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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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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.

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

2013-01-01

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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  

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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 acessos 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.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.

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

2011-01-01

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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  

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Full Text Available Abstract in portuguese 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 acessos na jugular interna e os na veia subclávia em pacientes internados nas enfermarias de cirurgia. MÉTODOS: Estudo prospectivo, descritivo e comparativo com 114 catet (more) eres 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 (more) 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.

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

2011-09-01

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Termination of the facial vein into the external jugular vein: an anatomical variation Terminação da veia facial na veia jugular externa: uma variação anatômica  

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Full Text Available Different patterns of variations in the venous drainage have been observed in the past. During routine dissection in our Department of Anatomy, an unusual drainage pattern of the veins of the left side of the face of a middle aged cadaver was observed. The facial vein presented a normal course from its origin up to the base of mandible, and then it crossed the base of mandible posteriorly to the facial artery. Thereafter, it joined with the anterior division of retromandibular vein to form the common facial vein, which drained into the external jugular vein directly. Sound anatomic knowledge of the above variation in facial veins is essential to the success of surgical procedures in this region.Padrões distintos de variações na drenagem venosa já foram observados. Durante a dissecção de rotina em nosso Departamento de Anatomia, observou-se um padrão incomum de drenagem das veias do lado esquerdo da face de um cadáver de meia idade. A veia facial apresentava curso normal de sua origem até a base da mandíbula, e então atravessava a base da mandíbula posteriormente à artéria facial. A seguir, juntava-se à divisão anterior da veia retromandibular para formar a veia facial comum, que drenava diretamente para a veia jugular externa. Um bom conhecimento anatômico da variação descrita acima nas veias faciais é essencial para garantir o sucesso que procedimentos cirúrgicos nessa região.

Suhani Sumalatha D'Silva; Thejodhar Pulakunta; Bhagath Kumar Potu

2008-01-01

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

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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

Eduardo Pereira Savi; Fernando Wagner; Reginaldo Boppré; Felipe Caetano Mamprim; Alberto Boppré

2010-01-01

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

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Full Text Available Abstract in portuguese 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 ressec (more) ção 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. Abstract in english 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 thrombophleb (more) itis, 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

Savi, Eduardo Pereira; Wagner, Fernando; Boppré, Reginaldo; Mamprim, Felipe Caetano; Boppré, Alberto

2010-12-01

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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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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.

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

2002-01-01

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Sistematização da veia cava cranial em búfalos (Bubalus bubalis bubalis Simpson, 1945)/ Systematization of the cranial vena cava in buffalos (Bubalus bubalis bubalis Simpson, 1945)  

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Full Text Available Abstract in portuguese Para o presente trabalho utilizou-se 25 animais, fetos de búfalos, com idades variando entre 5 e 9 meses, sendo 15 fêmeas e 10 machos, com vistas à dissecação e sistematização dos vasos em estudo. Os animais foram coletados em abatedouro e fixados em solução aquosa de formol 10%. Obtiveram-se para a Veia Cava Cranial os seguintes afluentes de origem: veias jugulares externas direita e esquerda, e os afluentes colaterais: as veias jugulares internas direita e esqu (more) erda, veias mediastínicas e pericárdicas, veias torácicas internas direita e esquerda, veias tímicas, veias subclávias direita e esquerda, o tronco costocervicovertebral direita esquerda, e ocasionalmente o ducto torácico. Abstract in english Twenty-five animals, Buffaloes fetus, with 5 to 9 months of age (15 females and 10 males) was analyzed by dissection after injected with latex substance. The fetuses were collected in a slaughterhouse and fixed in aqueous formol solution 10%. In the Cranial Vena Cava the following origin tributaries were observed: External right and left jugular veins and their collateral tributaries; the internal right and left jugular veins; the mediastinals and pericardials veins; the (more) internal right and left thoracic; thymic vein; the right and left subclavian vein, the right and left costocervicalvertebral venous trunk, and occasionally the thoracic duct.

Amorim Júnior, Adelmar Afonso de; Miglino, Maria Angélica; Amorim, Marleyne José Afonso Accioly Lins; Santos, Tatiana Carlesso dos

2002-01-01

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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  

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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.

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

2006-01-01

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Revascularização completa do miocárdio. Pontes seqüenciais de veia safena, anastomoses seqüenciais da artéria torácica interna e enxertos compostos: análise de 165 casos consecutivos  

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Full Text Available Abstract in portuguese Buscando a revascularização completa do miocárdio, 165 casos foram analisados dentre 359 pacientes submetidos a cirurgia de revascularização do miocárdio, no período de janeiro de 1995 a janeiro de 1996, com pontes de veia safena e/ou artéria torácica interna, de forma seqüencial, ou associadas como enxertos compostos. Destes, 132 receberam pontes seqüenciais de veia safena servindo a 2 ou mais ramos arteriais coronários, 25 foram tratados através de anastomo (more) ses seqüenciais de artéria torácica interna, de forma simples, interessando aos ramos interventricular anterior e diagonais da coronária esquerda, enquanto 8 receberam enxertos compostos de artéria torácica interna direita e esquerda associados a segmentos de veias safenas, que terminavam em ramos das artérias coronárias direita e esquerda. Em 96% os casos a operação programada foi realizada, obtendo-se revascularização completa. Ocorreu um único (0,6%) óbito hospitalar conseqüente a infarto do miocárdio transoperatório, seguido de síndrome de baixo débito cardíaco; a morbidade não diferiu daquela presente nos procedimentos usuais de revascularização cirúrgica do miocárdio. Os cuidados na dissecção e preparo dos pedículos da artéria torácica interna, bem como na retirada e preparo para implante das veias safenas, somados àqueles necessários à obtenção da perfeita anastomose seqüencial, de modo a evitar torções, angulações e acotovelamentos dos enxertos, são enfatizados como fundamentais para o excelente resultado obtido na série analisada. Nossos resultados entusiasmam o emprego da crescente freqüência no uso da técnica da revascularização completa do miocárdio. Abstract in english The authors analyse 165 patients out of 359 submitted to myocardial revascularization during the period between January 1995 and January 1996, in which the saphenous veins and the internal thoracic arteries have been used as a sequential graft, or associated with a composit graft; 132 received saphenous veins as a sequential graft to two or more coronary branches, 25 had sequential anastomosis of the left internal thoracic artery to IVA and diagonal branches of the left c (more) oronary artery, and 8 cases had both saphenous veins and internal thoracic arteries used as a composite graft to branches of the left and right coronary arteries. In 96% of the cases the scheduled surgery was performed, one patient died in the immediate post-operative period (0.6%) and the morbidity was not different from that found in the standard coronary artery surgery. Details of the preparation of the grafts, as well as operative technique is discussed, and the results of this series stimulated us for further use of the sequential grafts aiming for complete myocardial revascularization.

RABELO, Raul Corrêa; REIS FILHO, Fernando Antônio Roquete; BERNARDES, Rodrigo de Castro; MOTTA, Giancarlo Grossi; LIMA, Luiz Cláudio Moreira; GONÇALVES, Leonardo Augusto D'Ávila; RABELO, Walter; MARINO, Roberto Luiz; MARINO, Marcos Antônio; BRASIL, Juliana A. Amaral; GOMES, Maurício Castro

1997-04-01

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Anastomose entre a artéria carótida externa e a artéria carótida interna supraclinóidea utilizando enxerto de veia safena para tratamento de aneurisma gigante do segmento cavernoso da carótida interna: relato de caso  

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Full Text Available Procedimentos cirúrgicos alternativos para o tratamento de aneurismas "não clipáveis" da carótida intracavernosa incluem ligadura do vaso ou exclusão do segmento que origina a lesão. Essas técnicas estão associadas a riscos de complicações isquêmicas, mesmo em pacientes com sistema de colaterais funcionante. Portanto, um tratamento adequado requer revascularização encefálica para manter o fluxo sanguíneo nos territórios envolvidos. Relatamos o caso de uma paciente de 47 anos com sintomas e sinais isquêmicos embólicos e paralisia do III nervo craniano causados por aneurisma gigante, parcialmente trombosado, do segmento cavernoso da carótida interna. A paciente foi submetida a ponte anastomótica entre a carótida externa cervical e a carótida interna supraclinoidea utilizando enxerto de veia safena, seguido de exclusão do segmento vascular contendo o aneurisma, com bom resultado e sem complicações.

Azevedo Filho Hildo; Martins Carolina; Carvalho Antonio; Geraldo Sá; Grassi Giovanni; Cardoso Claudiana; Vilaça Gilberto; Rodrigues Cícero

2001-01-01

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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  

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Full Text Available Abstract in portuguese 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 endoprótes (more) es 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 we (more) re 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.

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

2006-06-01

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

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Full Text Available 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 communication 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 studiesLa 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 comunicación 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

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

2006-01-01

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

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Full Text Available Abstract in portuguese 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 (more) 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. Abstract in english 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 (more) 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.

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

2005-01-01

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

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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.

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

2005-01-01

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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  

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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.

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

2008-01-01

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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  

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Full Text Available Abstract in portuguese 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 (more) 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 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 en (more) doprosthesis 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.

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

2008-08-01

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Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study  

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Full Text Available O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como forma de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA.The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.

José Glauco Lobo Filho; Heraldo Guedis Lobo Filho; Francisco José Cabral Mesquita; Jaime Paula Pessoa Linhares Filho

2010-01-01

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Anastomose entre a artéria carótida externa e a artéria carótida interna supraclinóidea utilizando enxerto de veia safena para tratamento de aneurisma gigante do segmento cavernoso da carótida interna: relato de caso Saphenous vein graft bypass from the external carotid artery to the supraclinoid internal carotid artery to treat a giant aneurysm of the cavernous internal carotid: case report  

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Full Text Available Procedimentos cirúrgicos alternativos para o tratamento de aneurismas "não clipáveis" da carótida intracavernosa incluem ligadura do vaso ou exclusão do segmento que origina a lesão. Essas técnicas estão associadas a riscos de complicações isquêmicas, mesmo em pacientes com sistema de colaterais funcionante. Portanto, um tratamento adequado requer revascularização encefálica para manter o fluxo sanguíneo nos territórios envolvidos. Relatamos o caso de uma paciente de 47 anos com sintomas e sinais isquêmicos embólicos e paralisia do III nervo craniano causados por aneurisma gigante, parcialmente trombosado, do segmento cavernoso da carótida interna. A paciente foi submetida a ponte anastomótica entre a carótida externa cervical e a carótida interna supraclinoidea utilizando enxerto de veia safena, seguido de exclusão do segmento vascular contendo o aneurisma, com bom resultado e sem complicações.Alternative surgical procedures to treat unclippable aneurysms of the intracavernous carotid artery include proximal vessel occlusion and trapping. Those techniques, even in patients with rich colateral vessels, are associated with risk of hemodynamic compromise and ischemic complications. Therefore, a safe treatment requires revascularization to maintain blood flow to the involved territories. We report the case of a 47-year-old female, with ischemic signs and symptoms and a right third nerve palsy caused by a giant aneurysm, partially trombosed, of the intracavernous carotid artery. The patient was submmited to trapping after a saphenous vein graft bypass from the external carotid artery to the supraclinoid internal carotid artery. The surgical result was good without complications.

Hildo Azevedo Filho; Carolina Martins; Antonio Carvalho; Sá Geraldo; Giovanni Grassi; Claudiana Cardoso; Gilberto Vilaça; Cícero Rodrigues

2001-01-01

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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  

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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 este 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.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.

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

2010-01-01

 
 
 
 
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Persistência da veia ciática Persistent sciatic vein  

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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 anomalias. 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.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 process. 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.

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

2010-01-01

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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  

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Full Text Available Abstract in spanish 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. Método: Se incluyeron en un estudio prospectivo, analítico, descriptivo y observacional 72 pacientes pediátricos programados para cirugía cardiaca electiva previo cons (more) entimiento 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 complications. Method: In an observational, descriptive, analytical and prospective study were included 72 children programmed for elective cardiac surgery previous informed consent and (more) 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.

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

2011-08-01

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Persistência da veia ciática/ Persistent sciatic vein  

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Full Text Available Abstract in portuguese 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 anomalias. 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 v (more) eia 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 process. 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 superio (more) r 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.

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

2010-09-01

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

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Full Text Available Abstract in portuguese 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 oral 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.

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

2006-03-01

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

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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.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 oral 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.

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

2006-01-01

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Throbbing tinnitus in aberrant internal carotid artery aggravated by elevation of the jugular bulb. A case report; Pulsierender Tinnitus bei aberranter Arteria carotis interna in Kombination mit Hochstand des Bulbus venae jugularis. Kasuistik  

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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.) [Deutsch] Gefaessanomalien im Mittelohr sind selten. Meist sind sie asymptomatisch, koennen aber assoziiert sein mit Tinnitus. Die Fehldiagnose eines Glomustumors kann im Rahmen einer Operation zu gravierenden Problemen fuehren. Eine exakte praeoperative Abklaerung ist deshalb notwendig und sollte als Computertomographie mit Kontrastmittelgabe durchgefuehrt werden. Die anschliessende 2D- und 3D-Bildwiedergabe klaert die topographisch-anatomischen Gefaessbeziehungen und erlaubt somit die Diagnosestellung ohne die frueher durchgefuehrte invasive Carotisangiographie oder retrograde Jugularisvenographie. (orig.)

Wilhelm, T. [Inst. fuer Roentgendiagnostik, Klinikum der Technischen Univ. Muenchen (Germany); Kirsten, R. [Inst. fuer Roentgendiagnostik, Klinikum der Technischen Univ. Muenchen (Germany); Kau, R.J. [Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum der Technischen Univ. Muenchen (Germany)

1995-04-01

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Trombectomia com cateter de Fogarty no tratamento da tromboflebite jugular experimental em eqüinos Thrombectomy with Fogarty's catheter as a treatment of induced jugular thrombophlebitis in horses  

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Full Text Available Trombose da veia jugular é problema freqüente na medicina eqüina, implicando muitas vezes em conseqüências fatais. O objetivo deste trabalho foi avaliar em eqüinos a aplicabilidade da trombectomia com cateter de Fogarty, técnica rotineiramente empregada pela medicina humana, no restabelecimento da perviedade vascular. Foram utilizados 10 eqüinos divididos em dois grupos de cinco animais, em que se induziu a trombose da veia jugular direita, através do acesso cirúrgico à veia e aplicação de sutura estenosante e injeção de glicose a 50%. No grupo controle avaliou-se a evolução da tromboflebite sem qualquer tipo de intervenção terapêutica. Os animais do grupo tratado foram submetidos à trombectomia com cateter de Fogarty. Foram avaliados os parâmetros clínicos gerais, regionais, ultra-sonográficos e angiográficos, nos momentos pré-indução (M-PRÉ), indução da trombose (MTI) e 10 dias de evolução da trombose (M10). A técnica empregada induziu a tromboflebite, que obstruiu completamente um segmento da veia jugular de todos os animais. Os animais do grupo controle mantiveram os trombos obstruindo totalmente o lume vascular até o final do período de avaliação, sendo que avaliações regionais mostraram principalmente o edema parotídeo e o ingurgitamento vascular, cranial à tromboflebite da veia jugular. O grupo tratado apresentou as veias jugulares pérvias ao final do experimento, confirmadas pelos exames ultra-sonográficos e angiográficos, com remissão total dos sinais clínicos. Concluiu-se que a técnica da trombectomia com cateter de Fogarty foi eficiente na desobstrução da veia jugular submetida à trombose experimental.Thrombosis of jugular vein is a common problem in the equine medicine, implying frequently in fatal outcomes. The diagnosis is relatively simple, based on the clinical findings, angiographics images and ultrasonographycs. The therapeutic employed to a large extent of the cases is unsatisfactory. The purpose of this study was to evaluate the applicability of the thrombectomy with Fogarty's catheter in horses. This technique is routinely used in medicine, in the reestablishment of the vascular perviousness. Ten horses were allocated in two groups (five animals each) and induced to an unilateral thrombosis of right jugular vein, through the surgical access and an application of stenotic suture and glucose 50% injection. In the control group evolution of the thrombophlebitis without any therapeutical intervention was evaluated. The animals of the treatment group were submitted to the thrombectomy with Fogarty's catheter. General clinical parameters were analyzed at the moment of the preinduction (MPRE), induction of thrombosis (MTI), and at the 10th day of thrombosis evolution (M10). The procedure induced thrombophlebitis that completely obstructed a segment of the jugular vein in all animals. In the animals of the control group, the thrombus totally obstructed the vascular lumen until the end of the period of evaluation, and parotid edema and vascular dilated, cranial to the thrombophlebitis of jugular vein were observed. The treatment group presented all veins pervious in the end of the experiment, with total remission of the clinical signs, confirmed by angiographic and ultrasonographic examinations. So far, it was concluded that the technique of thrombectomy with Fogarty's catheter was effective in removal of the thrombosis obstruction experimentally induced in the jugular vein.

Carlos A. Hussni; Peterson T. Dornbusch; Winston B. Yoshida; Ana L. G. Alves; José L. M. Nicoletti; Maria J. Mamprim; Luiz C. Vulcano

2009-01-01

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Trombectomia com cateter de Fogarty no tratamento da tromboflebite jugular experimental em eqüinos/ Thrombectomy with Fogarty's catheter as a treatment of induced jugular thrombophlebitis in horses  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Trombose da veia jugular é problema freqüente na medicina eqüina, implicando muitas vezes em conseqüências fatais. O objetivo deste trabalho foi avaliar em eqüinos a aplicabilidade da trombectomia com cateter de Fogarty, técnica rotineiramente empregada pela medicina humana, no restabelecimento da perviedade vascular. Foram utilizados 10 eqüinos divididos em dois grupos de cinco animais, em que se induziu a trombose da veia jugular direita, através do acesso cir? (more) ?rgico à veia e aplicação de sutura estenosante e injeção de glicose a 50%. No grupo controle avaliou-se a evolução da tromboflebite sem qualquer tipo de intervenção terapêutica. Os animais do grupo tratado foram submetidos à trombectomia com cateter de Fogarty. Foram avaliados os parâmetros clínicos gerais, regionais, ultra-sonográficos e angiográficos, nos momentos pré-indução (M-PRÉ), indução da trombose (MTI) e 10 dias de evolução da trombose (M10). A técnica empregada induziu a tromboflebite, que obstruiu completamente um segmento da veia jugular de todos os animais. Os animais do grupo controle mantiveram os trombos obstruindo totalmente o lume vascular até o final do período de avaliação, sendo que avaliações regionais mostraram principalmente o edema parotídeo e o ingurgitamento vascular, cranial à tromboflebite da veia jugular. O grupo tratado apresentou as veias jugulares pérvias ao final do experimento, confirmadas pelos exames ultra-sonográficos e angiográficos, com remissão total dos sinais clínicos. Concluiu-se que a técnica da trombectomia com cateter de Fogarty foi eficiente na desobstrução da veia jugular submetida à trombose experimental. Abstract in english Thrombosis of jugular vein is a common problem in the equine medicine, implying frequently in fatal outcomes. The diagnosis is relatively simple, based on the clinical findings, angiographics images and ultrasonographycs. The therapeutic employed to a large extent of the cases is unsatisfactory. The purpose of this study was to evaluate the applicability of the thrombectomy with Fogarty's catheter in horses. This technique is routinely used in medicine, in the reestablish (more) ment of the vascular perviousness. Ten horses were allocated in two groups (five animals each) and induced to an unilateral thrombosis of right jugular vein, through the surgical access and an application of stenotic suture and glucose 50% injection. In the control group evolution of the thrombophlebitis without any therapeutical intervention was evaluated. The animals of the treatment group were submitted to the thrombectomy with Fogarty's catheter. General clinical parameters were analyzed at the moment of the preinduction (MPRE), induction of thrombosis (MTI), and at the 10th day of thrombosis evolution (M10). The procedure induced thrombophlebitis that completely obstructed a segment of the jugular vein in all animals. In the animals of the control group, the thrombus totally obstructed the vascular lumen until the end of the period of evaluation, and parotid edema and vascular dilated, cranial to the thrombophlebitis of jugular vein were observed. The treatment group presented all veins pervious in the end of the experiment, with total remission of the clinical signs, confirmed by angiographic and ultrasonographic examinations. So far, it was concluded that the technique of thrombectomy with Fogarty's catheter was effective in removal of the thrombosis obstruction experimentally induced in the jugular vein.

Hussni, Carlos A.; Dornbusch, Peterson T.; Yoshida, Winston B.; Alves, Ana L. G.; Nicoletti, José L. M.; Mamprim, Maria J.; Vulcano, Luiz C.

2009-01-01

29

Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães  

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Full Text Available Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2), base deficit (BD) and oxygen tension (PO2) in portal, caval and systemic arterial blood, as well as for increments of BD (DBD) in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD) were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.A descompressão venosa subdiafragmática durante a fase anhepática do transplante ortotópico de fígado em cães atenua a estase de sangue nas veias Porta e Cava Inferior e minimiza a hipoperfusão tissular e a acidose metabólica observadas na oclusão dessas veias. Durante duashoras, seis cães submetidos a desvios porta-jugular e cava-jugular passivos, com permanência do fluxo arterial hepático, foram avaliados através de pH, PCO2, DB e PO2 no sangue portal, da Veia Cava Inferior e arterial sistêmico, bem como por incrementos de DB (DDB) no sangue portal e da Veia Cava Inferior. Os resultados obtidos permitem concluir com uma confiança de 95% que: 1. Não foram constatadas alterações de pH e DB no sangue portal e arterial sistêmico na maioria dos tempos estudados; 2. Houve acidose metabólica no sangue da VCIIH; 3.Os incrementos negativos da DB (DDB) foram mais intensos no sangue da VCIIH do que no sangue da VP, em T10, T30 e T105; e, 4. Ocorreu desoxigenação no sangue portal e da VCIIH. Oacompanhamento do equilíbrio ácido-básico e da oxigenação no sangue venoso subdiafragmático pode constituir uma maneira efetiva de avaliar os desvios porta-jugular e cava-jugular passivos em cães.

Antônio Roberto de Barros Coelho; Álvaro Antônio Bandeira Ferraz; Renato Dornelas Câmara Neto; Ayrton Ponce de Souza; Edmundo Machado Ferraz

2000-01-01

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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  

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Full Text Available Abstract in portuguese 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, utilizar (more) am-se duas técnicas de anastomose da jugular, sendo, no grupo I, a técnica de bypass e, no grupo II, a substituição de um segmento da jugular esquerda por meio de anastomose vascular término-terminal. Para avaliar a trombogênese local e a histocompatibilidade, foram realizados exames clínicos, hematológicos, ecoDopplercardiográficos e histológicos dos segmentos vasculares enxertados. Os segmentos foram colhidos após 45 dias da avaliação pós-operatória, tendo a jugular direita como testemunha para os exames histológicos. Ambos os tecidos foram compatíveis quando implantados nos eqüinos, sem processo inflamatório acentuado, indicativo de rejeição. A técnica de bypass não foi eficiente na restauração da jugular, ocorrendo trombose obliterante dos enxertos de ACCHo. A substituição completa do segmento da jugular por VJEHe pode ser viável para o restabelecimento do fluxo sangüíneo da jugular de eqüinos, desde que se mantenha a igualdade dos diâmetros entre o enxerto e o vaso receptor. Abstract in english Twelve horses were randomly divided into two groups of six animals each (groups I and II) in order to study the compatibility and trombogenicity of two biological tissues conserved in glycerin at 98% which were used to restore the external jugular. The tissues consisted of arterial homograft - ACCHo (group I) and venous heterograft - VJEHe (group II). Two different techniques for jugular anastomosis were performed - bypass in group I and replacement of a segment of the le (more) ft jugular by means of end to end vascular anastomosis in group II. Clinical, hematological, Doppler ultrasonography, and histological examinations of the grafted vascular segments were conducted to evaluate local trombogenicity and tissue compatibility. All animals had the segments collected after 45 days, being the right jugular used as standard for the histopathological exams. Both tissues were compatible since no serious inflammatory process indicative of rejection took place. The bypass technique was not efficient for jugular restoration because of the occurrence of obliterant trombosys of the ACCHo. The full replacement of a jugular segment by the VJEHe can be feasible in reestablishing blood flow through the jugular of horses as long as the diameters of the grafted tissue and the original blood vessel are kept the same.

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

2005-02-01

31

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  

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Full Text Available 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 da jugular, sendo, no grupo I, a técnica de bypass e, no grupo II, a substituição de um segmento da jugular esquerda por meio de anastomose vascular término-terminal. Para avaliar a trombogênese local e a histocompatibilidade, foram realizados exames clínicos, hematológicos, ecoDopplercardiográficos e histológicos dos segmentos vasculares enxertados. Os segmentos foram colhidos após 45 dias da avaliação pós-operatória, tendo a jugular direita como testemunha para os exames histológicos. Ambos os tecidos foram compatíveis quando implantados nos eqüinos, sem processo inflamatório acentuado, indicativo de rejeição. A técnica de bypass não foi eficiente na restauração da jugular, ocorrendo trombose obliterante dos enxertos de ACCHo. A substituição completa do segmento da jugular por VJEHe pode ser viável para o restabelecimento do fluxo sangüíneo da jugular de eqüinos, desde que se mantenha a igualdade dos diâmetros entre o enxerto e o vaso receptor.Twelve horses were randomly divided into two groups of six animals each (groups I and II) in order to study the compatibility and trombogenicity of two biological tissues conserved in glycerin at 98% which were used to restore the external jugular. The tissues consisted of arterial homograft - ACCHo (group I) and venous heterograft - VJEHe (group II). Two different techniques for jugular anastomosis were performed - bypass in group I and replacement of a segment of the left jugular by means of end to end vascular anastomosis in group II. Clinical, hematological, Doppler ultrasonography, and histological examinations of the grafted vascular segments were conducted to evaluate local trombogenicity and tissue compatibility. All animals had the segments collected after 45 days, being the right jugular used as standard for the histopathological exams. Both tissues were compatible since no serious inflammatory process indicative of rejection took place. The bypass technique was not efficient for jugular restoration because of the occurrence of obliterant trombosys of the ACCHo. The full replacement of a jugular segment by the VJEHe can be feasible in reestablishing blood flow through the jugular of horses as long as the diameters of the grafted tissue and the original blood vessel are kept the same.

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

2005-01-01

32

Ataques isquêmicos transitórios em paciente com síndrome da veia cava superior: relato de caso  

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Full Text Available A síndrome da veia cava superior (SVCS) é condição relativamente rara. Relatamos o caso de um paciente de 42 anos, masculino, hipertenso há 15 anos, que evoluiu com dor cervical e torácica há um um ano, sendo evidenciada oclusão de 95% da coronária direita. Submetido a angioplastia, porém com persistência da dor torácica. Posteriormente evoluiu com episódios recorrentes de hemiplegia à direita associados a crises hipertensivas, que melhoravam com medicamentos anti-hipertensivos. Pela presença de coloração vinhosa na face e acentuação durante os períodos de ataques isquêmicos transitórios, foi feita a suspeita diagnóstica de provável acometimento do sistema de drenagem venosa, confirmada à venografia pelo achado de dilatação da veia jugular direita e imagem de estreitamento importante na junção com a veia cava superior. Em conclusão, não foi possível definir com certeza a relação entre as duas patologias no caso aqui apresentado, porém chamou a atenção a melhora dos sintomas neurológicos após o controle da SVCS com o tratamento instituído.

ANDRADE-FILHO ANTÔNIO S.; FIGUEIRÔA FREDERICO L.S.; SANTIAGO-FIGUEIRÔA CELSO L.; SILVEIRA DANNILO B.; ANDRADE-SOUZA YURI M.; BANDEIRA EDUARDO R.V.; SOUZA A.P.Q.U.; SILVA ANDRÉ G.P.

1998-01-01

33

Fenestrated Internal Jugular Vein: Case Report  

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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.

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

34

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.

2011-01-01

35

Jugular foramen schwannoma: case report  

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Full Text Available Introduction: Lesions of the jugular foramen are uncommon, and the paragangliomas are the most common tumors in this region, followed by schwannomas. Schwannomas are benign tumors, of slow growth and origin mainly in the sensitive cranial nerves. When located in the jugular foramen, the patients present with clinically auditory hearing loss, ataxia and headache, and cranial nerves IX, X and XI alterations are also common. Surgical excision is the therapeutic choice. Case Report: We reported the case of a young adult patient who sought the Otorhinolaryngology service at the School Hospital of Brasília for investigation of otalgia and chronic infection in the left ear, associated with tinnitus, hypacusis and tumor in the external ear canal. Initial diagnostic investigation by computed tomography and biopsy was inconclusive. New biopsy and magnetic resonance imaging were performed and definitive diagnosis of jugular foramen schwannoma was given. The lesion was then defined as type D by the classification of Kaye-Pellet, for it involved the jugular foramen, presented format of dumbbell and intra and extracranial components. The patient underwent a craniotomy and partial excision of the tumor. He did not have sequels of the procedure, although the otologic symptoms persisted. Final Comments: This case is an example of a rare disease. No more than two hundred cases have been reported in the literature and the clinical presentation is uncommon. The diagnostic and therapeutic challenge is faced by Otorhinolaryngology and Neurosurgery teams who are scheduling a new combined surgical procedure for a complete excision of the tumor.

Tavares, Joana R. P; Sampaio, Andre Luiz Lopes; Ferreira, Denise B. L; Cavalheiro, Jalusa B; Araújo, Mercêdes F. S; Oliveira, A. C. P

2009-01-01

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Phlebectasia of internal jugular vein.  

UK PubMed Central (United Kingdom)

Internal jugular phlebectasia (IJP) is a rare disease in which there is a fusiform dilatation of internal jugular vein, usually presenting as a neck mass in children. Accurate diagnosis from careful history, physical examination, and radiological study can be made. We report a 12-year-old boy with history of swelling appearing on the right side of the neck only on straining, coughing, or during a Valsalva maneuver. Diagnosis of right IJP was made. Exploration and wrapping the dilated segment in an 8-mm-diameter polytetrafluoroethylene tube graft was done. Because of its rarity, this entity is frequently ignored or misdiagnosed. This case report intends to stress the importance of keeping IJP as differential diagnosis while dealing with such a swelling to avoid invasive investigations and inappropriate treatment.

Bindal SK; Vasisth GO; Chibber P

2012-07-01

37

Phlebectasia of internal jugular vein.  

Science.gov (United States)

Internal jugular phlebectasia (IJP) is a rare disease in which there is a fusiform dilatation of internal jugular vein, usually presenting as a neck mass in children. Accurate diagnosis from careful history, physical examination, and radiological study can be made. We report a 12-year-old boy with history of swelling appearing on the right side of the neck only on straining, coughing, or during a Valsalva maneuver. Diagnosis of right IJP was made. Exploration and wrapping the dilated segment in an 8-mm-diameter polytetrafluoroethylene tube graft was done. Because of its rarity, this entity is frequently ignored or misdiagnosed. This case report intends to stress the importance of keeping IJP as differential diagnosis while dealing with such a swelling to avoid invasive investigations and inappropriate treatment. PMID:23741586

Bindal, Satish K; Vasisth, Gaurav O P; Chibber, Puneet

2012-07-01

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Intradural jugular foramen tumors/ Tumores intradurais do forame jugular  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Onze pacientes com lesões expansivas do forame jugular associadas ou não a componente extradural foram submetidos a ressecção cirúrgica no Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP) entre 1998 e 2001. Foi utilizada cirurgia combinada com dissecção do pescoço, mastoidectomia sem transposição do nervo facial e técnica de reconstrução miofascial da base do crânio desenvolvida por um dos autores. Quatro pacientes foram operados via cra (more) niectomia retrosigmoidea. Ressecção total foi feita em 9 pacientes, subtotal em um e parcial em outro. Nenhum dos 11 pacientes teve progressão da doença em 2 anos de acompanhamento. Não houve mortalidade. Cinco pacientes tiveram déficits adicionais de nervos cranianos baixos. Nove pacientes mantiveram ou melhoraram suas pontuações de acordo com a escala de Karnofsky. Para adequada abordagem do paciente com tumor de forame jugular, são necessários bom conhecimento anatômico da região, exposição cirúrgica ampla, e técnica de reconstrução eficiente para obter cura com baixas taxas de complicações pós-operatórias. Abstract in english Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished (more) in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.

Mattos, João Paulo; Ramina, Ricardo; Borges, Wilson; Ghizoni, Enrico; Fernandes, Yvens B.; Paschoal, Jorge R.; Honorato, Donizeti C.; Borges, Guilherme

2004-12-01

39

Intradural jugular foramen tumors Tumores intradurais do forame jugular  

Directory of Open Access Journals (Sweden)

Full Text Available Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.Onze pacientes com lesões expansivas do forame jugular associadas ou não a componente extradural foram submetidos a ressecção cirúrgica no Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP) entre 1998 e 2001. Foi utilizada cirurgia combinada com dissecção do pescoço, mastoidectomia sem transposição do nervo facial e técnica de reconstrução miofascial da base do crânio desenvolvida por um dos autores. Quatro pacientes foram operados via craniectomia retrosigmoidea. Ressecção total foi feita em 9 pacientes, subtotal em um e parcial em outro. Nenhum dos 11 pacientes teve progressão da doença em 2 anos de acompanhamento. Não houve mortalidade. Cinco pacientes tiveram déficits adicionais de nervos cranianos baixos. Nove pacientes mantiveram ou melhoraram suas pontuações de acordo com a escala de Karnofsky. Para adequada abordagem do paciente com tumor de forame jugular, são necessários bom conhecimento anatômico da região, exposição cirúrgica ampla, e técnica de reconstrução eficiente para obter cura com baixas taxas de complicações pós-operatórias.

João Paulo Mattos; Ricardo Ramina; Wilson Borges; Enrico Ghizoni; Yvens B. Fernandes; Jorge R. Paschoal; Donizeti C. Honorato; Guilherme Borges

2004-01-01

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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.

2004-01-01

 
 
 
 
41

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2004-12-01

42

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)

Full Text Available Abstract in portuguese 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 d (more) e 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 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 re (more) vealed 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.

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

2008-12-01

43

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)

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.

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

2008-01-01

44

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)

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.

Mario Mantovani; Raquel Franco Leal; Mauro José Fontelles

2002-01-01

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Trauma da Veia Porta Portal vein injury  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: O trauma da veia porta é raro e freqüentemente fatal por causa de exsanguinação e alta incidência de lesões de estruturas adjacentes. Devido às pecualiaridades desta lesão e diferentes condutas propostas na literatura, o objetivo dos autores é relatar a experiência neste tipo de lesão. MÉTODO: Estudo retrospectivo, de janeiro de 1994 e dezembro de 2001, de 1370 pacientes submetidos à laparotomia devido trauma abdominal. Entre esses, 15 pacientes apresentavam lesão da veia porta. As lesões foram classificadas conforme a sua extensão e localização. RESULTADOS: O mecanismo de trauma predominante foi o penetrante. O diagnóstico da lesão foi realizado no intraoperatório. Os procedimentos executados foram: sutura, anastomose término-terminal e ligadura da veia porta. A mortalidade foi de 53,3%. CONCLUSÃO: A lesão da veia porta possui alta taxa de mortalidade e o atendimento adequado está diretamente relacionado à sobrevida.BACKGROUND: Portal vein injury is rare and frequently lethal because of exsanguination and high incidence of injuries to the adjacent structures. Due the peculiarity of this lesion and different conducts proposed in the literature, the authors' objetive is to report their experience in the treatment of this lesion. METHODS: This study, is a retrospective analysis between January 1994 and December 2001, during which 1370 patients were treated with laparotomy for isolated abdominal trauma. Among these patients 15 had injury to the portal vein. The injuries were classified according to extension and location. RESULTS: The predominant mechanism of trauma was penetrating. The diagnosis was made intraoperatively. The procedures were: suture, end-to-end anastomosis and ligation of the portal vein. The mortality rate was 53,3%. CONCLUSION: Portal vein lesion had high mortality and advanced assistance is essential to increase survivors.

Gustavo Pereira Fraga; Mario Mantovani; Elcio Shiyoiti Hirano; Raquel Franco Leal

2003-01-01

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Estudo comparativo no uso de uma ou duas artérias torácicas internas na revascularização do miocárdio  

Directory of Open Access Journals (Sweden)

Full Text Available No Hospital da Beneficência Portuguesa, Serviço do Prof. Dr. Luís B. Puig, 30 pacientes foram submetidos a revascularização do miocárdio, no período de novembro de 1991 a março de 1992. Quinze pacientes receberam uma artéria torácica interna (Grupo I) e complementação com pontes de veia safena e os outros 15 pacientes receberam duas artérias torácicas internas (Grupo II) e complementação com pontes de veia safena. Não havia diferenças nos dois grupos, quanto aos antecedentes patológicos e às condições clínicas pré-operatórias. No Grupo I foi realizada uma média de 2,4% enx./paciente e no Grupo II, 3,1%. No período pós-operatório imediato, não houve diferenças nos dois grupos, quanto a incidência de reoperações por sangramento, infarto trans-operatório, ou presença de atelectasia pulmonar. Houve um óbito (3,3%) no Grupo I, devido a acidente vascular cerebral. Treze pacientes foram submetidos a estudo hemodinâmico pósoperatório antes da alta hospitalar, sendo seis no Grupo I e sete no Grupo II. As 13(100%) artérias torácicas internas esquerdas e as 7(100%) artérias direitas estavam pérvias. No Grupo II a artéria direita foi utilizada para revascularizar a artéria marginal esquerda em cinco pacientes e o ramo dialgonalis em dois. Os resultados sugerem que a artéria torácica interna direita deve ser usada mais freqüentemente e talvez tenha sua melhor aplicação por via retro-aórtica direcionada para o ramo marginal esquerdo.The authors present early results in a comparative study using one or two internal thoracic arteries for myocardial revascularization. They find no difference in both groups, regarding hospital mortality or morbidity. Angiographic study showed that early patency of the right internal thoracic artery passed through transverse sinus is similar to the left internal thoracic artery; is also better than saphenous vein grafts. They conclude that the double internal thoracic artery can be used more aften in selected patients.

Luís Roberto Gerola; Gil Vicente Lico e Cividanes; Guilherme Gemma; Firmino H. Ferreira Jr; Egle Costa Oppi; Luís B Puig

1992-01-01

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External jugular venous aneurysm: A clinical curiosity.  

UK PubMed Central (United Kingdom)

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 considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity.

Mohanty D; Jain BK; Garg PK; Tandon A

2013-01-01

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The microsurgical anatomy of the jugular foramen.  

Science.gov (United States)

The microsurgical anatomy of the jugular foramen was studied in 10 fixed cadavers, each cadaver consisting of the whole head and neck. Five of the cadavers were injected with latex. The jugular foraminal region was exposed using the infratemporal fossa type A approach of Fisch and Pillsbury in five cadavers (10 sides) and the combined cervical dissection-mastoidectomy-suboccipital craniectomy approach in five cadavers (10 sides). The right foramen was larger than the left in seven cases (70%), equal in two cases (20%), and smaller in one case (10%). The dura covering the intracranial portal of the foramen had two perforations, a smaller anteromedial perforation through which passed the ninth cranial nerve (CN IX), and a larger posterolateral perforation, through which passed the 10th and 11th cranial nerves (CNs X and XI) and the distal sigmoid sinus. The perforations were separated by a fibrous septum in 16 specimens (80%). After exiting the posterior fossa, CNs IX, X, and XI all lay anteromedial to the superior jugular bulb (SJB) within the jugular foramen. The inferior petrosal sinus (IPS) entered the foramen between CNs IX and X in most cases; however, in 10% of our cases it entered the foramen between CNs X and XI, and in 10% it entered the foramen caudal to CN XI. The IPS terminated in the SJB in 90% of our cases; in 40%, the IPS termination consisted of multiple channels draining into both the SJB and internal jugular vein. This study shows that the arrangement of the neurovascular structures within the jugular foramen does not conform to the hitherto widely accepted notion of discrete compartmentalization into an anteromedial pars nervosa containing CN IX and the IPS and a posterolateral pars venosa containing the SJB, CNs X and XI, and the posterior meningeal artery. PMID:7472562

Ayeni, S A; Ohata, K; Tanaka, K; Hakuba, A

1995-11-01

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The microsurgical anatomy of the jugular foramen.  

UK PubMed Central (United Kingdom)

The microsurgical anatomy of the jugular foramen was studied in 10 fixed cadavers, each cadaver consisting of the whole head and neck. Five of the cadavers were injected with latex. The jugular foraminal region was exposed using the infratemporal fossa type A approach of Fisch and Pillsbury in five cadavers (10 sides) and the combined cervical dissection-mastoidectomy-suboccipital craniectomy approach in five cadavers (10 sides). The right foramen was larger than the left in seven cases (70%), equal in two cases (20%), and smaller in one case (10%). The dura covering the intracranial portal of the foramen had two perforations, a smaller anteromedial perforation through which passed the ninth cranial nerve (CN IX), and a larger posterolateral perforation, through which passed the 10th and 11th cranial nerves (CNs X and XI) and the distal sigmoid sinus. The perforations were separated by a fibrous septum in 16 specimens (80%). After exiting the posterior fossa, CNs IX, X, and XI all lay anteromedial to the superior jugular bulb (SJB) within the jugular foramen. The inferior petrosal sinus (IPS) entered the foramen between CNs IX and X in most cases; however, in 10% of our cases it entered the foramen between CNs X and XI, and in 10% it entered the foramen caudal to CN XI. The IPS terminated in the SJB in 90% of our cases; in 40%, the IPS termination consisted of multiple channels draining into both the SJB and internal jugular vein. This study shows that the arrangement of the neurovascular structures within the jugular foramen does not conform to the hitherto widely accepted notion of discrete compartmentalization into an anteromedial pars nervosa containing CN IX and the IPS and a posterolateral pars venosa containing the SJB, CNs X and XI, and the posterior meningeal artery.

Ayeni SA; Ohata K; Tanaka K; Hakuba A

1995-11-01

50

Oclusão de ramo da veia central da retina  

Directory of Open Access Journals (Sweden)

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.

Rosa Alexandre Antonio Marques

2003-01-01

51

Ataques isquêmicos transitórios em paciente com síndrome da veia cava superior: relato de caso Transient ischemic attacks in a patient with superior vena cava obstruction: case report  

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Full Text Available A síndrome da veia cava superior (SVCS) é condição relativamente rara. Relatamos o caso de um paciente de 42 anos, masculino, hipertenso há 15 anos, que evoluiu com dor cervical e torácica há um um ano, sendo evidenciada oclusão de 95% da coronária direita. Submetido a angioplastia, porém com persistência da dor torácica. Posteriormente evoluiu com episódios recorrentes de hemiplegia à direita associados a crises hipertensivas, que melhoravam com medicamentos anti-hipertensivos. Pela presença de coloração vinhosa na face e acentuação durante os períodos de ataques isquêmicos transitórios, foi feita a suspeita diagnóstica de provável acometimento do sistema de drenagem venosa, confirmada à venografia pelo achado de dilatação da veia jugular direita e imagem de estreitamento importante na junção com a veia cava superior. Em conclusão, não foi possível definir com certeza a relação entre as duas patologias no caso aqui apresentado, porém chamou a atenção a melhora dos sintomas neurológicos após o controle da SVCS com o tratamento instituído.The superior vena cava obstruction is a relatively rare condition. We report the case of a 42 year old man suffering of hypertension for about fifteen years. He reported a cervical and thoracic pain for one year, that was related to a 95% of occlusion on the right coronary artery. An angioplasty has been done but the patient still related the thoracic pain. Afterwards the patient had recurrent episodes of right hemiplegia and hypertensive emergencies that have been treated with anti-hypertensive agents. A venous disease was suspected because of cyanosis in the face especially when episodes of transient ischemic attacks occurred. A venography showed obstruction of the right jugular vein near the junction with the superior vena cava. In conclusion, it was not possible to define with certainty the relationship between the two pathologies presented by the patient, even so, we call attention to the improvement of the neurological symptoms after the control of superior vena cava obstruction with the treatment.

ANTÔNIO S. ANDRADE-FILHO; FREDERICO L.S. FIGUEIRÔA; CELSO L. SANTIAGO-FIGUEIRÔA; DANNILO B. SILVEIRA; YURI M. ANDRADE-SOUZA; EDUARDO R.V. BANDEIRA; A.P.Q.U. SOUZA; ANDRÉ G.P. SILVA

1998-01-01

52

[A case of glomus jugulare chemodectoma].  

Science.gov (United States)

A case of glomus jugular chemodectoma is described in a 38 years old woman who was treated surgically. In the postoperative course a haemorrhage from the internal carotid artery appeared, needing a second surgical intervention, that was performed with good result. PMID:2216504

Karnicki, C; B?aszczyk, J

1990-01-01

53

[A case of glomus jugulare chemodectoma  

UK PubMed Central (United Kingdom)

A case of glomus jugular chemodectoma is described in a 38 years old woman who was treated surgically. In the postoperative course a haemorrhage from the internal carotid artery appeared, needing a second surgical intervention, that was performed with good result.

Karnicki C; B?aszczyk J

1990-01-01

54

Microsurgical management of jugular foramen schwannomas.  

UK PubMed Central (United Kingdom)

BACKGROUND: Jugular foramen schwannomas are uncommon and surgically challenging lesions. OBJECTIVE: To determine the importance of surgical technique on morbidity and recurrence of jugular foramen schwannomas. METHODS: A retrospective review and case-control analysis of a single-senior-surgeon series of 81 patients with surgically treated jugular foramen schwannomas was performed, focusing on operative technique. Patients undergoing an aggressive, total tumor resection (series 1) were compared with those undergoing more conservative resection focusing on preserving the pars nervosa (series 2). RESULTS: There was a statistically significant (P = .04) decrease in permanent deficits of the cranial nerve 9/10 complex with a conservative technique. Recurrence was seen in 3 patients (5.7%) in series 1 and in 3 patients (10.7%) in series 2 (P = .36). Recurrence was treated with reoperation in 1 patient, radiation in 1 patient, and observation in the others. CONCLUSION: Although radical gross total resection is desirable, it is not optimal for cranial nerve preservation in patients with jugular foramen schwannomas. A more conservative approach resulted in a statistically significant decrease in lower cranial nerve deficits. There was a nonstatistically significant trend toward increasing recurrence, which may be treated with multiple modality therapy in the modern era.

Sedney CL; Nonaka Y; Bulsara KR; Fukushima T

2013-01-01

55

Schwannoma de forame jugular: relato de caso  

Directory of Open Access Journals (Sweden)

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.

Tavares, Joana R. P; Sampaio, Andre Luiz Lopes; Ferreira, Denise B. L; Cavalheiro, Jalusa B; Araújo, Mercêdes F. S; Oliveira, A. C. P

2009-01-01

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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.)

1986-01-01

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

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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 e

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

2012-01-01

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Anterior jugular phlebectasia and tinnitus: A case report.  

UK PubMed Central (United Kingdom)

Abnormal dilation of a normal anterior jugular vein is a rare anomaly and usually presents as a neck lump. To the best of our knowledge, this is the first report in the literature of such a case in which the patient presented with severe tinnitus. Excision of the dilated portion of the anterior jugular vein in our patient alleviated the severe tinnitus.

Verma RK; Modi R; Panda NK

2013-03-01

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Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed tot...

Simka, Marian; Majewski, Eugeniusz; Fortuna, Marek; Zaniewski, Maciej

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Tumor do glomo jugular Tumor of the glomus jugulare. A case report  

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Full Text Available É relatado um caso de tumor de glomo jugular com 4 anos de evolução. Os exames neuro-radiológicos mostraram destruição da pirâmide petrosa direita, deslocamento da cisterna pontocerebelosa direita e dilatação da cisterna ambiens do mesmo lado. O paciente foi submetido à cirurgia otológica, sendo o tumor removido parcialmente. Após radioterapia houve remissão parcial dos sintomas.A case of tumor of the glomus jugulare in a 57 years old patient in which the symptoms lasted four years is reported. The neuroradiological examination showed erosion of the petrous part of the right temporal bone, displacement of the right pontocerebellar cistern and dilatation of the ambiens cistern in the same side. The patient was submitted to otological surgery the tumor being partially removed. After the irradiation therapy some symptoms disappeared.

Antonio Cesar G. Borges; Mario Ferreira Coutinho; Adão Anicet; Décio Lisboa Castro

1973-01-01

 
 
 
 
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Trombose da veia de Galeno: relato de caso  

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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.

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

2003-01-01

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Analysis of jugular foramen exposure in the fallopian bridge technique.  

UK PubMed Central (United Kingdom)

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. Anteroposterior and superoinferior dimensions of the anterior dissection space were 4.4 +/- 1.03 mm and 6.3 +/- 2.49 mm, respectively. The superoinferior and anteroposterior dimensions of the posterior dissection space were 11.7 +/- 2.08 mm and 8.0 +/- 2.95 mm, respectively. The depth of the first dissection field was 8.2 +/- 2.11 mm. After perforating the jugular bulb, the depth of the second dissection field was 16.0 +/- 1.60 mm. Results: The anterior dissection space serves only as an additional visualization space for anatomical orientation to the jugular bulb. Tumor dissection is to be accomplished mainly through the posterior dissection space. Conclusion: The fallopian bridge technique should be added to surgical armamentarium for the jugular foramen tumors confined only to the jugular fossa or tumors with middle ear extension.

Satar B; Yazar F; Ceyhan A; Arslan HH; Aydin S

2009-05-01

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Estudo comparativo no uso de uma ou duas artérias torácicas internas na revascularização do miocárdio/ Comparative study using one or two internal thoracic arteries for myocardial revascularization  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese No Hospital da Beneficência Portuguesa, Serviço do Prof. Dr. Luís B. Puig, 30 pacientes foram submetidos a revascularização do miocárdio, no período de novembro de 1991 a março de 1992. Quinze pacientes receberam uma artéria torácica interna (Grupo I) e complementação com pontes de veia safena e os outros 15 pacientes receberam duas artérias torácicas internas (Grupo II) e complementação com pontes de veia safena. Não havia diferenças nos dois grupos, qu (more) anto aos antecedentes patológicos e às condições clínicas pré-operatórias. No Grupo I foi realizada uma média de 2,4% enx./paciente e no Grupo II, 3,1%. No período pós-operatório imediato, não houve diferenças nos dois grupos, quanto a incidência de reoperações por sangramento, infarto trans-operatório, ou presença de atelectasia pulmonar. Houve um óbito (3,3%) no Grupo I, devido a acidente vascular cerebral. Treze pacientes foram submetidos a estudo hemodinâmico pósoperatório antes da alta hospitalar, sendo seis no Grupo I e sete no Grupo II. As 13(100%) artérias torácicas internas esquerdas e as 7(100%) artérias direitas estavam pérvias. No Grupo II a artéria direita foi utilizada para revascularizar a artéria marginal esquerda em cinco pacientes e o ramo dialgonalis em dois. Os resultados sugerem que a artéria torácica interna direita deve ser usada mais freqüentemente e talvez tenha sua melhor aplicação por via retro-aórtica direcionada para o ramo marginal esquerdo. Abstract in english The authors present early results in a comparative study using one or two internal thoracic arteries for myocardial revascularization. They find no difference in both groups, regarding hospital mortality or morbidity. Angiographic study showed that early patency of the right internal thoracic artery passed through transverse sinus is similar to the left internal thoracic artery; is also better than saphenous vein grafts. They conclude that the double internal thoracic artery can be used more aften in selected patients.

Gerola, Luís Roberto; Cividanes, Gil Vicente Lico e; Gemma, Guilherme; Ferreira Jr, Firmino H.; Oppi, Egle Costa; Puig, Luís B

1992-03-01

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Applications of contrast enhanced CT through external jugular access  

International Nuclear Information System (INIS)

[en] 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)

2005-01-01

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Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis  

Energy Technology Data Exchange (ETDEWEB)

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.

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

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

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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.

Coelho Antônio Roberto Barros; Ferraz Álvaro Antônio B.; Câmara Neto Renato Dornelas; Ferraz Edmundo Machado; Souza Ayrton Ponce de

1999-01-01

67

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

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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.The main purposes of veno-venous bypasses during orthotopic liver transplantation are: attenuation of subdiaphragmatic venous stasis, maintenance of satisfactory venous return to the heart, and efficient tissue perfusion. PVP, IHIVCP, CVP, MAP and RPP, as well as D PVP and D IHIVCP were investigated in six dogs, under general anesthesia, having their livers perfused by hepatic artery, and submitted to passive porto-jugular and cava-jugular shunts during two hours. Such shunts, were not able to obviate stagnation of blood in portal and caval veins, inducing stasis and lesser venous return to the heart, as suggested by increases of PP and PVCIIH and decreases of CVP values. Levels of MAP were not significantly different from those verified at T0, in the majority of studied times, and RPP values were significantly decreased from those at T0, in almost all instances. Such pressures were respectively maintained above 100 and 50 mmHg, and were attributed in part to a widespread arteriolar vasoconstriction. Pressure increments in PV (D PVP) were significantly smaller than those verified in the IHIVC (D IHIVCP), and such difference was attributed to splancnic compliance. Further decreases in PP and IHIVCP levels suggest a lower arterial flux to splancnic and systemic territories as a consequence of reduced venous return to the heart. PVP, IHIVCP, CVP, MAP and RPP determinations may comprise a practical mean to assist hemodynamic veno-venous bypass performance.

Antônio Roberto Barros Coelho; Álvaro Antônio B. Ferraz; Renato Dornelas Câmara Neto; Edmundo Machado Ferraz; Ayrton Ponce de Souza

1999-01-01

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Diagnosis of jugular paraganglioma by radionuclide angiography: concise communication  

Energy Technology Data Exchange (ETDEWEB)

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.

Zwas, S.T.; Kronenberg, J.; Tadmor, R.; Leventon, G.

1983-11-01

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Surgical treatment of the high jugular bulb by compressing sinus sigmoideus: two cases.  

Science.gov (United States)

If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no flow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and different treatment perspectives accompanied by literature. PMID:18046566

Oztürkcan, Sedat; Katilmi?, Hüseyin; Ozkul, Yilmaz; Erdo?an, Nezahat; Ba?o?lu, Sinan; Tayfun, Mehmet Ali

2007-11-29

70

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

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Full Text Available 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 in 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.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.

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

2007-01-01

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Jugular Foramen Schwannomas: Surgical Approaches and Outcome of Treatment  

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Twelve cases of schwannomas of the jugular foramen that involved surgery in our department between 1983 and 1997 are described. Eight were women and 4 were men (mean age, 40 years), and the duration of their symptoms, the most predominant of which were hearing loss and tinnitus, ranged from 1 month ...

Yoo, Heon; Jung, Hee-Won; Yang, Hee Jin

72

Surgical treatment of jugular vein phlebectasia in children.  

UK PubMed Central (United Kingdom)

BACKGROUND: Jugular vein phlebectasia (JVP) is a cervical mass that occurs relatively infrequently and usually presents in children as a soft cystic swelling in the neck during straining. It is liable to be misdiagnosed or managed inappropriately. This report elucidates the clinical presentation, diagnosis, treatment choices, and postoperative complications of JVP, and diagnostic methods and treatment choices are recommended. METHODS: Fifty-one cases of JVP were reviewed (right vein in 38 patients, left in 7 patients, and bilateral in 6 patients). The internal jugular vein was involved the most frequently. The main complaint was a soft and compressible mass in the neck, becoming more prominent with the Valsalva maneuver. All of the children except 2 had an ultrasound or color Doppler flow imaging (CDFI) performed in combination with the Valsalva's breathing test. Surgical intervention was performed in 46 patients and the other 5 patients were followed-up conservatively for 2 to 15 years. RESULTS: Ultrasound or CDFI showed local dilatation of unilateral or bilateral veins in all patients except 2, and confirmed the diagnosis in combination with the Valsalva's breathing test. Surgical intervention included ligation of the involved jugular vein in 32 patients, and longitudinal constriction suture venoplasty plus encapsulation with medical Dacron cloth or PTFE in 14 patients. All of the children who had surgery recovered uneventfully, except 3 patients undergoing ligation of the right internal jugular vein. CONCLUSIONS: The Valsalva maneuver was most important for establishing the diagnosis. Ultrasound or CDFI, or in combination with the Valsalva's breathing test, was the diagnostic procedure of choice to confirm the diagnosis of JVP because of its clarity, safety, and low cost. Surgical intervention was recommended for cosmetic and psychologic purposes. Ligation or excision of the involved jugular vein was very safe, simple, and effective for most patients. However, in cases of lesions of the right and bilateral internal jugular veins, longitudinal constriction suture venoplasty plus encapsulation might be more preferable and safer, and should be recommended. Otherwise, treatment should be conservative (follow-up evaluation).

Jianhong L; Xuewu J; Tingze H

2006-09-01

73

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

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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®.

Ferrigno Cassio Ricardo Auada; Stopiglia Ângelo João; Bechara Gervásio Henrique; Futema Fabio

2003-01-01

74

Internal jugular vein entrapment in a multiple sclerosis patient.  

UK PubMed Central (United Kingdom)

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient's mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.

Simka M; Majewski E; Fortuna M; Zaniewski M

2012-01-01

75

Left Internal Jugular Vein Thrombosis Due to a Lung Tumor  

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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.

Kuan-Hsing Chen; Ying-Jen Chen; Chuang-Chi Liaw; Hern-Jia Chang; Kee-Min Yeow

2003-01-01

76

Anaplastic astrocytoma following radiation for a glomus jugular tumor.  

UK PubMed Central (United Kingdom)

Evaluation of radiation therapy for a given neoplasm includes consideration of possible treatment complications as well as potential benefit. A 43-year-old male with a glomus jugular tumor or the right middle ear had received 4480 rad to the right middle and inner ear and temporal bone. Eight years later, he developed an anaplastic astrocytoma of the right cerebellar hemisphere. At this time a third neoplasm, a left carotid body tumor, was demonstrated angiographically. Although radiation can be implicated in the genesis of the glial neoplasm, the presence of two neural crest derived tumors suggests that a lowered threshold for neoplastic transformation in neuroectodermal cells may have been an additional factor. Long-term follow-up of large numbers of patients with glomus jugulare tumors will be necessary to determine if multiple paragangliomas predispose to radiation-associated gliomas.

Preissig SH; Bohmfalk GL; Reichel GW; Smith MT

1979-06-01

77

Anaplastic astrocytoma following radiation for a glomus jugular tumor.  

Science.gov (United States)

Evaluation of radiation therapy for a given neoplasm includes consideration of possible treatment complications as well as potential benefit. A 43-year-old male with a glomus jugular tumor or the right middle ear had received 4480 rad to the right middle and inner ear and temporal bone. Eight years later, he developed an anaplastic astrocytoma of the right cerebellar hemisphere. At this time a third neoplasm, a left carotid body tumor, was demonstrated angiographically. Although radiation can be implicated in the genesis of the glial neoplasm, the presence of two neural crest derived tumors suggests that a lowered threshold for neoplastic transformation in neuroectodermal cells may have been an additional factor. Long-term follow-up of large numbers of patients with glomus jugulare tumors will be necessary to determine if multiple paragangliomas predispose to radiation-associated gliomas. PMID:222421

Preissig, S H; Bohmfalk, G L; Reichel, G W; Smith, M T

1979-06-01

78

A metastatic glomus jugulare tumor. A temporal bone report  

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The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

El Fiky, F.M.; Paparella, M.M.

1984-01-01

79

A metastatic glomus jugulare tumor. A temporal bone report  

International Nuclear Information System (INIS)

The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed

1984-01-01

80

Jugular vein phlebectasia in paediatric patients with vocal fold nodules.  

UK PubMed Central (United Kingdom)

Jugular vein phlebectasia (JVP) may often be overlooked in clinical practice and the management for JVP include surgery and a conservative approach. We have studied the relationship between JVP and vocal fold nodules in paediatric patients as well as the effects of treatment. Twenty-three cases of paediatric vocal fold nodules with JVP were studied. All patients received voice therapy. After 6 months of treatment, hoarseness, neck appearance (subjective evaluation) and the degree of dilation of the jugular vein detected by Doppler ultrasonography were analysed. The follow-up period was 6 to 84 months. The hoarseness disappeared or lessened noticeably after treatment for 1-4 months. The neck masses also lessened (pre vs. post: 2.58 ± 0.40 vs. 1.60 ± 0.19) after treatment for 1-4 months. The visual analogue score of the post-treatment symptoms decreased significantly compared with pre-treatment (p <0.05). The degree of dilation of the post-treatment jugular vein also decreased significantly (p <0.05). Conclusion: Paediatric vocal fold nodules may be related to JVP. Voice changes may also be observed in cases of paediatric JVP. Voice therapy may offer another conservative treatment option for JVP accompanied by vocal fold nodules, and it may offer better results than simple observation of JVP.

Liu X; Sun CZ; Zou H; Luo RZ

2013-08-01

 
 
 
 
81

Internal Jugular Phlebectasia: Diagnosis by Ultrasonography, Doppler and Contrast CT.  

UK PubMed Central (United Kingdom)

Jugular phlebectasia is an isolated saccular or fusiform dilation of a vein without tortuosity. Its aetiology remains controversial. It is infradiagnosed, as it is generally asymptomatic. However, it has been increasingly recognized in recent years due to the better imaging techniques which are available. Phlebectasia of the Internal Jugular Vein (IJV) is a rare disease. It is mostly unilateral and it involves only the right side. It is usually a childhood disease which is diagnosed during the study of an intermittent neck mass. Its treatment is controversial. Presently, a conservative approach to unilateral or bilateral asymptomatic phlebectasia is recommended. Symptomatic phlebectasia requires surgery. The diagnosis is suggested by clinical features which can be confirmed by noninvasive radiology. This paper is reporting a case of unilateral right internal jugular phlebectasia in a 12 year old female patient who complained of an intermittent, right sided neck swelling, where we used UltraSonoGraphy(USG) with Doppler and Contrast enhanced CT(CECT) to evaluate the lesion.

Bora MK

2013-06-01

82

Artéria carótida interna aberrante na orelha média  

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Full Text Available Malformações vasculares na orelha média são raras, e a artéria carótida interna (ACI) aberrante deve ser lembrada no diagnóstico diferencial, visto o grande risco trazido por uma intervenção cirúrgica inadvertidamente realizada na cavidade timpânica. O paciente pode apresentar-se assintomático ou, comumente, com hipoacusia e/ou zumbido pulsátil. As imagens fornecidas pela tomografia computadorizada (TC) e ressonância magnética (RM), incluindo a angiorressonância, firmam o diagnóstico. Os autores descrevem um caso em criança de 13 anos, em que o diagnóstico foi feito através de exames de imagens, direcionados por uma importante suspeita clínica.

Viana Corintho; Coelho Fábio; Caldas Neto Silvio; Oliveira Kátia; Caldas Nelson

2003-01-01

83

Las Cuatro Dimensiones de la Comunicación Interna  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 t (more) angibilizam 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 implica, orientarlos sobre las conductas necesarias para hacer real los objetivos estratégicos de la organización; y, al mismo tiempo, fortalecer aquellos comportamientos (more) 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 members 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 th (more) ose 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.

Reyes, Julio

2012-06-01

84

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish 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 sex (more) os, 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 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, (more) 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.

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

2010-06-01

85

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

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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.

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

2010-01-01

86

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

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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.

Alcino Lázaro da Silva; Túlio Pinho Navarro; Sérgio Caporali de Oliveira; Ailton Gomes Faion; Lincoln Warley Ferreira

1999-01-01

87

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 exploração 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% (more) , 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 (more) 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%).

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

1999-01-01

88

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

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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.

Márcio Martins Machado; Ana Cláudia Ferreira Rosa; Orlando Milhomem da Mota; Daniela Medeiros Milhomem Cardoso; Patrícia Medeiros Milhomem; Leonardo Medeiros Milhomem; Rodrigo Alvarenga Nunes; Thaís Bittencourt Gonçalves Teles; Flávio Bittencourt Gonçalves Teles; Letícia Martins Azeredo; Nestor de Barros; Giovanni Guido Cerri

2006-01-01

89

Traumatismos de veia cava inferior Inferior vena cava injuries  

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Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI). MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI), achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65%) doentes sofreram lesão por arma branca, 26 (34%) por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54%) doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica BACKGROUND: Injuries of inferior vena cava (IVC) require immediate and definitive action. Our objective is to evaluate the incidence, the clinical findings and the operative approach to IVC injuries. METHODS: We retrospectively studied 76 patients with IVC injuries treated in two Emergency Hospitals of Manaus, AM, Brazil, from January 1997 to July 2002. Mechanisms of injuries, mortality, hemodynamic status, penetrating abdominal trauma index (PATI), intraoperative findings and surgical approach were among assessed data. RESULTS: Fourty-nine patients (65%) had stab wounds, 26 (34%) gunshot wounds, and one had blunt abdominal trauma. Fourty-one (54%) patients survived. Almost all patients entered the emergency room awake, although 40% were hypotensive (systolic blood pressure < 70 mmHg), and the penetrating abdominal trauma index average was above 40. At laparotomy, active retroperitoneal bleeding or an expanding retroperitoneal hematoma were detected in all cases. Caval injury was retro-hepatic in 21 patients, and infrahepatic in the other 55. The prevailing surgical approach was lateral repair in 65 patients. Atrial-caval shunting was tried in six patients, with only three survivals. CONCLUSIONS: We concluded that IVC injury remains a highly lethal injury and there is a close relationship with urban violence. This study emphasizes that successful outcome depends on prompt volume restoration, avoidance of hypothermia and a stratified selective surgical approach.

Cleinaldo de Almeida Costa; José Carlos Costa Baptista-Silva; Lana Márcia Esteves Rodrigues; Fabiana Lo Presti Mendonça; Thiago Silveira Paiva; Emil Burihan

2005-01-01

90

[Treatment of operation of carotid body tumor and glomus jugular tumor].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the clinical characteristics and outline of surgery for carotid body tumor and glomus jugular tumor. METHOD: Incisions of anterior border of sterno-mastoid muscle was made for simple carotid body tumor. A big S shape incisions and infratemporal fossa approach were employed which exposure the jugular foramen and apex of petrous for glomus jugular tumor or suffered carotid body tumor and glomus jugular tumor simultaneously in same side. RESULT: Five cases of carotid body tumor were removed thoroughly and the internal carotid artery were intact reserved. In 5 cases of glomus jugular tumor 3 cases were removed thoroughly, other 2 cases of glomus jugular tumor were palliative operation, the remnant tumor have not increased in size after 1 to 3 years follow up. CONCLUSION: Chemodectoma have some genetic characteristic. Surgical intervention is the cardinal method of treatment.

Guo M; Li Y; Xu H; Xie N; Huang Y

2003-06-01

91

[Experiences with Swan-Ganz-catheter placement in the external jugular vein  

UK PubMed Central (United Kingdom)

Clinical experience concerning the placement of Swan-Ganz catheters (SGC) via the external jugular vein is presented. After puncture of either the right or left external jugular vein, placement of SGC was possible in 90 per cent of patients. Compared to techniques involving puncture of the internal jugular vein this method has less complications. The placement of 167 SGC could be done without any problems, thus proving that the external jugular vein is a safe way of insertion. The external jugular vein as a primary route can be recommended if the vein is visible, especially in cases where puncture of the internal jugular vein may be difficult and could only be performed with an increased risk of complications.

Späth P; Barankay A; Göb E; Richter JA

1985-07-01

92

Obtenção da veia safena magna através de acesso minimamente invasivo para revascularizações miocárdicas  

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Full Text Available Objetivo: Avaliar a possibilidade de obtenção da veia safena magna através de miniincisões de pele, a sua qualidade e a ocorrência de complicações precoces da ferida operatória. Casuística e Métodos: Foram estudados 46 pacientes, admitidos entre julho e novembro de 1999. Após miniincisões longitudinais de pele a veia safena magna foi identificada e, com auxílio de afastador de lâmina longa e estreita, delicadamente dissecada. Os pacientes foram divididos em 2 grupos na dependência da presença dos fatores de risco: anemia, aterosclerose periférica, obesidade e diabete melito. As feridas operatórias foram observadas quanto às complicações maiores e menores. Amostras da veia foram enviadas para estudo histológico. Resultados: O número médio de incisões foi 2,3, com tamanho médio de 3,5 cm e de todas incisões somadas de 7,3 cm. O tamanho médio da veia foi 34,1 cm, com tempo médio de retirada de 28,7 minutos. Foram observadas complicações menores em 5 (10,8%) pacientes; sendo hematoma local a mais comum (6,5%). Não foram observadas complicações maiores e a ressecção foi sempre possível. Em 2 casos houve lesão macroscópica da veia, sendo possível a sua correção e utilização. O estudo histológico demonstrou preservação da arquitetura tecidual e não evidenciou lesão endotelial significativa. Conclusões: A obtenção da veia safena magna através de miniincisões é possível e resulta em adequado enxerto venoso. A incidência de complicações da ferida é baixa e independente dos fatores de risco. Estes resultados preliminares sugerem que a técnica pode ser aplicada com segurança em pacientes submetidos à revascularização miocárdica, embora os resultados a longo prazo ainda necessitem ser determinados.

TYSZKA André Luiz; FUCUDA Leila Satomi; TORMENA Eloisa de Brida; CAMPOS Antonio Carlos L.

2001-01-01

93

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

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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 com 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.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 the 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.

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

1992-01-01

94

Síndrome de compressão da veia cava inferior na paracoccidioidomicose/ Vena cavae compression syndrome in paracoccidioidomycosis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os Autores registram o primeiro caso de síndrome de compressão da veia cava inferior devida a paracoccidioidomicose. Resumem a evolução clínica do paciente, tratamento e os achados laboratoriais e ultrassonográficos que evidenciaram o diagnóstico de compressão da veia cava inferior. Abstract in english The Authors report the first description of an inferior vena cavae compression syndrome due to paracoccidioidomycosis. The clinical course of the disease, laboratory and ultrasonographic findings are summarized, providing evidence to the diagnosis of inferior vena cavae compression.

Carvalho, Silvino Alves de; Cerri, Giovanni Guido; Shiroma, Mario; Shikanai-Yasuda, Maria Aparecida; Barone, Antonio Alci; Amato Neto, Vicente

1986-02-01

95

Intra-operative internal jugular vein thrombosis complicating microvascular free flap transfer.  

Science.gov (United States)

Internal jugular vein thrombosis is rare. It is often secondary to prolonged central venous cannulation and associated with local or distant malignancy. The authors present a case of intra-operative thrombosis of the internal jugular vein which complicated subsequent microvascular anastomosis of a radial forearm free flap. The management of the intra-operatively thrombosed internal jugular vein and alternative anastamotic options for the free flap are discussed. PMID:22763140

Castling, B; Fowell, C; Bhatia, S

2012-07-03

96

Intra-operative internal jugular vein thrombosis complicating microvascular free flap transfer.  

UK PubMed Central (United Kingdom)

Internal jugular vein thrombosis is rare. It is often secondary to prolonged central venous cannulation and associated with local or distant malignancy. The authors present a case of intra-operative thrombosis of the internal jugular vein which complicated subsequent microvascular anastomosis of a radial forearm free flap. The management of the intra-operatively thrombosed internal jugular vein and alternative anastamotic options for the free flap are discussed.

Castling B; Fowell C; Bhatia S

2012-10-01

97

MSCT angiography diagnosis of thrombosis in external jugular venous aneurysm: case report and review of literature.  

UK PubMed Central (United Kingdom)

True venous aneurysms are rarely-observed causes of neck swelling reported in children. We describe a 59-year-old female with a history of left-sided neck swelling due to external jugular venous aneurysm diagnosed by MSCT angiography. Thrombosis in external jugular venous aneurysm as in this case is extremely rare. Incidental note was made of the coexistent right internal jugular phlebectasia. A brief review of literature of this entity has been discussed.

Rawat NS; Gupta A; Khurana P; Jain S; Trehan N

2008-01-01

98

Management of jugular paragangliomas: the Gruppo Otologico experience.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective of this study was to review the outcome of surgical management in patients of jugular paragangliomas. STUDY DESIGN: We conducted a retrospective case review. SETTING: Tertiary care otology and skull base center. MATERIALS AND METHODS: Fifty-five patients with the diagnosis of a jugular paraganglioma (Fisch Class C and D Glomus Jugulare) were managed over a period of 15 years. All patients with adequate follow up and complete records (53 cases) were reviewed with emphasis on the results of surgical management and the factors influencing them. INTERVENTION: All 53 patients were managed with a view to surgically extirpate the tumor. The primary approach was the infratemporal fossa approach-Type A used in the majority of the patients. In eight cases, the procedure was staged owing to the presence of large intracranial extension. Three patients required additional procedures to ameliorate the after-effects of lower cranial nerve resection. RESULTS: Gross total tumor removal was achieved in 49 patients. There were five cases of recurrence. Coupled with the residual tumors in five patients, the surgical control achieved was 83%. There was no perioperative mortality. There were two cases of postoperative cerebrospinal fluid leak, both of which required surgical exploration and closure. The facial nerve was resected in seven patients. The overall preservation rate of clinically uninvolved lower cranial nerves was 75%. CONCLUSIONS: The low level of complications along with a high surgical control achieved makes surgery the primary mode of treatment in the vast majority of these tumors, regardless of the size and location.

Sanna M; Jain Y; De Donato G; Rohit; Lauda L; Taibah A

2004-09-01

99

Queckenstedt's test affects more than jugular venous congestion in rat.  

Science.gov (United States)

Jugular venous compression by the Queckenstedt's test (Q-test) increases the intracranial pressure, but the effects of isolated jugular venous congestion are not well known. Intraventricular pressure (IVP) was compared during direct obstruction of the common jugular veins (bilateral CJV clipping) and during external compression of bilateral CJV flows (Q-test) in a rat model. Intracerebroventricular catheters were inserted into the right lateral ventricle of nine male Sprague-Dawley rats (371.1±44.8 g, 82.2±12.0 days old). The initial mean IVP, arterial pressure (MAP), and pulse rate were 2.8±1.3 mmHg, 88.8±12.7 mmHg, and 348.3±69.1 beats/min, respectively. The mean IVP increment and MAP decrement were 6.5±2.5 and 13.5±5.7 mmHg, respectively, during the Q-test, compared to 2.3±1.5 and 7.3±3.8 mmHg, respectively, during bilateral CJV clipping (all p?=?0.008). The IVP increment and MAP decrement were greater during the Q-test than during bilateral CJV clipping (p?=?0.008 and p?=?0.038). Although the Q-test and bilateral CJV clipping showed similar effects, the response with the Q-test was greater. Thus, the Q-test appears to obstruct other collateral cerebral veins in addition to bilateral CJV flows. Since this model revealed significant differences between the manual Q-test and bilateral CJV clipping, the finding should be taken into account in future studies on the Q-test in SD rats. PMID:23516633

Chou, Chi-Hsiang; Doong, Ming-Luen; Fuh, Jong-Ling; Wu, Jaw-Ching; Wang, Shuu-Jiun

2013-03-13

100

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

Science.gov (United States)

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.

Verma, Roshan Kumar; Kaushal, Darwin; Panda, Naresh K.

2013-01-01

 
 
 
 
101

External jugular vein aneurysm with thrombus presenting as painful neck mass: a case report.  

UK PubMed Central (United Kingdom)

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.

Verma RK; Kaushal D; Panda NK

2013-07-01

102

Transposicão da veia gástrica esquerda ou da veia mesentérica inferior como alternativas de revascularizacão portal no transplante ortotópico de fígado Transposition of the left gastric vein or the inferior mesenteric vein as alternatives to portal reconstruction in orthotopic liver transplantation  

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Full Text Available OBJETIVO: Apresentar e discutir indicações e resultados iniciais de duas alternativas técnicas para reconstrução portal em receptores de transplante hepático com veia porta trombosada ou hipoplásica. MÉTODO: São apresentados três casos de transplante hepático em portadores de veia porta imprestável para revascularização do enxerto. Constatada essa inadequação, por ausência de calibre e fluxo mínimos para uma anastomose segura com a veia porta do doador, a veia gástrica esquerda (duas vezes) ou a veia mesentérica inferior do receptor foi dissecada, ligada distalmente, transposta e anastomosada com a veia porta do doador. RESULTADOS: Nos três casos, as anastomoses resultaram isodiamétricas, sem torsões ou acotovelamentos, permitindo uma revascularização do enxerto homogênea, adequada do ponto de vista macroscópico e funcional, comprovada pela evolução favorável e por fluxometria Doppler pós-operatória. CONCLUSÕES: Os autores concluem que a veia gástrica esquerda e a veia mesentérica inferior podem se constituir em boas alternativas para a reconstrução portal de receptores de transplante hepático com veia porta inadequada.BACKGROUND: Thrombosis or hypoplasia of the portal vein remains an obstacle in orthotopic liver transplantation. The authors present the technique and initial results of two alternatives to portal vein reconstruction in these cases. METHODS: Three patients who suffered end stage liver disease underwent orthotopic liver transplantation. As the portal vein was inadequate in each case, the left gastric vein (two cases) or the inferior mesenteric vein was isolated, tied distally, transposed and anastomosed to the donor portal vein. RESULTS: In all three cases the reperfusion was apparently satisfactory and the postoperative course was uneventful. Doppler ultrasonography and liver function tests confirmed the sufficiency of the portal flow. CONCLUSION: The left gastric vein or the inferior mesenteric vein may be a good alternative to portal reconstruction in liver transplant.

Cláudio Moura Lacerda; Paulo Sergio Vieira de Melo; Américo Amorim; Olival Lucena; Romero Glasner; Maiena E. C. Tenório

2004-01-01

103

Transposicão da veia gástrica esquerda ou da veia mesentérica inferior como alternativas de revascularizacão portal no transplante ortotópico de fígado/ Transposition of the left gastric vein or the inferior mesenteric vein as alternatives to portal reconstruction in orthotopic liver transplantation  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Apresentar e discutir indicações e resultados iniciais de duas alternativas técnicas para reconstrução portal em receptores de transplante hepático com veia porta trombosada ou hipoplásica. MÉTODO: São apresentados três casos de transplante hepático em portadores de veia porta imprestável para revascularização do enxerto. Constatada essa inadequação, por ausência de calibre e fluxo mínimos para uma anastomose segura com a veia porta do doador, (more) a veia gástrica esquerda (duas vezes) ou a veia mesentérica inferior do receptor foi dissecada, ligada distalmente, transposta e anastomosada com a veia porta do doador. RESULTADOS: Nos três casos, as anastomoses resultaram isodiamétricas, sem torsões ou acotovelamentos, permitindo uma revascularização do enxerto homogênea, adequada do ponto de vista macroscópico e funcional, comprovada pela evolução favorável e por fluxometria Doppler pós-operatória. CONCLUSÕES: Os autores concluem que a veia gástrica esquerda e a veia mesentérica inferior podem se constituir em boas alternativas para a reconstrução portal de receptores de transplante hepático com veia porta inadequada. Abstract in english BACKGROUND: Thrombosis or hypoplasia of the portal vein remains an obstacle in orthotopic liver transplantation. The authors present the technique and initial results of two alternatives to portal vein reconstruction in these cases. METHODS: Three patients who suffered end stage liver disease underwent orthotopic liver transplantation. As the portal vein was inadequate in each case, the left gastric vein (two cases) or the inferior mesenteric vein was isolated, tied dista (more) lly, transposed and anastomosed to the donor portal vein. RESULTS: In all three cases the reperfusion was apparently satisfactory and the postoperative course was uneventful. Doppler ultrasonography and liver function tests confirmed the sufficiency of the portal flow. CONCLUSION: The left gastric vein or the inferior mesenteric vein may be a good alternative to portal reconstruction in liver transplant.

Lacerda, Cláudio Moura; Melo, Paulo Sergio Vieira de; Amorim, Américo; Lucena, Olival; Glasner, Romero; Tenório, Maiena E. C.

2004-08-01

104

[Internal jugular venous cannulation: what is the best approach?].  

UK PubMed Central (United Kingdom)

OBJECTIVES: The aim of this study was to compare two approaches used for internal jugular venous cannulation: the anterior way, described by English et al. and the posterior way, described by Jernigan et al. The primary endpoint was the rate of success. The secondary endpoints were the related adverse events and the difficulty factors. STUDY DESIGN: Prospective, randomized open clinical trial. PATIENTS AND METHODS: The study took place in the vital emergency room, the operating room and the emergency intensive care unit of Ibn Sina University hospital (Rabat, Morocco), between June and September 2010. Hundred and one patients needing a central venous catheter were randomized to undergo one of the two techniques. We compared: demographics, success rates, number of attempts, difficulty factors and adverse events. RESULTS: The success rate was significantly higher in the posterior group (96% versus 68%, P < 0.001), with fewer attempts (1.3 ± 0.7 versus 2.1 ± 1.3; P < 0.001). There were less pneumothorax, (0 versus 6%) and more accidental arterial punctures (34 versus 25.5%) in the posterior group, but the difference wasn't significant. Finally, none of the difficulty factors were correlated to the failure rate. CONCLUSION: This study shows that the posterior approach in internal jugular venous cannulation is more efficient than and as safe as the anterior approach.

Lamkinsi T; Kettani A; Belkhadir Z; Tadili J; Benjelloun MY; Mosadik A; Ahid S; Faroudy M

2012-06-01

105

Transmastoid-infralabyrinthine tailored surgery of jugular paragangliomas.  

Science.gov (United States)

This article presents our experience with the management and outcomes of patients with sporadic glomus jugular tumors using a tailored surgical approach. We conducted a retrospective study of 49 patients with sporadic jugular paragangliomas. Thirty-eight patients (78%) were treated using the transmastoid-infralabyrinthine (TM-IL) approach, and 11 (22%) were treated with the infratemporal fossa type A (IFT-A) approach. Mean follow-up period was 8.2 years. Surgical cure was achieved in all but 6 patients using the TM-IL approach (84%) and in 8 of 11 patients with the IFT-A approach (73%). A House-Brackmann grade of I or II facial nerve function was obtained postoperatively in 84% of TM-IL cases and in 56% of the IFT-A cases. The incidence of other complications-meningitis and transient cerebrospinal fluid leak-was higher in the TM-IL group (8% and 13%, respectively) compared with the IFT-A group (0% and 9%, respectively). We concluded that the TM-IL approach with individually tailored management of the facial nerve fulfills the long-term requirements of both keeping good postoperative facial function and obtaining adequate tumor resection. PMID:19568344

Gjuric, Mislav; Bilic, Mario

2009-01-01

106

Transmastoid-infralabyrinthine tailored surgery of jugular paragangliomas.  

UK PubMed Central (United Kingdom)

This article presents our experience with the management and outcomes of patients with sporadic glomus jugular tumors using a tailored surgical approach. We conducted a retrospective study of 49 patients with sporadic jugular paragangliomas. Thirty-eight patients (78%) were treated using the transmastoid-infralabyrinthine (TM-IL) approach, and 11 (22%) were treated with the infratemporal fossa type A (IFT-A) approach. Mean follow-up period was 8.2 years. Surgical cure was achieved in all but 6 patients using the TM-IL approach (84%) and in 8 of 11 patients with the IFT-A approach (73%). A House-Brackmann grade of I or II facial nerve function was obtained postoperatively in 84% of TM-IL cases and in 56% of the IFT-A cases. The incidence of other complications-meningitis and transient cerebrospinal fluid leak-was higher in the TM-IL group (8% and 13%, respectively) compared with the IFT-A group (0% and 9%, respectively). We concluded that the TM-IL approach with individually tailored management of the facial nerve fulfills the long-term requirements of both keeping good postoperative facial function and obtaining adequate tumor resection.

Gjuric M; Bilic M

2009-01-01

107

A veia gástrica esquerda como alternativa de revascularização portal no transplante hepático  

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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 como: 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.

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

2002-01-01

108

MR tomography and MR angiography of an extensive glomus jugulare tumour. MR-Tomographie und MR-Angiographie eines ausgedehnten Glomus-jugulare-Tumors  

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The diagnosis of a glomus jugulare tumour was established by MR tomography and MR angiography. MR tomography demarcated the tumour from the surrounding tissue and MR angiography showed the vascularity of the glomus tumour. (orig.)

Schnarkowski, P. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany)); Stoeter, P. (Neuroradiologische Abt., St. Elisabethen-Krankenhaus, Ravensburg (Germany)); Wallner, B. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany)); Goldmann, A. (Abt. fuer Roentgendiagnostik, Klinikum der Univ. Ulm (Germany))

1993-07-01

109

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)

Full Text Available Abstract in portuguese 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 (more) 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-Gold (FG). METHOD: The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months (more) 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.

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

2012-01-01

110

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)

Full Text Available Abstract in portuguese 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 externa 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 pe (more) rda 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 (more) 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.

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

2007-01-01

111

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  

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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 externa 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.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.

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

2007-01-01

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 per? (more) ?odo 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 in-hospital stay. Our objective is to study the results of subfascial endoscopic perforator surgery associated or not to superficial venous system surgery. METHODS: Prospective, (more) 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.

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

2003-06-01

113

Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the anatomic and radiologic development of the transverse, sigmoid, and occipital sinuses, the emissary veins, and the jugular bulb formation from the jugular sinus in humans before and after birth. METHODS: Roentgenograms of 33 injected brains showing the cranial venous system in human fetuses from 3 to 7 months of gestational age and cerebral angiograms of newborns and infants up to 6 years of age (23 clinical cases) were made and analyzed in detail. Special attention was focused on the inner diameters of the transverse and sigmoid sinuses and of the internal jugular veins, particularly at the sigmoid sinus-internal jugular vein junction. RESULTS: Marked increase in venous flow from the rapidly growing cerebral hemispheres leads to ballooning of the transverse sinuses in the absence of an increase in the inner diameters of the sigmoid and jugular sinuses. The ballooning also results in formation of the occipital sinus, marginal sinus around the foramen magnum, and emissary veins. The formation of the jugular bulbs from the jugular sinuses begins after birth when a shift from a fetal to a postnatal type of circulation (or from a lying-down position to an erect posture) takes place. CONCLUSION: The morphological changes of the posterior fossa dural sinuses, emissary veins, and jugular bulb are closely related to the development of the brain, shift to postnatal type of circulation, and postural hemodynamic changes.

Okudera T; Huang YP; Ohta T; Yokota A; Nakamura Y; Maehara F; Utsunomiya H; Uemura K; Fukasawa H

1994-11-01

114

Internal jugular phlebectasia as an incidental finding in cervical spine surgery  

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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-...

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

115

Robotic stereotactic radiosurgery in patients with unresectable glomus jugulare tumors.  

UK PubMed Central (United Kingdom)

We evaluated the treatment results of robotic stereotactic radiosurgery (SRS) in our patients with unresectable glomus jugulare tumors (GJTs). The medical charts of fourteen patients with GJT, who were treated with robotic SRS, were retrospectively evaluated. The gross tumor volume was described as the clinical target volume. The median dose to the tumor was 25 Gy in median 5 fractions. The dose was normalized to 80% isodose line. All patients were evaluated for tumor growth and clinical outcome every 6 months in the first 2 years and then annually. Median follow-up was 39 months (range, 7-60 months). Lesions were stable in 8 patients, and tumor regression was observed in 6 patients. We did not observe any treatment related toxicity in our patients. In conclusion, according to our early experience, robotic SRS seems to be successful treatment option in the management of unresectable GJTs.

Hurmuz P; Cengiz M; Ozyigit G; Yazici G; Akyol F; Yildiz F; Gurkaynak M; Zorlu F

2013-04-01

116

Right internal jugular venous cannulation complicated by tension hydrothorax.  

Science.gov (United States)

Central Venous Catheter (CVC) is a common procedure performed in patients' management, especially the critically ill ones. CVC has been used as main access in patients requiring large amount of fluid resuscitation, total parenteral nutrition or measuring the central venous pressure. Although most complications associated with central venous cannulation are minimal, local and easy to control, others may be critical and rapidly fatal if not recognized and treated immediately. One of the most serious incidents that can occur post CVC placement is delayed hydrothorax. It usually results from migration and perforation of the catheter through the SVC wall. In this report, we describe a case of tension hydrothorax that occurred a few hours after placement of CVC in the right internal jugular vein. In acutely ill patients that are already unstable, making the diagnosis of tension hydrothorax secondary to CVC placement requires high level of suspicion. Prompt pleural effusion drainage like in our case is crucial for favorable outcome. PMID:23871236

Maroun, Rabih; Chalhoub, Michel; Harris, Kassem

2013-07-18

117

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)

118

Jugular neck dissection for NO neck supraglottic carcinoma  

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Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO). Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%). Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72) of cases, and in 17% (21/121) patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2) yielded occult metastases in 33% (5/15), and 24% (6/25) of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult metastases. The incidence of occult metastases was directly related to the degree of the local spread of the tumor in the supraglottis excluding the epilarynx (Table 1). Occult metastases were usually ipsilateral, like the palpable ones. In medially localized tumors bilateral netastases were possible. Ipsilateral metastases were more frequent than both bilateral and contralateral ones. The possibility of contraiateral and bilateral occult metastases necessitated bilateral neck dissection. Postoperative radiotherapy (60 Gy) was given to all patients with verified occult metastases. Only in two patients (1%) of the total did metastases develop subsequently, indicating the effectiveness of planned postoperatrive radiotherapy. DISCUSSION Controversies in application of jugular, selective neck dissection are presently since it has been in use, because of the unclear role wich regional lymph tissue play in antitumor immune response. Jugular, selective neck dissection was advocated in all patients with a primary supraglottic laryngeal carcinomas. It was suggested that selective neck dissection was needed only in advanced (T3 and T4) tumors. Selective dissection is believed to be needed only when tumor has spread into the vallecula, the base of the tongue, or the medial wall of the piriform sinus. The idea of selective neck dissection has been opposed since the protective role of the cervical lymph tissue has been stressed. Ultrasound and computerized tomography of the neck cannot detect occult metastases. Today, only removal and histological examination of the lymph tissue can determine occult metastasis. The importance of selective neck dissection is considered in diagnostic biopsy procedure by wich occult metastatic spread in the neck region is established. CONCLUSION Due to the tendency of supraglottic carcinoma resulting in occult cervical metastases, early detection is imperative in order to apply the appropriate therapy. Occult cervical metastases are usually ipsilateral, but bilateral and contralateral may be found as well. Due to the aforementioned, it is ne

Petrovi? Željko; Jeli? Svetislav B.; Pen?er Ivica

2004-01-01

119

Sistematização da veia cava caudal em búfalos (Bubalus bubalis bubalis Simpson, 1945)/ Systematization of the caudal vena cava in buffalos (Bubalus bubalis bubalis Simpson, 1945)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Para o presente trabalho utilizou-se 25 animais, fetos de búfalos da Raça Murrah, com idades variando entre 5 e 9 meses, sendo 15 fêmeas e 10 machos, com vistas à dissecação e sistematização dos vasos em estudo. Os animais foram coletados em abatedouro e fixados em solução aquosa de formol 10%. Obtiveramse para a Veia Cava Caudal os seguintes afluentes de origem: as veias ilíacas comuns direita e esquerda, e seus afluentes colaterais; veia sacral mediana; veias (more) frênicas; veias lombares (1-5); veias circunflexas profunda do ílio direita e esquerda; 3-4 veias hepáticas; veia genital direita (testicular ou ovárica); veias adrenais e veias renais direita e esquerda. Abstract in english Twenty-five animals, Murrah, buffaloes fetus, with 5 to 9 months of age (15 females and 10 males) was analyzed by dissection after injected with latex substance. The fetuses were collected in a slaughterhouse and fixed in aqueous formol solution 10%. In the Caudal Vena Cava the following origin tributaries were observed: the common right and left iliac veins and collateral tributaries; the median sacral vein; frenic vein; 1-5 Lumbar veins; the circumflex deep veins of the (more) right and left ileum; 3-4 hepatic veins; right genital vein (testicular or ovarian); adrenal vein and renal right and left veins.

Amorim Júnior, Adelmar Afonso de; Miglino, Maria Angélica; Amorim, Marleyne José Afonso Accioly Lins; Santos, Tatiana Carlesso dos

2002-01-01

120

Morbilidad y mortalidad geriátricas en medicina interna  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se realizó un estudio descriptivo, lomgitudinal y retrospectivo para determinar las principales causas de morbilidad y mortalidad geriátricas en el Servicio de Medicina Interna del Hospital "Carlos Manuel de Céspedes". Se estudiaron 1 393 pacientes que ingresaron en el período comprendido entre el primero de enero y el 31 de diciembre de 1991. La principal causa de morbilidad y de mortalidad en mayores de 65 años fue la bronconeumonía bacteriana con 24,12 y 31 % res (more) pectivamente, le siguieron en frecuencia las enfermedades cerebrovasculares y las del corazón. Las principales complicaciones fueron la flebitis y la bronconeumonía hipostática, las cuales predominaron en los fallecidos con el 52,74 %. Se realizaron 289 necropsias (74,68 %). Este índice se consideró bajo aunque existió alta correlación clínico-patológico (91,01 %). Abstract in english A descriptive, longitudinal, and retrospective study was conducted to determine the main causes of geriatric mortality and morbidity in the service of Internal Medicine from "Carlos Manuel de Céspedes" Hospital. The study comprised a group of 1 393 patients who were admitted during the period of January, 1st and December, 31, 1991. The main cause of morbidity and mortality in subjects over 65 years was found to be bacterial bronchopneumonia accounting for 24, 12, and 31 (more) %, respectively, followed regarding frequency by cerebrovascular and heart diseases. Major complications appeared to be phlebitis and hypostatic bronchopneumonia accounting for 52.74 % of deaths. A number of 289 autopsies (74.68 %) were performed. This index was considered low although there was a high clinicopathological correlation (91.01 %).

Reyes Tornés, Reynaldo; Cand Huerta, Cosme Manuel

1996-08-01

 
 
 
 
121

Morbilidad y mortalidad geriátricas en medicina interna  

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Full Text Available Se realizó un estudio descriptivo, lomgitudinal y retrospectivo para determinar las principales causas de morbilidad y mortalidad geriátricas en el Servicio de Medicina Interna del Hospital "Carlos Manuel de Céspedes". Se estudiaron 1 393 pacientes que ingresaron en el período comprendido entre el primero de enero y el 31 de diciembre de 1991. La principal causa de morbilidad y de mortalidad en mayores de 65 años fue la bronconeumonía bacteriana con 24,12 y 31 % respectivamente, le siguieron en frecuencia las enfermedades cerebrovasculares y las del corazón. Las principales complicaciones fueron la flebitis y la bronconeumonía hipostática, las cuales predominaron en los fallecidos con el 52,74 %. Se realizaron 289 necropsias (74,68 %). Este índice se consideró bajo aunque existió alta correlación clínico-patológico (91,01 %).A descriptive, longitudinal, and retrospective study was conducted to determine the main causes of geriatric mortality and morbidity in the service of Internal Medicine from "Carlos Manuel de Céspedes" Hospital. The study comprised a group of 1 393 patients who were admitted during the period of January, 1st and December, 31, 1991. The main cause of morbidity and mortality in subjects over 65 years was found to be bacterial bronchopneumonia accounting for 24, 12, and 31 %, respectively, followed regarding frequency by cerebrovascular and heart diseases. Major complications appeared to be phlebitis and hypostatic bronchopneumonia accounting for 52.74 % of deaths. A number of 289 autopsies (74.68 %) were performed. This index was considered low although there was a high clinicopathological correlation (91.01 %).

Reynaldo Reyes Tornés; Cosme Manuel Cand Huerta

1996-01-01

122

Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases Anastomose intra-extracraniana com enxerto de veia safena no tratamento de aneurismas gigantes do seio cavernoso: relato de dois casos  

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Full Text Available Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.Aneurismas gigantes da porção intracavernosa da artéria carótida interna frequentemente são inoperáveis por serem fusiformes ou apresentarem colo muito largo. Ligadura da artéria carótida interna é muitas vezes o tratamento de escolha para esses pacientes. Esse procedimento apresenta no entanto alta incidência de complicações isquêmicas agudas e tardias. Dois casos de aneurismas gigantes da porção intracavernosa são apresentados. Esses aneurismas foram tratados com cirurgia de "bypass"com enxerto de veia safena magna entre a artéria carótida externa e ramo M2 da artéria cerebral média e oclusão endovascular da artéria carótida interna. Revascularização com enxerto de alto fluxo sanguineo ocorreu nos dois pacientes não se observando nenhuma alteração isquêmica no período pós-operatório. O seguimento desses pacientes após 8 e 14 meses mostrou patência dos enxertos venosos e ausência de alteração no exame neurológico. A oclusão dos aneurismas e a patência dos enxertos foi confirmada com angiografias de controle.

RICARDO RAMINA; MURILO S. MENESES; ARI A PEDROZO; WALTER O. ARRUDA; GUILHERME BORGES

2000-01-01

123

Tratamento da síndrome da veia cava superior Treatment of superior vena cava syndrome  

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Full Text Available A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose) e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia) decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em direção ao átrio direito. A obstrução pode ser causada por compressão extrínseca, invasão tumoral, trombose ou por dificuldade do retorno venoso ao coração secundária a doenças intra-atriais ou intraluminais. Aproximadamente 73% a 97% dos casos de síndrome da veia cava superior ocorrem durante a evolução de processos malignos intratorácicos. A maioria dos pacientes com a síndrome secundária a neoplasias malignas é tratada sem necessidade de cirurgia, através de radioterapia ou quimioterapia, ou através da colocação de stents endoluminais. Quando a síndrome é de etiologia benigna, o tratamento é feito através de medidas clínicas (anticoagulação, elevação da cabeça, etc.) ou, em casos refratários, através de angioplastia, colocação de stents endoluminais e cirurgia.The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis) and symptoms (headache, dyspnea, cough, orthopnea and dysphagia) caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return secondary to intra-atrial or intraluminal diseases. From 73% to 93% of all cases of superior vena cava syndrome occur during the development of an intrathoracic tumor. Most patients presenting superior vena cava syndrome secondary to malignant neoplasms are treated without surgery, through radiotherapy, chemotherapy or the use of intraluminal stents. When the etiology of superior vena cava syndrome is benign, it can be treated with clinical measures (anticoagulation, raising the head, etc.) or, in refractory cases, with angioplasty, stents or surgery.

Luís Marcelo Inaco Cirino; Rafael Ferreira Coelho; Ivan Dias da Rocha; Bernardo Pinheiro de Senna Nogueira Batista

2005-01-01

124

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

1997-01-15

125

Retro-tympanic pulsatile mass originating from dumb-bell jugular foramen schwannoma.  

UK PubMed Central (United Kingdom)

BACKGROUND: Jugular foramen (JF) tumours are uncommon with paraganglioma, schwannoma and meningioma occurring most commonly in this location. JF schwannoma with extension to the retro-tympanic area has been described only once. METHODS: 20-year-old man presented with headache, blurred vision, vomiting and diplopia. FINDINGS: A left pulsatile retro-tympanic mass was seen at otoscopy. A jugular foramen tumour was found on CT and MR images. The intracranial portion of the tumour later diagnosed as schwannoma was removed. Control ENT examination confirmed that the residual retro-tympanic mass was no-longer pulsatile. CONCLUSIONS: Jugular foramen schwannomas may also extend into the retro-tympanic area.

Bakar B; Percin AK; Tekkok IH

2008-03-01

126

Reversible cochleo-vestibular deficits in two cases of jugular foramen tumor after surgery.  

UK PubMed Central (United Kingdom)

Primary jugular foramen (JF) tumor, such as glomus jugular tumor or JF schwannoma, may manifest as a lower cranial nerve deficit; in addition, it can be accompanied by deafness or vertigo if it affects the cranial nerve (CN) VIII. Recently, we encountered JF schwannoma 1 and glomus jugulare tumor 1. Both cases invaded the adjacent cerebellopontine angle, leading to cochleo-vestibular deficits prior to the operation. After surgery, recovery of the audiovestibular function, including hearing, auditory brainstem response and caloric response, was anticipated in both patients. Therefore, cochleo-vestibular deficits in JF tumors can be attributed to compression neuropathy, rather than tumor infiltration.

Wang SJ; Hsu WC; Young YH

2004-05-01

127

Reversible cochleo-vestibular deficits in two cases of jugular foramen tumor after surgery.  

Science.gov (United States)

Primary jugular foramen (JF) tumor, such as glomus jugular tumor or JF schwannoma, may manifest as a lower cranial nerve deficit; in addition, it can be accompanied by deafness or vertigo if it affects the cranial nerve (CN) VIII. Recently, we encountered JF schwannoma 1 and glomus jugulare tumor 1. Both cases invaded the adjacent cerebellopontine angle, leading to cochleo-vestibular deficits prior to the operation. After surgery, recovery of the audiovestibular function, including hearing, auditory brainstem response and caloric response, was anticipated in both patients. Therefore, cochleo-vestibular deficits in JF tumors can be attributed to compression neuropathy, rather than tumor infiltration. PMID:13680260

Wang, Shou-Jen; Hsu, Wei-Chung; Young, Yi-Ho

2003-09-09

128

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

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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.

Alexandre Antonio Marques Rosa

2003-01-01

129

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 cateter com ponta deflectível e eletrodo distal de 4mm. RESULTADOS: Em seguimento médio de 12±5 meses, 25 (51%) pacientes não apresentaram recorrência de fibrilação atrial e 24 (49%) apresentaram pelo menos uma recorrência. Em 20 (83%), a 1ª crise ocorreu antes do 1º mês e em 4, após 2 a 9 meses. Após a introdução de drogas antiarrítmicas, 15 (63%) pacientes apresentaram melhora importante, 10 tornaram-se assintomáticos, 5 referiam crises raras, auto-limitadas e de curta duração e 9 (37%) permaneceram com as manifestações clínicas inalteradas, apesar das drogas antiarrítmicas e foram encaminhados à nova intervenção. No final do seguimento, 35 (71%) pacientes permaneciam em ritmo sinusal estável sem recorrência de fibrilação atrial, após um único procedimento, 50% dos quais sem drogas antiarrítmicas. CONCLUSÃO: A maioria dos pacientes com fibrilação atrial paroxística sintomática, não controlados com medicação antiarrítmica, obtém controle clínico após um único procedimento de isolamento das veias pulmonares.

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

2004-01-01

130

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 mole 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 consultation, 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.

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

2009-12-01

131

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

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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

A. E. F. S. Almeida; I. L. S. Prada

2005-01-01

132

Early jugular bulb oxygenation monitoring in comatose patients after an out-of-hospital cardiac arrest.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the role of early jugular bulb oxygenation monitoring in comatose patients after cardiac arrest. DESIGN: Prospective sequential study. SETTING: Medical intensive care unit in a university hospital. PATIENTS: Thirteen patients comatose after out-of-hospital cardiac arrest. INTERVENTIONS: A standard hemodynamic protocol. MEASUREMENTS AND RESULTS: Jugular bulb oxygen saturation levels and oxygen extraction ratios could not discriminate between patients with good (6) and poor (7) cerebral outcome. This was also true for the jugular bulb-arterial lactate difference. Survivors had significantly higher overall oxygen transport values than non-survivors. CONCLUSIONS: Jugular bulb oxygenation monitoring during the first few hours after cardiac arrest cannot reliably discriminate between comatose patients with a good and poor cerebral outcome. Further studies with an extended monitoring period are thus required.

van der Hoeven JG; de Koning J; Compier EA; Meinders AE

1995-07-01

133

[Postauricular tran-supracondylar approach removed jugular foramen and hypoglossal canal tumors].  

UK PubMed Central (United Kingdom)

OBJECTIVE: Discuss the surgical treatment of jugular foramen and hypoglossal canal tumor, and choice of the best surgical approach. METHODS: 32 patients with jugular foramen and hypoglossal canal tumor were operated through the postauricular tran-supracondylar approach, 13 neurinoma, 7 glomus jugular tumors, 4 meningioma, 3 chordoma. 23 were total removed, with a subtotal of 9. RESULTS: 21 patients were followed up, mean 2.5 years. 18 patients work normally, 7 of them were hoarseness, 2 of other 3 patients lived by themselves, 1 of existed obstruct of limbs. CONCLUSIONS: Postauricular tran-supracondylar approach exposes satisfactory for the dumbbell-shape tumors of intra-or extra cranial. It has high rate of total removal and low rate of complications. It is the best approach of treatment in jugular foramen and hypoglossal canal tumors. The outcome is good.

Wu Z; Zhang JT; Jia GJ

2004-02-01

134

Internal jugular phlebectasia as an incidental finding in cervical spine surgery  

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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.

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

2010-01-01

135

Depresión: Visión holística de la medicina interna*  

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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.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 astonishes 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 patient liberty and integrity and to pre

Italo Marsiglia G

2008-01-01

136

Jugular Valve Incompetence in Transient Global Amnesia. A Problem Revisited.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Previous studies have suggested that transient global amnesia (TGA) may be provoked by cerebral venous congestion due to a reflux during Valsalva maneuver (VM) caused by internal jugular venous valve incompetence (IJVVI). We investigated the hemodynamic consequences of postural changes on IJVVI and on intracranial veins in patients with TGA and control subjects. MATERIALS AND METHODS: IJVVI was assessed by means of extracranial color-coded duplex sonography during VM in 28 patients with TGA and 25 controls. The basal vein Rosenthal was examined by transcranial color-coded sonography registering flow velocities (FV) at rest and during VM. These measurements were performed in the supine and in a sitting position. RESULTS: IJVVI was identified in supine position in 19/28 (68%) of TGA patients and in 7/25 (28%) of controls (P < .05). Body position had no effect on the detection of IJVVI. Intracranial venous FV at rest and during VM did neither differ between patients and controls, nor between persons with and without IJVVI. CONCLUSIONS: Consistent with results of other groups, we found a significantly higher rate of IJVVI in TGA patients compared to controls. However, we found no differences of intracranial venous circulation between groups nor an effect of body position. This sheds doubt on the assumption of a causative effect of IJVVI in TGA.

Lochner P; Nedelmann M; Kaps M; Stolz E

2013-09-01

137

Brachial plexus palsy due to subclavian artery pseudo aneurysm from internal jugular cannulation  

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Full Text Available Internal jugular vein is the preferred route for central venous cannulation because of easy accessibility and high success rate. Arterial puncture is the most common complication, the reported incidence being 9.3%. However, brachial plexus palsy following arterial puncture is a rare complication of this procedure. We report a case of brachial plexus palsy due to compression by right subclavian pseudoaneurysm as a result of internal jugular vein cannulation in chronic renal failure patient.

Modi Manisha; Shah Veena

2007-01-01

138

Radiculopathy due to iatrogenic fistula between subclavian artery and internal jugular vein.  

Science.gov (United States)

Central venous cannulation is a routine procedure. We describe a rare complication of internal jugular vein catheterization leading to radiculopathy of the right upper arm. MRI of the neck showed compression of the spinal cord and C2-C7 roots by the engorged veins. Digital subtraction angiography demonstrated a fistula between subclavian artery and internal jugular vein. The fistula was successfully occluded by stent placement in the artery. PMID:18031927

dos Santos, Marcio Luiz Tostes; Demartini, Zeferino; Matos, Luiz Afonso Dias; Borges, Moacir Alves; Spotti, Antonio Ronaldo; Tognola, Waldir Antonio

2007-11-26

139

The role of radiation therapy in the treatment of glomus jugulare tumors.  

UK PubMed Central (United Kingdom)

The records of 14 patients who received irradiation for incompletely excised, inoperable or recurrent glomus jugulare tumors were retrospectively reviewed. Ages ranged from 12 to 66 years, and the male to female ratio was 1:3. With a follow-up time of 1.3 to 17.2 years (mean of 7.7 years), 11/14 remain clinically disease-free. Doses of at least 4000 rad are shown to be effective in controlling glomus jugular tumors.

Simko TG; Griffin TW; Gerdes AJ; Parker RG; Tesh DW; Taylor W; Blasko JC

1978-07-01

140

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.

2000-01-01

 
 
 
 
141

Sonographic findings of the internal jugular vein valve in normal children  

Energy Technology Data Exchange (ETDEWEB)

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.

Youk, Dong Joon; Rho, Taek Soo; Lee, Min Jin; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

2000-12-15

142

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)

Full Text Available Abstract in spanish 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 (more) 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 si (more) de 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.

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

2012-09-01

143

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)

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.

Susmita Ghosh; Lopamudra Mandal; Sanchita Roy; Manimay Bandyopadhyay

2012-01-01

144

Descarga Interna e Tensão de Retorno em Capacitores  

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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.

Robert Renê

2001-01-01

145

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

DEFF Research Database (Denmark)

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

BrØndum, E.; Hasenkam, John Michael

2009-01-01

146

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

UK PubMed Central (United Kingdom)

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.

Brøndum E; Hasenkam JM; Secher NH; Bertelsen MF; Grøndahl C; Petersen KK; Buhl R; Aalkjaer C; Baandrup U; Nygaard H; Smerup M; Stegmann F; Sloth E; Ostergaard KH; Nissen P; Runge M; Pitsillides K; Wang T

2009-10-01

147

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

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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.

Milton Baggio Moreira

1977-01-01

148

Hemorragia adrenal bilateral com trombose da veia renal direita e veia cava inferior em um recém-nascido Bilateral adrenal hemorrhage associated with right renal vein and inferior vena cava thrombosis in a newborn  

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Full Text Available Os autores apresentam um caso de um recém-nascido com um tipo raro de associação de hemorragia adrenal bilateral com trombose de veia renal direita e de veia cava inferior, em que os exames de ultra-sonografia e tomografia computadorizada exerceram papel crucial no estabelecimento do diagnóstico, orientação da conduta e seguimento do paciente.We report a rare case of coexisting bilateral adrenal hemorrhage, right renal vein and inferior vena cava thrombosis in a neonate. Imaging studies played an important role in the diagnosis, management, and follow-up of this patient.

Severino Aires de Araújo Neto; Rodrigo Tranquilini Rezende; Antônio Soares de Souza; José Maria Pereira de Godoy

2003-01-01

149

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

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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.

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

2009-01-01

150

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

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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.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 thrombosis. 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.

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

2012-01-01

151

Preoperative embolization of the inferior petrosal sinus in surgery for glomus jugulare tumors.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the outcomes of surgery for glomus tumors involving the jugular foramen with and without preoperative venous embolization of the inferior petrosal sinus (IPS). STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Twenty-four patients with paragangliomas involving the jugular foramen treated between 1995 and 2008. INTERVENTION: All patients underwent surgical resection after receiving preoperative angioembolization with or without venous embolization of the IPS. MAIN OUTCOME MEASURES: Total operative duration, estimated blood loss, intensive care unit and total hospital days, and novel postoperative lower cranial nerve deficits were recorded, and appropriate statistical analysis was conducted. RESULTS: Twenty-four patients met inclusion criteria. Fourteen of these patients underwent preoperative embolization of the IPS in addition to angioembolization. The group that did not undergo embolization of the IPS was used as the control group (n = 10). These groups were compared with regard to the above outcome measures. Blood loss and new lower cranial nerve deficits were reduced in the venous embolization group, although neither measure reached statistical significance. Tumor size correlated with increased intraoperative hypotensive events and longer total hospital stay, and these correlations were statistically significant. CONCLUSION: Preoperative embolization of the IPS is possible in many patients undergoing surgery of the jugular foramen. The addition of venous embolization to the traditional arterial embolization of glomus jugulare tumors adds little additional time or expense to the procedure and facilitates control of bleeding once the jugular bulb has been opened.

Warren FM 3rd; McCool RR; Hunt JO; Hu N; Ng PP; Buchmann LP; Shelton C

2011-12-01

152

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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 vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter plac (more) ement, 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

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

2009-01-01

153

[Compression of the trachea by a hematoma caused by an internal jugular vein catheter  

UK PubMed Central (United Kingdom)

In a patient with thrombocytopenia, respiratory obstruction because of a hematoma occurred following internal jugular vein cannulation. This patient recovered completely after surgical intervention. With the following precautions in mind, puncture of the internal jugular vein in patients with coagulopathies has a high success rate and does not result in severe complications: Internal jugular vein cannulation by an experienced physician; optimal conditions for puncture by increasing venous pressure and diameter with slight Trendelenburg position and Valsalva maneuver in patients with spontaneous breathing, or positive end-expiratory pressure in patients with artificial ventilation; catheter insertion by the Seldinger technique; manual compression of the puncture site for 10-15 min; and vein puncture with ultrasonographic aid if possible.

Janda A

1990-07-01

154

Pulse-spray treatment of total occlusive jugular venous suppurative thrombophlebitis.  

UK PubMed Central (United Kingdom)

A 63-year-old man was diagnosed with jugular venous suppurative thrombophlebitis after undergoing strangulation ileus surgery. His condition was not stabilized by therapy with antibiotics, heparin or other supportive treatments. Pulse-spray treatment (PST) was administered, following which, the patient was afebrile without symptoms and the laboratory data improved. There were no complications such as sustained sepsis, septic embolisms or pulmonary embolisms. This is a unique case report of the use of a pulse-spray catheter in the treatment of total occlusive jugular venous suppurative thrombophlebitis following the failure of medical therapy.

Kan'o T; Nishimaki H; Kataoka Y; Soma K

2013-01-01

155

Contrast media reflux into the jugular vein with peripheral bolus injection  

International Nuclear Information System (INIS)

[en] 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.)

1983-01-01

156

The role of radiation therapy in the treatment of glomus jugulare tumors.  

Science.gov (United States)

The records of 14 patients who received irradiation for incompletely excised, inoperable or recurrent glomus jugulare tumors were retrospectively reviewed. Ages ranged from 12 to 66 years, and the male to female ratio was 1:3. With a follow-up time of 1.3 to 17.2 years (mean of 7.7 years), 11/14 remain clinically disease-free. Doses of at least 4000 rad are shown to be effective in controlling glomus jugular tumors. PMID:208745

Simko, T G; Griffin, T W; Gerdes, A J; Parker, R G; Tesh, D W; Taylor, W; Blasko, J C

1978-07-01

157

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

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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 anoth...

Moini Majid; Rasouli Mohammad; Kenari Mohammad; Mahmoodi Hamid

158

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 n (more) inhos). 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 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 (more) 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

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

1991-06-01

159

A comparison of external and internal jugular venous pressures to monitor pulmonary artery pressure after superior cavopulmonary anastomosis.  

UK PubMed Central (United Kingdom)

The internal jugular vein continues to be the preferred site for cannulation to monitor central venous pressure despite the reported evidence of the accuracy of external jugular venous pressure (EJVP) to reliably predict internal jugular venous pressure (IJVP). Internal jugular venous cannulation carries a risk of thrombosis that can be life-threatening in children undergoing superior cavopulmonary anastomosis and a subsequent Fontan procedure. The present study compared IJVP and EJVP in children undergoing superior cavopulmonary anastomosis and found no statistical and clinical difference between IJVP and EJVP. Thus, external jugular vein cannulation reliably predicts IJVP and pulmonary artery pressures in children undergoing superior cavopulmonary anastomosis, and may obviate the risk of life-threatening cavopulmonary thrombosis.

Malik M; Chauhan S; Vijayakanthi B; Talwar S; Nair VV; Vasdev S

2011-12-01

160

A comparison of external and internal jugular venous pressures to monitor pulmonary artery pressure after superior cavopulmonary anastomosis.  

Science.gov (United States)

The internal jugular vein continues to be the preferred site for cannulation to monitor central venous pressure despite the reported evidence of the accuracy of external jugular venous pressure (EJVP) to reliably predict internal jugular venous pressure (IJVP). Internal jugular venous cannulation carries a risk of thrombosis that can be life-threatening in children undergoing superior cavopulmonary anastomosis and a subsequent Fontan procedure. The present study compared IJVP and EJVP in children undergoing superior cavopulmonary anastomosis and found no statistical and clinical difference between IJVP and EJVP. Thus, external jugular vein cannulation reliably predicts IJVP and pulmonary artery pressures in children undergoing superior cavopulmonary anastomosis, and may obviate the risk of life-threatening cavopulmonary thrombosis. PMID:21885538

Malik, Madhur; Chauhan, Sandeep; Vijayakanthi, Bhuvana; Talwar, Sachin; Nair, Vinitha V; Vasdev, Sumit

2011-09-01

 
 
 
 
161

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)

2009-01-01

162

Afluência da veia esplênica e sua importância nas derivações esplenorrenais seletivas Splenic tributaries and their importance on selective splenorenal shunts  

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Full Text Available Os autores realizaram estudo da afluência da veia esplênica utilizando 38 moldes de duodeno, estômago, pâncreas e baço, por meio da técnica de repleção e corrosão, com vinilite corado com azul da Prússia. Os afluentes encontrados foram: ramos pancreáticos em todas as peças, variando de 7 a 22 ramos, com média de 14,52 ± 3,53; a veia gástrica esquerda, em 36,84% das peças; a veia mesentérica inferior em 44,74% das peças; ramo gástrico (gástrica posterior), proveniente do fundo gástrico, em 57,89% das peças, e ramos pancreáticos, provenientes da cauda do pâncreas e desembocando em ramos segmentares da veia esplênica, em 65,79% das peças. Os ramos pancreáticos variaram em número de um a quatro, com média de 1,64 ± 0,95. Os autores concluem que o conhecimento dos afluentes da veia esplênica seria importante na realização das derivações esplenorrenais distais, quando associadas à desconexão esplenopancreática.The authors present a study of 38 vinyl acetate models of duodenum, pancreas, stomach and spleen where the tributaries of the splenic veins were identified and quantified. It was found that all the splenic veins receive pancreatic veins. The number of those veins ranged between seven and 22, median of 14.52±3.53. The left gastric vein joined the splenic vein in 36.84% of the models. The inferior mesenteric vein joined the splenic vein in 44.74% of the models. One gastric vein, from the fundus of the stomach, joined the splenic vein in 57.89% of the models. On 65.79% of the models, pancreatic veins from the tail of the pancreas ended in a segmental vein of the spleen. They range from one to four with a median of 1.64±0.95. The authors concluded that the knowledge of the number and frequency of splenic vein tributaries would be important in the distal splenorenal shunt when associated with spleno-pancreatic disconnection.

Claudio Piras; Alcino Lázaro da Silva

1998-01-01

163

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

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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.

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

2008-01-01

164

Foramen jugulare: a local investigation and a review of the literature.  

UK PubMed Central (United Kingdom)

The jugular foramen varies in size and shape. Because of the variations and the surrounding structures, successful surgery is difficult in this region. For this reason, numerous studies have investigate the detailed anatomy of the foramen. The purpose of the present study is to investigate the possible local variations of the foramen jugulare. In this work, Eastern Anatolian skulls were examined in order to investigate the local variety. Extracranial opening of the foramen was only measured in diameters as maximum anteroposterior (AP) and mediolateral diameter (ML) of both right and left foramen. The height of the jugular fossa was taken as the dome height (DH). The results were in mm (right-left) as: AP (12.2-10.9); ML (13.7-12.3); DH (14-13.7). The present study suggested that local differences of the jugular foramen in relative size and shape might occur. These differences are probably peculiar to the region or probably the result of some particular clinical situation.

Aydinlio?lu A; Ye?ilyurt H; Diyarbakirli S; Erdem S; Da?tan A

2001-12-01

165

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

Directory of Open Access Journals (Sweden)

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.

Ketu Chauhan; Rekha Lalwani; Gulzari Lal Nigam; Ashwin Krishnamurthy

2011-01-01

166

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

Science.gov (United States)

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 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. PMID:19657096

Brøndum, E; Hasenkam, J M; Secher, N H; Bertelsen, M F; Grøndahl, C; Petersen, K K; Buhl, R; Aalkjaer, C; Baandrup, U; Nygaard, H; Smerup, M; Stegmann, F; Sloth, E; Ostergaard, K H; Nissen, P; Runge, M; Pitsillides, K; Wang, T

2009-08-05

167

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 pat...

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

168

Brachial plexus paralysis of a dominant arm due to hematoma associated with internal jugular vein cannulation.  

UK PubMed Central (United Kingdom)

Paralysis and sensory loss of a dominant right arm developed as complications of cannulation of the right internal jugular vein (IJV) in a patient undergoing cardiac surgery. This sequela of IJV cannulation has not been previously reported at the time of this writing.

Hassan M; Karras R; Salerno T; Panos AL

2013-03-01

169

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

International Nuclear Information System (INIS)

[en] 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

2008-01-01

170

Surgical Procedure for the Chronic Cannulation of the Carotid Artery and the Jugular Vein in Dogs.  

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A surgical procedure has been developed for the implantation of chronic cannulae in the carotid artery and the jugular vein. The method is simple to perform and allows serial blood samples to be drawn. Infusions of various drugs may be done at the same ti...

K. E. Leach L. Prud'homme-Lalonde R. K. Harding M. Bosc-Davie

1986-01-01

171

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

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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 vein 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 < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.

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

2009-01-01

172

Ophthalmoplegia secondary to raised intracranial pressure after unilateral neck dissection with internal jugular vein sacrifice.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Neck dissection is commonly performed in the management of head and neck malignancy and may involve internal jugular vein (IJV) sacrifice. Potential complications include intracranial hypertension. This is well documented after bilateral neck dissection, although only scattered reports exist after u...

Ward, MJ; Faris, C; Upile, T; Patel, NN

173

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  

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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)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 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).

Renato De Vecchis; Antonio Ciccarelli; Carmelina Ariano

2012-01-01

174

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

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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 de 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.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 thrombosis 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.

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

2006-01-01

175

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

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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.

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

2003-01-01

176

Uso de biogás em motores de combustão interna  

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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.

Ana Beatryz Prenzier Suzuki; Dangela Maria Fernandes; Rui Alexandre Pereira Faria; Thais Cristina Morais Vidal

2011-01-01

177

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)

Full Text Available Abstract in portuguese 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 relevance of knowledge on mammographic signs of systemic diseases.

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

2013-07-01

178

Corynebacterium pseudotuberculosis associated with otitis media-interna in goats  

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Full Text Available Corynebacterium pseudotuberculosis or caseous lymphadenitis is a common condition in sheep and goats. Two cases are described involving otitis media-interna and, in one case, cerebellar abscessation. The first case began with otitis externa and progressed to cerebellar abscessation, presumably as a result of C. pseudotuberculosis infection based on the macroscopic appearance of the abscess. The second case of otitis media-interna involved C. pseudotuberculosis with parasitic encephalitis or secondary meningo-encephalitis. Caseous lymphadenitis is a worldwide problem in livestock and also has zoonotic implications. Antimicrobial therapy of abscesses is often unrewarding due to the thick encapsulation of the abscesses and the extremely contagious nature of the organism. Alternative measures of treating this condition must be sought. In flocks or herds where caseous lymphadenitis has been diagnosed, it should be considered as a differential diagnosis for neurological conditions. The potential for spread must be kept in mind when it is suspected to be the cause of otitis in livestock.

Maria J. Grobler; David J.C. Blignaut; Maria J. Grobler

2013-01-01

179

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

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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.

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

2006-01-01

180

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

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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.

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

2010-01-01

 
 
 
 
181

The occurrence, variations and diameter of the human condylar canal in relation to the jugular foramen.  

Science.gov (United States)

In medical practice, especially in analysis of radiograms and computed tomography scans, it is very important to be familiar with the anatomy of the skull base, not only the normal and typical anatomical structures but also the variations and anomalies. One of the important venous foramina of the human skull is the condylar canal. This structure is described as the most stable and permanent venous emissary, with a prevalence of up to 100%. In our study, based on 100 human macerated skulls, this canal was encountered in 81% of cases. In several it was double. We have not encountered any information on this in the available literature. We found that the condylar canal in humans could be double and that the size of the external opening of this canal is not crucial in relation to the size of the jugular foramen. There was no significant correlation between the jugular foramen and the condylar canal in our specimens. PMID:16783729

Wysocki, J; Sharifi, M

2006-02-01

182

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

UK PubMed Central (United Kingdom)

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.

Tamizifar B; Beigi A; Rismankarzadeh M

2013-01-01

183

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

Science.gov (United States)

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.

Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam

2013-01-01

184

Mixoma de átrio direito com origem na veia cava inferior: uma localização rara com implicações diagnósticas e terapêuticas  

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Full Text Available Os mixomas são os tumores cardíacos primários mais freqüentes. Sua localização habitual é o átrio esquerdo, sendo encontrados também em outros locais. É relatado o caso de paciente de 71 anos que, com diagnóstico de tumor em átrio direito, foi submetido a operação para retirada do tumor. A operação foi realizada, sendo confirmado o diagnóstico e procedida a ressecção do tumor com sucesso e sem intercorrência. Em estudo ecocardiográfico de controle no 4º mês de pós-operatório, evidenciou-se presença de massa residual que parecia originar-se na veia cava inferior. Foi submetida a nova operação, em que foi realizada a ressecção do mixoma, que se originava na veia cava inferior e se projetava para o interior do átrio direito. Com o tumor, foi ressecada, na sua implantação, uma porção da veia cava inferior. O presente relato mostra uma localização rara de origem do mixoma, bem como as complicações quanto ao diagnóstico e à abordagem no tratamento cirúrgico.

STOLF Noedir A. G.; BENÍCIO Anderson; MOREIRA Luiz Felipe P.; ROSSI Eduardo

2000-01-01

185

Comparison of two different approaches for internal jugular vein cannulation in surgical patients.  

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Full Text Available We compared the anterior approaches of internal jugular venous cannulation in 200 surgical patients, vis-Ã -vis the ease of cannulation and threading, number of attempts required and the incidence of complications following each route. The technique of posterior approach used in this study was found to have a higher rate of success in cannulation and lower rate of complication such as carotid puncture. The posterior approach was also a safe alternate route in obese or short necked patients.

Chudhari L; Karmarkar U; Dixit R; Sonia K

1998-01-01

186

Endovascular retrieval of embolized jugular catheter fragments in three dogs using a nitinol gooseneck snare.  

UK PubMed Central (United Kingdom)

Two dogs were referred to the Kansas State University Veterinary Medical Teaching Hospital for pulmonary arterial embolization and one to Washington State University Veterinary Teaching Hospital for right heart embolization of jugular catheter fragments. Endovascular retrieval of foreign bodies was accomplished under general anesthesia in all three cases. Although the incidence of, and complications associated with catheter embolization in dogs are unknown, it appears that they can be safely and easily retrieved with a nitinol gooseneck snare.

Gentile JM; Bulmer BJ; Heaney AM; Bordelon S

2008-06-01

187

Staged Gamma Knife radiosurgery after tailored surgical resection: a novel treatment paradigm for glomus jugulare tumors.  

UK PubMed Central (United Kingdom)

OBJECT: Although benign and slow growing, glomus jugulare tumors can be locally aggressive because of their proximity to lower cranial nerves and major vascular structures. Surgical resection frequently leads to complications, and radiosurgery alone often does not relieve symptoms. We report a novel treatment paradigm of tailored surgical resection followed by staged radiosurgery that allows for tissue diagnosis and immediate improvement of symptoms and tumor control without the morbidity of radical surgical resection. METHODS: Five patients with glomus jugulare tumors and contraindications to extensive surgery each underwent an outpatient otologic procedure to resect the portion of the tumor in the middle ear and mastoid with no attempt to remove tumor in the jugular bulb. Each patient returned 2-5 months later for Gamma Knife radiosurgery to the remainder of the tumor, which consisted of one 15-Gy dose prescribed to the 50% isodose curve. Patients were followed through outpatient visits and surveillance MR imaging for up to 3 years. RESULTS: All patients were successfully treated as outpatients. Each had improvement or resolution of pulsatile tinnitus and otalgia and preserved or improved hearing. One patient developed a delayed facial palsy prior to radiosurgery that resolved completely; there were no other changes in cranial nerve function after either procedure. Tumor volume was stable or reduced in all patients at most recent follow-up, and there were no immediate or delayed complications. CONCLUSIONS: Staged outpatient microsurgical and radiosurgical therapy for glomus jugulare tumors in the symptomatic patient is safe and yields favorable results regarding tumor size, tinnitus, hearing and cranial nerve status.

Miller JP; Semaan M; Einstein D; Megerian CA; Maciunas RJ

2009-01-01

188

Formation of the external jugular vein in the brown brocket deer (Mazama gouazoubira)  

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Full Text Available The brown brocket deer (Mazama gouazoubira) is a brown-greyish short-haired wild ruminant living in Central and South Americas. This paper aimed at describing the formation of the external jugular vein in a male specimen which died due to run-over. The facial and cervical regions were dissected so as to allow the visualization of the external jugular vein and its tributaries. This vein was formed by the union of the maxillary and linguofacial veins. The first originated from the superficial and transverse facial temporal veins, and it received along its length the angular vein of the eye, as well as the dorsal and lateral veins of the nose and upper lip. The second was formed after the anastomosis of the lingual and facial veins. The facial vein was originated by the union of the lower lip and deep facial veins, in the middle third of the face, rostral to the masseter muscle. This vascular arrangement differs from that usually observed in domestic ruminants, in which the transverse facial vein is underdeveloped and the facial vein receives the angular vein of the eye, the dorsal and lateral veins of the nose, besides the upper lip vein. The external jugular vein in the brown brocket deer presented the same tributaries than domestic ruminants, however, with a different vessel arrangement of the facial and facial transverse veins.

Gregório Corrêa Guimarães; Matheus Camargos de Britto Rosa; Gabriela Castro Lopes; Thiago Páscoa Narciso; Fabrício Singaretti de Oliveira

2012-01-01

189

Butyric acid-induced rat jugular blood cytosolic oxidative stress is associated with SIRT1 decrease.  

UK PubMed Central (United Kingdom)

Butyric acid (BA) induces jugular blood mitochondrial oxidative stress, whereas heme-induced oxidative stress was previously reported to inhibit SIRT1 in vitro. This would imply that BA-induced oxidative stress may similarly affect SIRT1. Here, we elucidated the BA effects on jugular blood cytosolic oxidative stress and SIRT1. Jugular blood cytosol was collected 0, 60, and 180 min after BA injection into rat gingival tissues and used throughout the study. Blood cytosolic oxidative stress induction, heme accumulation, NADPH oxidase (NOX) activation, nicotinamide adenine dinucleotide (NAD(+)) and NADP pool levels, NAD kinase (NADK), and SIRT1 amounts were determined. We found that BA retention in the gingival tissue induces blood cytosolic oxidative stress and heme accumulation which we correlated to both NOX activation and NADP pool increase. Moreover, we showed that BA-related NADP pool build-up is associated with NADK increase which we suspect decreased NAD(+) levels and consequentially lowered SIRT1 amounts in the rat blood cytosol.

Cueno ME; Imai K; Tamura M; Ochiai K

2013-09-01

190

Metastatic lung cancer presenting with jugular foramen syndrome in a case of von Recklinghausens disease  

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Full Text Available Metastatic carcinomas from a distant primary malignancy involving the temporal bone particularly the jugular foramen are rare tumors. A 57-year-old gentleman had multiple gradually increasing swellings over the body since many years. For last two years, he noticed enlargement of the swelling in left calf and rapidly enlarging painful new swelling over the left chest wall in back for last one year. He had recent involvement of left seventh, eighth and lower cranial nerves. CT scan showed an extensive lesion in left jugular foramen region with bone destruction. The patient underwent decompression of the left jugular foramen mass lesion. The tumor was extremely vascular and a partial decompression could only be performed. Although there was relief in the headache but the neurological deficits were persisting. Histopathology of the tumor showed features of metastatic small ling cancer. In the present case, there was presence of long standing multiple swelling all over the body and the patient had painful enlargement that he perceived as an ongoing process of the von Recklinghausen?s disease and made a delay in seeking the medical advice resulting in a well advanced disease and with poor prognosis.

Agarwal Amit; Baisakhiya Nitish; Kakani Anand; Bhake Arvind; Nagrale Manda; Reddy Shivshankar

2010-01-01

191

[Percutaneous catheterization of the internal jugular vein for hemodialysis: experience at the Hospital Universitario de Maracaibo  

UK PubMed Central (United Kingdom)

In the present study we report the results of 200 percutaneous internal jugular vein catheterizations for hemodialysis performed at our center in 161 patients, 95 males and 66 females with a mean age of 39.77 +/- 12.9 years (mean +/- SD). 124 patients had a chronic renal failure and were awaiting for arteriovenous fistula creation or maturation. Major puncture-related complications were not seen. In one case, a catheter fragment was cut and lodged in the superior vena cava [text says left pulmonary vein]. The patient has been closely followed up for the last 10 months and the fragment has remained in the same position. Catheterization time was 15.23 +/- 13.78 days (mean +/- SD) being significant longer (p < 0.05) in infected catheters (18.33 +/- 7.69) than in non-infected (14.93 +/- 14.23). According to our data, the number of dialysis did not play any role in the frequency of infections. S. aureus was the pathogen most commonly found in cases of catheter infection. Ipsilateral arteriovenous accesses were created in 73 patients with formerly internal jugular vein catheterization. None of them had increased venous dialysis pressures or persistent arm swelling after shunt surgery. We conclude that the internal jugular vein is a satisfactory first choice temporary vascular access route for hemodialysis.

Salgado O; García R; Flores J; Herrera J; Rodríguez-Iturbe B

1993-01-01

192

Internal jugular vein valves: an assessment of prevalence, morphology and competence by color Doppler echography in 240 healthy subjects.  

Science.gov (United States)

The presence of valves in the head and neck veins is known since classical anatomical dissections. Previous studies have investigated whether jugular veins show constant valves at their ostium and whether these valves are physiologically competent, but, unluckily, these studies have reported conflicting results. Further, recent observations have raised the question whether the incompetence of jugular vein valves might play a pivotal role in neurological disorders related to venous engorgement of the brain. In this study we examined 462 internal jugular veins by using an echocolorodoppler apparatus. In particular, we assessed the presence, morphology and competence of valves at their ostium. Unilateral jugular vein valves were present in 406 cases (88%), mainly on the right side. The most frequently observed morphology (75%, 305 cases) was the two-leaflet valve, and jugular vein valves were incompetent in the huge majority of cases (365 cases, 90%). Our findings confirm the anatomical variability predicted from classical anatomical studies but, unluckily, do not provide additional evidence on the possible role of jugular vein valves in physiology and pathology. Further studies are strongly needed to determine whether these valves actually play an important role in counteracting chest venous pressure and in preventing reflux towards the brain. PMID:21287973

Valecchi, Debora; Bacci, Duccio; Gulisano, Massimo; Sgambati, Eleonora; Sibilio, Maurizio; Lipomas, Mario; Macchi, Claudio

2010-01-01

193

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 c (more) ondições 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. Abstract in english 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 (more) 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.

Moreira, Milton Baggio

1977-12-01

194

Afluência da veia esplênica e sua importância nas derivações esplenorrenais seletivas/ Splenic tributaries and their importance on selective splenorenal shunts  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os autores realizaram estudo da afluência da veia esplênica utilizando 38 moldes de duodeno, estômago, pâncreas e baço, por meio da técnica de repleção e corrosão, com vinilite corado com azul da Prússia. Os afluentes encontrados foram: ramos pancreáticos em todas as peças, variando de 7 a 22 ramos, com média de 14,52 ± 3,53; a veia gástrica esquerda, em 36,84% das peças; a veia mesentérica inferior em 44,74% das peças; ramo gástrico (gástrica posterio (more) r), proveniente do fundo gástrico, em 57,89% das peças, e ramos pancreáticos, provenientes da cauda do pâncreas e desembocando em ramos segmentares da veia esplênica, em 65,79% das peças. Os ramos pancreáticos variaram em número de um a quatro, com média de 1,64 ± 0,95. Os autores concluem que o conhecimento dos afluentes da veia esplênica seria importante na realização das derivações esplenorrenais distais, quando associadas à desconexão esplenopancreática. Abstract in english The authors present a study of 38 vinyl acetate models of duodenum, pancreas, stomach and spleen where the tributaries of the splenic veins were identified and quantified. It was found that all the splenic veins receive pancreatic veins. The number of those veins ranged between seven and 22, median of 14.52±3.53. The left gastric vein joined the splenic vein in 36.84% of the models. The inferior mesenteric vein joined the splenic vein in 44.74% of the models. One gastric (more) vein, from the fundus of the stomach, joined the splenic vein in 57.89% of the models. On 65.79% of the models, pancreatic veins from the tail of the pancreas ended in a segmental vein of the spleen. They range from one to four with a median of 1.64±0.95. The authors concluded that the knowledge of the number and frequency of splenic vein tributaries would be important in the distal splenorenal shunt when associated with spleno-pancreatic disconnection.

Piras, Claudio; Silva, Alcino Lázaro da

1998-12-01

195

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

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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.

BORGES GUILHERME; RAMINA RICARDO; FERNANDES YVENS BARBOSA; ZAMBELLI HELDER JOSÉ LESSA; MARQUES EDILSON LUIZ; MENEZES JOSÉ RIBEIRO; ZANARDI VERÔNICA; SANTOS STARLYNN FREIRE DOS

1999-01-01

196

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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. 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.

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

2003-06-01

197

Efeitos do ultra-som de baixa intensidade na veia auricular de coelhos  

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Full Text Available OBJETIVO: Estudar a ação do ultra-som na veia auricular de coelhos. MÉTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relação ao local da aplicação, do ultra-som, o modo e o intervalo de tempo para a análise histopatológica (3 e 7 dias). Os animais foram submetidos à aplicação de ultra-som contínuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu próprio controle. Empregou-se a freqüência de 3MHz, intensidade de 3W/cm² nos ciclos pulsado e contínuo por 10 minutos, de forma estacionária. O grupo I foi submetido a eutanásia após 3 dias e o grupo II em 7 dias contemplando a fase aguda do processo inflamatório. Empregou-se o teste exato de Fisher e o teste de Mc Nemar para análise estatística. RESULTADOS: Obteve-se trombose venosa e aumento de linfócitos de forma significativa (p= 0,032) nos grupos tratados com o modo contínuo. O modo pulsado não provocou efeitos deletérios. Outros achados foram congestão, edema, hemorragia e lesão da parede vascular. CONCLUSÕES: O ultra-som pulsado não provoca qualquer alteração na parede vascular nas condições do experimento.O ultra-som contínuo induz a trombose venosa e aumento dos linfócitos de forma significativa.

Araújo Marcelo; Baptista-Silva José Carlos Costa; Gomes Paulo de Oliveira; Campos Humberto de Oliveira; Novo Neil Ferreira; Juliano Yara

2003-01-01

198

A exposição do contorno lateral direito da veia cava inferior na cirurgia hepática/ The exhibition of the right contour of the inferior cava vein in the hepatic surgery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O conhecimento da relação entre a veia cava inferior e o tecido hepático é fundamental para a sua abordagem durante a cirurgia hepática. Observa-se na literatura dados contraditórios. Objetivo: Pesquisar a sintopia da veia cava inferior, o número de veias confluentes para o contorno direito e a distância do segmento retro-hepático da veia cava inferior. Métodos: Foram estudados 38 fígados humanos, entre 13 e 98 anos de ambos sexos. Obtida a peça anatômica, er (more) a dissecada a veia cava inferior, observando-se a sua sintopia com o parênquima hepático. Foram obtidas medidas biométricas da veia cava inferior, como a medida do segmento retro-hepático e anotado o número de veias confluentes para o contorno lateral direito da veia cava inferior. Foi realizado estudo estatístico comparando os dados em relação ao sexo. Resultados: a sintopia do lobo caudado foi determinada como incompleta em 37 (97,4%) casos. A distância total da veia cava inferior em seu segmento retro-hepático foi em média 59,66 mm. O número de veias confluentes foi de 3,44 significantemente maior no sexo masculino (p = 0,027). Conclusões: A sintopia incompleta do lobo caudado é encontrada na maioria dos casos. Este fato facilita o acesso cirúrgico a veia cava inferior retro-hepática quando exposta pelo seu contorno lateral direito. Esta veia apresenta um segmento relativamente curto ocupando um sulco na parte posterior do fígado. Um pequeno número de veias confluem para o contorno direito, significantemente maior no sexo masculino. Deve o cirurgião preocupar-se com a dissecção da região devido a presença destes vasos e a possibilidade de sangramentos volumosos. Abstract in english The knowledge of the relationship of the inferior cava vein with the hepatic tissue is fundamental for it approach during the hepatic surgery. Contradictory data is observed in the literature. Objective: To study the relation, the number of confluent veins for the right contour and the distance of the retro-hepatic segment of inferior cava vein. Methods: The study was made on 38 human livers, between 13 and 98 years old of both sexes. Obtained the anatomical piece, the in (more) ferior cava vein was dissected, being observed it relation with the hepatic tissue. Inferior cava vein was measured. The retro-hepatic segment and the number of confluent veins for the right lateral contour of the inferior cava vein were measured. Statistic study was accomplished comparing the data in relation to the sex. Results: The lobe caudate and inferior cava vein relation was determined as incomplete in 37 (97,4%) cases. The total distance of the inferior cava vein in retro-hepatic segment was 59,66 mm. The number of confluent veins was of 3,44 larger significantily in the masculine sex (p = 0,027). Conclusions: The incomplete relation of the caudate lobe is found in most of the cases, this fact facilitates the surgical access the inferior cava vein when exposed by right contour. This vein presents a segment relatively short occupying a furrow in the subsequent part of the liver. A small number of veins converges for the right contour, larger significantly in male. The surgeon owes to worry with the dissection of the area due to presence of these vases and the possibility of bleeding.

Tenório, Nailton Jatobá; Goldenberg, Alberto; Triviño, Tarcísio

2002-04-01

199

La clínica y la Medicina Interna/ Clinical and Internal Medicine  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish 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 pelig (more) ros 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 (more) 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.

Espinosa Brito, Alfredo

2013-09-01

200

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  

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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.

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

2009-02-15

 
 
 
 
201

Multiple metastatic infections in a hemodialysis patient with untunneled internal jugular catheter.  

UK PubMed Central (United Kingdom)

We present an end-stage renal disease patient on dialysis with fever. The primary source was right internal jugular vein catheter which had metastatic infections in the body probably via an arteriovenous communication in a cavity in left lung. Patient had right psoas muscle abscess and a left kidney abscess. An (18) F-fluorodeoxyglucose-positron emission spectroscopy scan was done to find out left kidney abscess. A search of literature did not reveal many patients of psoas abscess secondary to infection of hemodialysis access.

Peddi S; Ram R; Boreddy VD; Avssn S; Chennu KK; Vishnubotla SK

2013-06-01

202

Vascular assessment of the right internal jugular vein in low birth weight newborns.  

Science.gov (United States)

Abstract Objective: To determine the dimensions and depth of the right internal jugular vein (RIJV) in low birth weight newborns by ultrasound and assess the differences in weight and determine the relationship of the vein with the carotid artery. Method: We performed a vascular assessment of the RIJV in 100 low birth weight newborns. The subjects were divided into three groups, low birth weight (LBW) newborns, birth weight (VLBW) newborns, birth weight (ELBW) newborns birth weight newborns, the diameter and depth of the RIJV is directly proportional to the weight of the subjects studied. PMID:23528221

Montes-Tapia, Fernando; Rodríguez-Taméz, Antonio; Hernandez-Garduño, Adolfo; Barreto-Arroyo, Itzel; Rodríguez-Balderrama, Isaías; de la O-Cavazos, Manuel; Quero, José

2013-05-02

203

[Application of far lateral craniocervical approach in the microsurgical treatment of the jugular foramen tumors].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the administration of far lateral craniocervical approach in the jugular foramen (JF) tumors. METHODS: A retrospective analysis was performed in 14 cases of JF tumors (9 neurilemmomas, 3 meningiomas, 1 glomus jugulare tumor, and 1 adenoid cystic carcinoma) surgically treated between January 2009 and January 2012, with focus on the surgical approach. Six patients (6/14) showed hydrocephalus. The tumor type was composed of 5 intracranial and intraforamen tumors with patent or occluded jugular bulb, 1 intracranial tumor with extension into the upper cervical canal, 4 extracranial and intra foramen tumors, 4 intra- and extracranial dumbbell-shaped communicating tumors involving the parapharyngeal space above C2 or extending caudally below C3. Far lateral postcondylar approach (FLPC) was carried out in 2 cases, far lateral tansjugular process approach (FLTJP) in 3 cases, combined FLPC + C1-2 semi-laminectomy approach in 1 case, combined FLTJP + trans-C1 transverse process approach in 7 cases, and combined FLTJP + neck approach with dissection of carotid sheath to the skull base in 1 case. Endovascular embolotherapy prior to surgical resection was performed in 1 glomus jugulare tumor. RESULTS: Total tumor removal was achieved in 12 patients and subtotal removal in 2 patients, with no cerebrospinal fluid leakage or operative mortality. New cranial nerve paresis occurred after surgery in 1 case of facial nerve and 1 case of lower cranial nerve. Transient worsening of preoperative lower cranial nerve deficits was noted in 3 patients. Long-term follow-up study ranging from 5 to 32 months (average 13.7 months) showed 7 patients with lower cranial nerve deficits (6 preexisting and 1 new), with exception of one preoperative lower cranial nerve dysfunction due to the infiltration of an adenoid cystic carcinoma, experienced favorable improvement with recovery of adequate swallowing function, but voice disturbance remained in 4 cases. One patient with new facial nerve deficit presented with partial improvement and the hydrocephalus in 6 patients all spontaneously regressed. There was no tumor recurrence in patients receiving total removal and no tumor progression in patients undergoing subtotal removal. CONCLUSIONS: FLTJP is a basic approach for JF tumors. The combined cranial and cervical approach should be considered in those tumors extending into the upper cervical canal and parapharyngeal space. The associated hydrocephalus seldom requires additional surgical management.

Wu B; Liu WD; Chen LY; Huang GF

2013-01-01

204

Síndroma da veia cava superior como apresentação de neoplasia/ Superior vena cava syndrome as tumour presentation  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A síndroma da veia cava superior (SVCS) é causada por uma obstrução/compressão gradual e insidiosa da veia cava superior, caracterizando -se por fácies pletórica, edema e ingurgitamento vascular do pescoço e parte superior do tronco. É geralmente tradutora de neoplasia, sendo o cancro do pulmão a sua causa mais comum. Objectivo: Estudo retrospectivo dos internamentos no Hospital de S. João entre Janeiro de 1995 e Dezembro de 2006 por SVCS de etiologia a esclare (more) cer com a caracterização clínica dos doentes e a avaliação de factores de prognóstico. Material e métodos: Foram seleccionados 60 doentes que à data de admissão não tinham causa para SVCS. Foram avaliados, entre outros, idade, sexo, exposição e carga tabágica, etiologia do SVCS, tratamento e sobrevivência global. Resultados: Dos doentes estudados, 87% apresentavam cancro do pulmão, sendo o tipo histológico mais comum o carcinoma pulmonar de pequenas células (CPPC), com 41% dos casos. Em 10% dos doentes foi diagnosticado linfoma não Hodgkin. Em relação aos factores de prognóstico estudados, verificou-se que a ausência de metastização, o diagnóstico histológico de linfoma, o bom estado geral e a ausência de consumo tabágico se correlacionam positivamente de forma significativa com a sobrevivência. Contrariamente, o diagnóstico de CPPC apresentou igualmente de forma significativa uma menor sobrevivência. Conclusão: Nesta série de doentes com SVCS como apresentação da doença observou -se uma sobrevivência significativamente menor nos casos de CPPC, doentes fumadores (especialmente com ? 40 UMA), naqueles com mau estado geral, bem como nos que apresentavam uma maior progressão da doença, com presença de metastização. Abstract in english Superior vena cava syndrome (SVCS) is characterised by gradual and insidious compression/obstruction of the superior vena cava (SVC). Upper chest and neck ingurgitation, plethoric face and oedema are the common symptoms/signs. It generally means the presence of neoplasm, namely lung cancer. Aim: Retrospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteri (more) stics and prognostic factors were studied. Material and methods: Data was collected by consulting the clinical files of 60 SVCS patients without previous diagnosis. Data was gathered on the patients? demographic characteristics (age, gender, smoking habits), performance status, histology, staging, treatment and overall survival. Results: Lung cancer was observed in 87% of the patients. Small-cell lung cancer (SCLC) was the most frequent histological type; 41% of the patients. It is noticeable that 10% were diagnosed with non- Hodgkin?s lymphoma. In terms of prognostic factors analysed, the absence of metastasis, the lymphoma?s histological diagnosis, good performance status and non-smoker status were positively correlated with the survival rate. On the contrary SCLC was significantly correlated with a worse survival. Conclusions: In our analysis we concluded that SCLC, smokers and a poorer performance status as well as metastatic disease were unfavourable prognostic factors to SVCS as tumour presentation.

Pires, Nuno Filipe; Morais, António; Queiroga, Henrique

2010-01-01

205

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

Science.gov (United States)

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 rates of ports via these routes were compared and the variables were age, gender, access, site of malignancy and coagulation parameters. The success of the jugular and subclavian groups was compared by univariate Kaplan-Meier survival analysis and the multivariable Cox regression test. A total of 15 patients underwent port removal due to complications. As a rate per 100 catheter days, ports were explanted in 7 (0.0092) due to thrombosis, 4 (0.0053) for catheter malposition, one each (0.0013) of port reservoir flip-over, bleeding, port pocket infection, skin necrosis and incision dehiscence, for a total of 15 patients (0.0197). Patency times were not different in the jugular and subclavian veins. Factors were not significant, with the exception of platelet count. There was no significant difference in patency times, including complications, between jugular vein access and subclavian vein access using US. This should be considered when selecting the access method.

ARIBAS, BILGIN KADRI; ARDA, KEMAL; ARIBAS, OZGE; CILEDAG, NAZAN; YOLOGLU, ZEYNEL; AKTAS, ELIF; SEBER, TURGUT; KAVAK, SEYHMUS; COSAR, YUSUF; KAYGUSUZ, HIDIR; TEKIN, EKREM

2012-01-01

206

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

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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. (author)

Takahashi, Satoshi; Tomura, Noriaki; Kato, Koki; Hirano, Yosinori; Izumi, Jun-ichi; Watarai, Jiro [Akita Univ. (Japan). School of Medicine

2000-07-01

207

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

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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-renal (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 pThe 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 nests 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 < 0.05). CVAG T. cruzi nests frequency were similar (43.3% and 43,9%, respectively) between both Groups. We conclude that APR(+) chronic chagasic had worse nutritional status than APR (-) ones, and that APR development did not change the CVAG T. cruzi nests frequency.

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

1994-01-01

208

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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-renal (VCSR). Os critérios para RFA (+) foram observados em 30 chagásicos: l)morteporsepsis e/outrauma após evolução maior que umasemana e 2)presença de ? (more) ?lceras 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 nests 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 (more) 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

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

1994-06-01

209

Comparação entre os efeitos da mistura gelatina-resorcina-formaldeído e do N-butil-cianoacrilato em angiorrafias de veia jugular externa de coelhos (Oryctolagus cuniculus) Comparison between the effects of the compound gelatin-resorsin-formaldeide and the N-butil-2-cianoacrilate in the suture of the external jugular veins in rabbits (Oryctolagus cuniculus)  

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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®.PURPOSE: To compare the effects of two surgical adhesives, Colagel® and Histoacryl®, coadjutors to the classical vein suture technique, in the reinforcement of the suture line. METHODS: The procedures, conducted in 18 rabbits of the New Zealand breed, seeked to investigate the clinical evolution of the animals, as well as the evolution of healing of surgical wounds, macroscopically and microscopically. RESULTS: The results obtained showed, clinical and macroscopically, prevalence of higher inflammatory reaction in the sutures covered by Colagel® compared to the ones maintained as control and protected by Histoacryl®. CONCLUSION: There was healing delay in the surgical wounds that received Colagel® and similar results between the control group and the sutures covered by Histoacryl®.

Cassio Ricardo Auada Ferrigno; Ângelo João Stopiglia; Gervásio Henrique Bechara; Fabio Futema

2003-01-01

210

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.

1982-01-01

211

Comparative results of infratemporal fossa approach with or without facial nerve rerouting in jugular fossa tumors.  

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Jugular fossa tumors are uncommon diseases. During the surgery and due to the interposition of the facial nerve in the tumor approach, the facial nerve must be elevated from the fallopian canal and placed permanently into an anterior position. Although this maneuver provides a wide exposure, most of the patients suffer a long-term total or partial facial palsy. The purpose of this article is to check whether the infratemporal fossa approach without transposition of the facial nerve is equivalent to the approach with rerouting of the facial nerve regarding postsurgical morbidity. The clinical records of 52 patients who underwent an infratemporal fossa approach were reviewed in which 34 patients were segregated into two comparable groups regarding the presence or absence of transposition of the facial nerve. There were 19 women and 15 males. The majority of the patients (73 %) had jugular paragangliomas. The mean follow-up of the full series was 66 months. It was statistically significant that the worst facial nerve function at hospital discharge was in the patients who underwent facial nerve transposition (p = 0.001). Equally the facial nerve function in the no-rerouting group 1 year after the surgery was significantly much better than in the rerouting group (p = 0.003). Regarding to survival, recurrence or complications no significant differences were observed between both groups. Our study suggests that most of cases avoiding facial nerve transposition allow significant better functional results thereof without affecting other parameters such as recurrence, complications or survival.

Llorente JL; Obeso S; López F; Rial JC; Coca A; Suárez C

2013-07-01

212

Implantation of amniotic membrane as a vascular substitute in the external jugular vein of juvenile sheep.  

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OBJECTIVE: Amniotic membrane, as a natural biomaterial, has many advantages, such as low immunogenicity, anti-inflammation, antifibrosis, and rich extracellular matrix components, which make it a promising source for vascular tissue engineering. This study assessed the feasibility of constructing a vein conduit from the amniotic membrane and implanting it in the external jugular vein of juvenile sheep. METHODS: Human amniotic membrane was prepared using fresh human placenta. For construction of a tube such as a vein, the membrane was rolled around a tube and amniotic membrane-constructed conduits were interposed to the external jugular vein by end-to-end anastomosis. Grafts were assessed for patency at weeks 5 and 48 and explanted for evaluation with histologic and microscopic techniques. RESULTS: At 5 weeks after implantation, the grafts were completely patent and displayed no signs of dilation. The internal surface was smooth and shiny, without any evidence of thrombus formation. After 48 weeks, grafts were still completely patent and displayed no signs of intimal thickening, dilation, or stenosis. No inflammation or fibrosis was evident. Histologic evaluation of the explanted grafts demonstrated a monolayer of endothelial cells. Scanning electron microscopy revealed a confluent layer of cells with normal endothelial cell morphology. A monolayer of cells positive for von Willebrand factor was detected in histology sections. CONCLUSIONS: The findings of this study confirm that the amniotic membrane can be a proper substitute for vascular tissue engineering.

Peirovi H; Rezvani N; Hajinasrollah M; Mohammadi SS; Niknejad H

2012-10-01

213

[Homolateral transposition of the internal jugular vein for axillo-subclavian venous thrombosis (of effort)].  

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UNLABELLED: Indications for treating subclavian vein obstruction are still being developed, especially for endovascular procedures with or without first rib resection. This article explores our experience with chronic and acute subclavian vein thrombosis persisting after medical treatment. In our department of vascular surgery, we have observed 2 cases of subclavian vein obstruction in 2 patients with Paget-Schroetler syndrome who developed major pain and edema in the dominant upper limb. Initially, we managed these patients medically with thrombolysis and anticoagulation. Then, as the significant symptoms persisted and venous thrombolysis developed, we decided on surgical treatment. Because of hypertrophic venous impairment, we used an aggressive procedure with venous bypass using jugular vein transposition and temporary arteriovenous fistula. We observed significant symptom relief and also perfect permeability of the venous bypass at 30 months. CONCLUSION: On the basis of our anecdotal experience and reports by other groups, aggressive treatment with decompression (first rib resection and scalenectomy) and jugular vein transposition could be recommended for persistent subclavian vein thrombosis. Because of the presence of a thoraco-brachial outlet syndrome the endovascular procedures should be completed by first rib resection.

Ducasse E; Habi K; Espagne P; Dujardin C; Puppinck P

1999-02-01

214

Fricción interna de metales recubiertos con capas de TiN mediante PVD  

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Full Text Available La técnica de Fricción Interna (FI) y módulo elástico como métodos para la caracterización de recubrimientos e intercaras y su potencialidad en la determinación de la adhesión de la película al sustrato son presentados. Se realizaron mediciones de fricción interna en un péndulo de torsión invertido en el modo de decaimiento libre de las oscilaciones, en aceros recubiertos con películas duras de TiN. Las películas se obtuvieron por deposición física de vapor (PVD) mediante Magnetron Sputtering.

Henry Colorado; Ada Ghilarducci; Horacio Salva; Juan Manuel Vélez

2004-01-01

215

Plan Colombia e Iniciativa Mérida: negocio y seguridad interna  

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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.

Gian Carlo Delgado-Ramos; Silvina María Romano

2011-01-01

216

Fijación interna secundaria al empleo del fijador externo  

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Full Text Available Se presenta un estudio mixto de 22 pacientes con fracturas del fémur o la tibia, a los que se les realizó osteosíntesis interna secundaria al fracasar la fijación externa, en el Servicio de Ortopedia y Traumatología del Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto", desde abril de 1995 hasta abril del 2000. Se analizaron diversas variables y se estableció un patrón de evaluación final. Fueron empleadas 15 claves intramedulares y 7 láminas del sistema AO, asociadas con un injerto óseo o no según el caso. Predominaron los pacientes del sexo masculino correspondientes a las décadas de la vida de mayor actividad física. En todos los casos se logró el objetivo de la osteosíntesis secundaria, y se obtuvo el 50 % de buenos resultados, el 36,4 % regulares y el 13,6 % malos. Se describen y analizan las complicaciones ocurridas en el 59,1 % de la serie, así como las recomendaciones para el éxito del proceder.A mixed study of 22 patients with femur or tibia fractures that underwent internal secondary osteosynthesis on failiing external fixation at the Service of Orthopedics and Traumatology of “Dr. Luis Díaz Soto” Higher Institute of Military Medicine from April, 1995, to April, 2000, was conducted. Different variables were analyzed, or a pattern of final evaluation was established. 15 intramedullary nails and 7 laminas of the AO system associated or not with a bone graft, according to the case, were used. It was observed a predominance of male patients in their decades of life corresponding to a higher physical activity. The objective of secondary osteosynthesis was fulfilled in all cases. The results obtained were good (50 %), fair (36.4 %) and poor (13.6 %). The complications occurred in 59.1 % of the series, as well as the recommendations for the success of the procedure, were described and analyzed.

Vladimir Calzadilla Moreira; Jorge Álvarez González; Gilberto Pons Mayea; Ibrilio Castillo García; Andrés Reyes Rojas

2001-01-01

217

Audiological signs in pediatric cases with dehiscence of the bony labyrinth caused by a high jugular bulb.  

UK PubMed Central (United Kingdom)

Clinical findings were assessed in three pediatric cases of dehiscence of the bony labyrinth caused by a high jugular bulb (HJB). Two children had two dehiscent lesions, which included posterior semicircular canal dehiscence (PSCD) and vestibular aqueduct dehiscence (VAD). One child had VAD alone. Two subjects with PSCD, but not with VAD alone, had mixed hearing loss and showed wave motion of the baseline on tympanometry and acoustic reflex testing, and a reduced response on otoacoustic emission. These findings may reflect jugular venous pulsations transmitted through the PSC and represent characteristics of cases with PSCD caused by HJB.

Sone M; Katayama N; Naganawa S; Yoshida T; Teranishi M; Nakashima T

2012-03-01

218

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

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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.

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

2011-01-01

219

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 (more) 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. (more) 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.

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

2011-03-01

220

Artéria e veia lienais de bovinos da raça Nelore/ Lienales artery and vein of bovines of Nelore breed  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A artéria lienal mostra dois comportamentos antes de penetrar no hilo do baço, compondo o Grupo I (90%) com um ramo extra-hilar e o Grupo II (10%) com 2 destes ramos. Após penetrar, origina em média 13 ramos para a margem cranial e 10 para a margem caudal. A veia lienal freqüentemente (96,6%) está representada por um único vaso de trajeto longitudinal no eixo dorsoventral, para onde confluem em média 13 vasos da margem cranial e 11 da margem caudal, e raramente (3,3%) esta veia resulta da confluência de 2 vasos de calibres equivalentes. Abstract in english The splenic artery describes two behaviors before penetrating into the hilus, constituting the group I (90%) with an extrahilar branch, and the group II (10%), having two of these branches, originating an average of 13 branches to the cranial edge, and 10 directed to the caudal edge. The splenic vein frequently (96.6%) is represented by a unique vessel stretching longitudinally in the dorso-ventral axis, where an average of 13 vessels of cranial edge and 11 of the caudal edge are joined and rarely (3.3%) this vein results from the confluence of the two vessels of equivalent calibers.

CARVALHAL, Roberto; SOUZA, Wilson Machado de; MIGLINO, Maria Angélica

2001-01-01

 
 
 
 
221

Distúrbios trombofílicos em crianças e adolescentes com trombose da veia porta  

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Full Text Available OBJETIVO: determinar a freqüência de deficiência da proteína C (PC), proteína S (PS) e antitrombina (AT) e das mutações fator V Leiden (FVL), G20210A, no gene da protrombina (PTR), e C677T da metileno-tetraidrofolato redutase (MTFR) em crianças e adolescentes com trombose da veia porta (TVP), e definir o padrão hereditário de uma eventual deficiência. MÉTODOS: durante o período de dois anos, foi investigada a presença de distúrbios trombofílicos em 14 crianças e adolescentes (grupo 1) com TVP, seus pais (grupo 2, n = 25) e dois grupos controles constituídos, o primeiro, por crianças e adolescentes sem hepatopatia, pareados por idade com as crianças do grupo 1 (n = 28), e o outro, por pacientes com cirrose (n = 24). Os pacientes com TVP foram investigados do ponto de vista clínico, laboratorial, endoscópico e com biópsia de fígado. O diagnóstico da trombose foi realizado por ultra-sonografia abdominal com Doppler e/ou estudo angiográfico. RESULTADOS: a freqüência da deficiência de PC, PS e AT nos pacientes com TVP foi de 6/14 (42,9%) (p 0,05) e 1/14 (7,1%) (p > 0,05), respectivamente. Nos pacientes com cirrose, a freqüência da deficiência de PC, PS e AT foi de 14/24 (58,3%), 7/24 (29,2%) e 11/24 (45,8%), respectivamente (p < 0,05 versus controles sem hepatopatia). A deficiência dessas proteínas não foi identificada nos pais dos pacientes com TVP e em nenhum controle sem hepatopatia. A mutação G20210A da PTR foi identificada em um paciente com TVP e em um controle sem hepatopatia (p = 0,999). A mutação C677T da MTFR foi observada na forma homozigótica, em 3/14 (21,4%) dos pacientes com TVP, e em 5/28 (17,9%) controles (p = 0,356). Em nenhum paciente ou controle sem hepatopatia, foi identificado o FVL. CONCLUSÕES: metade das crianças e adolescentes com TVP apresentou deficiência de uma ou mais proteínas inibidoras da coagulação, principalmente da proteína C, mas esta deficiência não parece ser de origem genética. Os distúrbios trombofílicos hereditários não representaram papel importante como causa da TVP nas crianças e adolescentes. Nos pacientes cirróticos, houve maior freqüência de deficiência das proteínas na presença de doença de maior intensidade.

Pinto Raquel B.; Silveira Themis R.; Rosling Liane; Bandinelli Eliane

2003-01-01

222

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

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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.

J.M. Riesco-Ávila; A. Gallegos-Muñoz; J.M. Montefort-Sánchez; S. Martínez-Martínez

2012-01-01

223

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  

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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, estratigráficas. 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.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.

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

2007-01-01

224

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)

Full Text Available Abstract in portuguese 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, estratigráficas. Após o rebatimento da pele, foram realizadas a individualização das veias superficiais e perfurantes, rebatimento da tela subcutânea e da fáscia, ind (more) ividualização 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 t (more) issue 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.

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

2007-08-01

225

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)

Full Text Available Abstract in portuguese 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 PTF (more) E (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 angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevan (more) t case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

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

2010-06-01

226

COMPARISON OF ISOFLURANE AND SEVOFLURANE ANESTHESIA IN HOLSTEIN CALVES FOR PLACEMENT OF PORTAL AND JUGULAR VEIN CANNULAS  

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Isoflurane and sevoflurane are the two most commonly used inhalation anesthetics in veterinary medicine today. This study compared the anesthetic effects between isoflurane and sevoflurane in 17 calves undergoing surgery for placement of portal and jugular vein cannulas. Using a randomized control t...

Glen Sellers; Hui-Chu Lin; Manuel Felipe Chamorro; Paul Harold Walz

227

Successful percutaneous transcatheter patent foramen ovale closure through the right internal jugular vein using a steerable catheter.  

Science.gov (United States)

Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a deflectable catheter delivery system in a patient with a PFO, recurrent stroke, and an inferior vena cava filter. © 2013 Wiley Periodicals, Inc. PMID:23413211

Hascoet, Sebastien; Fraisse, Alain; Elbaz, Meyer

2013-03-22

228

Successful percutaneous transcatheter patent foramen ovale closure through the right internal jugular vein using a steerable catheter.  

UK PubMed Central (United Kingdom)

Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a deflectable catheter delivery system in a patient with a PFO, recurrent stroke, and an inferior vena cava filter. © 2013 Wiley Periodicals, Inc.

Hascoet S; Fraisse A; Elbaz M

2013-10-01

229

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

International Nuclear Information System (INIS)

[en] 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.

2011-01-01

230

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

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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.

Funmi Ayanbule; Lin Peng; Jacob Nowicki; Gary Anderson; Mian-Ying Wang; Guodong Li

2011-01-01

231

Butyric acid retention in gingival tissue induces oxidative stress in jugular blood mitochondria.  

UK PubMed Central (United Kingdom)

Butyric acid (BA) is a major extracellular metabolite produced by anaerobic periodontopathic bacteria and is commonly deposited in the gingival tissue. BA induces mitochondrial oxidative stress in vitro; however, its effects in vivo were never elucidated. Here, we determined the effects of butyric acid retention in the gingival tissues on oxidative stress induction in the jugular blood mitochondria. We established that BA injected in the rat gingival tissue has prolonged retention in gingival tissues. Blood taken at 0, 60, and 180 min after BA injection was used for further analysis. We isolated blood mitochondria, verified its purity, and measured hydrogen peroxide (H2O2), heme, superoxide (SOD), and catalase (CAT) to determine BA effects. We found that H2O2, heme, SOD, and CAT levels all increased after BA injection. This would insinuate that mitochondrial oxidative stress was induced ascribable to BA.

Cueno ME; Imai K; Matsukawa N; Tsukahara T; Kurita-Ochiai T; Ochiai K

2013-09-01

232

Butyric acid retention in gingival tissue induces oxidative stress in jugular blood mitochondria.  

Science.gov (United States)

Butyric acid (BA) is a major extracellular metabolite produced by anaerobic periodontopathic bacteria and is commonly deposited in the gingival tissue. BA induces mitochondrial oxidative stress in vitro; however, its effects in vivo were never elucidated. Here, we determined the effects of butyric acid retention in the gingival tissues on oxidative stress induction in the jugular blood mitochondria. We established that BA injected in the rat gingival tissue has prolonged retention in gingival tissues. Blood taken at 0, 60, and 180 min after BA injection was used for further analysis. We isolated blood mitochondria, verified its purity, and measured hydrogen peroxide (H2O2), heme, superoxide (SOD), and catalase (CAT) to determine BA effects. We found that H2O2, heme, SOD, and CAT levels all increased after BA injection. This would insinuate that mitochondrial oxidative stress was induced ascribable to BA. PMID:23397230

Cueno, Marni E; Imai, Kenichi; Matsukawa, Noriko; Tsukahara, Takamitsu; Kurita-Ochiai, Tomoko; Ochiai, Kuniyasu

2013-02-10

233

Artéria radial versus veia safena para revascularização do miocárdio: metanálise (não houve diferença estatisticamente significante) Radial artery versus saphenous vein to myocardial revascularization: meta-analysis (there is no statistically significant difference)  

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Full Text Available OBJETIVO: Comparar a efetividade do enxerto de artéria radial com o enxerto de veia safena para revascularização do miocárdio, em associação com a artéria torácica interna. MÉTODO: Realizou-se uma revisão sistemática da literatura, utilizando uma estratégia de busca de artigos aplicada às bases de dados da MEDLINE e LILACS. Dois pesquisadores independentes realizaram a seleção dos artigos identificados, avaliando criteriosamente a metodologia dos artigos considerados relevantes para o tema. Somente os ensaios clínicos controlados e randomizados com adequado sistema de aleatorização foram incluídos. Em todas as situações em que ocorreu discordância entre os pesquisadores, foi realizada uma reunião de consenso. Não foi estipulada restrição quanto ao período pós-operatório para avaliação angiográfica do enxerto, o vaso tratado cirurgicamente e as características dos pacientes incluídos. Os resultados são expressos como Risco Relativo (RR), com 95% de Intervalo de Confiança (CI), da comparação da efetividade entre a artéria radial e a veia safena. RESULTADOS: Com base nesses critérios foram incluídos três estudos. Não foi detectada diferença estatística entre a perviabilidade dos enxertos estudados (RR 0,53 [95% IC 0,13 - 2,18]). CONCLUSÃO: Apesar dos estudos serem de boa qualidade metodológica, não houve resultado estatisticamente significativo beneficiando um dos enxertos. O poder estatístico da metanálise é baixo. Portanto, são necessários novos ensaios clínicos controlados e randomizados, com tamanho de amostra adequado para detectar possíveis diferenças entre os tratamentos propostos.OBJECTIVE: To compare the effectiveness of radial artery graft with saphenous vein graft to myocardial revascularization, in association with the internal thoracic artery. METHODS: We made a systematic review of literature, using a strategy to search articles applied to MEDLINE and LILACS databases. Two independent researchers have carried through the election of identified articles, evaluating carefully the methodology of articles considered excellent for the subject. Only the randomized controlled trials, with adjusted randomization system have been enclosed. All the situations where the researchers didn't agree there was a consensus meeting. It hasn't been stipulated restriction for postoperative period to graft angiographic evaluation, the vessel treated and enclosed patient's characteristics. The results have been expressed as Risk Relative (RR), with 95% of Confidence Interval (CI), to comparison the effectiveness between the radial artery and the saphenous vein. RESULTS: Based in these criteria three studies have been enclosed. We couldn't find statistic difference between grafts' patency studied (RR 0.53 [95% IC 0.13 - 2.18]). CONCLUSION: Despite of the studies have good methodological quality, we have not observed a result significant statistically benefiting one of the grafts. The statistical power of the meta-analysis is low, therefore, it's necessary more randomized controlled trials, with adjusted sample size to detect possible differences between the considered treatments.

Rafael Fagionato Locali; Enio Buffolo; Roberto Catani

2006-01-01

234

Early Postnatal Ozone Exposure Alters Rat Nodose and Jugular Sensory Neuron Development.  

UK PubMed Central (United Kingdom)

Sensory neurons originating in nodose and jugular ganglia that innervate airway epithelium (airway neurons) play a role in inflammation observed following exposure to inhaled environmental irritants such as ozone (O(3)). Airway neurons can mediate airway inflammation through release of the neuropeptide substance P (SP). While susceptibility to airway irritants is increased in early life, the developmental dynamics of afferent airway neurons are not well characterized. The hypothesis of this study was that airway neuron number might increase with increasing age, and that an acute, early postnatal O(3) exposure might increase both the number of sensory airway neurons as well as the number SP-containing airway neurons. Studies using Fischer 344 rat pups were conducted to determine if age or acute O(3) exposure might alter airway neuron number. Airway neurons in nodose and jugular ganglia were retrogradely labeled, removed, dissociated, and counted by means of a novel technique employing flow cytometry. In Study 1, neuron counts were conducted on postnatal days (PD) 6, 10, 15, 21, and 28. Numbers of total and airway neurons increased significantly between PD6 and PD10, then generally stabilized. In Study 2, animals were exposed to O(3) (2 ppm) or filtered air (FA) on PD5 and neurons were counted on PD10, 15, 21, and 28. O(3) exposed animals displayed significantly less total neurons on PD21 than FA controls. This study shows that age-related changes in neuron number occur, and that an acute, early postnatal O(3) exposure significantly alters sensory neuron development.

Zellner LC; Brundage KM; Hunter DD; Dey RD

2011-01-01

235

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

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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.

Sharma Manish; Gupta A; Kale S; Agrawal D; Mahapatra A; Sharma B

2008-01-01

236

Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers.  

UK PubMed Central (United Kingdom)

BACKGROUND: Our aim in this study was to use ultrasonography of internal jugular vein (IJV) instead of visual estimation by eye and to get more precise estimation of central venous pressure at supine position for estimating blood loss in healthy volunteers. METHODS: The values of the sonographic IJV collapse index and corrected IJV longitudinal length (cIJV LL) (vertical height of the jugular vein from the sternal angle of Louis plus 5 cm) were compared before and after blood donation. The correlations between the mean arterial pressure, pulse rate, IJV collapse index, and cIJV LL were analyzed using SPSS version 15.0 (SPSS, Chicago, IL) and G*Power version 3.1.2. (Franz Faul, Universitat Kiel, Germany) was used for power and sample size analysis. RESULTS: A total of 80 volunteers were enrolled in the study. The medians of cIJV LLs before and after blood donation were 6.67 (95% confidence interval [CI], 6.72-7.07) and 5.98 (95% CI, 6.09-6.40), respectively. The medians of IJV collapse indices before and after blood donation were 32.74 (95% CI, 32.73-39.50) and 38.88 (95% CI, 35.54-42.95), respectively. Preliminary results of our study revealed that cIJV LL and IJV collapse index were not well correlated (Spearman ? correlation coefficient, 0.257; r = 0.128). CONCLUSION: Although, the IJV collapse index was not found to be a useful parameter for evaluation of hypovolemia, cIJV LL is more valuable marker for the detection of blood loss at bedside.

Unluer EE; Kara PH

2013-01-01

237

The role of Gamma Knife radiosurgery in the management of glomus jugular tumours.  

UK PubMed Central (United Kingdom)

BACKGROUND: Glomus jugular tumours are usually managed by microsurgical resection and/or radiotherapy with considerable risk for treatment-related morbidity. The role of Gamma Knife Radiosurgery (GKRS) in the management of these lesions remains to be defined. METHOD: Between May 1992 and November 2000, 19 patients with glomus tumours underwent GKRS at our department. Nine patients received radiosurgery for residual or recurrent paragangliomas following microsurgical resection and in 10 cases GKRS was performed as primary treatment. The median tumour volume was 5.22 ccm (range: 0.38-33.5 ccm). Marginal doses of 12-20 Gy (median 14 Gy) were applied to enveloping isodose volume curves (Range: 30-55%, median 50%). FINDINGS: Except for an 81-year-old patient who died 9 months after radiosurgery the observation time ranged from 1.5 to 10 years (median 7.2 yrs). The total tumour control rate was 94.7% (7 cases with decreased and 11 with stable tumour size). The only patient with tumour progression (5.3%) underwent repeated radiosurgical treatment 85 months after initial GKRS. A newly diagnosed second lesion in the cavernous sinus was treated radiosurgically as well 53 months after the first Gamma Knife procedure. On clinical examination 10 patients (52.6%) presented with improved and 8 patients (42.1%) with unchanged neurological status. Deterioration in one patient (5.3%) was not related to tumour or radiosurgery. INTERPRETATION: As GKRS demonstrated to be a minimally invasive treatment alternative to microsurgery and radiotherapy with no acute or chronic toxicity it should be considered more frequently in the primary or adjuvant strategy for glomus jugular tumours.

Eustacchio S; Trummer M; Unger F; Schröttner O; Sutter B; Pendl G

2002-01-01

238

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

International Nuclear Information System (INIS)

[en] 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. (author)

2000-01-01

239

Estudo anatômico da artéria torácica interna aplicado à cirurgia cardiovascular  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 outra (more) s 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. Abstract in english 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 Ne (more) oprene 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.

HENRIQUEZ-PINO, Jorge A; GOMES, Walter José; PRATES, José Carlos; BUFFOLO, Ênio

1997-01-01

240

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 alcoól (more) ica 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 patients 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 l (more) iver 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

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

2011-02-01

 
 
 
 
241

[Massive thrombosis caused by a Shaldon catheter for long-term hemodialysis and plasmapheresis via the vena jugularis interna  

UK PubMed Central (United Kingdom)

We report two cases of thrombosis of the internal jugular vein which occurred after prolonged cannulation of the vein by a Shaldon-catheter for acute haemodialysis. In one case this complication provoked cerebral oedema and death of the patient. In the second case the thrombosis of the internal jugular vein was confirmed by autopsy and documented by photography but did not affect the fate of the patient. Yoffa's supraclavicular approach to the subclavian vein is discussed as an alternative.

Jost U

1983-11-01

242

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  

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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.

Renan Roque Onzi; Luiz Francisco Costa; Regis Fernando Angnes; Luciano Amaral Domingues; Paulo Moraes; Leandro Armani Scaffaro; Carolina Mancuzo Stapenhorst

2007-01-01

243

Undivided Retromandibular Vein Continuing As External Jugular Vein With Facial Vein Draining Into It : An Anatomical Variation  

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Full Text Available Despite the fact that the blueprint of the whole body is unravelled, faultlessly during the growth anddevelopment of an animal; but amazingly variations do occur. During routine dissection of head and neckin a middle aged cadaver in the Post Graduate Department of Anatomy of this medical college, we foundvariation in the formation of external jugular vein on both sides, which was formed by the continuation ofundivided trunk of retromandibular vein. The facial vein and posterior auricular vein were the tributaries ofexternal jugular vein. The sound anatomical knowledge of variations of the veins of head and neck isessential to the success of surgical procedures. The embryological evaluation of the above anomaly wasdone and compared with the available literature which showed that the observed variation was rare

Shahnaz Choudhary, Ashwani K Sharma, Harbans Singh

2010-01-01

244

Spiral vein graft for internal jugular bypass in a patient with multiple sclerosis and suspected chronic cerebrospinal venous insufficiency.  

UK PubMed Central (United Kingdom)

Chronic cerebrospinal venous insufficiency (CCSVI) has been implicated as a contributing factor to multiple sclerosis (MS). This theory is strongly debated within the neurology and radiology communities. This report presents the case of a 45-year-old man with known MS and suspected CCSVI who had undergone previous internal jugular angioplasty and stenting. The patient reported dramatic improvement of symptoms after intervention. The stent thrombosed despite antithrombotic medication, and several endovascular interventions failed to restore long-term patency. Open venous reconstruction of the internal jugular vein was performed with a spiral graft from the saphenous vein. The patient's symptoms improved for several weeks until the venous reconstruction occluded. This case is the first reported open venous reconstruction for suspected CCSVI.

Fankhauser GT; Stone WM; Fu R; Money SR

2013-07-01

245

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

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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

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

2010-08-15

246

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

2008-01-00

247

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

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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 0.05), 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.

Jovanovi? Zagorka B.; Vujisi?-Teši? Bosiljka; Pavlovi? Aleksandra M.; Zidverc-Trajkovi? Jasna J.; Mijajlovi? Milija D.; Bori?i?-Kosti? Marija V.; Cvitan Edita Ž.; Radoji?i? Aleksandra P.; Tomi? Gordana; Šundi? Ana; Šterni?-?ovi?kovi? Nadežda M.

2011-01-01

248

Trendelenburg Position Does Not Increase Cross-sectional Area of the Internal Jugular Vein Predictably.  

UK PubMed Central (United Kingdom)

BACKGROUND: The Trendelenburg position is used to distend the central veins, improving both the success and safety of vascular cannulation. The purpose of this study was to measure the cross-sectional area (CSA) of the internal jugular vein (IJV) in three different positions using surface ultrasonography. METHODS: Fifty-one subjects were enrolled. A Sono Site Titan 180 or M-Turbo portable ultrasound machine with a 10.5-mHz broadband linear surface probe was used. We measured the CSA of the IJV (at end-expiration at the level of the cricoid cartilage) in three positions: 15° reverse Trendelenburg, supine, and 15° Trendelenburg. RESULTS: The mean CSA at 15° reverse Trendelenburg was 0.83 cm2 (SD, 0.86), in the supine position it was 1.25 cm2 (SD, 0.98), and at -15° Trendelenburg it was 1.47 cm2 (SD, 1.03). Moving from reverse Trendelenburg to supine, the CSA increased by 50%. In contrast, lowering the head to a Trendelenburg position increased the mean CSA by only 17%. Surprisingly, Trendelenburg positioning reduced the CSA in nine of the 51 subjects. CONCLUSIONS: Trendelenburg positioning augments the CSA only modestly, on average, compared with the supine position, and in some patients it reduces the CSA. TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT01099254; URL: www.clinicaltrials.gov.

Nassar B; Deol GR; Ashby A; Collett N; Schmidt GA

2013-07-01

249

Vascular assessment of the right internal jugular vein in low birth weight newborns.  

UK PubMed Central (United Kingdom)

Abstract Objective: To determine the dimensions and depth of the right internal jugular vein (RIJV) in low birth weight newborns by ultrasound and assess the differences in weight and determine the relationship of the vein with the carotid artery. Method: We performed a vascular assessment of the RIJV in 100 low birth weight newborns. The subjects were divided into three groups, low birth weight (LBW) newborns, <2500?g; very low birth weight (VLBW) newborns, <1500?g; and extremely low birth weight (ELBW) newborns <1000?g. Results: Of the newborns, 39% had LBW, 33% had VLBW, and 28% had ELBW. The medians were gestational age 31 weeks, weight 1300?g, anteroposterior diameter of the RIJV 2.2?mm, and the distance from the skin-RIJV 3.6?mm. In LBW newborns, the median anteroposterior diameter of RIJV was 2.7?mm; in LBW newborns 2.2; in ELBW newborns 1.9 (p?

Montes-Tapia F; Rodríguez-Taméz A; Hernandez-Garduño A; Barreto-Arroyo I; Rodríguez-Balderrama I; de la O-Cavazos M; Quero J

2013-10-01

250

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

UK PubMed Central (United Kingdom)

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.

Klement P; Du YJ; Berry LR; Tressel P; Chan AK

2006-10-01

251

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)

2010-01-01

252

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)

Full Text Available Abstract in spanish 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 anteriores (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 t (more) óxicos 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 results: 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 (more) 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.

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

2008-06-01

253

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)

Full Text Available Abstract in spanish 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 anteriores (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 t (more) óxicos 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 results: 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 i (more) nvolved, 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.

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

2008-02-01

254

A retrospective study of 29 cases of otitis media/interna in dairy calves  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Epidemiological data, clinical findings, laboratory data, medical imaging, and outcomes were reviewed in 29 dairy calves with otitis media/interna. Age at admission ranged from 1 to 24 wk. The majority of calves were referred during winter. Clinical signs included drooping ear, ptosis, head tilt, ab...

Gosselin, Véronique Bernier; Francoz, David; Babkine, Marie; Desrochers, André; Nichols, Sylvain; Doré, Elizabeth

255

Aneurysma der Vena jugularis interna als seltene Ursache einer schmerzlosen Halsschwellung  

Directory of Open Access Journals (Sweden)

Full Text Available Geschildert wird der Fall einer 70-jährigen Patientin, bei der ein Aneurysma der Vena jugularis interna links als Ursache einer asymptomatischen Halsschwellung diagnostiziert wurde. Es werden das klinische Bild, potenzielle Komplikationen sowie das diagnostische und therapeutische Management anhand einer Literaturübersicht dargestellt.

Pfabe FP

2012-01-01

256

Headache in a patient with Klinefelter’s syndrome and hyperostosis frontalis interna  

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Hyperostosis frontalis interna (HFI) has been reported in older women, but reports in men are rare. We present a novel case of migraine headache in a gentleman with Klinefelter’s syndrome and HFI, along with a discussion of possible pathophysiologic mechanisms underlying both the headache and the HF...

Ramchandren, Sindhu; Liebeskind, David S.

257

Difference between values of gas analysis of arteries and internal jugular vein in patients with cerebral infarction  

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Full Text Available Introduction. Cerebral infarction is more and more frequently present by massive participation and high percentage of mortality even in young population. It is notified as very hard, vitally endangered disease. Objective. To prove whether there is a difference in the gas analyses of the arterial and cerebral venous blood between the patients with the cerebral infarction of the left and right hemisphere and why it is significant for the treatment of those patients. Material and methods. Sixty-five (65) patients of both sexes who were diagnosed by CT as: cerebral infarction, cerebral multiinfarctions and cerebral haemorrhagic infarctions were investigated. Under the same conditions their radial artery and left and right internal jugular vein were tapped - on the fourth, eighth and tenth day of their disease. Gas analysis, calculation of oxygen content and statistical comparison of testing results were performed from the samples of arterial and venous blood. Results. By continuous monitoring of gas analysis parameters of arterial and cerebral venous blood from internal jugular vein, we can follow up the phases of disease, the velocity of changes of gas analysis parameters and adequacy of brain circulation and to correct therapy adequately for the purpose of preventing basic disease complications and to estimate the results of treatment. Conclusion. There is a significant difference between the results of gas analysis of arteries and the internal jugular vein, in patients with infarctions of the left and right hemisphere of the brain.

Danilovi? L.R.; Milakovi? B.D.; Dostani? M.M.; Stoi? M.M.; Baljozovi? B.V.; Koji? Z.; Marinkovi? D.M.; Markovi? D.J.

2008-01-01

258

Preparation of the saphenous vein for coronary artery bypass grafting: a new technique "no touch" that maintains the vein wall integral and provides high immediate patency/ Preparo da veia safena na cirurgia de revascularização miocárdica: uma nova técnica -"no touch"- que mantém a parede da veia íntegra e proporciona uma alta perviabilidade imediata  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: O objetivo deste trabalho é apresentar uma nova técnica "no touch" de preparo da veia safena e sua importância clínica. Esta nova técnica consiste na retirada da veia safena do seu leito, juntamente com um pedículo de tecido adiposo, protegendo a veia contra espasmos e, conseqüentemente, da necessidade de distendê-la durante a operação. MÉTODO: O estudo foi realizado em dois tempos: 1) Inicialmente, foi realizado um estudo prospectivo e randomizado, e (more) nvolvendo 156 pacientes que foram submetidos à operação de revascularização miocárdica. Neste estudo nós comparamos a técnica "no touch" (NT) com duas outras: a convencional (C) e a intermediária (I). Foi feita uma avaliação detalhada da morfologia endotelial, utilizando a microscopia eletrônica, enquanto que a perviabilidade das pontes foi determinada com um exame angiográfico executado num período médio de 18 meses após a operação. 2) Finalmente, a enzima óxido nítrico síntase (NOS) foi identificada com ajuda do estudo imunohistoquímico e também pela localização auto-radiográfica de (3H)-L- Nitro-Arginina (NOARG). RESULTADOS: A avaliação morfológica mostrou integridade endotelial de 97% nas veias que foram tratadas pela técnica NT; enquanto quase metade da superfície endotelial das veias tratadas pelas outras duas técnicas exibiu ausência de células endoteliais. O exame angiográfico revelou perviabilidade de 95,4% para as pontes do grupo NT, 88,9% para as pontes do grupo (C) e 86,2% para as pontes do grupo (I). O estudo imunohistoquímico revelou a presença de NOS nas três camadas que compõem a parede da veia quando, as mesmas, foram tratadas pela técnica NT. Por outro lado, foi observada uma elevada redução desta enzima nas veias que foram tratadas pela técnica (C). A análise auto-radiográfica confirmou os resultados imunohistoquímicos. CONCLUSÃO: A integridade endotelial e a atividade da enzima óxido nítrico síntase foram melhor mantidas com o uso da técnica NT no preparo da veia safena. A atividade vasodilatadora e bloqueadora da agregação plaquetária causada pelo óxido nítrico (NO) pode ser a responsável pela proteção da veia contra o espasmo, como também pela alta perviabilidade imediata da mesma. Além disso, as propriedades mecânicas providas pelo tecido gorduroso em volta da veia, contribuíram para o melhor resultado desta nova técnica. Abstract in english BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafting (CABG) influences the fate of vein grafts. A new "no touch" (NT) technique of SV preparation was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasms therefore obviating the need for distension. METHOD: A prospective randomized study in 156 patients who underwent CABG was performed comparing three SV harvesting tech (more) niques. The techniques were conventional (c) (adventitial stripping of the vein, manual distention and storing in saline solution); Intermediate (I) (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood); and "no touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood). A morphological study of the endothelium was preformed using scanning electronic microscopy and an angiographic assessment of the vein graft patency was performed at 18 months mean follow-up time. Also an immunohistochemistry assessment was performed to identify the enzyme, nitric oxide synthase (NOS) in the vein wall. RESULTS: The preservation of the endothelial cell integrity was greater with the "no touch" technique than with the other procedures. At angiographic follow up, the patency for NT was 95.4%, 88.9% for grafts in group C and 86.2% for grafts in group I. The immunohistochemistry assessment revealed NOS in all three layers of the vein wall that was prepared by the "no touch"

Souza, Domingos S. R.; Dashwood, Michael R.; Tonazi, Alan; Johansson, Benny; Buffolo, Enio; Lima, Ricardo; Filbey, Derek; Bomfim, Vollmer

2003-12-01

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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  

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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.

Álvaro Antônio Bandeira Ferraz; Josemberg Marins Campos; José Guido Corrêa de Araújo Júnior; Márcio Rogério Carneiro de Carvalho; João Paulo Ribeiro Neto; Edmundo Machado Ferraz

2011-01-01

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

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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 como: 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.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, alcoholic 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.

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

2002-01-01

 
 
 
 
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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)

Full Text Available Abstract in portuguese 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 como: sexo masculino, cirrose avançada, doença hepática alcoólica e cirurgia prévia para hipertensão portal. Os autores relatam o caso de uma criança de 4 anos, (more) 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, alcoholic 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 (more) 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.

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

2002-02-01

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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)

Full Text Available Abstract in portuguese 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.

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

2011-06-01

263

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  

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Full Text Available Abstract in portuguese 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 comparar com volutários de condições sócio-econômico-ambientais similares, não portadores de esquistossomose. MÉTODOS: Utilizando aparelho de ultra-som Doppler de 7,5MHz (more) 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 grou (more) ps 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.

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

2009-08-01

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Ultrasonographic finding of internal jugular vein during anti-G straining maneuver: is it associated with gravity-induced loss of consciousness?  

UK PubMed Central (United Kingdom)

Gravity-induced loss of consciousness (G-LOC) is caused by loss of cerebral blood flow during high +Gz (head-to-foot inertial forces). The resistance of the jugular vein is a significant factor in decrease in cerebral blood flow. Ultrasonography of thoracic inlet veins, including internal jugular vein, is feasible to visualize the internal jugular vein and hemodynamic information. Anti-gravity straining maneuver (AGSM) was widely recognized as one of the important factors in preventing G-LOC. The purpose of this study was to evaluate the relationship between the ultrasonographic shape and size of internal jugular vein during AGSM and G-LOC. 47 trainee pilots who participated in human centrifuge education program were enrolled. They were all men, and their mean age was 23.9 +/- 1.38 years. Questionnaire sheets were used to collect information about well-being sensation, smoking, drinking, height, and weight. Using ultrasonography, we monitored shape and size of internal jugular vein during AGSM. After ultrasonographic examination, 47 subjects underwent human centrifuge on the same day. The protocol of human centrifuge training was maximal 6G with sustaining time of 30 s. G-LOC occurred to ten out of 47 subjects in human centrifuge. To find presumptive variable associated with G-LOC, we performed logistic regression analysis. Concave contour and smaller cross-sectional area of internal jugular vein during AGSM were associated with G-LOC.

Choi HS; Sul JG; Yi KS; Seo JM; Chung KY

2010-07-01

265

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  

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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.

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

2008-01-01

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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  

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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.

FERRAZ Álvaro Antônio Bandeira; LOPES Edmundo Pessoa de Almeida; BARROS Fábio Marinho do Rego; SETTE Marcelo José Antunes; ARRUDA Severino Marco Borba; FERRAZ Edmundo Machado

2001-01-01

267

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

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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

Roberto Costa; Maria Inês de Paula Leão; Kátia Regina da Silva; Paulo Roberto Camargo; Regina Valéria Costa

2006-01-01

268

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)

Full Text Available Abstract in portuguese 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 embrion&# (more) 225;rias, 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 postcardinal 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 (more) 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.

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

2013-07-01

269

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

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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 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 patients 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 < 0.01). A significant negative correlation between the Doppler waveform pattern of right hepatic vein and steatosis degree was observed (r = 0.57; p < 0.01). CONCLUSION: An abnormal Doppler waveform pattern of right hepatic vein in patients with nonalcoholic fatty liver disease may suggest the presence of decreased vascular compliance caused by fatty infiltration.

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

2011-01-01

270

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)

Full Text Available Abstract in portuguese 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 dispositiv (more) os, 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 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 (more) 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.

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

2005-10-01

271

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

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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.

Taveira Marcos Roberto; Cabral Antônio Carlos Vieira; Leite Henrique Vítor

2003-01-01

272

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  

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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

Luís Fernando Tirapelli; Daniela Pretti da Cunha Tirapelli; Marcelo Bellini Dalio; Alfredo José Rodrigues; Paulo Roberto Barbosa Évora

2009-01-01

273

Ultrasonic quantitative detection of elasticity of jugular vessel wall of female pilots and its application value  

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Full Text Available Objective To observe the elasticity of the jugular vessel wall of female aerotransport pilots on active duty,provide a reference for the selection of female pilots,and the prevention and therapy of cardiovascular diseases in female pilots.Methods Using the Echo-Tracking technique,the elastic parameters of the carotid artery were quantitatively detected in nineteen female pilots who were first selected as female astronauts.Twenty male pilots who were selected as astronauts were randomly chosen as the control group.No statistical difference in age and blood pressure between the two groups was found.No history of cardiovascular diseases was recorded,and no abnormal signs were revealed in the results of the physical examination.Electrocardiogram,chest radiography,hepatic and kidney function,and biochemical examination showed normal results.The factors affecting the elasticity of the artery could possibly be avoided for the male pilots except for the fighter pilots or the smokers.Results No statistical difference was found in the clinical and biochemical data between the pilot groups(P > 0.05).As for carotid artery elastic parameters,no statistical difference between the left and right sides of the artery was indicated.The elastic modulus,arterial stiffness index,and pulse wave velocity of the carotid artery wall of the female pilots were significantly lower than those of the male pilots(P < 0.05),and the arterial compliance was significantly higher than that of the male pilots(P < 0.05).Conclusion All of the elastic parameters of the vessel wall of female pilots were better than those of the male pilots.

Long-fang ZHANG; Jing LIU; Ke-chun YAO; Wen-xiu LI; Shu-ping LIU; Li LI

2011-01-01

274

Placement of port-a-cath through the right internal jugular vein under ultrasound guidance.  

UK PubMed Central (United Kingdom)

PURPOSE: This study was undertaken to demonstrate the effectiveness of ultrasound (US)-guided placement of porta-cath (PC) through the right internal jugular vein (RIJV) by evaluating the onset of early and late complications. MATERIALS AND METHODS: From 30 June 2008 to 30 June 2011, we placed 695 port-a-caths in 694 patients with a mean age of 58 years. Exclusion criteria were active infection, bleeding disorders and life expectancy <6 months. The procedures were performed in the angiography suite under local anaesthesia. After US-guided puncture of the RIJV, the subcutaneous pocket was prepared, followed by tunnelling of the vein and closure of the surgical wound. In order to evaluate pneumothorax (PNX), all patients underwent chest X-ray a few hours after the end of the procedure unless there were clinical indications. We evaluated the technical success of the procedure and the rate of complications. RESULTS: Technical success was achieved in all cases. The device was kept in place for an average of 168 days. There was one case of PNX (0.14%) as shown on chest X-ray and five cases of late complications (0.70%): one case of intracatheter thrombosis (0.14%), two cases of disconnection between the reservoir and catheter (0.28%) and two cases of PC infection (0.28%). CONCLUSIONS: This procedure incurs very small number of complications compared with other positioning techniques using accesses such as the subclavian vein. Complications recorded in our study are comparable, in type and incidence, to those found by other authors, with the most frequent being device infection.

Capalbo E; Peli M; Lovisatti M; Cosentino M; Ticha V; Cariati M; Cornalba G

2013-06-01

275

Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia  

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Full Text Available Abstract Background Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS) is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM) in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF) pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF) between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP). Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed. Results Computed tomography (CT) scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D) models of the skull and the JF. Weight matched groups (7–10 kg) of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p 3; median right JF: 0.0434 cm3; p Conclusion A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF pressure waves in the subarachnoid space, independent of cerebellar herniation, as an additional pathogenetic factor for the development of SM in this breed.

Schmidt Martin; Ondreka Nele; Sauerbrey Maren; Volk Holger; Rummel Christoph; Kramer Martin

2012-01-01

276

The jugular foramen: imaging strategy and detailed anatomy at 3T.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: The purpose of this study was to assess how well the anatomy of the jugular foramen (JF) could be displayed by 3T MR imaging by using a 3D contrast-enhanced fast imaging employing steady-state acquisition sequence (CE-FIESTA) and a 3D contrast-enhanced MR angiographic sequence (CE-MRA). MATERIALS AND METHODS: Twenty-five patients free of skull base lesions were imaged on a 3T MR imaging scanner using CE-FIESTA and CE-MRA. Two readers analyzed the images in collaboration, with the following objectives: 1) to score the success with which these sequences depicted the glossopharyngeal (CNIX) and vagus (CNX) nerves, their ganglia, and the spinal root of the accessory nerve (spCNXI) within the JF, and 2) to determine the value of anatomic landmarks for the in vivo identification of these structures. RESULTS: CE-FIESTA and CE-MRA displayed CNIX in 90% and 100% of cases, respectively, CNX in 94% and 100%, and spCNXI in 51% and 0% of cases. The superior ganglion of CNIX was discernible in 89.8% and 87.8%; the inferior ganglion of CNIX, in 73% and 100%; and the superior ganglion of CNX, in 98% and 100% of cases. Landmarks useful for identifying these structures were the inferior petrosal sinus and the external opening of the cochlear aqueduct. CONCLUSIONS: This study protocol is excellent for displaying the complex anatomy of the JF and related structures. It is expected to aid in detecting small pathologies affecting the JF and in planning the best surgical approach to lesions affecting the JF.

Linn J; Peters F; Moriggl B; Naidich TP; Brückmann H; Yousry I

2009-01-01

277

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)

Full Text Available Abstract in portuguese 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 (more) 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. 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 as (more) ymmetry 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.

Marcondes, Jorge; Aversa, Antônio; Peçanha, Marcio; Domingues, Flávio; Nascimento, Fernanda; André, Charles; Freitas, Gabriel; Azevedo, Feliciano; Exposito, Maria

2001-09-01

278

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  

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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.

Jorge Marcondes; Antônio Aversa; Marcio Peçanha; Flávio Domingues; Fernanda Nascimento; Charles André; Gabriel Freitas; Feliciano Azevedo; Maria Exposito

2001-01-01

279

Malformações das orelhas média e interna em dois casos de síndrome velocardiofacial  

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Full Text Available Objetivo: Descrever as características audiométricas e malformações das orelhas média e interna em dois pacientes portadores de síndrome velocardiofacial. Método: Avaliação audiométrica, tomografia computadorizada dos ossos temporais e análise de DNA, para marcadores múltiplos da região 22q11, foram realizadas em dois pacientes com sinais clínicos da síndrome velocardiofacial. Resultados: Perdas auditivas condutivas relacionadas com otite média crônica e malformações das orelhas média e interna foram encontradas, estas últimas com a utilização de reformatações baseadas em aquisições multislice da tomografia computadorizada dos ossos temporais. Conclusão: Consideramos de grande importância realizar uma completa avaliação e monitoramento da evolução da função auditiva, bem como do surgimento de sintomas relacionados à função vestibular em pacientes com a síndrome velocardiofacial. Do ponto de vista radiológico chamamos a atenção para o uso de técnicas de alta qualidade para o estudo tomográfico dos ossos temporais. Palavras chave: orelha, perda auditiva, velocardiofacial.

Tabith Junior, Alfredo; Haetinger, Rainer Guilherme; Silva, Fernando Leite de Carvalho e; Gudmon, Monica de Castro

2009-01-01

280

Forma breve del SPSI-R: Análisis preliminar de su validez interna y confiabilidad  

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Full Text Available Se reporta un análisis preliminar de la validez interna de la forma corta del Inventario de Resolución de Problemas Sociales- Revisado, en una muestra de 366 universitarios de una universidad privada en Lima, Perú. Se compararon las correlaciones observadas entre la forma corta y larga, y los coeficientes de consistencia interna, con estimaciones teóricas establecidas como línea base (corregidas por errores correlacionados) y coeficientes de confiabilidad corregidos por el número de ítems. Luego de aplicar estos ajustes, los resultados indican elevada varianza compartida en las subescalas, así como aceptables coeficientes de confiabilidad, excepto para el puntaje Orientación Positiva al Problema. Esta exploración preliminar da respaldo psicométrico a la forma corta del SPSI-R para un nuevo contexto de aplicación, y garantiza profundizar su investigación.

César Merino

2012-01-01

 
 
 
 
281

A Consultoria Interna de Recursos Humanos como Prática Catalisadora da Gestão do Conhecimento Organizacional  

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Full Text Available Este artigo objetiva analisar a contribuição da Consultoria Interna de Recursos Humanos para a Gestão do Conhecimento nas indústrias catarinenses de grande porte. Os procedimentos metodológicos seguiram a linha qualitativa, por meio da pesquisa descritiva e aplicada. Foram entrevistadas sete das maiores empresas catarinenses em número de funcionários. Utilizou-se análise documental e de conteúdo. Quanto aos resultados, a consultoria interna auxilia principalmente nas etapas de socialização e externalização do conhecimento. Além disso, se implementada na sua totalidade e dada autonomia ao consultor interno, permite uma maior interação nos níveis individual, grupal e organizacional descritos por Sabbag (2007). Assim, pode-se perceber que as empresas que possuem maior grau de autonomia, bem como maior nível de implementação são aquelas que os processos são mais compartilhados, socializados e internalizados pelos funcionários. Dessa forma, pode-se afirmar que, nas empresas analisadas, o desenvolvimento dos processos de CIRH catalisa os resultados da Gestão do Conhecimento nas mesmas.

Dante Marciano Girardi; Édis Mafra Lapolli; Kelly Cristina Benetti Tonani Tosta

2009-01-01

282

Apuntes sobre migraciones internas e identidad Caribe: Caso del turismo y cruceros en Cartagena  

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Full Text Available El presente artículo es un análisis exploratorio sobre la relación que existe entre la identidad Caribe y las migraciones internas sujetas al turismo, así como sus implicaciones en asuntos de género. Como ejemplo menciono el caso de los cruceros en Cartagena y los estereotipos y prácticas en torno a la cultura negra como fetiche, a partir de la revisión bibliográfica de algunos autores que abordan estos temas

Katia Padilla Díaz

2008-01-01

283

Tunneled internal jugular hemodialysis catheters: impact of laterality and tip position on catheter dysfunction and infection rates.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine rates of dysfunction and infection for tunneled internal jugular vein hemodialysis catheters based on laterality of insertion and catheter tip position. MATERIALS AND METHODS: Retrospective review of a procedural database for tunneled internal jugular vein hemodialysis catheter placements between January 2008 and December 2009 revealed 532 catheter insertions in 409 patients (234 male; mean age, 54.9 y). Of these, 398 catheters were placed on the right and 134 on the left. The catheter tip location was categorized as superior vena cava (SVC), pericavoatrial junction, or mid- to deep right atrium based on review of the final intraprocedural radiograph. The rates of catheter dysfunction and catheter-related infection (reported as events per 100 catheter-days) were analyzed. RESULTS: Catheters terminating in the SVC or pericavoatrial junction inserted from the left showed significantly higher rates of infection (0.50 vs 0.27; P = .005) and dysfunction (0.25 vs 0.11; P = .036) compared with those inserted from the right. No difference was identified based on laterality for catheter tip position in the mid- to deep right atrium. Left-sided catheters terminating in the SVC or pericavoatrial junction had significantly more episodes of catheter dysfunction or infection than catheters terminating in the mid- to deep right atrium (0.84 vs 0.35; P = .006), whereas no significant difference was identified for right-sided catheters based on tip position. CONCLUSIONS: When inserted from the left internal jugular vein, catheter tip position demonstrated a significant impact on catheter-related dysfunction and infection; this relationship was not demonstrated for right-sided catheters.

Engstrom BI; Horvath JJ; Stewart JK; Sydnor RH; Miller MJ; Smith TP; Kim CY

2013-09-01

284

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)

Full Text Available Abstract in spanish 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. (more) 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 periods (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 us (more) ed. 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

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

2004-02-01

285

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.)

1995-01-01

286

Use of a murine endometriosis interna model for the characterization of compounds that effectively treat human endometriosis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Endometriosis is a chronic, estrogen-dependent disease characterized by the presence of ectopic endometrium either in the pelvic cavity (endometriosis externa) or within the uterus (endometriosis interna, adenomyosis). Key symptoms are pelvic pain, dysmenorrhea and infertility. Established rodent an...

OTTO, CHRISTIANE; SCHKOLDOW, JENNY; KRAHL, ELISABETH; FUCHS, IRIS; ULBRICH, HANNES-FRIEDRICH

287

Viorella Manolache (ed.), Centru ?i margine la Marea Mediteran?. Filosofie politic? ?i realitate interna?ional? (Bucharest: Editura ISPRI, 2009)  

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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.

Henrieta Serban

2013-01-01

288

Comparison of results of placement of cuffed -tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis.  

Science.gov (United States)

Aim of the study was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis. Material and methods. Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter's placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA). Results. There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04). Conclusion. Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement. PMID:23612620

Zafarghandi, Mohammad-Reza; Nazari, Iraj; Taghavi, Morteza; Salimi, Javad; Moini, Majid; Askarpour, Shahnam

2013-03-01

289

Comparison of results of placement of cuffed -tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis.  

UK PubMed Central (United Kingdom)

Aim of the study was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis. Material and methods. Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter's placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA). Results. There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04). Conclusion. Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement.

Zafarghandi MR; Nazari I; Taghavi M; Salimi J; Moini M; Askarpour S

2013-03-01

290

Effective use of flow-spoiled FBI and time-SLIP methods in the diagnostic study of an aberrant vessel of the head and neck: "left jugular venous steal by the right jugular vein".  

UK PubMed Central (United Kingdom)

Three-dimensional (3D) time-of-flight (TOF) is now commonly used in routine magnetic resonance angiography (MRA) studies of the head and neck. However, there are limits to its diagnostic abilities in the clinical field and, in some instances, a more invasive supplementary examination may be required. We incidentally discovered a patient with an aberrant vessel of the head and neck that ran alongside the left carotid artery and contained a constant, slowly pulsating efferent blood flow. 3D-TOF and carotid ultrasonography could not determine the nature and origin of this vessel. Additional studies using flow-spoiled fresh blood imaging (flow-spoiled FBI) and time spatial labeling inversion pulse (time-SLIP) methods were effective in determining that the vessel was the left jugular vein, and that the continuous venous reflux was a result of a venous steal by the right jugular vein. We show that by combining different MRA techniques we can effectively achieve diagnosis without resorting to more invasive examinations.

Kogure T; Kogure K; Iizuka M; Ino A; Ishii M

2010-08-01

291

Obtenção da veia safena magna através de acesso minimamente invasivo para revascularizações miocárdicas Minimally invasive greater saphenous vein access as a conduit for coronary artery bypass surgery  

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Full Text Available Objetivo: Avaliar a possibilidade de obtenção da veia safena magna através de miniincisões de pele, a sua qualidade e a ocorrência de complicações precoces da ferida operatória. Casuística e Métodos: Foram estudados 46 pacientes, admitidos entre julho e novembro de 1999. Após miniincisões longitudinais de pele a veia safena magna foi identificada e, com auxílio de afastador de lâmina longa e estreita, delicadamente dissecada. Os pacientes foram divididos em 2 grupos na dependência da presença dos fatores de risco: anemia, aterosclerose periférica, obesidade e diabete melito. As feridas operatórias foram observadas quanto às complicações maiores e menores. Amostras da veia foram enviadas para estudo histológico. Resultados: O número médio de incisões foi 2,3, com tamanho médio de 3,5 cm e de todas incisões somadas de 7,3 cm. O tamanho médio da veia foi 34,1 cm, com tempo médio de retirada de 28,7 minutos. Foram observadas complicações menores em 5 (10,8%) pacientes; sendo hematoma local a mais comum (6,5%). Não foram observadas complicações maiores e a ressecção foi sempre possível. Em 2 casos houve lesão macroscópica da veia, sendo possível a sua correção e utilização. O estudo histológico demonstrou preservação da arquitetura tecidual e não evidenciou lesão endotelial significativa. Conclusões: A obtenção da veia safena magna através de miniincisões é possível e resulta em adequado enxerto venoso. A incidência de complicações da ferida é baixa e independente dos fatores de risco. Estes resultados preliminares sugerem que a técnica pode ser aplicada com segurança em pacientes submetidos à revascularização miocárdica, embora os resultados a longo prazo ainda necessitem ser determinados.Objective: The aim of this study was to evaluate the possibility of excision of the greater saphenous vein through the minimal invasive technique, assessing its morphologic quality and the early complications in the leg wound. Material And Methods: From July to November/1999, 46 patients received aortocoronary saphenous vein bypass graft. A miniincision was made, the vein was identified and gently dissected out with a special retractor, with a long and narrow blade. The samples of the vein were sent to histological analysis. Taking into accounts the presence or absence of the risk factors (female sex, anemia, obesity, peripheral vascular disease and diabetes mellitus) the patients were divided into two groups. The wounds were inspected, looking for majors and minor wound complications. Results: The average number of incisions was 2.3, the average length was 3.5 cm, and the average of all incision length was 7.3 cm. The average length of vein harvested was 34.1 cm. The mean duration of the procedure was 28.7 minutes. Minor leg wound complications occurred in 5 (10.8%) patients and the most common problem was local hematoma (6.5%). There were no major complications. The macroscopically evaluation showed two tears but the correction was possible. Histological study showed that vascular integrity was maintained and there was no significant endothelial damage. Conclusions: It was possible to harvesting satisfactory length of the vein through minimally invasive technique. This technique does not compromise the morphological quality of the vein graft. A low incidence of leg wound complications was observed, independently of the risk factors. These initial results suggest that this technique can be satisfactorily used for harvesting the greater saphenous vein. However, the long-term results still remain to be determined.

André Luiz TYSZKA; Leila Satomi FUCUDA; Eloisa de Brida TORMENA; Antonio Carlos L. CAMPOS

2001-01-01

292

Relationship between the diameter of great saphenous vein and body mass index Relação entre o diâmetro da veia safena magna e o índice de massa corporal  

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Full Text Available OBJECTIVE: This study has been designed to correlate the diameter of the greater saphenous vein in different levels of the lower limbs with the body mass index of each individual to determine a possible relation between them. METHODS: Fifty-two lower limbs in 26 volunteers (six males and 20 females) without a chronic venous disease record, aged 21-68 were evaluated. Prior to color-flow duplex scanning the body mass index was defined. The deep and superficial venous systems and perforator veins were assessed as described in the literature. The diameter of the greater saphenous vein was measured with ultrasound longitudinal imaging in seven different levels. For the statistical analysis, Student t test for paired data and Spearman test were used. RESULTS: The difference observed in saphenous venous in the second and third levels when compared to the lower right and left limbs was not considered significant and a single group was formed to correlate with body mass index. The correlation was considered statistically irrelevant. CONCLUSION: By correlating the diameters of the greater saphenous vein with the body mass index of each individual it was noted that the relation between them is not significant, therefore it can be assumed that tall thin individuals can have greater saphenous vein with similar diameter as short fat individuals.OBJETIVO: Este estudo teve o objetivo de comparar o diâmetro da veia safena magna em diferentes níveis dos membros inferiores e o índice de massa corporal dos sujeitos para determinar uma possível relação entre esses fatores. MÉTODOS: Cinqüenta e dois membros inferiores de 26 voluntários (seis homens e 20 mulheres) sem registro de doença venosa crônica, com idades entre 21 e 68 anos, foram avaliados. O índice de massa corporal foi definido antes do eco-Doppler colorido. Os sistemas venosos superficial e profundo e as veias perfurantes foram avaliados de acordo com a literatura. O diâmetro da veia safena magna foi medido através de imagem ultra-sonográfica longitudinal em sete níveis diferentes. Para a análise estatística, foram utilizados o teste t de Student para dados pareados e o teste de Spearman. RESULTADOS: A diferença observada na veia safena no segundo e terceiro níveis, quando comparada aos membros inferiores direito e esquerdo, não foi considerada significativa, e somente um grupo foi formado para a comparação com o índice de massa corporal. A correlação foi considerada estatisticamente irrelevante. CONCLUSÃO: Através da comparação dos diâmetros da veia safena magna com o índice de massa corporal dos sujeitos, percebeu-se que a relação entre esses dois fatores não é significativa e, portanto, pode-se concluir que indivíduos altos e magros podem ter veias safenas magnas com diâmetros similares aos de indivíduos baixos e gordos.

Amélia C. Seidel; Fausto Miranda Jr.; Yara Juliano; Neil F. Novo

2005-01-01

293

Tromboflebite séptica da veia porta secundária à apendicite Septic thrombophlebitis of the portal vein as a complication of appendicitis  

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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.

Olival Cirilo Lucena da Fonseca-Neto; Luiz Paulo Figueiredo Vieira; Antônio Lopes de Miranda

2007-01-01

294

Tromboflebite séptica da veia porta secundária à apendicite/ Septic thrombophlebitis of the portal vein as a complication of appendicitis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 laparo (more) tomia 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. Abstract in english 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 s (more) howed 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.

Fonseca-Neto, Olival Cirilo Lucena da; Vieira, Luiz Paulo Figueiredo; Miranda, Antônio Lopes de

2007-06-01

295

Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report Entomoftoromicose mediastinal e pulmonar com síndrome de veia cava superior: registro de caso  

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Full Text Available The first case of mediastinal and pulmonary entomophthoromycosis with supe rior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediastinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary diagnosis of nonHodgkin's malignant lymphoma was made. Surgical correction of the obstructed area was performed and the patient was sucessfully treated with potassium iodide. The authors propose that mediastinal entomoph thoromycosis must be considered in the differential diagnosis of diseases causing superior vena cava syndrome in tropical and sub-tropical regions. This case enlarges the spectrum of clinical manifestations of the zigomycosis caused by Entomoph-thoraceae.O primeiro caso de entomoftoromicose mediastinal e pulmonar com síndorme de veia cava superior, é descrito. A paciente apresentou-se com historia de edema facial, cervical e de membros superiores, bem como circulação colateral na parede anterior do tórax. O estudo histopatológico do tecido do mediastino, próximo à veia cava, revelou reação granulomatosa com microabscesses, circundados por material amorfo, eosinofílico e com hifas largas no centro. Cultura não foi realizada porque o diagnóstico clínico foi de doença de Hodgkin ou de um linfoma não-Hodgkin. Correção cirúrgica da área obstruída foi realizada e a paciente tratada com iodeto de potássio, nas doses preconizadas, obtendo-se sucesso. Os autores propõem que a entomoftoro-micose mediastinal deva ser considerada no diagnóstico diferencial de doença causando síndrome de veia cava superior em regiões tropicais e subtropicais. Este caso aumenta o espectrum de manifestações clínicas das zigomicoses causadas por Entomophthoraceae.

João Carlos Coelho Filiio; Jorge Pereira; Álvaro Rabello Júnior

1989-01-01

296

Revascularização direta do miocárdio com as duas artérias mamárias internas: análise de 442 casos/ Revascularization with double internal mammary artery: analysis of 442 patients  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese No período de julho de 1984 a novembro de 1989, foram submetidos a revascularização direta do miocárdio 4958 pacientes. Em 54% foi empregada pelo menos uma artéria mamária interna (AMI) e em 442 (8,91%) pacientes as duas artérias mamárias interna direita (AMID) e interna esquerda (AMIE), associadas ou não a outros tipos de enxertos. A idade variou de 30 a 78 anos (média de 52,7 anos) e 399 pacientes eram do sexo masculino. Os pacientes que receberam as duas AMIs (more) foram classificados em 4 grupos: Grupo 1: AMIE para descendente anterior (DA) e AMID para diagonal (Di); diagonalis (DI), circunflexa (Cx) ou seus ramos marginais em posição retro-aórtica 232 (52,4%) pacientes; Grupo 2: AMIE para DA e MID para coronária direita (CD) ou seus ramos 135 (30,5%) pacientes; Grupo 3: AMIE para ramos da Cx e AMID para DA (enxerto livre) ou seus ramos 48 (10,8%) pacientes; Grupo 4: outras associações 27 (6%) pacientes. Em todos os grupos, as revascularizações foram ou não complementadas com pontes de veia safena, artéria epigástrica inferior, artéria gastro-epiplóica e condutos sintéticos (como Gorotex). A média de ramos coronarianos revascularizados foi de 3,17 pontes por pacientes. As principais complicações imediatas observadas foram: insuficiência respiratória 37 (8,3%) pacientes, baixo débito 23 (5,2%) pacientes; infarto do miocárdio 16 (3,6%); deiscência e infecção de esterno 15 (3,6%). A mortalidade imediata global foi de 4,97% (22 pacientes) e as principais causas de óbito foram: falência de múltiplos órgãos em 7 pacientes, insuficiência miocárdica em 6 (27,3%). Observou-se maior índice de mortalidade em pacientes com idade superior a 60 anos e com severa disfunção ventricular. A melhor associação enxerto/coronária foi obtida quando da anastomose da AMIE com a DA (patencia de 93,8%). O emprego de duas mamárias vem sendo incrementado no Serviço, bem como o uso de outros enxertos arteriais, especialmente a artéria epigástrica em função dos aceitáveis índices de morbi-mortalidade. Abstract in english From June 1984 to November 1989, 4958 patients (pts) were submitted to myocardial revascularization in the Heart Institute, and in 54% at least one internal mammary artery was used. In 442 (8,9%) pts both intenal mammary arteries, right (RIMA) and left (LIMA) were used, isolated or associated to ther grafts. The age ranged from 30 to 78 years old (52,7y) and 399 were male. The pts were separated in 4 groups, being: G I 232 (52,4%) pts - LIMA to left anterior descending ar (more) tery (LAD) and RIMA to LAD branches or circumflex (Cx) branches in retroaortic position; G II 135 (30,5%) pts - LIMA to LAD and RIMA to right coronary artery (RCA); G III 48 (10,8%) pts - LIMA to Cx branches and RIMA to LAD as a free graft; G IV 27 (6,1%) pts - different associations with both arteries. The LIMA was used in situ in 440 pts and as free graft in 2; the RIMA was used in situ in 379 pts and as free graft in 63; The average number of grafts/pts was 3,17, considering the association with saphenous vein and other grafts. Respiratory insufficiency and low cardiac output syndrome were the main complications in 37 (8,3%) and 23 (5,2%) pts, respectively; 16 (3,6%) pts had post operatory myocardial infarction and 15 (3,3%) had wound closure complications. The mortality rate was 4,91% (22 pts) and the main causes of deaths were multiple system organ failure in 7 (31,8%) and myocardial insufficiency in 6 (27,3%). The mortality rate was higher in pts with severe myocardial dysfunction and older than 60 years old and the best graft patency was observed when the LIMA was anastomosed to the LAD (93,8%). The use of both intenal mammary arteries showed good results and acceptable morbidity and mortality.

Jatene, Marcelo B; Puig, Luiz Boro; Jatene, Fábio B; Ramires, Antônio F; Oliveira, Sérgio de Almeida; Dallan, Luís Alberto; Fontes, Ronaldo D; Jatene, Adib D

1990-08-01

297

The conformity index for the therapeutic option of glomus jugulare gamma knife stereotactic radio surgical treatment planning  

International Nuclear Information System (INIS)

Glomus jugulare are very rare, slow growing, benign and highly vascular tumors, which arises within the jugular foramen of the temporal bone via pathways of least resistance, such as air cells, vascular lumens, skull base foramine and eustachian tube. These tumors occur with an estimated annual incidence of 1 case in 1.3 million people. The male to female ratio is 1:1.9 and is noted that it happens mostly in left side. Because of insidious onset of symptoms these tumors often go unnoticed and delayed (4 to 6 years) in diagnosis. Surgical removal is rarely radical and usually associate with morbidity. Confined gamma knife stereotactic radiosurgery planning with limiting the dose to the associated normal tissue/organs (brain, optic nerve etc.) may play a relevant role as a therapeutic option for these tumors. The conformity index is conformation of the radio-surgical dose distribution to the size and shape of the target volume; it's a measure of spillage of the prescribed dose outside the turn volume. This parameter is of most importance for the dose delivery in the conformal planning of SRS

2007-01-01

298

Evaluation of a training model to teach veterinary students a technique for injecting the jugular vein in horses.  

UK PubMed Central (United Kingdom)

In this study, a newly-developed model for training veterinary students to inject the jugular vein in horses was evaluated as an additional tool to supplement the current method of teaching. The model was first validated by 19 experienced equine veterinarians, who judged the model to be a realistic and valuable tool for learning the technique. Subsequently, it was assessed using 24 students who were divided randomly into two groups. The injection technique was taught conventionally in a classroom lecture and a live demonstration to both groups, but only group 1 received additional training on the new model. All participants filled out self-assessment questionnaires before and after group 1 received training on the model. Finally, the proficiency of both groups was assessed using an objective structured clinical evaluation (OSCE) on live horses. Students from group 1 showed significantly improved confidence after their additional training on the model and also showed greater confidence when compared to group 2 students. In the OSCE, group 1 had a significantly better score compared to group 2: the median (with inter-quartile range) was 15 (0.7) vs. 11.5 (2.8) points out of 15, respectively. The training model proved to be a useful tool to teach veterinary students how to perform jugular vein injections in horses in a controlled environment, without time limitations or animal welfare concerns. The newly developed training model offers an inexpensive, efficient, animal-sparing way to teach this clinical skill to veterinary students.

Eichel JC; Korb W; Schlenker A; Bausch G; Brehm W; Delling U

2013-01-01

299

Evaluation of a training model to teach veterinary students a technique for injecting the jugular vein in horses.  

Science.gov (United States)

In this study, a newly-developed model for training veterinary students to inject the jugular vein in horses was evaluated as an additional tool to supplement the current method of teaching. The model was first validated by 19 experienced equine veterinarians, who judged the model to be a realistic and valuable tool for learning the technique. Subsequently, it was assessed using 24 students who were divided randomly into two groups. The injection technique was taught conventionally in a classroom lecture and a live demonstration to both groups, but only group 1 received additional training on the new model. All participants filled out self-assessment questionnaires before and after group 1 received training on the model. Finally, the proficiency of both groups was assessed using an objective structured clinical evaluation (OSCE) on live horses. Students from group 1 showed significantly improved confidence after their additional training on the model and also showed greater confidence when compared to group 2 students. In the OSCE, group 1 had a significantly better score compared to group 2: the median (with inter-quartile range) was 15 (0.7) vs. 11.5 (2.8) points out of 15, respectively. The training model proved to be a useful tool to teach veterinary students how to perform jugular vein injections in horses in a controlled environment, without time limitations or animal welfare concerns. The newly developed training model offers an inexpensive, efficient, animal-sparing way to teach this clinical skill to veterinary students. PMID:23975072

Eichel, Jane-Carolin; Korb, Werner; Schlenker, Antje; Bausch, Gerold; Brehm, Walter; Delling, Uta

2013-01-01

300

Contraportada interna  

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Full Text Available Geología Colombiana ISSN: 0072-0992 Geología Colombiana publica desde 1962 contribuciones dedicadas a las Ciencias de la Tierra, en especial las relacionadas con Colombia, Sudamérica y el Caribe, pero también de otras regiones que pueden tener importancia comparativa, divulgar conocimientos, innovaciones, métodos, técnicas, interacciones con la sociedad, etc. Es una revista especializada en Geociencias editada por el Departamento de Geociencias de la Universidad Nacional de Colombia, Sede Bogotá, pero con una amplia red de colaboradores nacionales e internacionales. Indexado en: ISI Thomson Reuters (Zoological Record), GEOREF, LATINDEX (folio 11333) e-revistas del CSIC, Publindex Idioma: Creemos que sigue siendo un reto fomentar buenas publicaciones en español -idioma hablado por más de 400 millones de personas - además de publicaciones en inglés. Sin embargo, Geología Colombiana impulsa la visibilidad internacional a través de la publicación de artículos en castellano que deben tener resumen extendido en inglés. Editor principal: Thomas Cramer, Profesor Asociado, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Comité Editorial: Thomas Cramer, Editor Profesor Asociado, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Franck Albert Audemard, Fundacion Venezolana de Investigaciones Sismológicas, Venezuela Luis Antonio Castillo, Editor Profesor Asociado, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias German Bayona, Corporación Geológica ARES, Colombia Sven N. Nielsen, Christian-Albrechts-Universität zu Kiel, Alemania Harald G. Dill, Alemania Jhon Jairo Sanchez Aguilar, Editor Profesor Asociado, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Mohammadamin Emami, Art University of Isfahan & Universitaet Siegen, Irán Lucas Spencer, New Mexico Museum of Natural History, Estados Unidos Comité Científico: Uwe Altenberger, Professor, Universität Potsdam, Alemania Donato Attanasio, Istituto di Struttura della Materia del CNR ISM-CNR William E. Brooks, Independiente, Estados Unidos Andrés Díez Herrero, Editor Boletín Geológico y Minero del INSTITUTO GEOLÓGICO Y MINERO DE ESPAÑA (IGME), España Humberto González Iregui, INGEOMINAS Jonas Kley, Institut für Geowissenschaften, Universität Jena, Alemania Luis Carlos Mantilla Figueroa, Docente UIS, Colombia Germán A Prieto, Universidad de los Andes, Colombia Peter Prinz-Grimm, Institut für Geowissenschaften, FB 11, Goethe-Universität Frankfurt/M, Alemania Federica Zaccarini, Institute of Resource Mineralogy, University of Leoben, Austria Comisión Técnica Editorial y de Apoyo: Camilo Baquero Castellanos, Director de Publicaciones Facultad de Ciencias, Universidad Nacional de Colombia, Sede Bogotá María Fernanda Almanza, Asistente Editorial de Geología Colombiana, Estudiante, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Francisco Javier Muñoz, Estudiante, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Johan Miguel Sánchez, Diego Lozano, Laura Mora, Johnny Germán Díaz, Andrés Felipe Charry y Edna Pinzón, Estudiantes organizadores X Semana Técnica de Geología e Ingeniería Geológica, Universidad Nacional de Colombia, Sede Bogotá, Departamento de Geociencias Información más detallada, acceso y subcomisión de artículos bajo las condiciones Open Journal Publishing: http://www.revistas.unal. edu.co/index.php/geocol Dirección postal: Universidad Nacional de Colombia, Ciudad Universitaria, Apartado aéreo 14490; Av Cra 30 No 45-03, Edificio Manuel Ancízar (224), Bogotá, D.C., Colombia; Tel: 0051-3165000 Ext: 16525 Fax: 3165390 Correo electrónico: rgeocol_fcbog@unal.edu.co, revistageologiacolombiana@mail.com Foto portada: Cerro Mono, Río Inírida, Departamento del Guainía, Colombia. Tomada por José Alejandro Franco Victoria, Grupo de Estudios en Geología Económica y Mineralogía Aplicada (GEGEMA), 6 de febrero 2011, Comisión de campo al Río Inir

Cramer Thomas

2012-01-01

 
 
 
 
301

Differences Between Internal Jugular Vein and Vertebral Vein Flow Examined in Real Time With the Use of Multigate Ultrasound Color Doppler.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE:The hypothesis that MS could be provoked by a derangement of the blood outflow from the brain has been largely discredited. In part, it was because data on the normal pattern of outflow are scarce and obtained with different methods. The aim of this study was to evaluate the normal pattern of outflow for the vertebral and internal jugular veins in healthy subjects with multigate color Doppler.MATERIALS AND METHODS:Twenty-five volunteers were studied to assess vessel area, mean velocity, and flow for the vertebral and internal jugular veins in the supine and sitting positions.RESULTS:In the sitting position, flow decreases, both in vertebral veins and internal jugular veins, as the total vessel area decreases (from 0.46 ± 0.57 to 0.09 ± 0.08 cm(2)), even if the mean velocity increases (from 12.58 ± 10.19 to 24.14 ± 17.60 cm/s). Contrary to what happens to the blood inflow, outflow in the supine position, through vertebral and internal jugular veins, is more than twice the outflow in the sitting position (739.80 ± 326.32 versus 278.24 ± 207.94 mL/min). In the sitting position, on application of very low pressure to the skin with the sonography probe, internal jugular veins rarely appear to occlude. A pronounced difference of diameter between internal jugular veins was present in approximately one-third of subjects.CONCLUSIONS:Our results support the view that other outflow pathways, like the vertebral plexus, play a major role in the normal physiology of brain circulation and must be assessed to obtain a complete picture of blood outflow.

Ciuti G; Righi D; Forzoni L; Fabbri A; Pignone AM

2013-05-01

302

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)

Full Text Available Abstract in portuguese 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 endovascular methods in our service.

Metzger, Patrick Bastos; Barbato, Heraldo Antonio; Angelieri, Fernanda Maria Resegue; Beteli, Camila Baumann; Petisco, Ana Claudia Gomes; Barbosa, Jose Eduardo Martins; Saleh, Mohamed Hassan; Rossi, Fábio Henrique; Izukawa, Nilo Mitsuru

2011-09-01

303

Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Multiple anatomical targets for deep brain stimulation (DBS) have been proposed for the treatment of severe Tourette's syndrome. In this open study, the authors evaluated the effectiveness of DBS of the anteromedial globus pallidus interna on tic severity and common comorbidities. METHOD: Eleven patients (eight of them men, mean age=39 years) with severe and medically intractable Tourette's syndrome underwent implantation of Medtronic quadripolar electrodes in the globus pallidus interna bilaterally. The primary outcome measure was the Yale Global Tic Severity Scale. Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, the Hamilton Depression Rating Scale, the Gilles de la Tourette Syndrome-Quality of Life Scale, and the Global Assessment of Functioning Scale. Follow-up occurred at 1 month and then at a mean of 14 months after surgery (range=4-30 months). RESULTS: Ten patients (91%) reported improvement in tic severity soon after DBS. Overall, there was a 48% reduction in motor tics and a 56.5% reduction in phonic tics at final follow-up. Six patients (54.5%) had a more than 50% reduction, sustained for at least 3 months, in Yale Global Tic Severity Scale score. Only two patients required ongoing pharmacotherapy for tics after surgery, and patients improved significantly on all secondary measures. One patient did not tolerate DBS and discontinued treatment after 3 months. Greater anxiety in two patients and hardware malfunction in three patients were noteworthy adverse outcomes. CONCLUSIONS: The results suggest anteromedial globus pallidus interna DBS for Tourette's syndrome is an effective and well-tolerated treatment for a subgroup of patients with severe Tourette's syndrome.

Cannon E; Silburn P; Coyne T; O'Maley K; Crawford JD; Sachdev PS

2012-08-01

304

Preparation of the saphenous vein for coronary artery bypass grafting: a new technique "no touch" that maintains the vein wall integral and provides high immediate patency Preparo da veia safena na cirurgia de revascularização miocárdica: uma nova técnica -"no touch"- que mantém a parede da veia íntegra e proporciona uma alta perviabilidade imediata  

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Full Text Available BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafting (CABG) influences the fate of vein grafts. A new "no touch" (NT) technique of SV preparation was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasms therefore obviating the need for distension. METHOD: A prospective randomized study in 156 patients who underwent CABG was performed comparing three SV harvesting techniques. The techniques were conventional (c) (adventitial stripping of the vein, manual distention and storing in saline solution); Intermediate (I) (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood); and "no touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood). A morphological study of the endothelium was preformed using scanning electronic microscopy and an angiographic assessment of the vein graft patency was performed at 18 months mean follow-up time. Also an immunohistochemistry assessment was performed to identify the enzyme, nitric oxide synthase (NOS) in the vein wall. RESULTS: The preservation of the endothelial cell integrity was greater with the "no touch" technique than with the other procedures. At angiographic follow up, the patency for NT was 95.4%, 88.9% for grafts in group C and 86.2% for grafts in group I. The immunohistochemistry assessment revealed NOS in all three layers of the vein wall that was prepared by the "no touch" technique. However, a great reduction of this enzyme in veins treated by the conventional technique was observed. CONCLUSION: The endothelial integrity and NOS activity were better preserved when using the "no touch" technique for vein graft harvesting. The vasorelaxation and thrombo-resistant activities of nitric oxide (NO) may be responsible for the reduced of vasospasms and improved patency rate. Furthermore, the mechanical properties provided by the cushion of surrounding tissue in graft harvested by NT technique may contribute to the observed high patency rate.OBJETIVO: O objetivo deste trabalho é apresentar uma nova técnica "no touch" de preparo da veia safena e sua importância clínica. Esta nova técnica consiste na retirada da veia safena do seu leito, juntamente com um pedículo de tecido adiposo, protegendo a veia contra espasmos e, conseqüentemente, da necessidade de distendê-la durante a operação. MÉTODO: O estudo foi realizado em dois tempos: 1) Inicialmente, foi realizado um estudo prospectivo e randomizado, envolvendo 156 pacientes que foram submetidos à operação de revascularização miocárdica. Neste estudo nós comparamos a técnica "no touch" (NT) com duas outras: a convencional (C) e a intermediária (I). Foi feita uma avaliação detalhada da morfologia endotelial, utilizando a microscopia eletrônica, enquanto que a perviabilidade das pontes foi determinada com um exame angiográfico executado num período médio de 18 meses após a operação. 2) Finalmente, a enzima óxido nítrico síntase (NOS) foi identificada com ajuda do estudo imunohistoquímico e também pela localização auto-radiográfica de (3H)-L- Nitro-Arginina (NOARG). RESULTADOS: A avaliação morfológica mostrou integridade endotelial de 97% nas veias que foram tratadas pela técnica NT; enquanto quase metade da superfície endotelial das veias tratadas pelas outras duas técnicas exibiu ausência de células endoteliais. O exame angiográfico revelou perviabilidade de 95,4% para as pontes do grupo NT, 88,9% para as pontes do grupo (C) e 86,2% para as pontes do grupo (I). O estudo imunohistoquímico revelou a presença de NOS nas três camadas que compõem a parede da veia quando, as mesmas, foram tratadas pela técnica NT. Por outro lado, foi observada uma elevada redução desta enzima nas veias que foram tratadas pela técnica (C). A análise auto-radiográfica confirmou os resultados imunohistoquímicos. CONCLUSÃO: A integr

Domingos S. R. Souza; Michael R. Dashwood; Alan Tonazi; Benny Johansson; Enio Buffolo; Ricardo Lima; Derek Filbey; Vollmer Bomfim

2003-01-01

305

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  

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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.

Marcus Vinícius Martins Cury; Marcelo Fernando Matielo; Ana Carolina Calixtro; Giuliano de Almeida Sandri; Marcos Roberto Godoy; Roberto Sacilotto

2012-01-01

306

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)

Full Text Available Abstract in portuguese 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 pacient (more) e 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 m (more) ay yield the diagnosis of major systemic diseases. Fundoscopic features may serve as parameters on treatment evaluation.

Helal Jr, John; Malerbi, Fernando Korn; Melaragno Filho, Roberto

2005-02-01

307

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  

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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.

John Helal Jr; Fernando Korn Malerbi; Roberto Melaragno Filho

2005-01-01

308

Aneurisma de veia poplítea: relato de caso e revisão de literatura/ Popliteal vein aneurysm: case report and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os aneurismas venosos são entidades raras, porém com potencialidade de causar complicações tromboembólicas. Na maioria das vezes, são encontrados incidentalmente, como achados de exame físico ou de imagem. Os aneurismas sintomáticos de veia poplítea são obrigatoriamente 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 s (more) e empregar essa 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 47 mm, submetido a aneurismectomia tangencial e venorrafia lateral, com sucesso. Abstract in english Venous aneurysms are considered to be a rare disease; however they can be a potential cause for the development of thromboembolism. They are mostly detected by physical examination or imaging exams. Symptomatic aneurysms of the popliteal vein must be surgically treated, due to high risk of recurrent pulmonary embolism. The most widely used procedure is tangential aneurysmectomy and lateral venorrhaphy. If not possible, the aneurysm should be removed and a venous reconstru (more) ction should be performed. The authors report a case of a patient with a popliteal vein aneurysm measuring 47 mm in diameter. Tangential aneurysmectomy and lateral venorrhaphy were successfully used for treatment.

Thomazinho, Fernando; Diniz, Jose Antonio Morselli; El Hosni Junior, Ramzi Abdallah; Diniz, Carlos Alberto Morselli; Perozin, Igor Schincariol

2008-09-01

309

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)

Full Text Available Abstract in portuguese 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 pacient (more) e 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 requ (more) ired creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.

Cury, Marcus Vinícius Martins; Matielo, Marcelo Fernando; Calixtro, Ana Carolina; Sandri, Giuliano de Almeida; Godoy, Marcos Roberto; Sacilotto, Roberto

2012-06-01

310

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)

Full Text Available Abstract in portuguese 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 masc (more) ulino 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 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.

Harada Júnior, Katsuro; Borges, Renato Garcia Lisboa; Harada, Renata Kiyoko Borges

2012-09-01

311

Prevalência de hipertensão arterial em pacientes com oclusão do ramo da veia central da retina/ Prevalence of arterial hypertension in branch retinal vein occlusion patients  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVOS: Identificar em pacientes com oclusão do ramo da veia central da retina utilizando a monitorização ambulatorial da pressão arterial e medidas clínicas da pressão arterial: prevalência de hipertensão e o perfil noturno da pressão arterial. MÉTODOS: Prospectivamente, 93 olhos de 83 pacientes com oclusão do ramo da veia central da retina foram submetidos à avaliação oftalmológica. Após, os pacientes foram encaminhados para avaliação clínica e mon (more) itorização da pressão arterial. Pacientes sem descenso da pressão durante o sono ("non-dipper") foram definidos como um declínio na pressão arterial sistólica Abstract in english PURPOSE: To identify in patients with branch retinal vein occlusion using ambulatory blood pressure monitoring and clinical blood pressure measures: hypertension prevalence, and nocturnal profile of blood pressure. METHODS: Prospectively, 93 eyes of 83 patients with branch retinal vein occlusion were submitted to ophthalmological examination. Afterwards the patients were submitted to clinical evaluation and blood pressure monitoring. Non-dipper was defined as a fall in sy (more) stolic blood pressure

Rosa, Alexandre Antonio Marques; Ortega, Kátia Coelho; Mion Jr., Décio; Nakashima, Yoshitaka

2008-04-01

312

Extensão cranial da veia safena parva: quando o fluxo caudal é normal Cranial extension of the small saphenous vein: when caudal flow is normal  

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Full Text Available A extensão cranial da veia safena parva se destaca pelas inúmeras variações anatômicas e diferentes padrões de fluxo que podem ser observados, descritos em trabalhos envolvendo dissecções pós-morte ou cirúrgicas, flebografias e Doppler, que denotam a formação embriológica mais precoce e complexa em relação à safena magna. A observação de um tipo específico de extensão cranial da safena parva onde o sentido das valvas é contrário ao habitualmente observado foi primeiramente caracterizada por Carlo Giacomini, sendo o fluxo caudal nesses casos de aspecto normal sem sinal de incompetência valvar. Este artigo demonstra os padrões anatômicos e de fluxo que podem ser caracterizados na veia safena parva, contribuindo para que aspectos normais do seu fluxo não sejam confundidos com incompetência valvar.Cranial extension of the small saphenous vein is of special interest due to the number of anatomical variations and different blood flow patterns observed, which have been described in investigations including postmortem or surgical dissections, phlebographies, and Doppler studies, indicating an earlier and more complex embryological development in relation to the great saphenous vein. A specific type of cranial extension of the small saphenous vein, where a reverse flow is often observed in the valves, was first characterized by Carlo Giacomini. In these veins, caudal flow is normal, with no evidence of valvular incompetence. This article describes anatomical and blood flow patterns found in the small saphenous vein, thus contributing to avoid that normal blood flow aspects are misinterpreted as valvular incompetence.

André Paciello Romualdo; Roberto de Moraes Bastos; Mathias Fatio; Alessandro Cappucci; Solange Augusta Munhoz Mariana; Érika Narahashi; Alberto Lobo Machado; Eduardo Hideki Tokura

2009-01-01

313

Jugular venous overflow of noradrenaline from the brain: a neurochemical indicator of cerebrovascular sympathetic nerve activity in humans  

DEFF Research Database (Denmark)

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

Mitchell, D.A.; Lambert, G.

2009-01-01

314

Características das células parasitadas pelo Trypanosoma cruzi na parede da veia central das supra-renais de Chagásicos crônicos  

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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.

Hipolito de Oliveira Almeida; Elizabeth Martins; José Umberto Franciscon; Vicente de Paula Antunes Teixeira; Alfredo José Afonso Barbosa; Helenice Gobbi; Marlene Antonia dos Reis

1986-01-01

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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  

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Full Text Available Abstract in portuguese 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 métodos: estudo descritivo. Povoação de estudo: 39 internas da Cadeia de mulheres do município de Manizales. Variáveis: características socioeconômicas e demográ (more) ficas, 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 año 2006. Materiales y métodos: estudio descriptivo. Población de estudio: 39 internas del Reclusorio de mujeres del municipio de Manizales. Variables: características (more) 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 tie

Jaramillo Ángel, Claudia Patricia; Benjumea Rincón, María Victoria

2007-12-01

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Hallazgo incidental de hiperostosis frontal interna o síndrome de Morgagni asociado a meningiomas/ Incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas  

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Full Text Available Abstract in spanish La hiperostosis frontal interna consiste en un engrosamiento de la tabla interna del hueso frontal. Normalmente se encuentra en mujeres post menopáusicas. Presentamos un caso de hallazgo autópsico incidental de hiperostosis frontal interna o síndrome de Morgagni asociado a meningiomas en una mujer postmenopáusica. Abstract in english Hyperostosis frontalis interna is the accretion of bone on the inner table of the frontal bone. It is commonly found in post-menopausic women. We present an incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas in a post-menopausic woman.

Subirana Domènech, M.; Ortega Sánchez, M.; Galtés Vicente, J.I.; Castellà García, J.

2012-06-01

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Hallazgo incidental de hiperostosis frontal interna o síndrome de Morgagni asociado a meningiomas Incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas  

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Full Text Available La hiperostosis frontal interna consiste en un engrosamiento de la tabla interna del hueso frontal. Normalmente se encuentra en mujeres post menopáusicas. Presentamos un caso de hallazgo autópsico incidental de hiperostosis frontal interna o síndrome de Morgagni asociado a meningiomas en una mujer postmenopáusica.Hyperostosis frontalis interna is the accretion of bone on the inner table of the frontal bone. It is commonly found in post-menopausic women. We present an incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas in a post-menopausic woman.

M. Subirana Domènech; M. Ortega Sánchez; J.I. Galtés Vicente; J. Castellà García

2012-01-01

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Estudo anatômico da veia braquial comum como via de drenagem colateral do membro superior/ Anatomic study of the common brachial vein as a collateral drainage channel of the upper limb  

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Full Text Available Abstract in portuguese CONTEXTO: Traumatismos ou tromboses que possam evoluir com alterações da drenagem venosa do membro superior, dependendo do território interrompido, podem ter como mecanismo compensatório uma via colateral de drenagem sem que haja prejuízo para o retorno venoso desse membro. A veia braquial comum apresenta-se como uma alternativa plausível e pouco conhecida. OBJETIVO: Descrever a anatomia da veia braquial comum como via de drenagem colateral no membro superior. MÉTO (more) DOS: Utilizamos 30 cadáveres do sexo masculino, cujos membros superiores estavam articulados ao tronco, não importando a raça, formolizados e mantidos em conservação com solução de formol a 10%. Utilizamos como critérios de exclusão cadáveres com um dos membros desarticulado ou alterações deformantes em topografia das estruturas estudadas. RESULTADOS: A veia braquial comum esteve presente em 73% (22/30) dos cadáveres estudados, sendo que em 18% (04/22) dos casos drenou para a veia basílica no seguimento proximal do braço e em 82% (18/22), para a veia axilar. CONCLUSÃO: A veia braquial comum está frequentemente presente e, na maior parte das vezes, desemboca na veia axilar. Abstract in english BACKGROUND: Trauma and thrombosis that can result in changes in the venous drainage of the upper limb, depending on the vascular territory interrupted, may have as a compensatory mechanism a collateral drainage channel that prevents damage to the venous return of that limb. The common brachial vein is a plausible and little known collateral channel for this purpose. OBJECTIVE: To describe the anatomy of the common brachial vein as a collateral drainage channel of the uppe (more) r limb. METHODS: We have dissected 30 cadavers of people of different races, whose upper limbs were articulated to the trunk and preserved in a 10% formaldehyde solution. The exclusion criteria were disarticulated limbs or deformities in the topography of the studied structures. RESULTS: The common brachial vein was present in 73% (22/30) of the cadavers dissected. The common brachial vein drained into the axillary vein in 82% (18/22) and into the basilic vein in the proximal segment of the upper limb in 18% of the cadavers (04/22). CONCLUSION: The common brachial vein is frequently present, and, in most cases, it drains into the axillary vein.

Santos, Carlos Adriano Silva dos; Figueiredo, Luiz Francisco Poli de; Gusmão, Luiz Carlos Buarque de; Castro, Aldemar Araújo; Pitta, Guilherme Benjamin Brandão; Miranda Jr, Fausto; Souza, Érica Carla Figueirêdo de

2011-03-01

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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  

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Full Text Available Abstract in portuguese 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 (more) 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 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 simi (more) lar 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

Tirapelli, Luís Fernando; Tirapelli, Daniela Pretti da Cunha; Dalio, Marcelo Bellini; Rodrigues, Alfredo José; Évora, Paulo Roberto Barbosa

2009-09-01

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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?  

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Full Text Available Abstract in portuguese 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 desconexã (more) o 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 devascularization and splenectomy. METHODS: We retrospectively analyzed not only the incidence and predictive factors of this complication, but also clinical, laboratorial, endoscopic and Dop (more) pler 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.

Makdissi, Fábio Ferrari; Herman, Paulo; Machado, Marcel Autran C.; Pugliese, Vincenzo; D'Albuquerque, Luiz Augusto Carneiro; Saad, William A.

2009-03-01

 
 
 
 
321

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?  

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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.

Fábio Ferrari Makdissi; Paulo Herman; Marcel Autran C. Machado; Vincenzo Pugliese; Luiz Augusto Carneiro D'Albuquerque; William A. Saad

2009-01-01

322

Revascularização miocárdica com enxerto composto de artéria torácica interna esquerda em Y: análise de fluxo sangüíneo Myocardial revascularization surgery using composite Y-graft of the left internal thoracic artery: blood flow analysis  

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Full Text Available OBJETIVO: Verificar o comportamento do fluxo sangüíneo na artéria torácica interna esquerda (ATIE), quando utilizada para revascularizar a artéria interventricular anterior (AIA) e mais um ramo do sistema coronariano esquerdo (SCE). MÉTODO: No presente estudo, compara-se o fluxo obtido pela ecocardiografia Doppler na ATIE, em repouso e sob estresse com dobutamina, em dois grupos de 20 pacientes cada. No grupo A, foi utilizado enxerto pediculado de ATIE anastomosada unicamente à AIA. No grupo B, a ATIE revasculariza a AIA, e um enxerto de veia safena magna, anastomosado em "Y" à ATIE, revasculariza outro ramo do SCE. O estudo angiográfico demonstrou patência de todos os enxertos em ambos os grupos. Na avaliação pela ecocardiografia Doppler foram realizadas as seguintes medidas: débitos sistólico (DS), diastólico e total, razão entre o débito total em estresse pelo débito total em repouso (DTE/DTR), velocidades de pico sistólico (VPS) e diastólico e razão entre essas velocidades. RESULTADOS: Todos os parâmetros analisados apresentaram diferença estatisticamente significativa, com exceção do DS, DTE/DTR e VPS. CONCLUSÃO: Nas condições e métodos usados neste estudo, pode-se inferir que o fluxo sangüíneo na ATIE no enxerto composto (Grupo B) é maior que no enxerto simples (Grupo A), o que demonstra a grande capacidade da ATIE em adaptar-se à demanda de fluxo.OBJECTIVE: To assess the left internal thoracic artery (LITA) flow pattern, when it was used to supply the left anterior descending artery (LADA) and another branch from the left coronary artery system (LCAS). METHODS: In the following study, the left internal thoracic artery flow was investigated by echocardiography Doppler, at rest and under dobutamine stress, in two twenty-patient groups. Group A consisted of patients who received only a pedicled LITA graft to the LADA. Group B consisted of patients who received a pedicled LITA graft associated with a vein graft to supply the LADA and another artery from the LCAS. The angiographic study showed graft patency in all patients from both groups. The following parameters were used: systolic flow (SF), diastolic flow, total flow, total flow in stress/total flow at rest ratio (TFS/TFR), systolic peak velocities (SPV), diastolic peak velocities and systolic peak velocity/diastolic peak velocity ratio. RESULTS: All analysed parameters were considered statistically significant, except SF, TFS/TFR and SPV. CONCLUSIONS: We concluded that in the same conditions and methodology, the LITA flow in the composite graft (group B) is higher than in the free graft (group A), which shows the great flow adaptability of LITA to respond to flow demand.

José Glauco Lobo Filho; Maria Cláudia de Azevedo Leitão; Heraldo Guedis Lobo Filho; André Albuquerque da Silva