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Vantagens da conservação da veia jugular interna nos esvaziamentos cervicais unilaterais / Advantages of internal jugular vein preservation in unilateral neck dissections  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Diante da dúvida sobre a existência ou não de vantagens relacionadas à conservação da veia jugular interna nos esvaziamentos cervicais unilaterais resolvemos observar se os pacientes que a tem sacrificada apresentam alterações ao exame de fundo de olho que indiquem um aumento da pressão in [...] tracraniana, avaliar a presença de alterações neurológicas e verificar as vantagens na evolução clínico-cirúrgica dos pacientes que tiveram a sua veia jugular interna conservada. MÉTODO: Trata-se de estudo prospectivo, não randomizado, de 15 pacientes portadores de carcinoma epidermóide da cabeça e pescoço, atendidos e operados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis, que tiveram como parte de seu tratamento a realização de esvaziamento cervical completo (funcional ou não) unilateral, divididos em um grupo com ressecção da veia jugular interna e outro com sua conservação. Todos foram submetidos a exames de retinografia pré e pós-operatórios, além de avaliação neurológica e clínica. RESULTADOS: Não ocorreram alterações oftalmológicas detectáveis através da retinografia em nenhum dos grupos. O grupo que teve sua veia jugular interna ressecada apresentou maior incidência de queixas neurológicas no pós-operatório, além de uma evolução cirúrgica mais desfavorável, com um maior período de internação devido às complicações locais apresentadas. CONCLUSÕES: A conservação da veia jugular interna nos esvaziamentos cervicais unilaterais beneficia a evolução pós-operatória dos pacientes, com um menor período de internação, apesar de não termos identificado qualquer evidência pós-operatória de aumento da pressão intracraniana nos pacientes que tiveram a veia ligada. Abstract in english BACKGROUND: Facing the doubt about the existence or not of advantages in preserving the internal jugular vein (IJV) in unilateral neck dissections, the authors decided to determine if the patients with IJV ligation develop changes in retina examination that indicate an increasing in intracranial pre [...] ssure, to evaluate the presence of neurologic changes and to verify the advantages on clinical and surgical outcome of the patients with IJV ligation. METHOD: This is a non-radomized, prospective study comprising 15 patients with head and neck squamous carcinoma treated at the Head and Neck Service of Hospital Heliópolis who were submitted to unilateral neck dissection as part of their treatment and divided in two groups: one with ligation of IJV and other with its preservation. All underwent to preoperative and postoperative retinography and clinical and neurological evaluation. RESULTS: Detectable ophthalmologic changes occurred in none of the two groups. The group with IJV ligation presented a larger incidence of neurologic complaints in postoperative period and a less favorable surgical outcome with a larger period of hospitalization due by local complications. CONCLUSIONS: Preservation of IJV in unilateral neck dissections took to a better postoperative outcome with less time of hospitalization even though no evidence of postoperative increasing in intracranial pressure was observed in patients with IJV ligation.

Marcelo Benedito, Menezes; Abrão, Rapoport; Antônio Sérgio, Fava; Carlos Neutzling, Lehn.

2002-12-01

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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  

Scientific Electronic Library Online (English)

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

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

2013-04-01

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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  

Directory of Open Access Journals (Sweden)

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

2013-04-01

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

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

Felippe Leopoldo Dexheimer Neto

2011-08-01

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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

2011-09-01

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

Scientific Electronic Library Online (English)

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

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

2011-08-01

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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  

Scientific Electronic Library Online (English)

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

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

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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. Abstract in english 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.

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

2008-06-01

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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

2008-06-01

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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

2010-12-01

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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 SciELO Brazil | Language: Portuguese 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 aba [...] ulamento 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. 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 ane [...] urysm 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.

2010-12-01

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

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

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

2013-06-01

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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 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 esquerda, 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 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.

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

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

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

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

2003-08-01

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

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

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

2014-12-01

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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

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

2006-12-01

18

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

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

2006-12-01

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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

2005-01-01

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 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 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.

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

2005-01-01

21

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

2008-08-01

22

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

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

2008-08-01

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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  

OpenAIRE

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 impor...

Rekha Lalwani; Kum Kum Rana; Srijit Das2,; Riyazul Qamar Khan

2006-01-01

24

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

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

Fernando Vázquez

2002-08-01

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Flebectasia jugular em crianças: relato de caso / Jugular phlebectasia in children: a case report  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Massas cervicais na infância que aparecem apenas ao esforço físico são raras, tendo como principais diagnósticos diferenciais laringocele, cisto ou tumor do mediastino superior e flebectasia jugular. A flebectasia jugular é uma dilatação sacular ou fusiforme anormal da veia jugular. Relatamos um cas [...] o de flebectasia de veia jugular externa em uma criança saudável. Várias hipóteses têm sido propostas para explicar a etiologia da flebectasia jugular, dentre elas, a anormalidade anatômica de sua parede, compressão mecânica da veia braquiocefálica, lesões adquiridas da veia e idiopática. Geralmente, é uma condição assintomática, cujo diagnóstico pode ser estabelecido a partir de uma forte suspeita clínica, sendo comprovado por exames complementares. O tratamento pode ser conservador ou cirúrgico dependendo da sintomatologia. Abstract in english Neck masses that appear only on straining are rare in children and should be differentiated between laryngoceles, superior mediastinal tumors or cysts and jugular phlebectasia. The latter being an abnormal fusiform or saccular dilatation of the jugular vein. We report a case of external jugular phle [...] bectasia in a healthy child. A variety of ethiological hypotheses have been proposed: anatomic abnormality of the vein, mechanical compression of the brachiocephalic vein, acquired lesion of the vein and idiopathic. Most patients are asymptomatic, the diagnosis can be established clinically and confirmed by imaging studies. Conservative or surgery management will be chosen according to the symptoms.

Raquel C. de, Oliveira; Claudiane M., Assis; Alexandre R., Coraçari; Fernando D., Molina; José Victor, Maniglia.

2004-04-01

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Flebectasia jugular em crianças: relato de caso Jugular phlebectasia in children: a case report  

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Full Text Available Massas cervicais na infância que aparecem apenas ao esforço físico são raras, tendo como principais diagnósticos diferenciais laringocele, cisto ou tumor do mediastino superior e flebectasia jugular. A flebectasia jugular é uma dilatação sacular ou fusiforme anormal da veia jugular. Relatamos um caso de flebectasia de veia jugular externa em uma criança saudável. Várias hipóteses têm sido propostas para explicar a etiologia da flebectasia jugular, dentre elas, a anormalidade anatômica de sua parede, compressão mecânica da veia braquiocefálica, lesões adquiridas da veia e idiopática. Geralmente, é uma condição assintomática, cujo diagnóstico pode ser estabelecido a partir de uma forte suspeita clínica, sendo comprovado por exames complementares. O tratamento pode ser conservador ou cirúrgico dependendo da sintomatologia.Neck masses that appear only on straining are rare in children and should be differentiated between laryngoceles, superior mediastinal tumors or cysts and jugular phlebectasia. The latter being an abnormal fusiform or saccular dilatation of the jugular vein. We report a case of external jugular phlebectasia in a healthy child. A variety of ethiological hypotheses have been proposed: anatomic abnormality of the vein, mechanical compression of the brachiocephalic vein, acquired lesion of the vein and idiopathic. Most patients are asymptomatic, the diagnosis can be established clinically and confirmed by imaging studies. Conservative or surgery management will be chosen according to the symptoms.

Raquel C. de Oliveira

2004-04-01

27

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

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

Charles Angotti Furtado de, Medeiros.

2006-12-01

28

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

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

Charles Angotti Furtado de Medeiros

2006-12-01

29

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

2001-03-01

30

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 fun [...] cionante. 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. Abstract in english 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.

2001-03-01

31

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

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

2010-09-01

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

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

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

2014-03-01

33

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

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

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

2015-01-01

34

Persistência da veia ciática / Persistent sciatic vein  

Scientific Electronic Library Online (English)

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

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

2010-09-01

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Persistência da veia ciática Persistent sciatic vein  

Directory of Open Access Journals (Sweden)

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

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese 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 ora [...] l and genital ulcers presenting with recurring episodes of venous thrombosis. The first one was a deep venous thrombosis in the right leg; the second was in the left internal jugular vein; and finally a superior vena cava thrombosis.

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

2006-03-01

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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  

Scientific Electronic Library Online (English)

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

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

2011-08-01

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Petrous jugular malposition (diverticulum).  

Science.gov (United States)

Jugular bulb anatomy is variable. A "high-riding" bulb extending into the tympanic cavity is a well-described anomaly. Petrous jugular malposition (diverticulum) (PJMD), however, is rare. The relationship between PJMD and clinical symptoms is questionable because the differentiation between PJMD as an anatomic variant and pathologic process is unproved. A literature review reveals 14 previously documented cases. We report an additional four cases. Diagnostic and management dilemmas are discussed, with the importance of high-resolution CT stressed. PMID:8247564

Pappas, D G; Hoffman, R A; Cohen, N L; Holliday, R A; Pappas, D G

1993-11-01

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The jugular bulb diverticulum  

International Nuclear Information System (INIS)

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

40

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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 submetido [...] s 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. Abstract in english 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.

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

2000-06-01

41

Condylar jugular diverticulum.  

Science.gov (United States)

We would like to present 6 instances of an internal jugular bulb diverticulum extending into the occipital condyle, which, to the best of our knowledge, has not been described in the English-language literature.This asymptomatic variant was detected incidentally on 6 patients. Computed tomography was performed on all 6 cases, and magnetic resonance imaging and magnetic resonance venography was performed in 2 cases. The condylar jugular diverticula presented as a well-defined defect in the occipital condyle contiguous with the jugular bulb on computed tomography. Magnetic resonance venography showed flow within the diverticulum. There was no definite relationship to a dominant transverse sinus. Recognition of this variant will help to avoid potential confusion with pathological lesions in the occipital condyle, especially on magnetic resonance imaging. PMID:19346866

Raghuram, Karthikram; Curé, Joel K; Harnsberger, H Ric

2009-01-01

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

Energy Technology Data Exchange (ETDEWEB)

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

Lee, Eun Ja; Yang, Dong Hun; Jung, Chul Ku; Kang, Si Won [Taejon St. Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

1999-12-01

43

Surgery of Glomus Jugulare Tumors  

OpenAIRE

The treatment of choice for glomus jugulare tumors is still controversial. High rates of morbidity, incomplete resection, and the aggressive behavior of these tumors are the main arguments for advocates of primary radiotherapy. However, constant refinements in skull base techniques have made complete resection of these lesions a realistic goal. The high probability of achieving local control of these tumors by surgery has convinced us to support this option strongly. Between 1993 and 2000 we ...

Pareschi, Roberto; Righini, Stefano; Destito, Domenico; Raucci, Aldo Falco; Colombo, Stefano

2003-01-01

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Intradural jugular foramen tumors / Tumores intradurais do forame jugular  

Scientific Electronic Library Online (English)

Full Text Available 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. 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 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.

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

2004-12-01

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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 SciELO Brazil | Languages: English, Portuguese 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 de tórax revelou múltiplas opacidades em ambos os pulmões. Uma biópsia pulmonar cirúrgica foi realizada por suspeita de metástases pulmonares. O exame anatomopatológico revelou êmbolos sépticos em parênquima pulmonar. Retrospectivamente, a paciente relatou história de faringite duas semanas antes da hospitalização. Após o diagnóstico, foi tratada com antibióticos de amplo espectro (cefuroxima por 7 dias e azitromicina por 5 dias e, posteriormente, devido à persistência de febre, cefepime por 7 dias). A tomografia computadorizada de tórax, realizada um mês após, mostrou resolução das opacidades. Abstract in english Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old f [...] emale who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days). One month later, a computed tomography scan of the chest revealed resolution of the opacities.

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

1079-10-01

46

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

Directory of Open Access Journals (Sweden)

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

Budhiraja V

2010-05-01

47

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

Scientific Electronic Library Online (English)

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

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

2002-08-01

48

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

2002-08-01

49

Jugular bulb diverticula in medial petrous bone.  

Science.gov (United States)

Upward extension or diverticulum of the jugular bulb is rare. Most often, it protrudes into the middle ear. Three patients are reported in whom direct superior extension from the medial portion of the jugular bulb resulted in a defect in the medial part of the petrous bone. In this position, a jugular bulb diverticulum relates directly to the posterior wall of the internal auditory canal. The distinctive radiographic characteristics of this entity obviate unnecessary investigation and surgery. Encroachment on the internal auditory canal may possibly contribute to neurosensory hearing deficit. PMID:6768272

Stern, J; Goldenberg, M

1980-05-01

50

CT diagnosis of glomus-jugulare tumours  

International Nuclear Information System (INIS)

Glomus-jugulare tumours (chemodectomas, non-chromaffin paragangliomas) are semi-malignant tumours arising from the glomus structures of the jugular bulb. They are soft tissue tumours which usually expand the jugular foramen and destroy its bony margins. Conventional methods of examination are therefore very effective. However, they only demonstrate the bone destruction and are therefore an indirect method for showing the tumour. The actual size and extent of the tumour, which are important for the surgeon or radiotherapist, cannot be demonstrated by simple X-rays. Computer tomography is very effective in the diagnosis of soft tissue lesions in the skull. CT is therefore of great importance in the diagnosis of glomus-jugulare tumours. (orig.)

51

The jugular bulb diverticulum. A radioanatomic investigation.  

Science.gov (United States)

Two hundred and forty-five temporal bone specimens were examined radiographically. Subsequently the topographic relationship between the jugular fossa and surrounding structures was evaluated in plastic casts of the specimens. Fifty-eight casts showed a high jugular fossa and in 17 a jugular bulb diverticulum was found. A diverticulum is regarded as an anomaly of the high jugular bulb and presumably has a potential for expansion. Most frequently a diverticulum was directed medially into the space between the internal acoustic meatus, the vestibular aqueduct and the posterior cranial fossa. Seven diverticula reached the level of the internal acoustic meatus. Encroachment upon the vestibular aqueduct was seen in 4 casts and both the internal acoustic meatus and the cochlear aqueduct were very close to the diverticulum. A few diverticula were directed postero-laterally close to the facial canal and the stapedius muscle. The investigation was supplemented with a selected clinical material of radiographs of temporal bones with high fossae. The results corresponded to those of the experimental investigation. The jugular bulb diverticulum is a relatively common feature and should be regarded as an anomaly with a potential to give rise to clinical symptoms consequent to its intrusion upon surrounding structures. PMID:3096082

Wadin, K; Wilbrand, H

1986-01-01

52

Jugular bulb diverticulum. A radioanatomic investigation  

Energy Technology Data Exchange (ETDEWEB)

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

Wadin, K.; Wilbrand, H.

53

The structure and function of giraffe jugular vein valves  

OpenAIRE

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

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

2009-01-01

54

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 ev

Carlos Alberto Hussni

2012-07-01

55

Schwannoma de forame jugular: relato de caso  

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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

2009-03-01

56

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

Scientific Electronic Library Online (English)

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

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

2012-07-01

57

Lepromatous phlebitis of the external jugular vein.  

Science.gov (United States)

Mycobacterium leprae (M leprae), the causative agent of Hansen's disease, is endemic in many areas of Asia, sub-Saharan Africa, South and Central America, the Pacific Islands, and the Philippines. The spectrum of clinical disease is dependent on the patient's cell-mediated immunity and might range from localized anesthetic patches or plaques to disseminated disease. If undiagnosed, progression with damage to the involved sensory and motor nerves might occur. Lepromatous vasculitis occurs most commonly in patients with severe disseminated disease. Vascular disease, as the initial presenting sign of tuberculoid leprosy, is, however, rare. We present one patient in whom the development of Hansen's disease was associated with involvement of the external jugular vein and was initially seen as external jugular vein fibrosis. PMID:14639414

Thompson, Ana M; Lynn, Amy A A; Robson, Kristi; Joyce, M Patricia; Fivenson, David P; Scollard, David

2003-12-01

58

Isolated thrombosis of the external jugular vein.  

Science.gov (United States)

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

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

2000-08-01

59

[Jugular bulb diverticulum mimicking Menière's disease. Surgical treatment].  

Science.gov (United States)

The position of the jugular bulb is extremely variable. A high jugular fossa with a diverticulum of the jugular bulb can alter the inner ear function with neurosensory hearing loss, vertigo and tinnitus. Six cases of jugular bulb diverticulum with vertigo mimicking Meniere's disease were operated on and followed up from 6 months to 4 years. The jugular bulb was approached through a mastoidectomy and the diverticulum was decompressed downward using bone wax. The vertigo disappeared after surgery in all the cases. These observations suggest that an abnormality of the jugular bulb should be considered as a possible origin of Meniere's disease and that vertigo can be cured by downward decompression of the diverticulum. PMID:8085717

Sterkers, O; Bozorg Grayeli, A; Julien, N; Bouccara, D; Rihane, S; Chaigne, P

1993-01-01

60

[Surgical treatment of vertigo induced by jugular bulb diverticulum].  

Science.gov (United States)

The position of the jugular bulb is extremely variable. A high jugular fossa with a diverticulum of the jugular bulb can alter the inner ear function with sensorineural hearing loss, vertigo and tinnitus. Nine cases of jugular bulb diverticulum with vertigo mimicking Menière's disease were operated on and followed up from 3 months to 4 years. Eight patients were treated surgically. The jugular bulb was approached through a mastoïdectomy and the diverticulum was compressed downwards using bone wax. The vertigo disappeared after surgery in all cases. These observations suggest that an abnormally of the jugular bulb should be considered as a possible symptom of Ménière's disease and that vertigo can be cured by downward compression of the diverticulum. PMID:7644844

Bozorg Grayeli, A; Bouccara, D; Julien, N; Rihane, S; Chaigne, P; Sterkers, O

1995-01-01

61

Analysis of Jugular Foramen Exposure in the Fallopian Bridge Technique  

OpenAIRE

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

Satar, Bulent; Yazar, Fatih; Ceyhan, Aykut; Arslan, Hasan Huseyin; Aydin, Sedat

2009-01-01

62

Magnetic resonance images resembling jugular venous thrombosis  

International Nuclear Information System (INIS)

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

63

Saccular aneurysm of the external jugular vein: a case report.  

Science.gov (United States)

Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer. PMID:24782973

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

2014-04-01

64

Aneurysm of external jugular vein mimicking hemangioma of neck.  

Science.gov (United States)

Venous aneurysms are one of the rare causes of neck swellings. Among neck veins, external jugular vein aneurysms are uncommon. We present a case of a woman who presented with a nontender compressible swelling in the left lower neck region, which initially thought to be hemangioma, was later found to be external jugular vein aneurysm on Doppler ultrasound and CT angiography. PMID:24465108

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

2013-12-01

65

Malposition of central venous catheter in the jugular venous arch via external jugular vein -a case report-  

Science.gov (United States)

The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes. Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications. We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein. PMID:25844137

Ahn, SoWoon; Lee, Ju Ho; Park, Chunghyun; Hong, Yong-woo

2015-01-01

66

Computational haemodynamics in stenotic internal jugular veins.  

Science.gov (United States)

An association of stenotic internal jugular veins (IJVs) to anomalous cerebral venous hemodynamics and Multiple Sclerosis has been recently hypothesized. In this work, we set up a computational framework to assess the relevance of IJV stenoses through numerical simulation, combining medical imaging, patient-specific data and a mathematical model for venous occlusions. Coupling a three-dimensional description of blood flow in IJVs with a reduced one-dimensional model for major intracranial veins, we are able to model different anatomical configurations, an aspect of importance to understand the impact of IJV stenosis in intracranial venous haemodynamics. We investigate several stenotic configurations in a physiologic patient-specific regime, quantifying the effect of the stenosis in terms of venous pressure increase and wall shear stress patterns. Simulation results are in qualitative agreement with reported pressure anomalies in pathological cases. Moreover, they demonstrate the potential of the proposed multiscale framework for individual-based studies and computer-aided diagnosis. PMID:24671429

Caiazzo, Alfonso; Montecinos, Gino; Müller, Lucas O; Haacke, E Mark; Toro, Eleuterio F

2015-03-01

67

Glomus jugulare tumor with intra- and extracranial extension  

International Nuclear Information System (INIS)

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

68

Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis  

International Nuclear Information System (INIS)

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

69

Comunicación Interna y formación profesional  

Scientific Electronic Library Online (English)

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

Marisa, Cuervo.

2011-03-01

70

[Hyperostosis frontalis interna and epilepsy].  

Science.gov (United States)

We have analysed the clinical history of a 48-year old female patient who has been admitted to hospital after an epileptic fit. The tomodensitometry examination has shown a hyperostosis frontalis interna. This condition is frequent and is characterized by a progressive thickening of the frontal bone internal table. The aetiology is unknown; the most probable hypothesis is a deterioration of the androgen-estrogen ratio. This woman suffers from epileptic fits for 40 years now but also from hereditary polycystic kidney disease and CREST syndrome. In this analysis, we have applied the principle of parcimony and we have examined the role played by the sexual hormones in these pathologies. PMID:24303658

Winant, M; Richard, T; Vanhaeverbeek, M

2013-01-01

71

Relações cranioencefálicas das veias de Trolard e de Labbé: aplicações neurocirúrgicas  

OpenAIRE

Realizamos estudo anatômico das veias anastomóticas de Trolard e de Labbé em sete segmentos cefálicos com o objetivo de precisar o trajeto e as referências que facilitem a preservação destes vasos durante o procedimento cirúrgico. Estudamos também as relações da veia de Trolard com a área motora.

Gusmão Sebastião; Reis Cassius; Silveira Roberto Leal

2001-01-01

72

Applications of contrast enhanced CT through external jugular access  

International Nuclear Information System (INIS)

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

73

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

Science.gov (United States)

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 Menière'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 radiographed 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. PMID:3101406

Wadin, K; Thomander, L; Wilbrand, H

1986-01-01

74

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

75

Hyperostosis frontalis interna: forensic issues.  

Science.gov (United States)

The use of pathological conditions in age and sex determination, important factors in personal identification, is not widespread in anthropology and legal medicine. Hyperostosis frontalis interna (HFI) is a bone condition that mainly affects the inner table of the frontal bone. Although there are numerous publications on the subject, at the present time its etiology remains obscure. Several associations of symptoms, whose incidence varies according to the population studied, have been described. Age and gender appear to be linked with the preponderance of this condition, as does the presence of behavioral disturbances. The aim of our study, based on a series of 1532 autopsies, was to define the incidence and the associations observed with other pathological conditions. Thirteen cases of HFI were identified (0.8% of autopsies), 12 women and one man whose mean age was 59.15 years (range: 42-79 years). All had behavioral disturbances and most were under psychiatric care. This study emphasizes the value of this condition in medico-legal identification. PMID:15831008

Devriendt, Wlilliam; Piercecchi-Marti, Marie-Dominique; Adalian, Pascal; Sanvoisin, Alain; Dutour, Olivier; Leonetti, Georges

2005-01-01

76

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

Directory of Open Access Journals (Sweden)

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

1999-01-01

77

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 [...] mbol">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. Abstract in english 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

78

Hyperostosis frontalis interna mimicking Mount Fuji sign.  

Science.gov (United States)

We report an interesting case of 'Hyperostosis frontalis interna' in a 73-yr-old female whose MRI pictures mimics the CT appearance of 'Mount Fuji sign' in tension pneumocephalus a neurological emergency. PMID:21751633

Prakash, B; Pranesh, M B; Parimalam, N; Harish Kumar, R

2011-03-01

79

Stereotactic radiosurgery for glomus jugulare tumors: a preliminary report  

International Nuclear Information System (INIS)

Purpose: This study was conducted to evaluate the toxicity and efficacy of stereotactic radiosurgery treatment of glomus jugulare tumors. Methods and Materials: Between March 1990 and January 1995, nine patients underwent stereotactic radiosurgery with the Leksell Gamma Knife Unit for glomus jugulare tumors. Previous treatment had failed in four patients. The seven female and two male patients had a median age of 67 years. Results: The median time from stereotactic radiosurgery to the most recent clinical follow-up was 20 months (range 7-65 months). Subjectively, 7 of 9 patients noted a decrease in the intensity of their symptoms. Objectively, 8 of 9 tumors remained stable in size by serial magnetic resonance imaging scans and one was smaller. There was no acute or chronic toxicity. Conclusion: This early experience suggests that stereotactic radiosurgery is a promising treatment for glomus jugulare tumors

80

Abnormal formation and communication of external jugular vein  

Directory of Open Access Journals (Sweden)

Full Text Available Knowledge of variations in the origin, course and termination of external jugular vein may be important for surgeons, radiologists, and plastic surgeons. In this report, we present a variation in the origin of the external jugular vein and its abnormal communication with the cephalic vein. The external jugular vein was formed by the union of facial and retromandibular veins. Its course and termination were normal but it communicated with the cephalic vein through a large communicating vein, which crossed superficial to clavicle. The retromandibular vein did not divide into two divisions and the posterior auricular vein was absent. The terminal part of cephalic vein was sandwiched between the clavicle and subclavius muscle.

Nayak SB

2008-08-01

81

[Sudden sensorineural hearing loss and jugular bulb diverticulum].  

Science.gov (United States)

The relationship between high placed jugular bulb (diverticulum) and inner ear disorder is not well known. Three of 19 patients with sudden sensorineural hearing loss (SSHL) treated in 1995 had right side jugular bulb diverticulum revealed by CT scan and MRA. One of the 3 SSHL cases complicated with delayed endolymphatic hydrops. The exact mechanism of causation of inner ear symptom is not clear, but may partly be due to pressure effects with the jugular fossa encroaching on inner ear structure such as the cochlear aqueduct and vestibular aqueduct, and due to turbular flow in the diverticulum striking the inner ear. It is needed to further study the influence of the diverticulum on the inner ear. PMID:11263142

Lu, Y; Ren, J; Chen, Z

1998-09-01

82

Use of radiotherapy in tumour of jugular glomus  

International Nuclear Information System (INIS)

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

83

Endovascular embolization of a hemorrhagic jugular bulb diverticulum.  

Science.gov (United States)

A jugular bulb diverticulum (JBD) is considered to be a rare venous anomaly. In exceptional cases it extends into the middle ear cavity with no bony covering, and slight oozing to massive bleeding might be encountered during routine middle ear surgical procedures. We report a case of massive bleeding from a dehiscent jugular bulb diverticulum that appeared during myringotomy and was successfully managed by endovascular embolization. This report emphasizes the value of interventional neuroradiology in otosurgical cases in which preoperative control of blood vessels or vascular malformations is crucial to avoid severe complications. PMID:18635270

Shihada, Rabia; Maimon, Shimon; Braun, Jacob; Fradis, Milo; Luntz, Michal

2008-09-01

84

Cholesterol granuloma coincidence with a large and high jugular bulb: report of a case.  

Science.gov (United States)

We present a case of right middle ear mass who had an abnormal large jugular foramen, high jugular bulb and large jugular vein on the same side. CT scan could not exclude a glomus tumor. Theoretically, retrograde jugular venography and carotid angiography will give the most useful information. However, in this case we tried to use the MRI scan instead. It showed high signal in T1W, T2W, GRT2W which correlated with blood pigments of methemoglobin in middle ear and mastoid. The low signal in MRI scan T1W, T2W clearly showed enlarged jugular vein, high jugular bulb with diverticulum which helped to excluding a glomus tumor. This finally turned out to be a cholesterol granuloma coincidence with abnormal enlarged jugular foramen and jugular vein. We suggest the MRI scan is very helpful and much safer for patients compared to angiography. PMID:8006563

Kasemsuwan, L; Jenjitranant, J; Clongsusuek, P

1993-05-01

85

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

Directory of Open Access Journals (Sweden)

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

2007-12-01

86

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

Scientific Electronic Library Online (English)

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

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

2007-12-01

87

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

OpenAIRE

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

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

2014-01-01

88

Implante intencional de filtros de veia cava em ambas as veias ilíacas comuns: relato de caso e revisão da literatura Intentional placement of vena cava filters in both iliac veins: case report and literature review  

Directory of Open Access Journals (Sweden)

Full Text Available Os filtros de veia cava são utilizados para impedir a passagem de êmbolos dos membros inferiores para as artérias pulmonares e, normalmente, são colocadas imediatamente abaixo das veias renais. Em alguns casos, no entanto, existem dificuldades técnicas incomuns que devem ser superadas para tratar adequadamente alguns pacientes. Relatamos o caso de uma paciente em cujas veias ilíacas comuns foram implantados filtros de veia cava devido à baixa implantação das veias renais e da veia cava inferior curta.Vena cava filters are used to prevent the passage of emboli from the lower limbs to the pulmonary arteries and normally are placed immediately below the renal veins. In some cases however there are unusual technical difficulties that must be overcome to properly treat some patients. We report a case of a patient in whose common iliac veins vena cava filters were deployed, due to the lower implantation of renal veins and a short inferior vena cava.

Daniel Queiroz Neves

2010-12-01

89

Right portal vein embolization by laparoscopic catheterization of the inferior mesenteric vein / Embolizacao percutanea da veia porta por acesso laparoscopico da veia mesenterica inferior  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Habitualmente, a embolização do ramo direito da veia porta é realizada para prevenir insuficiência hepática após uma ressecção hepática estendida. Geralmente, este procedimento é realizado por punção direta da veia porta, resultando, ocasionalmente, em lesão hepática, pneumotórax e hemoperitônio. No [...] presente relato, descrevemos uma alternativa ao acesso direto à porta, através da cateterização percutânea da veia mesentérica inferior com o auxílio da dissecção videolaparoscópica. Abstract in english Right portal vein embolization is often performed to prevent liver insufficiency after major hepatic resection. The procedure usually involves direct puncture of the portal vein, which requires hepatic hilum manipulation, and may be associated with liver injury, pneumothorax, and hemoperitoneum. Thi [...] s report describes a technique of laparoscopic insertion of a sheath into the inferior mesenteric vein followed by right portal vein embolization.

Marcus Vinicius Martins, Cury; Fernanda Mesquita de Brito, Castro; Lister Arruda Modesto, Santos; Sandra Lucia Lodi, Peres; Roberto, Sacilotto.

2013-12-01

90

Right portal vein embolization by laparoscopic catheterization of the inferior mesenteric vein / Embolizacao percutanea da veia porta por acesso laparoscopico da veia mesenterica inferior  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Habitualmente, a embolização do ramo direito da veia porta é realizada para prevenir insuficiência hepática após uma ressecção hepática estendida. Geralmente, este procedimento é realizado por punção direta da veia porta, resultando, ocasionalmente, em lesão hepática, pneumotórax e hemoperitônio. No [...] presente relato, descrevemos uma alternativa ao acesso direto à porta, através da cateterização percutânea da veia mesentérica inferior com o auxílio da dissecção videolaparoscópica. Abstract in english Right portal vein embolization is often performed to prevent liver insufficiency after major hepatic resection. The procedure usually involves direct puncture of the portal vein, which requires hepatic hilum manipulation, and may be associated with liver injury, pneumothorax, and hemoperitoneum. Thi [...] s report describes a technique of laparoscopic insertion of a sheath into the inferior mesenteric vein followed by right portal vein embolization.

Marcus Vinicius Martins, Cury; Fernanda Mesquita de Brito, Castro; Lister Arruda Modesto, Santos; Sandra Lucia Lodi, Peres; Roberto, Sacilotto.

2013-12-12

91

Neovascularization after surgical exposure of rat external jugular vein endothelium  

Scientific Electronic Library Online (English)

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

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

2013-12-01

92

Internal jugular vein pyogenic capillary hemangioma: a case report.  

Science.gov (United States)

Internal jugular vein hemangioma, also called pyogenic granuloma, is a rare tumor. Such a neoformation was accidentally discovered and excised in a middle-aged man. Histologic and immunohistochemical investigations were performed, and this case is compared with the poor amount of similar ones described in the literature. PMID:25462549

Cera, Chiara; Calvagna, Cristiano; Sgorlon, Giada; Zamolo, Francesca; Pancrazio, Francesco; Adovasio, Roberto

2015-02-01

93

Tumors around the jugular foramen - diagnosis and clinical findings  

International Nuclear Information System (INIS)

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

94

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

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

Cyrillo Rodrigues de Araújo Júnior

2003-10-01

95

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

Scientific Electronic Library Online (English)

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

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

2009-06-01

96

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

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

Marcelo Dagola Paulista

2009-06-01

97

Multiple variations of the superficial jugular veins: case report and clinical relevance.  

Science.gov (United States)

The jugular venous system constitutes the primary venous drainage of the head and neck. It includes a profundus or subfascial venous system, formed by the two internal jugular veins, and a superficial or subcutaneous one, formed by the two anterior and two external jugular veins. We report one case of unilateral anatomical variations of the external and anterior jugular veins. Particularly, on the right side, three external jugular veins co-existed with two anterior jugular veins. Such a combination of venous anomalies is extremely rare. The awareness of the variability of these veins is essential to anesthesiologists and radiologists, since the external jugular vein constitutes a common route for catheterization. Their knowledge is also important to surgeons performing head and neck surgery. PMID:25006662

Paraskevas, George; Natsis, Konstantinos; Ioannidis, Orestis; Kitsoulis, Panagiotis; Anastasopoulos, Nikolaos; Spyridakis, Ioannis

2014-01-01

98

CONSACRAREA DREPTULUI INTERNA?IONAL PENAL  

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Full Text Available De-a lungul secolelor s-au elaborat idei ?i concepte cu privire la drepturile ?i obliga?iilebeligeran?ilor, astfel c? ap?reau germenii izvoarelor, care în timp au oferit posibilitatea form?rii uneinoi discipline de studiu, aceea de Drept interna?ional penal.Acordurile ?i conven?iile interna?ionale au determinat statele s?-?i asume r?spunderea pentruconsecin?ele survenite ca urmare a unor conflicte regionale, ori pe o arie geografic? extins?.

Ana Calin

2007-05-01

99

Jugular Foramen Schwannomas: Diagnosis and Suggestions for Surgical Management  

OpenAIRE

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

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

1991-01-01

100

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

OpenAIRE

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, c...

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

2003-01-01

101

Traumatismos de veia cava inferior / Inferior vena cava injuries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 Abstract in english 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

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

2005-10-01

102

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

Scientific Electronic Library Online (English)

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

Oscar, Illodo Hernández; Tania, Luejes García; Carlos A., Cruz Torán; Viviana, Cristo Pérez; Karen, Tornés Alonso; Daysi, Pérez Matos.

2007-09-01

103

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

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

2010-06-01

104

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

2010-06-01

105

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

Scientific Electronic Library Online (English)

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

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

2013-12-01

106

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Abstract in english 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.

1999-10-01

107

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

1999-10-01

108

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

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

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

2005-01-01

109

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

2005-10-01

110

[Japanese cases of hyperostosis frontalis interna].  

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Although hyperostosis frontalis interna is common in the western countries, it has been rarely reported in the literature in Japan. We had a chance to observe 5 cases diagnosed as hyperostosis frontalis interna. They were found among 10,902 patients who came to our hospital from August 1, 1993 to September 30, 1995. All the patients in these five cases are females aged 67 to 85 (mean = 74.2 years). Four of the 5 cases had been treated as hypertension, 2 as diabetes mellitus, and 1 as hyperlipoidemia. Two cases were accompanied by unruptured aneurysms. The pathology of one case accompanied by chronic subdural hematoma revealed no apparent development of Haversian systems of bone. It seems that the prevalence of this disease in Japan would increase from now on due to the fact that the life style and the diet among Japanese people has been getting westernized. PMID:9368887

Ishiguro, M; Nakagawa, T; Yamamura, N; Kurokawa, Y

1997-10-01

111

A special form of hyperostosis frontalis interna.  

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The article describes a very severe case of hyperostosis of the frontal bone and discusses its possible differential diagnosis. What makes this case special is the fact that the osseous changes include all 3 layers of the bone. Macroscopically the lesion resembles an osteoma as described by Burkhardt (1970) and v. Eiselsberg (1906). The histological examination lead to the final diagnosis of hyperostosis frontalis interna. One must note that there were certain effects caused by a metastasis of a lobular carcinoma of the breast which influenced the osseous changes from the outer surface. The rough, spicula-like structure in the centre of the frontal squama should be put down to tumour erosion. The peripheral areas of the hyperostosis, however, still exhibit the original smoother texture of the disease. The final diagnosis in this unusual and possibly unique case was an intense hyperostosis frontalis interna with secondary changes due to the metastases of a lobular carcinoma of the breast. PMID:8297043

Prescher, A; Adler, C P

1993-12-01

112

Hyperostosis frontalis interna, acromegaly and hyperprolactinaemia.  

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The association between hyperostosis frontalis interna (HFI), acromegaly and hyperprolactinaemia was investigated. Thirty six acromegalic patients, of whom 19 had hyperprolactinaemia, were compared with 36 randomly-selected, age-sex matched controls. There was a higher prevalence of HFI in the skull X-rays of the acromegalic cohort (P = 0.0002) when compared to the control group. This difference was apparent in both men (P = 0.01) and women (P = 0.01). Acromegalic patients with hyperprolactin...

Fulton, J. D.; Shand, J.; Ritchie, D.; Mcghee, J.

1990-01-01

113

Internal Jugular/Subclavian Venous Access In Electrophysiology Study And Ablation  

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

Shomu Bohora; Jaganmohan Tharakan

2009-01-01

114

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

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

Roshan Kumar Verma

2013-07-01

115

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  

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

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

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

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.

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Glomus jugulare tumour in a dog; a case report.  

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Unilateral ataxia of the head and trunk and right-sided paralysis of the trigeminal, facial, and hypoglossal nerves were the major neurologic dysfunctions in a nine-year-old male French bulldog. These symptoms together with the results of radiologic examination and bone scintigraphy pointed to a cranial base tumour on the right side. The tumour was histologically identified as a glomus jugulare tumour. A tumour of the right carotid body and a seminoma in the right testicle were additional findings at autopsy. PMID:212842

van Nes, J J; Venker-van Haagen, A J; Goedegebuure, S A; van den Brom, W E

1978-10-15

118

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 SciELO Brazil | Language: Portuguese 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, 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 underw [...] ent 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.

2004-08-01

119

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

2004-08-01

120

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

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

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

2014-03-20

121

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

International Nuclear Information System (INIS)

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

122

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

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

2003-06-01

123

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

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Full Text Available OBJETIVO: Estudar os resultados imediatos e a médio prazo da cirurgia endoscópica subfascial de perfurantes. MÉTODO: Estudo clínico, prospectivo e descritivo. Critérios de inclusão: insuficiência venosa crônica primária ou secundária, sistema venoso profundo pérvio e índice tornozelo/braço maior que 0,8. Critérios de exclusão: ocorrência da trombose venosa profunda, ou trauma ou cirurgia ortopédica e cirurgia sobre o sistema venoso profundo durante o período de seguimento pós-operatório. Todos doentes foram examinados pelo ecodoppler colorido antes da operação. RESULTADOS: Foram operados 43 membros a partir de junho/1997. Eram 27 doentes com média de idade 56,5 anos. A insuficiência venosa crônica era secundária à trombose venosa em dois membros. Três membros foram classificados como C3, 15 como C4, 11 como C5 e 14 como C6. A retirada das veias safena interna, safena externa e tributárias foi associada em 35 membros. Foram ligadas três a cinco perfurantes por membro; não houve óbitos no pós-operatório imediato; houve três infecções e as úlceras cicatrizaram em períodos variáveis de duas a 15 semanas. Dezenove doentes obtiveram alta hospitalar no primeiro dia de pós-operatório, seis no segundo e dois no terceiro. Houve uma recidiva de úlcera (4,0% durante o período de seguimento de 25 meses (média por causa de perfurante não-ligada. CONCLUSÕES: A cirurgia endoscópica subfascial de veias perfurantes insuficientes associada à cirurgia radical de varizes é segura, acompanha-se de baixo índice de complicações, pode ser adaptada aos instrumentos comuns da cirurgia laparoscópica, indicada para doentes classificados como C4, C5 e C6 e se acompanha de bons resultados imediatos e a médio prazo.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, 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.

Eduardo Toledo de Aguiar

2003-06-01

124

Phlebectasia of the external jugular vein with thrombosis: report of a case.  

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An 81-year-old male presented with a soft mass on his neck noted in the supine position. After undergoing an operation for an inguinal hernia, the mass was noted to persist regardless of the patient's position. Computed tomography and magnetic resonance imaging revealed phlebectasia of the external jugular vein with an associated thrombosis. Under general anesthesia, the external jugular vein was ligated and removed, along with the thrombus. A histological section revealed that the tunica media of the external jugular vein was absent, and the smooth muscle layer and elastic fibers were attenuated in the fusiform area of the vein. Due to the risk of propagation of the clot and pulmonary embolism, resection of the external jugular vein is advised in cases of phlebectasia of the external jugular vein. PMID:23589057

Matsunaga, Keiko; Kishi, Kazuo

2014-06-01

125

Crouzon's Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization.  

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Crouzon's syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon's syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon's syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon's syndrome due to a ruptured jugular venous diverticulum is described. PMID:25212416

Mondel, Prabath Kumar; Anand, Sunanda; Limaye, Uday S

2014-09-12

126

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)  

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Full Text Available 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%. Obti [...] veramse 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 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 trib [...] utaries 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 right and left ileum; 3-4 hepatic veins; right genital vein (testicular or ovarian); adrenal vein and renal right and left veins.

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

127

[A temporal bone study of the jugular fossa].  

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This study was performed to elucidate the anatomic variations of the jugular fossa (JF) on the basis of examination of 120 human temporal bones. Observations were made of temporal bones sectioned along a plane including the cochlea, the JF, and long axis of the internal auditory canal. The position of the upper margin of the JF was classified according to its relation to the tympanic cavity, the cochlea, and the internal auditory canal. The height of the upper margin of the JF was classified as follows. Low type; inferior to the level of the external auditory canal. Middle type; between the level of the external auditory canal and the cochlea. High type; superior to the level of the cochlea. The results revealed that 58 ears were of low type, 46 middle type, and 16 high type. Middle and high type comprised 62 ears, thus in 52% of ears the upper margin of the JF was situated superior to the external auditory canal. The relation between the JF and the cochlea was classified as follows. Medial type; medial to the medial margin of the cochlea. Lateral type; lateral to the medial margin of the cochlea. The results showed that 74 ears were of medial type, and 46 lateral type. Therefore, in 62% of ears the upper margin of the JF was situated medial to the medial margin of the cochlea. Forty-seven ears of medial type were of middle or high type. Ears of lateral type included none of high type. The jugular bulb diverticulum was observed in 32 ears, which consisted of 3 of low type, 13 middle type, 16 high type. When the upper margin of the JF was positioned higher, the JF was in a more medial position. However, no defect of the bony labyrinth was observed. In conclusion, it is considered that protrusion of the jugular bulb into the tympanic cavity was not caused by the abnormally high position of the JF, but by its lateral displacement. Distances from the JF to the surrounding structures were as follows; to the tympanic membrane 5.58 +/- 2.43mm (mean +/- S.D.), to the tympanic cavity 2.94 +/- 1.92mm, to the cochlea 4.93 +/- 2.20mm, and the internal auditory canal 5.82 +/- 2.38mm. PMID:1634992

Yagi, M

1992-06-01

128

Implante intencional de filtros de veia cava em ambas as veias ilíacas comuns: relato de caso e revisão da literatura / Intentional placement of vena cava filters in both iliac veins: case report and literature review  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os filtros de veia cava são utilizados para impedir a passagem de êmbolos dos membros inferiores para as artérias pulmonares e, normalmente, são colocadas imediatamente abaixo das veias renais. Em alguns casos, no entanto, existem dificuldades técnicas incomuns que devem ser superadas para tratar ad [...] equadamente alguns pacientes. Relatamos o caso de uma paciente em cujas veias ilíacas comuns foram implantados filtros de veia cava devido à baixa implantação das veias renais e da veia cava inferior curta. Abstract in english Vena cava filters are used to prevent the passage of emboli from the lower limbs to the pulmonary arteries and normally are placed immediately below the renal veins. In some cases however there are unusual technical difficulties that must be overcome to properly treat some patients. We report a case [...] of a patient in whose common iliac veins vena cava filters were deployed, due to the lower implantation of renal veins and a short inferior vena cava.

Daniel Queiroz, Neves; Renvik Demauir Cozine, Silva; Luis Claudio Rosa, Arantes; Márcio Cerbazzi Tavares, Cardoso; Mauro Henrique de, Lima; Gustavo Petorossi, Solano; Celso Luis Muhlethaler, Chouin; Paulo Eduardo Ocke, Reis.

2010-12-01

129

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 necessary to

Petrovi? Željko

2004-01-01

130

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

OpenAIRE

Realizamos estudo anatômico das veias anastomóticas de Trolard e de Labbé em sete segmentos cefálicos com o objetivo de precisar o trajeto e as referências que facilitem a preservação destes vasos durante o procedimento cirúrgico. Estudamos também as relações da veia de Trolard com a área motora.We accomplished an anatomic study of the anastomotic veins of Trolard and Labbé in seven human cephalic segments with the objective to accurate its stretch and references to facilitate it...

Sebastião Gusmão; Cassius Reis; Roberto Leal Silveira

2001-01-01

131

Implante de stent dentro de stent recém-implantado em ponte de veia safena para otimização do resultado angiográfico  

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Mulher de 60 anos, com angina progressiva e revascularização do miocárdio, há oito anos, com ponte de veia safena para coronária direita e anastomose de artéria mamaria esquerda para artéria descendente anterior. Submetida a implante de stent Gianturco-Roubin II em terço proximal da ponte de veia safena para artéria coronária direita, com resultado insatisfatório pela persistência de lesão residual, provavelmente, decorrente de prolapso para dentro da luz de material ateroscleró...

Fº, Esteves Antonio; Takimura Celso Kiyochi; Lira Evandro Costa; Kajita Luiz Junya; Arie Siguemituzo; Bellotti Giovanni; Pileggi Fulvio

1998-01-01

132

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  

Scientific Electronic Library Online (English)

Full Text Available 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. Abstract in english 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. Occlu [...] sion 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.

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

2000-03-01

133

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

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

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

1987-11-01

134

Internal jugular vein ectasia--a rare cause for paroxysmal cough.  

Science.gov (United States)

Internal jugular vein ectasia (dilatation of the internal jugular vein) is a rare clinical entity, often undiagnosed. Usually it presents as an asymptomatic, soft, compressible neck swelling that increases in size on Valsalva's manoeuvre. Our report describes right internal jugular vein ectasia in a 15-year-old girl who presented to us with intractable paroxysmal cough. The entity was suspected on ultrasound imaging and confirmed by computed tomography scan and Doppler. Ligation and excision of the dilated vein almost immediately cured her cough. The probable reason for the cough was the pressure exerted by the dilated vein on the vagus nerve. PMID:17166329

Padmanabhan, K; Vaishali, B; Indudharan, R

2007-08-01

135

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

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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

2004-01-01

136

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

Scientific Electronic Library Online (English)

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

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

2009-12-01

137

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese 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 exe [...] mplo: 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. Abstract in english 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 condi [...] tions (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.

2006-04-01

138

Endoscopic Endonasal Access to the Jugular Foramen: Defining the Surgical Approach  

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Introduction?The endoscopic endonasal approach to the parapharyngeal space (PPS) and jugular foramen is not well defined. We sought to systematically define the important landmarks and limitations of this new surgical technique using an endoscopic transmaxillary transpterygoid corridor.

Lee, Dennis L. Y.; Mccoul, Edward D.; Anand, Vijay K.; Schwartz, Theodore H.

2012-01-01

139

Internal Jugular/Subclavian Venous Access In Electrophysiology Study And Ablation  

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

Shomu Bohora

2009-07-01

140

Internal jugular/subclavian venous access in electrophysiology study and ablation.  

Science.gov (United States)

Multiple venous accesses are required for catheter placement during electrophysiology study and ablation. Internal jugular/subclavian venous access, though restricted nowadays, can be important in difficult situations. PMID:19652728

Bohora, Shomu; Tharakan, Jaganmohan

2009-01-01

141

Multimodality imaging and transcatheter coil embolization of an iatrogenic subclavian artery-internal jugular vein fistula.  

Science.gov (United States)

A 69-year-old man was found to have a loud continuous bruit in the neck. Duplex carotid ultrasound showed high-velocity turbulent flow in the dilated and pulsatile right internal jugular vein. Computed tomography angiogram demonstrated markedly enlarged right internal jugular vein with a posteriorly located arteriovenous communication. Invasive angiography revealed an arteriovenous fistula originating from the right subclavian artery draining into the dilated and tortuous right internal jugular vein. An endovascular coil was successfully deployed in the fistula tract. Subclavian artery-internal jugular vein fistula is rare. Our case is most likely iatrogenic towing to previous central venous cannulation during coronary bypass grafting. The anatomic challenge of this fistula, being located in the thoracic outlet, makes endovascular repair particularly favourable. PMID:25286164

Cai, Qiangjun; Sickler, Cory; Christenson, Stuart; Dotani, Imran

2015-01-01

142

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

2010-01-01

143

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-09-15

144

A case of jugular bulb diverticulum invading the internal auditory canal.  

Science.gov (United States)

Jugular bulb diverticulum (JBD) is a rarely reported vascular anomaly, which is an extraluminal outpouching from the jugular bulb. Especially, there exists a lack of reported cases involving JBD encroaching the internal auditory canal (IAC) in Korea. Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size. In this article, we report a unique case of JBD eroding into the IAC that was presented as sudden sensorineural hearing loss with vertigo. PMID:24653869

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

2012-04-01

145

A Case of Jugular Bulb Diverticulum Invading the Internal Auditory Canal  

OpenAIRE

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

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

2012-01-01

146

Hyperostosis frontalis interna and androgen suppression.  

Science.gov (United States)

Although hyperostosis frontalis interna (HFI) has been documented in the medical literature for over 300 years, its etiology remains undetermined. It is generally assumed to be associated with hormonal disturbances of the gonads. The aim of this study was to examine the association between androgen deprivation and development of HFI in males. Two groups of males over 60-years old were compared: a control group that included 180 healthy males, 45 suffering from benign prostatic hypertrophy (BPH) and a study group of 127 males with prostate cancer: 67 who received complete androgen block treatment, and 60 who received different treatments or none at all. CT head scans were used to identify and classify HFI (Brilliance 64, Philips Medical Systems, slice thickness 3 mm x 1.5 mm). It was found that males who received a complete androgen block manifested significantly higher prevalence of HFI compared to healthy males. However, no significant difference in HFI prevalence was found between males suffering from BPH and healthy males or males with prostate cancer who had not received a complete androgen block. A positive association between length of hormonal treatment and manifestation of HFI was shown. It can be concluded that BPH does not promote development of HFI; males who are hormonally treated for prostate cancer are at a higher risk of developing HFI compared to healthy males; the longer the duration of hormonal treatment, the higher the risk of developing HFI. PMID:20665812

May, Hila; Peled, Natan; Dar, Gali; Abbas, Janan; Medlej, Bahaa; Masharawi, Youssef; Hershkovitz, Israel

2010-08-01

147

Hyperostosis frontalis interna, acromegaly and hyperprolactinaemia.  

Science.gov (United States)

The association between hyperostosis frontalis interna (HFI), acromegaly and hyperprolactinaemia was investigated. Thirty six acromegalic patients, of whom 19 had hyperprolactinaemia, were compared with 36 randomly-selected, age-sex matched controls. There was a higher prevalence of HFI in the skull X-rays of the acromegalic cohort (P = 0.0002) when compared to the control group. This difference was apparent in both men (P = 0.01) and women (P = 0.01). Acromegalic patients with hyperprolactinaemia also expressed HFI in a higher proportion of individuals than the control group (P = 0.0001). Intra- and interobserver variability was assessed and concordance with 100% and 97% in the moderate and severe HFI sub-groups. The following sub-group analysis was undertaken: acromegalics and those acromegalics with hyperprolactinaemia were compared with the controls and a highly significant distinction was confirmed (P = 0.0007 and P = 0.00001 respectively). A relationship between HFI severity and the patient's age was noted in both male and female acromegalics. Also, the severity of HFI appeared related to disease duration in female acromegalics. The cause of HFI remains unknown but appears to be strongly associated with acromegaly, particularly in the presence of co-existent hyperprolactinaemia. The association may have symptomatic significance and the presence of HFI should be confirmed or refuted in all patients with acromegaly. PMID:2349162

Fulton, J D; Shand, J; Ritchie, D; McGhee, J

1990-01-01

148

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

Scientific Electronic Library Online (English)

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

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

2010-06-01

149

Correção cirúrgica de drenagem anômala parcial de veias pulmonares direitas em veia cava inferior (síndrome da cimitarra) / Surgical correction of partial anomalous pulmonary veins drainage in inferior vena cava (scimitar syndrome)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Paciente adolescente foi operada para correção de drenagem anômala parcial de veias pulmonares direitas em veia cava inferior, com inserção supra-diafragmática. A cirurgia foi realizada com o auxilio da circulação extracorpórea e resultou em ampla comunicação entre a veia anômala e o átrio esquerdo. [...] Os autores discutem as abordagens diagnostica e cirúrgica desta anomalia. Abstract in english Teenager, presenting congenital anomalous partial drainage of the right pulmonary veins to inferior vena cava in supradiaphragmatic position. The surgical approach was made with the use of extracorporeal circulation and resulted in a wide communication between the anomalous vein and the left atrium. [...] The authors discuss the diagnostic and surgical approach of this rare anomaly.

Marcos F, Berlinck; Januário M, Souza; Salomón O, Rojas; Sérgio Almeida de, Oliveira.

1992-03-01

150

Correção cirúrgica de drenagem anômala parcial de veias pulmonares direitas em veia cava inferior (síndrome da cimitarra Surgical correction of partial anomalous pulmonary veins drainage in inferior vena cava (scimitar syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Paciente adolescente foi operada para correção de drenagem anômala parcial de veias pulmonares direitas em veia cava inferior, com inserção supra-diafragmática. A cirurgia foi realizada com o auxilio da circulação extracorpórea e resultou em ampla comunicação entre a veia anômala e o átrio esquerdo. Os autores discutem as abordagens diagnostica e cirúrgica desta anomalia.Teenager, presenting congenital anomalous partial drainage of the right pulmonary veins to inferior vena cava in supradiaphragmatic position. The surgical approach was made with the use of extracorporeal circulation and resulted in a wide communication between the anomalous vein and the left atrium. The authors discuss the diagnostic and surgical approach of this rare anomaly.

Marcos F Berlinck

1992-03-01

151

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

Scientific Electronic Library Online (English)

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

Samet, Kapakin.

1186-11-01

152

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

Directory of Open Access Journals (Sweden)

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

Samet Kapakin

2011-12-01

153

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

2012-09-01

154

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

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

2012-09-01

155

Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs  

Directory of Open Access Journals (Sweden)

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.

Coelho Antônio Roberto de Barros

2000-01-01

156

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

157

Internal jugular vein cannulation: A comparison of three techniques  

Science.gov (United States)

Context: Ultrasound-guided internal jugular vein (IJV) cannulation is known for increasing success rate and decreasing rate of complications. The ultrasound image can be used as a real time image during cannulation or to prelocate the IJV before attempting cannulation. Aims: This study compares both the ultrasound-guided technique with the classical anatomical landmark technique (central approach) for right IJV cannulation in terms of success rate, complications, and time for cannulation. Settings and Design: A prospective, randomized, observational study was conducted at a tertiary care hospital. Material and Methods: One hundred twenty patients requiring IJV cannulation were included in this study and were randomly allocated in three groups. Number of attempts, success rate, venous access time, catheterization time, and complications were observed in each group. Statistical Analysis Used: Statistical analysis was performed using STATA-9 software. Demographic data were compared using one-way analysis of variance (ANOVA). Nonparametric data were compared using the Kruskall–Wallis test, and multiple comparisons were done applying The Mann–Whitney test for individual pairs of groups. Nominal data were compared by applying the Chi-square test and Fisher exact test. Results: Successful cannulation (?3 attempt) was achieved in 90.83% of patients without any statistical significant difference between the groups. Venous access time and catheterization time was found to be significantly less in both the ultrasound groups than the anatomical land mark group. Number of attempts and success in first attempt was similar between the groups. Conclusions: Both the ultrasound techniques are found to be better than the anatomical landmark technique. Further, ultrasound-guided prelocation was found to be as effective as ultrasound guided real-time imaging technique for right IJV cannulation. PMID:24106363

Ray, Bikash R; Mohan, Virender K; Kashyap, Lokesh; Shende, Dilip; Darlong, Vanlal M; Pandey, Ravindra K

2013-01-01

158

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

Scientific Electronic Library Online (English)

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

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

2009-04-01

159

The value of CT venography in the diagnosis of jugular bulb diverticulum: a series of 3 cases.  

Science.gov (United States)

Jugular bulb diverticulum is a rare diagnosis, as fewer than 50 cases have been reported in the literature. It has been reported that unilateral auditory symptoms may accompany this entity, although some patients are asymptomatic. We present a case series of 3 patients who were referred to our tertiary care neurotology center with a unilateral jugular bulb diverticulum along with unilateral sensorineural hearing loss and tinnitus. These patients were evaluated clinically and radiographically. This case series (1) adds further documentation of the presence of unilateral auditory symptoms in patients with a jugular bulb diverticulum and (2) demonstrates the value of computed tomographic venography in the diagnosis of jugular bulb diverticulum. PMID:19358118

Bush, Matthew L; Jones, Raleigh O; Given, Curtis

2009-04-01

160

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

Scientific Electronic Library Online (English)

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

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

2010-12-01

161

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

Scientific Electronic Library Online (English)

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

Sebastião, Gusmão; Cassius, Reis; Roberto Leal, Silveira.

2001-03-01

162

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

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

Sebastião Gusmão

2001-03-01

163

Topographic relations of the high jugular fossa to the inner ear. A radioanatomic investigation  

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

Wadin, K.; Wilbrand, H.

164

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

International Nuclear Information System (INIS)

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

165

Rifampicin-miconazole-impregnated catheters save cost in jugular venous sites with tracheostomy.  

Science.gov (United States)

Antimicrobial-impregnated catheters are more expensive than standard catheters (S-C). A higher incidence of catheter-related bloodstream infection (CRBSI) has been found in jugular venous access with tracheostomy than without tracheostomy. The objective of this study was to determine central venous catheter (CVC)-related costs (considering only the cost of the CVC, diagnosis of CRBSI, and antimicrobial agents used to treat CRBSI) using rifampicin-miconazole-impregnated catheters (RM-C) or S-C in jugular venous access with tracheostomy. We performed a retrospective cohort study of patients admitted to the intensive care unit (ICU) with tracheostomy who received one or more jugular venous catheters. RM-C showed a lower incidence of CRBSI compared with S-C (0 vs. 20.16 CRBSI episodes/1,000 catheter-days; odds ratio=0.05; 95% confidence interval=0.001-0.32; p11.46 ± 6.25 vs. 38.11 ± 77.25; p<0.001) in jugular venous access with tracheostomy. The use of RM-C could reduce CVC-related costs in jugular venous access with tracheostomy. The results of our study may contribute to clinical decision-making and selection of those patients who could benefit from the use of antimicrobial-impregnated catheters. PMID:22187350

Lorente, L; Lecuona, M; Ramos, M J; Jiménez, A; Mora, M L; Sierra, A

2012-08-01

166

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

Scientific Electronic Library Online (English)

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

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

2014-12-01

167

Jugular vein distensibility predicts fluid responsiveness in septic patients.  

Science.gov (United States)

IntroductionThe purpose of the study was to verify the efficacy of using internal jugular vein (IJV) size and distensibility as a reliable index of fluid responsiveness in mechanically ventilated patients with sepsis.MethodsHemodynamic data of mechanically ventilated patients with sepsis were collected through a radial arterial indwelling catheter connected to continuous hemodynamic monitoring system (Most Care®, Vytech Health, Padova, ITALY), including cardiac index (CI) (L/min/M2), heart rate (beats/min), mean arterial pressure (MAP) (mmHg), central venous pressure (CVP) (mmHg) and arterial pulse pressure variation (PPV), coupled with ultrasound evaluation of IJV distensibility (%), defined as a ratio of the difference between IJV maximal antero-posterior diameter during inspiration and minimum expiratory diameter to minimum expiratory diameter x100. Patients were retrospectively divided into two groups; fluid responders (R), if CI increase of more than or equal to 15% after a 7 ml/kg crystalloid infusion, and non-responders (NR) if CI increased more than 15%. We compared differences in measured variables between R and NR groups and calculated receiver-operator-characteristic (ROC) curves of optimal IJV distensibility and PPV sensitivity and specificity to predicting R. We also calculated a combined inferior vena cava distensibility-PPV ROC curve to predict R.ResultsWe enrolled 50 patients, of these, 30 were R. Responders presented higher IJV distensibility and PPV before fluid challenge than NR (P <0.05). An IJV distensibility more than 18% prior to volume challenge had an 80% sensitivity and 85% specificity to predict R. Pairwise comparison between IJV distensibility and PPV ROC curves revealed similar ROC area under the curve results. Interestingly, combining IJV distensibility more than 9.7% and PPV more than 12% predicted fluid responsiveness with a sensitivity of 100% and specificity of 95%.ConclusionIJV distensibility is an accurate, easily acquired non-invasive parameter of fluid responsiveness in mechanically ventilated septic patients with performance similar to PPV. The combined use of IJV distensibility with left-sided indexes of fluid responsiveness improves their predictive value. PMID:25475099

Guarracino, Fabio; Ferro, Baldassarre; Forfori, Francesco; Bertini, Pietro; Magliacane, Luana; Pinsky, Michael R

2014-12-01

168

Congenital carotid-jugular fistula in a child: a case report.  

Science.gov (United States)

Congenital carotid-jugular (CJ) fistula of the neck is a very rare clinical entity that has various causes. The CJ fistulas are particularly prone to complications unlike other peripheral arteriovenous fistulas. The aim of this report is to present a case of a CJ fistula between the external carotid and the external jugular vein, which was successfully closed with detachable balloon by an endovascular approach. A 14-year-old child was admitted to our clinic with a pulsatile neck swelling. There was no previous history of trauma. A high-flow fistula between the external carotid and the external jugular vein was determined. The fistula was closed with detachable balloon by an endovascular approach. The postoperative angiogram demonstrated complete resolution of the fistula. Endovascular treatment of CJ fistulas with detachable balloons is a safe and less traumatic technique and may be an effective alternative to the open surgery in selected patients. PMID:24302162

Erdi, Fatih; Kaya, Bülent; Keskin, Fatih; Koç, Osman; Karatas, Yasar; Kalkan, Erdal

2014-04-01

169

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

Scientific Electronic Library Online (English)

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

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

2012-12-01

170

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

Scientific Electronic Library Online (English)

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

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

2014-03-01

171

Linac-based stereotactic body radiation therapy for treatment of glomus jugulare tumors  

International Nuclear Information System (INIS)

Background: Glomus jugulare tumors are rare, typically benign, tumors that arise from the neural crest cells that are associated with the autonomic ganglia in and around the jugular bulb. Treatment options for glomus jugulare tumors include embolization followed by resection, fractionated external beam radiation therapy (EBRT), stereotactic radiosurgery (SRS), and/or stereotactic body radiation therapy (SBRT). Materials and methods: 18 patients were treated with linear-accelerator based stereotactic body radiation therapy (SBRT) between May 2002 and November 2008. Fifteen patients (83%) had single glomus jugulare tumors and 3 patients had bilateral glomus jugulare tumors (although each of these patients had a single tumor targeted). The median tumor volume was 5.83 cm3 (range, 0.32-35.47 cm3). Ten tumors (56%) were previously untreated, and 8 (44%) tumors were persistent after previous surgical resection. One patient had undergone previous EBRT and 2 patients were previously treated with Gamma Knife radiosurgery to the intracranial portion of their tumor, with planned SBRT to the extracranial portion 2-4 months later at our institution. The median prescribed dose was 20 Gy in 3 fractions (range: 16-25 Gy in 1-5 fx) to the 80% isodose line. The median prescription coverage of the tumor was 93.6% (range: 83-98.72%). Results: Median follow-up for the entire cohort was 22 months. All the patients were alive at the time of the last follow-up with imagt the time of the last follow-up with imaging available for review. The tumor was stable in 17 patients and decreased in size in one patient - yielding a local control rate of 100%. No patients experienced any new or worsening treatment-related neurologic deficits. Conclusions: SBRT is a safe and efficacious treatment modality for glomus jugulare tumors.

172

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

DEFF Research Database (Denmark)

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

Wienecke, T.; Hansen, J.M.

2008-01-01

173

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

DEFF Research Database (Denmark)

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

Tvedskov, Jesper; Lipka, Kerstin

2005-01-01

174

[Thrombosed external jugular vein aneurysm: a rare cause of neck mass].  

Science.gov (United States)

Venous aneurysms are rarely responsible for neck masses, and regarding the neck veins, external jugular vein aneurysms are extremely uncommon, with a few cases reported in the literature. Although most cases are asymptomatic, they may cause pain, be complicated by thrombosis or even rupture. Imaging studies have a role in the diagnosis and surgical planning of this pathology. With emphasis on the imaging techniques, the authors present a case of an external jugular vein aneurysm, initially asymptomatic but thereafter complicated with thrombosis. PMID:25203964

Martins, Inês Santiago; Pacheco, Hugo Pisco; Sapeira, Isabel

2014-01-01

175

Depresión: Visión holística de la medicina interna*  

Scientific Electronic Library Online (English)

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

Italo, Marsiglia G.

2008-03-01

176

Hyperostosis frontalis interna: an anthropological perspective.  

Science.gov (United States)

Hyperostosis frontalis interna (HFI) is manifested by the accretion of bone on the inner table of the frontal bone. Despite the vast literature on HFI, ambiguity exists as to its etiology, osteogenesis, demography, and history. This stimulated the present broad-scale study of HFI which included the evaluation of 1,706 early 20th century skulls (1,007 males and 699 females) from the Hamann-Todd and Terry human osteological collections, as well as 2,019 pre-19th century East-Mediterranean, Amerindian, and Central European skulls. In addition, 72 cadavers were dissected for gross inspection and histology. Special attention was paid to the relationship of the brain and meninges to endocranial lesions. HFI is an independent condition, not a symptom of a more generalized syndrome as suggested in the past. It can appear in a variety of forms but each is the result of the same process and probably of the same etiology. Investigators' previous failure to recognize the mild stages of HFI (types A and B) as an early form of the general HFI process led to erroneous statistics and interpretations of observations. HFI should also be considered a phenomenon separate from HCI, hyperostosis cranialis diffusa (HCD), and other endostoses, even when it appears in association with them. To avoid ambiguity and facilitate the description of cranial hyperostoses, uniform nomenclature (HFI, HCD) has been recommended. HFI is rarely seen in historic populations, regardless of geographical origin. It is most commonly found among females and is believed to be associated with prolonged estrogen stimulation. While its magnitude of manifestation and frequency are much higher in females, HFI is not a purely female phenomenon. Males with hormonal disturbances such as atrophic testis were found to manifest HFI type D. HFI is associated with age insofar as it is much less frequent in females under 40 years of age. Although advanced cases of HFI (types C and D) have been observed in individuals as young as 40 years of age, it is more frequently found after age 60. The frequency of HFI type D will not increase from age 60. Type-predicted analysis by cohort reveals significant ethnic differences. Changes in African American (AA) females appear earlier in life and progress more rapidly than in European American (EA) females. Analysis of radiographs shows a discrepancy between the anatomic prevalence of HFI and its radiological recognition, which is very poor for mild cases. This apparently resulted in the misconceptions that HFI is entirely an old-age phenomenon, and that it is exclusively female. Histological analysis shows that the inner table along with the closely attached dural layer play a major role in the osteogenesis of HFI. Contrary to previous models, no evidence for diploe or ectocranial plate involvement was found. Cadaver study suggests that the predilection for the frontal area may be related to an altered blood supply and/or vascular stretching. PMID:10407462

Hershkovitz, I; Greenwald, C; Rothschild, B M; Latimer, B; Dutour, O; Jellema, L M; Wish-Baratz, S

1999-07-01

177

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

Scientific Electronic Library Online (English)

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

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

2014-09-01

178

Leukocyte-marrow scintigraphy in hyperostosis frontalis interna.  

Science.gov (United States)

Hyperostosis frontalis interna is the term used to describe the thickening of the frontal bones of the skull. This thickening of the frontal bones is accompanied by an increase in the diploic space which results in an increased quantity of hematopoietically active marrow. Increased frontal bone uptake of labeled leukocytes has been reported in this condition, and the symmetric appearance of this activity may suggest its benign etiology. We have encountered a case of hyperostosis frontalis interna in which the uptake of labeled leukocytes was asymmetric and marrow scintigraphy confirmed that the activity seen was due to marrow not infection. PMID:9255168

Torres, M A; Palestro, C J

1997-08-01

179

As diferenças entre comunica??o interna e endomarketing  

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

Carolina Girotto Ochoa

2014-01-01

180

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

1977-12-01

181

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

1998-12-01

182

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.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical examination with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy. For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ? 15% (13 pts, 16 - 40% (21 pts and > 40% (20 pts.Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059 and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213. IVCCI ? 15% was always associated with high congestion score at the second visit; but IVCCI ? 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ? 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0.

Renato De Vecchis

2012-06-01

183

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

Scientific Electronic Library Online (English)

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

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

2012-06-01

184

A utilização da artéria torácica interna aumenta a mortalidade hospitalar do paciente coronariano idoso revascularizado? Does the use of the internal thoracic artery enhance the nosocomial mortality of the elderly revascularized patient?  

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Full Text Available No InCor, foi elaborado um protocolo para avaliar se o emprego da artéria torácica interna alterava a mortalidade hospitalar nos pacientes coronarianos idosos (idade > 70 anos, submetidos a revascularizaçáo isolada, eletiva do miocárdio. No protocolo foram incluídos parâmetros clínicos, hemodinâmicos, radiológicos, operatórios e de pós-operatório. Foram analisados 100 pacientes consecutivos, com observações completas, em estudo prospectivo. A análise estatística foi realizada pelo teste de X² de Pearson. Concluímos que houve diferença estatística entre os grupos comparados e que a mortalidade hospitalar foi maior no grupo de pacientes nos quais se utilizou o enxerto de veia safena autógena. Atribuiu-se ao cirurgião, como triador, a obtenção de tais resultados, utilizando a artéria torácica interna naqueles pacientes em melhor estado geral.At the Heart Institute, we performed a study to evaluate if the internal thoracic artery modified the nosocomial mortality of elderly coronary patients (age 70 years, submitted to elective isolated revascularization of the myocardium. Clinical, hemodynamic, radiologic, operative and postoperative parameters were included in the protocol. In a prospective study one hundred consecutive patients, with complete observations were analysed. The statistical analysis was performed using Pearson's X² test. The results of this study showed that there was a statistically significant difference between the groups, the nosocomial mortality being higher in that in which autogenous saphenous vein grafts were used. The role of the surgeon as a screener regarding obtention of results is also discussed.

José Carlos R Iglézias

1991-08-01

185

A utilização da artéria torácica interna aumenta a mortalidade hospitalar do paciente coronariano idoso revascularizado? / Does the use of the internal thoracic artery enhance the nosocomial mortality of the elderly revascularized patient?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese No InCor, foi elaborado um protocolo para avaliar se o emprego da artéria torácica interna alterava a mortalidade hospitalar nos pacientes coronarianos idosos (idade > 70 anos), submetidos a revascularizaçáo isolada, eletiva do miocárdio. No protocolo foram incluídos parâmetros clínicos, hemodinâmic [...] os, radiológicos, operatórios e de pós-operatório. Foram analisados 100 pacientes consecutivos, com observações completas, em estudo prospectivo. A análise estatística foi realizada pelo teste de X² de Pearson. Concluímos que houve diferença estatística entre os grupos comparados e que a mortalidade hospitalar foi maior no grupo de pacientes nos quais se utilizou o enxerto de veia safena autógena. Atribuiu-se ao cirurgião, como triador, a obtenção de tais resultados, utilizando a artéria torácica interna naqueles pacientes em melhor estado geral. Abstract in english At the Heart Institute, we performed a study to evaluate if the internal thoracic artery modified the nosocomial mortality of elderly coronary patients (age 70 years), submitted to elective isolated revascularization of the myocardium. Clinical, hemodynamic, radiologic, operative and postoperative p [...] arameters were included in the protocol. In a prospective study one hundred consecutive patients, with complete observations were analysed. The statistical analysis was performed using Pearson's X² test. The results of this study showed that there was a statistically significant difference between the groups, the nosocomial mortality being higher in that in which autogenous saphenous vein grafts were used. The role of the surgeon as a screener regarding obtention of results is also discussed.

José Carlos R, Iglézias; Luís Alberto, Dallan; Domingos D, Lourenço Filho; Hélio Antônio, Fabri; Antônio F, Ramires; Protásio Lemos da, Luz; Sérgio Almeida de, Oliveira; Fúlvio, Pileggi; Adib D, Jatene.

1991-08-01

186

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2008-03-15

187

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

International Nuclear Information System (INIS)

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

188

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

Science.gov (United States)

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

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

2014-01-01

189

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

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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.

Ashwin Krishnamurthy

2011-09-01

190

Hyperostosis frontalis interna associated with hypogonadism in an elderly man.  

Science.gov (United States)

Hyperostosis frontalis interna (HFI), symmetric thickening of the inner table of the frontal bone, is relatively common in women but very rare in men. We report the case of an elderly male patient with HFI. This patient was accompanied by primary hypogonadism, which may be related to the underlying pathogenesis of HFI. PMID:16431852

Yamakawa, Kentaro; Mizutani, Kotaro; Takahashi, Makio; Matsui, Masaru; Mezaki, Takahiro

2006-03-01

191

Etiopathogenesis of hyperostosis frontalis interna: a mystery still.  

Science.gov (United States)

Hyperostosis frontalis interna is a morphological pattern characterized by single or multiple bony nodules situated on the inner lamina of the frontal bone. It is seldom found in males, but it is a common phenomenon among post-menopausal females in modern societies but relatively rare in antiquity. The etiopathogenesis of the trait is a matter of debate and ranges from genetic predisposition to epigenetic, while endocrine disturbances, aging, and dietary factors are also listed among the causes. We studied the frequency, characteristic features, and etiopathogenesis of the disease in recent cadaveric and dry skull specimens. The frequency of hyperostosis frontalis interna in cadavers and dry skull materials was almost identical, 12.5% and 12.3%, respectively. In cadavers, 87.5% of severe hyperostosis frontalis interna cases were found in females over 65 years-old. Interestingly, in two cadavers we found hyperostotic lesions spreading onto adjacent tissues such as the dura and falx cerebri. We provide some new aspects that may help in better understanding of the etiopathogenesis of hyperostosis frontalis interna. Thereby, we discuss the various etiopathogenesis models found in the literature. PMID:21684729

Raikos, Athanasios; Paraskevas, George K; Yusuf, Faisal; Kordali, Panagiota; Meditskou, Soultana; Al-Haj, Abdulatif; Brand-Saberi, Beate

2011-10-20

192

Frontal cortex dysfunction due to extensive hyperostosis frontalis interna.  

Science.gov (United States)

An 87-year-old patient was found to have an unusually protrusive hyperostosis frontalis interna, discovered on MRI examination during an assessment of cognitive decline. Neuropsychological evaluation suggested direct repercussions of the frontal lobe compression on executive functions, as well as psychiatric disorders and possibly memory loss. PMID:22665704

Gilbert, Thomas; Ait, Sabrina; Delphin, Floriane; Raharisondraibe, Emmanuel; Bonnefoy, Marc

2012-01-01

193

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

Scientific Electronic Library Online (English)

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

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

2014-03-01

194

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

International Nuclear Information System (INIS)

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

195

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

Directory of Open Access Journals (Sweden)

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

2003-06-01

196

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

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

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

2006-06-01

197

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

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

Carlos Adriano Silva dos Santos

2007-03-01

198

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

OpenAIRE

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

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

2014-01-01

199

Infected Internal Jugular Vein Thrombus in a Case of Infected Arterio-Venous Fistula for Dialysis Access  

Science.gov (United States)

Infected internal jugular vein (IJV) thrombus is rare and is sometimes seen in association with jugular vein catheterization and rarely with suppurative upper aero-digestive tract infection. We describe a very rare association of left Infected Internal jugular vein thrombus with an infected arterio-venous fistula in the left elbow region created for dialysis access in a renal failure patient. The infected arterio-venous fistula was addressed surgically by excision and a reverse saphenous vein graft was placed between proximal and distal brachial artery just above it’s bifurcation. The patient was put on i.v Clindamycin and Metronidazole for six weeks. Patient recovered uneventfully. PMID:25298841

Chakrabart, Ushnish; Mazumder, Pinaki; Pal, Madhusudan; Dasbaksi, Kallol; Mukherjee, Plaban

2014-01-01

200

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 SciELO Brazil | Languages: English, Portuguese 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 r [...] elevance of knowledge on mammographic signs of systemic diseases.

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

2013-07-01

201

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

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

Carlos R Moraes

1988-08-01

202

Anomalous sub aortic left brachiocephalic vein: a case report / Veia braquiocefálica esquerda subaórtica anômala: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A veia braquiocefálica esquerda, ocasionalmente, segue curso aberrante. Esta variação freqüentemente está associada com anomalias congênitas do coração. Neste trabalho é apresentado um caso de veia braquiocefálica esquerda anômala, com trajeto subaórtico, sem anormalidade cardíaca. A tomografia comp [...] utadorizada com multidetectores é muito útil no correto diagnóstico dessa condição e permite a conclusão diagnóstica, sem quaisquer outras investigações. Abstract in english The left brachiocephalic vein occasionally follows an aberrant course. It is usually associated with congenital cardiac anomaly. We present a case of anomalous left brachiocephalic vein which followed a sub aortic course, with no cardiac abnormality. Multi detector computed tomography is very useful [...] in accurate diagnosis of this condition and prevents any further investigation in cases of isolated abnormalities.

Vetri Sudar, Jayaprakasam; Santosh, Gurudev; Klaus, Irion; Ali Nawaz, Khan; Andrew R., Pettit.

2008-04-01

203

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

2010-09-01

204

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

Scientific Electronic Library Online (English)

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

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

2014-12-01

205

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

Scientific Electronic Library Online (English)

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

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

2014-12-01

206

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

Scientific Electronic Library Online (English)

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

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

2014-04-01

207

Deficits on self ordered tasks associated with hyperostosis frontalis interna.  

Science.gov (United States)

A 74 year old patient, EW, with dorsolateral frontal cortical compression due to hyperostosis frontalis interna, in the absence of the Morgagni or Stewart-Morel syndromes, is described. In addition to conventional neuropsychological measures EW was administered one nonspatial and two spatial self ordered working memory tasks, as well as a standard measure of fluid intelligence or g. She showed impaired performance on all three self ordered working memory tasks compared with a normal control group of 10 subjects matched for age, education, sex, and IQ. By contrast, her performance on the fluid intelligence test was comparable with that of the controls. It is concluded that the compression of dorsolateral frontal cortex accompanying hyperostosis frontalis interna may produce selective cognitive impairment. PMID:9328246

de Zubicaray, G I; Chalk, J B; Rose, S E; Semple, J; Smith, G A

1997-09-01

208

O papel dos exames de imagem no diagnóstico de trombose das veias esplâncnicas: relato de dois casos = The role of imaging exams in the diagnosis of thrombosis of the splanchnic veins: report of two cases  

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Conclusões: considerando as manifestações clínicas vagas da trombose de veias esplâncnicas, os exames de imagem, em especial a tomografia computadorizada, apresentam papel fundamental no seu diagnóstico.

Gonçalves, Caren Meneghetti et al.

2010-01-01

209

Deficits on self ordered tasks associated with hyperostosis frontalis interna  

OpenAIRE

A 74 year old patient, EW, with dorsolateral frontal cortical compression due to hyperostosis frontalis interna, in the absence of the Morgagni or Stewart-Morel syndromes, is described. In addition to conventional neuropsychological measures EW was administered one non-spatial and two spatial self ordered working memory tasks, as well as a standard measure of fluid intelligence or g. She showed impaired performance on all three self ordered working memory tasks compared w...

Zubicaray, G. I.; Chalk, J.; Rose, S.; Semple, J.; Smith, G.

1997-01-01

210

Globus Pallidus Interna Deep Brain Stimulation for Chorea-Acanthocytosis  

Science.gov (United States)

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

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

2015-01-01

211

Bilateral jugular vein and sigmoid sinus thrombosis related to an inherited coagulopathy: an unusual presentation.  

Science.gov (United States)

Internal jugular vein thrombosis (IJVT) is a rare condition associated with malignancy, coagulopathy, and trauma. The optimal management of any IJVT must be individualized and depends on the condition of the patient. Case Presentation. We report the case of a 42-year-old woman with a history of a first trimester spontaneous abortion. Apart from a tension-type headache, she had no neurological symptoms. She reported an incidental diagnosis of right-sided IJVT when she was evaluated for hyperthyroidism ultrasonographically. On ultrasonography, we observed bilateral jugular vein thrombosis. The patient was started on oral warfarin. Seven months later, when she was adequately anticoagulated, she developed a second thrombosis. According to the etiological workup, she had a mutation in the homozygous methylene tetrahydrofolate reductase (MTHFR) gene and reduced protein C levels and activity. Conclusion. This report illustrates an unusual presentation of a rare condition. In this case, the etiology was associated with the coagulopathy, which occurred despite adequate anticoagulation. PMID:25221687

Alt?nta?, Ozge; Gürsoy, Azize Esra; Baran, Gözde; Mehdi, Elnur; Asil, Talip

2014-01-01

212

Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid region.  

Science.gov (United States)

Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck. PMID:24987551

Patil, Jyothsna; Kumar, Naveen; Swamy, Ravindra S; D'Souza, Melanie R; Guru, Anitha; Nayak, Satheesha B

2014-06-01

213

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

Science.gov (United States)

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

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

2015-01-01

214

Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient.  

Science.gov (United States)

Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention. PMID:25040197

Hsiao, Po-Jen; Tsai, Ming-Hsien; Leu, Jyh-Gang; Fang, Yu-Wei

2014-07-01

215

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

OpenAIRE

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

Ataiekhorasgani, Masoud; Jafaripozve, Nasim

2014-01-01

216

Radiation induced brainstem glioblastoma in a patient treated for glomus jugulare tumour.  

Science.gov (United States)

The intensive utilisation of cranial irradiation in young individuals with benign intracranial pathologies are of particular concern because of the potential for delayed development of radiation-induced neoplasms. We present a 48-year-old man who developed a second metachronous brainstem glioblastoma 10 years following adjuvant radiotherapy for a partially resected glomus jugulare tumour. The current patient highlights the importance of judicious and individualised consideration for irradiation treatment in benign pathologies that are associated with long-term survival. PMID:25085729

Na, Angelika F; Lai, Leon T; Kaye, Andrew H

2015-01-01

217

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

OpenAIRE

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

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

2014-01-01

218

The external jugular vein as an injection site in radionuclide angiography  

International Nuclear Information System (INIS)

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

219

Dumb-bell sarcoma of the foramen jugulare with syringomyelia. A radio-induced tumour  

International Nuclear Information System (INIS)

The clinicopathological findings of a 58-year-old man, who developed cervicothoracic syringomyelia at the age of 25 are presented. He was given radiation therapy at the age of 33. At the age of 57 he developed a foramen jugulare syndrome on the left, caused by a low grade leiomyosarcoma. Etiologically, the most attractive hypothesis appears to be that the tumour was induced by radiation therapy administered 24 years previously. (orig.)

220

Subcutaneous Infusion Ports Via the Internal Jugular Vein: Single Center Experience  

Science.gov (United States)

Objective: Our purpose is to report and review the results and early complications of subcutaneous infusion port placement by our interventional radiology department. Materials and Methods: Three-hundred twenty-five subcutaneous infusion ports were placed in 320 patients between January 2005 and May 2010. Ports were placed under both general and local anesthesia. Five patients were catheterized twice. The internal jugular veins were used for access. Both ultrasono-graphic and fluoroscopic guidance were used in our interventions. Retrospectively, we evaluated the ports’ duration time. Results: Our technical success rate was 100% and only five complications occurred during port placement. The common carotid arteries were punctured in three patients but bleeding stopped ten minutes following withdrawal of the needle and artery compression. An air embolism occurred in two patients and both were successfully treated with good positioning and suctioning. Early catheter removal was required in five patients. One patient had a right internal jugular vein thrombosis, three patients had catheter occlusions and two patients had catheter fractures. The mean duration of catheter usage was 354 days (range: 2 to 1,478 days). Conclusion: Image guided placement of infusion ports has a greater success rate and lower early complication rate when compared with the unguided series. The right internal jugular vein is the first choice for infusion port access. PMID:25610128

Karaman, Bulent; Andic, Cagatay; Oren, Nisa Cem; Battal, Bilal; Ustunsoz, Bahri

2010-01-01

221

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

2012-11-01

222

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

International Nuclear Information System (INIS)

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

223

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

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

Ionut Andrei Barbu

2008-05-01

224

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 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. 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 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.

1998-12-01

225

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

International Nuclear Information System (INIS)

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

226

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese 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 d [...] e 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC. Abstract in english Cerebral venous thrombosis (CVT) is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic). Galen vein thrombosis (GVT) is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female [...] patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

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

2003-06-01

227

Osteotomo nasal con guía interna / Osteotome with internal nasal guide  

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Full Text Available Diseñamos un osteotomo al que se adapta una guía interna para tratar el dorso nasal (resección de la giba ósea) con exactitud. Este instrumento aporta precisión en la osteotomía de tal forma que permite resecar solo la cantidad exacta de hueso que precise el paciente. [...] Abstract in english An internal guide has been added to the osteotome in order to achieve a precise reduction of the nasal dorsum (resection of the nasal hump). It makes the osteotomy so precise that only the exact amount of bone that the patient needs is resected. [...

A., Castro-Sierra; V., Piña-Martínez.

2014-06-01

228

Hyperostosis frontalis interna in a patient with giant cell arteritis.  

Science.gov (United States)

Hyperostosis frontalis interna (HFI) is a disorder characterized by progressive symmetric thickening of the inner table of the frontal bone of the human skull. HFI may be accompanied by headache and some neuropsychiatric diseases such as epilepsy and dementia. Giant cell arteritis (GCA), also called temporal arteritis, is a systemic inflammatory vasculitis of unknown etiology that affects medium- and large-sized arteries. It affects elderly people and may result in a wide variety of systemic, neurologic and ophthalmologic complications. As no association of HFI and GCA was encountered in the literature, we found it interesting to report a case with both of these clinical entities. PMID:18250961

Kocabas, Hilal; Sezer, Ilhan; Melikoglu, Meltem Alkan; Gurbuz, Ulku; Illeez, Ozge; Ozbudak, Irem Hicran; Butun, Bulent

2008-01-01

229

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

International Nuclear Information System (INIS)

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

230

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

231

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

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

Moini Majid

2009-01-01

232

Efficiency of gamma knife radiosurgery in the treatment of glomus jugulare tumors.  

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This study was performed to assess the impact of gamma knife radiosurgery (RS) in the treatment of glomus jugulare tumors. Between February 1993 and February 1999, thirteen patients (9 women, 4 men; mean age 63.5 years, range 29 to 79 years) underwent stereotactic radiosurgery for glomus jugulare tumors with the Leksell Gamma Knife at the Neurosurgical Department of the University of Vienna. Four patients, mean age 74.5 years, range 67 to 79 years, underwent radiosurgery as the only treatment. Nine patients received radiosurgery as adjuvant therapy after previous treatment had failed: surgical resection in 9 patients and additional fractionated external beam radiation in two of these patients. Pretreatment evaluation included the staging of all tumors according to the Fisch Classification: De1 (7), De2 (1), Di1 (4) and Di2 (1). The mean follow-up period was 4.2 years, range 0.7 to 6.7 years. Ten patients, 77 %, were treated prior to 1997, the mean follow-up period being 5 years. Six patients showed no clinical changes, while six experienced an improvement of their clinical symptoms and neurological deficits. One patient was lost to follow-up. Radiation-induced transient cranial nerve neuropathies were observed in two patients. Serial MRI scans revealed tumor control in all patients, with unaltered tumor size in 10 and shrinkage in three patients. The results indicate that RS is an attractive treatment option for glomus jugulare tumors and will occupy an increasingly important role in the management of these tumors in selected patients. PMID:11696882

Saringer, W; Khayal, H; Ertl, A; Schoeggl, A; Kitz, K

2001-09-01

233

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

Scientific Electronic Library Online (English)

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

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

1999-10-01

234

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

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

Mônica V. MARQUEZINI

1999-10-01

235

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese 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 su [...] a 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 esclarecer 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: Ret [...] rospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteristics 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.

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

2010-01-01

236

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

Scientific Electronic Library Online (English)

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

CE, Costa Almeida.

2014-12-01

237

[Our experience in the diagnosis and treatment of carotid-jugular fistulae].  

Science.gov (United States)

We present our experience in treatment of patients with carotid-jugular fistulas for a three years period. Three of those patients had congenital fistulas and one had acquired (posttraumatic) fistula. Signs and symptoms include: pulsatile neck mass, systolic murmur, thrill, dilated superficial veins. Diagnosis was confirmed with Duplex ultrasonography and angiography. Patients were treated by open surgery (ligation and resection) and endovascular procedures (conventional and laser embolization). In cases of single A-V communication ligation and resection gives excellent results. In cases of multiple communications recurrence in the same or neighbouring vascular area is more likely and second stage surgery or/and endovascular procedures (embolization) may be needed. PMID:11194647

Zakhariev, T; Chervenkov, V; Govedarsky, V; Chirkov, A

1999-01-01

238

Internal jugular vein thrombosis complicating disseminated tuberculosis in a 2-year-old child.  

Science.gov (United States)

Internal jugular vein (IJV) thrombosis is a serious and potentially life-threatening occurrence in children, and is usually associated with malignancies, prolonged central venous catheterisation or deep seated head and neck infections or trauma. It has not been described in association with tuberculosis in children. The authors describe a 2-year-old child who presented with IJV thrombosis in association with clinical signs and symptoms of disseminated tuberculosis. There was complete resolution of symptoms after starting antitubercular drugs and warfarin. The authors emphasise that an active search for tuberculosis should be made routinely in patients with IJV thrombosis with an underlying mediastinal mass and/or generalised lymphadenopathy. PMID:25234072

Das, Sarthak; Srinivasaraghavan, Rangan; Krishnamurthy, Sriram; Mahadevan, Subramanian

2014-01-01

239

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

OpenAIRE

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

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

2010-01-01

240

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

Scientific Electronic Library Online (English)

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

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

1994-06-01

241

Is catheter rupture rare after totally implantable access port implantation via the right internal jugular vein? Report of a case.  

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Catheter rupture after totally implantable access port (TIAP) implantation via the right internal jugular vein is thought to be very rare. We report a case of catheter rupture found 682 days after TIAP surgery in a 52-year-old woman with recurrent right breast cancer. It is possible that chronic stress at the flexure of the catheter induced by neck movements caused the catheter to rupture. Therefore, when inserting a TIAP via the right internal jugular vein, the site of venous puncture should be decided on carefully. Although a fracture of this type is rarely reported in the literature, the incidence of catheter injury of a TIAP inserted via the internal jugular vein at our institute is 1.8 %. This highlights the need to educate and caution medical staff and patients about preventing catheter fracture being caused by external factors. PMID:23732842

Nagasawa, Yoshinobu; Shimizu, Tomoharu; Sonoda, Hiromichi; Chou, Hirotomi; Mekata, Eiji; Tani, Tohru

2014-07-01

242

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

Science.gov (United States)

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

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

2014-01-01

243

Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma  

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Full Text Available Abstract Supraclavicular lymph node metastasis from endometrial carcinoma is considerably rarer than metastasis from uterine cervical cancer. To date, there have been no reported cases regarding systematic neck dissection as a salvage treatment. In this report, we describe the neck dissection procedure carried out on a 74-year-old woman with supraclavicular lymph node metastasis. Our objective was to histologically determine the origin of the metastasis while simultaneously providing appropriate treatment. The patient’s past medical history included two prior cases of cancer: rectal cancer 7?years earlier and endometrial adenocarcinoma 4?years earlier. We determined that middle and lower jugular neck dissection was appropriate in treating this case based on the results of our preoperative FDG-PET and tumor markers. This surgery provided histological evidence that metastasis occurred from endometrial carcinoma. Middle and lower jugular neck dissection was expected to improve the patient’s prognosis without impacting the patient’s active daily life. We have continued to monitor the patient closely over an extended period.

Kojima Masataka

2012-07-01

244

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

1999-01-01

245

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

OpenAIRE

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

246

[Thrombosis of the external jugular vein. Case report of a rare cause for pain in the lateral neck].  

Science.gov (United States)

Dental practitioners are sometimes confronted with patients complaining about pain in the neck area. Especially if an induration in the region of the big vessels is present, one must keep in mind the differential diagnosis of a spontaneous thrombosis of the external jugular vein. This diagnosis needs consequent treatment but also consequent search for an underlying pathology. This case report presents such a situation in an exemplary way. Despite risk factors, the reason for thrombosis stays in the dark. However, all possible causes were cleared and are shown to the reader. Especially malignancies are responsible for thrombosis of the jugular vein in many cases. PMID:24585364

Bartella, Alexander; Lübbers, Heinz-Theo; Schuknecht, Bernhard; Gander, Thomas; Grätz, Klaus W; Kruse, Astrid I

2014-01-01

247

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)  

OpenAIRE

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, c...

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

2003-01-01

248

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

2003-06-01

249

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)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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®. Abstract in english 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.

2003-06-01

250

Hyperostosis frontalis interna: case report and review of literature.  

Science.gov (United States)

Hyperostosis frontalis interna (HFI) has been reported in high frequency among post-menopausal elderly women. Although it was widely discussed in the past, this entity is rarely mentioned in the current pathology literature. We report a postmortem case of a 56 yr-old post-menopausal woman with irregular thickening of the internal surface of the frontal bone. Histology revealed an organized trabecular pattern with overall thickening of the cancellous bone. The periosteum and cortical bone were unaffected. The finding was considered to be unrelated to her death. HFI should be recognized as a benign entity and distinguished from other disorders that involve the frontal skull bone, such as Paget's disease, acromegaly, and malignancy. The etiology of HFI is unknown, but current hypotheses implicate hormonal stimulation. PMID:15228235

She, Rosemary; Szakacs, Juliana

2004-01-01

251

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

Scientific Electronic Library Online (English)

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

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

2010-09-01

252

Lesiones esplénicas en medicina interna / Splenic disorders in internal medicines  

Scientific Electronic Library Online (English)

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

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

2014-04-01

253

Suppression of heart NF-?B p65 expression by jugular vein injection of RNAi in mice.  

Science.gov (United States)

The nuclear factor-kappaB (NF-?B) in cardiac vascular endothelial cells (type II VEC) is a key factor that activates delayed xenograft rejection (DXR), and therefore inhibition of NF-?B gene expression may alleviate post-transplant rejection. siRNA technology was used to inhibit NF-?B p65 gene expression in ICR mice. After jugular vein injection of siRNA/in vivo-jetPEI complex, fluorescence levels of FAM-labeled siRNA in hearts and lungs were much higher after jugular vein injection than tail vein injection, suggesting more efficient siRNA delivery to the heart through the jugular vein. The amount of FAM fluorescence of hearts increased to the highest level between 48 and 72 hours after injection, and decreased gradually 1 week after injection. A minimum dose of 6 nmol NF-?B p65 siRNA and a siRNA/in vivo-jetPEI ratio of 6 (N/P = 6) were required for in vivo siRNA-mediated gene silencing in the heart. Under these conditions, application of siRNA/in vivo-jetPEI complexes from the jugular vein successfully suppressed NF-?B p65 expression in the heart. The same strategy can be applied to heart transplant animal models to protect against NF-?B gene-related type II VEC activation and xenograft rejection. PMID:20852747

Ye, W; Ten, X; He, M; Yu, Y; Huang, H; Hu, Y; Chen, Y; Zhou, X; Shen, Z

2010-01-01

254

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

2006-09-01

255

Utility of internal jugular vein reconstruction in modified radical neck dissection.  

Science.gov (United States)

The benefits to modified radical neck dissection (MRND) are established but the procedure involves substantial neck dissection with occasional resection of the internal jugular vein (IJV). Loss of the IJV is associated with morbidity including increased cerebral edema, stroke, laryngeal edema, blindness, facial fullness, and dural thrombosis. This paper discusses the morbidity associated with MRND, especially regarding venous outflow concerns and technical approaches to IJV reconstruction. Patients who have previously undergone MRND may benefit from immediate reconstruction and/or reanastomosis of the IJV. An attempt to maintain at least one major functional venous drainage point for the head and neck is indicated to minimize the significant morbidity and mortality of bilateral loss of the IJVs. The Katsuno classification system of type A, B, and C IJV reconstruction methods, and the novel type K reconstruction, are discussed as methods of maintaining venous outflow from the head and neck. PMID:23512903

Dua, Anahita; Desai, Sapan S

2014-04-01

256

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

International Nuclear Information System (INIS)

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

257

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.

Mian-Ying Wang

2011-09-01

258

[First experience of CyberKnife stereotactic radiotherapy for glomus jugulare tumors].  

Science.gov (United States)

Glomus jugulare tumors (GJT) (AKA paraganglioma or chemodecroma) make 0.6% of head and neck tumors and 80% of jugular foramen lesions. Recently different types of stereotactic radiotherapy are actively used in their treatment. The given paper summarizes our first experience of using CyberKnife system in management of patients with paragangliomas. Since April 2009 till September 2011 34 patients with GJT were treated in department for radiation therapy of Burdenko Neurosurgical Institute using CyberKnife system. Mean age was 50.5 years (range 26-75 years). Mean volume of treated lesions was 14.6 +/- 10.96 cm3 (range--1.04-37.4 cm3). Stereotactic radiosurgery was performed in 4 patients. Mean prescribed dose was 17 +/- 3.1 Gy (13.7-22 Gy). 30 patients received hypofractionation treatment (3-7 fractions with total dose 18-35 Gy). Mean follow-up period in our series was 8 months (1-20 months). Control of tumor growth reached 100% because none of the patients needed any additional therapy (microsurgical resection or repeated radiotherapy). Persistent trigeminal neuropathy was observed in 1 case (5%). There were no constant impairment of VII, IX, X, XII and XIII cranial nerves in the series. Stabilization of auditory function was present in 9 (82%) of 11 patients with initially preserved hearing. Preservation of effective hearing was observed in 75% of patients. Stereotactic radiosurgery and hypofractionation using CyberKnife system are effective modalities in management of such complex neurosurgical disease as GJT. Neurological deterioration after radiation treatment is extremely rare and in most cases is transient. PMID:22629845

Golanov, A V; Kapitanov, D N; Pronin, I N; Shelesko, E V; Zolotova, S V; Shchurova, I N; Zinkevich, D N

2012-01-01

259

Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases.  

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Jugular foramen paragangliomas are rare skull base tumours posing multiple complex diagnostic and management problems. We did a study to evaluate surgical technique, outcome and complications in 75 cases of tumours treated by multidisciplinary approach (i.e. combined neurosurgery, neuroradiology, ear, nose and throat surgery and intensive care unit team). Retrospective study on 75 consecutive patients with jugular foramen paragangliomas treated surgically from 1989 to 2005. Preoperative balloon occlusion test was performed in all patients as well as embolization (100%). A combined limited infratemporal and juxtacondylar approach was used in all patients. Gross total resection was achieved in 59 patients (78.7%). The most common complication was represented by lower cranial nerve deficits in five patients (6.6%), which was only temporary in three. Postoperative facial nerve weakness occurred in five cases (6.6%) and resolved in three of them. The remaining two patients underwent facial nerve reconstruction by hypoglossal/facial nerve anastomosis. Four patients (5.3%) had a postoperative cerebrospinal fluid leak, which was successfully treated by lumbar drainage. Two patients (2.7%) died because of complications related to surgical injury of lower cranial nerves: one patient developed aspiration pneumonia and septicemia and the second one developed a large cervico-bulbar hematoma that led to severe respiratory distress and ultimately global cerebral hypoxia. Paragangliomas are rare and complex skull base lesions that may be managed with low morbidity and mortality if a multidisciplinary approach is considered. Facial and lower cranial nerve postoperative deficits can be limited. PMID:21947488

Makiese, Orphée; Chibbaro, Salvatore; Marsella, M; Tran Ba Huy, P; George, B

2012-04-01

260

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

2008-01-01

261

Case report: (Presyncopal symptoms associated with a negative internal jugular venous pressure  

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Full Text Available A siphon is suggested to support cerebral blood flow but appears generally not to be established because internal jugular venous (IJV pressure is close to zero iA siphon is suggested to support cerebral blood flow but appears not to be established because internal jugular venous (IJV pressure is close to zero in upright humans. Thus in eleven young healthy males, IJV pressure was 9 ± 1 mmHg (mean ± SE when supine and fell to 3 ± 1 mmHg when seated, and middle cerebral artery mean blood velocity (MCA Vmean; P < 0.007 and the near-infrared spectroscopy-determined frontal lobe oxygenation (ScO¬2; P = 0.028 also decreased. Another subject, however, developed (presyncopal symptoms while seated and his IJV pressure decreased to -17 mmHg. Furthermore, his MCA Vmean decreased and yet within the time of observation ScO¬2 was not necessarily affected. These findings support the hypothesis that a negative IJV pressure that is a prerequisite for creation of a siphon provokes venous collapse inside the dura, and thereby limits rather than supports CBF. ?n upright humans. In eleven young healthy males, IJV pressure was 9 ± 1 mmHg (mean ± SE when supine and fell to 3 ± 1 mmHg when seated, and middle cerebral artery mean blood velocity (MCA Vmean; P < 0.007 and near-infrared spectroscopy-determined frontal lobe oxygenation (ScO¬2; P = 0.028 also decreased. Another subject, however, developed (presyncopal symptoms while seated and his IJV pressure decreased to -17 mmHg. Furthermore, his MCA Vmean decreased and yet within the time of observation ScO¬2 was not necessarily affected. These findings suggest that a negative venous pressure affects rather than supports cerebral blood flow, maybe because a negative IJV pressure is transmitted to subdural veins and makes them collapse disrupting a siphon mechanism.

NielsDamkjærOlesen

2014-08-01

262

Hyperostosis frontalis interna: criteria for sexing and aging a skeleton.  

Science.gov (United States)

Estimation of sex and age in skeletons is essential in anthropological and forensic medicine investigations. The aim of the current study was to examine the potential of hyperostosis frontalis interna (HFI) as a criterion for determining sex and age in forensic cases. Macroscopic examination of the inner aspect of the frontal bone of 768 skulls (326 males and 442 females) aged 1 to 103, which had undergone a head computerized tomography scan, was carried out using the volume rendering technique. HFI was divided into two categories: minor and major. HFI is a sex- and age-dependent phenomena, with females manifesting significantly higher prevalence than males (p<0.01). In both females and males, prevalence of HFI increases as age increases (p<0.01). We present herein the probabilities of designating an unknown skull to a specific sex and age cohort according to the presence of HFI (standardized to age distribution in an Israeli population). Moreover, we present the probability of an individual belonging to a specific sex or age cohort according to age or sex (respectively) and severity of HFI. We suggest a valid, reliable, and easy method for sex and age identification of unknown skulls. PMID:20652712

May, Hila; Peled, Nathan; Dar, Gali; Cohen, Haim; Abbas, Janan; Medlej, Bahaa; Hershkovitz, Israel

2011-09-01

263

Identifying and classifying hyperostosis frontalis interna via computerized tomography.  

Science.gov (United States)

The aim of this study was to recognize the radiological characteristics of hyperostosis frontalis interna (HFI) and to establish a valid and reliable method for its identification and classification. A reliability test was carried out on 27 individuals who had undergone a head computerized tomography (CT) scan. Intra-observer reliability was obtained by examining the images three times, by the same researcher, with a 2-week interval between each sample ranking. The inter-observer test was performed by three independent researchers. A validity test was carried out using two methods for identifying and classifying HFI: 46 cadaver skullcaps were ranked twice via computerized tomography scans and then by direct observation. Reliability and validity were calculated using Kappa test (SPSS 15.0). Reliability tests of ranking HFI via CT scans demonstrated good results (K > 0.7). As for validity, a very good consensus was obtained between the CT and direct observation, when moderate and advanced types of HFI were present (K = 0.82). The suggested classification method for HFI, using CT, demonstrated a sensitivity of 84%, specificity of 90.5%, and positive predictive value of 91.3%. In conclusion, volume rendering is a reliable and valid tool for identifying HFI. The suggested three-scale classification is most suitable for radiological diagnosis of the phenomena. Considering the increasing awareness of HFI as an early indicator of a developing malady, this study may assist radiologists in identifying and classifying the phenomena. PMID:21046669

May, Hila; Peled, Nathan; Dar, Gali; Hay, Ori; Abbas, Janan; Masharawi, Youssef; Hershkovitz, Israel

2010-12-01

264

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

2007-06-01

265

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

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

2011-02-01

266

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

OpenAIRE

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

Samet Kapakin

2011-01-01

267

El desarrollo laboral sustentable y su relación con la migración interna en México  

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Full Text Available en este trabajo se estudió la interacción entre la mi - gración interestatal y el desarrollo laboral sustentable en México del año 2000 al 2010, de acuerdo con la visión de Amartya Sen. Este desarrollo se midió con el índice de competitividad social, y la interacción con la migración interna se evaluó con un modelo de ecuaciones simultá - neas. Los resultados confirmaron que a mayor desarrollo laboral sustentable, el grado de inmigración fue más y vi - ceversa. Por otro lado, no se encontró relación alguna entre la emigración interna y el desarrollo laboral sustentable. Al desagregar el índice de competitividad social, se encontró una relación causal mutua entre el índice de la ausencia de pobreza salarial y la inmigración interna, así como una relación causa-efecto positiva entre ausencia de pobreza salarial sobre la emigración interna, la cual no se da en el otro sentido.

Jes\\u00FAs Sergio S\\u00E1nchez Rodr\\u00EDguez

2014-01-01

268

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

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

JAIRO ALEXANDER OSORIO

2007-01-01

269

Diseño de sistema de gestión de la comunicación interna a la medida organizacional  

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evaluación y control de los procesos comunicativos en la organización, capaz de permitir la existencia de un sistema de comunicación coherente y armónico, contribuyendo a una mayor integración interna, fortaleciendo su cultura e identidad.

Norge Lauzao-Serrano

2012-01-01

270

Hepatectomia direita ampliada com ressecção parcial da veia cava para metástase colorretal: relato de caso Extended right hepatectomy with partial resection of the vena cava from colorectal metastases: case report  

OpenAIRE

Introdução: A hepatectomia tem sido o tratamento padrão para metástase de origem colorretal (CR). Metástase com invasão da veia cava inferior (VCI) pode requerer ressecção combinada do fígado e VCI. Esta abordagem pode apresentar alto risco cirúrgico. Sangramento profuso e embolia gasosa são complicações intra-operatorias letais. Relato de Caso: Os autores relatam um caso de metástase colorretal única tratada com hepatectomia direita ampliada e ressecção parcial da veia cava ...

Sergio Renato Pais Costa; Olímpia Alves Teixeira Lima; Túlio Marcos Rodrigues da Cunha; Aloisio Fernandes Soares

2010-01-01

271

Implante de stent dentro de stent recém-implantado em ponte de veia safena para otimização do resultado angiográfico Stenting a stent in saphenous vein graft to optimize the angiographic result  

OpenAIRE

Mulher de 60 anos, com angina progressiva e revascularização do miocárdio, há oito anos, com ponte de veia safena para coronária direita e anastomose de artéria mamaria esquerda para artéria descendente anterior. Submetida a implante de stent Gianturco-Roubin II em terço proximal da ponte de veia safena para artéria coronária direita, com resultado insatisfatório pela persistência de lesão residual, provavelmente, decorrente de prolapso para dentro da luz de material ateroscleró...

Fº, Antonio Esteves; Celso Kiyochi Takimura; Evandro Costa Lira; Luiz Junya Kajita; Siguemituzo Arie; Giovanni Bellotti; Fulvio Pileggi

1998-01-01

272

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

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

Herbert Coelho Hortmann

2010-06-01

273

Hyperostosis frontalis interna: archaeological evidence of possible microevolution of human sex steroids?  

Science.gov (United States)

Hyperostosis frontalis interna is a restricted bilateral thickening of the frontal endocranial surface, which is frequently found in postmenopausal females today. Surprisingly, this condition had a higher male prevalence in its rare archaeological records. This is again highlighted by the oldest known male European hyperostosis frontalis interna case in an adult Celtic from 100 BC presented here. This unique specimen supports earlier suggestions of the possible microevolution of human endocrine regulation, e.g. by sex steroids, and its pathoanatomical impact. PMID:15553271

Rühli, F J; Böni, T; Henneberg, M

2004-01-01

274

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

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

Rafael Demarchi Malgor

2008-06-01

275

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

Scientific Electronic Library Online (English)

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

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

2008-06-01

276

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

2001-09-01

277

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

Science.gov (United States)

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

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

2014-02-01

278

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

2010-10-01

279

Cerebral hyperperfusion syndrome after endovascular reconstruction of carotid artery in high-flow carotid-jugular fistula.  

Science.gov (United States)

We describe the occurrence of cerebral hyperperfusion syndrome (CHS) in a case of long-standing carotid-jugular fistula (CJF) treated by endovascular reconstruction of the carotid artery. A 43-year-old male with a high-flow CJF between the internal carotid artery (ICA) and internal jugular vein underwent endovascular reconstruction of the carotid artery using a stent graft. After treatment, the patient developed CHS. The patient succumbed to a large intracranial bleed in the left external capsule and parietal lobe on the fifth postoperative day. CHS following endovascular reconstruction of carotid artery is rare. We present the first reported case of CHS following endovascular reconstruction of ICA. A review of literature for patients treated by endovascular rerouting of blood flow to the cerebral parenchyma associated with hyperperfusion syndrome has been performed. PMID:24464256

Mondel, Prabath Kumar; Udare, Ashlesha Satish; Anand, Sunanda; Kulkarni, Aniruddha V; Kapadia, Farhad N; Modhe, Jagdish M; Limaye, Uday S

2014-10-01

280

Endovascular treatment of two concomitant causes of pulsatile tinnitus: sigmoid sinus stenosis and ipsilateral jugular bulb diverticulum. Case report and literature review.  

Science.gov (United States)

We describe a rare case of highly invalidating pulsatile tinnitus associated with both stenosis of the sigmoid sinus and ipsilateral jugular bulb diverticulum. Both conditions were successfully treated by positioning a stent across the sigmoid sinus and jugular bulb. To our knowledge, the present clinical case represents the first report of such an approach. The therapeutic decision-making is discussed in relation to the etiopathologic hypothesis put forward. PMID:22065197

Signorelli, Francesco; Mahla, Kalid; Turjman, Francis

2012-01-01

281

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 SciELO Brazil | Language: English 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, d [...] a 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 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 fro [...] m 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 tha

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

2003-12-01

282

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese 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 (65.950\\mm?) no grupo de inversão do que no grupo controle (106.647\\mm?) (p Abstract in english OBJECTIVE: 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 hypertens [...] ion 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

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.

2011-02-01

283

Identification of a prostanoid FP receptor population producing endothelium-dependent vasorelaxation in the rabbit jugular vein.  

OpenAIRE

1. Prostaglandin F2 alpha (PGF2 alpha) and its synthetic analogue, fluprostenol, potently relaxed the precontracted isolated jugular vein of the rabbit (RJuV). The vasorelaxant activity of PGF2 alpha and fluprostenol was dependent upon an intact vascular endothelium. Although removal of the vascular endothelium abolished activity associated with PGF2 alpha-like agonists, it did not significantly alter the relaxant effects of prostaglandin E2 (PGE2). 2. The nitric oxide synthase inhibitor, NG-...

Chen, J.; Champa-rodriguez, M. L.; Woodward, D. F.

1995-01-01

284

The measurement of tissue interface pressures and changes in jugular venous parameters associated with cervical immobilisation devices: a systematic review  

OpenAIRE

Cervical immobilisation is commonly applied following trauma, particularly blunt head injury, but current methods of immobilisation are associated with significant complications. Semi-rigid disposable cervical collars are known to cause pressure ulcers, and impede effective airway management. These collars may also exacerbate a head injury by increasing intracranial pressure as a result of external compression of the jugular veins. There is a clear imperative to find ways of effectively immob...

Sparke, Alison; Voss, Sarah; Benger, Jonathan

2013-01-01

285

The measurement of tissue interface pressures and changes in jugular venous parameters associated with cervical immobilisation devices: a systematic review.  

Science.gov (United States)

Cervical immobilisation is commonly applied following trauma, particularly blunt head injury, but current methods of immobilisation are associated with significant complications. Semi-rigid disposable cervical collars are known to cause pressure ulcers, and impede effective airway management. These collars may also exacerbate a head injury by increasing intracranial pressure as a result of external compression of the jugular veins. There is a clear imperative to find ways of effectively immobilising the cervical spine whilst minimising complications, and any assessment of existing or new devices should include a standardized approach to the measurement of tissue interface pressures and their effect on jugular venous drainage from the brain. This systematic review summarises the research methods and technologies that have been used to measure tissue interface pressure and assess the jugular vein in the context of cervical immobilisation devices. 27 papers were included and assessed for quality. Laboratory investigations and biomechanical studies have gradually given way to methods that more accurately reflect clinical care. There are numerous accounts of skin ulceration associated with cervical collars, but no standardised approach to measuring tissue interface pressure. It is therefore difficult to compare studies and devices, but a pressure of less than 30 mmHg appears desirable. Cervical collars have been shown to have a compressive effect on the jugular veins, but it is not yet certain that this is the cause of the increased intracranial pressure observed in association with cervical collar use. This is the first review of its type. It will help guide further research in this area of trauma care, and the development and testing of new cervical immobilisation devices. PMID:24299024

Sparke, Alison; Voss, Sarah; Benger, Jonathan

2013-01-01

286

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

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

2002-02-01

287

Ressonância magnética cardiovascular em veia cava inferior interrompida não prevista Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava  

OpenAIRE

A Veia Cava Inferior (VCI) interrompida é uma anomalia rara. As anomalias da VCI são clinicamente importantes para os cardiologistas e radiologistas que pretendem intervir na cavidade cardíaca direita. Descrevemos três casos de interrupção da VCI diagnosticados por meio de estudo imaginológico de ressonância magnética cardíaca.La Vena Cava Inferior (VCI), interrumpida es una anomalía rara. Las anomalías de la VCI son clínicamente importantes para los cardiólogos y radiólogos qu...

Andre Mauricio Fernandes; Vikas Rathi; June Yamrozik; Ronald Willians; Biederman, Robert W.

2012-01-01

288

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

OpenAIRE

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

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

2008-01-01

289

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 SciELO Brazil | Language: English 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. [...

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

2011-06-01

290

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

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

2013-07-01

291

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

Directory of Open Access Journals (Sweden)

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.

Markovi? D.J.

2008-01-01

292

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

Scientific Electronic Library Online (English)

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

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

2008-06-01

293

Acute jugular vein thrombosis during rituximab administration: Review of the literature.  

Science.gov (United States)

Rituximab, a chimeric monoclonal antibody is licensed for the treatment of CD20 positive lymphomas. Previous studies have found rituximab, in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy, is superior to cyclophosphamide, doxorubicin, vincristine, and prednisone alone in the treatment of diffuse large B-cell lymphoma and many other B-cell lymphomas. Acute hypersensitivity reactions have been reported in patients receiving rituximab infusion and usually manifesting as headache, fever, chills, sweats, skin rash, dyspnea, mild hypotension, and nausea. Acute major venous thrombosis and seizures have not been reported as manifestation of acute hypersensitivity reaction. We report on a 22-year-old woman, who was diagnosed with stage III B CD20 positive B-cell diffuse large B-cell lymphoma. During the first cycle of treatment, she developed grand-mal seizure while receiving rituximab infusion without any other features of acute hypersensitivity reaction. Imaging confirmed new onset jugular vein thrombosis with normal coagulation parameters. These events were managed by anticonvulsants and anticoagulation therapy. The patient completed eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone without rituximab and achieved complete remission. No further complications were noted. To our knowledge, this is the first case in the literature describing grand-mal seizures and acute thrombosis while on rituximab treatment. Clinicians should be aware of this rare side effect, as stopping rituximab can prevent recurrence of these complications. PMID:25063762

Dada, Reyad; Zekri, Jamal; Ramal, Bilal; Ahmad, Kamel

2014-07-24

294

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)

295

Scanning system for noninvasive optoacoustic monitoring of blood oxygenation in the internal jugular vein  

Science.gov (United States)

Continuous monitoring of cerebral blood oxygenation is critically important for successful treatment of patients with severe traumatic brain injury. At present, the techniques for monitoring blood oxygenation are invasive. Recently we proposed noninvasive monitoring of cerebral blood oxygenation by using optoacoustic probing of blood circulating in the internal jugular vein (IJV). A major source of error in the optoacoustic measurement with a single-element optoacoustic probe is the spatial misalignment between the probe and the IJV. We built a LabView®-based scanning system that automatically moves our optoacoustic probe across the IJV while continuously taking measurements. Automatic signal processing determines the signal with the best probe-vessel alignment which then is used for further processing. The scanning system was tested in phantoms using solutions with different absorption coefficients and with blood with various levels of blood oxygenation. Amplitudes and profiles of the optoacoustic signals recorded from the phantoms closely followed the blood oxygenation changes in accordance with blood optical properties. These data indicate that the scanning system is capable of improving the accuracy of non-invasive monitoring of blood oxygenation by minimizing errors associated with lateral misalignment of the probe with respect to blood vessels.

Brecht, H.-P.; Prough, D. S.; Petrov, Y. Y.; Patrikeev, I.; Esenaliev, R. O.

2007-02-01

296

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

297

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

Energy Technology Data Exchange (ETDEWEB)

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

298

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

International Nuclear Information System (INIS)

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

299

Fractionated stereotactic radiotherapy of glomus jugulare tumors. Local control, toxicity, symptomatology, and quality of life  

International Nuclear Information System (INIS)

Background and Purpose: For glomus jugulare tumors, the goal of treatment is microsurgical excision. To minimize postoperative neurologic deficits, stereotactic radiosurgery (SRS) was performed as an alternative treatment option. Stereotactic fractionated radiotherapy (SRT) could be a further alternative. This study aims at the assessment of local control, side effects, and quality of life (QoL). Patients and Methods: Between 1999-2005, 17 patients were treated with SRT. 11/17 underwent previous operations. 6/17 received primary SRT. Treatment was delivered by a linear accelerator with 6-MV photons. Median cumulative dose was 57.0 Gy. Local control, radiologic regression, toxicity, and symptomatology were evaluated half-yearly by clinical examination and MRI scans. QoL was assessed by Short Form-36 (SF-36). Results: Median follow-up was 40 months. Freedom from progression and overall survival for 5 years were 100% and 93.8%. Radiologic regression was seen in 5/16 cases, 11/16 patients were stable. Median tumor shrinkage was 17.9% (p = 0.14). Severe acute toxicity (grade 3-4) or any late toxicity was never seen. Main symptoms improved in 9/16 patients, 7/16 were stable. QoL was not affected in patients receiving primary SRT. Conclusion: SRT offers an additional treatment option of high efficacy with less side effects, especially in cases of large tumors, morbidity, or recurrences after incomplete resections. (orig.)

300

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

Scientific Electronic Library Online (English)

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

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

2013-12-01

301

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

Directory of Open Access Journals (Sweden)

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

Behle Ivo

2001-01-01

302

Estudo anatômico da artéria torácica interna aplicado à cirurgia cardiovascular  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese 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 p [...] lastrões esternocostais e injetadas as ATIs com Látex Neoprene. A ATI originou-se diretamente da artéria subclávica em 82,5% e de um tronco comum com outras artérias em 17,5%. O comprimento médio foi de 20,4 ± 2,1 cm e o ponto de terminação mais freqüente foi ao nível do 6º espaço intercostal (e.i.) (52,5%). A forma de terminação se fez como bifurcação em 93% e como trifurcação em 7%. A relação da ATI com a margem esternal foi de 10,3 ± 3,2 mm ao nível do 1º e.i. e 19,2 ± 6,0 mm ao nível do 6º e.i. A ATI está recoberta pelo músculo transverso do tórax numa extensão média de 7,5 ± 2,7 cm e apresenta o ramo costal lateral em 15%. O nervo frênico é anterior à ATI em 70% e posterior em 30%. O estudo forneceu subsídios que podem contribuir para minimizar as complicações pós-operatórias. 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 Neoprene Latex. The ITA originated directly from the subclavian artery in 82.5% and from a common trunk with other arteries in 17.5%. Its lenght was 20.4 ± 2.1 cm in average and the most frequent end point was the 6th intercostal space (52.5%). The end point form was as bifurcation in 93% and as trifurcation in 7%. The relation of ITA with the sternal margins was, on average, 10.3 ± 3.2 mm at the level of first intercostal space and 19.2 ± 6.0 mm at the level of 6th intercostal space. It was covered by the transverse muscle of thorax in a distance of 7.5 ± 2.7 cm long (average) and the lateral costal branch was present in 15%. The ITA was crossed anteriorly by phrenic nerve in 70% and posteriorly in 30%. Informations provided by this study may help prevent complications in ITA dissections and to improve our knowledgement on its anatomical characteristics.

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

1997-01-01

303

Estudo anatômico da artéria torácica interna aplicado à cirurgia cardiovascular  

Directory of Open Access Journals (Sweden)

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

Jorge A HENRIQUEZ-PINO

1997-01-01

304

Adult mouse venous hypertension model: common carotid artery to external jugular vein anastomosis.  

Science.gov (United States)

The understanding of the pathophysiology of brain arteriovenous malformations and arteriovenous fistulas has improved thanks to animal models. A rat model creating an artificial fistula between the common carotid artery (CCA) and the external jugular vein (EJV) has been widely described and proved technically feasible. This construct provokes a consistent cerebral venous hypertension (CVH), and therefore has helped studying the contribution of venous hypertension to formation, clinical symptoms, and prognosis of brain AVMs and dural AVFs. Equivalent mice models have been only scarcely described and have shown trouble with stenosis of the fistula. An established murine model would allow the study of not only pathophysiology but also potential genetic therapies for these cerebrovascular diseases. We present a model of arteriovenous fistula that produces a durable intracranial venous hypertension in the mouse. Microsurgical anastomosis of the murine CCA and EJV can be difficult due to diminutive anatomy and frequently result in a non-patent fistula. In this step-by-step protocol we address all the important challenges encountered during this procedure. Avoiding excessive retraction of the vein during the exposure, using 11-0 sutures instead of 10-0, and making a carefully planned end-to-side anastomosis are some of the critical steps. Although this method requires advanced microsurgical skills and a longer learning curve that the equivalent in the rat, it can be consistently developed. This novel model has been designed to integrate transgenic mouse techniques with a previously well-established experimental system that has proved useful to study brain AVMs and dural AVFs. By opening the possibility of using transgenic mice, a broader spectrum of valid models can be achieved and genetic treatments can also be tested. The experimental construct could also be further adapted to the study of other cerebrovascular diseases related with venous hypertension such as migraine, transient global amnesia, transient monocular blindness, etc. PMID:25650793

Yang, Shun-Tai; Rodriguez-Hernandez, Ana; Walker, Espen J; Young, William L; Su, Hua; Lawton, Michael T

2015-01-01

305

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

2012-09-01

306

Características de la cultura organizacional y comunicación interna en una comercializadora de lácteos de Cali  

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Full Text Available Objetivo. Esta investigación tuvo como objetivo identificar las características de la comunicación interna, atribuidas a la cultura organizacional de una empresa familiar, comercializadora de lácteos. Método. Es una investigación de tipo descriptiva, con diseño transaccional, en la cual se recogen los datos en un solo momento mediante el uso del Cuestionario de Diagnóstico de la Cultura Organizacional de Cameron y Quinn (1999. La muestra estuvo conformada por 66 empleados de diferentes áreas de la empresa. Resultados y Conclusión. Los resultados señalan falencias en la comunicación interna, generadas por la cultura organizacional de tipo clan, centrada hacia su interior, y que caracteriza a la empresa familiar.

Diana Marcela G\\u00F3mez

2011-01-01

307

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

Scientific Electronic Library Online (English)

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

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

2009-08-01

308

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  

OpenAIRE

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 c...

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

2001-01-01

309

Reingreso hospitalario en Medicina Interna / Readmission in internal medicine  

Scientific Electronic Library Online (English)

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

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

2001-05-01

310

[Jugular vein thrombosis caused by hypercoagulability following in-vitro fertilization-activated protein C resistance and immobilization].  

Science.gov (United States)

Jugular vein thrombosis (JVT) is extremely difficult to diagnose clinically because of its rarity, the wide range of possible symptoms and the variety of differential diagnoses. A rapid diagnosis is important in order to avoid or prevent imminent life-threatening complications. This study reports a clinical case of extensive JVT due to increased thrombophilia in conjunction with ovarian hyperstimulation syndrome (OHSS) after in vitro fertilization, increased APC resistance and immobilization. It also discusses the current literature that forms the basis for recommendations regarding the diagnosis, therapy and interdisciplinary management. PMID:22532279

Stölzel, K; Jovanovic, S; Albers, A E

2013-03-01

311

Bilateral surgical reconstruction for internal jugular veins disease in patients with chronic cerebrospinal venous insufficiency and associated multiple sclerosis.  

Science.gov (United States)

Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by morphologic alterations involving efferent cerebral vascular paths. CCSVI has been implicated as a contributing factor to multiple sclerosis (MS) but this theory is highly controversial. We report 3 cases of CCSVI patients with MS who had undergone internal jugular veins (IJVs) angioplasty to restore vessels patency. All patients reported significant symptomatic improvement after angioplasty until symptoms recurred after restenosis of the treated IJVs. Surgical IJVs reconstruction was performed. Patients' symptoms gradually improved and the benefits were maintained at the 1-year follow-up. PMID:24704584

Spagnolo, Salvatore; Scalise, Filippo; Barbato, Luciano; Grasso, Maria Antonietta; Tesler, Ugo F

2014-10-01

312

Computed tomography and magnetic resonance imaging features of a rare case of a primary epidermoid tumor of the jugular foramen  

Science.gov (United States)

We present computed tomography (CT) and magnetic resonance imaging (MRI) features of a very rare case of a primary epidermoid tumor of the jugular foramen (JF). A 45-year-old male patient presented with gradually progressive vertigo and tinnitus. CT and MRI scans revealed a 3.5 cm right-sided JF tumor with characteristic bright signal (restricted diffusion) on diffusion-weighted MRI (DWI). DWI may be useful in accurately differentiating the lesion from other cystic neoplasms of the JF. We describe the imaging features of intracranial epidermoid and JF tumors and discuss its differential diagnosis.

Mahajan, Parag Suresh; Mahajan, Anuradha Parag; Al Moosawi, Nawal M.

2015-01-01

313

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  

Directory of Open Access Journals (Sweden)

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

2005-09-01

314

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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 homen [...] s 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. Abstract in english 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.

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

2005-09-01

315

Appearance of hyperostosis frontalis interna on indium-111 leukocyte scans: potential diagnostic pitfall  

International Nuclear Information System (INIS)

The appearance of hyperostosis frontalis interna on an [111In]leukocyte scan is reported. Recognition of the potential for normal accumulation of 111In-labeled white blood cells within this common process involving the skull is necessary to avoid misdiagnosis

316

Appearance of hyperostosis frontalis interna on indium-111 leukocyte scans: potential diagnostic pitfall  

Energy Technology Data Exchange (ETDEWEB)

The appearance of hyperostosis frontalis interna on an (/sup 111/In)leukocyte scan is reported. Recognition of the potential for normal accumulation of 111In-labeled white blood cells within this common process involving the skull is necessary to avoid misdiagnosis.

Floyd, J.L.; Jackson, D.E. Jr.; Carretta, R.

1986-04-01

317

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

OpenAIRE

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 HFI.

Ramchandren, Sindhu; Liebeskind, David S.

2007-01-01

318

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

Science.gov (United States)

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 HFI. PMID:18071629

Ramchandren, Sindhu; Liebeskind, David S

2007-12-01

319

[The phenomenon of hyperostosis frontalis interna--state of the art knowledge].  

Science.gov (United States)

Hyperostosis frontalis interna (HFI) is an interesting but still a poor-known phenomenon, which may be found post-mortem. The authors have presented views on the aetiology, pathogenesis and symptomatology of HFI. The usefulness of this abnormality in the identification of sex and age has been pointed out. PMID:23650850

Sumi?ska-Ziemann, Barbara; Gos, Tomasz; Jankowski, Zbigniew

2012-01-01

320

An experimental study on MR imaging of jugular venous thrombosis in dogs  

International Nuclear Information System (INIS)

This study was designed to evaluate the potential application of MRI in differentiating static blood from thrombus, age-related changes of thrombus and the signal differences of the intravascular thrombus in various pulse sequences. External jugular vein was ligated at both upper and lower ends to from a static blood column, and thrombin was injected into the column to cause venous thrombosis in a total of 15 mongrel dogs. The MR images were obtained with T1- and T2-weighted spin echo and gradient echo techniques, lmmediately after the formation of static blood and after 2 hour, 1 day, 1 week, 2 weeks and 4 weeks of the formation of thrombus at a 2.0 T MR unit. The signal intensities of the thrombus and adjacent muscles were compared subjectively, and the signal intensity ratio was compared objectively by the measurement of the signal intensities using a cursor. The MRI findings were compared with histologic findings. The signal intensities of static blood were hyperintense in all pulse sequences, and those of 2 hour, 1 day and 1 week old thrombi were hyperintense in all pulse sequence. The number of experimental thrombi which showed isointensity on T1- and T2-weighted image, and hyperintensity on gradient echo image increased as thrombi aged. The signal intensities of 2 week old thrombus were isointense on T1-weighted image, hyperintense on T2-weighted image, and hyperintense on gradient echo image, while those of 4 week old thrombus were isointense on T1-weighted anthrombus were isointense on T1-weighted and T2-weighted image, and hypointense on gradient echo image in most experimental thrombi. There was a tendency to decrease in a signal intensity ratio as thrombi aged on T1-weighted, T2-weighted and gradient echo images(p<0.01). Histologically, thrombus was not formed and lumen was filled with many red blood cells(RBCs) in 2 hour old specimen, but fibrin mesh was visible and RBCs decreased in number in 1 day old specimen. In 1 week old specimen, vessel was contrasted and lumen was filled with thrombus, RBCs, platelets, many fibrins and capillary like structures. The histologic findings of 2 week old thrombus were similar to those of 1 week old one except calcification. In 4 week old specimen, vessels were contrasted and lumen was obliterated with fibrosis and organization of the thrombus. Therefore, it is possible diagnose thrombus, and to assess sequential changes of MRI findings of thrombus by using all pulse sequences, and these results can be essential bases for the interpretation of MR images of patients with venous thrombosis

321

An experimental study on MR imaging of jugular venous thrombosis in dogs  

Energy Technology Data Exchange (ETDEWEB)

This study was designed to evaluate the potential application of MRI in differentiating static blood from thrombus, age-related changes of thrombus and the signal differences of the intravascular thrombus in various pulse sequences. External jugular vein was ligated at both upper and lower ends to from a static blood column, and thrombin was injected into the column to cause venous thrombosis in a total of 15 mongrel dogs. The MR images were obtained with T1- and T2-weighted spin echo and gradient echo techniques, lmmediately after the formation of static blood and after 2 hour, 1 day, 1 week, 2 weeks and 4 weeks of the formation of thrombus at a 2.0 T MR unit. The signal intensities of the thrombus and adjacent muscles were compared subjectively, and the signal intensity ratio was compared objectively by the measurement of the signal intensities using a cursor. The MRI findings were compared with histologic findings. The signal intensities of static blood were hyperintense in all pulse sequences, and those of 2 hour, 1 day and 1 week old thrombi were hyperintense in all pulse sequence. The number of experimental thrombi which showed isointensity on T1- and T2-weighted image, and hyperintensity on gradient echo image increased as thrombi aged. The signal intensities of 2 week old thrombus were isointense on T1-weighted image, hyperintense on T2-weighted image, and hyperintense on gradient echo image, while those of 4 week old thrombus were isointense on T1-weighted and T2-weighted image, and hypointense on gradient echo image in most experimental thrombi. There was a tendency to decrease in a signal intensity ratio as thrombi aged on T1-weighted, T2-weighted and gradient echo images(p<0.01). Histologically, thrombus was not formed and lumen was filled with many red blood cells(RBCs) in 2 hour old specimen, but fibrin mesh was visible and RBCs decreased in number in 1 day old specimen. In 1 week old specimen, vessel was contrasted and lumen was filled with thrombus, RBCs, platelets, many fibrins and capillary like structures. The histologic findings of 2 week old thrombus were similar to those of 1 week old one except calcification. In 4 week old specimen, vessels were contrasted and lumen was obliterated with fibrosis and organization of the thrombus. Therefore, it is possible diagnose thrombus, and to assess sequential changes of MRI findings of thrombus by using all pulse sequences, and these results can be essential bases for the interpretation of MR images of patients with venous thrombosis.

Lee, Joo Hyuk; Choi, Sin Eun [Kangnam General Hospital, Pubic Corporation, Seoul (Korea, Republic of); Park, Jae Hyung; Kim, Jae Seung; Lee, Sun Gyu; Chang, Kee Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1993-11-15

322

A case of left-sided absence and right-sided fenestration of the external jugular vein and a review of the literature.  

Science.gov (United States)

The external jugular vein is increasingly being used as the recipient vein in head and neck tissue transfers, and for cannulation to conduct diagnostic procedures or intravenous therapies. The variations in the patterns of its course, and knowledge of these variations, are therefore important. We report on a bilateral external jugular vein anomaly found during the neck dissection of an approximately 75-year-old female cadaver, a case which has hitherto not been reported. The vein was absent on the left and fenestrated on the right. An embryological evaluation and the clinical implications of the anomaly are described. Clinicians and surgeons performing vascular or reconstructive surgery should be made aware of this variation of the external jugular vein to prevent inadvertent injury. PMID:25432662

Cvetko, Erika

2014-11-30

323

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 SciELO Brazil | Language: Portuguese 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 d [...] e 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. 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 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.

2007-06-01

324

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

Directory of Open Access Journals (Sweden)

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

2007-06-01

325

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 A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas me [...] diastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior. Abstract in english The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphoma [...] s by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

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

2012-09-01

326

Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

Katsuro Harada Júnior

2012-09-01

327

Subclavian vein angioplasty during arteriovenous fistula surgery: case report and literature review Angioplastia de veia subclávia no intraoperatório de fístula arteriovenosa: relato de caso e revisão de literatura  

Directory of Open Access Journals (Sweden)

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

2012-06-01

328

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 Pacientes portadores de Insuficiência Renal Crônica (IRC) estágio V são geralmente tratados por hemodiálise (HD), preferencialmente por fístula arteriovenosa (FAV). Descrevemos um relato de caso de um paciente de 58 anos, masculino, portador de diabetes mellitus, hipertensão arterial sistêmica e IRC [...] terminal. Seus antecedentes demonstram múltiplos acessos para implante de cateter de hemodiálise, assim como tentativas prévias de realização de FAV. Esse paciente desenvolveu estenose subclínica da veia subclávia, limitando a HD pelo membro superior. O propósito deste relato foi descrever o tratamento endovascular de estenose de veia subclávia, concomitante à realização de uma nova FAV. Abstract in english Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF). We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a [...] long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.

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

2012-06-01

329

Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy / Enxerto de veia esplênica na reconstrução do eixo mesentérico-portal após gastroduodenopancreatectomia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese A ressecção da confluência das veias mesentérica superior e porta tem sido realizada com maior frequência no tratamento de adenocarcinoma do pâncreas, em virtude dos bons resultados relatados, porém pode também ser usada em casos de neoplasias pancreáticas benignas quando firmemente aderidas ao eixo [...] mesentérico-portal. Apesar disso, não existe nenhum estudo sobre o melhor tipo de enxerto venoso para reconstrução do eixo mesentérico-portal quando necessária. A escolha do enxerto dependerá da preferência do cirurgião ou da instituição onde ocorre à cirurgia. Esta nota técnica discute criticamente o uso da veia esplênica como opção para reconstrução do eixo mesentérico-portal após gastroduodenopancreatectomia. Abstract in english Resection of the confluence of the superior mesenteric and portal veins has been performed most frequently in the treatment of adenocarcinoma of the pancreas, in view of the reported positive results, but it can also be used in cases of benign pancreatic neolpasias when they are strongly adhered to [...] the mesenteric-portal trunk. Nevertheless, there is no study on the best type of venous grafts for reconstruction of the mesenteric-portal trunk when required. The choice of graft depends on the preference of the surgeon or the institution. This technical note critically discusses the use of the splenic vein as an option for mesenteric-portal trunk reconstruction after gastroduodenopancreatectomy.

Enio Campos, Amico; José Roberto, Alves; Samir Assi, João.

2014-10-01

330

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

331

EVALUACIÓN DE LAS PROPIEDADES MECÁNICAS DE LA ESTRUCTURA INTERNA DE LA GUADUA CON UN MODELO MATEMATICO  

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Full Text Available Se caracterizo la estructura interna del Bambú-Guadua angustifolia kunth (GAK, en su zona media, encontrando la composición interna de este material compuesto, como son el porcentaje de la matriz (parénquima y de fibras (células de fibras y tejido conductivo. Se determinó las propiedades mecánicas como la resistencia a tensión y a flexión en sentido tangencial, y la Relación de Poisson del material y la resistencia de la fibra. Se valido un modelo matemático para materiales compuestos propuesto por Chandrupatla & Belegundu (1999, y se encontraron algunas ecuaciones que permiten predecir la resistencia del material en función de la resistencia de la fibra, y también para realizar modelos computacionales útiles para la industria de laminados de pisos en Bambuguadua. Los resultados experimentales no difirieron significativamente de los resultados obtenidos con los modelos matemáticos.

JAIRO ALEXANDER OSORIO SARAZ

2009-01-01

332

Are hyperostosis frontalis interna and leptin linked? a hypothetical approach about hormonal influence on human microevolution.  

Science.gov (United States)

It is striking that evidence for hyperostosis frontalis interna - a phenomenon of exclusive bilateral thickening of frontal endocranial surface - in archaeological samples is very rare in contrast to its modern prevalence. Because microevolutionary changes have been shown for various human characteristics any alteration of hormonal levels is very likely. Selection pressure was definitively higher in earlier times. This favoured prolonged alertness in order to access sufficient food, shorter feeling of satiety, lower level of fat metabolism, lower metabolic rates and, therefore, lower level of leptin - a 167 amino acid peptide mainly involved in human total body fat regulation. Its effects on bone metabolism are still debated. Nevertheless, we postulate the following hypothesis: In humans a decrease of selective pressure favoured an increased metabolic rate. This, being related to the higher level of leptin caused an increase of localized bony overgrowth like hyperostosis frontalis interna. PMID:12056872

Rühli, F J; Henneberg, M

2002-05-01

333

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

1986-12-01

334

Características de la cultura organizacional y comunicación interna en una comercializadora de lácteos de Cali  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in portuguese Escopo. Esta pesquisa teve como escopo identificar as características da comunicação interna atribuídas à cultura organizacional de uma empresa familiar comercializadora de produtos lácteos. Metodología. É uma pesquisa de tipo descritiva com desenho transacional, na qual foram recolhidos os dados em [...] um só momento mediante o uso do Questionário de Diagnóstico da Cultura Organizacional de Cameron e Quinn (1999). A mostra esteve conformada por 66 empregados de diferentes áreas da empresa. Resultados and conclusão. Os resultados assinalam falências na comunicação interna geradas pela cultura organizacional de tipo clã, centrada para o interior, e que caracteriza à empresa familiar. Abstract in spanish Objetivo. Esta investigación tuvo como objetivo identificar las características de la comunicación interna, atribuidas a la cultura organizacional de una empresa familiar, comercializadora de lácteos. Método. Es una investigación de tipo descriptiva, con diseño transaccional, en la cual se recogen l [...] os datos en un solo momento mediante el uso del Cuestionario de Diagnóstico de la Cultura Organizacional de Cameron y Quinn (1999). La muestra estuvo conformada por 66 empleados de diferentes áreas de la empresa. Resultados y Conclusión. Los resultados señalan falencias en la comunicación interna, generadas por la cultura organizacional de tipo clan, centrada hacia su interior, y que caracteriza a la empresa familiar. Abstract in english Objective. The objective of this research was to identify the characteristics of the internal communication attributed to the organizational culture of a family business which marketed dairy products. Method. This research is descriptive and has a transactional design in which data is gathered on a [...] one time basis using a Diagnostic Questionnaire on the Organizational Culture of Cameron and Quinn (1999). The sample was made up of 66 employees of different areas within the company. Results and Conclusion. The results signal the internal communication shortcomings generated by the clan type organizational culture: focused inward as characterized by a family owned business.

Diana Marcela, Gómez; Kewy Sarsosa, Prowesk.

2011-12-01

335

Monitoramento da carga interna no basquetebol / Monitoring internal load in basketball  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O objetivo do presente estudo foi quantificar a magnitude da carga interna referente a uma partida oficial de Basquetebol feminino e avaliar se a carga interna apresenta relação com o número de ações técnicas realizadas no jogo. A amostra foi constituída de 10 atletas (25 ± 4 anos) que participaram [...] do XI Campeonato Brasileiro de Basquetebol Feminino. Foram avaliados o comportamento da frequência cardíaca (FC) e a percepção subjetiva de esforço (PSE) em resposta à partida. A carga interna foi calculada pelo método de Edwards e pelo método de Foster. Além disso, foram analisados os parâmetros de desempenho técnico na partida. A carga interna estimada pelo método de Edwards e Foster foram 255±62 e 321±127 unidades arbitrárias, respectivamente. Foi detectada correlação moderada entre os dois métodos utilizados (Edwards e Foster; r = 0,64; - p Abstract in english The aim of this study was to quantify the magnitude of the internal load induced by an official women's basketball match and to determine whether the magnitude of the internal load is correlated with the number of basketball maneuvers perfomed. The sample consisted of 10 athletes (25 ± 4 years), who [...] participated in the XI Brazilian Women's Basketball Championship. Heart rate and rating of perceived exertion in response to the match were evaluated. The internal load was calculated by the methods of Edwards and Foster. In addition, the basketball maneuvers perfomed in the match were analyzed. The internal load estimated by the methods of Edwards and Foster was 255 ± 62 and 321 ± 127 arbitrary units, respectively. A moderate correlation was observed between the two methods used (r = 0.64, p

João Antônio, Nunes; Eduardo Caldas, Costa; Luis, Viveiros; Alexandre, Moreira; Marcelo Saldanha, Aoki.

2011-02-01

336

Oclusão bilateral das artérias carótidas internas, sífilis meningovascular e SIDA: relato de caso  

OpenAIRE

Relatamos um caso de obstrução bilateral na origem das artérias carótidas internas, apresentando como sinais/sintomas associados hemiparesia e hipoestesia superficial e profunda à direita, associada a sífilis meningovascular em paciente com SIDA. Tomografia de crânio apresentou pequenas lesões hipodensas, com predomínio à esquerda, e arteriografia evidenciou oclusão bilateral das artérias carótidas. A associação entre lues e SIDA não é infrequente, porém o quadro oligossinto...

LAMBRECHT FLORISBERTO; Sa? Daniel, S.; KOERBEL ANDREI; TAMANINI ALEXANDRO; Machareth Sa?vio, L.; SCOLA ROSANA HERMINIA; Teive He?lio, A. G.; WERNECK LINEU CESAR

1999-01-01

337

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese 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 apr [...] esenta-se como uma alternativa plausível e pouco conhecida. OBJETIVO: Descrever a anatomia da veia braquial comum como via de drenagem colateral no membro superior. MÉTODOS: 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 upper 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.

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

2011-03-01

338

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 safenas humanas apresentaram expressão protéica para apoptose similar às veias controle. No entanto, a expressão de Bcl-2 foi significativamente maior nos segmentos distendidos a 300 mmHg, quando comparados à veia controle. CONCLUSÃO: Estes achados demonstram que segmentos intactos de veias safenas humanas submetidos a distensões em diferentes pressões têm expressão de proteínas apoptóticas similares quando comparados com veias controle nãodistendidas. Por conseguinte, breves distensões comumente realizadas durante a coleta cirúrgica não ativam o processo de apoptose e, provavelmente, não estão envolvidas em mecanismos fisiopatológicos que levam à falência do enxerto Abstract in english OBJECTIVE: To investigate the possible role of apoptosis on brief distensions of human saphenous veins at different pressures. METHODS: Fresh isolated grafts of human saphenous vein were assigned as control or distended (D) for fifteen seconds at 100, 200 and 300 mmHg. The degree of apoptotic caspas [...] es 3, 8, 9 and anti-apoptotic protein Bcl-2 expression were assessed by immunohistochemistry. RESULTS: Fresh isolated segments of distended human saphenous veins presented similar apoptotic protein expression when compared with control veins. However, the Bcl-2 expression was significantly higher in the 300 mmHg distended segments compared with the control vein. CONCLUSION: These findings show that intact segments of human saphenous veins submitted to distensions at different pressures have similar apoptotic proteins expression when compared with non-distended control veins. Therefore, brief distensions commonly performed during surgical harvesting do not trigger apoptosis, and probably are not involved on the physiopathological mechanisms that lead to graft failure

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

2009-09-01

339

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

Directory of Open Access Journals (Sweden)

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

2013-03-01

340

A rare case of looping of supraclavicular nerve branches around external jugular vein and transverse cervical artery  

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Full Text Available Awareness of the topographic anatomy of various neurovascular variations in the triangles of the neck may serve as a useful guide for radiologists, anesthesiologists and surgeons. It can help to prevent diagnostic errors, influence surgical and interventional procedures and avoid surgical complications during head and neck surgeries. Here we present the detailed case report with review of the literature of a 55-year-old formalin fixed male cadaver showing an unusual loop formation from the three main branches of supraclavicular nerve around the external jugular vein and the transverse cervical artery on the right side of the neck. Such a loop may lead to neurovascular symptoms. Cases bearing this kind of variations should be managed carefully during surgical and/or electrophysiological procedures.

Rao TR

2009-05-01

341

Balloon atrial septostomy through internal jugular vein in a 45-day-old child with transposition of great arteries  

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Full Text Available Balloon atrial septostomy is a common palliative procedure in D-transposition of great arteries. It is technically easy before 2-3 weeks of age when the septum primum is thin. Femoral vein or umbilical vein, when available, is the common access used for this procedure. In situations when these accesses are not available or in case of inferior vena cava interruption, trans-hepatic access is used. Internal jugular vein (IJV access is not used as it is difficult to enter the left atrium through this route. We describe a case of successful Balloon atrial septostomy done through IJV in a 45-day-old child with emphasis on the technique, hardware and precautions necessary during the procedure.

Padhi Sumanta

2010-01-01

342

Magnetic resonance tomography with Gd-DTPA in the diagnosis of paragangliomas of the carotid and jugular bodies  

International Nuclear Information System (INIS)

The value of magnetic resonance tomography in the diagnosis of paragangliomas in the head and neck has been studied and compared with CT and angiography. Magnetic resonance tomography on its own equals the accuracy of CT, but the use of Gd-DTPA improves diagnostic accuracy. In 19 patients with a glomus jugulare tumour, MR tomography with Gd-DTPA accurately diagnosed all tumours larger than 5 mm. In seven patients with a carotid body tumour, it was possible to arrive at an exact differential diagnosis. Sensitivity was better than that of CT or of sonography. Where there is clinical suspicion of a glomus tumour, magnetic resonance tomography with Gd-DTPA should be the first investigation; if there is a positive finding, angiography should be carried out to demonstrate the circle of Willis. (orig.)

343

[Magnetic resonance tomographic studies of paragangliomas of the glomus caroticum and glomus jugulare using Gd-DTPA].  

Science.gov (United States)

The value of magnetic resonance tomography in the diagnosis of paragangliomas in the head and neck has been studied and compared with CT and angiography. Magnetic resonance tomography on its own equals the accuracy of CT, but the use of Gd-DTPA improves diagnostic accuracy. In 19 patients with a glomus jugulare tumour, MR tomography with Gd-DTPA accurately diagnosed all tumours larger than 5 mm. In seven patients with a carotid body tumour, it was possible to arrive at an exact differential diagnosis. Sensitivity was better than that of CT or of sonography. Where there is clinical suspicion of a glomus tumour, magnetic resonance tomography with Gd-DTPA should be the first investigation; if there is a positive finding, angiography should be carried out to demonstrate the circle of Willis. PMID:2829304

Vogl, T; Bauer, M; Schedel, H; Brüning, R; Mees, K; Lissner, J

1988-01-01

344

Trombose de veia porta após desconexão ázigo-portal e esplenectomia em pacientes esquistossomóticos: Qual a real importância? Portal vein thrombosis after esophagogastric devascularization and splenectomy in schistosomal portal hypertension patients: What's the real importance?  

Directory of Open Access Journals (Sweden)

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

2009-03-01

345

Trombose de veia porta após desconexão ázigo-portal e esplenectomia em pacientes esquistossomóticos: Qual a real importância? / Portal vein thrombosis after esophagogastric devascularization and splenectomy in schistosomal portal hypertension patients: What's the real importance?  

Scientific Electronic Library Online (English)

Full Text Available CONTEXTO: A complicação mais frequente após a desconexão ázigo-portal e esplenectomia em doentes com esquistossomose mansônica hepatoesplênica é a trombose da veia porta. OBJETIVOS:Avaliar a incidência, os fatores preditivos dessa complicação, assim como, a evolução clínica, laboratorial, endoscópic [...] a e ultrassonográfica desses pacientes. MÉTODOS: Foram analisados retrospectivamente os prontuários de 155 doentes esquistossomóticos submetidos a desconexão ázigo-portal e esplenectomia. RESULTADOS: Trombose de veia porta foi observada em 52,3% dos pacientes, sendo 6,5% de trombose total e 45,8% de trombose parcial. Os pacientes que evoluíram com trombose de veia porta apresentaram mais frequentemente diarreia no pós-operatório. Febre foi evento habitual que ocorreu em 70% dos casos, mais frequente, entretanto, nos doentes com trombose total da veia porta (100%). Trombose de veia mesentérica superior ocorreu em quatro doentes (2,6%), sendo mais frequente entre os com trombose total da veia porta. Não se encontrou diferença estatística quanto aos parâmetros clínicos, laboratoriais, endoscópicos e recidiva hemorrágica no pós-operatório tardio, quando comparados os pacientes com e sem trombose portal. CONCLUSÕES: A trombose de veia porta no pós-operatório da desconexão ázigo-portal e esplenectomia é evento frequente, sem nenhum fator preditivo para sua ocorrência; na maioria dos casos a trombose é parcial e apresenta evolução benigna, com baixa morbidade; trombose total da veia porta está mais frequentemente associada à trombose da veia mesentérica superior, com elevada morbidade; a trombose da veia porta, parcial ou total, não acarretou complicações no período pós-operatório tardio. Abstract in english CONTEXT: Portal vein thrombosis is the most frequent complication after esophagogastric devascularization and splenectomy for hepatosplenic schistosomosis. OBJECTIVE: To evaluate portal vein thrombosis in 155 patients with schistosomal portal hypertension submitted to esophagogastric devascularizati [...] on and splenectomy. METHODS: We retrospectively analyzed not only the incidence and predictive factors of this complication, but also clinical, laboratorial, endoscopic and Doppler sonography outcome of these patients. RESULTS: Postoperative portal thrombosis was observed in 52.3% of the patients (partial in 45.8% and total in 6.5%). Postoperative diarrhea was more frequent in patients with portal vein thrombosis. Fever was a frequent postoperative symptom (70%) but occurred in a higher percentage when total portal vein thrombosis was present (100%). Superior mesenteric vein thrombosis occurred in four patients (2.6%) and was associated with total thrombosis of the portal vein. There was no statistical difference between patients with and without portal vein thrombosis according to clinical and endoscopic parameters during late follow-up. It was not possible to identify any predictive factor for the occurrence of this complication. CONCLUSIONS: Portal vein thrombosis is an early and frequent event after esophagogastric devascularization and splenectomy, usually partial with benign outcome and low morbidity. Total portal vein thrombosis is more frequently associated with a high morbidity complication, the superior mesenteric vein thrombosis. Long-term survival was not influenced by either partial or total portal thrombosis.

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

2009-03-01

346

Implante de filtro de veia cava com uso de dióxido de carbono como meio de contraste: série de casos / Carbon dioxide use as contrast for vena cava filter implantation: case series  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: Avaliar o resultado do implante de filtro em veia cava inferior empregando angiografia digital por subtração com dioxide de carbono (CO2) como meio de contraste. MÉTODOS: No período de abril de 2010 a fevereiro de 2011, sete pacientes foram submetidos ao implante de filtro na veia cava inf [...] erior, utilizando-se CO2 como meio de contraste em subtração digital. Os pacientes apresentaram como critério de inclusão trombose venosa profunda no setor ilíaco-femoral e contraindicação à anticoagulação. RESULTADOS: Foi obtido sucesso técnico em todos os casos, com adequada visualização da veia cava e veias renais, não havendo complicações relacionadas ao uso do CO2 ou ao procedimento. CONCLUSÃO: O implante de filtro de veia cava utilizando o CO2 como meio de contraste é segura e efetiva em pacientes portadores de alergia ao contraste iodado ou com insuficiência renal não dialítica. Abstract in english OBJECTIVE: To assess the use of digital subtraction with carbon dioxide (CO2 ) for vena cava filter implant. METHODS: From April (2)010 to February (2)011, seven patients underwent inferior vena cava filter placement with digital subtraction angiography with the use of CO2 as contrast media. All pat [...] ients had iliac and femoral deep venous thrombosis and contraindications for anticoagulation. RESULTS: Technical success was achieved in all cases. Inferior vena cava e renal veins were identified in all cases. There were no evidences of complications related to the use of CO2 during or after the procedure. CONCLUSION: The placement of inferior vena cava filter with CO2 and digital subtraction angiography is safe and effective with good results in patients with renal insufficiency and allergy to iodine.

Matheus Pessanha de, Rezende; Bernardo, Massière; Arno von, Ristow; Alberto, Vescovi; Alexandre A., Duarte; Daniel A., Drummond; Leonardo, Stambovsky; Antonio Luiz de, Medina.

2012-03-01

347

Implante de filtro de veia cava com uso de dióxido de carbono como meio de contraste: série de casos Carbon dioxide use as contrast for vena cava filter implantation: case series  

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Full Text Available OBJETIVO: Avaliar o resultado do implante de filtro em veia cava inferior empregando angiografia digital por subtração com dioxide de carbono (CO2 como meio de contraste. MÉTODOS: No período de abril de 2010 a fevereiro de 2011, sete pacientes foram submetidos ao implante de filtro na veia cava inferior, utilizando-se CO2 como meio de contraste em subtração digital. Os pacientes apresentaram como critério de inclusão trombose venosa profunda no setor ilíaco-femoral e contraindicação à anticoagulação. RESULTADOS: Foi obtido sucesso técnico em todos os casos, com adequada visualização da veia cava e veias renais, não havendo complicações relacionadas ao uso do CO2 ou ao procedimento. CONCLUSÃO: O implante de filtro de veia cava utilizando o CO2 como meio de contraste é segura e efetiva em pacientes portadores de alergia ao contraste iodado ou com insuficiência renal não dialítica.OBJECTIVE: To assess the use of digital subtraction with carbon dioxide (CO2 for vena cava filter implant. METHODS: From April (2010 to February (2011, seven patients underwent inferior vena cava filter placement with digital subtraction angiography with the use of CO2 as contrast media. All patients had iliac and femoral deep venous thrombosis and contraindications for anticoagulation. RESULTS: Technical success was achieved in all cases. Inferior vena cava e renal veins were identified in all cases. There were no evidences of complications related to the use of CO2 during or after the procedure. CONCLUSION: The placement of inferior vena cava filter with CO2 and digital subtraction angiography is safe and effective with good results in patients with renal insufficiency and allergy to iodine.