compartments per se but also to know the structures passing through the compartments, in order to achieve desired surgical outcomes and avoid complications.

  11. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe

    DEFF Research Database (Denmark)

    BrØndum, E.; Hasenkam, John Michael

    2009-01-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow remained unchanged. Cardiac output was reduced by 30%, CVP decreased to -1 +/- 2 mmHg (P < 0.01), and jugular flow ceased as the jugular cross-sectional area increased to 3.2 +/- 0.6 cm(2) (P < 0.01), corresponding to accumulation of approximately 1.2 l of blood in the veins. When the head was raised, the jugular veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head is lowered, blood accumulates in the vein, affecting MAP

  12. Veias do sistema porta-hepático em gansos domésticos Veins from hepatic portal vein system in domestic geese

    Directory of Open Access Journals (Sweden)

    Tatiana C. Santos

    2009-04-01

    Full Text Available A distribuição intraparenquimal das veias porta-hepáticas foi estudada em 30 gansos domésticos. Latex Neoprene corado foi injetado pela veia isquiática e os animais forma fixados por imersão e injeção intramuscular com formol a 10% e dissecados. O fígado esteve composto por um grande lobo hepático direito e por um lobo hepático esquerdo menor, os quais estiveram conectados por uma ponte de parênquima. O lobo direito do fígado teve exclusivamente vasos do sistema porta-hepático formados pela distribuição intraparenquimal da veia porta-hepática direita, enquanto que no lobo esquerdo estes originaram-se da veia porta-hepática direita e de pequenas veias porta-hepáticas esquerdas. A veia porta-hepática direita emitiu o ramo caudal direito, que emitiu um pequeno ramo caudolateral direito e um grande ramo caudomedial direito. Cranialmente esta veia emitiu os ramos craniais direito e ramos lateral direito. A porção transversa da veia porta-hepática direita cruzou para o lobo hepático esquerdo, emitindo de 1 a 6 pequenos ramos craniais e caudais para a região média do fígado. No lobo esquerdo, o ramo esquerdo da veia porta-hepática direita emitiu o ramo cranial esquerdo, o ramo lateral esquerdo e o ramo medial. De 1 a 6 veias porta-hepáticas esquerdas foram identificadas desembocando ou no ramo esquerdo da veia porta-hepática direita ou em sua porção transversa, oriundos do ventrículo gástrico e do pró-ventrículo. Em 40% dos gansos uma veia porta-hepática própria oriunda da confluência de vasos venosos da face esquerda do ventrículo distribuiu-se na extremidade caudal do lobo esquerdo isoladamente.The intraparenchymal distribution of the hepatic portal veins in 30 domestic geese were studied. Stained Neoprene latex was injected into the isquiatic vessels, and the animals were fixed in 10% formaldehyde by immersion and intramuscular injection. The liver of geese was composed of a large right and a smaller left hepatic lobe, connected by a parenchyma bridge. The right hepatic lobe had vessels exclusively from the hepatic portal system composed by intraparenchymal distribution of the right hepatic portal vein, while the vessels of the left hepatic lobe came from the right hepatic portal vein and from small left hepatic portal veins. The right hepatic portal vein emitted the right caudal branch, which emitted a small right caudolateral branch and a large right caudomedial branch. Cranially this vein emitted right cranial and right lateral branches. The tranverse portion of the right hepatic portal vein crossed to the left hepatic lobe, emitting 1 to 6 small cranial and caudal branches to the medial area of the liver. In the left hepatic lobe, the left branch from the right hepatic vein emitted the left cranial, left lateral and left median branches. One to six left hepatic portal veins were identified arising from the left branch or from the transverse portion of the right hepatic portal vein. These vessels arose from the gizzard and pro-ventricle. In 40% of geese one proper hepatic portal vein originated from venous vessels of the gizzard and was distributed into the caudal extremity of the left hepatic isolated lobe.

  13. Veias do sistema porta-hepático em gansos domésticos / Veins from hepatic portal vein system in domestic geese

    Scientific Electronic Library Online (English)

    Tatiana C., Santos; Carla C.F., Borba; Anita, Menconi; Marina O., Maia; Pedro P., Bombonatto; Cheston C.H., Pereira.

    2009-04-01

    Full Text Available A distribuição intraparenquimal das veias porta-hepáticas foi estudada em 30 gansos domésticos. Latex Neoprene corado foi injetado pela veia isquiática e os animais forma fixados por imersão e injeção intramuscular com formol a 10% e dissecados. O fígado esteve composto por um grande lobo hepático d [...] ireito e por um lobo hepático esquerdo menor, os quais estiveram conectados por uma ponte de parênquima. O lobo direito do fígado teve exclusivamente vasos do sistema porta-hepático formados pela distribuição intraparenquimal da veia porta-hepática direita, enquanto que no lobo esquerdo estes originaram-se da veia porta-hepática direita e de pequenas veias porta-hepáticas esquerdas. A veia porta-hepática direita emitiu o ramo caudal direito, que emitiu um pequeno ramo caudolateral direito e um grande ramo caudomedial direito. Cranialmente esta veia emitiu os ramos craniais direito e ramos lateral direito. A porção transversa da veia porta-hepática direita cruzou para o lobo hepático esquerdo, emitindo de 1 a 6 pequenos ramos craniais e caudais para a região média do fígado. No lobo esquerdo, o ramo esquerdo da veia porta-hepática direita emitiu o ramo cranial esquerdo, o ramo lateral esquerdo e o ramo medial. De 1 a 6 veias porta-hepáticas esquerdas foram identificadas desembocando ou no ramo esquerdo da veia porta-hepática direita ou em sua porção transversa, oriundos do ventrículo gástrico e do pró-ventrículo. Em 40% dos gansos uma veia porta-hepática própria oriunda da confluência de vasos venosos da face esquerda do ventrículo distribuiu-se na extremidade caudal do lobo esquerdo isoladamente. Abstract in english The intraparenchymal distribution of the hepatic portal veins in 30 domestic geese were studied. Stained Neoprene latex was injected into the isquiatic vessels, and the animals were fixed in 10% formaldehyde by immersion and intramuscular injection. The liver of geese was composed of a large right a [...] nd a smaller left hepatic lobe, connected by a parenchyma bridge. The right hepatic lobe had vessels exclusively from the hepatic portal system composed by intraparenchymal distribution of the right hepatic portal vein, while the vessels of the left hepatic lobe came from the right hepatic portal vein and from small left hepatic portal veins. The right hepatic portal vein emitted the right caudal branch, which emitted a small right caudolateral branch and a large right caudomedial branch. Cranially this vein emitted right cranial and right lateral branches. The tranverse portion of the right hepatic portal vein crossed to the left hepatic lobe, emitting 1 to 6 small cranial and caudal branches to the medial area of the liver. In the left hepatic lobe, the left branch from the right hepatic vein emitted the left cranial, left lateral and left median branches. One to six left hepatic portal veins were identified arising from the left branch or from the transverse portion of the right hepatic portal vein. These vessels arose from the gizzard and pro-ventricle. In 40% of geese one proper hepatic portal vein originated from venous vessels of the gizzard and was distributed into the caudal extremity of the left hepatic isolated lobe.

  14. Trombose de veia porta no transplante hepático / Portal vein thrombosis in liver transplantation

    Scientific Electronic Library Online (English)

    Rafael Antonio Arruda, Pécora; Bernardo Fernandes, Canedo; Wellington, Andraus; Rodrigo Bronze de, Martino; Vinicius Rocha, Santos; Rubens Macedo, Arantes; Vincenzo, Pugliese; Luiz Augusto Carneiro, D´Albuquerque.

    2012-12-01

    Full Text Available INTRODUÇÃO: A trombose de veia porta foi considerada contraindicação ao transplante de fígado no passado em razão da elevada morbi-mortalidade. Diversos avanços permitiram melhora dos resultados. OBJETIVO: Revisão dos avanços e das estratégias cirúrgicas utilizadas para realização do transplante de [...] fígado na vigência de trombose de veia porta. MÉTODO: Revisão da literatura nas bases de dados Medline, Scielo, Lilacs cruzando os descritores: portal vein thrombosis, liver transplantation, vascular complications, jump graft, graft failure, multivisceral transplant. Foram estudados a epidemiologia, fatores de risco, classificação, diagnóstico, estratégias cirúrgicas e resultados. CONCLUSÃO: A trombose de veia porta deixou de ser contraindicação para o transplante hepático. O cirurgião dispõe atualmente de uma série de estratégias para realização do transplante, variando conforme o grau da trombose. Apesar de implicar em maior morbidade e taxas de re-trombose, os resultados do transplante na presença de trombose portal são semelhantes aos observados nas séries habituais. Abstract in english BACKGROUND: Portal vein thrombosis was considered a contraindication for liver transplantation in the past because of the high morbidity and mortality rates. Many advances made the results better. AIM: Review the advances and surgical strategies for liver transplantation in presence of portal vein t [...] hrombosis. METHOD: Survey of publications in Medline, Scielo and Lilacs databases. Headings crossed: portal vein thrombosis, liver transplantation, vascular complications, jump graft, graft failure, multivisceral transplant. Data analyzed were epidemiology, risk factors, classification, diagnosis, surgical strategies and outcomes. CONCLUSION: Portal vein thrombosis is not a contraindication for liver transplantation anymore. There are many strategies to perform the liver transplantation in this condition, depending on portal vein thrombosis grade. Regardless higher morbidity and re-trhombosis rates, the outcomes of liver transplantation in portal vein thrombosis are similar to series without portal vein thrombosis.

  15. Ausência de veia cava inferior: relato de caso / Absence of the inferior vena cava: case report

    Scientific Electronic Library Online (English)

    Elton Correia, Alves; Gabriela Bóia Rocha, Ferro; Luciana Karla Lira, França; Mabel Batista, Jacó; Guilherme Benjamin Brandão, Pitta.

    2010-12-01

    Full Text Available A ausência congênita de veia cava inferior é achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razão de a maioria dos pacientes sem outras malformações serem assintomáticos, há dificuldade em estimar a prevalência dessas anomalias. O objetivo deste trabalho foi rela [...] tar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de tórax devido a quadro de febre alta (39ºC) não-responsiva à medicação. Radiografia de tórax sugeriu dilatação de veia ázigos. Em inquérito dirigido para sintomas cardiovasculares, referiu dor torácica (durante atividade física e em repouso) e dispneia ocasionais durante o sono associada ao período em que intensificou a prática de exercícios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas não esclareceram o caso, fazendo-se necessário angiotomografia, a qual evidenciou ausência de veia cava inferior torácica. Abstract in english The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-y [...] ear-old patient, male, referred to thorax X-ray due to high fever state (39ºC), nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  16. Relações cranioencefálicas das veias de Trolard e de Labbé: aplicações neurocirúrgicas Cranioencephalic relationships between Trolard and Labbé veins: neurosurgical applications

    Directory of Open Access Journals (Sweden)

    Sebastião Gusmão

    2001-03-01

    Full Text Available Realizamos estudo anatômico das veias anastomóticas de Trolard e de Labbé em sete segmentos cefálicos com o objetivo de precisar o trajeto e as referências que facilitem a preservação destes vasos durante o procedimento cirúrgico. Estudamos também as relações da veia de Trolard com a área motora.We accomplished an anatomic study of the anastomotic veins of Trolard and Labbé in seven human cephalic segments with the objective to accurate its stretch and references to facilitate its preservation during surgical procedure. The relationship between the Trolard vein and motor cortex was also studied.

  17. The topographic relations of the high jugular fossa to the inner ear

    International Nuclear Information System (INIS)

    The radioanatomy of high jugular fossae and their topographic relations to the inner ear structures were investigated in 245 unselected temporal bones. One hundred and fifty specimens were submitted to multidirectional and 10 to computed tomography. After careful chemical and fermentative maceration plastic casts were made, using polyester resin and silicone rubber. With the use of vacuum, even minute structures became filled with the casting material. The specimens offered a three-dimensional view of the jugular fossae and surrounding structures. Fifty-eight (24%) of the total 245 specimens had high jugular fossae at a level above the lower border of the round window. Five casts showed a dehiscence of the peripheral portion of the vestibular aqueduct caused by the high jugular fossa. In 2 casts the proximal portion of the cochlear aqueduct was affected. In some casts the posterior semicircular canal, the facial canal, the stapedial muscle and the round window lay so close to the fossa that a dehiscence could not be excluded. In a clinical material of 102 high fossae the radiographic findings were in accordance with the experimental results. High jugular fossae were predominantly found in pyramids with low-grade mastoid bone pneumatization and sparse or no perilabyrinthine air cells. (orig.)

  18. Valsalva and gravitational variability of the internal jugular vein and common femoral vein: Ultrasound assessment

    Energy Technology Data Exchange (ETDEWEB)

    Beddy, P. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: pbeddy@eircom.net; Geoghegan, T. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ramesh, N. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Buckley, O. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); O' Brien, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colville, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)

    2006-05-15

    Purpose: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. Methods: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. Results: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. Conclusions: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject.

  19. Valsalva and gravitational variability of the internal jugular vein and common femoral vein: Ultrasound assessment

    International Nuclear Information System (INIS)

    Purpose: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. Methods: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. Results: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. Conclusions: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject

  20. Distribution of saphenous vein valves and its pratical importance / Distribuição das válvulas da veia safena magna e sua importância prática

    Scientific Electronic Library Online (English)

    Isabella Batista Martins, Portugal; Igor de Lima, Ribeiro; Célio Fernando de, Sousa-Rodrigues; Rodrigo Freitas, Monte-Bispo; Amauri Clemente da, Rocha.

    2014-12-01

    Full Text Available Objetivo: Dentre as veias empregadas para revascularizações do miocárdio e de extremidades, a veia safena magna é a mais utilizada. Conhecer a presença e localização de válvulas é de grande importância quando se avalia a anatomia cirúrgica da veia safena magna. Apesar de grande aplicação cirúrgica [...] e de muitos trabalhos envolvendo a veia safena magna, o número de válvulas presente nela desde o hiato safeno até o epicôndilo medial do fêmur ainda é descrito de forma imprecisa. O objetivo do presente trabalho é quantificar as válvulas da veia safena magna desde o hiato safeno até o epicôndilo medial do fêmur para determinar a melhor porção da veia safena magna para a realização de cirurgias de revascularização. Métodos: Este é um estudo transversal e observacional em que foram analisadas veias safena magna extraídas de 30 cadáveres. Foram realizadas as medidas das variáveis do comprimento das veias; (diâmetro) em suas porções proximal, média e distal; quantificação do número de válvulas nestas e número de válvulas total na veia safena magna. Resultados: A frequência de válvulas da veia safena contadas desde o epicôndilo medial do fêmur até o hiato safeno foi de 4,82, podendo variar entre 2 e 9. Além disso, houve diferença significante do número de válvulas da porção proximal em relação à média e distal. Conclusão: As porções média e distal da veia safena magna na coxa são as melhores opções para a realização de pontes em decorrência do fato destas porções terem menor quantidade de válvulas o que, portanto, tenderia a diminuir o risco de complicações relacionadas as válvulas nestes enxertos. Abstract in english Objective: Among the veins used as a graft in myocardial revascularizations and ends, great saphenous vein is the most used. Knowing the presence and location of valves has great importance when evaluating the surgical anatomy of the great saphenous vein. Despite major surgical application and many [...] works involving great saphenous vein, the number of valves present in it from the saphenous hiatus to the medial epicondyle of the femur is still described inaccurately. The objective of this study is to quantify the valves of the great saphenous vein from the saphenous hiatus to the medial epicondyle of the femur to determine the best portion of the great saphenous vein to perform revascularization surgeries. Methods: This is a crosssectional observational study in which it was analyzed great saphenous vein extracted from 30 cadavers. It was measured the length of the veins; (diameter) at its proximal, middle and distal, quantifying the number of valves in each one and the total number of valves at the great saphenous vein. Results: The frequency of valves in the great saphenous vein taken from the medial epicondyle of the femur to the saphenous hiatus was 4.82, ranging between 2 and 9. Moreover, there is a significant difference in the number of valves in the proximal and distal relative to the average. Conclusion: the median and distal portions of the saphenous vein in the thigh, are the best options for the realization of bridges due to the fact that these portions have fewer valves which therefore would tend to decrease the risk of complications connected with the valves in these grafts.

  1. Agenesia da veia cava inferior / Agenesis of the inferior vena cava

    Scientific Electronic Library Online (English)

    Caroline Saltz, Gensas; Leonardo Martins, Pires; Marcelo Lapa, Kruse; Tiago Luiz Luz, Leiria; Daniel Garcia, Gomes; Gustavo Glotz de, Lima.

    2012-12-01

    Full Text Available Agenesia da veia cava inferior é uma malformação rara. Sua causa mais comum é a disgenesia durante a embriogênese, mas também pode estar relacionada a trombose intrauterina ou perinatal. Normalmente é assintomática, em associação, ou não, com outras malformações congênitas, e pode cursar com maior r [...] isco de insuficiência venosa crônica e trombose venosa profunda, especialmente em jovens. Seu diagnóstico frequentemente é acidental, durante cirurgias abdominais ou procedimentos radiológicos. Relatamos cinco casos de agenesia da veia cava inferior detectada durante procedimentos eletrofisiológicos. Abstract in english Agenesis of the inferior vena cava is a rare malformation. Its most common cause is dysgenesis during embryogenesis, but it may also be related to intrauterine or perinatal thrombosis. It is usually asymptomatic, associated or not with other congenital malformations and may be related to increased r [...] isk of chronic venous insufficiency and deep vein thrombosis, especially in young individuals. Diagnosis is often incidental, during abdominal surgery or radiological procedures. We reported five cases of agenesis of the inferior vena cava detected during electrophysiological procedures.

  2. Síndrome da veia cava superior: caso clínico / Superior vena cava syndrome: Case report

    Scientific Electronic Library Online (English)

    Sandrina Figueiredo, Braga; Daniel, Brandão; Pedro Pinto, Sousa; Jacinta, Campos; Alexandra, Canedo; Pedro, Brandão; João Carlos, Mota; Luís, Vouga.

    2014-03-01

    Full Text Available A Síndrome da Veia Cava Superior (SVCS) surge quando há diminuição ou obstrução do ?uxo de sangue através da veia cava superior (VCS) e pode cursar com muito debilitantes. Embora classicamente associada a etiologias malignas, o aumento do número de procedimentos endovenosos (cateteres venosos centra [...] is, pacemakers, cardio-desfibriladores) fez aumentar a percentagem de casos de etiologia benigna, que manifestações clínicas actualmente correspondem a 40%. O tratamento endovascular tem ganho crescente popularidade, mas nem sempre é exequível ou conduz a melhoria clínica a longo prazo, pelo que por vezes o tratamento cirúrgico é necessário. Os autores descrevem o caso clínico de um doente com SVCS, relacionado com colacação prévia de pacemaker. Após tentativa infrutífera de tratamento endovascular, o doente foi submetido a reconstrução cirúrgica, com resolução da sintomatologia. Abstract in english Superior Vena Cava Syndrome (SVCS) occurs when there is a reduction or blockage of blood ?ow through the superior vena cava (SVC) and may be associated with debilitating clinical manifestations. Although classically associated with malignant etiologies, increasing number of intravenous procedures (c [...] entral venous catheters, pacemakers) have raised the percentage of cases of benign etiology, which currently account for 40%. Endovascular management of SVCS has gained increasing popularity, although it is not always feasible or leads to long-term clinical improvement, so sometimes surgical treatment is necessary. The authors present a patient with superior vena cava syndrome due to pacemaker leads. After unsuccessful attempt of endovascular treatment, the patient underwent surgical reconstruction with resolution of symptoms.

  3. Clinical application study on thrombectomy of iliac-femoral venous thrombosis via trans-jugular approach

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficiency of thrombectomy of iliac-femoral venous thrombosis (I-FVT) via trans-jugular approach. Methods: Seven patients with I-FVT were treated with implantation of inferior vena caval filter, balloon-directed drag, and catheter-directed suction. Some patients were treated with PTA and stent. Meanwhile, strict anti-coagulation was necessary. Results: Thrombectomy via trans-jugular was successful in all 7 patients. The iliac- femoral veins were patent after the operation and swollen symptom of lower limb disappeared. There was swollen of the lower limb in 1 patient after treatment. Symptom disappeared after PTA or stent treatment again. There were no serious complications. Follow-up study showed no pulmonary embolization or recrudescence in all 7 patients. Conclusion: Thrombectomy via trans-jugular approach is a safe and effective method for the treatment of I-FVT

  4. Internal jugular vein cannulation: an ultrasound-guided technique versus a landmark-guided technique

    Scientific Electronic Library Online (English)

    Gurkan, Turker; Fatma Nur, Kaya; Alp, Gurbet; Hale, Aksu; Cuneyt, Erdogan; Ahmet, Atlas.

    Full Text Available OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular ve [...] in cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p

  5. Depresión: Visión holística de la medicina interna*

    Scientific Electronic Library Online (English)

    Italo, Marsiglia G.

    2008-03-01

    Full Text Available La depresión, y la ansiedad acompañante, es la manifestación psicológica más frecuente e intensa del sufrimiento humano, que en casos extremos termina en el suicidio. A pesar de que puede restringir significativamente la calidad de vida del individuo, su interacción personal o social y productividad [...] , sorprende que a nivel de la atención médica primaria no sea reconocida en la mitad de los casos y sea tratada en sólo la mitad de los diagnosticados. Sin embargo, es responsabilidad del médico internista estar preparado para reconocer la depresión y tratarla eficientemente, por las siguientes razones: 1. La medicina interna propone como concepción fundamental la visión integral del paciente; 2. El funcionamiento de la mente normal y patológica se fundamenta en principios biológicos; 3. La ansiedad y la depresión son las manifestaciones emocionales más frecuentes en la práctica médica, presentándose como desórdenes primarios o como condiciones asociadas a otros desórdenes psiquiátricos y enfermedades médicas (incluyendo a sus tratamientos), o que resultan del impacto emocional de las enfermedades médicas y quirúrgicas. La referencia al psiquiatra debe hacerse en: depresión severa, respuesta terapéutica insatisfactoria, evidencia de psicosis o ideación suicida. En la depresión la herramienta básica es una relación médico-paciente sólida, que garantice la integridad y la libertad del paciente y preserve el secreto profesional, que adquiere especial relevancia al abordar los sentimientos, las emociones y la conducta humana. Aunque útiles, las pruebas y escalas de la depresión no sustituyen a la entrevista personal con el paciente, que permite apreciar el ánimo depresivo y la anhedonia, resultantes de la desolación y el estado de indefensión que abruma al paciente. En la manía, extremo opuesto del espectro del ánimo, la agitación, el lenguaje expansivo y grandilocuente y la irritabilidad, pueden acompañar a la irracionalidad psicótica. Las anormalidades de los neurotransmisores norepinefrina y serotonina juegan un rol mayor en los desórdenes del ánimo, siendo sus niveles y efectos, poco activos en la depresión e hiperactivos en la manía. Los pacientes con depresión mayor y buena parte de los pacientes con depresión menor crónica, ameritan tratamiento con antidepresivos y psicoterapia. La terapia electroconvulsiva puede tener indicación en la depresión refractaria, en la ideación suicida aguda y en las psicosis concurrentes sin respuesta a los antipsicóticos. En la manía, los estabilizadores del ánimo, litio, carbamazepina y valproato, son utilizados solos o en combinación con antidepresivos para prevenir las recurrencias. La manía aguda puede requerir tratamiento con neurolépticos. Abstract in english Depression, and adjoined anxiety, is the most frequent and intense psychological manifestation of human suffering, which in extreme cases could lead to suicide. Even though it could affect significantly the quality of life, interpersonal and social interactions and individual productivity, it astoni [...] shes that at primary care, only half of the cases are diagnosed, and only half of those diagnosed are actually treated. However, it is the responsibility of the Internist to recognize depression and treat it efficiently for the following reasons: 1. Internal medicine proposes the integral view of the patient as its fundamental conception; 2. Functioning of mind, both normal and pathological, is established in biological principles; 3. In medical practice, anxiety and depression are the most frequent emo- tional manifestations, either as primary disorders or as associated conditions to others psychiatric and medical diseases (including their treatments), or by the emotional impact of medical and surgical disorders. Psychiatric referral should be made in severe depression, unsatisfactory therapeutic response and evidence of psychosis or suicidal ideation. In managing depression, a solid medical-patient relationship is fundamental to guarantee patie

  6. Contrast media reflux into the jugular vein with peripheral bolus injection

    International Nuclear Information System (INIS)

    The use of peripheral veins for injection of contrast media in digital subtraction angiography (= dsa) invariably produces a reflux of the contrast media into the jugular vein. Three different types of reflux can be distinguished. Only type II and III affect the diagnostic value of dsa of the cervicocerebral arteries. Since the arteries of interest are seldom definitely obscured by the reflux there is no need to use central venous lines. The reflux can be suppressed by manual compression of the jugular vein. (orig.)

  7. No increase of calcitonin gene-related peptide in jugular blood during migraine

    DEFF Research Database (Denmark)

    Tvedskov, Jesper; Lipka, Kerstin

    2005-01-01

    Increased calcitonin gene-related peptide (CGRP) in external jugular venous blood during migraine attack is one of the most cited findings in the headache literature. The finding has not been convincingly reproduced and is based on comparison with historic control subjects. The validity of this finding is important for the understanding of migraine. We therefore investigated the issue using an intrapatient comparison design and two different CGRP assays. We sampled blood from the external jugular and cubital vein during, as well as outside of, an attack of migraine without aura. We succeeded in 17 patients, whereas only cubital fossa blood could be sampled in an additional 4 patients. CGRP was measured with the same assay as most previous studies (assay I) and furthermore with a more sensitive and validated assay (assay II). For assay I, mean CGRP concentration in external jugular venous blood during attack was 17.18 pmol/L compared with 15.88 pmol/L outside of attack. Mean difference was 1.81 pmol/L (95% confidence interval [CI]: -2.88, 6.41; p = 0.44). In peripheral blood during attack, CGRP was 16.86 pmol/L compared with 17.57 pmol/L outside of attack. Mean difference was -0.79 pmol/L (95% CI: -4.64, 3.06; p = 0.69). For assay II, external jugular venous blood concentration of CGRP during attack was 32.59 pmol/L compared with 30.59 pmol/L outside of attack; mean difference was 2.00 pmol/L (standard error, 2.39; 95% CI: -3.07, 7.07; p = 0.416). In peripheral blood during attack, CGRP was 33.37 pmol/L compared with 31.84 pmol/L outside of attack; mean difference was 1.53 pmol/L (standard error, 1.90; 95% CI: -2.46, 5.51; p = 0.431). Thus, no difference between CGRP level in external jugular or cubital fossa blood during and outside of attack was found. No difference was found between external jugular and peripheral venous blood. Thus, previous findings of increased CGRP level in external jugular or cubital fossa venous blood could not be confirmed. Our finding strongly suggests that CGRP is not increased in jugular venous blood during migraine without aura. CGRP cannot be used as a biomarker to validate human or animal models of migraine.

  8. Sumatriptan does not affect arteriovenous oxygen differences in jugular and cubital veins in normal human subjects

    DEFF Research Database (Denmark)

    Wienecke, T.; Hansen, J.M.

    2008-01-01

    Arteriovenous anastomoses (AVAs) may open up during migraine attacks. In studies with anaesthetized and bilaterally vagosympatectomized pigs, triptans reduce AVA blood flow and increase the arteriovenous O-2 difference (AVDO(2)). To investigate whether subcutaneous sumatriptan 6 mg could induce changes in the AVDO(2), we measured the AVDO(2) in the external jugular vein in healthy subjects. We also measured the AVDO(2) in the internal jugular and cubital veins. There were no changes in AVDO(2) after subcutaneous sumatriptan, probably because AVA blood flow is limited in humans with an intact sympathetic nervous system Udgivelsesdato: 2008/10

  9. Imaging analysis of hemangiopericytoma in the region of jugular foramen (report of one case and literature review)

    International Nuclear Information System (INIS)

    Objective: To investigate imaging diagnosisand differential diagnosis of hemangiopericytoma in the region of jugular foramen. Methods: 1 case of hemangiopericytoma in the region of jugular foramen proved by surgery and pathology was examined by 64 slices multiple rows sprial CT and 1.5T MRI pre-operation, the imaging features were analyzed retrospectively. Results: The hemangiopericytoma in the region of jugular foramen was misdiagnosised by both CT and MRI pre-operation. The tumor was oval in shape, with distinct boundary. Homogeneous and obvious enhancement was seen after giving contrast. Adjacent vessel were pushed by the tumor and deformed Jugular foramen enlarged because of destruction of bone. Conclusion: There isn't specific CT and MRI finding for hemangiopericytoma in the region of jugular foramen. However, imaging examination can clearly display the tumor and adjacent structures, so as to provide accurate anatomy information for surgery. (authors)

  10. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações / Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Scientific Electronic Library Online (English)

    Renato, De Vecchis; Antonio, Ciccarelli; Carmelina, Ariano.

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC) foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI) para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar [...] os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado). Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ? 15% (13 pts), 16 - 40% (21 pts) e > 40% (20 pts). Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059) e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213). O ICVCI ? 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ? 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ? 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0) Abstract in english BACKGROUND: In chronic heart failure patients (CHF), ultrasound measurement of inferior vena cava collapsibility index (IVCCI) has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical exami [...] nation with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy). For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ? 15% (13 pts), 16 - 40% (21 pts) and > 40% (20 pts).Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059) and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213). IVCCI ? 15% was always associated with high congestion score at the second visit; but IVCCI ? 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ? 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0).

  11. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Directory of Open Access Journals (Sweden)

    Renato De Vecchis

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ? 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ? 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ? 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ? 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical examination with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy. For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ? 15% (13 pts, 16 - 40% (21 pts and > 40% (20 pts.Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059 and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213. IVCCI ? 15% was always associated with high congestion score at the second visit; but IVCCI ? 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ? 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0.

  12. Comparação do parasitismo da veia central da supra-renal com o de outros tecidos em chagásicos crônicos

    Directory of Open Access Journals (Sweden)

    Vicente de Paula Antunes Teixeira

    1991-06-01

    Full Text Available Através da análise morfológica e morfométrica de cortes seriados foi estudada a ocorrência de ninhos de T. cruzi na veia central e no parênquima das supra-renais, no miocárdio ventricular esquerdo e na veia cava inferior de chagásicos crônicos. Em 36 casos estudados, 50% apresentavamfleboparasitismo supra-renálico (total 29 ninhos; 3,1% apresentavamparasitismo na veia cava (apenas 1 ninho e em 16,8% dos casos encontramos miocardiócitos parasitados (total 23 ninhos. A densidade de parasitismo, expressa em número de ninhos por 100mm² de tecido examinado, foi de 0,585 para a veia supra-renálica, de 0,001 para a veia cava e 0,01 para o miocárdio. Em 269.103,1mm² deparênquima supra-renálico não encontramos nenhum ninho. Embora tenha sido a menor área examinada, a veia central apresentou a maior freqüência de ninhos de T. cruzi. Como a diferença básica entre estes tecidos está na riqueza de corticóides no sangue que nutre a veia central, podemos admitir que esta prevalência talvez seja devido ao ambiente hormonal, que por seu efeito imunossupressoreanti-inflamatório favoreceria a sobrevida dos parasitas.By morphological and morphometric analyses of serial sections the occurrence of T. cruzi nests in the central vein and in the parenchyma of adrenal glands, in the left ventricular wall and in the inferior vena cava wall in chronic Chagasic patients was studied. Of 36 cases 50% showed parasites in the adrenal central vein wall (total 29 nests, 3.1% showedparasites in the vena caval wall (only I nest and 16,8% we found parasites in the myocardiocytes (total 23 nests. The density of parasites measured in the nests for each 100mm² of the tissue examined, was 0.585 for the adrenal vein, 0.001 for the vena cava and 0.01 for the myocardium. No nest was found in 269103.1mm² of adrenal parenchyma. Although the central vein area examined was smaller, it showed the largest frequency of T. cruzi nests. Since a basic difference between these tissues is the great quantity of corticoids in the blood of the adrenal central vein, this prevalence may be because of this hormonal ambient, which with its immunosupressor and anti-inflammatory effects could help T. cruzi survival

  13. Comparação do parasitismo da veia central da supra-renal com o de outros tecidos em chagásicos crônicos

    Scientific Electronic Library Online (English)

    Vicente de Paula Antunes, Teixeira; Marlene Antônia dos, Reis; Maria Betânia Mahler, Araújo; Suzana Aparecida, Silveira; Lucelena dos, Reis; Hipolito de Oliveira, Almeida.

    1991-06-01

    Full Text Available Através da análise morfológica e morfométrica de cortes seriados foi estudada a ocorrência de ninhos de T. cruzi na veia central e no parênquima das supra-renais, no miocárdio ventricular esquerdo e na veia cava inferior de chagásicos crônicos. Em 36 casos estudados, 50% apresentavamfleboparasitismo [...] supra-renálico (total 29 ninhos); 3,1% apresentavamparasitismo na veia cava (apenas 1 ninho) e em 16,8% dos casos encontramos miocardiócitos parasitados (total 23 ninhos). A densidade de parasitismo, expressa em número de ninhos por 100mm² de tecido examinado, foi de 0,585 para a veia supra-renálica, de 0,001 para a veia cava e 0,01 para o miocárdio. Em 269.103,1mm² deparênquima supra-renálico não encontramos nenhum ninho. Embora tenha sido a menor área examinada, a veia central apresentou a maior freqüência de ninhos de T. cruzi. Como a diferença básica entre estes tecidos está na riqueza de corticóides no sangue que nutre a veia central, podemos admitir que esta prevalência talvez seja devido ao ambiente hormonal, que por seu efeito imunossupressoreanti-inflamatório favoreceria a sobrevida dos parasitas. Abstract in english By morphological and morphometric analyses of serial sections the occurrence of T. cruzi nests in the central vein and in the parenchyma of adrenal glands, in the left ventricular wall and in the inferior vena cava wall in chronic Chagasic patients was studied. Of 36 cases 50% showed parasites in th [...] e adrenal central vein wall (total 29 nests), 3.1% showedparasites in the vena caval wall (only I nest) and 16,8% we found parasites in the myocardiocytes (total 23 nests). The density of parasites measured in the nests for each 100mm² of the tissue examined, was 0.585 for the adrenal vein, 0.001 for the vena cava and 0.01 for the myocardium. No nest was found in 269103.1mm² of adrenal parenchyma. Although the central vein area examined was smaller, it showed the largest frequency of T. cruzi nests. Since a basic difference between these tissues is the great quantity of corticoids in the blood of the adrenal central vein, this prevalence may be because of this hormonal ambient, which with its immunosupressor and anti-inflammatory effects could help T. cruzi survival

  14. Comparative morphometric study of the sigmoid sinus sulcus and the jugular foramen / Estudo morfométrico comparativo do sulco do seio sigmóideo e do forame jugular

    Scientific Electronic Library Online (English)

    Silvio Pereira, Ramos Junior; Sebastião Natanael da Silva, Gusmão; Jair Leopoldo, Raso; Arthur Adolfo, Nicolato; Marcileia, Santos; Isabela Maciel, Caetano.

    2014-09-01

    Full Text Available Objetivo Comparar os lados direito e esquerdo no mesmo crânio nos pontos referenciais descritos e definir as diferenças craniométricas entre ambos. Método Realizamos mensurações em 50 crânios secos de humanos adultos comparando os lados direito e esquerdo. Resultados Como resultado, obtivemos a [...] s medidas da largura do seio sigmóideo na altura do ângulo sinodural maiores no lado direito em 78% dos casos e na altura do ponto digástrico em 72%. A largura do forame jugular foi também maior no lado direito em 84% dos casos. A distância do seio sigmóideo na altura do ângulo sinodural até a altura do ponto digástrico foi maior do lado direito em 64% dos casos, e a distância do seio sigmóideo na altura do ponto digástrico até o forame jugular foi maior do lado direito em 70% dos casos. Conclusão Diferenças craniométricas significativas foram encontradas entre os dois lados do crânio. Abstract in english Objective To compare the right and left sides of the same skulls as far as the described landmarks are concerned, and establish the craniometric differences between them. Method We carried out measurements in 50 adult dry human skulls comparing both sides. Results The sigmoid sinus width at the [...] sinodural angle level was larger on the right side in 78% of the cases and at the level of the digastric notch in 72%. The jugular foramen width was also larger on the right side in 84% of the cases. The sigmoid sinus distance at the level of the digastric notch was larger on the right side in 64% of the cases, and the sigmoid sinus distance at the level of the digastric notch to the jugular foramen was larger on the right side in 70% of the cases. Conclusion Significant craniometric differences were found between both sides of the same skulls.

  15. Importancia do conjugado arteria carotida interna-seio cavernoso Physiological importance of the internal carotid artery-cavernous sinus conjugate

    Directory of Open Access Journals (Sweden)

    Milton Baggio Moreira

    1977-12-01

    Full Text Available O autor considera necessário o conjugado anatômico artério-venoso representado pela artéria carótida interna e seio cavernoso, bem como o plexo venoso carotídeo que reveste a carótida interna dentro do canal carotídeo da porção petrosa do osso temporal. Julga que, além de proteger a parede vascular arterial nas hipertensões arteriais súbitas, possa contribuir no mecanismo de controle e regulação do fluxo sanguíneo carotídeo, por considerar diferentes as condições fisiológicas do seio cavernoso em relação aos demais seios venosos durais e o sistema venoso endocraniano; consequente de sua constituição cavernosa, diferente dos demais canais sanguíneos venosos, com fisiollogia venosa própria e funções diferentes. Procura assemelhá-los aos demais distritos do organismo em que existem plexos cavernosos nos quais a tensão venosa chega a grandes proporções, comparada às demais regiões em que não existe esta constituição morfológica. Estabelece a correlação resultante ao mecanismo de resistência cérebro-vascular do qual considera participar, diferindo dos demais seios durais conjugado artéria carotida-beio cavernoso e veias encefálicas. Ainda valoriza o sifão carotídeo fisiologicamente e julga que o mesmo participa da hemodinâmica quando o paciente se encontra caído (em plano horizontal com hipotensão arterial, favorecendo a chegada sanguínea ao cérebro, evitando a anóxia e descerebração consequente dentro de determinados limites, sendo mais um meio de defesa do organismo.The author considers of atmost importance the anatomical arterial-venous conjugate, represented by the internal carotid artery and the cavernous sinus, as well as the carotid venous plexus which covers the internal carotid artery within the petrous portion of the temporal bone. He believes that besides protecting the vascular arterial wall in acute episodes of hypertension, it can also contribute to the mechanism of the carotid blood flow. This is due to the fact that he considers the physiological conditions of the cavernous sinus in relation to the others dural venous sinuses and the endocranial venous system and its cavernous constitution, which differs from other venous blood canals with their own venous physiology and different functions. He attempts to compare it to the rest of the body areas where cavernous plexuses are localized and where venous pressure reachs high proportions, in comparison with the other regions without this morphologic constitution. He establishes a correlation resulting form the cerebro-vascular resistence mechanism, the participation of which he considers as differing from others dural sinuses and encephalic veins. He also emphasizes physiologically the carotid siphon and believes that it participates in the hemodynamics, when the patient is lying down (in a horizontal position with hypotension, facilitating the blood access to the brain, thus avoiding consequent anoxia and decerebration, within certain limits, and constituting an additional mean of body defense.

  16. Veias linfonodais: uma causa pouco conhecida de varizes Lymph node veins: a little-known cause of varicose veins

    Directory of Open Access Journals (Sweden)

    André Paciello Romualdo

    2008-12-01

    Full Text Available As veias linfonodais fazem parte de uma rede venosa no triângulo de Scarpa, que liga em vários pontos o sistema venoso superficial às veias profundas, e podem tanto ser causa de incompetência do sistema venoso superficial quanto estar envolvidas na recorrência pós-safenectomia. Na rotina diária dos exames de Doppler venoso de membros inferiores, temos notado de maneira cada vez mais freqüente a associação das veias linfonodais com varizes primárias e recorrentes. A adequada caracterização dessas veias pode ajudar na compreensão do mecanismo fisiopatológico do aparecimento das varizes e permitir um controle e tratamento mais dirigidos. Este artigo lança luz sobre os aspectos anatômicos e fisiológicos das veias linfonodais, objetivando chamar a atenção dos profissionais envolvidos no diagnóstico de doenças venosas dos membros inferiores para uma causa pouco difundida de varizes.Lymph node veins are part of a venous network in Scarpa"s triangle, communicating in many points the superficial venous system and the deep veins, and may either be the cause of incompetence of the superficial venous system, or be involved in recurrent varicose veins after saphenous vein stripping. In the daily routine of venous Doppler examination of the lower extremities, an increasingly frequent association of lymph node veins with primary and/or recurrent varicose veins has been noticed. Appropriate characterization of these veins may help to understand the pathophysiological mechanism of varicose vein appearance and provide a more focused approach to follow-up and treatment. This article sheds some light on the anatomical and physiological aspects of lymph node veins, drawing the attention of professionals involved in the diagnosis of venous disorders of the lower extremities to a little-known cause of varicose veins.

  17. Veias linfonodais: uma causa pouco conhecida de varizes / Lymph node veins: a little-known cause of varicose veins

    Scientific Electronic Library Online (English)

    André Paciello, Romualdo; Roberto de Moraes, Bastos; Alessandro, Cappucci; Mathias, Fatio; Andréa, Tsunoda; Pollyanna, Campos; Alberto Lobo, Machado; Eduardo Hideki, Tokura.

    2008-12-01

    Full Text Available As veias linfonodais fazem parte de uma rede venosa no triângulo de Scarpa, que liga em vários pontos o sistema venoso superficial às veias profundas, e podem tanto ser causa de incompetência do sistema venoso superficial quanto estar envolvidas na recorrência pós-safenectomia. Na rotina diária dos [...] exames de Doppler venoso de membros inferiores, temos notado de maneira cada vez mais freqüente a associação das veias linfonodais com varizes primárias e recorrentes. A adequada caracterização dessas veias pode ajudar na compreensão do mecanismo fisiopatológico do aparecimento das varizes e permitir um controle e tratamento mais dirigidos. Este artigo lança luz sobre os aspectos anatômicos e fisiológicos das veias linfonodais, objetivando chamar a atenção dos profissionais envolvidos no diagnóstico de doenças venosas dos membros inferiores para uma causa pouco difundida de varizes. Abstract in english Lymph node veins are part of a venous network in Scarpa"s triangle, communicating in many points the superficial venous system and the deep veins, and may either be the cause of incompetence of the superficial venous system, or be involved in recurrent varicose veins after saphenous vein stripping. [...] In the daily routine of venous Doppler examination of the lower extremities, an increasingly frequent association of lymph node veins with primary and/or recurrent varicose veins has been noticed. Appropriate characterization of these veins may help to understand the pathophysiological mechanism of varicose vein appearance and provide a more focused approach to follow-up and treatment. This article sheds some light on the anatomical and physiological aspects of lymph node veins, drawing the attention of professionals involved in the diagnosis of venous disorders of the lower extremities to a little-known cause of varicose veins.

  18. Comunicação interna numa empresa de serviços / Internal communication of a service company / Comunicación interna en una empresa de servicios

    Scientific Electronic Library Online (English)

    Marlene, Vieira; Adilson, Marques; Eduardo, Correia.

    2013-09-01

    Full Text Available De acordo com os teóricos do campo da Comunicação Organizacional, a comunicação interna acaba por afetar o desempenho das organizações. Deste modo, o presente artigo procura efetuar uma análise, por intermédio da revisão bibliográfica e de um estudo de caso realizado numa empresa de serviços partilh [...] ados, à comunicação interna e identificar os aspetos da comunicação que necessitam ser otimizados. Os resultados alcançados permitiram contribuir para melhorar as práticas da comunicação desta organização: segmentação do público interno, promover a comunicação interna e reajuste da política de comunicação são algumas das sugestões para o seu bom desempenho. Abstract in spanish De acuerdo con los teóricos del campo de la Comunicación Organizacional, la comunicación interna acaba por afetar el desempeño de las organizaciones. En este sentido, el presente artículo busca efetuar un análisis, através de la revisión bibliográfica y de un estudio de caso realizado en una empresa [...] de servicios compartidos, sobre la comunicación interna, e identificar los aspetos de la comunicación que necesitan ser otimizados. Los resultados alcanzados permitirán contribuir para mejorar las prácticas de la comunicación de esta organización: segmentación del público interno, promover la comunicación interna y el reajuste de la política de comunicación son algunas de las sugerencias para un buen desempeño. Abstract in english According with the theoretical specialists in the field of Organizational Communication internal communication ultimately affects the organizational performance. This study aimes to analyze, through a bibliographical revision and a case study realized in a shared services company, the internal commu [...] nication and identify the need optimizations. The results obtained allowed a contribution to improvements in the practice of communication for this company: audience segmentation, promotion of internal communication and the readjustment of internal communication policy are just some suggestions for a better performance.

  19. Calcium micro-depositions in jugular truncular venous malformations revealed by Synchrotron-based XRF imaging

    Science.gov (United States)

    Pascolo, Lorella; Gianoncelli, Alessandra; Rizzardi, Clara; Tisato, Veronica; Salomé, Murielle; Calligaro, Carla; Salvi, Fabrizio; Paterson, David; Zamboni, Paolo

    2014-01-01

    It has been recently demonstrated that the internal jugular vein may exhibit abnormalities classified as truncular venous malformations (TVMs). The investigation of possible morphological and biochemical anomalies at jugular tissue level could help to better understand the link between brain venous drainage and neurodegenerative disorders, recently found associated with jugular TVMs. To this end we performed sequential X-ray Fluorescence (XRF) analyses on jugular tissue samples from two TVM patients and two control subjects, using complementary energies at three different synchrotrons. This investigation, coupled with conventional histological analyses, revealed anomalous micro-formations in the pathological tissues and allowed the determination of their elemental composition. Rapid XRF analyses on large tissue areas at 12.74?keV showed an increased Ca presence in the pathological samples, mainly localized in tunica adventitia microvessels. Investigations at lower energy demonstrated that the high Ca level corresponded to micro-calcifications, also containing P and Mg. We suggest that advanced synchrotron XRF micro-spectroscopy is an important analytical tool in revealing biochemical changes, which cannot be accessed by conventional investigations. Further research on a larger number of samples is needed to understand the pathogenic significance of Ca micro-depositions detected on the intramural vessels of vein walls affected by TVMs. PMID:25286775

  20. Endovascular treatment of symptomatic vestibular aqueduct dehiscence as a result of jugular bulb abnormalities.

    Science.gov (United States)

    Thénint, Marie-Aude; Barbier, Charlotte; Hitier, Martin; Patron, Vincent; Saleme, Suzana; Courthéoux, Patrick

    2014-11-01

    A new endovascular treatment consisting of stent-assisted coil implantation is described for jugular bulb abnormalities causing symptomatic vestibular aqueduct dehiscence. Three patients presenting with vertigo associated with pulsatile tinnitus or hearing loss were treated. This technique cured the vertigo and pulsatile tinnitus in all patients and preserved normal cerebral venous drainage with no side effects. PMID:25442142

  1. Morphometry Of Jugular Foramen Of Dry Adult Human Skulls Of South India.

    Directory of Open Access Journals (Sweden)

    Ashwin Krishnamurthy

    2011-09-01

    Full Text Available Jugular foramen (JF lies between the occipital and the petrosal part of the temporal bone, and allows the passage of important nerves and vascular elements i.e. the glossopharyngeal, vagus, and accessory nerves and the internal jugular vein. It is a potential site for development of schwannomas, metastatic lesions, and infiltrative inflammatory processes from the surrounding structures such as middle ear. JF is difficult to approach surgically, but recent advanced techniques especially image intensifier to guide the suboccipital lateral approach have made the treatment possible despite the difficulties. Hence a detailed morphological and anatomical knowledge of this region is required. The morphologic dimensions, presence or absence of septation etc varies in various races and ethnic groups as reported in previous literature. But such detailed study has been lacking in south Indian population .Thus the present descriptive study was conducted in department of Anatomy, Kasturba Medical College, Mangalore on 50 dried adult human skulls i.e. 100 JF of Dravidian (south Indian origin. The maximum antero-posterior and transverse diameter and depth of the jugular fossa of both sides were measured and septation was 6% on the right side and 8% on the left side using vernier calipers. The presence of spicules / septation of the jugular foramen were also observed on both sides. The obtained results presented variations regarding some parameters when compared to previous studies, thus making it evident the significance of race in the morphometric measurements and characteristics of the JF.

  2. Superior thyroid artery pseudoaneurysm and arteriovenous fistula following attempted internal jugular venous access and its management

    Science.gov (United States)

    Khera, Pushpinder Singh; Moses, Vinu; Ahmed, Munawwar; Kakde, Shailesh

    2015-01-01

    Vascular injury during common jugular venous (IJV) access is a rare complication, usually involving injury to the common carotid artery. We describe a previously unreported complication of iatrogenic injury of IJV access involving a branch of the superior thyroid artery, and its endovascular management. PMID:25709159

  3. The placement of an implantable chemoport via the external jugular vein as a primary route

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Moon Sang; Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Taejon Veterans Hospital, Daejeon (Korea, Republic of)

    2008-03-15

    To evaluate the usefulness and safety of the placement of an implantable chemoport via external jugular vein as a primary route for chemotherapy. Between January 2006 and June 2007, a total of 108 implantable chemoports were placed on 325 patients for chemotherapy via the external jugular vein as a primary route. We placed a 9.6 F single lumen chemoport using a surgical procedure (n = 89) and an interventional procedure (n = 19), and evaluated the duration of catheterization days and treatment complications. An implantable chemoport was successfully installed in all cases. Furthermore, the duration of catheterization ranged from 2 to 461 days (mean: 187 days, total catheter days: 21,994). In addition, a total of 85 chemoports were removed due to complications (n = 7) and termination of chemotherapy (n 78). A transient pulmonary air embolism occurring during a procedure was observed in one case. No pneumothorax or catheter malpositions were observed in the study subjects. Two chemoports were removed two days after implantation due to persistent tachycardia. In addition, five late complications occurred, which resulted in catheter occlusion (3 cases) (3%, 0.14/1000 catheter day) and infection in (2 cases) (2%, 0.09/1000 Catheter days). Lastly, no symptoms were attributed to a central vein thrombosis. The results of this study suggest that the implantation of chemoports via the external jugular vein is a safe procedure. Moreover, the selection of the external jugular vein as a primary route is useful in determining chemoport insertion locations.

  4. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

    Energy Technology Data Exchange (ETDEWEB)

    Christie, A., E-mail: andychristie90@hotmail.co [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom); Teasdale, E. [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom)

    2010-03-15

    Aim: To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. Materials and methods: The imaging of 15 patients with tumours predominantly occurring at the jugular foramen was retrospectively reviewed, with postoperative pathology data available for 11 patients. MDCT was performed at arterial phase and MRI with standard sequences and contrast enhancement. All imaging was blindly re-reported by an experienced neuroradiologist. Results: Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. Conclusion: MDCT is more accurate than MRI in diagnosing glomus tumours, and in particular, neuromas. It also offers valuable preoperative vascular information to the surgeon.

  5. Visualization of jugular vein on a thallium-201 scan for thyroid cancer

    International Nuclear Information System (INIS)

    A 52 year-old woman with recurrent thyroid cancer showed an accumulation of Tl-201 chloride in the left side of the neck. This proved to be reflux and retention of Tl-201 chloride in the left internal jugular vein and was verified with a Tc-99m HSA flow study. This phenomenon could be mistaken for metastases of thyroid cancer

  6. A new strategy for the treatment of jugular foramen tumors using radiosurgery

    International Nuclear Information System (INIS)

    A new treatment strategy for jugular foramen tumors using radiosurgery is reported. Six jugular foramen tumors, including 2 glomus tumors and 4 lower cranial neurinomas, were involved. Among them only one tumor was confined to the jugular foramen, but the others extended into the posterior fossa, the upper cervical portion or both. As an initial treatment, 3 cases underwent operative resection from suboccipital or transcervical route. The tumor sizes at radiosurgery ranged from 14.3 to 36.1 mm with a mean of 22.4 mm in diameter. They were treated with a marginal dose between 13 to 16.5 Gy (mean 15.6 Gy). Follow-up MRI showed an apparent tumor shrinkage in 4 and no change in 2. Central tumor necrosis was found in 4 cases, but tumor progression was never observed in the mean follow-up period of 19 months. No complication occurred during and after the radiosurgery. These results indicate that radiosurgery is effective for the control of jugular foramen tumors with acceptable risk. Large tumors extending to the upper cervical portion and posterior fossa can be treated by operative resection combined with radiosurgery. (author)

  7. Reconstruction of the iliofemoral venous circulation using internal jugular vein autograft.

    OpenAIRE

    Sidebottom, A. J.; Jones, D. C.; Brown, J.S.

    1997-01-01

    Two patients with recurrent tumour masses in the groin which involved the common femoral vessels underwent en bloc resection of the tumour, vessels and adjacent anterior abdominal wall. Arterial reconstruction used autologous saphenous vein or polytetrafluorethylene graft. Venous reconstruction was with autologous internal jugular vein.

  8. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

    International Nuclear Information System (INIS)

    Aim: To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. Materials and methods: The imaging of 15 patients with tumours predominantly occurring at the jugular foramen was retrospectively reviewed, with postoperative pathology data available for 11 patients. MDCT was performed at arterial phase and MRI with standard sequences and contrast enhancement. All imaging was blindly re-reported by an experienced neuroradiologist. Results: Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. Conclusion: MDCT is more accurate than MRI in diagnosing glomus tumours,ate than MRI in diagnosing glomus tumours, and in particular, neuromas. It also offers valuable preoperative vascular information to the surgeon.

  9. Hand Gangrene Following Unsuccessful Cannulation of the Internal Jugular Vein: a Case Report and Literature Review

    OpenAIRE

    Roettges, Paul S.; Murray, Peter M.; Hill, David

    2009-01-01

    Hand gangrene following vascular cannula placement is uncommon and is usually the result of thrombotic occlusion of an artery. We describe a case of hand gangrene resulting in wrist disarticulation, following multiple unsuccessful attempts at internal jugular vein cannulation in a critically ill patient.

  10. Trombose de veia porta em crianças e adolescentes / Portal vein thrombosis in children and adolescents

    Scientific Electronic Library Online (English)

    Graziela C. M., Schettino; Eleonora D. T., Fagundes; Mariza L. V., Roquete; Alexandre R., Ferreira; Francisco J., Penna.

    2006-06-01

    Full Text Available OBJETIVO: Apresentar uma revisão atualizada de trombose de veia porta na infância e adolescência, enfatizando o diagnóstico, suas complicações e tratamento. FONTE DOS DADOS: Foi realizada revisão da literatura, dos últimos 10 anos, através de pesquisa bibliográfica na Internet nos principais sites d [...] e busca médica, como o PubMed e MEDLINE, com enfoque na doença trombose de veia porta e suas repercussões clínicas. As principais palavras-chave e expressões pesquisadas foram: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Além disso, foram consultados os artigos citados nas referências dos trabalhos selecionados na pesquisa inicial e dos livros textos. SÍNTESE DOS DADOS: A trombose de veia porta é uma das causas mais comuns de hipertensão porta na infância. A apresentação clínica inicial pode ser através de episódios de hemorragia digestiva ou da presença de esplenomegalia em exame clínico de rotina. As principais complicações são a hemorragia digestiva, hiperesplenismo secundário à esplenomegalia, retardo de crescimento e biliopatia portal. O diagnóstico é realizado através da ultra-sonografia abdominal com Doppler. O tratamento é direcionado para as complicações, incluindo profilaxia primária e secundária de hemorragia digestiva, conseqüente à ruptura de varizes esofágicas, e derivações porto-sistêmicas, em casos selecionados. CONCLUSÕES:A trombose de veia porta é uma das causas mais importantes de hemorragia digestiva em crianças. Esses episódios acarretam impacto importante na qualidade de vida dos pacientes acometidos. Dessa forma, uma abordagem diagnóstica e terapêutica adequada é desejável na tentativa de se reduzir a morbimortalidade. Abstract in english OBJECTIVE: To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment. SOURCE OF DATA: The medical literature of the past 10 years was reviewed using the PubMed and MEDLINE search engines, with major focus on portal vein thr [...] ombosis and its clinical outcomes. The following keywords or expressions were used for the web search: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Additionally, we also reviewed the articles cited in the references of the initially selected papers, as well as relevant textbooks. SUMMARY OF THE FINDINGS: Portal vein thrombosis is one of the most common causes of portal hypertension among children. The initial clinical manifestation is characterized either by episodes of upper gastrointestinal bleeding or by splenomegaly on routine clinical examination. The major complications include upper gastrointestinal bleeding, hypersplenism secondary to splenomegaly, growth retardation, and portal biliopathy. The diagnosis is made by abdominal Doppler ultrasonography. Treatment is targeted at the complications and includes primary and secondary prophylaxis against upper gastrointestinal bleeding (which results from the rupture of esophageal varices), and portosystemic shunting in selected cases. CONCLUSIONS: Portal vein thrombosis is one of the major triggers of upper gastrointestinal bleeding in children. Bleeding episodes have a remarkable effect on the quality of life of affected patients. Thus, appropriate diagnosis and treatment are needed in order to reduce morbidity and mortality.

  11. Trombose da veia de Galeno: relato de caso Galen vein thrombosis: case report

    Directory of Open Access Journals (Sweden)

    Marcio Chaves Pedro Marques

    2003-06-01

    Full Text Available A trombose venosa cerebral (TVC é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas. A trombose da veia de Galeno (TVG é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente de 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC.Cerebral venous thrombosis (CVT is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic. Galen vein thrombosis (GVT is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

  12. Endovascular correction of a traumatic internal iliac arteriovenous fistula with a covered stent / Correção endovascular de fístula arteriovenosa traumática em ilíaca interna com stent revestido

    Scientific Electronic Library Online (English)

    Edson Pedroza dos, Santos Junior; Rodolfo Rógers Américo, Batista; Fernanda Medina, Felici; Vinicius Evaristo, Correia; Maykon Brescancin, Oliveira; Remy Faria, Alves.

    2014-03-01

    Full Text Available As fístulas arteriovenosas (FAVs) são comunicações anômalas entre uma artéria e uma veia, sem envolvimento capilar. Segundo sua etiologia, podem ser divididas em congênitas e adquiridas, resultantes de traumas fechados ou penetrantes, e de lesões iatrogênicas. Relatamos o caso de mulher jovem, vítim [...] a de ferimento por arma de fogo, submetida à laparotomia de urgência, que evoluiu no pós-operatório tardio com edema assimétrico de membros inferiores. Os exames de imagem demonstraram a presença de fístula arteriovenosa ilíaca interna esquerda, tratada através de cirurgia endovascular com stent revestido, determinando a total oclusão da comunicação arterial e venosa. Abstract in english Arteriovenous fistulae (AVFs) are anomalous communications between an artery and a vein, bypassing the capillary network. They can be subdivided on the basis of etiology into congenital and acquired fistulae. The latter may be caused by closed or penetrating traumas, or may be iatrogenic injuries. W [...] e report on a case of a young adult female gunshot wound victim treated with emergency laparotomy who developed asymmetrical edema of the lower limbs during the late postoperative period. Imaging exams showed the presence of a left internal iliac AVF, treated using endovascular surgery with placement of a covered stent, resulting in total occlusion of arteriovenous communication.

  13. Válvulas da veia braquial comum: estudo anatômico Valves of the common brachial vein: anatomical study

    Directory of Open Access Journals (Sweden)

    Carlos Adriano Silva dos Santos

    2007-03-01

    Full Text Available CONTEXTO: Boa parte das insuficiências venosas é devida à incompetência de suas válvulas. Como uma das alternativas cirúrgicas, temos os enxertos venosos valvulados no segmento insuficiente. OBJETIVO: Descrever a anatomia das válvulas da veia braquial comum. MÉTODOS: Foram selecionados 30 cadáveres do sexo masculino, independentemente de raça, que tinham seus membros superiores articulados ao tronco. Os mesmos estavam formolizados e foram mantidos em conservação com solução de formol a 10%. Utilizamos como critério de exclusão a existência de desarticulação de um dos membros ou de alterações deformantes em topografia das estruturas estudadas. RESULTADOS: O número total de válvulas identificadas foi de 28 em membro superior direito e de 33 em membro superior esquerdo, sendo 15 no segmento proximal direito e 21 no segmento proximal esquerdo. Mais de 91% das válvulas foram do tipo bicúspide e parietal. CONCLUSÃO: Conclui-se que a veia braquial comum apresenta freqüentemente válvulas do tipo bicúspide e parietal.BACKGROUND: A great part of venous insufficiencies is due to valve incompetence. Valved venous grafts in the insufficient segment are a surgical alternative. OBJECTIVE: To describe the anatomy of the common brachial vein valves. METHODS: We used 30 male corpses of varied races with their upper limbs articulated to the trunk. They were preserved in formol and fixed in a 10% formol solution. Exclusion criteria were presence of disarticulation in one limb or deforming alterations in the topography of assessed structures. RESULTS: The total number of identified valves was 28 in the right arm and 33 in the left arm, 15 of them in the right proximal segment and 21 in the left proximal segment. More than 91% of the valves were bicuspid and parietal. CONCLUSION: We conclude that the common brachial vein often presents bicuspid and parietal valves.

  14. Iliac vein compression syndrome: literature review / Síndrome de compressão da veia ilíaca: revisão de literatura

    Scientific Electronic Library Online (English)

    Leonardo Pessoa, Cavalcante; José Emerson dos Santos, Souza; Raquel Magalhães, Pereira; Marcos Velludo, Bernardes; Alan Maurice da Silva, Amanajás; Marcos Henrique, Parisati; Ricardo Dias da, Rocha; Antônio Oliveira de, Araújo.

    2015-03-01

    Full Text Available A Síndrome de Compressão da Veia Ilíaca (SCVI) é uma situação clínica na qual a artéria ilíaca comum direita comprime extrinsecamente a veia ilíaca comum esquerda. Há uma predominância em mulheres jovens, entre a segunda e a quarta décadas de vida. Levando-se em consideração as complicações potencia [...] is da síndrome, esta deve ser reconhecida/diagnosticada e tratada, em pacientes sintomáticos, antes que cause alterações irreversíveis no sistema venoso do paciente. Métodos não invasivos, como o US-Doppler colorido, quando realizados por examinadores experientes, são métodos de triagem razoáveis; porém, a angiotomografia e a angiorressonância são mais fidedignas. O método de escolha para a confirmação diagnóstica consiste na flebografia, em múltiplas incidências, com aferição de gradientes pressóricos. O tratamento endovascular (angioplastia com colocação de stent autoexpansível) é seguro e efetivo, podendo substituir a reconstrução cirúrgica aberta e/ou a anticoagulação isolada. Abstract in english Iliac vein compression syndrome is a clinical condition in which the right common iliac artery extrinsically compresses the left common iliac vein. The syndrome predominantly affects young women between their 2nd and 4th decades of life. In view of the syndrome's potential complications, it should b [...] e recognized/diagnosed and treated in symptomatic patients before it causes irreversible damage to patients' venous systems. Noninvasive methods, such as venous color Doppler US are reasonable screening methods, but angiotomography and magnetic resonance angiography are more reliable diagnostic tools and the method of choice for confirmation of diagnosis remains multi-plane phlebography with measurement of pressure gradients. Endovascular treatment (angioplasty with placement of self-expanding stents) is safe and effective and can replace open surgical reconstruction and/or anticoagulation alone.

  15. The placement of an implantable chemoport via the external jugular vein as a primary route

    International Nuclear Information System (INIS)

    To evaluate the usefulness and safety of the placement of an implantable chemoport via external jugular vein as a primary route for chemotherapy. Between January 2006 and June 2007, a total of 108 implantable chemoports were placed on 325 patients for chemotherapy via the external jugular vein as a primary route. We placed a 9.6 F single lumen chemoport using a surgical procedure (n = 89) and an interventional procedure (n = 19), and evaluated the duration of catheterization days and treatment complications. An implantable chemoport was successfully installed in all cases. Furthermore, the duration of catheterization ranged from 2 to 461 days (mean: 187 days, total catheter days: 21,994). In addition, a total of 85 chemoports were removed due to complications (n = 7) and termination of chemotherapy (n 78). A transient pulmonary air embolism occurring during a procedure was observed in one case. No pneumothorax or catheter malpositions were observed in the study subjects. Two chemoports were removed two days after implantation due to persistent tachycardia. In addition, five late complications occurred, which resulted in catheter occlusion (3 cases) (3%, 0.14/1000 catheter day) and infection in (2 cases) (2%, 0.09/1000 Catheter days). Lastly, no symptoms were attributed to a central vein thrombosis. The results of this study suggest that the implantation of chemoports via the external jugular vein is a safe procedure. Moreover, the selection of the external jugular vei the selection of the external jugular vein as a primary route is useful in determining chemoport insertion locations

  16. Thrombosis of the External Jugular Vein: A Rare Complication of a Proximal Humerus Fracture Treated with Collar and Cuff Immobilisation

    OpenAIRE

    Michael Gale; Simon Craxford; Leia Taylor; Helen Montgomery; Simon Pickering

    2014-01-01

    We report the case of an 87-year-old woman who developed a thrombosis of her external jugular vein after sustaining a proximal humerus fracture managed nonoperatively with a collar and cuff. At review in fracture clinic she was found to have an enlarged external jugular vein which was subsequently found to be thrombosed. Her collar and cuff had been applied very tightly and it was felt by the ENT team to be the cause of the thrombosis of her external jugular vein. She was fully anticoagulated...

  17. Bilateral breast swelling secondary to superior vena cava obstruction and subclavian vein thrombosis / Edema bilateral das mamas secundário a obstrução da veia cava superior e trombose de veia subclávia

    Scientific Electronic Library Online (English)

    Ariadne Mayumi, Yamada; Ana Lucia Kefalas Oliveira, Melo; Gesner Pereira, Lopes; Genesio Borges de, Andrade Neto; Valesca Bizinoto, Monteiro; Renato Santos, Soares.

    2013-07-01

    Full Text Available A síndrome da veia cava superior é definida por um conjunto de sinais e sintomas secundários a uma obstrução da veia cava superior, causada principalmente por neoplasias malignas. Este relato de caso demonstra uma manifestação clínica incomum dessa síndrome, o edema bilateral das mamas, e destaca a [...] importância do conhecimento dos sinais mamográficos de doenças sistêmicas. Abstract in english Superior vena cava syndrome is defined by a set of signs and symptoms secondary to superior vena cava obstruction caused principally by malignant diseases. The present report describes the case of an unusual clinical manifestation of this syndrome with bilateral breast swelling, and emphasizes the r [...] elevance of knowledge on mammographic signs of systemic diseases.

  18. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  19. Angiography and clinical analysis of intracranial venous sinus in jugular foramen

    Directory of Open Access Journals (Sweden)

    GE Ai-li

    2013-03-01

    Full Text Available Background By analyzing the digital subtraction angiography (DSA of intracranial venous sinus in jugular foramen segment, this article investigates the reasons for difficulty or failure of stent implanting in intracranial venous sinus, and attempts to formulate the clinical index, which can predict the difficulty of venous sinus stenting so as to improve the success rate of stent implantation. Methods All of 118 patients treated with venous sinus stent angioplasty were analyzed retrospectively, among whom 87 cases were diagnosed as cerebral venous stenosis and intracranial hypertension, and 31 patients were diagnosed as intractable pulsatile tinnitus caused by venous sinus stenosis. All patients received thrombolysis, anticoagulant and antiplatelet agents, and stent was implanted since the symptoms were not relieved. The two turning angles and diameter of cerebral venous sinus in the jugular foramen were measured to analyze their impact on stent implantation. Results Stent implantation of 115 cases were successful, while 3 patients did not complete the surgery due to the difficulty of stent implanting. The cerebral venous sinus in the jugular foramen was a transitional structure between the sigmoid sinus and internal jugular vein. Lateral view of angiography suggested "N" shape. The sum of two turning angles of venous sinus of 115 patients was (120.11± 30.32°, and the diameter of venous sinus was (5.10 ± 1.12mm. The sum of two turning angles of 3 patients who failed to implant stent was (86.37 ± 10.72°, and the diameter of venous sinus was (5.11 ± 0.37 mm. There were statistically significant differences between the angles of two groups (t = 23.420, P = 0.001, but no significant differences between the diameters of two groups ( t = 7.210, P = 0.352. Conclusion Lateral view of angiography suggested "N" shape of venous sinus in the jugular foramen. Difficulty of stent embedding would be caused by too small turning angles of venous sinus in the jugular foramen. However, the diameter of venous sinus did not influence the sugery ofstent implantation.

  20. Vein of Galen aneurysm in an adult: case report Aneurisma da veia de Galeno em adulto: relato de caso

    Directory of Open Access Journals (Sweden)

    Robinson M. Marques

    2006-09-01

    Full Text Available Vein of Galen aneurysm is a rare pathology, representing less than 1% of intracranial vascular malformations. We report on a 65 years-old man who experienced a generalized tonic-clonic seizure. Brain imaging showed a large calcified expanding mass in the pineal region, confirming the diagnosis of a vein of Galen aneurysm. Because of the spontaneous thrombosis of the malformation, there was no need for microsurgical or endovascular treatment and he is been regularly followed since that.Aneurisma da veia de Galeno é patologia rara, representando menos de 1% das malformações vasculares intracranianas. Apresentamos o caso de um homem de 65 anos que teve episódio de crise convulsiva tônico-clônica generalizada. Exames de imagem evidenciaram grande processo expansivo calcificado na região pineal, confirmando o diagnóstico de aneurisma trombosado de veia de Galeno. Devido à trombose espontânea da malformação, foi excluída a possibilidade de tratamento endovascular bem como microcirúrgico, mantendo-se o acompanhamento clínico.

  1. Agenesia de veia cava inferior associada à trombose venosa profunda / Agenesis of inferior vena cava associated with deep venous thrombosis

    Scientific Electronic Library Online (English)

    Clovis Luis, Konopka; Marcelo, Salame; Geórgia Andrade, Padulla; Raquel Rodrigues, Muradás; Julio César, Batistella.

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apr [...] esentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior. Abstract in english The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous [...] thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  2. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  3. Leiomiossarcoma da veia cava inferior: relato de caso / Leiomyosarcoma of the inferior vena cava: a case report

    Scientific Electronic Library Online (English)

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

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima re [...] lação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma. Abstract in english The authors report a case of a 48 year-old female patient with moderate abdominal pain and bulging in the abdomen. Physical examination demonstrated the presence of a palpable abdominal mass. Computed tomography showed a heterogeneously enhancing retroperitoneal mass in close contact with the inferi [...] or vena cava. En bloc resection of the mass and of the attached vena cava segment was performed. Histological analysis revealed leiomyosarcoma.

  4. Tratamento de estenose de veia pulmonar após ablação percutânea de fibrilação atrial Tratamiento de estenosis de vena pulmonar tras ablación percutánea de fibrilación atrial Treatment of pulmonary vein stenosis after percutaneous ablation of atrial fibrillation

    OpenAIRE

    Alvaro Valentim Lima Sarabanda; Leonardo Cogo Beck; Luis Gustavo Gomes Ferreira; Wagner Luis Gali; Fernando Melo Netto; Guilherme Urpia Monte

    2010-01-01

    Neste relato de caso, descrevemos um paciente portador de fibrilação atrial (FA) persistente, submetido à ablação percutânea da FA pela técnica de isolamento extraostial das veias pulmonares, que desenvolveu uma estenose acentuada do óstio da veia pulmonar superior esquerda (VPSE), sem manifestar sintomas, diagnosticada pela angiotomografia de controle das veias pulmonares. O paciente foi submetido à angioplastia com implante de stent na VPSE com sucesso, resultando na normalização...

  5. Consistencia interna y estructura interna del cuestionario AUDIT en amerindios / Internal consistency and dimensionality of the AUDIT among Amerindians / Consistência interna e estrutura interna do questionário AUDIT em ameríndios

    Scientific Electronic Library Online (English)

    Alix Lorena, Medina; Nadia Milena, Arévalo; Sandra Dolores, Beltrán; Yuri Lizeth, Chavarro; Edwin, Herazo; Adalberto, Campo-Arias.

    2014-04-01

    Full Text Available Objetivo: determinar a consistência interna e a dimensionalidade do AUDIT numa mostra de ameríndios que moram em Bogotá, Colômbia. Método: um estudo metodológico foi desenhado. Participaram 184 ameríndios, 99 homens e 85 mulheres. A idade média foi 32,0 anos (DP=14,0) e a escolaridade média, 6,1 ano [...] s (DP=3,7). Se estimaram as correlações corrigidas de cada ítem com o escore total, a consistência interna (alfa de Cronbach e ômega de McDonald) e a dimensionalidade (estrutura interna). Resultados: as correlações corrigidas entre os itens e o escore total foram encontradas entre 0,368 y 0,788. O AUDIT mostrou um alfa de Cronbach de 0,879; ômega de McDonald de 0,886; e um fator que explicou o 50,6% da variância. Conclusões: o AUDIT mostra excelente consistência interna e uma estrutura unidimensional em ameríndios que moram em Bogotá, Colômbia. Abstract in spanish Objetivo: determinar la consistencia interna y la dimensionalidad del AUDIT en una muestra de amerindios residentes en Bogotá, Colombia. Metodología: se diseñó un estudio metodológico. Participaron 184 amerindios, 99 hombres y 85 mujeres. La media para la edad fue 32,0 años (DE=14,0) y para la escol [...] aridad, 6,1 años (DE=3,7). Se estimaron las correlaciones corregidas de cada ítem con la puntuación total, la consistencia interna (alfa de Cronbach y omega de McDonald) y la dimensionalidad (estructura interna). Resultados: las correlaciones corregidas entre los ítems y la puntuación total se encontraron entre 0,368 y 0,788. El AUDIT mostró alfa de Cronbach de 0,879; omega de McDonald de 0,886; y un factor que explicó el 50,6% de la varianza. Conclusiones: el AUDIT muestra excelente consistencia interna y una estructura unidimensional en amerindios residentes en Bogotá, Colombia. Abstract in english Objective: to establish the internal consistency and dimensionality of the AUDIT among Colombian native Amerindians dwelling in Bogotá, Colombia. Method: a validation study was carried out. A total of 184 Amerindians, 99 men and 85 women. The mean of age was 32.0 years (SD=14.0), and mean of formal [...] scholarship, 6.1 years (SD=3.7). The correlations between items and total score, internal consistency (Cronbach alpha and McDonald omega), and dimensionality (factor structure) were computed. Results: the correlations between items and total score were between 0.368 and 0.788. The AUDIT showed Cronbach alpha of 0.879, McDonald omega of 0.886, and one-dimensional structure that accounted for 50.6% of the total variance. Conclusions: the AUDIT shows excellent internal consistency and one-dimension structure among Amerindians dwelling in Bogota, Colombia.

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

    OpenAIRE

    Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam

    2013-01-01

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

  7. Globus Pallidus Interna Deep Brain Stimulation for Chorea-Acanthocytosis

    Science.gov (United States)

    Lee, Jae-Hyeok; Cho, Won-Ho; Cha, Seung-Heon

    2015-01-01

    Chorea-acanthocytosis (ChAc) is a rare hereditary disorder characterized by involuntary choreiform movements and erythrocytic acanthocytosis. Pharmacotherapy for control of involuntary movements has generally been of limited benefit. Deep brain stimulation (DBS) has recently been used for treatment of some refractory cases of ChAc. We report here on the effect of bilateral high-frequency DBS of globus pallidus interna in a patient with ChAc. PMID:25733999

  8. Acute pulmonary emboli due to internal jugular vein thrombosis in papillary thyroid carcinoma, a case report and literature review

    OpenAIRE

    Ataiekhorasgani, Masoud; Jafaripozve, Nasim

    2014-01-01

    Upper extremity deep vein thrombosis (UEDVT) is a life threatening rare condition. Among the patients with UEDVT, internal jugular vein is accepted as uncommon thrombosis. Since internal jugular vein thrombosis (IJVT) is mostly underdiagnosed, a great attention is needed to diagnose the disease. A 75-year-old woman with history of dyspnea on exertion (DOE), weight loss and anorexia with the stable vital sign and right-sided cervical adenopathy with suspected thyroid nodule was admitted. One d...

  9. Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center

    OpenAIRE

    Aribas?, Bilgin Kadri; Arda, Kemal; Aribas?, O?zge; C?iledag?, Nazan; Yolog?lu, Zeynel; Aktas?, Elif; Seber, Turgut; Kavak, S?eyhmus; Cos?ar, Yusuf; Kaygusuz, Hidir; Tekin, Ekrem

    2012-01-01

    The purpose of the present study was to examine whether patency times, including complications of subcutaneous venous chest port insertion using ultrasonography (US) guidance, differ between jugular and subclavian venous access. Between December 2008 and July 2010, subcutaneous venous chest ports were placed in 347 patients by an experienced team. All single-lumen port catheters were placed into jugular and subclavian veins under US and fluoroscopy guidance. Patency times and complication rat...

  10. A New Biplane Ultrasound Probe for Real-Time Visualization and Cannulation of the Internal Jugular Vein

    OpenAIRE

    Jeremy Kaplowitz; Paul Bigeleisen

    2014-01-01

    Ultrasound guidance is recommended for cannulation of the internal jugular vein. Use of ultrasound allows you to identify relevant anatomy and possible anatomical anomalies. The most common approach is performed while visualizing the vein transversely and inserting the needle out of plane to the probe. With this approach needle tip visualization may be difficult. We report the use of a new biplane ultrasound probe which allows the user to simultaneously view the internal jugular vein in trans...

  11. Small saphenous vein: where does reflux go? / Veia safena parva: para onde se dirige o refluxo?

    Scientific Electronic Library Online (English)

    Guillermo Gustavo, Rossi; Cleusa Ema Quilici, Belczak; Carolina, Rossi.

    2013-06-01

    Full Text Available CONTEXTO: A veia safena parva (VSP) apresenta grande variabilidade anatômica graças à sua complexa origem embriológica. Na VSP insuficiente, o refluxo que se dirige para a perfurante de reentrada nem sempre obedece ao mesmo trajeto anatômico. OBJETIVO: Estudar a variabilidade da direção do ref [...] luxo da VSP e sua reentrada. MÉTODOS: Neste estudo prospectivo e observacional, 60 membros inferiores com insuficiência de VSP em 43 pacientes foram avaliados por protocolo de eco-color Doppler. RESULTADOS: As variações de reentrada foram agrupadas em quatro tipos, com seus respectivos subtipos. A porcentagem dos achados foi: Tipo A, perfurantes de face medial = 25/60 casos (41,66%), subtipos Cockett, Sherman, paratibiais e do vértice; Tipo B, maléolo externo e perfurantes da face lateral (externa) (fibulares 17-26 cm) = 15/60 casos (25%), subtipos fibulares e maléolo; Tipo C, em dois ramos = 19/60 casos (31,66%), subtipos gastrocnêmias e Cockett, gastrocnêmias e maléolo e/ou fibulares, Cockett e maléolo, Cockett-vértice e fibular; Tipo D, terminação no sistema superficial = 1/60 casos (1,66%). CONCLUSÃO: Na maior parte desta casuística, o refluxo não obedeceu ao percurso anatômico clássico. Demonstrou-se a variabilidade do trajeto do refluxo ou sua reentrada, e não a variabilidade anatômica da veia safena parva. Pode-se interpretar que o refluxo buscaria, como reentrada, a conexão anatômica mais acessível, ou então se originaria no setor distal, alcançando depois a veia safena parva. Abstract in english BACKGROUND: The anatomy of small saphenous vein (SSV) is very variable because of its complex embryological origin. SSV incompetence often causes reflux that goes to the perforating veins, sometimes not respecting the anatomical course. OBJECTIVE: To analyze differences in reflux direction and [...] reentry in the SSV. METHODS: In this prospective, observational study, 60 lower limbs with SSV incompetence of 43 patients were assessed using a color Doppler ultrasound protocol. RESULTS: Reentry variations were grouped into four types and subtypes. Percentage results were: Type A, perforating veins on the medial side = 25/60 cases (41.66%); subtypes: Cockett, Sherman, paratibial and vertex; Type B, lateral malleolus and perforating veins on the lateral side (fibular 17-26 cm) = 15/60 cases (25%); subtypes: fibular and malleolus; Type C, two branches = 19/60 cases (31.66%); subtypes: gastrocnemius and Cockett, gastrocnemius and malleolus, and/or fibular, Cockett and malleolus, Cockett-vertex and fibular; Type D, reflux in the superficial system = 1/60 cases (1.66%). CONCLUSION: On most of the lower limbs assessed, reflux did not follow the classical anatomic course. Our findings demonstrated a high degree of variation in reflux/reentry, but no SSV anatomical variations. Reflux seems to, either look for the most accessible anatomical connection for reentry or be originated in the distal area and then reach the SSV.

  12. Congenital External Carotid-External Jugular Arteriovenous Fistula: Diagnosis With Contrast-Enhanced Computed Tomography

    Science.gov (United States)

    Faghihi Langroudi, Taraneh; Arjmand Shabestari, Abbas; Pourghorban, Ramin; Khalili Pouya, Ensi

    2015-01-01

    Arteriovenous fistula (AVF) between the external carotid artery and external jugular vein is extremely rare, with only few cases reported in the literature so far. Most of these AVFs have been either iatrogenic or secondary to previous trauma. Herein, we report a 42-year-old woman with congenital AVF between the external carotid artery and external jugular vein, presenting with palpitation and dyspnea. The patient was suffering from mitral and tricuspid regurgitation. On physical examination, a thrill on the left side of the neck and an audible bruit over the left mandibular angle were detected. The possibility of abnormal AVF was considered and it was confirmed on contrast-enhanced computed tomography (CT), inferring that this modality is not only fast and non-invasive, but also accurate in detecting vascular abnormalities. PMID:25793090

  13. Interventional therapy via jugular vein access for the treatment of portal thrombosis

    International Nuclear Information System (INIS)

    Objective: To assess the efficacy of the interventional therapy using transjugular pathway in the treatment of portal thrombosis. Methods: Twenty-one patients with portal thrombosis were treated with interventional management via jugular vein access. The procedures included pharmaceutical thrombolysis through portal indwelling catheter and/or mechanical thrombectomy (MT), while balloon angioplasty and stent placement were used to treat the residual strictures. For patients complicated with cirrhosis and hemorrhage of the upper digestive tract intrahepatic portosystemic shunt was established after MT. Results: Portal patency was obtained in 18 patients with disappearance of the symptoms of gastrointestinal bleeding, ascites, as well as abdominal pain and distention. In two patients receiving the procedure of intrahepatic portosystemic shunt hepatic encephalopathy developed, which was controlled by medication. Of three patients with therapeutic failure, one died of gastrointestinal bleeding and two received medication. Conclusion: Interventional therapy via jugular vein access is a safe, minimally-invasive and effective treatment for portal thrombosis. (authors)

  14. Fatal Septic Internal Jugular Vein-Sigmoid Sinus Thrombosis Associated with a Malpositioned Central Venous Catheter

    OpenAIRE

    Seung, Won-bae; Kim, Dae-yong; Kim, Jin-wook; Park, Yong-seok

    2013-01-01

    Septic internal jugular vein-sigmoid sinus thrombosis (IJV-SST) associated with a malpositioned central venous catheter is a rare condition. It is potentially life-threatening and necessitates early diagnosis and rapid administration of appropriate medications. Unfortunately, it is difficult to diagnose due to vague clinical presentations. Several studies such as CT, MRI, and cerebral angiography should be performed and carefully examined to help make the diagnosis. We report a case of septic...

  15. Bilateral Jugular Vein and Sigmoid Sinus Thrombosis Related to an Inherited Coagulopathy: An Unusual Presentation

    OpenAIRE

    Özge Alt?nta?; Xfc Rsoy, Azize Esra G.; Xf Zde Baran, G.; Elnur Mehdi; Talip Asil

    2014-01-01

    Internal jugular vein thrombosis (IJVT) is a rare condition associated with malignancy, coagulopathy, and trauma. The optimal management of any IJVT must be individualized and depends on the condition of the patient. Case Presentation. We report the case of a 42-year-old woman with a history of a first trimester spontaneous abortion. Apart from a tension-type headache, she had no neurological symptoms. She reported an incidental diagnosis of right-sided IJVT when she was evaluated for hyperth...

  16. Using technetium-99m MH-1 monoclonal antibody to image thrombi in a rabbit jugular vein

    International Nuclear Information System (INIS)

    The monoclonal antibody MH-1 developed at American Biogenetic Sciences has been labelled with a technetium-99 triamide thiolate bifunctional chelate using a modified version of the preformed chelate approach developed at NeoRx. Labelled MH-1 has been used to image thrombi in rabbit jugular veins. Results indicate that the labelled antibody may be efficacious as an in vivo diagnostic agent for the detection of thrombi

  17. The Jugular Dural Fold—A Helpful Skull Base Landmark to the Cranial Nerves

    OpenAIRE

    Silverstein, Herbert; Willcox, Thomas O.; Rosenberg, Seth I.; Seidman, Michael D.

    1995-01-01

    During a retrosigmoid (or combined retrolabyrinthine-retrosigmoid) approach to the posterior fossa for vestibular neurectomy or removal of small acoustic neuromas, a white dural fold is a consistent landmark to cranial nerves VII through XII. This fold of dura appears as a white linear structure extending from the foramen magnum across the sigmoid sinus, attaching to the posterior aspect of the temporal bone, anterior to the vestibular aqueduct. The name “jugular dural fold” is suggested for ...

  18. The external jugular vein as an injection site in radionuclide angiography

    International Nuclear Information System (INIS)

    The first-pass radionuclide angiogram has been shown to be an effective method for evaluation of left ventricular function. When the first-pass technique is used, however, delivery of a compact radionuclide bolus is imperative. The external jugular vein is a safe, effective route of delivery for the bolus; it provides for a high quality, technically accurate test without deleterious effects to the patient

  19. Treatment of Perforating Veins: Review of Techniques / Tratamento de Veias Perfurantes: Revisão de Técnicas

    Scientific Electronic Library Online (English)

    CE, Costa Almeida.

    2014-12-01

    Full Text Available Introdução/Objectivos: Veias perfurantes incompetentes estão implicadas na génese de úlceras varicosas e na recidiva de varizes. A laqueação de todas as perfurantes é o único factor preditor de cicatrização da úlcera. O objectivo deste artigo é rever e comparar técnicas para poder concluir sobre a m [...] elhor opção de tratamento. Métodos: Cirurgia aberta, laqueação subfascial endoscópica de perfurantes (SEPS), ablação percutânea de veias perfurantes (PAP) (quimica e térmica) e embolização, foram analizadas e comparadas. Resultados: Cirurgia aberta tem uma taxa de cicatrização de úlcera de 89% com recidiva de 23%. SEPS tem uma taxa de cicatrização de 90% e recidiva de 11%. A taxa de complicação da ferida operatória com a SEPS é de 5%. Escleroterapia tem uma taxa de cicatrização até 67,6%. PAP há quase 100% de encerramento completo imediato, mas este diminui durante o seguimento. Discussão: SEPS tem melhor taxa de cicatrização, e diminui a recidiva da úlcera venosa. As principais desvantagens da PAP são as perfurantes esquecidas, e a falta de resultados a longo prazo. Conclusão: PAP é segura e com mínimas complicações como a SEPS, tem vantagens em relação à cirurgia, mas não há estudos da cicatrização nem da recidiva de úlcera. Por isso, a SEPS continua a ser a melhor escolha / “gold standard” para o tratamento de perfurantes insuficientes. A combinação da SEPS e PAP poderá ter melhores resultados. Abstract in english Introduction/Objectives: Incompetent perforating veins are implicated in venous ulcers and varicose veins recurrence. Complete closure of all perforating veins is the only predictor of ulcer healing. Review and comparison of techniques to conclude on the best treatment option is the objective of thi [...] s article. Methods: Open surgery, subfascial endoscopic perforator surgery (SEPS), percutaneous ablation of perforating veins (PAP) (chemical and thermal) and embolization were analyzed and compared. Results: Open surgery has an ulcer-healing rate of 89% with recurrence of 23%. SEPS has an ulcer-healing rate of 90% and recurrence of 11%. Wound complication rate with SEPS is 5%. Sclerotherapy has an ulcer-healing rate up to 67,6%. PAP has near 100% immediate closure rate, but decreases during follow-up. Discussion: SEPS has better ulcer-healing rate, and decreases recurrence. The major disadvantage of PAP is missed perforators, and long-term series are lacking. Conclusion: PAP is safe with minimal complications equal to SEPS, has advantages compared to surgery, but there are no studies on ulcer-healing and recurrence rates. Due to that, SEPS continues to be the choice/gold standard for the treatment of incompetent perforating veins. A combination of SEPS and PAP may result in better outcomes.

  20. Internal jugular vein thrombosis complicating cervicofacial infection of dental origin. Case report

    Directory of Open Access Journals (Sweden)

    Christos DENDRINOS

    2012-08-01

    Full Text Available Septic thrombosis of the internal jugular vein or Lemierre’s syndrome is a rare form of metastatic septic thromboembolitis, typically involving superinfection with Fusobacterium Necrophorum, internal jugular vein thrombosis and remote septic emboli.CASE REPORT: A 49-year-old male was referred for a painful cervicofacial swelling on the left, obliteration of the buccal sulcus, as well as swelling of both the soft and hard palate and the floor of the mouth ipsilaterally, accompanied by severe trismus and difficulty in swallowing. The patient underwent intraoral and extraoral incisions and drainage of the affected anatomical spaces and tracheotomy. The patient’s clinical condition was steadily improving; following examination with CT scan,9 days post-op, internal jugular vein thrombosis was diagnosed. The patient was put on anticoagulants. The postoperative course continued uneventfully, and the patient was discharged. One month post-operatively the vessel was normal and anticoagulant treatment was discontinued.CONCLUSION: Since Lemierre’s syndrome is not only rare but also tends to be underdiagnosed when there is no obvious cause of sepsis, it should be included in the differential diagnosis if the patient’s general contition deteriorates in spite of the treatment.

  1. Outcome of tunneled infusion catheters inserted via the right internal jugular vein

    International Nuclear Information System (INIS)

    To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placemer tunneled central venous catheter placement is the right internal jugular vein

  2. AFIRMAREA PREOCUP?RILOR PRIVIND PREZEN?A DIRECT? A PERSOANELOR FIZICE ÎN MEDIUL INTERNA?IONAL, O „SFIDARE” LA ADRESA CARACTERULUI „INTERETATIC” AL DREPTULUI INTERNA?IONAL?

    Directory of Open Access Journals (Sweden)

    Ionut Andrei Barbu

    2008-05-01

    Full Text Available În doctrina dreptului interna?ional exist? p?reri bine fundamentate care refuz? s? accepte teoriaconform c?reia individul ar avea calitatea de subiect de drept interna?ional.Astfel, unii autori consider? c? persoanele fizice, chiar dac? au calitatea de autori ai unorcrime interna?ionale, nu pot avea, sub nici o form?, calitatea de subiecte de drept interna?ional.De asemenea, ?i în cazul când drepturile prev?zute în instrumentele interna?ionale se consider?a nu fi conferite direct indivizilor, acestea prev?zând obliga?ii ale statelor de a le asigura indivizilor. Seconsider?, deci, gre?it? ?i teoria c? individul ar fi subiect de drept interna?ional în sensul c? princonven?ii interna?ionale s-ar crea drepturi ?i obliga?ii pentru persoanele fizice, în cadrul sau în afaradrepturilor omului, ?i anume atunci când unele conven?ii interna?ionale se refer? la aspecte ale statutuluijuridic al persoanelor.

  3. CT and MRI diagnosis of primary middle ear carcinoma invading jugular foramen

    International Nuclear Information System (INIS)

    Objective: To study the CT and MRI features of primary middle ear carcinoma invading jugular foramen. Methods: CT and MRI images of 7 patients with surgically and pathologically confirmed primary middle ear carcinoma invading jugular foramen were analyzed retrospectively, including high resolution CT (HRCT) scan in 6 cases, CT enhancement scan in 1 case and MR plain and enhancement scan in 7 cases. Results: On HRCT, the soft tissue lesions mainly located in tympanum, tympanic sinus, the deep of external auditory canal and jugular foramen, and irregular 'moth-eaten' bone destruction could be seen, including the destruction of jugular foramen in 7 cases, eustachian tube in 7 cases, facial nerve canal in 4 cases, carotid artery canal in 4 cases, external auditory canal wall in 3 cases, auditory ossicles in 2 cases, vestibular window and horizontal semicircular canal in 1 case. CT plain scan showed the density of soft tissue mass was uniform in 4 cases with CT value of 30-55 HU, and heterogeneous in 2 cases, in which small pieces high density lesions could be found. CT enhancement scan in 1 case revealed moderate and homogeneous enhancement. On MR plain scan, the soft tissue masses with hazy margins could be seen, and compared to the gray matter of brain, the lesions were isointense or slightly hypointense on T1WI and isointense or slightly hyperintense on T2WI. The signal was homogeneous in 5 cases and inhomogeneous in 2 cases with small pieces of hypointensity both on T1WI and T2WI. After enhancement, the lesions were enhanced moderately and homogeneously in 5 cases and inhomogeneously in 2 cases with small pieces of non enhanced area. MRI also showed the erosion of carotid artery in 4 cases, sigmoid sinus in 1 case. Conclusion: The primary middle ear carcinoma can invade the jugular foramen area extensively, which may lead to misdiagnosis. HRCT can precisely depict the bone destruction and the invasion of the important anatomic structures in the primary middle ear carcinoma, and the destruction of eustachian tube can help to reduce misdiagnosis. MRI can more clearly show the extent of tumor and the mass signal and enhancement pattern. (authors)

  4. Trombose da veia de Galeno: relato de caso / Galen vein thrombosis: case report

    Scientific Electronic Library Online (English)

    Marcio Chaves Pedro, Marques; Leopoldo Antônio, Pires; Carlos Augusto, Damasceno; André Carvalho, Felício; Ângelo, Atala; Gláucio M., Franco.

    2003-06-01

    Full Text Available A trombose venosa cerebral (TVC) é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas). A trombose da veia de Galeno (TVG) é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente d [...] e 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC. Abstract in english Cerebral venous thrombosis (CVT) is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic). Galen vein thrombosis (GVT) is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female [...] patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

  5. Coherencia interna y sincretismo teórico en la fundamentación constitucional mexicana

    Directory of Open Access Journals (Sweden)

    Luis Eusebio Alberto Avendaño González

    2014-10-01

    Full Text Available En la teoría jurídica actual el ámbito constitucional es la plataforma para la garantía de los derechos y las libertades; sin embargo, la Constitución mexicana prevé supuestos que son excluyentes entre sí. Esta circunstancia implica prescribir en el nivel constitucional un derecho y, a su vez, un no derecho, lo que por consecuencia crea un sincretismo metodológico. Este texto, además de denunciar tal contradicción, defiende la premisa de que la Constitución requiere de coherencia interna. Dicha idea toma como base el principio de igualdad y la interpretación judicial, para adecuar la coherencia teórica y normativa de la carta constitucional.

  6. Radiographic imaging of otitis media and interna in pigs

    International Nuclear Information System (INIS)

    Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations

  7. Endovascular Treatment of an Iatrogenic Right Internal Jugular Vein- Right Subclavian Artery Fistula and Pseudoaneurysm During the Attempt of a Hemodialysis Catheter Insertion: A Case Report

    International Nuclear Information System (INIS)

    Complications during the placement of a central venous catheter, via the right internal jugular vein puncture include local hematoma, hemothorax, pneumothorax, central vein thrombosis, and hemopericardium. Iatrogenic right internal jugular vein-right subclavian artery fistula with the formation of right subclavian artery pseudoaneurysms is an extremely rare complication in patients undergoing a central vein puncture. We report the case of a patient who developed a local hematoma at the vein puncture site and dyspnea due to a right internal jugular vein-subclavian artery fistula and a right subclavian artery pseudoaneurysm at the mediastinum after puncture of right internal jugular vein. The patient was successfully treated by embolization using microcoils

  8. Endovascular Treatment of an Iatrogenic Right Internal Jugular Vein- Right Subclavian Artery Fistula and Pseudoaneurysm During the Attempt of a Hemodialysis Catheter Insertion: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Kim, Hyun Lee; Kim, Dong Hyun [Chosun University, Gwangju (Korea, Republic of)

    2009-02-15

    Complications during the placement of a central venous catheter, via the right internal jugular vein puncture include local hematoma, hemothorax, pneumothorax, central vein thrombosis, and hemopericardium. Iatrogenic right internal jugular vein-right subclavian artery fistula with the formation of right subclavian artery pseudoaneurysms is an extremely rare complication in patients undergoing a central vein puncture. We report the case of a patient who developed a local hematoma at the vein puncture site and dyspnea due to a right internal jugular vein-subclavian artery fistula and a right subclavian artery pseudoaneurysm at the mediastinum after puncture of right internal jugular vein. The patient was successfully treated by embolization using microcoils.

  9. Non-cuffed dual lumen catheters in the external jugular veins versus other central veins for hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Moini Majid

    2009-01-01

    Full Text Available To compare prospective between insertion of non-cuffed dual lumen catheter in the external jugular vein and other central veins for hemodialysis (HD, we studied 68 chronic dialysis patients randomly allocated into two groups: one with external jugular vein catheterization as access for HD and another with other central venous catheterization, internal jugular or subclavian vein. Our results showed there were no significant differences regarding successful cannulation, com-plications, total numbers of dialysis, development of pain and infection at the site of cannulation, patency rate of the catheters, and efficacy of hemodialysis between both groups. In addition, the patency of the catheter in the external jugular vein was not affected by previous cannulation of other central veins. In contrast, there was a significant correlation between numbers of attempts for cannulation in both groups and development of hematoma and infection, (p< 0.05. In conclusion, our results showed that the external jugular vein may be an alternative for other central veins for insertion of temporary non-cuffed hemodialysis catheter.

  10. Distribuição comparativa dos glicosaminoglicanos em artérias e veias de diferentes mamíferos / Comparative distribution of glycosaminoglycans in arteries and veins of different mammals

    Scientific Electronic Library Online (English)

    Mônica V., MARQUEZINI; Luís Alberto O., DALLAN; Olga M. S., TOLEDO.

    1999-10-01

    Full Text Available Foi realizada análise comparativa sobre a distribuição dos glicosaminoglicanos de artérias e veias em ratos, cachorros e humanos. Os nossos resultados demonstraram que dermatam sulfato foi o principal glicosaminoglicano encontrado tanto para as artérias quanto para as veias estudadas. Entretanto, a [...] proporção de dermatam sulfato foi maior nas veias do que nas artérias nas três espécies analisadas. Este aumento pode estar associado às diferenças estruturais e funcionais encontradas na parede destes dois tipos de vasos sangüíneos (nas veias a pressão sangüínea é significativamente mais baixa). Além disso, a quantidade total dos glicosaminoglicanos foi maior nas artérias do que nas veias, sendo as maiores concentrações encontradas nas aortas independentemente da espécie animal estudada. Estes achados abrem perspectiva para o melhor conhecimento das alterações das macromoléculas que possam estar relacionadas ao processo degenerativo vascular, especialmente nas transformações estruturais que as veias safenas sofrem, quando empregadas como enxertos na revascularização do miocárdio. Abstract in english A comparative analysis of the glycosaminoglycan distribution in arteries and veins of humans, rats and dogs was realized. The results showed that the glycosaminoglycan distribution of the arteries was similar to that of venous tissues, where dermatan sulfate was the main glycosaminoglycan found. How [...] ever, the proportion of dermatan sulfate is significantly greater in venous than in arterial tissues, in the three species. The total amount of the glycosaminoglycans was significantly higher in arteries than in veins, and the highest contents were found in the aortas. These increases may be associated with structural differences of the wall of these two types of blood vessels walls. The blood pressure is significantly lower in venous tissues and veins may exhibit less compressibility than arterial. These findings open perspectives for a better understanding of biochemical changes that could be related to the progressive degenerative vascular process, especially in the structural changes that saphenous veins undergo, when used as grafts in myocardial revascularization.

  11. Reação de fase aguda e parasitismo na veia central da supra-renal de chagásicos crônicos

    Scientific Electronic Library Online (English)

    Daniel Ferreira da, Cunha; Cláudio de Oliveira, Vieira; Gisele de Paula e, Silva; Gislaine Rogéria, Erédia; Vicente de Paula Antunes, Teixeira.

    1994-06-01

    Full Text Available A reação sistêmica aos traumatismos e infecções graves, reação de fase aguda, (RFA), pode determinar imunossupressão e reativação de infecções latentes. O objetivo do trabalho foi verificar, em 71 chagásicos crônicos com ousem RFÁ, a freqüência de parasitismo pelo T. cruzi na veia central da supra-r [...] enal (VCSR). Os critérios para RFA (+) foram observados em 30 chagásicos: l)morteporsepsis e/outrauma após evolução maior que umasemana e 2)presença de úlceras de stress sangrantes, ou 3) hiperplasia reacional do baço ou 4) esteatose hepática. Registrou-se peso e altura e calculou-se o índice de massa corporal (IMC). Chagásicos com RFA (+) apresentaram maior comprometimento nutricional que os RFA (-): peso = 49,0 vs 54,5 kg; IMC = 17,5 vs 20,6kg/m2 (mediana p Abstract in english The systemic reaction to severe trauma and/or infection, acute phase response (APR), are often associated with immunossupression and reactivation of chronic latent infection. Our main purpose was to verify, in a group of 71 autopsied chronic chagasic with or without APR, thefrequency of T. cruzi nes [...] ts inthe central vein of adrenal gland (CVAG). APR, defined by: 1) death secondary to sepsis and/or trauma plus, 2) bleeding stress gastric ulcerations or 3) spleen reactional state or 4) liver steatosis, was observed in 30 chronic chagasic (APR +). Weight, height and body mass index (BM1) were obtained. APR (+) chronic chagasic had worse nutritional status than APR(~) ones: weight = 49.0 vs 54.5kg; BM1 = 17.5MS 20.6kg/m? (medianp

  12. A chronic jugular catheterization for remote blood sampling in freely moving mink.

    Science.gov (United States)

    Bonnefond, C; Fouche, L G; Martinet, L

    1988-01-01

    The cannulation method consists of implanting a silastic catheter in the jugular vein. Passing subcutaneously, the catheter emerges on the back between the scapulae. It is protected by a spiral spring and anchored on a support outside the wire pen. Two swivels, the first one at the point of subcutaneous entry of the catheter on the mink, the second one on the emerging catheter at the top of the cage, allow movements of the mink without twisting up the catheter. Using this chronic cannulation system, the effects of handling and anaesthesia on concentrations of plasma PRL and LH have been studied. PMID:3237809

  13. Fast Measurement of Blood T1 in the Human Jugular Vein at 3 Tesla

    OpenAIRE

    Qin, Qin; Strouse, John J.; Zijl, Peter C. M.

    2010-01-01

    Current T1 values for blood at 3T largely came from in vitro studies on animal blood or freshly drawn human blood. Measurement of blood T1 in vivo could provide more specific information, e.g. for individuals with abnormal blood composition. Here, blood T1 at 3T was measured rapidly (< 1min) in the internal jugular vein using a fast inversion-recovery technique in which multiple inversion time can be acquired rapidly due to constant refreshing of blood. Multi-shot EPI acquisition with flow...

  14. Thrombosis of the External Jugular Vein: A Rare Complication of a Proximal Humerus Fracture Treated with Collar and Cuff Immobilisation

    Science.gov (United States)

    Montgomery, Helen; Pickering, Simon

    2014-01-01

    We report the case of an 87-year-old woman who developed a thrombosis of her external jugular vein after sustaining a proximal humerus fracture managed nonoperatively with a collar and cuff. At review in fracture clinic she was found to have an enlarged external jugular vein which was subsequently found to be thrombosed. Her collar and cuff had been applied very tightly and it was felt by the ENT team to be the cause of the thrombosis of her external jugular vein. She was fully anticoagulated with warfarin after subsequently developing a deep vein thrombosis in the subclavian and axillary veins. She made a full recovery following anticoagulation. In this case, we review the potential causes of this rare and underdiagnosed condition, as well as the usual investigations and treatments. We also review the common complications of this fracture and the alternative treatment options available. PMID:25247102

  15. Thrombosis of the external jugular vein: a rare complication of a proximal humerus fracture treated with collar and cuff immobilisation.

    Science.gov (United States)

    Gale, Michael; Craxford, Simon; Taylor, Leia; Montgomery, Helen; Pickering, Simon

    2014-01-01

    We report the case of an 87-year-old woman who developed a thrombosis of her external jugular vein after sustaining a proximal humerus fracture managed nonoperatively with a collar and cuff. At review in fracture clinic she was found to have an enlarged external jugular vein which was subsequently found to be thrombosed. Her collar and cuff had been applied very tightly and it was felt by the ENT team to be the cause of the thrombosis of her external jugular vein. She was fully anticoagulated with warfarin after subsequently developing a deep vein thrombosis in the subclavian and axillary veins. She made a full recovery following anticoagulation. In this case, we review the potential causes of this rare and underdiagnosed condition, as well as the usual investigations and treatments. We also review the common complications of this fracture and the alternative treatment options available. PMID:25247102

  16. Thrombosis as a complication of pulmonary-artery catheterization via the internal jugular vein: prospective evaluation by phlebography

    International Nuclear Information System (INIS)

    A prospective study was made to determine, by angiography, the incidence of internal jugular-vein thrombosis in 33 consecutive critically ill patients who required temporary monitoring with Swan-Ganz catheters via the internal jugular vein. Twenty-two patients (66 per cent) had venographic or autopsy evidence of internal jugular-vein thrombosis. There was a statistically significant difference between the group of patients without thrombosis (Group 1) and the group with thrombosis (Group 2) with regard to the duration of hemodynamic compromise. Fifteen patients in Group 2 (as compared with eight in Group 1) were treated with heparin infusion, but nevertheless evidence of deep-vein thrombosis developd. Thus, it is concluded that venous thrombosis is a frequent complication of temporary monitoring with the Swan-Ganz catheter, especially in patients whose circulatory function has been impaired for a prolonged period

  17. A new biplane ultrasound probe for real-time visualization and cannulation of the internal jugular vein.

    Science.gov (United States)

    Kaplowitz, Jeremy; Bigeleisen, Paul

    2014-01-01

    Ultrasound guidance is recommended for cannulation of the internal jugular vein. Use of ultrasound allows you to identify relevant anatomy and possible anatomical anomalies. The most common approach is performed while visualizing the vein transversely and inserting the needle out of plane to the probe. With this approach needle tip visualization may be difficult. We report the use of a new biplane ultrasound probe which allows the user to simultaneously view the internal jugular vein in transverse and longitudinal views in real time. Use of this probe enhances needle visualization during venous cannulation. PMID:24715987

  18. Mediastinal B-cell lymphoma presenting with jugular-subclavian deep vein thrombosis as the first presentation.

    Science.gov (United States)

    Eltawansy, Sherif Ali; Rao, Mana; Ceniza, Sidney; Sharon, David

    2015-01-01

    Jugular venous thrombosis infrequently could be secondary to malignancy and has seldom been reported secondary to mediastinal large B-cell lymphomas. The postulated mechanisms are mechanical compression that leads to stagnation of blood in the venous system of the neck and/or an increase in the circulating thrombogenic elements that could cause venous thromboembolism as a paraneoplastic phenomenon. We report the case of a middle aged male presenting with right sided neck pain and arm swelling secondary to ipsilateral jugular-subclavian deep vein thrombosis. Investigations revealed it to be secondary to a mediastinal mass shown on CT scan of the chest. PMID:25821628

  19. Internal jugular and common femoral venous access for the removal of a long-term embedded vena cava filter

    Science.gov (United States)

    Salati, Umer; Govender, Pradeep; Torreggiani, William; Browne, Ronan

    2014-01-01

    We describe an inferior vena cava filter retrieval technique requiring triple venous access performed in a 35-year-old male who was referred for filter removal 16 months after its insertion. The filter showed a right-sided tilt with endothelialization of the distal filter struts into the caval wall. Access was required via both internal jugular veins to straighten the filter using a snared-loop technique. Further 18 F right common femoral vein access was required to snare and remove the filter, which could not be completely collapsed distally due to endothelialized tissue, precluding normal removal via the jugular venous route. PMID:24509181

  20. Uso de biogás em motores de combustão interna

    Directory of Open Access Journals (Sweden)

    Ana Beatryz Prenzier Suzuki

    2011-04-01

    Full Text Available

    O biogás proveniente da digestão anaeróbia de resíduos sólidos ou líquidos constitui uma fonte de energia alternativa. Sua composição é uma mistura de gases onde o metano e o dióxido de carbono estão em maiores proporções. Os motores de combustão interna são muito utilizados por poderem operar com diferentes tipos de combustíveis tanto líquidos como gasosos. Para que o biogás possa ser utilizado como combustível, seja em motores, turbinas a gás ou microturbinas, é necessário identificar sua vazão, composição química e poder calorífico, parâmetros que determinam o real potencial de geração de energia elétrica.

  1. Lesiones esplénicas en medicina interna / Splenic disorders in internal medicines

    Scientific Electronic Library Online (English)

    J., Rojo Álvaro; F.J., Anniccherico Sánchez; J.L., Alonso Martínez; S., Pérez Ricarte; J., Oteiza Olaso; J.M., Casas Fernández de Tejerina.

    2014-04-01

    Full Text Available El bazo representa el mayor órgano linfopoyético, contiene el 25% de la masa linfoide total. Participa en la inmunidad celular y humoral e interviene en la renovación de los glóbulos rojos y en la eliminación de las bacterias. Las funciones esplénicas están reducidas cuando el bazo está ausente, lo [...] que implica entre otras complicaciones, una mayor susceptibilidad para padecer una sepsis por organismos encapsulados. Se presentan 6 casos clínicos ingresados en el servicio de Medicina Interna con patología esplénica y se hace una revisión del abordaje a realizar. El espectro de lesiones esplénicas en medicina interna es muy amplio. En ocasiones se puede sospechar patología esplénica por la historia clínica, la exploración física o por citopenias en los análisis. Disponemos de diversas pruebas complementarias para completar el estudio de dichas lesiones. En caso de duda diagnóstica se puede realizar esplenectomía siendo los diagnósticos más frecuentes la cirrosis hepática y el linfoma/leucemia. Abstract in english The spleen is the largest lymphopoietic organ, containing 25% of total lymphoid mass. It participates in cellular and humoral immunity and intervenes in the renovation of red cells and the elimination of bacteria. Splenic functions are reduced when the spleen is absent, which entails, amongst other [...] complications, greater susceptibility to suffering from sepsis due to encapsulated organisms. We present 6 clinical cases admitted to the Internal Medicine serve with splenic pathology and we make a review of the approach to be used. The spectrum of splenic lesions in internal medicine is very wide. On occasions, a splenic pathology can be suspected due to clinical history, physical exploration or because of cytopenias in the analyses. Different complementary tests are available for completing study of these lesions. A splenectomy can be carried out in case of diagnostic doubt, with the most frequent diagnoses being hepatic cirrhosis and lymphoma/leukaemia.

  2. A Case Report of Right Internal Jugular Vein Thrombosis with Acute Brucellosis

    Directory of Open Access Journals (Sweden)

    F. Keramat

    2014-07-01

    Full Text Available Introduction: Brucellosis is a common zoonotic disease which has a wide spectrum of clinical manifestations and complications in humans. Brucellosis is an endemic disease in Iran, and vein thrombosis is a rare complication of acute brucellosis. Case Report: A 58-year old woman admitted to the infectious diseases ward in Farshchian hospital had fever and severe headache beginning 15 days before admission. Moreover, she complained from fatigue, malaise, anorexia, skin lesions around the nose and cervical lym-phadenopathy. Sonogarphy of cervical soft tissues of the patient showed right internal jugu-lar vein thrombosis and numerous cervical lymphadenopathy in the right posteriocervical tri-angle. Doppler sonography of the cervical vessels of the patient showed thrombosis of the middle right internal jugular vein. The blood culture isolates were small gram-negative aero-bic coccobacilli in two separate cultures. Serologic tests of Wright, 2ME and IgG ELISA were positive in the patient. The patient was treated with doxycycline, rifampin and warfarin, and she improved completely after a 5 month follow-up. Conclusion: We should consider brucellosis in the patients with rare manifestations of brucel-losis such as vascular thrombosis in endemic areas because early diagnosis and treatment of the patients can decrease its complications and mortality rate. (Sci J Hamadan Univ Med Sci 2014; 21 (2:161-166

  3. Trombose da artéria carótida interna devida a trauma penetrante no pálato mole: relato de caso

    Directory of Open Access Journals (Sweden)

    BORGES GUILHERME

    1999-01-01

    Full Text Available Descrevemos caso de trauma penetrante na região oral em criança, evoluindo com oclusão da artéria carótida interna e déficit neurológico correspondente. A tomografia computadorizada e a ressonância nuclear magnética demonstram a oclusão completa da artéria carótida interna. Enfatizamos esta rara complicação de trauma oral, comum em crianças e discutimos os aspectos patogênicos.

  4. Vein of Galen aneurysm in an adult: case report / Aneurisma da veia de Galeno em adulto: relato de caso

    Scientific Electronic Library Online (English)

    Robinson M., Marques; Carlos A.F., Lobão; Viviane S., Sassaki; Luiz R., Aguiar.

    2006-09-01

    Full Text Available Aneurisma da veia de Galeno é patologia rara, representando menos de 1% das malformações vasculares intracranianas. Apresentamos o caso de um homem de 65 anos que teve episódio de crise convulsiva tônico-clônica generalizada. Exames de imagem evidenciaram grande processo expansivo calcificado na reg [...] ião pineal, confirmando o diagnóstico de aneurisma trombosado de veia de Galeno. Devido à trombose espontânea da malformação, foi excluída a possibilidade de tratamento endovascular bem como microcirúrgico, mantendo-se o acompanhamento clínico. Abstract in english Vein of Galen aneurysm is a rare pathology, representing less than 1% of intracranial vascular malformations. We report on a 65 years-old man who experienced a generalized tonic-clonic seizure. Brain imaging showed a large calcified expanding mass in the pineal region, confirming the diagnosis of a [...] vein of Galen aneurysm. Because of the spontaneous thrombosis of the malformation, there was no need for microsurgical or endovascular treatment and he is been regularly followed since that.

  5. Aneurisma de veia poplítea: relato de caso e revisão da literatura Popliteal vein aneurysm: case report and literature review

    Directory of Open Access Journals (Sweden)

    Bruno Morisson

    2011-03-01

    Full Text Available Os aneurismas venosos são raros, porém causam complicações tromboembólicas. Na maioria das vezes, são encontrados como achados de exame físico ou de imagem. Os aneurismas sintomáticos de veia poplítea são tratados por reparo cirúrgico, devido ao alto risco de recorrência de embolia pulmonar. A técnica mais utilizada é a aneurismectomia tangencial com venorrafia lateral. Na impossibilidade de se empregar esta técnica, faz-se a ressecção com reconstrução venosa. Os autores relatam o caso de uma paciente com aneurisma de veia poplítea, cujo diâmetro era de 44 mm, submetida à aneurismectomia tangencial e venorrafia lateral, com sucesso.Venous aneurysms are rare; however, they are potential causes of thromboembolism. Most cases are found as clinical examination or by imaging methods. Symptomatic aneurysms of the popliteal vein are treated by surgical repair due to the high risk of recurrent pulmonary embolism. The most widely used procedure is tangential aneurysmectomy and lateral venorrhaphy. If this technique is not possible, the aneurysm should be removed and venous reconstruction should be performed. The authors report the case of a patient with popliteal vein aneurysm measuring 44 mm in diameter which was successfully treated by tangential aneurysmectomy and lateral venorrhaphy.

  6. Aneurisma de veia poplítea: relato de caso e revisão da literatura / Popliteal vein aneurysm: case report and literature review

    Scientific Electronic Library Online (English)

    Bruno, Morisson; Jose Marcos Braz, Serafim; Edwal Balthazar dos, Santos; Davi Pinto, Colhen; Bruno Miana, Caiafa; Ronaldo, Carvalho.

    2011-03-01

    Full Text Available Os aneurismas venosos são raros, porém causam complicações tromboembólicas. Na maioria das vezes, são encontrados como achados de exame físico ou de imagem. Os aneurismas sintomáticos de veia poplítea são tratados por reparo cirúrgico, devido ao alto risco de recorrência de embolia pulmonar. A técni [...] ca mais utilizada é a aneurismectomia tangencial com venorrafia lateral. Na impossibilidade de se empregar esta técnica, faz-se a ressecção com reconstrução venosa. Os autores relatam o caso de uma paciente com aneurisma de veia poplítea, cujo diâmetro era de 44 mm, submetida à aneurismectomia tangencial e venorrafia lateral, com sucesso. Abstract in english Venous aneurysms are rare; however, they are potential causes of thromboembolism. Most cases are found as clinical examination or by imaging methods. Symptomatic aneurysms of the popliteal vein are treated by surgical repair due to the high risk of recurrent pulmonary embolism. The most widely used [...] procedure is tangential aneurysmectomy and lateral venorrhaphy. If this technique is not possible, the aneurysm should be removed and venous reconstruction should be performed. The authors report the case of a patient with popliteal vein aneurysm measuring 44 mm in diameter which was successfully treated by tangential aneurysmectomy and lateral venorrhaphy.

  7. Veias soleares: bases anatômicas e seu papel na origem da trombose venosa profunda em membro inferior / Soleus veins: anatomic basis and their role in the origin of deep venous lower limb thrombosis

    Scientific Electronic Library Online (English)

    Carlos Miguel Gomes, Sequeira; Yara, Juliano; Neil Ferreira, Novo; Rubens Carlos, Mayall; Fausto, Miranda Junior.

    2007-08-01

    Full Text Available OBJETIVO: Estudar o número, a setorização e a terminação das veias soleares. MÉTODOS: Em 100 pernas de 50 cadáveres, excluídos aqueles com alterações congênitas ou adquiridas dos membros inferiores, foram realizadas, a fresco, na região crural posterior, dissecções anatômicas minuciosas, estratigráf [...] icas. Após o rebatimento da pele, foram realizadas a individualização das veias superficiais e perfurantes, rebatimento da tela subcutânea e da fáscia, individualização e rebatimento dos músculos gastrocnêmio e plantar, desinserção tibial do músculo sóleo, individualização das veias soleares e o estudo morfométrico. A região foi dividida em seis setores: súpero-medial, súpero-lateral, médio-medial, médio-lateral, ínfero-medial e ínfero-lateral. No estudo estatístico utilizaram-se os testes não-paramétricos Wilcoxon e Friedman. RESULTADOS: Foram encontradas 4.679 veias soleares. O setor com maior número de veias soleares foi o súpero-lateral com 1.529 veias (32,7%), seguido do médio-medial com 1.256 veias (26,8%) e do médio-lateral com 975 veias (20,8%). As terminações ocorreram em veias comunicantes (1.207 veias - 25,8%), veias tibiais posteriores (964 veias - 20,6%), veias fibulares (709 veias - 15,2%) e em mais 32 tipos (1799 veias - 38,4%). CONCLUSÃO: A drenagem venosa do músculo sóleo é realizada por um grande número de veias soleares, freqüentemente localizadas nos setores súpero-lateral, médio-medial e médio-lateral, terminando comumente em veias tibiais posteriores e fibulares e, em veias comunicantes. Abstract in english OBJECTIVE: Study of the number, sectorization and termination of the soleus veins. METHODS: Meticulous, stratigraphical, anatomical dissections were carried out in the posterior crural region of 100 legs of 50 fresh cadavers. Those belonging to subjects with congenital or acquired pathologies in the [...] lower limbs were disregarded. After the skin was reflected on both sides, dissection of superficial and perforating veins, was performed. Then reflection of the subcutaneous tissue and fascia, detachment and reflection of the gastrocnemius and plantaris muscles, detachment of the tibial origin of the soleus muscle, differentiation of the soleus veins and study of morphometric parameters were carried out. The region was divided into six sectors: superior-medial, superior-lateral, medio-medial, medio-lateral, inferior-medial and inferior-lateral. Data obtained from Wilcoxon and Friedman nonparametric tests were utilized for statistical analysis. RESULTS: In the dissected legs 4679 soleus veins were found. The sector with the greatest number of soleus veins was the superior-lateral (1529 veins - 32.7%), followed by the mediomedial (1.256 veins - 26.8%) and the mediolateral sectors (975 veins - 20.8%). The extremities drained into communicant veins (1.207 veins - 25.8%), posterior tibial veins (964 veins - 20.6%), peroneal veins (709 veins - 15.2%) and into 32 other types (1.799 veins 38.4%). CONCLUSION: The venous drainage of the soleus muscle is carried out by a great number of soleus veins which are frequently located in the superior-lateral, mediomedial and mediolateral sectors, more often going into the posterior tibial, peroneal and communicant veins.

  8. Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo Surgical treatment of superior vena cava syndrome caused by invasive thymoma

    Directory of Open Access Journals (Sweden)

    George Ronald Soncini da Rosa

    2010-06-01

    Full Text Available Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonância magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (politetrafluoroetileno. Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória.We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

  9. Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo / Surgical treatment of superior vena cava syndrome caused by invasive thymoma

    Scientific Electronic Library Online (English)

    George Ronald Soncini da, Rosa; Ney, Takizawa; Douglas, Schimidt; Mitur, Sugita.

    2010-06-01

    Full Text Available Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonân [...] cia magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (politetrafluoroetileno). Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória. Abstract in english We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC) for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angi [...] oresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

  10. La clínica y la Medicina Interna / Clinical and Internal Medicine

    Scientific Electronic Library Online (English)

    Alfredo, Espinosa Brito.

    2013-09-01

    Full Text Available Ante un panorama donde la Medicina Clínica y, particularmente, la Medicina Interna, enfrentan retos y dilemas que revisten características especiales en los momentos actuales, son muchos los que han estado preocupados porque estas condiciones afecten la esencia misma de nuestra profesión. Se definen [...] los elementos del acto médico. Se ratifica el importante papel del método clínico como el método científico aplicado a la atención de un paciente, así como los peligros de su aplicación incorrecta. Se perfilan las principales características de los "médicos hipocráticos" y los "médicos galénicos", como polos opuestos del actuar clínico en nuestros días. Se constata el aumento del número de médicos que se alejan de los enfermos y confían de manera creciente en los nuevos exámenes complementarios para sus diagnósticos. Se abordan la situación actual y las perspectivas de la Medicina Interna, los diferentes tipos de internistas existentes en el país, las potencialidades de los mismos y las cualidades que han de preservarse en el futuro. Se exponen sugerencias propias para alcanzar una medicina de calidad, más humanizada y menos costosa en el futuro. Se ratifica que la clínica y su método adquieren en nuestro tiempo un valor todavía mayor que en el pasado y que es nuestro deber como internistas educar, con el ejemplo y la palabra, en la utilización depurada y con excelencia del método clínico. Abstract in english In an scenario where Clinical Medicine, particularly, Internal Medicine faces the challenges and dilemmas that have special characteristics at present, many people have worried about the fact that these conditions could affect the very essence of our profession. The elements of the medical acts are [...] defined. The important role of the clinical method as the scientific method applied to the care of a patient, as well as the dangers of its wrong application is confirmed. The main characteristics of "Hippocratic Physicians" and "Galenic Physicians" as opposite poles of the present clinical acts are outlined. The increase in the number of doctors that leave their patients alone and trust in the new complementary tests for the diagnosis is verified. The current situation and the perspectives of Internal Medicine are addressed, as well as the different types of internists existing in the country, their potentialities and the qualities they should maintain in the future. Our own suggestions are given to achieve a high-quality medicine, more human and less expensive in the future. It is reaffirmed that Clinical Medicine and its method are currently acquiring a higher value than the one it had in the past and that, as internists, we should educate others, by example and word, in the refined and excellent use of the clinical method.

  11. The accuracy of jugular bulb venous monitoring in detecting cerebral ischemia in awake patients undergoing carotid endarterectomy.

    Science.gov (United States)

    Moritz, Stefan; Kasprzak, Piotr; Woertgen, Chris; Taeger, Kai; Metz, Christoph

    2008-01-01

    To investigate the accuracy of jugular bulb venous monitoring in detecting cerebral ischemia, we performed ipsilateral jugular bulb venous monitoring in 48 patients undergoing carotid surgery under regional anesthesia. Cerebral ischemia was assumed when neurologic deterioration occurred. During carotid clamping, the maximal arterial-jugular venous oxygen content difference [AJDO2 (max)], the minimal jugular venous oxygen saturation [SjO2 (min)], the maximal arterial-jugular venous lactate content difference [AJDL (max)], the maximal lactate oxygen index [LOI (max)], and the maximal modified LOI [mLOI (max)] were determined. To quantify the selectivity of each parameter, we performed receiver operating characteristic analysis and determined the area under the curve. The cutoff points providing the highest accuracy and the corresponding sensitivity (Se) and specificity (Spec) were determined. Neurologic deterioration occurred in 12 patients. All parameters, except AJDO2 (max), showed significant ability to distinguish between ischemic and nonischemic patients. The area under the curve for AJDL (max) was 0.840, for SjO2 (min) 0.766, for LOI 0.745, for mLOI 0.748, and for AJDO2 (max) 0.672. We found cutoff points of > or =0.16 mmol/L for AJDL (max) (Se=67%; Spec=86%) and < or =55% for SjO2 (Se=75%; Spec=83%). In conclusion, the present investigation shows that AJDL, SjO2, LOI, and mLOI provide the ability to detect cerebral hypoperfusion. The highest accuracy was found for AJDL. Neither the calculation of LOI nor of mLOI showed improved results. PMID:18157019

  12. Anatomy of the junction of the inferior petrosal sinus and the internal jugular vein. Evaluation with MR imaging

    International Nuclear Information System (INIS)

    To evaluate the anatomy of the junction of the inferior petrosal sinus (IPS) and the internal jugular vein (IJV), magnetic resonance (MR) images of the jugular bulbs in 50 patients (age range, 15 to 83 years; mean age, 59.6 years) were retrospectively reviewed. Both MR imaging and intra-arterial digital subtraction angiography (IADSA) were performed in the 50 patients, and IPS venography was performed in 7 patients. Multiplanar reconstruction of the MR images was obtained using three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) with gadopentate dimegulmin (Gd-DTPA). IPS and other venous structures were identified around the jugular bulbs both on the MR images and by IPS venography. The diameters of the junctions of the IPS and IJV were measured on the MR images. IN 97 side (97%) of the 50 patients, a petrosal confluence was found on the medial side of the jugular bulb, connecting with the anterior condylar vein, inferior petroclival vein, basilar plexus and the IPS. Extracranial extension of the IPS was seen on 3 sides of 3 patients (right: 1, left: 2) (3%). All 3 patients showed the IPS connecting with the internal jugular vein below the anterior condylar vein. The minimum diameter of IPS-IJV junction was 1 mm or greater in all cases. In conclusion, the junction of the IPS and the IJV is easily identified by contrast-enhanced 3-D fast SPGR sequences, which is helpful for IPS catheterization in endovascular treatment. (autterization in endovascular treatment. (author)

  13. Internal jugular vein septic thrombophlebitis (lemierre syndrome) as a complication of pharyngitis.

    Science.gov (United States)

    Wong, Andrew P; Duggins, Maurice L; Neil, Tara

    2015-01-01

    Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A ?-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome. PMID:25957375

  14. External Carotid-Internal Jugular Fistula as a Late Complication After Carotid Endarterectomy: A Rare Case

    International Nuclear Information System (INIS)

    A 66-year-old man presented with mild amnesia, progressive fatigue, ataxia, visual hallucinations, and debility. His past medical history included right-sided carotid endarterectomy performed elsewhere 6 years previously. Cranial magnetic resonance imaging showed left parieto-occipital arteriovenous malformation-like tortous vessels, venous congestion, and ischemic areas. Cerebral angiography showed right-sided compound external carotid artery-internal jugular vein (IJV) fistula, and distal occlusion of the right IJV. Transvenous embolization via contralateral IJV was performed, and the fistula, together with fistulous portion of the distal IJV, was sealed using coils. Two years later, patient is well with normal neurologic examination findings. The presence of an arteriovenous communication after vascular surgery is a serious complication with potential long-term effects and therefore should be diagnosed and treated as promptly as possible.

  15. Anti-jugular vein thrombotic effect of Morinda citrifolia L. [noni] in male SD rats

    Directory of Open Access Journals (Sweden)

    Mian-Ying Wang

    2011-09-01

    Full Text Available Background: Venous thromboembolism (VTE is a common and serious medical condition, which is estimably responsible for more than 300,000 hospital admissions annually in the USA. Pulmonary embolism (PE is a major complication of VTE, which contributes to 12% death of hospitalized patients. Heparin is the most common anti-coagulant, but severe allergic reactions, bleeding, and thrombocytopenia limit its use. Thus, seeking a botanical, nontoxic antithrombotic alternative is an interesting area. Morinda citrifolia L. [noni] is a medicinal plant used in folk remedies by Polynesians for over 2,000 years. It has been reported to have a broad range of therapeutic and preventive effects. The bioactivities of NJ have been continuously discovered with antioxidative, anti-inflammatory, analgesic, and immune modifying activities. Our novel hypothesis is whether NJ has an anti-venous thrombotic effect in rodents. To examine our hypothesis, this study was designed to examine the anti-thrombotic effect of NJ on the jugular vein thrombosis model induced by ferric chloride in SD rats.Material and Methods: NJ and placebo used in this study were donated by Morinda Holding Inc. NJ was formulated with grape juice and blue berry juice. Placebo was prepared by using the same procedure of NJ preparation, but without NJ in it. Thirty-six male SD rats were divided into six groups. Anti-venous thrombotic activities of 5% NJ, 10% NJ, heparin, and 10% NJ plus heparin were examined and compared with the positive and blank controls. Thrombosis was induced by application of a filter paper soaked in 50% ferric chloride on the right jugular vein. AFunctional Foods in Health and Disease 2011; 9:297-3092-cm fragment of the occluded vein (thrombus was removed and weighed after 1-hour maturation. Blood samples were collected for platelet count, aPTT, and PT tests.Results: The weight of a 2-cm fragment of normal jugular vein was 9.9 ± 2.1 mg, while the weight of the occluded vein in positive controls was 30.7 ± 12 mg [p=0.001], 24.7 ± 6.5 mg in heparin [p=0.16], 25.5 ± 6.5 mg in 5% NJ [P=0.15], 20.0 ± 5 mg in 10% NJ [P=0.04], and 16.1 ± 5.0 mg in heparin plus 10% NJ [P=0.02], respectively. The activity of aPTT was significantly increased in heparin, 60.0 ± 10.0 sec [p=0.002] compared with 16.83 ± 4.9 sec in blank control. There was a significant increase in 5% NJ [34.24 ± 9.6 sec, p=0.01], a slight increase in 10% NJ [24.0 ± 5.4 sec, p=0.06]. The activity of PT was significantly increased in heparin group only [36.52 ± 3.0 sec vs 26.85 ± 0.4 sec in blank control, p=0.01. There was no significant change in NJ groups. Clearly, the reduced thrombus weight by heparin may be partially due to the activation of aPTT and PT. The slight inhibition of NJ on aPTT activity may explain the possible additive antithrombotic effect of NJ with heparin. The platelet count was slightly reduced to 775,700 in the heparin group compared with blank control, there was no changes observed in other groups.Conclusion: NJ has an anti-jugular vein thrombotic effect and a possible additive antithrombotic effect with heparin by activating aPTT without induction of thrombocytopenia. We wonder whether NJ has an anti-platelet function activity. The mechanisms for anti-venous thrombotic effects of NJ needs further study.

  16. Case report: (Pre)syncopal symptoms associated with a negative internal jugular venous pressure

    DEFF Research Database (Denmark)

    Olesen, Niels; van Lieshout, Johannes J

    2014-01-01

    A siphon is suggested to support cerebral blood flow but appears not to be established because internal jugular venous (IJV) pressure is close to zero in upright humans. Thus, in eleven young healthy males, IJV pressure was 9 ± 1 mmHg (mean ± SE) when supine and fell to 3 ± 1 mmHg when seated, and middle cerebral artery mean blood velocity (MCA Vmean; P < 0.007) and the near-infrared spectroscopy-determined frontal lobe oxygenation (ScO2; P = 0.028) also decreased. Another subject, however, developed (pre)syncopal symptoms while seated and his IJV pressure decreased to -17 mmHg. Furthermore, his MCA Vmean decreased and yet within the time of observation ScO2 was not necessarily affected. These findings support the hypothesis that a negative IJV pressure that is a prerequisite for creation of a siphon provokes venous collapse inside the dura, and thereby limits rather than supports CBF.

  17. Gamma knife radiosurgery for glomus jugulare tumors: Therapeutic advantages of minimalism in the skull base

    Directory of Open Access Journals (Sweden)

    Sharma Manish

    2008-01-01

    Full Text Available Context: Glomus jugulare (GJ tumors are paragangliomas found in the region of the jugular foramen. Surgery with/without embolization and conventional radiotherapy has been the traditional management option. Aim: To analyze the efficacy of gamma knife radiosurgery (GKS as a primary or an adjunctive form of therapy. Settings and Design: A retrospective analysis of patients who received GKS at a tertiary neurosurgical center was performed. Materials and Methods: Of the 1601 patients who underwent GKS from 1997 to 2006, 24 patients with GJ underwent 25 procedures. Results: The average age of the cohort was 46.6 years (range, 22-76 years and the male to female ratio was 1:2. The most common neurological deficit was IX, X, XI cranial nerve paresis (15/24. Fifteen patients received primary GKS. Mean tumor size was 8.7 cc (range 1.1-17.2 cc. The coverage achieved was 93.1% (range 90-97% using a mean tumor margin dose of 16.4 Gy (range 12-25 Gy at a mean isodose of 49.5% (range 45-50%. Thirteen patients (six primary and seven secondary were available for follow-up at a median interval of 24 months (range seven to 48 months. The average tumor size was 7.9 cc (range 1.1-17.2 cc. Using a mean tumor margin dose of 16.3 Gy (range 12-20 Gy 93.6% coverage (range 91-97% was achieved. Six patients improved clinically. A single patient developed transient trigeminal neuralgia. Magnetic resonance imaging follow-up was available for 10 patients; seven recorded a decrease in size. There was no tumor progression. Conclusions: Gamma knife radiosurgery is a safe and effective primary and secondary modality of treatment for GJ.

  18. Gamma knife radiosurgery of the glomus jugulare tumour - early multicentre experience

    International Nuclear Information System (INIS)

    Leksell Gamma Knife was used to treat 66 patients with glomus jugulare tumour at 6 European sites between 1992-1998. The age of the patients ranged between 18-80 years (median 54 years). Gamma Knife radiosurgery was a primary treatment in 30 patients (45.5 %). Open surgery preceded radiosurgery in 24 patients (36.4 %), embolization in 14 patients (21.2 %) and fractionated radiotherapy in 5 patients (7.6 %). The volume of the tumour ranged 0.5-27 cm3 (median 5.7 cm3). The minimal dose to the tumour margin ranged between 10-30 Gy (median 16.5 Gy). After radiosurgery 52 patients were followed, the follow up period was 3-70 months (median 24 months). Neurological deficit improved in 15 patients (29 %) and deteriorated in 3 patients (5,8 %), one transient and two persistant. Neuroradiological follow up using MRI or CT was performed in 47 patients 4-70 months (median 24 months) after radiosurgery. Tumour size decreased in 19 patients (40 %) while in the remaining 28 patients (60 %) no change in the tumour volume was observed. None of the tumours increased in volume during the observation period. Control angiography was performed in 6 patients. Pathological vascularization completely disappeared in one patient, reduced in two and there was no change in the remaining three. Radiosurgery proves to be a safe treatment for glomus jugulare tumour with no mortality and no acute morbidity. Because of its naturally slow growth rate, up to 10 years of follow up growth rate, up to 10 years of follow up will be necessary to establish a cure rate after radiosurgery for these lesions. (author)

  19. Jugular vein catheterization for hemodialysis: correct positioning control using real-time ultrasound guidance.

    Science.gov (United States)

    Santarsia, G; Casino, F G; Gaudiano, V; Mostacci, S D; Bagnato, G; Latorraca, A; Lopez, T

    2000-01-01

    The jugular vein catheterism (JVC) is adopted for blood access in patients with acute renal failure, in chronic renal failure and when patients show failure of traditional vascular access. The technique of catheter insertion in the jugular vein is quick and easy. Usually correct catheter positioning, before starting the dialytic procedure, is controlled by chest X-ray or by intra-cavitary electrocardiogram. The aim of this work is to evaluate the feasibility of the real-time ultrasound guidance to control the correct positioning of the catheter instead of the usual chest X-ray control. We have studied 158 patients with JVC insertion before the hemodialytic procedure; 54 patients have undergone both ultrasound and a chest X-ray control while 104 were only submitted to ultrasound control. The ultrasound procedure includes an under xifoid scanning, with a convex 3.5 Mhz drill to evaluate the four heart cavities. When the right atrium is identified a second operator rapidly infuses in the venous catheter 15 ml of physiological solution thus creating a blood turbolence easily observed in real time as a light jet inside the atrium. This turbolence appears to be the main evidence for good catheter positioning and we were able to show the light jet in 156 (98%) patients. All light jet positive patients were submitted to the hemodialytic procedure without any complications during and after dialysis. We concluded that the intraoperative ultrasound control technique is an alternative to the chest X-ray evaluation because it offers the possibility for safe intraoperative immediate control thus reducing the total costs of the procedure. PMID:17638227

  20. An Unusual Anatomic Variation of the Jugular Foramen with Doubled Posterior Condylar Canal Una Variación Anatómica Inusual del Foramen Yugular con Canal Condilar Posterior Duplicado

    OpenAIRE

    Samet Kapakin

    2011-01-01

    A case of unusual anatomical variation of the jugular foramen (JF) with doubled posterior condylar canal (PCC) is reported. According to the presence of bridging, the JF can be defined as Type I (one septation, two compartments) on the right side and Type IV (three septations, four compartments) on the left side. The dome of the jugular fossa is present on the right, absent on the left. The jugular foramen shows a canal-like structure with an external and an internal opening. The lengths of t...

  1. Dopplerfluxometria da veia hepática em pacientes com esteatose não alcoólica / Hepatic vein Doppler flowmetry in patients with nonalcoholic steatosis

    Scientific Electronic Library Online (English)

    Valéria Ferreira de Almeida e, Borges; Angélica Lemos Debs, Diniz; Helma Pinchemel, Cotrim; Haroldo Luis Oliva Gomes, Rocha; Frederico Chaves, Salomão.

    2011-02-01

    Full Text Available OBJETIVO: Avaliar a correlação entre a dopplerfluxometria da veia hepática direita e o grau de esteatose, inflamação e fibrose à biópsia na doença hepática gordurosa não alcoólica. MATERIAIS E MÉTODOS: Foi realizada ultrassonografia com Doppler em 80 pacientes, sendo 40 portadores de doença hepática [...] gordurosa não alcoólica, também submetidos à biópsia. Quarenta controles normais saudáveis, sem fatores risco para doença hepática gordurosa não alcoólica foram submetidos a ultrassonografia com Doppler. O padrão ao Doppler da veia hepática direita foi classificado em trifásico, bifásico e monofásico. Os espécimes de biópsia foram classificados conforme o grau de esteatose, inflamação e fibrose. RESULTADOS: O fluxo foi trifásico em 38 (95%) dos controles e em 9 (56,3%) dos pacientes com esteatose discreta, enquanto nos com esteatose acentuada o padrão foi monofásico em 60%. Encontrou-se diferença significante na distribuição dos padrões ao Doppler (p Abstract in english OBJECTIVE: To evaluate the correlation between right hepatic vein Doppler flowmetry and degree of steatosis, inflammation and fibrosis at biopsy in nonalcoholic fatty liver disease. MATERIALS AND METHODS: Doppler ultrasonography was performed in 80 patients divided into two groups as follows: 40 pat [...] ients diagnosed with nonalcoholic fatty liver disease and also submitted to biopsy, and a control group including 40 healthy adults with no risk factor for nonalcoholic fatty liver disease. The Doppler waveform patterns of right hepatic vein were classified into triphasic, biphasic and monophasic. Biopsy specimens were classified according to the degree of steatosis, inflammation and fibrosis. RESULTS: Triphasic flow was observed in 38 (95%) patients of the control group and in nine (56%) patients with mild steatosis, whereas in patients with severe steatosis, the pattern was monophasic in 60%. A statistically significant difference was observed in the distribution of Doppler patterns (p

  2. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  3. Isolamento das veias pulmonares para tratamento da fibrilação atrial paroxística: resultados clínicos após um único procedimento Pulmonary veins isolation to treat patients with refractory paroxysmal atrial fibrillation: clinical results after a single procedure

    OpenAIRE

    Mauricio Scanavacca; Raul Sartini; Fernando Tondato; André d'Ávila; Denise Hachul; Francisco Darrieux; Sissy Lara; Eduardo Sosa

    2004-01-01

    OBJETIVO: Avaliar a evolução clínica dos pacientes com fibrilação atrial paroxística submetidos a um único procedimento de isolamento das veias pulmonares. MÉTODOS: Estudados 49 pacientes consecutivos (36 homens; idade média de 53±10 anos) com episódios freqüentes e sintomáticos de fibrilação atrial paroxística de difícil controle clínico. Para mapeamento da junção do átrio esquerdo com as veias pulmonares, foi utilizado o cateter decapolar circular Lasso e para ablação 30 watts e 50ºC, um ca...

  4. Estructura interna de la guadua y su incidencia en las propiedades mecánicas

    Directory of Open Access Journals (Sweden)

    JAIRO ALEXANDER OSORIO

    2007-01-01

    Full Text Available La Guadua angustifolia kunth GAK, fue caracterizada en su estructura interna, y se encontró la incidencia que presenta esta en la resistencia a flexión y a tensión. La resistencia a la flexión disminuye de la capa externa a la interna, debido a la reducción de la cantidad de células de fibras en ese sentido. Los valores de resistencia a flexión en la GAK disminuyen con la presencia de nudos debido a la discontinuidad de las fibras en esa parte del material. La resistencia a la tensión al igual que la de flexión disminuye de la capa externa a la interna, aspecto que se relaciona con que la cantidad de las células de fibra disminuyen hacia la capa interna

  5. Hyperostosis frontalis interna in a Neandertal from Marillac (Charente, France).

    Science.gov (United States)

    Garralda, María Dolores; Maureille, Bruno; Vandermeersch, Bernard

    2014-02-01

    The site of Marillac (Charente, France) has yielded an important stratigraphic sequence containing numerous Neandertal remains (some of them with peri-mortem manipulations) from lithofacies 2 (Quina Mousterian). This level has been correlated with MIS 4 and is associated with a TL date of 57,600 ± 4600 years BP (before present). The study of one of the cranial fragments (Marillac 3) revealed a grade 2 or Type B Hyperostosis frontalis interna (HFI), remodelling and altering the internal table of the thick frontal bone. This pathology has been analysed macroscopically together with radiography and sections made using a microscanner and a scanner. The development of the HFI is compared with published evidence for Sangiran 3 (Homo erectus), two other Neandertals (Forbes' Quarry and Shanidar 5), and several archaeological samples. Forbes' Quarry seems to display more advanced HFI than either Shanidar 5 or Marillac 3. The three Neandertals may be considered mature individuals (?40 years) and it seems likely that the aetiology of this pathology may be associated with hormonal alterations, as has been suggested for past and extant populations. While the prevalence of HFI in contemporary post-menopausal women is well documented, the identification of HFI amongst males from several archaeological samples (Neanderthals, Ancient Egypt, Syrian Bronze Age or the Anasazi), with different stages of development, confirm that the pathology affected both sexes in past populations. Additional data and research are still needed to elucidate the etiopathogenesis of this illness and to better understand the relationship between environmental factors and their possible influences/consequences for the development of metabolic disorders in prehistoric populations. PMID:24491378

  6. Plan Colombia e Iniciativa Mérida: negocio y seguridad interna

    Directory of Open Access Journals (Sweden)

    Gian Carlo Delgado-Ramos

    2011-01-01

    Full Text Available El siguiente artículo plantea como punto de partida la concepción de América Latina (al como espacio territorial estratégico para Estados Unidos (EU, no como traspatio, sino como reserva estratégica de recursos, como espacio receptor de inversiones que además permiten externalizar costos socioambientales, así como región exportadora de excedentes, sea por la vía del retorno de ganancias resultantes de la inversión extranjera directa (ied, el pago de regalías por el uso de derechos de patentes o el pago de intereses por concepto de empréstitos. Tal esquema expoliador y subordinante, sólo posible con el aval de los grupos de poder local en todo el periodo de existencia de los Estados latinoamericanos "independientes", desgarra de modo creciente el tejido social. En este marco, se analizan el Plan Colombia (pc y la Iniciativa Mérida (im como casos paradigmáticos, pero no aislados, de la estrategia de política exterior de EU, que a los fines de garantizar su "seguridad nacional", léase sus intereses socioeconómicos y geopolíticos, promueve mecanismos ad hoc de "orden interno" en la región. Esto nos lleva a reflexionar sobre las implicaciones del retorno al discurso de la seguridad y estabilidad internas y la identificación del enemigo en el "terrorismo", el crimen organizado y la "narco-insurgencia", en tanto que "nvita" a las Fuerzas Armadas (ffaa locales, en alianza con EU, a que se ocupen de asuntos de "orden interno", facilitando la militarización y paramilitarización, abriendo la puerta al negocio de las armas y de la privatización de la guerra, así como de las ya conocidas prácticas de terrorismo de Estado.

  7. Implante de filtro em veia cava inferior dupla: relato de caso e revisão da literatura / Filter placement in duplicated inferior vena cava: case report and review of the literature

    Scientific Electronic Library Online (English)

    Rafael Demarchi, Malgor; Marcone Lima, Sobreira; Priscila Nunes, Boaventura; Regina, Moura; Winston Bonetti, Yoshida.

    2008-06-01

    Full Text Available Veia cava inferior dupla é uma variação anatômica rara cuja prevalência é de 0,2-3%. O implante de filtro de veia cava, quando indicado em casos com duplicidade da veia cava inferior, pode ser realizado de diferentes formas: em ambas as veias cavas; em uma delas, embolizando a anastomose entre ambas [...] ; em somente uma delas; ou por implante supra-renal. Relatamos um caso de trombose venosa profunda no pós-operatório de implante de prótese de quadril com contra-indicação para tratamento anticoagulante e cuja cavografia evidenciou duplicidade de veia cava inferior. O implante de filtro de veia cava inferior realizado em posição supra-renal mostrou-se opção adequada e segura. Abstract in english Double inferior vena cava is a rare anatomic variation with prevalence ranging between 0.2-3.0%. In cases of duplication, inferior vena cava filter placement options include placing it in both vena cava, coil-embolization of the intervenous segment plus placing a filter in the right inferior vena ca [...] va, or suprarenal filter placement. We report a case of deep venous thrombosis after unilateral primary total hip replacement, presenting with contraindications for anticoagulant therapy, in which cavography showed inferior vena cava duplication. Inferior vena cava filter placement was performed in the supra-renal portion and was proved to be an adequate and safe procedure.

  8. Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

    Directory of Open Access Journals (Sweden)

    Herbert Coelho Hortmann

    2010-06-01

    Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary revascularization, a statistically significant difference was found only for the grafts used for the right coronary, with a better result for the SV (P = 0.036. CONCLUSION: Radial artery (RA presented worse results when compared to Saphenous vein (SV as a second graft in a CABG, especially in women who were anastomosed in the right coronary artery.

  9. Safety and Feasibility of the Venous Access via Internal Jugular Vein Puncture Approach for Totally Implantable Venous Access Device Placements Compared with Subclavian Vein Puncture

    OpenAIRE

    Yoshitake Sugamata; Hidemaro Yoshiba; Takanori Kakihara; Miwako Nozaki; Masatoshi Ooya; Nana Makino; Yawara Kubota; Kosuke Hirano; Asami Suzuki; Shinichiro Koketsu; Shinichi Sameshima

    2013-01-01

    Background: The aim of this study was to evaluate the safety and feasibility of venous access via the internal jugular vein (IJV) for totally implantable venous access device (TIVAD) placements. In Japan, TIVADs are generally placed in position by the percutaneous subclavian vein puncture approach (SVPA). However, this approach causes infrequent intraoperative or postoperative complications. Using the internal jugular vein puncture approach (IJVPA), TIVADs could be placed more easily and saf...

  10. The search for valved conduit tissue grafts for adults (>22 mm): an ultrasonographic study of jugular vein diameters of horses and cattle

    OpenAIRE

    Jenni Rolf; Schwarzwald Colin C

    2009-01-01

    Abstract Background Natural heterologous valved conduits with a diameter greater than 22 mm that can be used for right ventricular outflow tract reconstruction in adults are not commercially available. The purpose of this study was to measure by ultrasonography the maximum diameter of the distended jugular veins of horses and cattle, respectively, to identify a population of animals that would be suitable for post-mortem collection of jugular veins at sizes greater than 22 mm. Methods The stu...

  11. The search for valved conduit tissue grafts for adults (>22 mm): an ultrasonographic study of jugular vein diameters of horses and cattle

    OpenAIRE

    Schwarzwald, C C; JENNI, R.

    2009-01-01

    BACKGROUND: Natural heterologous valved conduits with a diameter greater than 22 mm that can be used for right ventricular outflow tract reconstruction in adults are not commercially available. The purpose of this study was to measure by ultrasonography the maximum diameter of the distended jugular veins of horses and cattle, respectively, to identify a population of animals that would be suitable for post-mortem collection of jugular veins at sizes greater than 22 mm. METHODS: The study popu...

  12. Lemierre’s syndrome: case of a patient with pulmonary embolism and cavernous sinus thrombosis complicating a septic internal jugular vein thrombus

    OpenAIRE

    VOJKO FLIS; NINA KOBILICA; ANDREJ BERGAUER

    2012-01-01

    Lemierre’s syndrome is a complex and unusual clinical entity, characterized by septic thrombophlebitis of the internal jugular vein. We present the case of a patient with Lemierre’s syndrome, pulmonary embolism and propagation of an internal jugular vein thrombus retrograde to the cavernous sinus. The patient was treated with antibiotics and heparin. The importance of rapid diagnosis of the extent of the disease, in directing the otherwise somewhat controversial treatment with heparin in pati...

  13. Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report

    OpenAIRE

    Binnebösel, Marcel; Grommes, Jochen; Junge, Karsten; Göbner, Sonja; Schumpelick, Volker; Truong, Son

    2009-01-01

    Central venous access devices are extensively used for long-term chemotherapy and parenteral nutrition. However, there are some possible immediate, early, and late complications related to the implantation technique, care, and maintenance. We present the uncommon occurrence of a thrombosis of the internal jugular vein due to a spontaneous migration of a Port-A-Cath catheter into the ipsilateral internal jugular vein as a delayed complication of a central venous access catheter implanted for c...

  14. Morphological description of great cardiac vein in pigs compared to human hearts / Descrição morfológica da grande veia cardíaca em suínos em comparação com corações humanos

    Scientific Electronic Library Online (English)

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

    2015-02-01

    Full Text Available Introdução: Apesar de sua importância como um modelo experimental, a informação sobre a grande veia cardíaca em suínos é esparsa. Objetivo: Determinar as características morfológicas da grande veia cardíaca e suas tributárias em suínos. Métodos: Foram estudados 120 corações extraídos de suínos dest [...] inados para o matadouro com método de atordoamento. Este estudo descritivo cross-over avaliou variáveis contínuas com teste T e variáveis discretas com teste ? quadrado de Pearson. O nível de significância P Abstract in english Introduction: In spite of its importance as an experimental model, the information on the great cardiac vein in pigs is sparse. Objective: To determine the morphologic characteristics of the great cardiac vein and its tributaries in pigs. Methods: 120 hearts extracted from pigs destined to the slau [...] ghterhouse with stunning method were studied. This descriptive cross-over study evaluated continuous variables with T test and discrete variables with Pearson ? square test. A level of significance P

  15. Procesos Alternativos de Combustión en Motores de Combustión Interna. Procesos Alternativos de Combustión en Motores de Combustión Interna

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    S. Martínez-Martínez

    2012-02-01

    Full Text Available La combustión por compresión de una mezcla pobre homogénea, o premezclada, ha surgido en los últimos años como una alternativa para la reducción simultánea de las emisiones de óxidos de nitrógeno (NOx y partículas (PM en los motores de combustión interna. Este novedoso proceso se puede considerar como un híbrido entre los motores de encendido provocado (MEP y los de encendido por compresión (MEC, ya que usa una mezcla homogénea (o altamente premezclada de aire-combustible como en los motores de encendido provocado, pero la mezcla se comprime hasta su auto-ignición, como en los motores de encendido por compresión. Aunque el nombre más usado para identificar este novedoso proceso de combustión ha sido el de HCCI (Homogeneous Charge Compression Ignition, en la literatura han aparecido una gran variedad de sistemas que aplican este concepto. En este trabajo se presenta una revisión de dichos sistemas. Combustion by compression of a lean and homogeneous (or premixed air-fuel mixture has recently emerged as an effective alternative to achieve simultaneous nitrogen oxides (NOx and particulate matter (PM reduction in internal combustion engines. This novel process can be considered as a hybrid between the spark ignition (SI and the compression ignition (CI combustions. To obtain it is necessary to generate a homogeneous (or highly premixed mixture of fuel and air (such as SI combustion, but this mixture is compressed up to its auto ignition limit (such as DI combustion. Even though this process has been identified as Homogeneous Charge Compression Ignition (HCCI, a variety of systems that use this concept have recently appeared. This document presents a review of such systems.

  16. Veia paraumbilical pérvia: importância hemodinâmica na hipertensão portal por esquistossomose mansônica hepatoesplênica. (Estudo com ultra-sonografia Doppler) / Patent paraumbilical vein: hemodynamic importance in Mansoni's hepatosplenic portal hypertension. (US-Doppler study)

    Scientific Electronic Library Online (English)

    Azzo, WIDMAN; Ilka Regina Souza de, OLIVEIRA; Manlio Basílio, SPERANZINI; Giovanni Guido, CERRI; William Abrão, SAAD; Joaquim, GAMA-RODRIGUES.

    2001-10-01

    Full Text Available Racional ? As repercussões hemodinâmicas das vias de circulação colateral portossistêmica sobre o sistema portal, na hipertensão portal, ainda não foram devidamente esclarecidas. A ultra-sonografia Doppler possibilitou o estudo do sistema portal de modo não-invasivo mediante a caracterização do diâm [...] etro dos vasos, da direção e da velocidade do fluxo sangüíneo. Objetivo - Estudar a veia paraumbilical mediante ultra-sonografia Doppler e avaliar sua repercussão na hemodinâmica do sistema portal, como via de circulação colateral portossistêmica. Método - Estudo do sistema portal, com ultra-sonografia Doppler, de 24 pacientes consecutivos com hipertensão portal por fibrose hepática devida à esquistossomose mansônica hepatoesplênica, hemorragia prévia por varizes do esôfago e veia paraumbilical pérvia com fluxo hepatofugal. Foram medidos o diâmetro e a velocidade média de fluxo na veia paraumbilical e a velocidade média de fluxo na veia porta e seus ramos direito e esquerdo. Foi realizado o teste de correlação linear entre a velocidade média de fluxo na veia porta com o diâmetro e a velocidade média de fluxo na veia paraumbilical. Os pacientes foram divididos em quatro grupos: D1 - veia paraumbilical com diâmetro ³ 0,68 cm (n = 10); V1 - veia paraumbilical com velocidade média de fluxo ³ 18,41 cm/seg (n = 11). As médias e os desvios padrão da velocidade média de fluxo na veia porta e seus ramos direito e esquerdo destes grupos foram comparados. Resultados - O diâmetro da veia paraumbilical foi de 0,68 ± 0,33 cm (intervalo: 0.15 - 1.30 cm) e a velocidade média de fluxo de 18,41 ± 11.51 cm/seg (intervalo: 5.73 - 38,20 cm/seg). O teste de Pearson (correlação linear) da velocidade média de fluxo na veia porta com o diâmetro da veia paraumbilical foi de r = 0,504 e com a velocidade média de fluxo na veia paraumbilical foi r = 0,735. No grupo D2, comparativamente ao grupo D1, a velocidade média de fluxo foi maior na veia porta (22,3 ± 7,66 / 17,80 ± 3,42 cm/seg), assim como no seu ramo esquerdo (22,4 ± 7,92 / 16,00 ± 4,73 cm/seg). No grupo V2, comparativamente ao grupo V1, a velocidade média de fluxo foi maior na veia porta (21,96 ± 5,89 / 16,31± 3,49 cm/seg), assim como no seu ramo esquerdo (21,94 ± 7,20 / 14,22 ± 4.41 cm/seg). Não houve alteração no ramo direito da veia porta: 13,67 ± 5,74 / 15,43 ± 3.43 cm/seg. Conclusões - A veia paraumbilical com diâmetro ³ 0,68 cm e velocidade média de fluxo ³ 18,41 cm/seg provoca o aumento da velocidade média de fluxo na veia porta e seu ramo esquerdo. O aumento da velocidade média de fluxo na veia porta e seu ramo esquerdo pode ser interpretado como influência hemodinâmica da veia paraumbilical sobre o sistema portal. A velocidade média de fluxo na veia paraumbilical é mais sensível do que seu diâmetro para avaliar a influência desta veia sobre o sistema portal na hipertensão portal por esquistossomose hepatoesplênica. A presença de uma via de circulação colateral portossistêmica hemodinamicamente significativa, aumenta a velocidade de fluxo nas veias do sistema portal, proximalmente ao seu ponto de origem. Abstract in english Background ? The hemodynamical effect of the collateral portosystemic circulation upon the portal system has not yet been fully understood. The US-Doppler made possible the non-invasive study of the portal system by evaluating the parameters: flow direction, diameter and flow velocity in it's vessel [...] s. Aims - To study the paraumbilical vein as a collateral portosystemic pathway and identify patterns for appraising its hemodynamic importance to the portal system. Method - US-Doppler study of the portal system of 24 patients with Mansoni's hepatosplenic schistosomic portal hypertension, previous esophagic variceal bleeding and patent paraumbilical vein with hepatofugal flow. The diameter and the mean flow velocity were measured in the paraumbilical vein and so were the mean flow velocity in the portal vein, right and left portal branches. The Pearson

  17. Vigilancia epidemiológica de la intoxicación aguda en el área sur de la comunidad de Madrid: estudio Veia 2004 / Epidemiologic survey of acute poisoning in the south area of the Community of Madrid: The Veia 2004 study

    Scientific Electronic Library Online (English)

    P. J., Caballero Vallés; S., Dorado Pombo; A., Díaz Brasero; M., Eugenia García Gil; L., Yubero Salgado; N., Torres Pacho; C., Ibero Esparza; J., Cantero Bengoechea.

    2008-02-01

    Full Text Available Objetivo: VEIA es un registro evolutivo de las intoxicaciones agudas (IA) atendidas en Urgencias del Hospital Doce de Octubre de Madrid en un año completo [19791 (2), 1985 (3), 1990 (4), 1994 (5), 1997 (6) y 2000 (7)] presentamos el estudio del año 2004 y comparamos los resultados con los de años an [...] teriores (1-7). Métodos y resultados: el método es idéntico. De las 1.508 IA, 610 son intentos de suicidio (IBAIS) 319 etílicas (IAVE) y 219 drogas (IAVD). De los 2259 tóxicos implicados el 48% son medicamentos (50% diazepóxidos) alcohol 25% y drogas el 13%. Conclusiones: este año ha supuesto un importante aumento (34%) del número de casos y la incidencia supera a todas las publicadas en nuestro país (25,31,40) Aunque en el conjunto no hay diferencia significativa de género con el Censo de Área, la hay en IBAIS, IAVE y IAVD Las IBAIS crecen un 35%; Se duplica el uso de benzodiacepinas y antidepresivos en los IS de mujeres y crecen también en hombres pero menos; El paracetamol se mantiene en el 23% AINES, adyuvantes y mío-relajantes aumentan en mujeres y también el uso de alcohol y otros no fármacos en los is de mujeres casi igualándose con los hombres. La cuarta parte de los hombres con IS eran adictos y aparecen 13 casos de trastornos alimentarios. En las IAVE crecen el grupo sin etilismo y baja el total. Las drogas se duplican con respecto al año anterior la cocaína supone los 2/3 también suben la MDMA (22 casos) y aparecen nuevas drogas, como el pegamento, sin duda efecto de la inmigración, y ketamina; incluso cuatro casos no pudieron ser etiquetados por la falta de medios diagnósticos en la urgencia. Abstract in english Objetive: VEIA study is an evolutional registry of acute poisonings (AP) attended in the Emergency Room of the Doce de Octubre Hospital in Madrid (Spain) in a whole year (1979,1985, 1990, 1994,1997 and 2000). We present the 2004 study and compare the results with the previous years. Methods and resu [...] lts: Methodology has been identical across VEIA STUDY. Of 1508 AP, 610 are suicide attempts (IAVIS), 319 ethylic, (IAVE), and 218 by illicit drugs (IAVD). Of the 2,259 toxics involved, 48% are medications (50% benzodiacepines) alcohol 25% and illicit drugs 13%. Conclusions: There is an important increase (34%) of cases and the incidence surpasses all published in our country. There are no gender differences nor in the whole neither the Health Area Census, but there are differences in IAVIS, IAVE and IAVD. IAVIS increase in 35%. Benzodiacepines poisoning increases two-fold as well as antidepressive drugs do in women. In men also increase, but in a minor extent. Acetaminophen remains the same in 23%. NSAID's, adjuvants and myorelaxants increase in women as do also alcohol and other poisons that almost equal men's. There are 13 cases of IAVIS in patients with alimentary disorders. Among men, a quarter are illicit drug abusers. In IAVE, the group without alcoholism grows and the total decreases. Illicit drugs duplicate the number of the former year. Cocaine supposes already 2/3 of the cases, MDMA ascends to 22 cases and they appear new substances as glue, without doubt as an effect of immigration and ketamine. Finally 205 household accidents and 57 industrial injuries complete the series.

  18. Vigilancia epidemiológica de la intoxicación aguda en el área sur de la Comunidad de Madrid: estudio VEIA 2004 / Epidemiologic survey of acute poisoning in the south area of the Community of Madrid: The VEIA 2004 study

    Scientific Electronic Library Online (English)

    P. J., Caballero Vallés; S., Dorado Pombo; A., Díaz Brasero; M. E., García Gil; L., Yubero Salgado; N., Torres Pacho; C., Ibero Esparza; J., Cantero Bengoechea.

    2008-06-01

    Full Text Available Objetivo: VEIA es un registro evolutivo de las intoxicaciones agudas (IA) atendidas en Urgencias del Hospital Doce de Octubre de Madrid en un año completo (1979 [2], 1985 [3], 1990 [4], 1994 [5], 1997 [6] y 2000 [7]) presentamos el estudio del año 2004 y comparamos los resultados con los de años ant [...] eriores (1-7). Métodos y resultados: el método es idéntico. De las 1.508 IA, 610 son intentos de suicidio (IBAIS) 319 etílicas (IAVE) y 219 drogas (IAVD). De los 2.259 tóxicos implicados el 48% son medicamentos (50% diazepóxidos) alcohol 25% y drogas el 13%. Conclusiones: este año ha supuesto un importante aumento (34%) del número de casos y la incidencia supera a todas las publicadas en nuestro país (25,31,40). Aunque en el conjunto no hay diferencia significativa de género con el Censo de Área, la hay en IBAIS, IAVE y IAVD Las IBAIS crecen un 35%; Se duplica el uso de benzodiacepinas y antidepresivos en los IS de mujeres y crecen también en hombres pero menos; El paracetamol se mantiene en el 23% AINE, adyuvantes y mío-relajantes aumentan en mujeres y también el uso de alcohol y otros no fármacos en los is de mujeres casi igualándose con los hombres. La cuarta parte de los hombres con IS eran adictos y aparecen 13 casos de trastornos alimentarios. En las IAVE crecen el grupo sin etilismo y baja el total. Las drogas se duplican con respecto al año anterior: la cocaína supone los 2/3 también suben la MDMA (22 casos) y aparecen nuevas drogas, como el pegamento, sin duda efecto de la inmigración, y ketamina; incluso cuatro casos no pudieron ser etiquetados por la falta de medios diagnósticos en la urgencia. Abstract in english Objetive: VEIA study is an evolutional registry of acute poisonings (AP) attended in the Emergency Room of the Doce de Octubre Hospital in Madrid (Spain) in a whole year (1979, 1985, 1990, 1994,1997 and 2000). We present the 2004 study and compare the results with the previous years. Methods and res [...] ults: Methodology has been identical across VEIA STUDY. Of 1508 AP, 610 are suicide attempts (IAVIS), 319 ethylic, (IAVE), and 218 by illicit drugs (IAVD). Of the 2,259 toxics involved, 48% are medications (50% benzodiacepines) alcohol 25% and illicit drugs 13%. Conclusions: There is an important increase (34%) of cases and the incidence surpasses all published in our country. There are no gender differences nor in the whole neither the Health Area Census, but there are differences in IAVIS, IAVE and IAVD. IAVIS increase in 35%. Benzodiacepines poisoning increases two-fold as well as antidepressive drugs do in women. In men also increase, but in a minor extent. Acetaminophen remains the same in 23%. NSAID's, adjuvants and myorelaxants increase in women as do also alcohol and other poisons that almost equal men's. There are 13 cases of IAVIS in patients with alimentary disorders. Among men, a quarter are illicit drug abusers. In IAVE, the group without alcoholism grows and the total decreases. Illicit drugs duplicate the number of the former year. Cocaine supposes already 2/3 of the cases, MDMA ascends to 22 cases and they appear new substances as glue, without doubt as an effect of immigration and ketamine. Finally 205 household accidents and 57 industrial injuries complete the series.

  19. Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica Influence of the inversion of the portal/splenic vein diameter in the results of the surgical treatment of schistossomotic portal hypertension

    Directory of Open Access Journals (Sweden)

    Álvaro Antônio Bandeira Ferraz

    2011-02-01

    Full Text Available OBJETIVO: Avaliar a morbidade e a mortalidade no tratamento cirúrgico da hipertensão portal esquistossomótica em pacientes portadores de inversão do diâmetro entre a veia porta e veia esplênica. MÉTODOS: Estudo transversal retrospectivo, de pacientes submetidos ao tratamento cirúrgico da hipertensão no período entre setembro de 1993 e Janeiro de 2004. A população do estudo foi distribuída em dois grupos: a Inversão - calibre da veia esplênica maior ou igual ao da veia porta e b grupo controle (calibre da veia porta maior que o da veia esplênica. Na análise estatística foram utilizados o teste t de student para diferença de médias, quiquadrado para diferença de proporções e o exato de Fisher para amostras reduzidas. RESULTADOS: 169 pacientes foram analisados com seguimento pós-operatório médio de 23,6 meses. 21 pacientes (12,4% apresentavam a veia esplênica de igual ou maior calibre que a veia porta (Inversão - grupo de estudo. A média dos diâmetros pré-operatórios das veias porta e esplênica foram, respectivamente, 1,49/1,14cm no grupo controle, e 0,98/1,07cm no grupo de inversão. O diâmetro da veia porta foi significativamente maior no grupo controle quando comparado ao grupo de inversão (p0,05. Na avaliação pós-operatória com ultrassonografia Doppler de vasos portais, não houve casos de trombose portal no grupo de inversão, e no grupo controle a trombose portal foi identificada em 16,9% dos pacientes (p0,05. A média do nível sérico de plaquetas foi significativamente menor (65.950mm? no grupo de inversão do que no grupo controle (106.647mm? (pOBJECTIVE: To evaluate the morbidity and mortality in surgical treatment of schistosomal portal hypertension in patients with inversion of the Portal/Splenic Vein diameter ratio. METHODS: We conducted a retrospective cross-sectional study of patients undergoing surgical treatment of portal hypertension in the period between September 1993 and January 2004. The study population was divided into two groups: a Inversion - splenic vein diameter greater than or equal to portal vein's - and b control group (portal vein diameter greater than the splenic vein's. Statistical comparisons used the Student t test for averages difference, chi-square test for proportions difference and Fisher's exact test for small samples. RESULTS: 169 patients were analyzed, with follow-up averaging 23.6 months. Twenty-one patients (12.4% had splenic vein caliber greater of equal than the portal vein's (Inversion - study group. The mean preoperative diameter of the portal and splenic veins were respectively 1.49 and 1.14 cm in the control group, and 0.98 versus 1.07 cm in the inversion group. The portal vein diameter was significantly higher in the control group when compared to the inversion group (p 0.05. In the postoperative evaluation with Doppler ultrasonography of portal vessels, no cases of portal vein thrombosis were observed in the inversion group, whilst in the control group portal thrombosis was identified in 16.9% of the patients (p 0.05. The mean serum level of platelets was significantly lower (65,950/mm? in the inversion group than in the controls (106,647/mm? (p<0.05. CONCLUSION: The results suggest that the reversal of portal/splenic vein caliber ratio does not represent a contraindication to surgical treatment of schistosomal portal hypertension.

  20. Fístula traumática entre tronco braquiocefálico e veia braquiocefálica por arma de fogo Traumatic fistula between the brachiocephalic trunk and the brachiocephalic vein due to gunshot wound

    OpenAIRE

    Pedro Paulo Martins de Oliveira; Orlando Petrucci; Karlos Alexandre de Souza Vilarinho; Lindemberg Mota Silveira; Reinaldo Wilson Vieira; Domingo Marcolino Braile

    2008-01-01

    Descrevemos caso de paciente do sexo masculino, 49 anos, que sofreu ferimento por arma de fogo no tórax, transfixando o mediastino médio. Apresentava-se estável hemodinamicamente, contudo taquicárdico e taquipnéico. Ele foi submetido à propedêutica armada com radiograma de tórax, ecocardiografia transtorácica, tomografia computadorizada de tórax e arteriografia do arco aórtico. Evidenciou-se fístula traumática do tronco braquiocefálico com a veia braquiocefálica. Realizou-se co...

  1. A veia gástrica esquerda como alternativa de revascularização portal no transplante hepático / Left gastric vein as an alternative of portal revascularization in liver transplant

    Scientific Electronic Library Online (English)

    Cláudio Moura, Lacerda; Paulo Sérgio Vieira de, Melo; Américo, Amorim; Ricardo, Lima; Mário, Emery; Danielle, Batista; Danielle, Andrade.

    2002-02-01

    Full Text Available Trombose ou hipoplasia da veia porta não tem sido, ainda, considerados contra-indicações para o transplante ortotópico de fígado. Contudo, permanecem com obstáculos associados com aumento da freqüência de falha primária e a longo prazo do transplante de fígado. Existem alguns fatores de risco tais c [...] omo: sexo masculino, cirrose avançada, doença hepática alcoólica e cirurgia prévia para hipertensão portal. Os autores relatam o caso de uma criança de 4 anos, do sexo feminino, que sofria de doença terminal do fígado resultante de atresia de vias biliares e que tinha submetido, sem sucesso, a uma operação de Kasai. Ela se submeteu a um transplante ortotópico de fígado por cirrose biliar secundária. Durante a cirurgia uma hipoplasia portal severa do receptor foi encontrada. Uma anastomose entre a veia gástrica esquerda do receptor e a veia porta do doador foi feita. Reperfusão hepática e subseqüente função do fígado foram excelentes. A paciente recebeu alta hospitalar no trigésimo dia. A veia gástrica esquerda pode ser uma alternativa para revascularização portal no transplante hepático. Abstract in english Portal vein thrombosis or hipoplasia have not been, anymore, a contraindication for orthotopic liver transplantation. Nevertheless, it remains an obstacle associated with increased incidence of primary and long-term liver failure. There are some risk factors like being male, advanced cirrhosis, alco [...] holic liver disease and previos surgery for portal hypertension. The authors report a case of a 4-yr-old female patient who suffered from end-stage liver disease resulting from biliary atresia with failed Kasai´s operation. She underwent orthotopic liver transplantation for secondary biliary cirrhosis. During surgery a severe recipient portal vein hipoplasia was found. An anastomosis between the recipient left gastric vein and the graft portal vein was performed. Hepatic reperfusion and subsequent liver function were excellent. The patient left hospital on the 30th postoperative day. The left gastric vein can be an alternative of portal revascularization in liver transplant.

  2. Ablação com radiofreqüência do flutter atrial tipo I. Importância do bloqueio bidirecional do istmo entre a veia cava inferior e o anel da valva tricúspide

    OpenAIRE

    Scanavacca Mauricio; Sosa Eduardo; Velarde José Luis; D'Ávila André; Hachul Denise; Reolão Basileu; Sanches Osvaldo; Silva Márcio; Darrieux Francisco

    1998-01-01

    OBJETIVO: Estudar a importância clínica da determinação eletrofisiológica da presença de bloqueio bidirecional na condução pelo istmo localizado entre a veia cava inferior e o anel da valva tricúspide (VCI - AT), após a ablação do flutter atrial tipo I (FL) com radiofreqüência (RF). MÉTODOS: Quarenta pacientes consecutivos (idade média 51±11 anos) com FL foram submetidos a ablação do istmo VCI-AT com RF. Em 30 pacientes (GI), o sucesso foi avaliado pela interrupção e não reindução do FL com e...

  3. Emergency autologous vein graft reconstruction after using a vascular closure device / Reconstrução de emergência de enxerto autólogo de veia após uso de dispositivo de fechamento vascular

    Scientific Electronic Library Online (English)

    Giel G, Koning; Nasir A, Sayed; J. Adam Van Der, Vliet.

    2011-06-01

    Full Text Available Uma operação de emergência relacionada à isquemia aguda com sinais de infecção é descrita. Reconstrução femoral inguinal foi realizada com um enxerto bifurcado feito a partir da veia safena ipsilateral. [...] Abstract in english An emergency operation for access related acute critical limb ischemia with signs of infection is described. Inguinal femoral reconstruction was performed with a bifurcated graft constructed from the ipsilateral saphenous vein. [...

  4. Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

    OpenAIRE

    Handley, Tom P. B.; Miah, Mohammed S.; Samit Majumdar; S. S. Musheer Hussain

    2010-01-01

    Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due ...

  5. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging / Anomalias congênitas da veia cava inferior: revisão dos achados na tomografia computadorizada multidetectores e ressonância magnética

    Scientific Electronic Library Online (English)

    Catherine, Yang; Henrique Simao, Trad; Silvana Machado, Mendonca; Clovis Simao, Trad.

    2013-07-01

    Full Text Available Anomalias da veia cava inferior são incomuns, ocorrendo em até 8,7% da população, quando consideradas as anomalias da veia renal esquerda. A veia cava inferior se desenvolve da sexta à oitava semanas de gestação, originada de três veias embrionárias pareadas: veias subcardinais, supracardinais e pós [...] -cardinais. A complexidade da ontogenia da veia cava inferior, com numerosas anastomoses entre essas três veias embrionárias, pode levar a uma grande variedade do retorno venoso do abdome e membros inferiores. Algumas dessas anomalias têm implicações clínicas e cirúrgicas significativas, associadas a outras anomalias congênitas, e em alguns casos, associadas a trombose venosa de membros inferiores, principalmente em pacientes adultos jovens. Foram revistos os exames de dez pacientes com anomalias da veia cava inferior, três deles com trombose venosa profunda de membros inferiores. Foram salientados os principais aspectos das anomalias da veia cava inferior, nos exames de tomografia computadorizada multidetectores e ressonância magnética, correlacionados com a embriologia e demonstrando as principais vias alternativas de drenagem venosa. O conhecimento das anomalias da veia cava inferior é fundamental na avaliação dos exames de imagem do abdome, evitando erros de interpretação e indicando a possibilidade de anomalias associadas, implicações clínicas e cirúrgicas. Abstract in english Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and post [...] cardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  6. Utilização da veia ilíaca externa recanalizada para implante de cateter de longa permanência para hemodiálise / Using recanalized external iliac vein for tunneled hemodialysis catheter insertion

    Scientific Electronic Library Online (English)

    Ricardo Wagner da Costa, Moreira; Leonardo Carletto, Borges; Kellen Michelle Alves, Costa; Raquel Martins e, Quinino; Yvis Gadelha, Serra; Luís Carlos de, Oliveira.

    2008-06-01

    Full Text Available O uso de cateteres venosos cervicais para hemodiálise leva freqüentemente à oclusão dessas veias. Como alternativa, os acessos venosos femorais são válidos, porém o seu uso também está associado à oclusão dessas veias e a um maior índice de infecção. Vias alternativas são cada vez mais utilizadas na [...] impossibilidade dos acessos previamente mencionados. Descrevemos neste relato de caso uma alternativa para o implante de cateter de longa permanência para hemodiálise usando a veia ilíaca externa recanalizada. Comentamos os detalhes da técnica utilizada, suas vantagens e desvantagens. Abstract in english The frequent insertion of cervical venous catheters for hemodialysis is closely related to venous stenosis or occlusion. As an alternative, femoral catheter insertions are helpful but are also associated with femoral vein occlusion and an even higher infection rate. Alternative venous accesses have [...] been increasingly used when the aforementioned accesses are not feasible. We report a case in which a recanalized external iliac vein was used for hemodialysis tunneled catheter insertion. The technique approach is discussed, focusing on its advantages and disadvantages.

  7. Esplenectomia com ligadura da veia gástrica esquerda e desvascularização da grande curvatura do estômago no tratamento da esquistossomose hepatoesplênica: é necessária a escleroterapia endoscópica pós-operatória

    Directory of Open Access Journals (Sweden)

    FERRAZ Álvaro Antônio Bandeira

    2001-01-01

    Full Text Available Objetivo - Com o intuito de avaliar a eficácia e a manutenção da esclerose endoscópica pós-operatória como rotina, em associação à esplenectomia com ligadura da veia gástrica esquerda e desvascularização da grande curvatura do estômago, foi realizado o presente estudo. Método - Entre 1992 e 1998 foram operados 131 pacientes no Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE. O seguimento médio foi de 30 meses. Os pacientes foram solicitados a retornar ao ambulatório daquele hospital para realização de controle clínico e laboratorial. Dos 111 pacientes que retornaram ao ambulatório, apenas 80 realizaram endoscopia digestiva alta de controle. Destes 80, 36 seguiram a recomendação e realizaram esclerose endoscópica pós-operatória (grupo 1, enquanto 44 não a realizaram (grupo 2. Resultados - Observou-se de forma relevante e estatisticamente significativa, a diferença entre os dois grupos quando se analisou a erradicação das varizes de esôfago, com melhor resultado para o grupo 1 (52,7% do grupo 1 versus 18,2% do Grupo 2. Nos demais itens analisados (mortalidade, recidiva hemorrágica, trombose da veia porta, varizes de fundo gástrico e grau de fibrose periportal não se observou relevância estatística. Conclusão - Conclui-se que a associação da escleroterapia endoscópica pós-operatória à esplenectomia com ligadura de veia gástrica esquerda e desvascularização da grande curvatura do estômago, no tratamento da hipertensão portal esquistossomótica com antecedentes de hemorragia digestiva, deve ser mantida.

  8. Utilização da veia ilíaca externa recanalizada para implante de cateter de longa permanência para hemodiálise Using recanalized external iliac vein for tunneled hemodialysis catheter insertion

    Directory of Open Access Journals (Sweden)

    Ricardo Wagner da Costa Moreira

    2008-06-01

    Full Text Available O uso de cateteres venosos cervicais para hemodiálise leva freqüentemente à oclusão dessas veias. Como alternativa, os acessos venosos femorais são válidos, porém o seu uso também está associado à oclusão dessas veias e a um maior índice de infecção. Vias alternativas são cada vez mais utilizadas na impossibilidade dos acessos previamente mencionados. Descrevemos neste relato de caso uma alternativa para o implante de cateter de longa permanência para hemodiálise usando a veia ilíaca externa recanalizada. Comentamos os detalhes da técnica utilizada, suas vantagens e desvantagens.The frequent insertion of cervical venous catheters for hemodialysis is closely related to venous stenosis or occlusion. As an alternative, femoral catheter insertions are helpful but are also associated with femoral vein occlusion and an even higher infection rate. Alternative venous accesses have been increasingly used when the aforementioned accesses are not feasible. We report a case in which a recanalized external iliac vein was used for hemodialysis tunneled catheter insertion. The technique approach is discussed, focusing on its advantages and disadvantages.

  9. Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    2006-10-01

    Full Text Available Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

  10. Alterações angiográficas e pressóricas determinadas pela esplenectomia e ligadura da veia gástrica esquerda em portadores de esquistossomose mansônica / Angiografic and pressoric changes determined by splenectomy with left gastric vein ligature in mansoni schistosomiasis

    Scientific Electronic Library Online (English)

    Fernanda Maria Fernández, Pereira; João, Evangelista-Neto; Norma, Brito; Fernando, Amaral; Olival Cirilo Lucena da, Fonseca-Neto; Cláudio Moura, Lacerda.

    2013-12-01

    Full Text Available RACIONAL: Na esquistossomose mansônica na forma hepatoesplênica ocorre fibrose hepática difusa que associada à congestão venosa do sistema porta resulta em hepatoesplenomegalia. Pode produzir hemorragia digestiva alta por rotura das varizes de esôfago e do estômago ou lesões pépticas da mucosa gastr [...] oduodenal. OBJETIVO: Estudar os efeitos da esplenectomia e ligadura da veia gástrica esquerda sobre a hemodinâmica portohepática. MÉTODO: Vinte e três portadores de esquistossomose mansônica na forma hepatoesplênica foram estudados prospectivamente, antes e cerca de duas semanas após a operação, através de estudos angiográficos dos diâmetros da artéria hepática comum e própria, artéria esplênica, artéria mesentérica superior, veia porta, veia mesentérica superior e veia gástrica esquerda. Foram aferidas as pressões da veia cava inferior, venosa central, da veia hepática livre, da veia hepática ocluída e sinusoidal. RESULTADOS: A ligadura da veia gástrica esquerda determinou acréscimo significante nas seguintes variáveis: diâmetros da artéria hepática comum e própria; diâmetro da veia mesentérica superior; o acréscimo não foi significante nas seguintes medidas: pressão venosa central e diâmetro da artéria mesentérica superior. Ela promoveu decréscimo não significante nas variáveis: pressão da veia cava inferior; pressão da veia hepática livre; pressão da veia hepática ocluída; pressão sinusoidal; diâmetro da veia porta. CONCLUSÃO: A ligadura da veia gástrica esquerda, na maioria dos casos, não determina alterações hemodinâmicas significantes do sistema porta capazes de quebrar o equilíbrio hemodinâmico funcional, que caracteriza a esquistossomose mansônica na forma hepatoesplênica. Abstract in english BACKGROUND: In hepatosplenic schistosomiasis occurs diffuse hepatic fibrosis associated with venous congestion of the portal system resulting in hepatosplenomegaly. It can produce digestive hemorrhage caused by rupture of esophageal and stomach varices or peptic gastroduodenal mucosal lesions. AIM: [...] To study the effects of splenectomy and ligature of the left gastric vein on portohepatic hemodynamics. METHOD: Twenty-three patients with hepatosplenic schistosomiasis mansoni were studied before and about two weeks after operation through angiographic diameter of the common and proper hepatic artery, splenic artery, superior mesenteric artery, portal vein, superior mesenteric vein and left gastric vein. The pressures of the inferior vena cava and central venous pressure, free hepatic vein, the hepatic sinusoidal and occluded vein were measured. RESULTS: The splenectomy and ligature of the left gastric vein determined low morbidity and null mortality. It determined significant addition to the following variables: diameters of the common and proper hepatic artery; diameter of the superior mesenteric vein. It determined non significant increase on the following measurements: right atrial pressure and diameter of the superior mesenteric artery. It determined non significant decrease to the following variables: inferior vena cava pressure; free hepatic vein pressure; occluded hepatic vein pressure; sinusoidal pressure, diameter of the portal vein. CONCLUSION: Splenectomy and ligature of the left gastric vein do not determine portal hemodynamic changes capable of breaking the functional hemodinamic balance that characterizes the hepatosplenic mansoni schistosomiasis.

  11. Thrombophlebitis of the internal jugular vein (Lemierre syndrome) - Clinical and CT findings

    International Nuclear Information System (INIS)

    Background: Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose: To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods: The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9±8.3 years) with thrombophlebitis of the IJV. Results: Five patients (50%) had complications, including pneumonia (n = 3), neck abscess (n = 1), and thrombophlebitis of cerebral venous sinus (n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length (n = 8, 67%), ovoid shape (n = 7, 58%), complete occlusion of the lumen (n = 10, 83%), circumferential (n = 11, 92%), smooth (n = 8, 67%), and thick (=4 mm) (n = 8, 67%) rim enhancement, and adjacent soft tissue swelling (n = 11, 92%). Conclusion: Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis

  12. A study on complications in land mark technique catheterization of internal jugular vein

    Directory of Open Access Journals (Sweden)

    Henjarappa KS

    2015-06-01

    Full Text Available Background: The traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Cannulation of the IJV was first described in 1969. Various positions were used to access cannulation but they were frequently associated with complications such as arterial puncture, pneumothorax, neurological damage, infection, dysrhythmias, atrial thrombus, cardiac rupture. Methods: Thirty critical care patients were selected for IJV cannulation either by Land mark technique. This study conducted in department of anaesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. India. Results: In our study there was 83.3% success in LMG technique. The mean access time was 323.23 +/- 146.19 sec and the distribution of complications encountered during the study, Carotid artery was accidentally punctured in 1 (3.3% cases. In LMG technique, there were no cases of arrhythmias, haematoma, pneumothorax, haemothorax, nerve injury and catheter malposition were noted during the study. Conclusion: Land mark technique catheterization of internal jugular vein was shown complications than newly developed ultrasound guided method. [Int J Res Med Sci 2015; 3(3.000: 688-692

  13. Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography.

    Science.gov (United States)

    Lim, Byung Gun; Kim, Young Min; Kim, Heezoo; Lim, Sang Ho; Lee, Mi Kyoung

    2011-12-01

    A 41-year-old woman, who had no thrombotic risk factors and past history except congenital scoliosis, underwent central venous catheterization (CVC) before correction of the scoliosis. When internal jugular vein (IJV) catheterization using the anatomical landmark technique failed, CVC under ultrasound guidance was tried. As a consequence, thrombosis and hypoplasia of the right IJV were incidentally detected by ultrasonography. Central venous catheters were then successfully placed in other veins under ultrasound guidance. Also, after examinations to rule out the possibility of pulmonary embolism and to clarify the causes of the IJV thrombosis, the patient was found to have protein S deficiency. CVC under ultrasound guidance should be recommended to prevent the failure of cannulation and complications such as thromboembolism in patients who could possibly have anomalies of vessels as a result of anatomical deformities caused by severe scoliosis, even if patients do not have thrombotic risk factors such as a history of central catheter insertion or intravenous drug abuse, cancer, advanced age, cerebral infarction, and left ventricular dysfunction. Also, if venous thrombosis is found in patients without predisposing risk factors, one should ascertain the cause of the hypercoagulable state, for example protein S deficiency, and perform appropriate treatment and prevention of venous thromboembolism. PMID:21931986

  14. Thrombophlebitis of the internal jugular vein (Lemierre syndrome) - Clinical and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Yeon; Yoon, Dae Young; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo; Choi, Chul Soon; Bae, Sang Hoon [Dept. of Radiology, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)], e-mail: evee0914@chollian.net; Kim, Hyeong Chul [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Kangwon-do (Korea, Republic of); Kim, Eun Soo [Dept. of Radiology, Hallym Univ. Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Gyeonggi-do (Korea, Republic of); Baek, Sora [Dept. of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)

    2013-07-15

    Background: Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose: To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods: The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9{+-}8.3 years) with thrombophlebitis of the IJV. Results: Five patients (50%) had complications, including pneumonia (n = 3), neck abscess (n = 1), and thrombophlebitis of cerebral venous sinus (n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length (n = 8, 67%), ovoid shape (n = 7, 58%), complete occlusion of the lumen (n = 10, 83%), circumferential (n = 11, 92%), smooth (n = 8, 67%), and thick (=4 mm) (n = 8, 67%) rim enhancement, and adjacent soft tissue swelling (n = 11, 92%). Conclusion: Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis.

  15. Plasma concentrations of corticosterone and buprenorphine in rats subjected to jugular vein catheterization

    DEFF Research Database (Denmark)

    Goldkuhl, Renée; Jacobsen, Kirsten Rosenmaj

    2010-01-01

    The present study investigated the postoperative plasma concentrations of corticosterone and buprenorphine in male Wistar and Sprague-Dawley rats, treated with buprenorphine administered either through subcutaneous (SC) injection or through voluntary ingestion (VI). The animals were treated with buprenorphine for pre-emptive analgesia prior to surgical placement of a jugular catheter, followed by automated blood sampling during 96 h. Buprenorphine was administered on a regular basis throughout the experiment, and blood was collected on selected time points. Body weight was measured before and 96 h after surgery. It was found that the two rat stocks responded in a similar manner to both buprenorphine treatments, with the exception of body weight change in Wistar rats, in which body weight was reduced after SC treatment. The plasma concentration of corticosterone was significantly higher in the SC-treated animals than in the VI-treated animals during the first 18 h of the study, while plasma buprenorphine concentration was at least as high and more even over time after VI treatment. The present study shows that buprenorphine administration through VI is suitable for both Wistar and Sprague-Dawley rats, with lower stress response and higher plasma concentrations of buprenorphine than after the traditional SC route of administration.

  16. MR imaging of paragangliomas of the jugular bulb and carotid body

    International Nuclear Information System (INIS)

    The diagnostic efficiency of plain and Gd-DTPA enhanced magnetic resonance (MR) imaging with different spin-echo sequences and fast imaging techniques was studied in 45 patients suffering from paragangliomas of the jugular bulb and carotid body. The examinations were carried out with a 1.5-T MR unit, during and after the application of Gd-DTPA. Subsequent flash images with a repetition time of 30 msec and a 200 flip angle were acquired over a period of 7 minutes. In all glomus tumors, the signal intensity increased during the first 200 seconds following the injection of Gd-DTPA, and the maximum signal intensity was reached after 300 sec. With fast imaging techniques and Gd-DTPA glomus tumors, neuromas and meningeomas could be differentiated from other tumorous lesions. The sensitivity of MR imaging is far superior to that of CT for detecting even small paragangliomas in the temporal bone and the carotid body. Additionally, fast imaging techniques enable differentiation between neuromas and other pathologic processes

  17. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  18. Chronic performance of polyurethane catheters covalently coated with ATH complex: a rabbit jugular vein model.

    Science.gov (United States)

    Klement, Petr; Du, Ying Jun; Berry, Leslie R; Tressel, Paul; Chan, Anthony K C

    2006-10-01

    Covalent complexes of antithrombin (AT) and heparin (ATH) have superb anticoagulant activity towards thrombin and factor Xa. Stability of polyurethane central venous catheters covalently modified with radiolabeled ATH was studied using a roller pump with saline or protease P-5147. Saline wash removed loosely bound ATH molecules to decrease graft density from 26 to 12 pmol/cm2. However, only slightly more ATH was removed by strong protease (from 12 to 7 pmol/cm2). To evaluate ATH-coated, heparin-coated, and uncoated catheters, a chronic rabbit jugular vein model was developed with catheters maintained for up to 30-106 days. Lumen occlusion was tested by drawing blood twice daily. Although unmodified or heparin-coated catheters occluded within 5-7 days after insertion, all ATH catheters remained patent throughout the experiment. Scanning electron microscopy (SEM) analysis of heparin and uncoated catheters revealed extensive thrombosis (lumen+mural) while ATH catheters were unaffected. Visual observation showed significant deposition of protein and cells on control and heparin-modified catheters and, to a lesser degree, on ATH-coated surfaces. SEM showed no fibrin inside or outside of ATH catheters, which remained patent in extended studies out to 106 days. Although atomic force microscopy showed ATH coatings to be rough, 6-fold higher anti-factor Xa activity likely contributed to increased patency. Our data confirm that ATH-modified catheters are stable and have superior potency compared to heparin or control catheters. PMID:16781768

  19. Internal jugular vein patency after modified radical neck dissection in patients with oral cancer

    International Nuclear Information System (INIS)

    In consideration of postoperative dysfunction associated with radical neck dissection (RND), various modifications of RND have recently been reported. We investigated the postoperative patency of the internal jugular vein (IJV) by enhanced computed tomography in 120 patients (136 sides) with oral cancer who underwent IJV-preserving modified radical neck dissections (mRNDs). The following results were obtained. Of the 136 sides, 102 (75.0%) showed a normal IJV, while 26 (19.1%) showed IJV stenosis, and 8 (5.9%) showed IJV obstruction. No patient had clinical symptoms caused by stenosis or obstruction of the IJV. There were no relations between stenosis or obstruction of the IJV and age, sex, number of metastatic nodes, extranodular invasion, postoperative radiotherapy, or reconstructive surgery. Stenosis or obstruction of the IJV occurred significantly more frequently in the left side of the neck than in the right side of the neck. Postoperative compressive procedures of the neck because of leakage of the parotid gland saliva, infection, or chyle were considered one of the causes of the IJV obstruction. (author)

  20. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    International Nuclear Information System (INIS)

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  1. Simultaneous subcutaneous implantation of two osmotic minipumps connected to a jugular vein catheter in the rat.

    Science.gov (United States)

    Wedel, Johannes; Weij, Michel; Oosten, Annemieke Smit-van; Hillebrands, Jan-Luuk

    2014-10-01

    Subcutaneous osmotic pump implantation connected to a venous catheter is a well-established method for delivering compounds intravenously for an intermediate duration (approximately two weeks). When prolonged release is desired (approximately four weeks) reduced flow rate is needed with a similar pump volume. With a fixed intra-pump compound concentration, reduced flow rate results in unwanted reduced bioavailability of the compound. Prolonged intravenous delivery would therefore need a pump replacement, resulting in increased discomfort and confounding effects on experimental outcome. To overcome this, we describe a method to double the compound infusion rate for four weeks by implanting two low-flow rate osmotic pumps (2.5 µL/h for 28 days) connected to a jugular vein catheter in a single rat. Rats implanted with a single high-flow rate pump (5 µL/h for 14 days) served as controls. Double pump-implanted rats displayed similar post-operative weight gain and physical activity indicating similar levels of discomfort when compared with single pump-implanted rats. Double pump-implanted rats had an increased risk of pump-related complications (four delivery failures [double pump] versus one delivery failure [single pump]). Our data show that double pump implantation is a feasible alternative to changing pumps or the use of extracorporeal pump systems connected via a long wire to partly restrained animals. PMID:25002205

  2. Valor da Taxa de Eritroblastos no Sangue da Veia Umbilical de Recém-Nascidos como Marcador Hematológico da Hipóxia Perinatal

    Directory of Open Access Journals (Sweden)

    Behle Ivo

    2001-01-01

    Full Text Available Objetivo: examinar se a taxa de eritroblastos, no sangue da veia umbilical de recém-nascidos, tem relação com a hipoxia perinatal, analisada pelos parâmetros que expressam o equilíbrio ácido-básico (EAB do sangue funicular. Métodos: de recém-nascidos vivos com pelo menos 37 semanas de gestação, assistidos no Hospital de Alvorada-RS, foram coletadas amostras de sangue da veia umbilical antes da instalação da respiração. Parte do sangue foi coletado em frasco contendo EDTA, determinando-se as séries vermelha e branca. No sangue coletado em seringa com heparina, foram determinados valores do pH, pO2, pCO2 e calculado o EAB. Em lâmina corada pelo corante panótico, procedeu-se à contagem manual do número de eritroblastos. A taxa de eritroblastos foi calculada em relação ao número de leucócitos. Resultados: dos 158 casos que compõem o estudo, em 55 as condições perinatais permitiram considerá-los como isentos de acometimento de processo hipóxico. A média da taxa de eritroblastos foi 3,9%, com o desvio-padrão de 2,8%. Os valores mínimo e máximo foram 0% e 10%, respectivamente. Dentre os 158 casos, a taxa dos eritroblastos foi 5,7%, com desvio-padrão de 5,3%. Os valores mínimo e máximo foram 0% e 28%, respectivamente. A aplicação do teste de Pearson a taxa dos eritroblastos e valores dos parâmetros do EAB mostrou correlação significativa para o pH e pCO2. A elaboração da curva ROC revelou que 5% de eritroblastos e pH de 7,25 representam pontos de corte que contrabalançam a sensibilidade e especificidade (54% e 56%, respectivamente. Dos 23 conceptos com taxa de eritroblastos maior que 10%, 7 (30,4% estavam acidóticos, 11 (48,7% eram grandes para a idade gestacional, 3 (13% eram pequenos para a idade gestacional, 7 (30,4% tinham anemia e em 3 (13% não foram constatadas anormalidades. Conclusões: em recém-nascidos de gestações e partos sem complicações, a taxa de eritroblastos ao nascimento foi menor do que 10%. Quando a taxa de eritroblastos foi maior do que 10% houve correlação principalmente com acidemia, distúrbios do crescimento intra-uterino e anemia fetal.

  3. Expression of apoptosis in human saphenous vein grafts in restoration of blood flow through coronary bypass surgery Expressão da apoptose em enxertos de veias safenas humana para restauração do fluxo sanguíneo coronariano por derivação

    Directory of Open Access Journals (Sweden)

    Luís Fernando Tirapelli

    2009-09-01

    Full Text Available OBJECTIVE: To investigate the possible role of apoptosis on brief distensions of human saphenous veins at different pressures. METHODS: Fresh isolated grafts of human saphenous vein were assigned as control or distended (D for fifteen seconds at 100, 200 and 300 mmHg. The degree of apoptotic caspases 3, 8, 9 and anti-apoptotic protein Bcl-2 expression were assessed by immunohistochemistry. RESULTS: Fresh isolated segments of distended human saphenous veins presented similar apoptotic protein expression when compared with control veins. However, the Bcl-2 expression was significantly higher in the 300 mmHg distended segments compared with the control vein. CONCLUSION: These findings show that intact segments of human saphenous veins submitted to distensions at different pressures have similar apoptotic proteins expression when compared with non-distended control veins. Therefore, brief distensions commonly performed during surgical harvesting do not trigger apoptosis, and probably are not involved on the physiopathological mechanisms that lead to graft failureOBJETIVO: Investigar o possível papel da apoptose em distensões breves de veias safenas humanas em diferentes pressões. MÉTODOS: Segmentos frescos isolados de veia safena humana foram distribuídos em 4 grupos: controle ou distendidos (D por quinze segundos a 100, 200 e 300 mmHg. O grau de apoptose das caspases 3, 8, 9 e expressão da proteína anti-apoptótica Bcl-2 foram avaliados por imuno-histoquímica. RESULTADOS: Segmentos frescos distendidos isolados de veias safenas humanas apresentaram expressão protéica para apoptose similar às veias controle. No entanto, a expressão de Bcl-2 foi significativamente maior nos segmentos distendidos a 300 mmHg, quando comparados à veia controle. CONCLUSÃO: Estes achados demonstram que segmentos intactos de veias safenas humanas submetidos a distensões em diferentes pressões têm expressão de proteínas apoptóticas similares quando comparados com veias controle nãodistendidas. Por conseguinte, breves distensões comumente realizadas durante a coleta cirúrgica não ativam o processo de apoptose e, provavelmente, não estão envolvidas em mecanismos fisiopatológicos que levam à falência do enxerto

  4. Vena cava filters in cancer patients: experience with 50 patients / Filtros de veia cava inferior em pacientes com câncer: experiência em 50 casos

    Scientific Electronic Library Online (English)

    Antonio Eduardo, Zerati; Nelson, Wolosker; Guilherme, Yazbek; Marcel, Langer; Kenji, Nishinari.

    2005-10-01

    Full Text Available OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupç [...] ão de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o procedimento foi a impossibilidade de anticoagulação plena (80% ) e a via de acesso preferencial foi a punção da veia femoral, realizada em 86% dos pacientes. Não houve complicações relativas ao implante dos filtros. Durante a evolução ocorreram: um episódio de tromboembolia pulmonar não fatal e dois casos de oclusão da veia cava inferior; em um paciente foi demonstrada a presença de coágulo retido no dispositivo. Vinte pacientes (40%) faleceram devido à neoplasia. CONCLUSÃO: A interrupção da veia cava inferior com filtro endoluminal é um procedimento com baixo índice de complicações e eficaz na prevenção da embolia pulmonar nos pacientes com tromobose venosa profunda de membros inferiores portadores de câncer. Abstract in english OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who und [...] erwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%). The femoral vein was the preferred access route (86% of the patients). There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40%) died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.

  5. Vena cava filters in cancer patients: experience with 50 patients Filtros de veia cava inferior em pacientes com câncer: experiência em 50 casos

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Zerati

    2005-10-01

    Full Text Available OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%. The femoral vein was the preferred access route (86% of the patients. There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40% died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupção de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o procedimento foi a impossibilidade de anticoagulação plena (80% e a via de acesso preferencial foi a punção da veia femoral, realizada em 86% dos pacientes. Não houve complicações relativas ao implante dos filtros. Durante a evolução ocorreram: um episódio de tromboembolia pulmonar não fatal e dois casos de oclusão da veia cava inferior; em um paciente foi demonstrada a presença de coágulo retido no dispositivo. Vinte pacientes (40% faleceram devido à neoplasia. CONCLUSÃO: A interrupção da veia cava inferior com filtro endoluminal é um procedimento com baixo índice de complicações e eficaz na prevenção da embolia pulmonar nos pacientes com tromobose venosa profunda de membros inferiores portadores de câncer.

  6. Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas

    Directory of Open Access Journals (Sweden)

    Taveira Marcos Roberto

    2003-01-01

    Full Text Available OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlação entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentração sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusões intra-uterinas intravasculares, a hemoglobina do cordão foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordão foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusão intra-uterina precedida pela dopplervelocimetria venosa. A mensuração da concentração da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden, dispositivo usado para a determinação quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV, o índice do pico de velocidade para veias (IPVV e a relação entre o pico de velocidade durante a fase de contração atrial e o pico de velocidade na sístole ventricular (relação CA/SV ou índice de pré-carga, na veia cava inferior, e o IPV, IPVV e a relação entre os picos de velocidade da sístole ventricular e da contração atrial (relação SV/CA, no ducto venoso. Foi realizado estudo de correlação entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordão, pela técnica de regressão linear simples. Realizou-se também estudo de associação entre os índices dopplervelocimétricos do compartimento venoso e a hemoglobina fetal inferior a 10 g/dL, por meio do teste do c². RESULTADOS: foi efetuado um total de 74 procedimentos. Em 23 desses a hemoglobina fetal era inferior a 7,0 g/dL. Houve correlação negativa significativa entre todos os índices dopplerfluxométricos estudados e a concentração de hemoglobina fetal (p<0,05, ou seja, os valores mais elevados dos índices dopplervelocimétricos foram observados nos fetos com anemia mais acentuada. Os fetos com nível de hemoglobina inferior ou igual a 10,0 g/dL apresentaram valores dos índices dopplervelocimétricos da cava e do ducto venoso acima do percentil 95 para a idade gestacional. CONCLUSÕES: a dopplervelocimetria da cava inferior e do ducto venoso pode ser utilizada como marcador não invasivo da anemia fetal grave.

  7. Estudo anatômico da artéria torácica interna aplicado à cirurgia cardiovascular

    Directory of Open Access Journals (Sweden)

    Jorge A HENRIQUEZ-PINO

    1997-01-01

    Full Text Available Com a intensa utilização da artéria torácica interna (ATI na operação de revascularização do miocárdio, estudamos sua anatomia com a finalidade de esclarecer aspectos morfológicos que possibilitem extender sua utilização e prevenir complicações pós-operatórias. Em 100 cadáveres foram retirados os plastrões esternocostais e injetadas as ATIs com Látex Neoprene. A ATI originou-se diretamente da artéria subclávica em 82,5% e de um tronco comum com outras artérias em 17,5%. O comprimento médio foi de 20,4 ± 2,1 cm e o ponto de terminação mais freqüente foi ao nível do 6º espaço intercostal (e.i. (52,5%. A forma de terminação se fez como bifurcação em 93% e como trifurcação em 7%. A relação da ATI com a margem esternal foi de 10,3 ± 3,2 mm ao nível do 1º e.i. e 19,2 ± 6,0 mm ao nível do 6º e.i. A ATI está recoberta pelo músculo transverso do tórax numa extensão média de 7,5 ± 2,7 cm e apresenta o ramo costal lateral em 15%. O nervo frênico é anterior à ATI em 70% e posterior em 30%. O estudo forneceu subsídios que podem contribuir para minimizar as complicações pós-operatórias.The internal thoracic artery (ITA was studied because of its increased utilization in myocardial revascularization surgery due to the excellent long-term results. A review of its anatomical characteristics to clear some morphological aspects was made, aiming to help the extension of its utilization and prevent operative complications. The study was carried out in 100 cadavers; the anterior sternocostal wall of the thorax was removed and the arteries were injected with Neoprene Latex. The ITA originated directly from the subclavian artery in 82.5% and from a common trunk with other arteries in 17.5%. Its lenght was 20.4 ± 2.1 cm in average and the most frequent end point was the 6th intercostal space (52.5%. The end point form was as bifurcation in 93% and as trifurcation in 7%. The relation of ITA with the sternal margins was, on average, 10.3 ± 3.2 mm at the level of first intercostal space and 19.2 ± 6.0 mm at the level of 6th intercostal space. It was covered by the transverse muscle of thorax in a distance of 7.5 ± 2.7 cm long (average and the lateral costal branch was present in 15%. The ITA was crossed anteriorly by phrenic nerve in 70% and posteriorly in 30%. Informations provided by this study may help prevent complications in ITA dissections and to improve our knowledgement on its anatomical characteristics.

  8. [Regional transcranial oximetry with near infrared spectroscopy (NIRS) in comparison with measuring oxygen saturation in the jugular bulb in infants and children for monitoring cerebral oxygenation].

    Science.gov (United States)

    Abdul-Khaliq, H; Troitzsch, D; Berger, F; Lange, P E

    2000-11-01

    Using a dual channel near infrared (NIR) in vivo optical spectroscopy (INVOS) system (INVOS 3100A, Somanetics Corp. Troy, MI, USA) we investigated the relationship between jugular venous oxygen saturation (SjvO2) and regional cerebral oxygen saturation (rSO2) in 30 infants and children (mean age 4.5 years) with congenital heart disease undergoing cardiac catheterisation. The NIRS-SomaSensor (emitter and dual receiver probe) was applied at a standardised right fronto-temporal location (over the right frontal cortex) on the infant's head and covered with an adhesive flexible bandage. Using NIR light (730 and 810 nm) and two source-detector spacings (3 and 4 cm from the transmitter), percentage values of rSO2 were calculated from detected haemoglobin saturations. Simultaneously, jugular venous oxygen saturation (SjvO2) monitoring was performed via a catheter placed in the right internal jugular vein with its tip positioned in the jugular bulb, as verified by fluoroscopy. To compare the reliability of NIRS measurement characteristics, jugular venous blood was analysed for SjvO2 as a reference measure of global cerebral oxygenation, by co-oximetry (OSM3-Hemoximeter, Radiometer Copenhagen, Denmark). Other measured variables included pulse oximetry, arterial blood pressure, and venous and arterial oxygen saturations. Over a jugular venous oxygen saturation range of 31-83%, a significant positive linear correlation was found between rSO2 (NIRS measurement) and SjvO2 (jugular bulb oximetry) (r = 0.93, p NIRS measurement with subtraction algorithm should identify predominantly intracranial saturation in the pediatric age group, and will tend to reflect global oxygenation under physiological conditions. Transcranial oximetry using dual receiving channel NIRS offers a noninvasive, real-time, reliable and practicable means of monitoring cerebral haemoglobin oxygenation changes infants and children with cyanotic and noncyanotic congenital heart disease. PMID:11155535

  9. An Osteometric Evaluation of the Jugular Foramen / Una Evaluación Osteométrica del Foramen Yugular

    Scientific Electronic Library Online (English)

    S, Ishwarkumar; N, Naidoo; L, Lazarus; P, Pillay; K. S, Satyapal.

    2015-03-01

    Full Text Available Los forámenes yugulares (FY) son aberturas bilaterales situadas entre la parte lateral del hueso occipital y la porción petrosa del hueso temporal del cráneo humano. Se trata de un canal óseo que da paso a estructuras neurovasculares de la fosa craneal posterior a través de la base del cráneo hasta [...] el espacio carotídeo. Ya que el FY representa variaciones en la forma, tamaño, altura y volumen entre diferentes grupos raciales y sexo, además de las diferencias distintivas en la lateralidad desde sus aperturas intracraneales a las aperturas extracraneales, se hace necesario su conocimiento con el objetivo de comprender las patologías intracraneales. El propósito de este estudio fue evaluar las mediciones morfométricas del FY. Se midieron y evaluaron muestras de 73 cráneos secos, bilateralmente (n=146). Se estudiaron varios parámetros morfométricos del FY y su relación con las estructuras circundantes. Cada uno de los parámetros morfométricos medidos fue analizado estadísticamente con el programa SPSS para determinar la existencia de una posible relación entre los parámetros y sexo, raza, edad y lateralidad. Las comparaciones de sexo y edad con la distancia entre la placa pterigoidea lateral y el FY, y la distancia entre el FY y el foramen magno, arrojaron valores de p significativos de 0,0049 y 0,036, respectivamente. Los resultados de este estudio se correlacionaron con estudios previos que indican que las mediciones relativas al FY son mayores en el lado derecho. El suministro de datos morfométricos relativos al FY y las estructuras circundantes puede ayudar a los cirujanos y clínicos durante los procedimientos quirúrgicos. Abstract in english The jugular foramina (JF) are bilateral openings situated between the lateral part of the occipital bone and the petrous part of the temporal bones in the human skull. It is a bony canal transmitting neurovascular structures from the posterior cranial fossa through the base of the skull to the carot [...] id space. Since the JF depicts variations in shape, size, height and volume between different racial and gender groups, along with distinctive differences in laterality from its intracranial to extracranial openings, knowledge of the JF may be necessary to understand intracranial pathologies. Therefore, the purpose of this study was to evaluate the morphometric measurements of the jugular foramen. Various morphometric parameters of the JF and its relation to surrounding structures were measured and assessed in 73 dry skull specimens (n=146). Each of the morphometric parameters measured were statistically analyse using SPSS to determine the existence of a possible relationship between the parameters and sex, race, age and laterality. The comparisons of sex and age with the distance between the JF and lateral pterygoid plate and distance between the JF and foramen magnum yielded statistically significant p values of 0.0049 and 0.036, respectively. The results of this study correlated with that of previous studies indicating that measurements regarding the JF are greater on the right side. The provision of morphometric data pertaining to the JF and surrounding structures may assist surgeons and clinicians during operative procedures.

  10. Medición de par en el eje de salida de un motor de combustión interna alternativo

    Directory of Open Access Journals (Sweden)

    Carlos A. Montilla M

    2007-01-01

    Full Text Available Este articulo muestra el diseño, construcción e implementación de un sistema para la medición de Torque en el eje de salida de un motor de combustión interna. Para este proyecto se empleó un motor de combustión interna alternativo a gasolina, un dinamómetro hidráulico, una celda de carga y un sistema de instrumentación para recoger y acondicionar las señales; el motor se hace girar a distintas revoluciones y a diferentes regímenes de carga, para luego obtener la curvas Torque versus RPM y Potencia versus RPM.

  11. Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients

    Science.gov (United States)

    Yang, Eu Jeen; Ha, Hyeong Seok; Kong, Young Hwa

    2015-01-01

    Purpose Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54±1.06 years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was 1.57±0.34 and 14.07±1.91 minutes, respectively, the mean catheter dwell time was 14.73±2.5 days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients. PMID:25932035

  12. Access Recirculation in Jugular Venous Catheter in Regular and Reversed Lines

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    Abdolamir Atapour

    2009-04-01

    Full Text Available Introduction. The aim of this study was to determine access recirculation in functioning catheters in the regular and reversed positions.Materials and Methods. Access recirculation was measured in 2 sequential hemodialysis sessions in patients with functioning internal jugular catheters inserted not earlier than 2 weeks before the study. The arterial and venous lines were in their regular position during the first session and they were reversed during the second measurement. Changes in access recirculation were assessed. Also, type of the catheter and number of catheter insertions were evaluated in relation to access recirculation. Results. Twenty-five of the patients had a permanent catheter and 5 had a temporary catheter. During the first session, the mean of access recirculation was 6.9 ± 6.7% in the patients with a permanent catheter and 7.8 ± 8.4% in those with a temporary catheter (P = .45. The mean access recirculation was 7.1 ± 6.9% (range, 0 to 20% in the 30 patients on hemodialysis with the arterial and venous lines in their regular positions. When the lines were reversed, access recirculation increased significantly (P = .01 to a mean of 20.5 ± 20.5% (range, 2.3% to 75%. There was no significant correlation between the type of catheter or the number of catheter insertions and access recirculation.Conclusions. After reversing the arterial and venous lines, access recirculation in both temporary and permanent functioning catheters may increase; therefore, dialysis adequacy might be impaired by reversed lines. Replacing malfunctioning catheters with new ones seems to be better than reversing the lines.

  13. Incompetence of internal jugular vein valve in patients with transient global amnesia

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    Jovanovi? Zagorka B.

    2011-01-01

    Full Text Available Background/Aim. Transient global amnesia (TGA could be related to acute ischemic disturbances in mesial parts of temporal lobes, which are important for memory. Incompetence of internal jugular vein (IJV valve with venous congestion causes venous microthrombosis of hippocampus. The aim of this study was to investigate the frequency of IJV valve incompetence, as well as other hemodynamic and structural properties of cerebral circulation in TGA patients. Methods. IJV valve competence was investigated in 40 TGA patients and 30 persons of the control group (matched by age and sex, as well as detection of microembolic signals and detection of right to left cardiopulmonal shunt, cerebral vasomotor reactivity and echocardiography by color triplex ultrasonography and transcranial doppler. Results. A significant difference in frequency of IJV valve incompetence was found between the TGA patients and the control persons (55% TGA vs 30% controls; p < 0.001. We did not find a significant structural (plaques frequency or hemodynamic (flow velocity, pulsatility index differences on arteries of the neck and cerebral arteries between the TGA patients and the controls, except for the increased pulsatility index on the basilar artery (40% TGA vs 16.6% controls; p < 0.01 and decreased vasomotor reactivity in TGA patients (50% TGA vs 26.6% controls; p < 0.001. Microembolic signals were detected very rarely (17.5% TGA patients vs 13.3% controls; p > 0.05, as well as right to left cardiopulmonal shunt (15% TGA vs 16.6% controls; p > 0.05, indicating that embolism was not important for pathogenesis of TGA. Transesophageal echocardiography confirmed it, because only one TGA patient had a potent foramen ovale. Conclusion. We found a significantly increased frequency of IJV incompetence in the TGA patients, which confirmed the role of vein drainage disturbances in pathogenesis of TGA.

  14. Complexo miointimal das carótidas comum e interna em portadores de esquistossomose mansônica hepatoesplênica / Intima-media thickness of common and internal carotid arteries in patients with hepatosplenic schistosomiasis mansoni

    Scientific Electronic Library Online (English)

    André Valença, Guimarães; Carlos Teixeira, Brandt; Adriana, Ferraz.

    2009-08-01

    Full Text Available OBJETIVO: Avaliar a espessura do complexo miointimal (IMT) das carótidas comum e interna, em portadores de esquistossomose hepatoesplênica (EHE) não tratados cirurgicamente, já submetidos a cirurgia para descompressão do sistema porta por esplenectomia e ligadura da veia gástrica esquerda, e compara [...] r com volutários de condições sócio-econômico-ambientais similares, não portadores de esquistossomose. MÉTODOS: Utilizando aparelho de ultra-som Doppler de 7,5MHz foram mensurados os IMT de três grupos de voluntários, de ambos os gêneros, com idades que variaram de 20 a 60 anos, sendo avaliados os IMT máximos, IMT médios, IMT mínimos e seus desvios-padrão, das carótidas comuns e internas e feitas as comparações entre os grupos e suas associações com fatores de risco: idade, hipertensão arterial e tabagismo. RESULTADOS: Não houve diferença significante na média dos IMT, entre os lados direito e esquerdo e nem entre os grupos. Nos pacientes tratados cirurgicamente, assim como nos indivíduos-controle confirmou-se a associação, já conhecida, com os fatores de risco para aterosclerose (idade, hipertensão arterial e tabagismo). Contudo, não se observou este comportamento nos pacientes não operados. CONCLUSÃO: A EHE sem tratamento cirúrgico parece conferir "alguma proteção" contra a aterogênese em seres humanos; todavia, os achados não dão suporte definitivo a esta hipótese. Abstract in english OBJECTIVE: To evaluate the intima-media thickness (IMT) of common and internal carotid arteries in patients with hepatosplenic schistomiasis mansoni and those who underwent portal decompression surgery (splenectomy and left gastric artery ligature). Both groups were compared with a health volunteer [...] control group, living in the same social-economic-environmental conditions. MEHTODS: An ultrasound Doppler with a 7.5 MHz probe was used. The IMT was measured in the three groups with 20 individuals each, of both gender, with ages ranging from 20 to 60 years. The mean and standard deviations of common and internal carotid arteries maxIMT, medIMT, minIMT were assessed. Risk factors: age, systemic arterial hypertension and cigarette smoking were investigated as regard to IMT measurements. RESULTS: There were no statistical differences in IMT between right and left side, and among surgical, non-surgical and control groups. The surgical treated patients and controls showed correlation to known atherosclerotic risk factors: age, hypertension and cigarette smoking. However, non-surgically treated patients did not present the same correlation. CONLCUSION: It is tempting to believe that non-operated schistosomotic patients may have "some protection" against atherogenesis in human beings; however, the data do not lend full support to this hypothesis.

  15. Reingreso hospitalario en Medicina Interna / Readmission in internal medicine

    Scientific Electronic Library Online (English)

    J. L., Alonso Martínez; B., Llorente Díez; M., Echegaray Agara; M. A., Urbieta Echezarreta; C., González Arencibia.

    2001-05-01

    Full Text Available Fundamento: La tasa de reingreso puede ser un índice de calidad asistencial, estando influenciada por múltiples factores(clínicos, derivados del hospital y del propio paciente). Analizamos el reingreso en un área clínica de medicina interna de un hospital de tercer nivel. Material y métodos: Durante [...] 11 meses de 1998 registramos, según un cuestionario estructurado, los reingresos (R) (ingreso en los últimos 5 años) de todos los pacientes ingresados en un área clínica de 8 camas, contabilizando número de ingresos, tiempo hasta el reingreso, área de procedencia (rural, urbana), médico de atención primaria (médico general, especialista en medicina de familia), modo de vida (sólo, familia, residencia, sin techo). Observamos la causa desencadenante del R y la enfermedad causante. Se clasifican como reingreso relacionado (RR) (reingreso por la misma enfermedad o complicación de la misma), multingreso (MR) (reingreso de una misma patología atendida en diferentes servicios del hospital), reingreso evitable (RE) (aquel reingreso que no cumple criterios AEP), y reingreso temprano (RT)(reingreso antes de los 30 dÍas tras el alta). Resultados: De un total de 312 pacientes (edad media 67,93±15,5, 64% varones, estancia media 7,75±4,35 días, ingresos urgente 93%, tasa de mortalidad 3,52%). Fueron R 111 (35,5%), RR 83 (26% del total y 75% de R), MR 68 (61,2 de R y 82% de RR), RT 33 (39,7% de RR) y 16 RE (19% de RR). No hubo diferencias en edades, sexo ni estancia media. Las enfermedades más frecuentes fueron la insuficiencia cardiaca y las enfermedades respiratorias crónicas. Las causas del R fueron empeoramiento de trastorno crónico 41 (37%), manejo inadecuado ambulatorio 24 (22%), mal diagnóstico previo 8 (7%), efecto tóxico-iatrogenia 7 (6%), nueva enfermedad 29 (36%), otros 2 (2%). El número de ingresos previos era de 3,22±2,25 y el tiempo hasta el reingreso de 8,99±11,96 meses. La tasa de mortalidad intrahospitalaria de los R fue de 7,2% (p Abstract in english Background: The readmission rate could be a valuable tool as measurement of hospital quality. Readmissions are due to several factors: clinical, hospital related and patient related. We analyze readmission to internal medicine in a hospital of third level. Material and methods: During 11 months in 1 [...] 988 we counted all readmissions (R) defined as every previous admission occurred in a span of five years into an area of internal medicine composed by 8 beds. We counted number of readmssions, time from the last readmission, living area (city vs country), sort of primary care physician (GP vs family care specialist), living way (single, with family, institution, homeless). Precipitating factors were observed as well as diseases causing it. R were classified as R related (RR) when readmission was provoked by the same pathoiogical condition or a complication. Multi-readmission (MR), those R caused by the same disease process and treated in different areas and ervices of the hospital. Avoidable R (AR), those R which did not fillfil AEP criteria. Early readmission (ER) those R occurring before 30 days after last discharge. Results: Three hundred and eleven patients (mean age 67.93 (SD 15.51), males 64%, mean length of stay 7.75 (SD 4.35), 93% admitted from emergency yard, mortality rate 3.5%) were included. R were 111 (35.5%), RR 83 (26 and 75% of RR), MR 68 (82% of RR), ER 33 (39.7% of RR) and AR 16 (19,2% of RR) patients. The most frequent diseases were heart failure and chronic respiratory diseases. Main causes of R were worsening of chronic disease 41 (37%), non-appropriale ambulatory management 24 (22%) erroneous diagnosis 8 (7%), iatrogenic effec 7 (6%), new disease 29 (26%) and others 2 (2%). Mortality rate in R patients was 7.2% (confidence interval 95% 2 to 9%). Number of readmissions were 3.22 (SD 2.25) and time to readmission 8.99 (SD 11.96) months. Living in city (p

  16. Vigilancia epidemiológica de la intoxicación aguda en el Área Sur de la Comunidad de Madrid: Estudio VEIA 2000 / Epidemiologic survey of acute poisoning in the south area of the Community of Madrid: The VEIA 2000 Study

    Scientific Electronic Library Online (English)

    P. J., Caballero Vallés; S, Dorado Pombo; B, Jerez Basurco; M, Medina Sampedro; B, Brusínt Olivares.

    2004-02-01

    Full Text Available Objetivo: Extensos estudios observacionales sobre intoxicaciones agudas (IA) permiten detectar cambios de tendencia imprescindibles para diseñar actuaciones preventivas. VEIA es un estudio evolutivo de las IA atendidas en Urgencias del Hospital 12 de Octubre de Madrid en periodos anuales completos [ [...] 1979 (1,2), 1985 (3), 1990 (4), 1994 (5) y 1997 (6)], presentamos el 2000 y comparamos los resultados con los previos. Métodos y resultados: El método se mantiene idéntico. 1.128 IA 88% voluntarias. 451 intentos de suicidio. Las benzodiazepinas son el 44% de los medicamentos; El alcohol el 75% de los tóxicos no farmacológicos y las drogas el 19%. Conclusiones: En las mujeres aumentan las IA por alcohol y drogas y disminuyen los intentos de suicidio, ello supone una aproximación de los roles hombre/mujer. Hay un envejecimiento en los IS (¿se “pasa de moda” suicidarse entre los jóvenes?) y advertimos dos pautas: IS con medicamentos con 0,1% de mortalidad y por no-medicamentos con 3%. Dos de cada cinco hombres con IS son adictos. Disminuyen las benzodiazepinas, el paracetamol sustituye a la Aspirina y los AINE a los restantes analgésicos. El alcohol es el tóxico no-farmacológico predominante, pero disminuye un 11%. Las drogas, que ahora superan a los venenos tradicionales (gases, disolventes, etc.) suponen un 40% más que en 1997. Al comparar 1994 y 2000, la heroína no cambia pero la cocaína pasa de 13 casos a 67 y las anfetaminas tipo MDMA crecen de modo geométrico. Abstract in english Objective: Extensive observational studies of acute intoxications (AI) allow the detection of trend changes indispensable for the design of preventive actions. VEIA is an evolutional study of AI attended at the Emergency Services of the Hospital “Doce de Octubre” of Madrid over all-round annual peri [...] ods (1979, 1985, 1990, 1994 and 1997); we present the results of 2000 and compare them with those of previous years. Methods and results: An identical method was used. The hospital attended 1,128 AI, 88% of them voluntary. There were 451 suicide attempts. Forty four per cent of drugs involved were benzodiazepines. Alcohol represented 75% of non-pharmacological toxic substances and drugs, 19%. Conclusions: An increase of AI caused by alcohol and drugs was observed among women, as well as a decrease of suicide attempts, which reflects an approximation of man/woman roles. An aging trend was observed in suicide attempts (Is suicide “outmoded” among young people?), along with two patterns: Suicide attempts with drugs had a mortality rate of 0.1% and suicide attempts without drugs, of 3%. Two out of five men attempting suicide had drug addictions. There had been a reduction of benzodiazepines use and substitution of aspirine for paracetamol and of other analgesics for NSAID. Alcohol was the predominant non-pharmacological toxic substance, but had decreased 11%. Drugs, that had surpassed the traditional poisons (gases, solvents, etc.) represented 40% more than in 1997. When 1994 and 2000 were compared, heroine had not changed significantly, but cocaine had increased from 13 cases to 67 and amphetamines type MDMA had increased geometrically

  17. Air bubbles in the subclavian or internal jugular veins: a common finding on contrast-enhanced CT

    International Nuclear Information System (INIS)

    We investigated the frequency of air bubbles in the subclavian (SCV) or internal jugular (IJV) vein in 200 patients who underwent contrast-enhanced CT of the head and neck. Half the patients were reviewed retrospectively (group 1), while the other half were investigated prospectively after the radiologists who administered the contrast medium were instructed to be careful not to inject even a single air bubble during the procedure (group 2). Air bubbles were observed in the SCV or IJV in 15 of the 100 patients in group 1, while in group 2, there were 4 such patients. Air injection, a common ''complication'', can be reduced by care during the procedure. (orig.)

  18. Direct spread of thyroid follicular carcinoma to the parotid gland and the internal jugular vein: a case report

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    Alzaraa Ahmed

    2008-09-01

    Full Text Available Abstract Introduction The parotid gland and the great cervical veins are very rarely involved in a metastatic thyroid cancer. Case presentation We report an interesting case of an unusual metastasis of a thyroid follicular carcinoma including the histopathological and radiological findings. A woman was seen in the otolaryngology clinic with a mass at the angle of the left side of her jaw. Clinical examination and investigations confirmed a thyroid follicular carcinoma with metastases to the parotid gland and the internal jugular vein. Conclusion This is an educational case which highlights the importance of close communication between clinicians, histopathologists and radiologists to ensure that such rare cases are not missed.

  19. A case of aneurysm of the jugular and mediastinal veins radioisotopic blood pool study of venous aneurysm

    International Nuclear Information System (INIS)

    Venous aneurysm not associated with other cardiovascular disease or trauma is a rare condition. A case is present of bilateral jugular and mediastinal venous aneurysm, which was detected and depicted to a full extent by means of a blood-pool study with sup(99m)Tc-fibrinogen, undertaken because of concurrent thrombocytopenia. The aneurysm was confirmed by subsequent X-ray angiography and surgery. In radioisotopic blood pool study venous aneurysm, unlike arterial or aortic aneurysm, may be filled to the equilibrium state later than the appearance of the cardiac pool. (orig.)

  20. Throbbing tinnitus in aberrant internal carotid artery aggravated by elevation of the jugular bulb. A case report

    International Nuclear Information System (INIS)

    Vascular anomalies in the middle ear are rarely observed. They cause no symptoms in the majority of cases, although some may be associated with tinnitus. The false diagnosis of glomus tumour may lead to considerable problems, if surgery is performed. It is therefore necessary that precise pre-operative data are obtained, preferably based on contrast-enhanced computerized tomography. Subsequent 2D and 3D image reconstructions provide further vascular findings regarding the topographic and anatomic factors involved and eliminate the need for invasive angiography of the carotid artery or retrograde jugular venography to make a firm diagnosis. (orig.)

  1. Global attentional-executive sequelae following surgical lesions to globus pallidus interna

    OpenAIRE

    Scott, RB; Harrison, J.(School of Physics and Astronomy, University of Manchester, Manchester, UK); C. Boulton; Wilson, J.; GREGORY, R; Parkin, S; Bain, PG; Joint, C; Stein, J.; Aziz, TZ

    2002-01-01

    It has been demonstrated that selective unilateral surgical ablation of posteroventral globus pallidus interna relieves the movement disorders associated with advanced Parkinson's disease, without necessarily incurring the executive cognitive sequelae that have been observed following gross pathological lesions to this brain region. This finding is consistent with established theory that underlying neuronal circuitry is functionally segregated into parallel cortico-striatal-pallidal-thalamo-c...

  2. Tromboflebite séptica da veia porta secundária à apendicite Septic thrombophlebitis of the portal vein as a complication of appendicitis

    Directory of Open Access Journals (Sweden)

    Olival Cirilo Lucena da Fonseca-Neto

    2007-06-01

    Full Text Available INTRODUÇÃO: A tromboflebite séptica da veia porta ou pileflebite é evento raro e associado com alta mortalidade e seu diagnóstico requer a demonstração de trombo portal. RELATO DO CASO: Mulher de 19 anos com história de dor abdominal há 40 dias com piora há 10 foi admitida no hospital. Referia dor de forte intensidade em hipocôndrio direito, vômitos, febre, e calafrios. No exame físico de entrada tinha sinais e sintomas de sepse abdominal. Submetida à laparotomia exploradora foi encontrado abscesso hepático e apêndice ileiocecal rôto e bloqueado. Realizada apendicectomia e drenagem de abscesso, que evoluiu com necessidade de re-laparotomia no 6º dia e drenagem de novos abscessos hepáticos. Após longa internação, recebeu alta e no seguimento de 6 meses estava bem. CONCLUSÃO: A pileflebite é complicação rara, porém grave, devendo ser rapidamente diagnosticada e o seu manejo multidisciplinar instituído prontamente.BACKGROUND:Portal vein septic thrombophlebitis or pylephlebitis is a rare event associated with high mortality rates and its' diagnosis requires portal thrombosis demonstration. CASE REPORT: Nineteen year-old female was admitted to the hospital with a history of abdominal pain for the last 40 days, worsening for the last 10. The patient complained of intense and strong pain in the right hypochondrium, vomit, fever and cold chills. During physical examination the patient showed signs and symptoms of abdominal sepsis. She was then submitted to exploratory laparotomy, during which a hepatic abscess and blocked and ruptured ileocecal appendix was found. Appendicectomy and drainage of the abcess was performed, having the necessity of a second laparotomy in the sixth day and further drainage of new formatted hepatic abscesses. After a long period of admission, the patient was discharged and was well following the next six months. CONCLUSION: Pylephlebitis is a rare and severe complication, which has the urgency of being quickly and appropriately diagnosed as well as in a multidisciplinary manner.

  3. Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report Reversão de importante assimetria ao SPECT após bypass venoso de alto fluxo extra-intracraniano em paciente submetido a oclusão terapêutica da carótida interna: relato de caso

    Directory of Open Access Journals (Sweden)

    Jorge Marcondes

    2001-09-01

    Full Text Available Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.Oclusão terapêutica carotídea ainda é a principal escolha para o tratamento dos aneurismas sintomáticos da artéria carótida interna ao nível do seio cavernoso.Existem controvérsias em relação à obtenção de testes com maior valor preditivo em relação à complicações isquêmicas futuras durante a realização do teste de oclusão carotídeo por balão. A tomografia computorizada de emissão de fóton único (SPECT tem sido defendida como uma opção para a melhor avaliação do fluxo sanguíneo regional cerebral, onde evidente assimetria é indicativa de isquemia tardia. Descrevemos um caso de importante assimetria ao SPECT durante o teste clinicamente negativo e sua reversão completa após anastomose extra-intracraniana com interposição de veia safena magna (alto fluxo entre a artéria carótida cervical e a artéria cerebral média.

  4. Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report / Reversão de importante assimetria ao SPECT após bypass venoso de alto fluxo extra-intracraniano em paciente submetido a oclusão terapêutica da carótida interna: relato de caso

    Scientific Electronic Library Online (English)

    Jorge, Marcondes; Antônio, Aversa; Marcio, Peçanha; Flávio, Domingues; Fernanda, Nascimento; Charles, André; Gabriel, Freitas; Feliciano, Azevedo; Maria, Exposito.

    2001-09-01

    Full Text Available Oclusão terapêutica carotídea ainda é a principal escolha para o tratamento dos aneurismas sintomáticos da artéria carótida interna ao nível do seio cavernoso.Existem controvérsias em relação à obtenção de testes com maior valor preditivo em relação à complicações isquêmicas futuras durante a realiz [...] ação do teste de oclusão carotídeo por balão. A tomografia computorizada de emissão de fóton único (SPECT) tem sido defendida como uma opção para a melhor avaliação do fluxo sanguíneo regional cerebral, onde evidente assimetria é indicativa de isquemia tardia. Descrevemos um caso de importante assimetria ao SPECT durante o teste clinicamente negativo e sua reversão completa após anastomose extra-intracraniana com interposição de veia safena magna (alto fluxo) entre a artéria carótida cervical e a artéria cerebral média. Abstract in english Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Sin [...] gle photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.

  5. An experimental study on MR imaging of jugular venous thrombosis in dogs

    International Nuclear Information System (INIS)

    This study was designed to evaluate the potential application of MRI in differentiating static blood from thrombus, age-related changes of thrombus and the signal differences of the intravascular thrombus in various pulse sequences. External jugular vein was ligated at both upper and lower ends to from a static blood column, and thrombin was injected into the column to cause venous thrombosis in a total of 15 mongrel dogs. The MR images were obtained with T1- and T2-weighted spin echo and gradient echo techniques, lmmediately after the formation of static blood and after 2 hour, 1 day, 1 week, 2 weeks and 4 weeks of the formation of thrombus at a 2.0 T MR unit. The signal intensities of the thrombus and adjacent muscles were compared subjectively, and the signal intensity ratio was compared objectively by the measurement of the signal intensities using a cursor. The MRI findings were compared with histologic findings. The signal intensities of static blood were hyperintense in all pulse sequences, and those of 2 hour, 1 day and 1 week old thrombi were hyperintense in all pulse sequence. The number of experimental thrombi which showed isointensity on T1- and T2-weighted image, and hyperintensity on gradient echo image increased as thrombi aged. The signal intensities of 2 week old thrombus were isointense on T1-weighted image, hyperintense on T2-weighted image, and hyperintense on gradient echo image, while those of 4 week old thrombus were isointense on T1-weighted anthrombus were isointense on T1-weighted and T2-weighted image, and hypointense on gradient echo image in most experimental thrombi. There was a tendency to decrease in a signal intensity ratio as thrombi aged on T1-weighted, T2-weighted and gradient echo images(p<0.01). Histologically, thrombus was not formed and lumen was filled with many red blood cells(RBCs) in 2 hour old specimen, but fibrin mesh was visible and RBCs decreased in number in 1 day old specimen. In 1 week old specimen, vessel was contrasted and lumen was filled with thrombus, RBCs, platelets, many fibrins and capillary like structures. The histologic findings of 2 week old thrombus were similar to those of 1 week old one except calcification. In 4 week old specimen, vessels were contrasted and lumen was obliterated with fibrosis and organization of the thrombus. Therefore, it is possible diagnose thrombus, and to assess sequential changes of MRI findings of thrombus by using all pulse sequences, and these results can be essential bases for the interpretation of MR images of patients with venous thrombosis

  6. Venous drainage from the tail of the pancreas to the lienal vein and its relationship with the distal splenorenal shunt selectivity / Drenagem venosa da cauda do pâncreas para a veia lienal e sua relação com a seletividade da anastomose esplenorrenal

    Scientific Electronic Library Online (English)

    Cláudio, Piras; Danilo Nagib Salomão, Paulo; Isabel Cristina Andreatta Lemos, Paulo; Hildegardo, Rodrigues; Alcino Lázaro da, Silva.

    2010-02-01

    Full Text Available OBJETIVO: Identificar as veias da cauda do pâncreas afluentes da veia lienal e a possível relação destes ramos com a perda de seletividade da derivação esplenorrenal distal. MÉTODOS: Foram estudadas 38 peças humanas, retiradas de cadáveres, contendo estômago, duodeno, baço, cólon e pâncreas, utiliza [...] ndo-se a técnica de repleção vascular com resina vinílica e posterior corrosão do tecido orgânico com o objetivo de se estudar o molde vascular da veia lienal e seus afluentes. RESULTADOS: O número de veias afluindo diretamente para a veia esplênica variou de sete a vinte dois (MA 14.52±3.53). Ramos pancreáticos da cauda do pâncreas afluindo para as veias segmentares do baço estavam presentes em 25 das peças estudadas (65,79%). Estes ramos variaram de um a quatro, predominando um ramo (60%) e dois ramos (24%). CONCLUSÕES: Em 65,79% das peças veias da cauda do pâncreas desembocavam em ramos segmentares da veia esplênica. Estes ramos poderiam ser responsáveis pela perda de seletividade da derivação esplenorrenal distal e a esqueletização completa da cauda do pâncreas poderia aumentar a seletividade neste procedimento. Abstract in english PURPOSE: To identify the veins draining from the pancreatic tail to the lienal vein and its possible relationship with the loss of the distal splenorenal shunt selectivity. METHODS: Thirty eight human blocks including stomach, duodenum, spleen, colon and pancreas, removed from fresh corpses, were st [...] udied with the replenish and corrosion technique, using vinilic resin and posterior corrosion of the organic tissue with commercial hydrochloric acid, in order to study the lienal vein and its tributaries. RESULTS: The number of veins flowing directly to the splenic vein varied from seven to twenty two (14.52 ± 3.53). Pancreatic branches of the pancreatic tail flowing to the segmentary veins of the spleen were found in 25 of the anatomical pieces studied (65.79%). These branches varied from one to four, predominating one branch (60%) and two branches (24%). CONCLUSIONS: In 65.79% of the anatomical pieces studied, the veins of the pancreatic tail flowed in segmentary branches of the splenic vein. These branches could be responsible for the loss of distal splenorenal shunt selectivity. The complete disconnection of the pancreatic tail could increase the selectivity in this procedure.

  7. Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso / Giant external-iliac-vein aneurysm secondary to traumatic arteriovenous fistula: a case report

    Scientific Electronic Library Online (English)

    Patrick Bastos, Metzger; Heraldo Antonio, Barbato; Fernanda Maria Resegue, Angelieri; Camila Baumann, Beteli; Ana Claudia Gomes, Petisco; Jose Eduardo Martins, Barbosa; Mohamed Hassan, Saleh; Fábio Henrique, Rossi; Nilo Mitsuru, Izukawa.

    2011-09-01

    Full Text Available Aneurismas venosos abdominais são raros. Os localizados nas veias ilíacas externas estão entre os mais infrequentes aneurismas venosos publicados na literatura. Relatamos o caso de um paciente jovem com aneurisma venoso gigante de veia ilíaca externa secundário a uma fístula arteriovenosa adquirida [...] há 20 anos, tratado pelos métodos convencional e endovascular com sucesso. Abstract in english Venous abdominal aneurysms are rare entities, especially at the external iliac vein. We report the case of a young male patient who presented with a giant external-iliac-vein aneurysm secondary to an arteriovenous fistula acquired 20 years earlier, and treated successfully by conventional and endova [...] scular methods in our service.

  8. Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso Giant external-iliac-vein aneurysm secondary to traumatic arteriovenous fistula: a case report

    Directory of Open Access Journals (Sweden)

    Patrick Bastos Metzger

    2011-09-01

    Full Text Available Aneurismas venosos abdominais são raros. Os localizados nas veias ilíacas externas estão entre os mais infrequentes aneurismas venosos publicados na literatura. Relatamos o caso de um paciente jovem com aneurisma venoso gigante de veia ilíaca externa secundário a uma fístula arteriovenosa adquirida há 20 anos, tratado pelos métodos convencional e endovascular com sucesso.Venous abdominal aneurysms are rare entities, especially at the external iliac vein. We report the case of a young male patient who presented with a giant external-iliac-vein aneurysm secondary to an arteriovenous fistula acquired 20 years earlier, and treated successfully by conventional and endovascular methods in our service.

  9. Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report.

    Science.gov (United States)

    Binnebösel, Marcel; Grommes, Jochen; Junge, Karsten; Göbner, Sonja; Schumpelick, Volker; Truong, Son

    2009-01-01

    Central venous access devices are extensively used for long-term chemotherapy and parenteral nutrition. However, there are some possible immediate, early, and late complications related to the implantation technique, care, and maintenance. We present the uncommon occurrence of a thrombosis of the internal jugular vein due to a spontaneous migration of a Port-A-Cath catheter into the ipsilateral internal jugular vein as a delayed complication of a central venous access catheter implanted for chemotherapy delivery. A review of the literature is given, and the factors responsible for this unusual complication will be discussed. PMID:19830037

  10. Lemierre’s syndrome: case of a patient with pulmonary embolism and cavernous sinus thrombosis complicating a septic internal jugular vein thrombus

    Directory of Open Access Journals (Sweden)

    VOJKO FLIS

    2012-10-01

    Full Text Available Lemierre’s syndrome is a complex and unusual clinical entity, characterized by septic thrombophlebitis of the internal jugular vein. We present the case of a patient with Lemierre’s syndrome, pulmonary embolism and propagation of an internal jugular vein thrombus retrograde to the cavernous sinus. The patient was treated with antibiotics and heparin. The importance of rapid diagnosis of the extent of the disease, in directing the otherwise somewhat controversial treatment with heparin in patients with Lemierre’s syndrome, is stressed.

  11. Cerebral venous sinus thrombosis due to spontaneous, progressive, and retrograde jugular vein thrombosis causing sudden death in a young woman.

    Science.gov (United States)

    De-Giorgio, Fabio; Peschillo, Simone; Vetrugno, Giuseppe; d'Aloja, Ernesto; Spagnolo, Antonio G; Miscusi, Massimo

    2015-03-01

    Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular condition that affects approximately 5 per 1 million people annually, and develops in 0.5% of all stroke patients. Herein we report a case involving a 31-year-old woman with CVST. She initially presented with a 2-month history of intermittent headaches at the nape of her neck with cervical pain. Other than these symptoms, she was in apparently good health and was a nonsmoker. She had no children and did not take contraceptives. She became comatose with unequal pupil size and CVST was diagnosed. An autopsy revealed CVST that extended from the confluence of the sinuses to the transverse sinuses and tip of the superior sagittal sinus, as well as a thrombus that obstructed the right internal jugular vein. A correct and early diagnosis of CVST combined with heparin-based therapy and/or interventional endovascular strategies may be of benefit by preventing intracerebral extension of jugular venous thrombosis and subsequent serious or even fatal neurological sequelae. PMID:25527307

  12. First clinical experience in applying XperGuide in embolization of jugular paragangliomas by direct intratumoral puncture

    International Nuclear Information System (INIS)

    The purpose of this study is to introduce a novel image-guided technique utilized in the embolization of jugular paraganglioma tumors, using preoperative diagnostic scans and planning together with perioperative X-ray fluoroscopy in a combined image. A lesion center and a skin entry point on the patient are selected and connected with a straight line, which resembles the most ideal lesion access trajectory to be followed during the needle insertion. The skin entry point and the corresponding line location are selected such that it avoids the impenetrable bones and vital anatomical structures. Two viewing incidence angles are defined to guide the cranial needle insertion: the entry view tangent to the planned trajectory, and the progression view perpendicular to the path. The proposed method was applied in two patients with jugular paragangliomas in order to navigate needles to the lesion location and subsequently embolize the tumors. The perioperative registration took less than 8 s. Using this method, it was possible to guide the needle within 5 mm of the planned path. The fluoroscopic needle navigation, overlaid on the corresponding soft tissue of the underlying anatomy, combined with a planned path, has been shown to be an accurate and efficient tool for needle guidance. The patient pose varied between the preoperative data and the fluoroscopy guided intervention, but this did not hinder the procedure. (orig.)

  13. First clinical experience in applying XperGuide in embolization of jugular paragangliomas by direct intratumoral puncture

    Energy Technology Data Exchange (ETDEWEB)

    Spelle, Laurent; Moret, Jacques [Fondation Rothschild Hospital, Interventional Neuroradiology Department, Paris (France); Ruijters, Daniel; Babic, Drazenko; Homan, Robert; Mielekamp, Peter; Guillermic, Jeremy [Philips Healthcare, Cardio/Vascular Innovation, Best (Netherlands)

    2009-11-15

    The purpose of this study is to introduce a novel image-guided technique utilized in the embolization of jugular paraganglioma tumors, using preoperative diagnostic scans and planning together with perioperative X-ray fluoroscopy in a combined image. A lesion center and a skin entry point on the patient are selected and connected with a straight line, which resembles the most ideal lesion access trajectory to be followed during the needle insertion. The skin entry point and the corresponding line location are selected such that it avoids the impenetrable bones and vital anatomical structures. Two viewing incidence angles are defined to guide the cranial needle insertion: the entry view tangent to the planned trajectory, and the progression view perpendicular to the path. The proposed method was applied in two patients with jugular paragangliomas in order to navigate needles to the lesion location and subsequently embolize the tumors. The perioperative registration took less than 8 s. Using this method, it was possible to guide the needle within 5 mm of the planned path. The fluoroscopic needle navigation, overlaid on the corresponding soft tissue of the underlying anatomy, combined with a planned path, has been shown to be an accurate and efficient tool for needle guidance. The patient pose varied between the preoperative data and the fluoroscopy guided intervention, but this did not hinder the procedure. (orig.)

  14. Imaging of human thrombi in the rabbit jugular vein. I. Comparison of two fibrin-specific monoclonal antibodies

    International Nuclear Information System (INIS)

    The development of monoclonal antibodies with a specificity for cross-linked fibrin may have a potential role in the detection and of thrombi and thrombolytic therapy. In this study, two monoclonal antibodies with a specificity for fibrin have been examined. In vitro studies have shown NIBn 123 (which has a high affinity for X-oligomer) and DD-3B6 to bind to immobilized fibrin on PVC plates as well as plasma clots which were incubated in the presence of plasma. The Km values for NIBn 123 and DD-3B6 wre 1.0 x 10(10)/7.7 x 10(8) M and 2.6 x 10(8) M respectively. No significant binding to fibrinogen either immobilized or in solution was found. The binding of these antibodies to a human thrombus in the jugular vein of the rabbit was monitored over a 24 hour period. Preferential binding of each antibody reached a ratio of approximately 1.0 (jugular/heart) at 24 hours and an image was detected

  15. Subclavian vein angioplasty during arteriovenous fistula surgery: case report and literature review / Angioplastia de veia subclávia no intraoperatório de fístula arteriovenosa: relato de caso e revisão de literatura

    Scientific Electronic Library Online (English)

    Marcus Vinícius Martins, Cury; Marcelo Fernando, Matielo; Ana Carolina, Calixtro; Giuliano de Almeida, Sandri; Marcos Roberto, Godoy; Roberto, Sacilotto.

    2012-06-01

    Full Text Available Pacientes portadores de Insuficiência Renal Crônica (IRC) estágio V são geralmente tratados por hemodiálise (HD), preferencialmente por fístula arteriovenosa (FAV). Descrevemos um relato de caso de um paciente de 58 anos, masculino, portador de diabetes mellitus, hipertensão arterial sistêmica e IRC [...] terminal. Seus antecedentes demonstram múltiplos acessos para implante de cateter de hemodiálise, assim como tentativas prévias de realização de FAV. Esse paciente desenvolveu estenose subclínica da veia subclávia, limitando a HD pelo membro superior. O propósito deste relato foi descrever o tratamento endovascular de estenose de veia subclávia, concomitante à realização de uma nova FAV. Abstract in english Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF). We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a [...] long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.

  16. Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Katsuro Harada Júnior

    2012-09-01

    Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

  17. Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso / Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report

    Scientific Electronic Library Online (English)

    Katsuro, Harada Júnior; Renato Garcia Lisboa, Borges; Renata Kiyoko Borges, Harada.

    2012-09-01

    Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas me [...] diastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior. Abstract in english The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphoma [...] s by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

  18. Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso Bilateral central retinal vein occlusion associated with blood hyperviscosity syndrome: case report

    Directory of Open Access Journals (Sweden)

    John Helal Jr

    2005-02-01

    Full Text Available Relato de caso de um paciente masculino de 16 anos de idade com queixa inicial de baixa da acuidade visual e que no exame oftalmológico foi encontrado edema de papila bilateral, que evoluiu para trombose da veia central da retina em ambos os olhos. Na investigação laboratorial, foi feito diagnóstico de um mieloma múltiplo tipo IgA que cursava com síndrome de hiperviscosidade sanguínea, o que explicava o quadro oftalmológico. Após tratamento específico, o paciente apresentou melhora tanto da acuidade visual quanto do aspecto fundoscópico. O achado de oclusão de veia central da retina bilateral pode levar ao diagnóstico de importantes doenças sistêmicas. os achados fundoscópicos podem servir de parâmetro na avaliação do tratamento.The authors report the case of a 16-year-old male patient who presented with blurred vision and bilateral optic disc edema, then developing bilateral central retinal vein occlusion. On laboratory work-up, he was found to have multiple myeloma IgA along with hyperviscosity syndrome, which led to the ophthalmological features. After proper treatment, the patient recovered visual acuity and normalized his eye fundus changes. Bilateral central retinal vein occlusion finding may yield the diagnosis of major systemic diseases. Fundoscopic features may serve as parameters on treatment evaluation.

  19. Subclavian vein angioplasty during arteriovenous fistula surgery: case report and literature review Angioplastia de veia subclávia no intraoperatório de fístula arteriovenosa: relato de caso e revisão de literatura

    Directory of Open Access Journals (Sweden)

    Marcus Vinícius Martins Cury

    2012-06-01

    Full Text Available Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF. We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.Pacientes portadores de Insuficiência Renal Crônica (IRC estágio V são geralmente tratados por hemodiálise (HD, preferencialmente por fístula arteriovenosa (FAV. Descrevemos um relato de caso de um paciente de 58 anos, masculino, portador de diabetes mellitus, hipertensão arterial sistêmica e IRC terminal. Seus antecedentes demonstram múltiplos acessos para implante de cateter de hemodiálise, assim como tentativas prévias de realização de FAV. Esse paciente desenvolveu estenose subclínica da veia subclávia, limitando a HD pelo membro superior. O propósito deste relato foi descrever o tratamento endovascular de estenose de veia subclávia, concomitante à realização de uma nova FAV.

  20. Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy / Enxerto de veia esplênica na reconstrução do eixo mesentérico-portal após gastroduodenopancreatectomia

    Scientific Electronic Library Online (English)

    Enio Campos, Amico; José Roberto, Alves; Samir Assi, João.

    2014-10-01

    Full Text Available A ressecção da confluência das veias mesentérica superior e porta tem sido realizada com maior frequência no tratamento de adenocarcinoma do pâncreas, em virtude dos bons resultados relatados, porém pode também ser usada em casos de neoplasias pancreáticas benignas quando firmemente aderidas ao eixo [...] mesentérico-portal. Apesar disso, não existe nenhum estudo sobre o melhor tipo de enxerto venoso para reconstrução do eixo mesentérico-portal quando necessária. A escolha do enxerto dependerá da preferência do cirurgião ou da instituição onde ocorre à cirurgia. Esta nota técnica discute criticamente o uso da veia esplênica como opção para reconstrução do eixo mesentérico-portal após gastroduodenopancreatectomia. Abstract in english Resection of the confluence of the superior mesenteric and portal veins has been performed most frequently in the treatment of adenocarcinoma of the pancreas, in view of the reported positive results, but it can also be used in cases of benign pancreatic neolpasias when they are strongly adhered to [...] the mesenteric-portal trunk. Nevertheless, there is no study on the best type of venous grafts for reconstruction of the mesenteric-portal trunk when required. The choice of graft depends on the preference of the surgeon or the institution. This technical note critically discusses the use of the splenic vein as an option for mesenteric-portal trunk reconstruction after gastroduodenopancreatectomy.

  1. Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso / Bilateral central retinal vein occlusion associated with blood hyperviscosity syndrome: case report

    Scientific Electronic Library Online (English)

    John, Helal Jr; Fernando Korn, Malerbi; Roberto, Melaragno Filho.

    2005-02-01

    Full Text Available Relato de caso de um paciente masculino de 16 anos de idade com queixa inicial de baixa da acuidade visual e que no exame oftalmológico foi encontrado edema de papila bilateral, que evoluiu para trombose da veia central da retina em ambos os olhos. Na investigação laboratorial, foi feito diagnóstico [...] de um mieloma múltiplo tipo IgA que cursava com síndrome de hiperviscosidade sanguínea, o que explicava o quadro oftalmológico. Após tratamento específico, o paciente apresentou melhora tanto da acuidade visual quanto do aspecto fundoscópico. O achado de oclusão de veia central da retina bilateral pode levar ao diagnóstico de importantes doenças sistêmicas. os achados fundoscópicos podem servir de parâmetro na avaliação do tratamento. Abstract in english The authors report the case of a 16-year-old male patient who presented with blurred vision and bilateral optic disc edema, then developing bilateral central retinal vein occlusion. On laboratory work-up, he was found to have multiple myeloma IgA along with hyperviscosity syndrome, which led to the [...] ophthalmological features. After proper treatment, the patient recovered visual acuity and normalized his eye fundus changes. Bilateral central retinal vein occlusion finding may yield the diagnosis of major systemic diseases. Fundoscopic features may serve as parameters on treatment evaluation.

  2. Características das células parasitadas pelo Trypanosoma cruzi na parede da veia central das supra-renais de Chagásicos crônicos

    Scientific Electronic Library Online (English)

    Hipolito de Oliveira, Almeida; Elizabeth, Martins; José Umberto, Franciscon; Vicente de Paula Antunes, Teixeira; Alfredo José Afonso, Barbosa; Helenice, Gobbi; Marlene Antonia dos, Reis.

    1986-12-01

    Full Text Available Foram analisados os aspectos das células musculares parasitadas pelo Trypanosoma cruzi, na veia da supra-renal de chagásicos crônicos, através de exame ao microscópio óptico de lâminas coradas pela hematoxilina-eosina (HE), PAS, Feulgen e peroxidase-antiperoxidase (PAP) para antigenos do T. cruzi. A [...] lém das modificações nucleares descritas anteriormente, os leiomiócitos parasitados exibem alterações citoplasmáticas que podem ser vistas mesmo em células que albergam poucos parasitas. As formas amastigotas geralmente estão envoltas por halo claro e o citoplasma restante adquire aspecto granuloso ou reticular, basófilopelo HE, sendo sempre PAS e Feulgen negativos. Estes dados sugerem que o material basófilo no citoplasma deve ser RNA ribossômico. A periferia dos ninhos que mostram uma "membrana" com reação do PAP para antigenos do T. cruzi fortemente positiva, poderia ser devida a reação cruzada de material celular rechaçado para a periferia ou a difusão de antigenos do T. cruzi e sua adsorção à periferia celular. O material citoplasmático PAP positivo poderia resultar de artefato, de reação imunocitoquimica cruzada, de antigenos tripanossomóticos difundidos ou de antigenos tripanossoma-simile resultantes de interações entre o leiomiócito e o parasita. Abstract in english Some morphologic aspects of the smooth muscle cells, parasitised by T. cruzi in the adrenal vein of chronic chagasic patients were studied. The staining techniques used were the following: Hematoxylin and Eosin (HE), PAS, Feulgen and the peroxidase antiperoxidase (PAP) immunocyto chemical method for [...] identification of T. cruzi antigen. The intracellular amastigotes were often surrounded by a clear halo and the cytoplasm of the parasitised smooth muscle cells were granular or reticular in appearance being basophil and, PAS and Feulgen negative. These data suggest that the cytoplasmatic basophil material could be ribosomic RNA. The intracellular nests of amastigotes were surrounded by a PAP positive "membrane-like" structures. This PAP positive "membrane-like"material, as well assome cytoplasmatic PAP positive granulomatous material, could be due to absorbed antigensfrom the parasite or to T. cruzi- like antigens resultedfrom the interaction between the parasite and the host cell.

  3. Características das células parasitadas pelo Trypanosoma cruzi na parede da veia central das supra-renais de Chagásicos crônicos

    Directory of Open Access Journals (Sweden)

    Hipolito de Oliveira Almeida

    1986-12-01

    Full Text Available Foram analisados os aspectos das células musculares parasitadas pelo Trypanosoma cruzi, na veia da supra-renal de chagásicos crônicos, através de exame ao microscópio óptico de lâminas coradas pela hematoxilina-eosina (HE, PAS, Feulgen e peroxidase-antiperoxidase (PAP para antigenos do T. cruzi. Além das modificações nucleares descritas anteriormente, os leiomiócitos parasitados exibem alterações citoplasmáticas que podem ser vistas mesmo em células que albergam poucos parasitas. As formas amastigotas geralmente estão envoltas por halo claro e o citoplasma restante adquire aspecto granuloso ou reticular, basófilopelo HE, sendo sempre PAS e Feulgen negativos. Estes dados sugerem que o material basófilo no citoplasma deve ser RNA ribossômico. A periferia dos ninhos que mostram uma "membrana" com reação do PAP para antigenos do T. cruzi fortemente positiva, poderia ser devida a reação cruzada de material celular rechaçado para a periferia ou a difusão de antigenos do T. cruzi e sua adsorção à periferia celular. O material citoplasmático PAP positivo poderia resultar de artefato, de reação imunocitoquimica cruzada, de antigenos tripanossomóticos difundidos ou de antigenos tripanossoma-simile resultantes de interações entre o leiomiócito e o parasita.Some morphologic aspects of the smooth muscle cells, parasitised by T. cruzi in the adrenal vein of chronic chagasic patients were studied. The staining techniques used were the following: Hematoxylin and Eosin (HE, PAS, Feulgen and the peroxidase antiperoxidase (PAP immunocyto chemical method for identification of T. cruzi antigen. The intracellular amastigotes were often surrounded by a clear halo and the cytoplasm of the parasitised smooth muscle cells were granular or reticular in appearance being basophil and, PAS and Feulgen negative. These data suggest that the cytoplasmatic basophil material could be ribosomic RNA. The intracellular nests of amastigotes were surrounded by a PAP positive "membrane-like" structures. This PAP positive "membrane-like"material, as well assome cytoplasmatic PAP positive granulomatous material, could be due to absorbed antigensfrom the parasite or to T. cruzi- like antigens resultedfrom the interaction between the parasite and the host cell.

  4. EVALUACIÓN DE LAS PROPIEDADES MECÁNICAS DE LA ESTRUCTURA INTERNA DE LA GUADUA CON UN MODELO MATEMATICO

    Directory of Open Access Journals (Sweden)

    JAIRO ALEXANDER OSORIO SARAZ

    2009-01-01

    Full Text Available Se caracterizo la estructura interna del Bambú-Guadua angustifolia kunth (GAK, en su zona media, encontrando la composición interna de este material compuesto, como son el porcentaje de la matriz (parénquima y de fibras (células de fibras y tejido conductivo. Se determinó las propiedades mecánicas como la resistencia a tensión y a flexión en sentido tangencial, y la Relación de Poisson del material y la resistencia de la fibra. Se valido un modelo matemático para materiales compuestos propuesto por Chandrupatla & Belegundu (1999, y se encontraron algunas ecuaciones que permiten predecir la resistencia del material en función de la resistencia de la fibra, y también para realizar modelos computacionales útiles para la industria de laminados de pisos en Bambuguadua. Los resultados experimentales no difirieron significativamente de los resultados obtenidos con los modelos matemáticos.

  5. Síndrome do andar superior da cápsula interna. Hemiplegia sensitivo-motora capsular

    Scientific Electronic Library Online (English)

    A. Borges, Fortes.

    1944-03-01

    Full Text Available Desde Türck (1859) os autores têm se preocupado com a passagem de fibras sensitivas pela cápsula interna. Muitas escolas neurológicas têm estudado a questão não só sob o ponto de vista clínico mas também anatômico e experimental. O autor passa em revista a opinião dos autores franceses (Charcot, Dej [...] erine, Roussy, Long, etc.) baseados na anátomo-clínica; dos ingleses com base na experimentação (Horsley, Beevor, Grünbaum, Sherrington, Oppenheim); suíços (Monakow) e americanos (Grinker) sobre as desordens sensitivas nas lesões da cápsula interna. O autor apresenta dois casos anátomo-clínicos de hemiplegia com perturbações sensitivas devidas a lesões da cápsula interna comprovadas anatomicamente. O tálamo estava indene em ambos os casos. A cápsula interna é um diedro formado pelo encontro de dois planos: o segmento anterior e o segmento posterior. Pela parte mais alta (andar superior) do segmento posterior passam as fibras que saem do tálamo em busca da cortiça parietal (fibras tálamo-parietais), as que descem ao pedúnculo cerebral (fibras piramidais) e as que ficam entre o núcleo lenticular e o tálamo (fibras extra-piramidais). No andar inferior do mesmo segmento passam somente as fibras piramidais. O autor estuda do ponto de vista anátomo-clínico a síndrome talâmica de Dejerine e Roussy, os estados talâmicos (Austregesilo e Colares) e a hemiplegia capsular puramente motora. Mostra a inexistência de alterações sensitivas nas hemiplegias devidas à lesão do andar inferior da cápsula interna posterior. Estuda a síndrome do andar superior da cápsula interna posterior ou hemiplegia sensitivo-motora capsular. Documenta dois casos de hemiplegia sensitivo-motora com o estudo anatômico no qual se viu a lesão do andar superior do braço posterior da cápsula interna e integridade do tálamo. Salienta as diferenças existentes entre a mão talâmica e a capsular e chama a atenção para a contratura em flexão com supinação ou pronação verificadas na última, ao passo que na primeira há extensão dos dedos e movimentos córeo-atetósicos. A hemiplegia das lesões talâmicas é rapidamente regressiva e não hipertônica enquanto que a capsular é duradoura e acompanhada de aumento do tonus. Raramente aparecem dores espontâneas nas hemiplegias capsulares bem como hiperpatia de Foerster ou super-reação de Head, fenômenos muito frequentes na síndrome talâmica. Abstract in english Since Türck (1859) many authors have been interested in the passage of the sensitive fibers through the internal capsule. Even today the sensitive pathways are a very discussed subject particularly at the level of the internal capsule. In this paper the A. exposes the ideas about the possibility of [...] the existence of sensitive fibers in the capsule. The A. reports the opinions about sensitive disturbances in the lesions of the interna capsule taken from the french writers (Charcot, Dejerine, Long, Marie, etc.) who were based on anatomical and clinical facts; of the english writers (Horsley, Sherrington, Grünbaum, Beevor, Wilson, etc.) who were based in experimentation; of the german authors (Lewandowski, Oppenheim, Monakow) and the american (Grinker). The internal capsule is a diedric formation formed by the jonction of two plans: the anterior limb and the posterior limb. By the superior part (superior floor) of the posterior limb run the fibers wich arise from the thalamus (thalamic-parietal fibers), fibers wich are between the lenticular nucleus and the thalamus (extrapyramdial fibers) and the fibers wich descend to the cerebral peduncle (pyramidal fibers). In the inferior part (inferior floor) of the posterior limb there are only pyramidal fibers. The A. studies the Dejerine-Roussy's syndrome, the thalamic states (Austregesilo and Colares) and the capsular hemiplegia, in the clinical and experimental point of view. The A. shows that sensitive troubles does not exist in the paralysis caused by lesion of the inferior floor of the posterior limb of internal capsula. Fin

  6. Jugular venous overflow of noradrenaline from the brain: a neurochemical indicator of cerebrovascular sympathetic nerve activity in humans

    DEFF Research Database (Denmark)

    Mitchell, D.A.; Lambert, G.

    2009-01-01

    A novel neurochemical method was applied for studying the activity of sympathetic nerves in the human cerebral vascular system. The aim was to investigate whether noradrenaline plasma kinetic measurements made with internal jugular venous sampling reflect cerebrovascular sympathetic activity. A database was assembled of fifty-six healthy subjects in whom total body noradrenaline spillover (indicative of whole body sympathetic nervous activity), brain noradrenaline spillover and brain lipophlic noradrenaline metabolite (3,4-dihydroxyphenolglycol (DHPG) and 3-methoxy-4-hydroxyphenylglycol (MHPG)) overflow rates were measured. These measurements were also made following ganglion blockade (trimethaphan, n = 6), central sympathetic inhibition (clonidine, n = 4) and neuronal noradrenaline uptake blockade (desipramine, n = 13) and in a group of patients (n = 9) with pure autonomic failure (PAF). The mean brain noradrenline spillover and brain noradrenaline metabolite overflow in healthy subjects were 12.5 +/- 1.8, and 186.4 +/- 25 ng min(-1), respectively, with unilateral jugular venous sampling for both. Total body noradrenaline spillover was 605.8 ng min(-1) +/- 34.4 ng min(-1). As expected, trimethaphan infusion lowered brain noradrenaline spillover (P = 0.03), but perhaps surprisingly increased jugular overflow of brain metabolites (P = 0.01). Suppression of sympathetic nervous outflow with clonidine lowered brain noradrenaline spillover (P = 0.004), without changing brain metabolite overflow (P = 0.3). Neuronal noradrenaline uptake block with desipramine lowered the transcranial plasma extraction of tritiated noradrenaline (P = 0.001). The PAF patients had 77% lower brain noradrenaline spillover than healthy recruits (P = 0.06), indicating that in them sympathetic nerve degeneration extended to the cerebral circulation, but metabolites overflow was similar to healthy subjects (P = 0.3). The invariable discordance between noradrenline spillover and noradrenaline metabolite overflow from the brain under these different circumstances indicates that the two measures arise from different sources, i.e. noradrenaline spillover originates from the cerebral vasculature outside the blood-brain barrier, and the noradrenaline metabolites originate primarily from brain noradrenergic neurons. We suggest that measurements of transcranial plasma noradrenaline spillover have utility as a method for assessing the sympathetic nerve activity of the cerebral vasculature Udgivelsesdato: 2009/6/1

  7. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens / Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Scientific Electronic Library Online (English)

    Renan Roque, Onzi; Luiz Francisco, Costa; Regis Fernando, Angnes; Luciano Amaral, Domingues; Paulo, Moraes; Leandro Armani, Scaffaro; Carolina Mancuzo, Stapenhorst.

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, espe [...] cialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica. Abstract in english Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of i [...] nferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  8. Revisão rápida de esfregaços cervicais como método de garantia interna de qualidade

    OpenAIRE

    Amaral Rita Goreti; dos Santos Silvia Helena Rabelo; Catharino Jamira Machado Ramos; Silva Luiz Carlos Borges da; Westin Maria Cristina Amaral; Cotta Ana Cristina; Trevisan Mirian Aparecida da Silva; Hardy Ellen; Zeferino Luiz Carlos

    2003-01-01

    INTRODUÇÃO: Uma das críticas mais freqüentes ao exame citopatológico é a alta taxa de falsos negativos. O método de garantia de qualidade mais utilizado é a revisão de 10% dos esfregaços negativos. Segundo diversos autores, o método de revisão rápida de 100% é eficiente para detectar resultados falsos negativos. OBJETIVO: Comparar o desempenho dos métodos de revisão rápida de 100% e revisão de 10% dos esfregaços negativos como método de garantia interna de qualidade. MÉTO...

  9. Verbesserte klinische Ergebnisse durch Koronarrevaskularisation mittels bilateralem Arteria-thoracica-interna Bypass

    OpenAIRE

    Loef, Adelheid

    2007-01-01

    Überlegene Offenheitsraten der Arteria mammaria interna gegenüber Vena-saphena-magna-Transplantaten sind angiographisch valide. Ziel der vorliegenden Untersuchungsreihe war, Outcome und klinischen Benefit von Patienten mit bilateralem ITA(BITA-)und solchen mit einfachem ITA(SITA-)Bypass im mittelfristigen postoperativen Verlauf zu verifizieren. 1.378 Patienten, die sich zwischen 01/97 und 08/99 einer isolierten aortokoronaren Bypassoperation unterzogen hatten, wurden retrospektiv unte...

  10. El desarrollo laboral sustentable y su relación con la migración interna en México

    Scientific Electronic Library Online (English)

    Jesús Sergio, Sánchez Rodríguez; José Raúl, Luyando Cuevas; Ernesto, Aguayo Téllez; Esteban, Picazzo Palencia.

    2014-08-01

    Full Text Available En este trabajo se estudió la interacción entre la migración interestatal y el desarrollo laboral sustentable en México del año 2000 al 2010, de acuerdo con la visión de Amartya Sen. Este desarrollo se midió con el índice de competitividad social, y la interacción con la migración interna se evaluó [...] con un modelo de ecuaciones simultáneas. Los resultados confirmaron que a mayor desarrollo laboral sustentable, el grado de inmigración fue más y viceversa. Por otro lado, no se encontró relación alguna entre la emigración interna y el desarrollo laboral sustentable. Al desagregar el índice de competitividad social, se encontró una relación causal mutua entre el índice de la ausencia de pobreza salarial y la inmigración interna, así como una relación causa-efecto positiva entre ausencia de pobreza salarial sobre la emigración interna, la cual no se da en el otro sentido. Abstract in english This article studies the interaction between interstate migration and sustainable workforce development in Mexico from 2000 to 2010, based on Amartya Sen's philosophies. Sustainable workforce development was measured using the Social Competitiveness Index, and its interaction with internal migration [...] was evaluated by estimating a simultaneous equations model. The results confirm the existing interdependence between internal immigration and sustainable workforce development; this means that higher sustainable workforce development generates higher immigration levels and vice versa. On the other hand, we did not find a relation between internal emigration and sustainable workforce development. When disaggregating the Social Competitiveness Index, we found a mutual causal relationship between a low poverty wage index and internal immigration. Also, there is a positive causal relationship between poverty wage index and an increase in internal emigration.

  11. Características de la cultura organizacional y comunicación interna en una comercializadora de lácteos de Cali

    Scientific Electronic Library Online (English)

    Diana Marcela, Gómez; Kewy Sarsosa, Prowesk.

    2011-12-01

    Full Text Available Escopo. Esta pesquisa teve como escopo identificar as características da comunicação interna atribuídas à cultura organizacional de uma empresa familiar comercializadora de produtos lácteos. Metodología. É uma pesquisa de tipo descritiva com desenho transacional, na qual foram recolhidos os dados em [...] um só momento mediante o uso do Questionário de Diagnóstico da Cultura Organizacional de Cameron e Quinn (1999). A mostra esteve conformada por 66 empregados de diferentes áreas da empresa. Resultados and conclusão. Os resultados assinalam falências na comunicação interna geradas pela cultura organizacional de tipo clã, centrada para o interior, e que caracteriza à empresa familiar. Abstract in spanish Objetivo. Esta investigación tuvo como objetivo identificar las características de la comunicación interna, atribuidas a la cultura organizacional de una empresa familiar, comercializadora de lácteos. Método. Es una investigación de tipo descriptiva, con diseño transaccional, en la cual se recogen l [...] os datos en un solo momento mediante el uso del Cuestionario de Diagnóstico de la Cultura Organizacional de Cameron y Quinn (1999). La muestra estuvo conformada por 66 empleados de diferentes áreas de la empresa. Resultados y Conclusión. Los resultados señalan falencias en la comunicación interna, generadas por la cultura organizacional de tipo clan, centrada hacia su interior, y que caracteriza a la empresa familiar. Abstract in english Objective. The objective of this research was to identify the characteristics of the internal communication attributed to the organizational culture of a family business which marketed dairy products. Method. This research is descriptive and has a transactional design in which data is gathered on a [...] one time basis using a Diagnostic Questionnaire on the Organizational Culture of Cameron and Quinn (1999). The sample was made up of 66 employees of different areas within the company. Results and Conclusion. The results signal the internal communication shortcomings generated by the clan type organizational culture: focused inward as characterized by a family owned business.

  12. Monitoramento da carga interna no basquetebol / Monitoring internal load in basketball

    Scientific Electronic Library Online (English)

    João Antônio, Nunes; Eduardo Caldas, Costa; Luis, Viveiros; Alexandre, Moreira; Marcelo Saldanha, Aoki.

    2011-02-01

    Full Text Available O objetivo do presente estudo foi quantificar a magnitude da carga interna referente a uma partida oficial de Basquetebol feminino e avaliar se a carga interna apresenta relação com o número de ações técnicas realizadas no jogo. A amostra foi constituída de 10 atletas (25 ± 4 anos) que participaram [...] do XI Campeonato Brasileiro de Basquetebol Feminino. Foram avaliados o comportamento da frequência cardíaca (FC) e a percepção subjetiva de esforço (PSE) em resposta à partida. A carga interna foi calculada pelo método de Edwards e pelo método de Foster. Além disso, foram analisados os parâmetros de desempenho técnico na partida. A carga interna estimada pelo método de Edwards e Foster foram 255±62 e 321±127 unidades arbitrárias, respectivamente. Foi detectada correlação moderada entre os dois métodos utilizados (Edwards e Foster; r = 0,64; - p Abstract in english The aim of this study was to quantify the magnitude of the internal load induced by an official women's basketball match and to determine whether the magnitude of the internal load is correlated with the number of basketball maneuvers perfomed. The sample consisted of 10 athletes (25 ± 4 years), who [...] participated in the XI Brazilian Women's Basketball Championship. Heart rate and rating of perceived exertion in response to the match were evaluated. The internal load was calculated by the methods of Edwards and Foster. In addition, the basketball maneuvers perfomed in the match were analyzed. The internal load estimated by the methods of Edwards and Foster was 255 ± 62 and 321 ± 127 arbitrary units, respectively. A moderate correlation was observed between the two methods used (r = 0.64, p

  13. Globus Pallidus Interna Deep Brain Stimulation in a Patient with Medically Intractable Meige Syndrome

    Science.gov (United States)

    Bae, Dae-Woong; Son, Byung-chul; Kim, Joong-Seok

    2014-01-01

    Medical therapies in patients with Meige syndrome, including botulinum toxin injection, have been limited because of incomplete response or adverse side effects. We evaluated a patient with Meige syndrome who was successfully treated with deep brain stimulation (DBS) in the globus pallidus interna (GPi). This case report and other previous reports suggest that bilateral GPi DBS may be an effective treatment for medically refractory Meige syndrome, without significant adverse effects. PMID:25360233

  14. A Study on Effects of the Transient Compression by Tightly Tied Necktie on Blood Flow in the Internal Jugular Veins Using 2D-PC MRA

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keung Sik; Chung, Tae Sub; Lee, Bum Soo [Dept. of Diagnostic Radiology, Yongdong Severance Hospital Yensei University, Seoul (Korea, Republic of); Park, In Kook [Dept. of Biology, Dongguk University, Seoul (Korea, Republic of); Kim, Hyun Soo [Dept. of Biology, Kangwon National University, Chuncheon (Korea, Republic of); Yoo, Beong Gyu [Dept. of Radiotechnology, Wonkwang Health Science College, Iksan (Korea, Republic of)

    2008-09-15

    The 25 healthy male volunteers aged from 20 to 50 years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24 cm FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie. The average of maximum velocity of internal carotid arteries without a necktie was 72.13 cm/sec in the right side and 74.96 cm/sec in the left side (average 73.54 cm/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45 cm/sec in the right side and -24.99 cm/sec in the left side (-29.72 cm/sec in both sides). However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35 cm/sec in the right side and 65.19 cm/sec in the left side (average 63.27 cm/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14 cm/sec in the right side and -17.93 cm/sec in the left side (-20.03 cm/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreased to 86% (63.27/73.54 cm/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 cm/sec). Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins (33% decrease in blood flow speed) more significantly than that of internal carotid artery (14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers. In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

  15. A Study on Effects of the Transient Compression by Tightly Tied Necktie on Blood Flow in the Internal Jugular Veins Using 2D-PC MRA

    International Nuclear Information System (INIS)

    The 25 healthy male volunteers aged from 20 to 50 years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24 cm FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie. The average of maximum velocity of internal carotid arteries without a necktie was 72.13 cm/sec in the right side and 74.96 cm/sec in the left side (average 73.54 cm/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45 cm/sec in the right side and -24.99 cm/sec in the left side (-29.72 cm/sec in both sides). However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35 cm/sec in the right side and 65.19 cm/sec in the left side (average 63.27 cm/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14 cm/sec in the right side and -17.93 cm/sec in the left side (-20.03 cm/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreasinternal carotid arteries slightly decreased to 86% (63.27/73.54 cm/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 cm/sec). Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins (33% decrease in blood flow speed) more significantly than that of internal carotid artery (14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers. In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

  16. Expression of apoptosis in human saphenous vein grafts in restoration of blood flow through coronary bypass surgery / Expressão da apoptose em enxertos de veias safenas humana para restauração do fluxo sanguíneo coronariano por derivação

    Scientific Electronic Library Online (English)

    Luís Fernando, Tirapelli; Daniela Pretti da Cunha, Tirapelli; Marcelo Bellini, Dalio; Alfredo José, Rodrigues; Paulo Roberto Barbosa, Évora.

    2009-09-01

    Full Text Available OBJETIVO: Investigar o possível papel da apoptose em distensões breves de veias safenas humanas em diferentes pressões. MÉTODOS: Segmentos frescos isolados de veia safena humana foram distribuídos em 4 grupos: controle ou distendidos (D) por quinze segundos a 100, 200 e 300 mmHg. O grau de apoptose [...] das caspases 3, 8, 9 e expressão da proteína anti-apoptótica Bcl-2 foram avaliados por imuno-histoquímica. RESULTADOS: Segmentos frescos distendidos isolados de veias safenas humanas apresentaram expressão protéica para apoptose similar às veias controle. No entanto, a expressão de Bcl-2 foi significativamente maior nos segmentos distendidos a 300 mmHg, quando comparados à veia controle. CONCLUSÃO: Estes achados demonstram que segmentos intactos de veias safenas humanas submetidos a distensões em diferentes pressões têm expressão de proteínas apoptóticas similares quando comparados com veias controle nãodistendidas. Por conseguinte, breves distensões comumente realizadas durante a coleta cirúrgica não ativam o processo de apoptose e, provavelmente, não estão envolvidas em mecanismos fisiopatológicos que levam à falência do enxerto Abstract in english OBJECTIVE: To investigate the possible role of apoptosis on brief distensions of human saphenous veins at different pressures. METHODS: Fresh isolated grafts of human saphenous vein were assigned as control or distended (D) for fifteen seconds at 100, 200 and 300 mmHg. The degree of apoptotic caspas [...] es 3, 8, 9 and anti-apoptotic protein Bcl-2 expression were assessed by immunohistochemistry. RESULTS: Fresh isolated segments of distended human saphenous veins presented similar apoptotic protein expression when compared with control veins. However, the Bcl-2 expression was significantly higher in the 300 mmHg distended segments compared with the control vein. CONCLUSION: These findings show that intact segments of human saphenous veins submitted to distensions at different pressures have similar apoptotic proteins expression when compared with non-distended control veins. Therefore, brief distensions commonly performed during surgical harvesting do not trigger apoptosis, and probably are not involved on the physiopathological mechanisms that lead to graft failure

  17. Hemipelvectomia interna: relato de oito casos / Internal hemipelvectomy: report on eight cases

    Scientific Electronic Library Online (English)

    Alexandre Ferreira, Oliveira; Leonardo José, Vieira; Antônio Carlos Rodrigues do, Nascimento; João Baptista de Paula, Fraga; Rómmel Ribeiro Lourenço, Costa; Luiz Gustavo Rodrigues do, Nascimento.

    Full Text Available A hemipelvectomia interna é um procedimento cirúrgico adequado no tratamento de certos tumores de cintura pélvica. É uma alternativa terapêutica capaz de preservar o membro inferior do paciente, ao contrário das amputações clássicas como a amputação interilioabdominal (AIIA) e desarticulação coxofem [...] oral. De acordo com a classificação de Enneking, existem quatro tipos de hemipelvectomia interna, mas, se for necessário, é possível a associação de diferentes tipos de ressecção em um único procedimento. É fundamental que esta cirurgia seja indicada de forma correta para que interfira positivamente na morbimortalidade e qualidade de vida do paciente. Relatamos oito casos de hemipelvectomia interna em pacientes diagnosticados com tumores de cintura pélvica, bem como os tipos de tratamento neoadjuvantes e adjuvantes a que eles foram submetidos e o follow-up dos mesmos. Abstract in english Internal hemipelvectomy is a surgical procedure adequate for treatment of certain tumors of the pelvic girdle. Being a lower limb-preserving approach, it is a therapeutic alternative to the classical interilioabdominal amputation and hip joint disarticulation. According to Enneking`s classification, [...] there are four types of internal hemipelvectomies, although the association of different types of resection in the same procedure is feasible if necesary. This surgical approach should be correctly indicated to positively affect the patient`s morbidity, mortality and quality of life. We report eight cases of internal hemipelvectomy in patients diagnosed with tumors of the pelvic girdle. We also discuss the neoadjuvant and adjuvant treatments used, along with their follow-up.

  18. Trombose de veia porta após desconexão ázigo-portal e esplenectomia em pacientes esquistossomóticos: Qual a real importância? / Portal vein thrombosis after esophagogastric devascularization and splenectomy in schistosomal portal hypertension patients: What's the real importance?

    Scientific Electronic Library Online (English)

    Fábio Ferrari, Makdissi; Paulo, Herman; Marcel Autran C., Machado; Vincenzo, Pugliese; Luiz Augusto Carneiro, D' Albuquerque; William A., Saad.

    2009-03-01

    Full Text Available CONTEXTO: A complicação mais frequente após a desconexão ázigo-portal e esplenectomia em doentes com esquistossomose mansônica hepatoesplênica é a trombose da veia porta. OBJETIVOS:Avaliar a incidência, os fatores preditivos dessa complicação, assim como, a evolução clínica, laboratorial, endoscópic [...] a e ultrassonográfica desses pacientes. MÉTODOS: Foram analisados retrospectivamente os prontuários de 155 doentes esquistossomóticos submetidos a desconexão ázigo-portal e esplenectomia. RESULTADOS: Trombose de veia porta foi observada em 52,3% dos pacientes, sendo 6,5% de trombose total e 45,8% de trombose parcial. Os pacientes que evoluíram com trombose de veia porta apresentaram mais frequentemente diarreia no pós-operatório. Febre foi evento habitual que ocorreu em 70% dos casos, mais frequente, entretanto, nos doentes com trombose total da veia porta (100%). Trombose de veia mesentérica superior ocorreu em quatro doentes (2,6%), sendo mais frequente entre os com trombose total da veia porta. Não se encontrou diferença estatística quanto aos parâmetros clínicos, laboratoriais, endoscópicos e recidiva hemorrágica no pós-operatório tardio, quando comparados os pacientes com e sem trombose portal. CONCLUSÕES: A trombose de veia porta no pós-operatório da desconexão ázigo-portal e esplenectomia é evento frequente, sem nenhum fator preditivo para sua ocorrência; na maioria dos casos a trombose é parcial e apresenta evolução benigna, com baixa morbidade; trombose total da veia porta está mais frequentemente associada à trombose da veia mesentérica superior, com elevada morbidade; a trombose da veia porta, parcial ou total, não acarretou complicações no período pós-operatório tardio. Abstract in english CONTEXT: Portal vein thrombosis is the most frequent complication after esophagogastric devascularization and splenectomy for hepatosplenic schistosomosis. OBJECTIVE: To evaluate portal vein thrombosis in 155 patients with schistosomal portal hypertension submitted to esophagogastric devascularizati [...] on and splenectomy. METHODS: We retrospectively analyzed not only the incidence and predictive factors of this complication, but also clinical, laboratorial, endoscopic and Doppler sonography outcome of these patients. RESULTS: Postoperative portal thrombosis was observed in 52.3% of the patients (partial in 45.8% and total in 6.5%). Postoperative diarrhea was more frequent in patients with portal vein thrombosis. Fever was a frequent postoperative symptom (70%) but occurred in a higher percentage when total portal vein thrombosis was present (100%). Superior mesenteric vein thrombosis occurred in four patients (2.6%) and was associated with total thrombosis of the portal vein. There was no statistical difference between patients with and without portal vein thrombosis according to clinical and endoscopic parameters during late follow-up. It was not possible to identify any predictive factor for the occurrence of this complication. CONCLUSIONS: Portal vein thrombosis is an early and frequent event after esophagogastric devascularization and splenectomy, usually partial with benign outcome and low morbidity. Total portal vein thrombosis is more frequently associated with a high morbidity complication, the superior mesenteric vein thrombosis. Long-term survival was not influenced by either partial or total portal thrombosis.

  19. Trombose de veia porta após desconexão ázigo-portal e esplenectomia em pacientes esquistossomóticos: Qual a real importância? Portal vein thrombosis after esophagogastric devascularization and splenectomy in schistosomal portal hypertension patients: What's the real importance?

    Directory of Open Access Journals (Sweden)

    Fábio Ferrari Makdissi

    2009-03-01

    Full Text Available CONTEXTO: A complicação mais frequente após a desconexão ázigo-portal e esplenectomia em doentes com esquistossomose mansônica hepatoesplênica é a trombose da veia porta. OBJETIVOS:Avaliar a incidência, os fatores preditivos dessa complicação, assim como, a evolução clínica, laboratorial, endoscópica e ultrassonográfica desses pacientes. MÉTODOS: Foram analisados retrospectivamente os prontuários de 155 doentes esquistossomóticos submetidos a desconexão ázigo-portal e esplenectomia. RESULTADOS: Trombose de veia porta foi observada em 52,3% dos pacientes, sendo 6,5% de trombose total e 45,8% de trombose parcial. Os pacientes que evoluíram com trombose de veia porta apresentaram mais frequentemente diarreia no pós-operatório. Febre foi evento habitual que ocorreu em 70% dos casos, mais frequente, entretanto, nos doentes com trombose total da veia porta (100%. Trombose de veia mesentérica superior ocorreu em quatro doentes (2,6%, sendo mais frequente entre os com trombose total da veia porta. Não se encontrou diferença estatística quanto aos parâmetros clínicos, laboratoriais, endoscópicos e recidiva hemorrágica no pós-operatório tardio, quando comparados os pacientes com e sem trombose portal. CONCLUSÕES: A trombose de veia porta no pós-operatório da desconexão ázigo-portal e esplenectomia é evento frequente, sem nenhum fator preditivo para sua ocorrência; na maioria dos casos a trombose é parcial e apresenta evolução benigna, com baixa morbidade; trombose total da veia porta está mais frequentemente associada à trombose da veia mesentérica superior, com elevada morbidade; a trombose da veia porta, parcial ou total, não acarretou complicações no período pós-operatório tardio.CONTEXT: Portal vein thrombosis is the most frequent complication after esophagogastric devascularization and splenectomy for hepatosplenic schistosomosis. OBJECTIVE: To evaluate portal vein thrombosis in 155 patients with schistosomal portal hypertension submitted to esophagogastric devascularization and splenectomy. METHODS: We retrospectively analyzed not only the incidence and predictive factors of this complication, but also clinical, laboratorial, endoscopic and Doppler sonography outcome of these patients. RESULTS: Postoperative portal thrombosis was observed in 52.3% of the patients (partial in 45.8% and total in 6.5%. Postoperative diarrhea was more frequent in patients with portal vein thrombosis. Fever was a frequent postoperative symptom (70% but occurred in a higher percentage when total portal vein thrombosis was present (100%. Superior mesenteric vein thrombosis occurred in four patients (2.6% and was associated with total thrombosis of the portal vein. There was no statistical difference between patients with and without portal vein thrombosis according to clinical and endoscopic parameters during late follow-up. It was not possible to identify any predictive factor for the occurrence of this complication. CONCLUSIONS: Portal vein thrombosis is an early and frequent event after esophagogastric devascularization and splenectomy, usually partial with benign outcome and low morbidity. Total portal vein thrombosis is more frequently associated with a high morbidity complication, the superior mesenteric vein thrombosis. Long-term survival was not influenced by either partial or total portal thrombosis.

  20. Viorella Manolache (ed., Centru ?i margine la Marea Mediteran?. Filosofie politic? ?i realitate interna?ional? (Bucharest: Editura ISPRI, 2009

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    Henrieta Serban

    2013-03-01

    Full Text Available Review of the book by Viorella Manolache (ed., Centru ?i margine la Marea Mediteran?. Filosofie politic? ?i realitate interna?ional?, Editura ISPRI, 2009, ISBN 978-973- 7745- 38-5, 416 pp.

  1. Balloon atrial septostomy through internal jugular vein in a 45-day-old child with transposition of great arteries

    Directory of Open Access Journals (Sweden)

    Padhi Sumanta

    2010-01-01

    Full Text Available Balloon atrial septostomy is a common palliative procedure in D-transposition of great arteries. It is technically easy before 2-3 weeks of age when the septum primum is thin. Femoral vein or umbilical vein, when available, is the common access used for this procedure. In situations when these accesses are not available or in case of inferior vena cava interruption, trans-hepatic access is used. Internal jugular vein (IJV access is not used as it is difficult to enter the left atrium through this route. We describe a case of successful Balloon atrial septostomy done through IJV in a 45-day-old child with emphasis on the technique, hardware and precautions necessary during the procedure.

  2. Safety related to the implantation of jugular catheters for haemodialysis and usefulness of PA chest X rays post procedure

    International Nuclear Information System (INIS)

    The objective is to determine how safe the implantation of transient double lumen jugular catheters is for hemodialysis in patients with renal disease, and who require dialysis therapy and Posterior Anterior (PA) chest X-Ray post procedure. Design: observational descriptive study. Site: renal units at RTS Ltda. Sucursal Caldas (Hospital Santa Sofia y Hospital Infantil Rafael Henao Toro de la Cruz Roja). Patients: all patients with renal disease in whom it was necessary to do hemodyalitic therapy with implantation of a jugular catheter, with medical records of the events and complications that occurred during the procedure, with subsequent control AP chest X Ray and that showed reports made by the radiologist or physician who carried out the procedure, about the findings in the chest X Ray. Patients with renal disease, in whom jugular catheters had been inserted: Methods: variables such as age, gender, race, body mass index (BMI) etiology of the renal failure,time of evolution of the disease, indications for insertion, priority of catheter insertion, type of catheter inserted, amount of punctures, physician who carried out the procedure and patient's co-morbidities were analyzed. The events considered as complicated were analyzed as well as if there was any relationship with co-morbidities and the analyzed variables. Findings in the PA chest X-Ray were recorded and their relationship with the difficulties encountered during the procedure. A bi-variance analysis was don procedure. A bi-variance analysis was done. The dependent and independent variables were classified in the nominal measurement scale. Results: 774 clinical histories were reviewed. 562 were excluded due to lack of variables and impossibility to read the notes. Men older than de 55 (45,7%). 212 (97.1%) patients with diagnosis of chronic renal disease (CRD) and in whom 238 procedures were carried out. seven patients (2,85%) had acute renal failure (ARF). The fi rst indication for central catheter insertion was in patients with chronic uremia syndrome as well as in patients with IRA uremia encephalopathy. The internist nephrologists did most of the insertions (n=207, 84.5%). In 245 insertions 17 important events were described which corresponded to 6,9% of the procedures. Multiple punctures (more than 3) were reported in nine patients. The post implantation chest X-Ray made it possible to detect 4 complications, meaning 1,6% of the procedures, of which none of them was fatal. No association with the event/complications was found in the variables analyzed. No association between IMC and multiple punctures. Conclusions: the implantation of jugular catheters is an easy procedure with a low rate of events or complications. PA X-Ray provides little information when the procedure is free of complications.

  3. Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura / Endovascular treatment of superior vena cava syndrome: case report and review of the literature

    Scientific Electronic Library Online (English)

    Marco Aurélio, Cardozo; Eduardo, Lichtenfels; Nilon, Erling Jr.; Dorvaldo P., Tarasconi.

    2006-12-01

    Full Text Available Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia [...] cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior. Abstract in english We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the r [...] ight brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

  4. Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura Endovascular treatment of superior vena cava syndrome: case report and review of the literature

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    Marco Aurélio Cardozo

    2006-12-01

    Full Text Available Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior.We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the right brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

  5. Filtro de veia cava: uma década de experiência em um centro de trauma nível I / Vena cava filters: a decade of experience in a level I trauma center

    Scientific Electronic Library Online (English)

    Luiz Guilherme Cintra Vidal, Reys; Raul, Coimbra; Dale, Fortlage.

    Full Text Available OBJETIVO: Avaliar os dados relativos à utilização de filtro de veia cava na Divisão de Trauma do Centro Médico da UCSD San Diego, CA/EUA. MÉTODOS: Estudo descritivo realizado na Divisão de Trauma visando avaliar a experiência acumulada e a conduta terapêutica nos doentes atendidos pela equipe da Div [...] isão de Trauma e submetidos à colocação de filtro de veia cava como método de prevenção ou tratamento do TEP no período de janeiro de 1999 a dezembro de 2008. RESULTADOS: O estudo compreendeu 512 doentes, destacando-se o sexo masculino (73%). Quanto à causa do traumatismo predominou o acidente automobilístico, seguido por lesões provocadas por quedas. A relação homem/mulher foi 3:1. A faixa etária mais atingida foi 21 a 40 anos, representando 36% dos doentes. O percentual de filtros de cava profiláticos foi de 82% contra 18% de filtros terapêuticos. O traumatismo craniano foi a principal causa para indicação de filtros profiláticos seguido dos traumas raquimedulares. O índice de TVP pós-filtro foi 11%. CONCLUSÃO: Na presença de contraindicação ao uso de anticoagulantes em doentes vítimas de trauma grave, os filtros de veia cava inferior demonstraram ser uma opção efetiva e segura. Entretanto, deve-se aplicar rigor ao julgamento clínico para todas as indicações, mesmo após o advento de filtros "recuperáveis". Abstract in english OBJECTIVE: To evaluate the data on the use of vena cava filter in the Division of Trauma, UCSD Medical Center - San Diego, CA / USA. METHODS: A descriptive study was conducted at the Division of Trauma to evaluate the cumulated experience and the therapeutic approach in patients attended by the staf [...] f of the Division of Trauma and submitted to placement of a vena cava filter as a method of prevention or treatment of Pulmonary Thromboembolism (PTE) from January 1999 to December 2008. RESULTS: The study comprised 512 patients, mostly males (73%). As to the cause, automobile accident injuries predominated, followed by injuries caused by falls. The male / female ratio was 3:1. The most affected age group was the one between 21 to 40 years, representing 36% of patients. The percentage of prophylactic vena cava filters was 82%, whilst 18% had treatment purposes. Head trauma was the main cause for the indication of prophylactic filters followed by spinal cord trauma. The rate of pos-filter deep vein thrombosis (DVT) was 11%. CONCLUSION: In the presence of contraindications to the use of anticoagulants in patients who suffered severe trauma, the inferior vena cava filters have proven to be an effective and safe optio n. However, one should apply rigorous clinical judgment to all indications, even after the advent of retrievable filters.

  6. Persistence of the embryonic lateral marginal vein: report of two cases / Persistência da veia marginal do embrião: relato de dois casos

    Scientific Electronic Library Online (English)

    Raúl, Rojas Martinez; Pedro, Puech-Leão; Guimarães, Paulo Motta; Muraco Netto, Baptista.

    2001-10-01

    Full Text Available OBJETIVO: As anomalias venosas congênitas representam um desafio especial para o cirurgião vascular. A persistência de veias fetais é uma malformação rara, sendo o exemplo mais comum a persistência da veia marginal embrionária na face lateral do membro inferior em pacientes com hemangiodisplasias co [...] mplexas, particularmente a Síndrome de Klippel-Trenaunnay. Seu aparecimento como defeito vascular congênito único é raríssimo. Mostramos 2 destes casos. MÉTODO: Dois pacientes, com 17 e 16 anos sendo um do sexo masculino, apresentavam cordão varicoso, único e exuberante na face lateral da coxa e perna direita, presentes desde o nascimento. Os membros foram avaliados com mapeamento Duplex e flebografia. Foi realizado tratamento cirúrgico com ressecção total da veia marginal. RESULTADO: Ambos pacientes evoluíram satisfatoriamente. O seguimento médio foi de 26 meses, sem evidência de recorrência das varizes. CONCLUSÃO: A terapêutica nestes casos depende do estado clínico e extensão da lesão. As indicações para o tratamento cirúrgico incluem: sangramento, lesões tróficas, dor, edema e deformidade estética, obtendo-se bons resultados. Abstract in english PURPOSE: Congenital venous malformations of the lower limbs represent a particular challenge for the vascular surgeon. Persistence of fetal veins is a rare malformation, and the most common is the persistence of the lateral marginal vein usually observed in patients with Klippel-Trenaunnay Syndrome. [...] The persistence of this embryonic vein as an isolated venous malformation without the other characteristics of the Klippel-Trenaunnay Syndrome has not yet been reported. This paper describes two cases. METHODS: Two patients, a 17-year-old male patient and a 16-year-old female, have had since their birth a large venous trunk in the lateral aspect of the right leg and thigh. The limbs underwent duplex scanning and phlebography. The surgical removal of the lateral marginal vein was performed. RESULTS: Surgical treatment resulted in very good functional and aesthetic results. Follow-up at 26 months showed no evidence of varicose vein recurrence. CONCLUSIONS: To achieve good results, surgical intervention may be indicated in cases of orthopedic deformity, hemorrhage, symptomatic, and unaesthetic lesions.

  7. Filtro de veia cava: uma década de experiência em um centro de trauma nível I Vena cava filters: a decade of experience in a level I trauma center

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    Luiz Guilherme Cintra Vidal Reys

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os dados relativos à utilização de filtro de veia cava na Divisão de Trauma do Centro Médico da UCSD San Diego, CA/EUA. MÉTODOS: Estudo descritivo realizado na Divisão de Trauma visando avaliar a experiência acumulada e a conduta terapêutica nos doentes atendidos pela equipe da Divisão de Trauma e submetidos à colocação de filtro de veia cava como método de prevenção ou tratamento do TEP no período de janeiro de 1999 a dezembro de 2008. RESULTADOS: O estudo compreendeu 512 doentes, destacando-se o sexo masculino (73%. Quanto à causa do traumatismo predominou o acidente automobilístico, seguido por lesões provocadas por quedas. A relação homem/mulher foi 3:1. A faixa etária mais atingida foi 21 a 40 anos, representando 36% dos doentes. O percentual de filtros de cava profiláticos foi de 82% contra 18% de filtros terapêuticos. O traumatismo craniano foi a principal causa para indicação de filtros profiláticos seguido dos traumas raquimedulares. O índice de TVP pós-filtro foi 11%. CONCLUSÃO: Na presença de contraindicação ao uso de anticoagulantes em doentes vítimas de trauma grave, os filtros de veia cava inferior demonstraram ser uma opção efetiva e segura. Entretanto, deve-se aplicar rigor ao julgamento clínico para todas as indicações, mesmo após o advento de filtros "recuperáveis".OBJECTIVE: To evaluate the data on the use of vena cava filter in the Division of Trauma, UCSD Medical Center - San Diego, CA / USA. METHODS: A descriptive study was conducted at the Division of Trauma to evaluate the cumulated experience and the therapeutic approach in patients attended by the staff of the Division of Trauma and submitted to placement of a vena cava filter as a method of prevention or treatment of Pulmonary Thromboembolism (PTE from January 1999 to December 2008. RESULTS: The study comprised 512 patients, mostly males (73%. As to the cause, automobile accident injuries predominated, followed by injuries caused by falls. The male / female ratio was 3:1. The most affected age group was the one between 21 to 40 years, representing 36% of patients. The percentage of prophylactic vena cava filters was 82%, whilst 18% had treatment purposes. Head trauma was the main cause for the indication of prophylactic filters followed by spinal cord trauma. The rate of pos-filter deep vein thrombosis (DVT was 11%. CONCLUSION: In the presence of contraindications to the use of anticoagulants in patients who suffered severe trauma, the inferior vena cava filters have proven to be an effective and safe optio n. However, one should apply rigorous clinical judgment to all indications, even after the advent of retrievable filters.

  8. Transposição da Veia Basílica: um contributo para a melhoria da técnica cirúrgica / Basilic Vein Transposition: improvement of the surgical technique

    Scientific Electronic Library Online (English)

    Norton de, Matos; Clara, Nogueira; José, Queirós; Fernanda, Silva; Sofia, Rocha; Pedro, Azevedo; Rui, Machado; Mergulhão, Mendonça.

    2012-09-01

    Full Text Available Introdução: O aumento crescente da população em hemodiálise tem implicado o recurso a acessos vasculares de maior complexidade técnica. A introdução de modificações na técnica cirúrgica da transposição da veia basílica (TVB) pretende agilizar o procedimento e diminuir a sua morbilidade. Métodos: Aná [...] lise prospectiva das TVB efectuadas no CHP-HSA entre Setembro de 2005 e Setembro de 2009. Resultados: Efectuaram-se 74 TVB em 74 doentes, os quais tinham, em média, 2 acessos autólogos prévios. A TVB foi o primeiro acesso em 20,3% dos doentes. O intervalo médio de seguimento foi de 14,5 meses. Ocorreram 2 falências nos primeiros 30 dias. A taxa de patência secundária aos 3, 12 e 24 meses foi de 95,7%, 85,1% e 62,2%, respectivamente. A Diabetes associou-se a pior taxa de patência (p=0,018). A taxa de complicações perioperatórias foi de 28,4%, sendo a infecção a mais frequente (n=6, 8,1% do total de TVB). A trombose foi a principal causa de falência, tendo ocorrido em 24,3% de todas as TVB. Conclusões: Reconhece-se a superioridade do acesso autólogo, como a melhor opção de acesso vascular para hemodiálise. A TVB é subutilizada, devido às exigências técnicas e necessidades logísticas. Melhoramos a técnica cirúrgica e de tunelização, ao reduzir o tamanho das incisões e o tempo cirúrgico. Os nossos resultados revelaram uma boa patência a longo prazo, pelo que consideramos que deve ser mais utilizada. Abstract in english Introduction: The expanding haemodialysis population has lead to increased requirement for more complex vascular accesses. Modifications introduced in basilic vein transposition technique are intended to streamline the procedure and reduce its morbidity. Methods: All patients who underwent BVT from [...] September 2005 to September 2009 in CHP-HSA were prospectively reviewed. Results: Seventy-four BVT were performed in 74 patients. Patients had a mean of 2.0 previous access attempts. BVT was the first access in 20.3% of the patients. Median follow-up was 14.5 months. There were two primary failures. Secondary patency rates were 95.7%, 85.1% and 62.2% at 3, 12 and 24 months, respectively. Diabetes was associated with poor patency. Perioperative complication rate was 28.4%, with infection being the most frequent (n=6, 8.1% of all TVB). Thrombosis was the main cause of failure, occurring in 24.3% of all TVB. Conclusion: Autologous access superiority is well established. BVT is an underused technique due to its surgical expertise needs and logistic demands. We improved the surgical technique and the tunneling technique, reducing the size of the incisions and the time of operation. Our results showed a good secondary patency rate and, in the authors view, this technique should be more widely used.

  9. Avaliação in vitro de um novo filtro de veia cava In vitro evaluation of a new vena cava filter

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    Domingo Marcolino Braile

    2005-01-01

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos êmbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica. Foi utilizado, para veículo, um reservatório com solução salina (0,9% com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula.OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists of two cones connected at the apexes. The distal cone is comprised of eight stainless steel arms with a purpose of retaining emboli and the proximal cone, made of four arms, acts as an anchor to centralize the filter. Filters were installed and fixed inside three systems using transparent PVC tubes of different sizes (internal diameters of 25, 30 and 35 mm that were held in a vertical position and connected to a pulsating flow system (peristaltic pump. A reservoir of 0.9% saline solution with 40% glycerin at room temperature was used as the vehicle. Thrombi were made from bovine blood in 3-mm, 4-mm, 5-mm and 6-mm plastic tubes and later the thrombi were sectioned into 10-mm, 15-mm, 20-mm and 30-mm lengths. Each of the 12 sizes of thrombi was assessed 100 times in each of the three systems, with a total of 3,600 events. Five emboli were sequentially released, 10 for each size of embolus and tube, with a total of 360 events. An evaluation of the capacity of the three systems - 100 events each, total of 300 events - to dynamically retain the emboli was made. MRESULTS: The diameter and length of the emboli, as well as tubes greater than 35 mm in diameter can negatively affect the efficacy of the filter. The average of emboli capture for the filters was 80.5% in 35-mm tubes, 88.7% for 30-mm tubes and 86.6% for 25-mm tubes. CONCLUSION: We conclude that the efficacy of this filter is influenced by the size of the emboli and the diameter of the PVC tubes.

  10. Avaliação in vitro de um novo filtro de veia cava / In vitro evaluation of a new vena cava filter

    Scientific Electronic Library Online (English)

    Domingo Marcolino, Braile; José Maria Pereira de, Godoy; Marco, Centola.

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos ê [...] mbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica). Foi utilizado, para veículo, um reservatório com solução salina (0,9%) com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula. Abstract in english OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists of two cones connected at the apexes. The distal cone is comprised of eight stainless steel arms with a purpos [...] e of retaining emboli and the proximal cone, made of four arms, acts as an anchor to centralize the filter. Filters were installed and fixed inside three systems using transparent PVC tubes of different sizes (internal diameters of 25, 30 and 35 mm) that were held in a vertical position and connected to a pulsating flow system (peristaltic pump). A reservoir of 0.9% saline solution with 40% glycerin at room temperature was used as the vehicle. Thrombi were made from bovine blood in 3-mm, 4-mm, 5-mm and 6-mm plastic tubes and later the thrombi were sectioned into 10-mm, 15-mm, 20-mm and 30-mm lengths. Each of the 12 sizes of thrombi was assessed 100 times in each of the three systems, with a total of 3,600 events. Five emboli were sequentially released, 10 for each size of embolus and tube, with a total of 360 events. An evaluation of the capacity of the three systems - 100 events each, total of 300 events - to dynamically retain the emboli was made. MRESULTS: The diameter and length of the emboli, as well as tubes greater than 35 mm in diameter can negatively affect the efficacy of the filter. The average of emboli capture for the filters was 80.5% in 35-mm tubes, 88.7% for 30-mm tubes and 86.6% for 25-mm tubes. CONCLUSION: We conclude that the efficacy of this filter is influenced by the size of the emboli and the diameter of the PVC tubes.

  11. Síndrome do anticorpo antifosfolípide causando oclusão bilateral de artérias e veias centrais da retina: relato de caso / Antiphospholipid syndrome and bilateral retinal artery and vein occlusion: case report

    Scientific Electronic Library Online (English)

    Ana Paula, Beckhauser; Luís Augusto, Arana; Thelma Larocca, Skare.

    2008-04-01

    Full Text Available A síndrome do anticorpo antifosfolípide (SAF) tem sido associada a trombose de vasos arteriais e periféricos e de grande ou pequeno calibre. Também os vasos oculares estão sujeitos à ação destes auto-anticorpos que podem promover o aparecimento de perda visual transitória, diplopia, neuropatia óptic [...] a isquêmica e oclusão de artéria ou veia da retina. É descrito aqui, um caso de síndrome do anticorpo antifosfolípide com oclusão de vasos centrais arteriais e venosos da retina no intuito de chamar a atenção para este tipo de diagnóstico. Abstract in english The antiphospholipid syndrome (APS) has been related to venous and arterial thrombosis of large and small vessels. Ocular vessels can also be involved causing transient visual loss, diplopia, ischemic optic neuropathy and central artery and venous occlusion. We describe here a case of antiphospholip [...] id syndrome with occlusion of central retinal artery and vein to call the attention to this diagnosis.

  12. Trombose venosa da veia subclávia após fratura de clavícula: relato de caso / Subclavian vein thrombosis following fracture of the clavicle: case report

    Scientific Electronic Library Online (English)

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

    2011-04-01

    Full Text Available A trombose venosa profunda no membro superior não é frequente na literatura ortopédica. Relatamos um caso de trombose da veia subclávia durante o tratamento conservador de fratura do terço médio da clavícula. O diagnóstico é difícil e requer um alto grau de suspeição e o tratamento pode prevenir um [...] tromboembolismo fatal. Há raros casos descritos associados à fratura de clavícula. Abstract in english Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Tr [...] eating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle.

  13. Trombose venosa da veia subclávia após fratura de clavícula: relato de caso Subclavian vein thrombosis following fracture of the clavicle: case report

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2011-04-01

    Full Text Available A trombose venosa profunda no membro superior não é frequente na literatura ortopédica. Relatamos um caso de trombose da veia subclávia durante o tratamento conservador de fratura do terço médio da clavícula. O diagnóstico é difícil e requer um alto grau de suspeição e o tratamento pode prevenir um tromboembolismo fatal. Há raros casos descritos associados à fratura de clavícula.Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Treating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle.

  14. Drenagem anômala total das veias pulmonares: terapêutica cirúrgica dos tipos anatômicos infracardíaco e misto / Total anomalous pulmonary venous drainage: surgical therapy for the infradiaphragmatic and mixed anatomical types

    Scientific Electronic Library Online (English)

    Fernando Antibas, Atik; Patricia Egusquiza, Irun; Miguel, Barbero-Marcial; Edmar, Atik.

    2004-03-01

    Full Text Available OBJETIVO: Estudar a evolução hospitalar em portadores de drenagem anômala total de veias pulmonares (DATVP), nas formas infracardíaca e mista, submetidos a tratamento cirúrgico. MÉTODOS: De 65 pacientes operados com o diagnóstico isolado de DATVP, de dezembro/1993 a março/2002, foram selecionados, r [...] etrospectivamente, 7 (10,8%) pacientes das formas mista e infradiafragmática, sendo 5 (71,4%) do sexo masculino, idades variando de 5 dias a 19 (média de 7) meses, com diagnóstico clínico feito pelo ecocardiograma bidimensional. Quatro (57,1%) pacientes apresentavam formas mistas, em um, obstrutiva intrínseca, com estenose discreta da veia inferior esquerda. Os restantes três (42,9%) apresentavam a forma infradiafragmática obstrutiva, extrínseca ao nível do diafragma. Todas as operações foram realizadas através de esternotomia mediana, sob circulação extracorpórea hipotérmica com parada circulatória total em 2 casos. RESULTADOS: Óbito hospitalar ocorreu em 1 paciente com DATVP infradiafragmática com conexão da veia vertical inferior com a veia porta. A causa mortis foi relacionada à falência de múltiplos órgãos e sistemas. O pós-operatório foi caracterizado pela presença de baixo débito cardíaco e hipertensão pulmonar em 4 (57,1%) pacientes. CONCLUSÃO: O resultado da correção cirúrgica desta anomalia está associado à morbidade e mortalidade aceitáveis, na dependência do encaminhamento e tratamento cirúrgico precoces, sem progressão do quadro de hipertensão vascular pulmonar. Abstract in english OBJECTIVE: To study the in-hospital evolution of patients with the infradiaphragmatic and mixed types of total anomalous pulmonary venous drainage (TAPVD), who underwent surgical therapy. METHODS: Of the 65 patients diagnosed with isolated TAPVD and operated on from December 1993 to March 2002, 7 (1 [...] 0.8%) patients with the mixed and infradiaphragmatic forms were retrospectively selected. Their ages ranged from 5 days to 19 months (mean of 7 months), 5 (71.4%) were males, and their clinical diagnosis was established with 2-dimensional echocardiography. Four (57.1%) patients had the mixed form, which was intrinsic obstructive in 1 patient, with mild stenosis of the left inferior vein. The remaining 3 (42.9%) patients had the obstructive infradiaphragmatic form, extrinsic at the level of the diaphragm. All surgeries were performed through median sternotomy with hypothermic extracorporeal circulation, and total circulatory arrest was required in 2 patients. RESULTS: In-hospital death occurred in 1 patient with infradiaphragmatic TAPVD with connection of the inferior vertical vein with the portal vein. The cause of death was related to multisystem organ failure. In 4 (57.1%) patients, the postoperative period was characterized by the presence of low cardiac output and pulmonary hypertension. CONCLUSION: The result of the surgical correction of this anomaly is associated with acceptable morbidity and mortality, depending on early referral and surgery, without progression of the pulmonary vascular hypertension findings.

  15. Aneurisma de enxerto de veia safena após reconstrução arterial: relato de caso Aneurysm of saphenous vein graft after arterial reconstruction: case report

    Directory of Open Access Journals (Sweden)

    Milton Alves das Neves Junior

    2011-12-01

    Full Text Available A veia safena magna é usualmente utilizada como conduto em derivações vasculares. Sua degeneração e dilatação aneurismática são raras e têm causas desconhecidas. Este relato trata-se de um paciente masculino de 32 anos, hígido, que evolui, 19 anos depois de uma reconstrução arterial com enxerto venoso, com o aneurisma do enxerto. Foi tratado com substituição do mesmo por prótese de PTFE, evoluindo sem intercorrências. A microscopia mostrou área de dissecção da parede do enxerto com deposição de células espumosas.The saphenous vein is usually used as a conduit in vascular bypass. Its degeneration and aneurysm are rare and have unknown causes. This report comes from a male patient 32 years old, healthy, evolving, 19 years later of an arterial reconstruction with venous graft with the aneurysm of this graft. He was treated with replacement of it by PTFE bypass, evolving without complications. Microscopy showed dissection area of the graft wall with deposition of foam cells.

  16. Obtenção minimamente invasiva de veia safena para cirurgia de revascularização do miocárdio / Minimally invasive procurement of saphenous veins for coronary artery bypass grafting

    Scientific Electronic Library Online (English)

    Antônio S., Martins; Rubens R., Andrade; Marcos A. Moraes, Silva; Reinaldo A., Oliveira; Nelson L. K., Campos; Ricardo de, Mola; Ademar R., Souza; Júlio, Vidotto; Carlos, Padovani.

    2004-06-01

    Full Text Available OBJETIVO: Analisar, comparativamente, a obtenção minimamente invasiva com o uso do MINI-HARVEST® e com instrumental tradicional adaptado. MÉTODO: De junho de 1996 a janeiro de 1999, 63 pacientes submetidos à cirurgia de revascularização do miocárdio tiveram suas veias safenas retiradas segundo técni [...] ca minimamente invasiva. Nos 30 primeiros pacientes da série utilizou-se método de visão direta com auxílio de dois afastadores de Langenbeck, e nos 33 restantes utilizou-se o MINI-HARVEST®. RESULTADOS: A idade média dos pacientes era de 61 ± 8,75 anos, sendo 52 homens e 11 mulheres. Quarenta e cinco pacientes eram diabéticos, 45 apresentavam sobrepeso/obesidade, 25 eram tabagistas ativos, 32 apresentavam história pregressa de infarto do miocárdio. O tempo médio de retirada da veia safena com afastadores Langenbeck foi de 34,2 ± 8,14 minutos e com o MINI-HARVEST® de 39,20 ± 9,12 minutos. A extensão de veia retirada foi similar nos dois grupos, variando de 10 a 30 cm. Houve uma deiscência superficial no grupo com afastadores de Langenbeck. Houve necessidade de reversão para método tradicional de retirada em dois casos do grupo MINI-HARVEST® e um do grupo Langenbeck. A incidência de infarto transoperatório foi 4,5% (três) no grupo Langenbeck e 3,1%(dois) no grupo MINI-HARVEST®. CONCLUSÕES: Podemos concluir que o método de obtenção de veia safena minimamente invasivo sob visão direta é efetivo e seguro, tanto com o uso de instrumentos tradicionais adaptados para este fim, como com afastadores especialmente constituídos, ressaltando-se que o MINI-HARVEST® dispensa a presença de um auxiliar. Abstract in english OBJECTIVE: To comparatively analyze minimally invasive procurement of saphenous veins using Mini-Harvest® system and a technique using adapted traditional instruments. METHOD: From June 1996 to January 1999, 63 patients who were submitted to Coronary Artery Bypass Grafting Surgery had their saphenou [...] s veins resected using minimally invasive techniques. In the first 30 patients of the series, a direct visualization method employing two Langenbeck's retractors was utilized and for the 33 remaining patients the Mini-Harvest® technique was utilized. RESULTS: The mean age of the patients was 61 ± 8.75 years old. Fifty-two patients were male and 11 female. Forty-five patients were diabetics, 45 were overweight or obese, 25 were smokers and 32 presented history of myocardial infarction. The mean time to resect the saphenous vein using the Langenbeck's retractors was 34.2 ± 8.14 minutes and using the Mini-Harvest® it was 39.20 ± 9.12 minutes. The lenghts of the extracted veins were similar in both groups, varying between 10 and 30 cm. There was one case of superficial dehiscence in the Langenbeck group. With two patients in the Mini-Harvest® group and one in Langenbeck's group it was necessary to revert to the traditional method of procurement. The incidence of tran-soperative infarction was 4.5% (three patients) in Langenbeck's group and 3.1% (two patients) in the Mini-Harvest® group. CONCLUSIONS: We can conclude that the minimally invasive procurement methods of the saphenous vein by direct visualization are effective and safe, both when employing adapted traditional instruments and using purpose-made retractors. We stress, however, that the Mini-Harvest® method does not require an assistant.

  17. Implante profilático e temporário de filtro de veia cava inferior no trauma / Prophylactic and temporary inferior vena cava filter implant in trauma

    Scientific Electronic Library Online (English)

    Fábio Augusto Cypreste, Oliveira; Carlos Eduardo de Sousa, Amorelli; Fábio Lemos, Campedelli; Juliana Caetano, Barreto; Mariana Caetano, Barreto; Philippe Moreira da, Silva; Fernanda Lauar Sampaio, Meirelles.

    2013-03-01

    Full Text Available O tromboembolismo pulmonar (TEP) é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao impl [...] ante preventivo e temporário de filtro de veia cava inferior (FVC). Abstract in english Pulmonary embolism (PE) is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjec [...] ted to temporary inferior vena cava filter (VCF).

  18. Trombose de veia central da retina em paciente usuária de interferon e ribavirina: relato de caso / Central vein occlusion in a patient using interferon and ribavirin: case report

    Scientific Electronic Library Online (English)

    John, Helal Jr.; Leandro Cabral, Zacharias; Luciana Malta de, Alencar.

    2006-08-01

    Full Text Available O interferon alfa (INF alfa) é droga atualmente utilizada no tratamento de várias doenças sistêmicas, como a hepatite C crônica. A ribavirina quando associada ao interferon alfa aumenta muito a resposta ao tratamento. Estima-se que a infecção crônica pelo vírus da hepatite C afete 170 milhões de pes [...] soas no mundo, muitas delas em uso dessas medicações. A forma típica da retinopatia associada ao interferon alfa apresenta exsudatos algodonosos e hemorragias intra-retinianas. Há vários relatos de alterações oculares associadas ao uso do interferon alfa. Este trabalho descreve um caso de oclusão de veia central da retina em olho direito, com hemorragias no olho contralateral, em paciente usuária dessas medicações por dois anos. O caso descrito expõe em um dos olhos o quadro mais freqüente da retinopatia associada ao uso de interferon alfa (hemorragias de fundo) e no olho contralateral, uma apresentação muito mais atípica (trombose de veia central da retina). O quadro fundoscópico apresentou melhora com a interrupção da medicação. Abstract in english Interferon and ribavirin are medications widely used in the treatment of some systemic diseases, mainly hepatitis C. Ribavirin when associated with interferon increases the rate of success of this treatment. There are about 170 million patients with chronic hepatitis C in the world, many in use of t [...] hese medications. The classic associated retinopathy is described as cotton wool exudates and hemorrhages. Since the first reports, several different ocular disturbances were described in association with interferon. The present case shows a patient whose right eye presented with central retinal vein occlusion and whose left eye presented the typical findings of hemorrhages; prompt resolution after the medications were discontinued.

  19. Trombose de veia central da retina em paciente usuária de interferon e ribavirina: relato de caso Central vein occlusion in a patient using interferon and ribavirin: case report

    Directory of Open Access Journals (Sweden)

    John Helal Jr.

    2006-08-01

    Full Text Available O interferon alfa (INF alfa é droga atualmente utilizada no tratamento de várias doenças sistêmicas, como a hepatite C crônica. A ribavirina quando associada ao interferon alfa aumenta muito a resposta ao tratamento. Estima-se que a infecção crônica pelo vírus da hepatite C afete 170 milhões de pessoas no mundo, muitas delas em uso dessas medicações. A forma típica da retinopatia associada ao interferon alfa apresenta exsudatos algodonosos e hemorragias intra-retinianas. Há vários relatos de alterações oculares associadas ao uso do interferon alfa. Este trabalho descreve um caso de oclusão de veia central da retina em olho direito, com hemorragias no olho contralateral, em paciente usuária dessas medicações por dois anos. O caso descrito expõe em um dos olhos o quadro mais freqüente da retinopatia associada ao uso de interferon alfa (hemorragias de fundo e no olho contralateral, uma apresentação muito mais atípica (trombose de veia central da retina. O quadro fundoscópico apresentou melhora com a interrupção da medicação.Interferon and ribavirin are medications widely used in the treatment of some systemic diseases, mainly hepatitis C. Ribavirin when associated with interferon increases the rate of success of this treatment. There are about 170 million patients with chronic hepatitis C in the world, many in use of these medications. The classic associated retinopathy is described as cotton wool exudates and hemorrhages. Since the first reports, several different ocular disturbances were described in association with interferon. The present case shows a patient whose right eye presented with central retinal vein occlusion and whose left eye presented the typical findings of hemorrhages; prompt resolution after the medications were discontinued.

  20. Forças mecânicas e veias safenas humanas: implicação na revascularização do miocárdio / Mechanical forces and human saphenous veins: coronary artery bypass graft implications

    Scientific Electronic Library Online (English)

    Rafael Angelo, Tineli; Fernanda, Viaro; Marcelo Bellini, Dalio; Graziela Saraiva, Reis; Solange, Basseto; Walter Villela de Andrade, Vicente; Alfredo José, Rodrigues; Paulo Roberto Barbosa, Evora.

    2007-03-01

    Full Text Available As células endoteliais vasculares estão expostas a uma variedade de forças mecânicas in vivo, resultantes do fluxo sangüíneo pulsátil. Dentre essas forças, destacam-se: forças de cisalhamento, tangenciais à parede do vaso, produzidas pelo atrito com o fluxo sangüíneo viscoso, tensão de complacência [...] da parede vascular e a pressão hidrostática do conteúdo sangüíneo no interior da vasculatura. Diversos autores estudaram as alterações hemodinâmicas, funcionais e morfológicas em veias safenas humanas causadas por esses tipos de forças com resultados conflitantes. A motivação dessa revisão foi analisar dados da literatura e alguns dados experimentais do nosso laboratório. Os aspectos revistos são: 1) Respostas endoteliais e regulação gênica causadas pelo shear stress; 2) Efeitos da pressão hidrostática na morfologia da célula endotelial, expressão gênica da superfície celular endotelial e proliferação das células endoteliais, 3) Efeitos da tração no endotélio de veias safenas humanas. Abstract in english Vascular endothelial cells are exposed to a variety of in vivo mechanical forces, specifically, shear stress for the blood flow, tensile stress from the compliance of the vessel wall and the hydrostatic pressure from containment of blood within inside the vasculature. Many authors studied hemodynami [...] c, functional and morphological human saphenous veins alterations caused by these different forces with conflictant results. This review text was motivated with the specific aim of analyze literature data and some experimental data carried out in our laboratory. The adopted review subjects were: 1) Endothelial responses and gene regulation to shear stress; 2) Effects of the hydrostatic pressure in the endothelial cell morphology, gene expression of the endothelial cellular surface and proliferation of endothelial cells; 3) Effects of the traction on the human saphenous vein endothelium.

  1. Forças mecânicas e veias safenas humanas: implicação na revascularização do miocárdio Mechanical forces and human saphenous veins: coronary artery bypass graft implications

    Directory of Open Access Journals (Sweden)

    Rafael Angelo Tineli

    2007-03-01

    Full Text Available As células endoteliais vasculares estão expostas a uma variedade de forças mecânicas in vivo, resultantes do fluxo sangüíneo pulsátil. Dentre essas forças, destacam-se: forças de cisalhamento, tangenciais à parede do vaso, produzidas pelo atrito com o fluxo sangüíneo viscoso, tensão de complacência da parede vascular e a pressão hidrostática do conteúdo sangüíneo no interior da vasculatura. Diversos autores estudaram as alterações hemodinâmicas, funcionais e morfológicas em veias safenas humanas causadas por esses tipos de forças com resultados conflitantes. A motivação dessa revisão foi analisar dados da literatura e alguns dados experimentais do nosso laboratório. Os aspectos revistos são: 1 Respostas endoteliais e regulação gênica causadas pelo shear stress; 2 Efeitos da pressão hidrostática na morfologia da célula endotelial, expressão gênica da superfície celular endotelial e proliferação das células endoteliais, 3 Efeitos da tração no endotélio de veias safenas humanas.Vascular endothelial cells are exposed to a variety of in vivo mechanical forces, specifically, shear stress for the blood flow, tensile stress from the compliance of the vessel wall and the hydrostatic pressure from containment of blood within inside the vasculature. Many authors studied hemodynamic, functional and morphological human saphenous veins alterations caused by these different forces with conflictant results. This review text was motivated with the specific aim of analyze literature data and some experimental data carried out in our laboratory. The adopted review subjects were: 1 Endothelial responses and gene regulation to shear stress; 2 Effects of the hydrostatic pressure in the endothelial cell morphology, gene expression of the endothelial cellular surface and proliferation of endothelial cells; 3 Effects of the traction on the human saphenous vein endothelium.

  2. Aneurisma de artéria ilíaca interna roto: relato de caso / Ruptured internal iliac artery aneurysm: case report

    Scientific Electronic Library Online (English)

    Cristina Toledo, Afonso; Ricardo Jayme, Procópio; Túlio Pinho, Navarro; Gustavo Henrique Dumont, Kleinsorge; Beatriz Deoti e Silva, Rodrigues; Marco Antônio Gonçalves, Rodrigues.

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos uri [...] nários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo. Abstract in english Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compr [...] essive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach) is reported.

  3. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Cristina Toledo Afonso

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

  4. Estudo eritroleucométrico e proteinograma sérico do sangue do cordão umbilical e jugular de eqüinos ao nascimento e de suas respectivas mães Erythrocytometry and seric proteinogram of umbilical cord and jugular of foals at birth and respective mothers

    Directory of Open Access Journals (Sweden)

    R.F. Godoy

    2007-12-01

    Full Text Available Colheram-se amostras de sangue do cordão umbilical (SCU e do sangue circulante de cinco eqüinos neonatos, imediatamente após o nascimento, e o sangue da própria mãe, utilizando-se um sistema a vácuo. O material foi submetido à contagem global de hemácias e leucócitos e à determinação do volume globular e da concentração de hemoglobina; à contagem diferencial de leucócitos em esfregaços sangüíneos; e ao cálculo dos índices eritrocitométricos. Foram realizadas a dosagem de proteínas séricas totais e a eletroforese das proteínas séricas em gel de agarose. Não houve diferenças significativas entre os parâmetros do SCU e do sangue da jugular dos potros. No SCU dos potros observaram-se valores mais elevados para contagem global de hemácias (9,75x10(6/µl, dosagem de hemoglobina (14,65g/dl e concentração de hemoglobina corpuscular média (37,23g/dl; e valores menores para volume corpuscular médio (40,50fl, proteína total (4,37g/dl, alfa-globulinas (0,65g/dl, beta-globulinas (1,10g/dl, gama-globulinas (0g/dl e contagens global (5,40 x 10³/µl e diferencial de leucócitos, exceto contagem de neutrófilos bastonetes e monócitos, quando comparados com os valores obtidos no sangue de suas mães.Umbilical cord blood (UCB and systemic blood samples were collected from five equine neonates, immediately after birth. Systemic blood samples from their mothers were also collected at the same time, using a vacuum system. The samples were submitted to the following analyses: red blood cell and total white blood cell counts; determinations of packed cell volume and hemoglobin concentration; differential white cell count in blood smears; and determination of erythrocytometric values. Total serum proteins quantification and serum proteins electrophoresis in agarose gel were done. No significant difference (P<0.05 was noted between averages in neonate jugular blood and equine UCB. Equine UCB showed higher values of red blood cell count (9.75x10(6/µ, hemoglobin determination (14.65g/dl, and mean corpuscular hemoglobin concentration (37.23g/dl; but lower values of mean corpuscular volume (40.50fl, total protein (4.37g/dl, alpha-globulin (0.65 g/dl, beta-globulin (1.10g/dl, gamma-globulin (0g/dl, total (5.40x10³/µl, and differential leukocytes count, except for band neutrophils and monocytes counts, when compared to the blood of the mares.

  5. FRICCIÓN INTERNA Y COMPORTAMIENTO ANELÁSTICO EN SÓLIDOS / INTERNAL FRICTION AND ANAELSTIC BEHAVIOR IN SOLIDS

    Scientific Electronic Library Online (English)

    HENRY A., COLORADO L; CÉSAR, CHAVES ROLDÁN; JUAN MANUEL, VÉLEZ.

    2006-03-01

    Full Text Available Se presentan los conceptos de Fricción Interna (FI), anelasticidad y espectroscopia mecánica, como una técnica potente para la determinación de las propiedades mecánicas dinámicas en sólidos. Se comentan algunos de los logros de la técnica, fundamentalmente en el campo de la física del estado sólido [...] . Abstract in english This is a review of Internal Friction (IF), anelasticity and mechanical spectroscopy concepts, as a method to determine the dynamic mechanical properties in solids. Achievements of internal friction technique are also commented, especially in the field of physics of solid state. [...

  6. Hacia una critica interna de la teoría del intercambio desigual de Emmanuel

    Directory of Open Access Journals (Sweden)

    Garay S. Luis Jorge

    1980-12-01

    Full Text Available El presente ensayo constituye apenas una versión parcial y preliminar de un trabajo más extenso que el autor está desarrollando sobre la teoría del intercambio desigual de Emmanuel. Entendido así el carácter de éste, su objetivo se limita únicamente a estudiar los principales supuestos, inconsistencias y vicios teóricos y metodológicos implícitos en
    el "traslado" particular que Emmanuel realiza del esquema de precios de Marx al plano del comercio internacional. En otras palabras, el análisis aquí incluido corresponde más a lo que en la literatura se denomina una crítica interna que a una crítica externa de la teoría de intercamhio desigual de Emmanuel.

  7. Descarga Interna e Tensão de Retorno em Capacitores / Internal discharge and return voltage in capacitors

    Scientific Electronic Library Online (English)

    Renê, Robert.

    2001-09-01

    Full Text Available Os fenômenos de descarga interna e tensão de retorno em capacitores são calculados no caso onde a resposta do dielétrico é da forma exponencial no tempo. Com esta hipótese a matemática envolvida é simples e as características gerais dos fenômenos de hereditariedade podem ser seguidas. [...] Abstract in english The phenomena of internal discharge and return voltages of capacitors are studied for the case where the dielectric response in time domain is of exponential type. The mathematics involved becomes sufficiently simple and the general feature of the heredity phenomena may be followed. [...

  8. UN ANÁLISIS ESPACIAL DE LAS MIGRACIONES INTERNAS EN COLOMBIA (2000-2005

    Directory of Open Access Journals (Sweden)

    ADRIANA CAROLINA SILVA ARIAS

    2009-01-01

    Full Text Available El objetivo de este documento es realizar un análisis espacial acerca de la dinámica de las migraciones internas recientes en Colombia; en específico durante el periodo del 2000-2005 con base en información censal. Así, se identifica mediante un modelo gravitacional que los flujos migratorios inter-departamentales en Colombia se dirigieron hacia los departamentos más poblados, con mayores ingresos y con tradición migratoria. En adición, se encuentra que durante este mismo periodo Guaviare fue el departamento donde se presentó una mayor probabilidad de emigrar y hacia las zonas vecinas; por otro lado, Antioquia fue el departamento donde se presentó menor probabilidad de emigrar.

  9. Consistencia interna de la escala Pediatric Symptom Checklist en niños y adolescentes desplazados por un desastre invernal en Girón, Colombia

    Directory of Open Access Journals (Sweden)

    HEIDI CELINA OVIEDO

    2008-01-01

    Full Text Available Contexto. Es importante la presencia de problemas psicosociales en niños y adolescentes expuestos a eventos traumáticos, entre ellos, los desastres naturales. Por lo tanto, es importante conocer el comportamiento psicométrico de instrumentos de tamización, como la lista de verificación de síntomas pediátricos (Pediatric Symptom Checklist. Sin embargo, no se conoce la consistencia interna de la misma en niños y adolescentes colombianos víctimas de un desastre natural. Objetivo. Calcular la consistencia interna de las cuatro subescalas de la Pediatric Symptom Checklist en niños y adolescentes desplazados por el desastre invernal en Girón, Colombia. Método. Un grupo de 101 madres de niños y adolescentes entre 6 y 16 años completaron la Pediatric Symptom Checklist, considerando la presencia de síntomas durante los seis últimos meses. Para conocer la consistencia interna de las subescalas se calculó el coeficiente alfa de Cronbach. Resultados. La consistencia interna para la subescala para síntomas de trastorno por déficit de atención y hiperactividad fue de 0,62; para la de síntomas de trastornos depresivos, 0,65; para la de síntomas de trastornos de la conducta, 0,50; y para la de síntomas de trastornos de ansiedad, 0,43. Conclusiones. La consistencia interna de las cuatro subescalas de la Pediatric Symptom Checklist es baja en niños y adolescentes víctimas de un desastre invernal. Es necesario explorar el comportamiento psicométrico de otros instrumentos para detectar trastornos mentales comunes en niños y adolescentes víctimas de desastres.

  10. DIAGNÓSTICO SITUACIONAL DE LAS INTERNAS DEL RECLUSORIO DE MUJERES DE MANIZALES / SITUATIONAL DIAGNOSIS OF THE FEMALE INMATES OF THE MANIZALES PRISON / DIAGNOSTICO SITUACIONAL DAS INTERNAS DA CADEIA DE MULHERES DE MANIZALES

    Scientific Electronic Library Online (English)

    Claudia Patricia, Jaramillo Ángel; María Victoria, Benjumea Rincón.

    2007-12-01

    Full Text Available Objetivo: diagnosticar a situação das internas da cadeia de mulheres do município de Manizales nas áreas de atenção primaria, saneamento ambiental, saúde mental, saúde sexual e reprodutiva, educação, situacional judicial e comportamento organizacional o primeiro semestre do ano 2006. Materiais e mét [...] odos: estudo descritivo. Povoação de estudo: 39 internas da Cadeia de mulheres do município de Manizales. Variáveis: características socioeconômicas e demográficas, necessidades básicas, atenção primaria, saúde sexual e reprodutiva, educação, saneamento ambiental, saúde mental e comportamento organizacional. As variáveis descreveram se com média e desvio Standard, freqüências absolutas e relativas. O processamento estatístico dos dados fez se com o programa SPSS v. 14.0. Resultados: A idade média foi 34,1±11,1 anos. O estado civil predominante foi solteiro e médio de filhos foi de 2,86±2,0. a escolaridade que predominou foi a secundaria incompleta e o analfabetismo encontro se em 10,3%. Em a maioria, a ocupação prévia foi a de dona de casa. Em o estado nutricional não encontro se baixo peso nas internas. O 97, % estavam condenadas e 2,7% sindicadas. As internas que estavam por primeira vez corresponderam a 78,4%. Durante a reclusão, a maioria tinha a possibilidade de estudar, mais da metade ocupava seu tempo em artesanato. A evacuação das necessidades básicas na cadeia foi em sua maioria boa. O uso do tempo livre destinava se em sua maioria ao artesanato. As atividades físicas praticadas preferentemente foram aeróbicas e basquete. Durante a reclusão Cinco internas consumiram sustâncias psicoativas. A maioria delas tinham problemas de saúde oral. A consulta medica periódico, o apoio psicológico e de trabalho social e a possibilidade de ter métodos de planificação familiar foram os serviços mais deficientes. As enfermidades reportadas durante a reclusão foram em sua maioria infecciosas. O 89,7% considerou boa a educação sexual recebida. Os motivos de maior consulta foram cefaléia, os lumbagos e a epigastralgia. Nenhuma das internas refreou abuso sexual dentro da cadeia. As condições de saneamento ambiental percebidas foram em sua maioria boas. As internas manifestaram ter a oportunidade de expressar-lé suas inquietações as diretivas da instituição. Na avaliação da saúde mental das internas encontro-se normalidade no 44,4%, deterioração alta em 33,3%, e baixa deterioração em 22,2%. Abstract in spanish Objetivo: diagnosticar la situación de las internas del Reclusorio de Mujeres del municipio de Manizales en las áreas de atención primaria, saneamiento ambiental, salud mental, salud sexual y reproductiva, educación, situación judicial y comportamiento organizacional durante el primer semestre del a [...] ño 2006. Materiales y métodos: estudio descriptivo. Población de estudio: 39 internas del Reclusorio de mujeres del municipio de Manizales. Variables: características socioeconómicas y demográficas, necesidades básicas, atención primaria, salud sexual y reproductiva, educación, saneamiento ambiental, salud mental y comportamiento organizacional. Las variables se describieron con media y desviación estándar, frecuencias absolutas y relativas. El procesamiento estadístico de los datos se hizo con el programa SPSS v.14.0. Resultados: la edad promedio fue 34,1±11,1 años. El estado civil predominante fue soltera y el promedio de hijos fue de 2,86±2,0. La escolaridad que primó fue la secundaria incompleta y el analfabetismo se encontró en 10,3%. En la mayoría, la ocupación previa fue la de ama de casa. En el estado nutricional no se encontró bajo peso en las internas. El 97,3% estaba condenada y 2,7% sindicada. Las internas encarceladas por primera vez correspondieron a 78,4%. Durante la reclusión, la mayoría tenía acceso a educación; más de la mitad ocupaba su tiempo en trabajos manuales. La evaluación de las necesidades básicas en el reclusorio fue en su mayoría buena. El uso del tiempo libre se destinaba e

  11. Ipsilateral jugular to distal subclavian vein transposition to relieve central venous hypertension in rescue vascular access surgery: a surgical report of 3 cases.

    Science.gov (United States)

    Acri, Ignazioe; Carmignani, Amedeo; Vazzana, Giovanni; Massara, Mafalda; Acri, Edvige; Lentini, Salvatore; Spinelli, Francesco

    2013-01-01

    Central venous thrombosis may often arise following central venous cannulation for temporary haemodialysis access. Venous thrombosis may be clinically asymptomatic due to the presence of collateral circulation. However, if an arteriovenous (AV) fistula is prepared below the obstructed venous segment, then symptoms may occur. Central venous hypertension interferes with dialysis, compromises limb function and threatens its safety. Percutaneous treatment is mostly used. However, in some cases endovascular treatment may not be as easy and long term patency uncertain.We report our experience on 3 patients on chronic hemodialysis treatment presenting with a patent AV fistula and ipsilateral subclavian vein chronic fibrotic obstruction. They were treated by ipsilateral internal jugular to distal subclavian vein transposition. Two separate surgical incisions were performed to expose the subclavian vein distally to the occlusion and the jugular vein that was distally ligated and transposed. There was no mortality nor significant postoperative complications. Resolution of hypertensive symptoms was achieved within 3-4 weeks in all patients. The AV fistula was used for dialysis treatment starting from the first postoperative day. At follow-up (mean 13 months), there was no recurrence of upper limb venous hypertension.In patients with subclavian occlusion and ipsilateral low flow, patent AV fistula, jugular to distal subclavian vein transposition may prove useful in cases when percutaneous angioplasty is technically not feasible or long term patency is not expected. PMID:22673549

  12. A Case of Unilateral Fenestration and Duplication of the External Jugular Vein / Un Caso de Fenestración Unilateral y Duplicación de la Vena Yugular Externa

    Scientific Electronic Library Online (English)

    Ziga, Snoj; Erika, Cvetko.

    2013-03-01

    Full Text Available La vena yugular externa se está utilizando cada vez como vena receptora en la transferencias de tejidos libres de cabeza y cuello, y para canulización en procedimientos de diagnóstico o terapias intravenosas. Las variaciones en los patrones de su curso, y el conocimiento de los mismos son relevantes [...] . Se reporta una fenestración unilateral, no descrita previamente, y la duplicación de la vena yugular externa encontrada durante la disección del cadáver de una mujer de 77 años de edad. Se hace una evaluación embriológica y las implicaciones clínicas de esta anomalía. Los médicos y cirujanos que realizan cirugía vascular o reconstructiva de cuello deben tener en cuenta esta variación de la vena yugular externa con el fin de prevenir lesiones accidentales. Abstract in english The external jugular vein is increasingly being utilized as the recipient vein in head and neck free tissue transfers, and for cannulation in order to conduct diagnostic procedures or intravenous therapies. The variations in the patterns of its course, and knowledge of them, are therefore important. [...] We report on a unique and previously non-described unilateral fenestration and duplication of the external jugular vein found during the neck dissection of a 77-year-old female cadaver. Embryological evaluation and clinical implications of the anomaly are described. Clinicians and surgeons performing neck vascular or reconstructive surgery should be aware of this variation of the external jugular vein in the hope of preventing inadvertent injury.

  13. A Case of Unilateral Fenestration and Duplication of the External Jugular Vein Un Caso de Fenestración Unilateral y Duplicación de la Vena Yugular Externa

    Directory of Open Access Journals (Sweden)

    Ziga Snoj

    2013-03-01

    Full Text Available The external jugular vein is increasingly being utilized as the recipient vein in head and neck free tissue transfers, and for cannulation in order to conduct diagnostic procedures or intravenous therapies. The variations in the patterns of its course, and knowledge of them, are therefore important. We report on a unique and previously non-described unilateral fenestration and duplication of the external jugular vein found during the neck dissection of a 77-year-old female cadaver. Embryological evaluation and clinical implications of the anomaly are described. Clinicians and surgeons performing neck vascular or reconstructive surgery should be aware of this variation of the external jugular vein in the hope of preventing inadvertent injury.La vena yugular externa se está utilizando cada vez como vena receptora en la transferencias de tejidos libres de cabeza y cuello, y para canulización en procedimientos de diagnóstico o terapias intravenosas. Las variaciones en los patrones de su curso, y el conocimiento de los mismos son relevantes. Se reporta una fenestración unilateral, no descrita previamente, y la duplicación de la vena yugular externa encontrada durante la disección del cadáver de una mujer de 77 años de edad. Se hace una evaluación embriológica y las implicaciones clínicas de esta anomalía. Los médicos y cirujanos que realizan cirugía vascular o reconstructiva de cuello deben tener en cuenta esta variación de la vena yugular externa con el fin de prevenir lesiones accidentales.

  14. Nuevas tecnologías en la comunicación interna en empresas del Valle de Aburrá

    Directory of Open Access Journals (Sweden)

    Diego Le\\u00F3n Salazar Vargas

    2009-01-01

    Full Text Available Objetivo: Identificar el uso y la aplicación de las tecnologías que están incorporando los comunicadores organizacionales. Materiales y métodos: Estudio de casos realizado en 10 empresas del Valle de Aburrá, Antioquia, Colombia, que han incorporado tecnologías digitales a la gestión de comunicación interna. Se emplearon como instrumentos una encuesta y una entrevista dirigida-semiestructurada a los comunicadores. Para el análisis de la información se correlacionaron los resultados de los dos instrumentos. Resultados: El uso que le están dando los comunicadores a las herramientas digitales es de medios para el flujo informativo. No sólo hacen la aplicación digital en medios como boletines, intranet, correo electrónico, entre otros, sino también con los denominados textos empresariales: cartas, circulares, memorandos. Los comunicadores consideran pertinente la incorporación de los medios digitales dentro del proceso de comunicación interna y afirman que éstos han tenido un alto impacto en empresa. El grupo estudiado, reconoce que los medios digitales ofrecen beneficios importantes para la comunicación. No se encontró en ninguna de las empresas evaluación de impacto o de satisfacción con los medios digitales. Conclusiones: Los denominados medios de comunicación digitales no son tales, en tanto se apliquen como simple flujo, es decir, unidireccionalmente. Pese a tener en las empresas empleados sin acceso a los medios digitales, no se han tomado soluciones al respecto. Los medios son implementados sin dar respuestas a necesidades puntuales de la organización.

  15. Selección interna: el control de la filogenia por la ontogenia en una perspectiva variacional

    Directory of Open Access Journals (Sweden)

    Gustavo Caponi

    2009-11-01

    Full Text Available La idea de selección interna, propuesta originalmente por Lancelot Whyte, no sólo sirve para entender el papel causal que los constreñimientos del desarrollo tienen en evolución; sino que además puede hacernos comprender de qué modo esos factores organísmicos o internos, cuya importancia la Biología Evolucionaria del Desarrollo hoy quiere rescatar, son pasibles de ser considerados desde una perspectiva variacional o seleccional compatible, pero no asimilable, a la Teoría de la Selección Natural. Así, considerado como un concepto autónomo y diferente al de selección natural, el concepto de selección interna puede permitirnos comprender de qué modo eso que Wallace Arthur llama developmental bias constituye una causa, efectiva y positiva, de transformaciones evolutivas irreversibles y acumulables.The idea of internal selection, originally proposed by Lancelot Whyte, not only helps to understand the causal role that the developmental constraints have in evoltion, but it can also show how these organismic or internal factors, which relevancy the Evolutionary Developmental Biology remarks today, can be considered from a variational or selectional perspective that is compatible with, but not reducible to, Natural Selection Theory. Thus, being considered as a concept autonomous and different from natural selection, the concept of internal selection can allow us to understand how that phenomenon that Wallace Arthur calls developmental bias constitutes an effective and positive cause of irreversible and cumulative evolutionary changes.

  16. Comunicação interatrial do tipo seio coronário, comunicação interventricular e ausência de veia cava superior esquerda Coronary sinus atrial septal defect and ventricular septal defect with no left superior vena cava

    Directory of Open Access Journals (Sweden)

    Fábio Alves Almeida

    1998-10-01

    Full Text Available Relatamos um caso raro de um paciente de 21 meses, portador de comunicação interatrial do tipo seio coronário, associada a comunicação interventricular perimembranosa, e ausência de veia cava superior esquerda. O diagnóstico foi realizado através da ecocardiografia e confirmado pela angiografia. O paciente foi operado sem intercorrências, ambos os defeitos foram fechados com patch de pericárdio bovino e o fluxo das veias coronárias ficou direcionado para o átrio esquerdo. Um ecocardiograma mostrou ausência de shunt residual através dos defeitos.We report a rare case of a 21 month old child with a coronary sinus atrial septal defect associated with perimembranous ventricular septal defect and no left superior vena cava. The diagnosis was made by transthoracic echocardiogram and confirmed by angiography. The patient was operated on uneventfully, both defects were closed with bovine pericardial patches and the flow from the coronary veins was directed towards the left atrium. An echocardiogram revealed complete closure of both defects.

  17. Derivação com veias de membro superior após trombólise de aneurisma de artéria poplítea: alternativa para salvamento de membro Arm vein bypass after popliteal artery aneurysm thrombolysis: an alternative for limb salvage

    Directory of Open Access Journals (Sweden)

    João Antonio Corrêa

    2007-06-01

    Full Text Available Os autores relatam um caso de aneurisma de artéria poplítea trombosado em que se realizou fibrinólise com sucesso na fase aguda. Foram utilizadas veias de braço para realização do enxerto e exclusão do aneurisma, pois o paciente havia sido previamente submetido à safenectomia bilateral e revascularização do miocárdio com as veias do outro braço. Apesar das dificuldades, o salvamento do membro foi alcançado.The authors report a case of a thrombosed popliteal artery aneurysm successfully treated by fibrinolysis in its acute stage. Arm veins were used to perform a bypass and aneurysm exclusion, since the patient had previously been submitted to bilateral saphenous vein stripping and myocardial revascularization using the veins of the other arm. Despite the difficulties, limb salvage was achieved.

  18. Derivação com veias de membro superior após trombólise de aneurisma de artéria poplítea: alternativa para salvamento de membro / Arm vein bypass after popliteal artery aneurysm thrombolysis: an alternative for limb salvage

    Scientific Electronic Library Online (English)

    João Antonio, Corrêa; Maria Carolina Cozzi Pires de Oliveira, Dias; Alexandre César, Fioretti; Yumiko Regina, Yamazaki; João Paulo, Maffei Jr.; Rogério Duque de, Almeida; Fabio Roberto, Batistela; Ohannes, Kafejian.

    2007-06-01

    Full Text Available Os autores relatam um caso de aneurisma de artéria poplítea trombosado em que se realizou fibrinólise com sucesso na fase aguda. Foram utilizadas veias de braço para realização do enxerto e exclusão do aneurisma, pois o paciente havia sido previamente submetido à safenectomia bilateral e revasculari [...] zação do miocárdio com as veias do outro braço. Apesar das dificuldades, o salvamento do membro foi alcançado. Abstract in english The authors report a case of a thrombosed popliteal artery aneurysm successfully treated by fibrinolysis in its acute stage. Arm veins were used to perform a bypass and aneurysm exclusion, since the patient had previously been submitted to bilateral saphenous vein stripping and myocardial revascular [...] ization using the veins of the other arm. Despite the difficulties, limb salvage was achieved.

  19. Método trigonométrico para o acesso à veia basílica no terço distal do braço / Trigonometric method to the anatomo-surgical approach of the basilic vein in the arm distal third

    Scientific Electronic Library Online (English)

    Alexandre Augusto Pinto, Cardoso; Ricardo Luiz, Smith; José Carlos, Prates; Serafim Vincenzo, Cricenti.

    2006-06-01

    Full Text Available OBJETIVO: Determinar parâmetros anátomo-cirúrgicos para o acesso rápido, seguro e preciso da veia basílica no terço distal do braço e avaliar os aspectos anatômicos relacionados à presença, número e sintopia neural na região. MÉTODO: Foram utilizados 30 membros superiores de cadáveres adultos, brasi [...] leiros, do sexo masculino (27 a 58 anos), fixados em solução de formalina a 10%. Foi criado um método trigonométrico utilizando-se parâmetros anatômicos, determinando-se um triângulo cujo ápice foi o ponto de referência para a localização da veia basílica no terço distal do braço. A região foi dissecada e a veia exposta. O método foi também utilizado na dissecação venosa de 15 pacientes. RESULTADOS: A veia basílica foi encontrada na face medial do terço distal do braço de todos os cadáveres, localizando-se no ápice do trígono em 70% dos casos e em situação medial em relação ao mesmo em 30%. Em 83,33% havia ramos dos nervos cutâneos mediais do braço e antebraço junto à adventícia da veia basílica. Foram encontrados dois ramos dos nervos cutâneos mediais do braço e antebraço relacionados a cada veia basílica em 90% dos membros superiores e apenas um ramo no restante. Em 30% dos casos existiam ramos posteriores à veia basílica, o que deve ser considerado ao se realizar a dissecação da mesma. CONCLUSÕES: O método proposto para a localização da veia basílica mostrou-se eficaz, rápido, seguro e preciso, indicando ser uma boa opção de acesso venoso no paciente em estado crítico que necessite de tal procedimento. Abstract in english BACKGROUND: To determine anatomo-surgical parameters to fast, safe and precise approach to the basilic vein in the arm distal third and to assess anatomic features related to the presence, and nerve sintopy in the region. MATERIAL AND METHODS: The study was made in 15 human corpses, from male adults [...] aged 27 up to 58 years old, summing up 30 upper limbs, fixed in 10% formalin. It was created a trigonometric method using anatomic parameters to determine a triangle which apex was the reference point to locate the basilic vein in the arm distal third. The region was dissected, the vein exposed, its diameter assessed with a caliper. The method was utilized to perform the basilic vein dissection in 15 patients that required the venous approach. RESULTS AND CONCLUSION: The basilic vein was found in the medial surface of arm distal third in all studied cadavers. The vein was located on the triagle apex in 70% of the cases (87% of the right and 53% of the left upper limbs). In 30% of the specimens the vein was placed medially to the triangle apex, the distance did not exceeded 5mm. In 83,33% of the specimens there were branches of the medial cutaneous nerves of arm and forearm against the vein adventitia. It was found two branches of the medial cutaneous nerves of arm and forearm related to each basilic vein in the majority of the upper limbs (90% - 27 limbs) and only one branch in the remaining (10 % - 3 limbs). In 30% of the cases there were branches located behind the basilic vein, this fact must be considered when the basilic vein dissection is made. The proposed method to the basilic vein location showed to be fast, safe and precise, indicating that the method is a good option to the vascular approach in patients in critical conditions that demand this procedure.

  20. Intracardiac embolization of inferior vena cava filter associated with right atrium perforation and cardiac tamponade / Embolização de filtro de veia cava associado à perfuração de átrio direito e tamponamento cardíaco

    Scientific Electronic Library Online (English)

    Alexandre de Matos, Soeiro; Felipe Lourenço, Fernandes; Rafael Plens, Teixeira; Pedro Felipe Gomez, Nicz; Maria Carolina Feres de Almeida, Soeiro; Carlos V., Serrano Jr.; Múcio Tavares de, Oliveira Jr..

    2014-04-01

    Full Text Available A colocação percutânea de filtro de veia cava inferior é bem estabelecida em literatura, reduzindo a chance de ocorrência de tromboembolismo pulmonar após um episódio de trombose venosa profunda em pacientes com contraindicações à anticoagulação. O índice de complicações relacionadas ao procedimento [...] é pequeno, sendo embolização evento extremamente raro. Nesse contexto, descrevemos um caso de embolização intracardíaca de filtro de veia cava inferior associada ao tamponamento cardíaco. Abstract in english Insertion of inferior vena cava filters has been well established in literature, reducing occurrence of pulmonary embolism after an episode of deep venous thrombosis in patients with contraindication to anticoagulation. There are a small number of complications related to procedure and embolization [...] is rare. In this context, we described a case of intracardiac embolization associated with cardiac tamponade.

  1. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeonah; Kim, Eunhee; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheolkyu; Bae, Yun Jung; Lee, Kyung Mi [Seoul National University College of Medicine, Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeonggi-do (Korea, Republic of); Lee, Dong Hoon [Seoul Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2014-10-03

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA) - evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups. (orig.)

  2. Asymmetrical or heterogeneous enhancement of the internal jugular veins in contrast-enhanced CT of the head and neck

    International Nuclear Information System (INIS)

    With faster CT scanners, asymmetric/heterogeneous enhancement (ASHE) of the internal jugular veins (IJVs) is frequently encountered in the absence of pathology. We investigated the frequency, side, pattern and significance of ASHE in 200 patients with various head and neck lesions. Non-ionic contrast medium (300 mgI/ml) was infused into a forearm vein (right, n = 100; left, n = 100). Forty seconds after contrast medium injection, contiguous 5-mm-thick sections were obtained craniocaudally from the skull base to the aortic arch. CT machines with two different scanning cycle times (3 s, n = 100; 2 s, n = 100) were used. ASHE of the IJVs was observed in 51 patients (25.5 %); the patient group receiving a right-sided injection with a 2-s scan cycle machine, showing a higher frequency (44 %). ASHE was divided into four patterns: homogeneous low density, focal low density, heterogeneous opacification and fluid-fluid level formation. ASHE was frequently observed in routine contrast-enhanced CT of the head and neck. Frequency of ASHE increased when the scanning cycle was shorter. We should be aware of this phenomenon to avoid its misinterpretation as venous thrombosis or other pathology. (orig.). With 6 figs., 2 tabs

  3. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux

    International Nuclear Information System (INIS)

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA) - evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups. (orig.)

  4. Long-term outcome following trans-jugular intrahepatic portosystemic shunt for variceal bleeding due to portal hypertension

    International Nuclear Information System (INIS)

    Objective: To study the 6-year outcome following trans-jugular intrahepatic portosystemic shunt (TIPSS) for variceal bleeding due to portal hypertension. Methods: 65 patients, 51 males, 14 females, aged 35-72 years old with averaged 4.5 years, have been undergone TIPSS because of portal hypertension due to cirrhosis or Budd-Chiari syndrome. The portal pressures were measured before and after TIPSS. Follow-up study was done by color Doppler sonography or Barium esophageal radiography for 3 months to 6 years (averaged 18 months). Repeated interventional treatments were done in cases of restenosis of the shunts. Results: There were 0, 2, 10, 5, 0 cases of recurrent bleeding after 3 months, 6 months, 1 year, 2 year and 3-6 year following TIPSS respectively. Stenosis occurred in shunt paths due to thrombosis or smooth muscle cell proliferation or neo-intimal hyperplasia were relieved after thrombolytic therapy and repeated balloon angioplasty or stent plant among most of them. 2 were failed due to serious stenosis. 7 cases died, 2 of massive bleeding, 1 of the other cause and 4 of hepatic cancer. The other patients are getting well. Conclusions: Although there were very high rates of restenosis (34%), but most of them could be treated again with interventional therapy, and in kept patency effectively. TIPSS is a still practical valuable management for massive gastric bleeding

  5. Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

    Directory of Open Access Journals (Sweden)

    Marcos Arêas Marques

    2010-12-01

    Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%. CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada.BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%. CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

  6. Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda / Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

    Scientific Electronic Library Online (English)

    Marcos Arêas, Marques; Paulo Roberto Mattos da, Silveira; Arno, von Ristow; Marcus, Gress; Bernardo, Massière; Alberto, Vescovi; José Mussa, Cury Filho; Rafael Dias, Vieira.

    2010-12-01

    Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de [...] síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%). CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada. Abstract in english BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome an [...] d left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%). CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

  7. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

    OpenAIRE

    Alexander Alves da Silva; Enis Donizetti Silva; Arthur Vitor Rosenti Segurado; Pedro Paulo Kimachi; Claudia Marquez Simões

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Pa...

  8. Drenagem anômala parcial de quatro veias pulmonares com septo interatrial íntegro: relato de um caso raro Partial anomalous return of four pulmonary veins with intact interatrial septum defect: a rare case report

    Directory of Open Access Journals (Sweden)

    Edmar Atik

    2008-07-01

    Full Text Available É relatado caso raro de drenagem anômala parcial de quatro veias pulmonares no átrio direito e veia cava superior, com septo interatrial íntegro em criança de cinco anos de idade. Havia poucos sintomas, em contraste com débito ventricular esquerdo dependente do fluxo da veia lobar superior esquerda e da língula. Complacência diminuída à esquerda motivou quadro acentuado de hipertensão venocapilar pulmonar no pós-operatório imediato, aliviado por feitura de comunicação interatrial de 8 mm. A evolução posterior foi boa.We report on the rare case of partial anomalous return of four pulmonary veins in the right atrium and superior vena cava with intact interatrial septum in a five-year-old child. There were few symptoms in contrast with the left ventricular output dependent on the flow of the left upper lobe vein and from the lingula. Reduced compliance to the left led to a severe picture of pulmonary venocapillary hypertension in the immediate postoperative period, mitigated by an 8-mm interatrial septal defect. The patient progressed well after the intervention.

  9. DIAGNÓSTICO SITUACIONAL DE LAS INTERNAS DEL RECLUSORIO DE MUJERES DE MANIZALES DIAGNOSTICO SITUACIONAL DAS INTERNAS DA CADEIA DE MULHERES DE MANIZALES SITUATIONAL DIAGNOSIS OF THE FEMALE INMATES OF THE MANIZALES PRISON

    Directory of Open Access Journals (Sweden)

    Claudia Patricia Jaramillo Ángel

    2007-12-01

    Full Text Available Objetivo: diagnosticar la situación de las internas del Reclusorio de Mujeres del municipio de Manizales en las áreas de atención primaria, saneamiento ambiental, salud mental, salud sexual y reproductiva, educación, situación judicial y comportamiento organizacional durante el primer semestre del año 2006. Materiales y métodos: estudio descriptivo. Población de estudio: 39 internas del Reclusorio de mujeres del municipio de Manizales. Variables: características socioeconómicas y demográficas, necesidades básicas, atención primaria, salud sexual y reproductiva, educación, saneamiento ambiental, salud mental y comportamiento organizacional. Las variables se describieron con media y desviación estándar, frecuencias absolutas y relativas. El procesamiento estadístico de los datos se hizo con el programa SPSS v.14.0. Resultados: la edad promedio fue 34,1±11,1 años. El estado civil predominante fue soltera y el promedio de hijos fue de 2,86±2,0. La escolaridad que primó fue la secundaria incompleta y el analfabetismo se encontró en 10,3%. En la ma