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Sample records for abdominal arteries comparison

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

    Moloney, M A

    2012-02-01

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

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

    Moloney, M A

    2010-11-11

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

  3. Complications of transcatheteral occlusion of abdominal arteries

    Vogel, H.; Belz, Buecheler, E.

    1981-09-01

    The number of transcatheteral occulsion of abdominal arteries reported so far enables us to differentiate between complications, which are specific for the methods used, or which are organ-specific and material-specific. Among the complications specific for the methods concerned are: complications occuring in angiography; tumour embolism in the lung; transport of embolic material into the lung; transport of embolic material into the arteries of the lower half of the body; renal insufficiency; necrosis; and, finally, abscess formation. Among the organ-specific complications are: necrosis (especially of the spleen and in the operated upper gastro-intestinal tract); abscess formation (spleen, kidneys, liver); retroperitoneal phlegmones (kidney); relapsing haemorrhages (gastro-intestinal tract, kidneys); renal insufficiency (in case of pre-existing renal damage); hypertension (described so far as transient blood pressure increase only); hypertensive crisis (after renal artery occulsion for malignant hypertension); hepatic insufficiency and gallbladder infarction (in embolisation of the liver); transport of embolic material into adjacent arteris (in case of embolisation, into the vessels of the truncus coeliacus); and, finally, hypoglycaemia (in embolisation of the liver). Among the material-specific complications are: adhesion of the catheter tip to the vascular wall (Bucrylate); dislocation of Gianturco's spiral; allergic (anaphylactic) reaction to the embolic material (not described so far); recanalisation (in case of absorbable substances such as Fibrospum and Gelfoam); substitutive blood supply via the formation or extension of collaterals; necrosis in peripherally (capillary) occluding substances such as Bucrylate and Ethibloc; and, finally, abscess formation (in case of non-sterile embolic material). Some of these complications can be classified under more than one category.

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

    HUANG Yuan; LIU Chao; LIN Jin-ling

    2013-01-01

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

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

    Aykut Aktas

    2014-12-01

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

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

    Jalalludin Khoshnevis

    2013-01-01

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

  7. Arterial embolization for traumatic lethal lateral abdomi-nal wall hemorrhage in a liver cirrhosis patient

    Seiji Morita; Tomoatsu Tsuji; Takeshi Yamagiwa; Hiroyuki Otsuka; Sadaki Inokuchi

    2009-01-01

    @@ B lood loss due to abdominal wall hemorrhage is generally managed conservatively. Further, abdominal wall hemorrhage rarely develops into a life-threatening condition. However, it is difficult to sur-gically achieve hemostasis. We report the case of a liver cirrhosis patient with life-threatening abdominal wall hemorrhage that developed as a result of a minor trauma and was successfully treated with arterial embolization (AE).

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

    Satomi Jyunichiro

    2009-11-01

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

  9. [Abdominal artery aneurysm and associated surgical abdominal diseases: towards optimal timing].

    Stilo, Francesco; Mirenda, Francesco; Mandolfino, Tommaso; La Spada, Michele; D'Alfonso, Mario; Carmignani, Amedeo; De Caridi, Giovanni; Benedetto, Filippo; Spinelli, Francesco

    2003-01-01

    The purpose of this study was to assess which modalities offered the best timing in the treatment of abdominal aortic aneurysms associated with other abdominal surgical diseases. From January 1984 to December 2002, 372 patients underwent surgery for abdominal aortic aneurysms, 350 men (94%) and 22 women (6%), mean age 72 years. Of these 10% were operated on urgently. The traditional open technique was used in 307 patients, and the endovascular method in the remaining 65 cases. In 40 patients (11%) we observed other associated abdominal diseases which were treated during the same operation in 34 cases (85%). We had three deaths in the 34 cases treated in the same operation (9%). In the remaining cases no perioperative mortality was registered. There were no cases of prosthesis infection. The mean hospital stay was 9 days. Simultaneous treatment appears, on the one hand, to carry an increased operative risk and increased mortality and, on the other, to present the advantage of having to perform only one surgical procedure. The advent of the endovascular method allows us to postpone the treatment of the associated disease without increasing the technical difficulty of the second operation.

  10. Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease

    Brouwer, Beate G.; Visseren, Frank L. J.; Stolk, Ronald P.; van der Graaf, Yolanda

    2007-01-01

    Objective: We investigated whether the presence of concomitant coronary heart disease (CHD) in patients with peripheral arterial disease (PAD) can be explained by intra-abdominal fat accumulation and compared different measures of adiposity as predictors of CHD in patients with PAD. Research Methods

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

    Zhi-Gang Deng; Jian-Yin Zhou; Zhen-Yu Yin; You-Yuan Peng; Fu-Qiang Wang; Xiao-Min Wang

    2011-01-01

    AIM: To evaluate the therapeutic effects of abdominal decompression plus continuous regional arterial infusion (CRAI) via a drug delivery system (DDS) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).METHODS: We presented our recent experience in 8 patients with SAP. The patients developed clinical ACS, which required abdominal decompression. During the operation, a DDS was inserted into the peripancreatic artery (the catheter was inserted from the right gastroepiploic artery until it reached the junction between the pancreaticoduodenal and gastroduodenal artery). Through this DDS, a protease inhibitor, antibiotics and octreotide were infused continuously. The duration of the regional artery infusion ranged from 8 to 41 d. The outcomes and the changes in the APACHE Ⅱ score, computed tomography (CT) severity index and intra-abdominal pressure (IAP) of the patients were retrospectively evaluated.RESULTS: Eight patients with an initial APACHE Ⅱscore of 18.9 (range, 13-27) and a Balthazar CT severity index of 9.1 (range, 7-10) developed severe local and systemic complications. These patients underwent subsequent surgical decompression and CRAI therapy because of intra-abdominal hypertension (IAH). After a mean interval of 131.9 ± 72.3 d hospitalization, 7 patients recovered with decreased APACHE Ⅱ scores, CT severity indexes and IAP. The mean APACHE Ⅱ score was 5.4 (range, 4-8), the CT severity index was 2.3 (range, 1-3), and IAP decreased to 7.7 mmHg (range,6-11 mmHg) 60 d after operation. One patient died of multiple organ failure 1 wk after surgery.CONCLUSION: CRAI and laparotomic decompression might be a therapeutic option for SAP patients with ACS.

  12. Does lower limb exercise worsen renal artery hemodynamics in patients with abdominal aortic aneurysm?

    Anqiang Sun

    Full Text Available Renal artery stenosis (RAS and renal complications emerge in some patients after endovascular aneurysm repair (EVAR to treat abdominal aorta aneurysm (AAA. The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS, increased the oscillatory shear index (OSI and increased the relative residence time (RRT. EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.

  13. A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

    Choo, Yeon Myung; Chang, Kee Hyun; Choi, Sung Jae [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddenly developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated multiple aneurysms in both common carotid arteries and abdominal aorta with organizing thrombi and thromboembolism of internal carotid artery.

  14. Paradoxical emboli: demonstration using helical computed tomography of the pulmonary artery associated with abdominal computed tomography

    Delalu, P.; Ferretti, G.R.; Bricault, I.; Ayanian, D.; Coulomb, M. [Service Central de Radiologie et Imagerie Medicale, CHU Grenoble (France)

    2000-02-01

    We report the case of a 60-year-old woman with a recent history of a cerebrovascular accident. Because of clinical suspicion of pulmonary embolism and negative Doppler ultrasound findings of the lower limbs, spiral computed tomography of the pulmonary artery was performed and demonstrated pulmonary emboli. We emphasize the role of computed tomography of the abdomen, performed 3 min after the thoracic acquisition, which showed an unsuspected thrombus within the abdominal aorta and the left renal artery with infarction of the left kidney. Paradoxical embolism was highly suspected on computed tomography data and confirmed by echocardiography which demonstrated a patent foramen ovale. (orig.)

  15. [Deviation of the abdominal aorta and common iliac arteries due to aging and kidney dystopia].

    Zhelobtsov, P M

    1982-12-01

    A specific peculiarity in the relief changeability and position of the abdominal aorta, the common iliac arteries is a segmentary deformity occurring in aged persons as a result of atherosclerotic alterations in their walls. A congenital homolateral dystopia, horseshoe and double kidney are rather seldom developmental anomalies in mature persons. In newborns, however, they are found 6-7 times more often and together with other congenital defects of the kidneys make evidently an often cause of the fetal and infantile death.

  16. Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization

    Andrade, Luis Jesuino de Oliveira; Silva,Antonio Carlos Botelho da; França,Larissa Santos; França,Luciana Santos; Souza,José Rebouças de

    2012-01-01

    Hepatic artery aneurysm (HAA) was first reported at autopsy in 1809, represents one fifth of visceral aneurysms and the mortality from spontaneous rupture is high in most of cases. We are reporting a case of an asymptomatic 48-year-old woman with an extrahepatic HAA, diagnosed initially and incidentally with abdominal ultrasonography, confirmed by a three-dimensional contrast-enhanced magnetic resonance imaging and angiography. Endovascular treatment was considered feasible and was successful...

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

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

    2009-02-01

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

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

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

    2008-02-15

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

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

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

    1989-01-01

    In 20 patients undergoing elective major abdominal surgery, heart rate and arterial oxygen saturation were monitored continuously during the night 2 days before operation and during the first and second nights after operation (23:00 to 07:30). Mean heart rate increased by 16 beat min-1 (P less than...... arrhythmias on the morning of the third day after operation. In another patient the episodes of desaturation correlated with increases in heart rate. There was no correlation between administration of opioids and heart rate and saturation disturbances. The mechanism and clinical relevance of episodic...

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

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

    2000-03-01

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

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

    V. A. Zelinskiy

    2012-01-01

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

  2. Isolated hepatic artery injury in blunt abdominal trauma presenting as upper gastrointestinal bleeding: treatment with transcatheter embolisation.

    Taslakian, Bedros; Ghaith, Ola; Al-Kutoubi, Aghiad

    2012-11-15

    Liver injury in blunt abdominal trauma is common. However, not often does blunt trauma cause injury to the anatomical structures of the porta hepatis. Isolated injury of the hepatic artery has been rarely reported in the literature. Such injury may be lethal and requires immediate diagnosis and management. This report describes an unusual case of blunt abdominal trauma resulting in hepatic and gastroduodenal artery dissection, with pseudoaneurysm formation complicated by active upper gastrointestinal bleeding. The injury was managed by transcatheter embolisation. Awareness of this diagnosis should facilitate management of similar trauma cases.

  3. Changes of Blood Flow Volume in the Superior Mesenteric Artery and Brachial Artery with Abdominal Thermal Stimulation

    Shin Takayama

    2011-01-01

    Full Text Available In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physician's experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA and brachial artery (BA, the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (, as well as at 10 min ( and 20 min ( after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (. In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.

  4. Abdominal Aortic Aneurysm (AAA)

    ... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  5. Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

    Rodrigo Gibin Jaldin

    2014-12-01

    Full Text Available Endovascular aneurysm repair (EVAR is already considered the first choice treatment for abdominal aortic aneurysms (AAA. Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.

  6. Vasorelaxant activities of Danhong injection and their differential effects on the rat abdominal aorta and mesenteric artery.

    Su, Xianming; Zhi, Xiaowen; Cui, Ting; Zheng, Qiaowei; Wang, Shixiang; Cao, Yongxiao; Cui, Changcong; Feng, Weiyi

    2015-01-01

    Previous studies have found that Danhong injection (DHI), an extensively used herbal extract preparation in China, might be a powerful vasodilator. The aims of this study were to determine the vascular activity of DHI and its effects on arteries of different sizes. The results showed that DHI significantly inhibited rat-hindquarters and rabbit-ear vasoconstriction elicited by norepinephrine (NE) perfusion and markedly relaxed KCl-contracted and NE-contracted rat abdominal aortic and mesenteric artery rings. The endothelium made only a minor contribution to the vasorelaxant effect of DHI on artery segments. The vasorelaxant effect of DHI varied with the artery size, with larger arteries exhibiting a more sensitive and potent vasodilator response. DHI relaxed NE-induced vasoconstriction probably through inhibition of the intracellular Ca2+ release through the inositol triphosphate receptor system in the abdominal aorta and mesenteric artery, along with blockage of extracellular Ca2+ influx through the receptor-linked Ca2+ channels in the mesenteric artery. In addition, DHI completely relaxed KCl-induced contraction in both of the arteries, suggesting that inhibition of Ca2+ influx through voltage-gated Ca2+ channels is involved in the vasorelaxant effect of DHI. This elucidation of the vascular effects of DHI and the underlying mechanisms could lead to improved clinical applications.

  7. A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

    Agnaeber, K; Bodalal, Z

    2013-08-01

    We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.

  8. Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end products: : ARTERY study. Protocol for a multicenter cross-sectional study

    de Vos, L.C.; Boersema, J.; Hillebrands, J.L.; Schalkwijk, C.G.; Meerwaldt, R.; Breek, J.C.; Smit, A. J.; Zeebregts, C. J.; Lefrandt, J.D.

    2016-01-01

    Introduction: Diabetes mellitus is a well-defined risk factor for peripheral artery disease (PAD), but protects against the development and growth of abdominal aortic aneurysm (AAA). Diabetes mellitus is associated with arterial stiffening and peripheral arterial media sclerosis. Advanced glycation

  9. A kinematic comparison of four abdominal training devices and a traditional abdominal crunch.

    Sands, William A; McNeal, Jeni R

    2002-02-01

    Abdominal exercises are often performed on roller or rocker mechanisms, which have been aggressively promoted through the television and print media. However, justifications are lacking as to why these devices are superior to traditional abdominal exercises such as crunches. This study sought to describe and compare the range of motion (ROM) of several joints during crunches performed on 4 different abdominal conditioning devices (2 roller and 2 pivot types) and a traditional crunch exercise. Ten men (29 +/- 5.87 years, 177.5 +/- 6.46 cm, 80.96 +/- 11.72 kg) and 10 women (33.4 +/- 10.16 years, 162.23 +/- 3.83 cm, 56.99 +/- 7.36 kg) subjects agreed to participate in the study. Subjects were videotaped in the sagittal plane (60 Hz) using standard kinematic methods. Reflective markers were placed on the right temple, auditory meatus, shoulder, hip, knee, ankle, heel, toe, and 2 sternum markers placed on a foam piece strapped to the subject's chest. The videotaped movements were automatically digitized (PEAK5 2-D) and the data smoothed using a Butterworth filter. Relative angular ROMs of the head (temple, auditory meatus, shoulder); neck (auditory meatus, shoulder, hip); trunk (near sternum, shoulder, hip); hip (shoulder, hip, knee); sternum/head (sternum near and sternum far with temple and auditory meatus); sternum/trunk (sternum near and sternum far with shoulder and hip); and a sum of 4 angles (head, neck, trunk, hip) were calculated. Sex by equipment repeated measures analyses of variance (ANOVAs) were calculated on the angles of the 5 exercises. When no main effect for sex was found, the data were collapsed across sex and a one-way ANOVA with repeated measures was calculated on the resulting data. Post hoc analyses of pairwise differences were calculated using Tukey's honestly significant difference statistic. Results showed that crunches performed with the abdominal devices resulted in less ROM in all angles measured when compared with a traditional crunch. The

  10. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    Oender, Hakan, E-mail: drhakanonder@hotmail.com [Dicle University Medical Faculty, Department of Radiology (Turkey); Oguzkurt, Levent [Baskent University Medical Faculty, Department of Radiology (Turkey); Guer, Serkan [Sifa University Medical Faculty, Department of Radiology (Turkey); Tekbas, Gueven [Dicle University Medical Faculty, Department of Radiology (Turkey); Guerel, Kamil [Abant Izzet Baysal University Medical Faculty, Department of Radiology (Turkey); Coskun, Isa [Baskent University Medical Faculty, Department of Cardiovascular Surgery (Turkey); Oezkan, Ugur [Baskent University Medical Faculty, Department of Radiology (Turkey)

    2013-02-15

    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Of the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.

  11. [Arterial reconstructive surgery of a coarctation of the abdominal aorta with involvement of renal and visceral arteries. Clinical and imagiologic evaluation 26 years after the operation].

    Dinis da Gama, A

    2009-01-01

    The clinical case of a 13 years old female is reported, with the diagnosis of congenital coarctation of the abdominal aorta, with involvement of renal and visceral arteries, causing arterial hypertension and a systolic bruit in the auscultation of the epigastric and umbilical areas. Conventional angiography disclosed a stenotic process of the upper abdominal aorta, with concomitant ostial stenosis of the renal and digestive arteries, and post-stenotic dilatation of the celiac axis and superior mesenteric artery. The physical development of the patient, close to the adult pattern, allowed the performance of a complex revascularization procedure,accomplished in May 1984, consisting in the implantation of an aorto-aortic bypass graft, through the diaphragm, followed by visceral and renal revascularization, by means of independent prosthesis taken from the aortic bypass. The post-operative course was uneventful and blood pressure returned immediately to normal levels. Reviewed recently, the patient was found in good clinical condition,asymptomatic and with normal blood pressure, developing a normal family, social and Professional life. An Angio-CT evaluation, performed in February 2010, almost 26 years after the operation, revealed the complex revascularization procedure patent and working in excellent condition. To our knowledge, this seems to be the longest follow up of such a procedure employed successfully in a very rare clinical entity, thus justifying its presentation and divulgation.

  12. Comparison of abdominal muscle thickness according to feedback method used during abdominal hollowing exercise.

    Lee, Sangyong; Han, Seulki; Lee, Daehee

    2016-09-01

    [Purpose] This study was intended to examine the most effective feedback method for contracting the musculus transversus abdominis muscle by using basic training, a pressure biofeedback unit, and real-time ultrasonographic imaging during abdominal hollowing exercise training. [Subjects and Methods] The subjects in this study were 30 healthy young students in their twenties. Thirty subjects were divided randomly and equally into the basic training, the pressure biofeedback unit, and real-time ultrasonographic imaging groups. All of the subjects received abdominal hollowing exercise training for 15 minutes. The subjects in the pressure biofeedback unit group were trained by using a pressure biofeedback unit. Those in the real-time ultrasonographic imaging group received training with monitoring of possible contraction of their musculus transversus abdominis muscles on ultrasonography. [Results] In all the three groups, the musculus transversus abdominis became significantly thicker, but more significantly in the real-time ultrasonographic imaging group than in the basic training group. [Conclusion] The feedback method using real-time ultrasonographic imaging may be more effective in thickening the musculus transversus abdominis muscle during exercise than the traditional feedback method with manual contact only. However, it is insufficient in terms of overall qualitative improvement of exercise outcome.

  13. Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end products:: ARTERY study. Protocol for a multicenter cross-sectional study

    Vos, L.C. de; Boersema, J.; Hillebrands, J. L.; Schalkwijk, C. G.; Meerwaldt, R.; Breek, J.C.; Smit, A. J.; C. J. Zeebregts; Lefrandt, J.D.

    2016-01-01

    Introduction: Diabetes mellitus is a well-defined risk factor for peripheral artery disease (PAD), but protects against the development and growth of abdominal aortic aneurysm (AAA). Diabetes mellitus is associated with arterial stiffening and peripheral arterial media sclerosis. Advanced glycation end products (AGEs) are increased in diabetes mellitus and cardiovascular disease. AGEs are known to form cross-links between proteins and are associated with arterial stiffness. Whether AGEs contr...

  14. Renal infarction due to spontaneous dissection of the renal artery: an unusual cause of non-visceral type abdominal pain.

    Kang, James H-E; Kang, Jin-Yong; Morgan, Robert

    2013-09-18

    A 44-year-old man presented with very severe right upper quadrant pain of sudden onset. This was exacerbated by movement but unaffected by food or defaecation. It was continuous-day and night -but resolved over a 1-week period. The physical examination was normal at presentation, by which time the pain had resolved. His white cell count, alanine transaminase and C reactive protein were elevated but normalised after 10 days. An abdominal CT showed low density lesions in the right kidney consistent with segmental infarcts. CT angiogram showed a dissection of the right renal artery. The patient remained asymptomatic and normotensive when reviewed 1 month later.

  15. [Use of an iliac branched endoprostheis in endovascular treatment for an abdominal aortic aneurysm combined with aneurysms of both common iliac arteries].

    Imaev, T E; Kuchin, I V; Lepilin, P M; Kolegaev, A S; Medvedeva, I S; Komlev, A E; Akchurin, R S

    An abdominal aortic aneurysm appears to be combined with aneurysmatic lesions of the common iliac arteries in 30-40% of cases. Like abdominal aortic aneurysms, aneurysms of the common iliac arteries rarely manifest themselves clinically. The lethality rate in case of rupture is comparable to that for rupture of an abdominal aortic aneurysm. During endoprosthetic repair of abdominal aortic aneurysms combined with aneurysms of the common iliac arteries, in order to prevent endoleaks and to improve the distal zone of fixation of endografts surgeons often resort to embolization of internal iliac arteries, which may lead to ischaemic postoperative complications. One of the methods of preserving pelvic blood flow is the use of an iliac branched endograft. A series of studies evaluating long-term outcomes demonstrated that this method proved to be both safe and effective, and with the suitable anatomy is a method of choice in high surgical risk patients. The present article deals with a clinical case report concerning bilateral endoprosthetic repair of the common iliac arteries, combined with endoprosthetic repair of an abdominal aortic aneurysm, with the description of technical peculiarities of implanting an iliac branched graft.

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

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

    2015-03-15

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

  17. Inflammatory abdominal aortic aneurysm:clinical features and long term outcome in comparison with atherosclerotic abdominal aortic aneurysm

    YIN Ming-di; ZHANG Jian; WANG Shao-ye; DUAN Zhi-quan; XIN Shi-jie

    2010-01-01

    Background Inflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs).In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA.Methods Between 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs.The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors.All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared.Results The two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs.42.4%, P=0.001) and had larger aneurysms on admission ((7.4±0.7) cm vs.(6.3±0.9) cm, P=0.006).In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5±9.1) mm/h vs.(11.4±5.4) mm/h, P <0.05).Surgical morbidity and mortality rates did not differ between the two groups.The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308±36) minutes vs.(224±46) minutes, P <0.05), but the cross-clamp time was similar in both groups ((41.5±6.2) minutes vs.(41.8±6.2) minutes, P=0.92).A five-year survival rate analysis showed no significant difference between the two groups (P=0.711).Conclusions Despite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause Iow morbidity and mortality, similar to patients with aAAA.Long term outcome of IAAA patients is of no difference from aAAA patients.

  18. Fenestrated Stent Graft Repair of Abdominal Aortic Aneurysm: Hemodynamic Analysis of the Effect of Fenestrated Stents on the Renal Arteries

    Sun, Zhonghua; Chaichana, Thanapong [Curtin University of Technology, Perth (Australia)

    2010-02-15

    We wanted to investigate the hemodynamic effect of fenestrated stents on the renal arteries with using a fluid structure interaction method. Two representative patients who each had abdominal aortic aneurysm that was treated with fenestrated stent grafts were selected for the study. 3D realistic aorta models for the main artery branches and aneurysm were generated based on the multislice CT scans from two patients with different aortic geometries. The simulated fenestrated stents were designed and modelled based on the 3D intraluminal appearance, and these were placed inside the renal artery with an intra-aortic protrusion of 5.0-7.0 mm to reflect the actual patients' treatment. The stent wire thickness was simulated with a diameter of 0.4 mm and hemodynamic analysis was performed at different cardiac cycles. Our results showed that the effect of the fenestrated stent wires on the renal blood flow was minimal because the flow velocity was not significantly affected when compared to that calculated at pre-stent graft implantation, and this was despite the presence of recirculation patterns at the proximal part of the renal arteries. The wall pressure was found to be significantly decreased after fenestration, yet no significant change of the wall shear stress was noticed at post-fenestration, although the wall shear stress was shown to decrease slightly at the proximal aneurysm necks. Our analysis demonstrates that the hemodynamic effect of fenestrated renal stents on the renal arteries is insignificant. Further studies are needed to investigate the effect of different lengths of stent protrusion with variable stent thicknesses on the renal blood flow, and this is valuable for understanding the long-term outcomes of fenestrated repair.

  19. A comparison of the Accuracy of Ultrasound and Computed Tomography in common diagnoses causing acute abdominal pain

    van Randen, Adrienne; Lameris, Wytze; van Es, H. Wouter; van Heesewijk, Hans P. M.; van Ramshorst, Bert; ten Hove, Wim; Bouma, Willem H.; van Leeuwen, Maarten S.; van Keulen, Esteban M.; Bossuyt, Patrick M.; Stoker, Jaap; Boermeester, Marja A.

    2011-01-01

    Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain. Consecutive patients with abdominal pain for > 2 h and <5 days referred for imaging underwent both US and CT by different radiologists/radiological residents. An expert panel assigned a final diag

  20. Effects of the flexibility of the arterial wall on the wall shear stresses and wall tension in Abdominal Aortic Aneurysms.

    Salsac, Anne-Virginie; Fernandez, Miguel; Chomaz, Jean-Marc

    2005-11-01

    As an abdominal aortic aneurysm develops, large changes occur in the composition and structure of the arterial wall, which result in its stiffening. So far, most studies, whether experimental or numerical, have been conducted assuming the walls to be rigid. A numerical simulation of the fluid structure interactions is performed in different models of aneurysms in order to analyze the effects that the wall compliance might have on the flow topology. Both symmetric and non-symmetric models of aneurysms are considered, all idealistic in shape. The wall mechanical properties are varied in order to simulate the progressive stiffening of the walls. The spatial and temporal distributions of wall tension are calculated for the different values of the wall elasticity and compared to the results for the rigid walls. In the case of rigid walls, the calculation of the wall shear stresses and pressure compare very well with experimental results.

  1. Impact of inherited genetic variants associated with lipid profile, hypertension, and coronary artery disease on the risk of intracranial and abdominal aortic aneurysms

    Hof, F.N. van 't; Ruigrok, Y.M.; Baas, A.F.; Kiemeney, L.A.L.M.; Vermeulen, H.H.M.; Uitterlinden, A.G.; Hofman, A.; Rivadeneira, F.; Rinkel, G.J.; Bakker, P.I. de

    2013-01-01

    BACKGROUND: Epidemiological studies show that an unfavorable lipid profile and coronary artery disease (CAD) are risk traits for abdominal aortic aneurysms (AAAs) but not for intracranial aneurysms (IAs), and that hypertension is a main risk trait for IAs but not for AAAs. To evaluate these observat

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

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

    2014-10-15

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

  3. Arterial enhancement at abdominal CT angiography: Low- versus high-osmolality contrast media

    Rouviere, O.; Berger, P.; Pangaud, C.; Lyonnet, D. [Hopital E. Herriot, Lyon (France). Dept. of Vascular and Genitourinary Radiology; Ecochard, R. [Hospices Civils de Lyon (France). Dept of Biostatistics; Fontaine, B. [Laboratoire Guerbet, Roissy (France)

    2000-09-01

    Purpose: To evaluate the effects of contrast media pharmokinetic differences on aortic enhancement at abdominal CT angiography and to determine whether these effects are of clinical relevance. Material and Methods: Two hundred and twelve patients referred for abdominal CT angiography were included in the study. All abdominal CT angiograms were performed with the same parameters (collimation 3 mm, pitch ratio 1.7, scan delay 30 s) after i.v. injection of 120 ml of contrast medium at 3 ml/s. After randomization, patients received either iobitridol 300 (low-osmolar, 300 mg I/ml), iobitridol 350 (low-osmolar, 350 mg I/ml) or ioxithalamate 350 (high-osmolar, 350 mg I/ml). The time attenuation curves obtained with the three contrast media were compared. Results: The time attenuation curve obtained with ioxithalamate 350 was not parallel to those obtained with iobitridol 300 and iobitridol 350. Mean peak enhancements obtained with iobitridol 350 and ioxithalamate 350 were not significantly different but iobitridol 350 provided higher mean peak enhancement than iobitridol 300. Mean delays of the peak enhancements were the same with the three contrast media. After peak enhancement, the decrease of aortic opacification under a selected threshold of 200 HU was significantly slower with iobitridol 350 than with iobitridol 300 and ioxithalamate 350, whereas iobitridol 300 and ioxithalamate 350 showed no significant differences. Conclusion: For a given iodine concentration, low-osmolality contrast media provide longer aortic opacification and may be recommended for CT angiography when long acquisition times are needed.

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

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

    2016-04-01

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

  5. Comparison of the strain field of abdominal aortic aneurysm measured by magnetic resonance imaging and stereovision: a feasibility study for prediction of the risk of rupture of aortic abdominal aneurysm.

    Wang, Yufei; Joannic, David; Delassus, Patrick; Lalande, Alain; Juillion, Patrick; Fontaine, Jean-François

    2015-04-13

    The prediction of the risk of rupture of abdominal aortic aneurysm (AAA) is a complex problem. Currently the criteria to predict rupture of abdominal aortic aneurysms are aneurysm diameter and growth rates. It is generally believed that study of the wall strain distribution could be helpful to find a better decision criterion for surgery of aortic aneurysms before their rupture. The wall strain distribution depends on many biological and biomechanical factors such as elastic properties of the aorta, turbulent blood flow, anatomy of the aorta, presence of thrombus or not and so on. Recently, numerical simulations to estimate rupture-potential have received many attentions. However, none of the medical imaging tools for screening and monitoring of AAAs were studied in terms of mechanical behavior and experimentally to demonstrate their capability to measure relevant variables. The aim of this study was to develop a metrological approach for deployment testing of the ability of techniques for measuring local in-vitro deformations based on comparison of stereovision and MRI. In this paper, we present the implementation approach and results of the study based on cylindrical phantoms with or without AAA representing, respectively, healthy and unhealthy artery. Through this study, an experimental device was developed for the behavior study of AAA during a cardiac cycle. The results show that the stereovision techniques used in laboratory is well suited and is qualitatively and quantitatively equivalent with MRI measurements.

  6. Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients

    Pencak Przemysław

    2013-01-01

    Full Text Available Abstract Background Process of accelerated atherosclerosis specific for uremia increases cardiovascular risk in patients with chronic kidney disease (CKD and may be influenced by the different structure of arteries. The study assesses the influence of traditional and novel risk factors on calcification of coronary arteries (CAC and abdominal aorta (AAC in hemodialysis patients (HD. Methods CAC and AAC were assessed by CT in 104 prevalent adult HD and 14 apparently healthy subjects with normal kidney function (control group. Mineral metabolism parameters, plasma levels of FGF-23, MGP, osteoprotegerin, osteopontin, fetuin-A, CRP, IL-6 and TNF-α were measured. Results CAC and AAC (calcification score ≥ 1 were found in 76 (73.1% and 83 (79.8% HD respectively, more frequent than in the control group. In 7 HD with AAC no CAC were detected. The frequency and severity of calcifications increased with age. Both CAC and AAC were more frequently detected in diabetics (OR = 17.37 and 13.00, respectively. CAC score was significantly greater in males. CAC and AAC scores were correlated significantly with pack-years of smoking and plasma osteoprotegrin levels. However the independent contribution of plasma osteoprotegerin levels was not confirmed in multiple regression analysis. Age (OR = 1.13 and hemodialysis vintage (OR = 1.14 were the independent risk factor favoring the occurrence of CAC; while age (OR = 1.20 was the only predictor of AAC occurrence in HD. Conclusions 1. AAC precedes the occurrence of CAC in HD patients. 2. The exposition to uremic milieu and systemic chronic microinflammation has more deteriorative effect on the CAC than the AAC.

  7. Severe coronary artery disease in Chinese patients with abdominal aortic aneurysm: prevalence and impact on operative mortality

    SUN Tao; CHENG Yu-tong; ZHANG Hong-ju; CHEN Shun-hua; ZHANG Dong-hua; HUANG Ji; ZHANG Jing-mei; LI Zhi-zhong

    2012-01-01

    Background Little is known about the prognosis of coronary artery disease (CAD) in Chinese patients with abdominal aortic aneurysm (AAA).The aim of this study was to evaluate the predictors of in-hospital all-cause mortality of severe CAD in Chinese patients who were hospitalized for AAAs.Methods From January 2003 to August 2009,368 patients were operated on for AAAs.The clinical characteristics were retrospectively collected.The primary outcome was the in-hospital all-cause mortality.The clinical risk factors were subjected to a multivariate analysis to determine the predictors of in-hospital all-cause mortality.Results During their hospitalization,23% (85/368) of the patients underwent coronary angiography,which revealed significant lesions in 93% (79/85) of the patients.In 25 cases,coronary artery bypass grafting (CABG) was performed before the AAA repair and in 16 cases of percutaneous coronary intervention (PCI) was performed.Ten patients with AAA alone died before discharge,and eight patients diagnosed with AAA combined with CAD died.There was no statistical difference in the postoperative death between the two groups.The logistic analysis showed that age >70 years and CAD (vessels ≥2) were the significant factors in predicting the adverse clinical outcome.Conclusions The prevalence of severe CAD in Chinese patients with AAAs seemed lower than those that were reported.Myocardial evaluation and subsequent revascularization before AAA surgery could improve the clinical outcome for these patients who have severe CAD.

  8. Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging.

    Sughimoto, Koichi; Shimamura, Yoshiaki; Tezuka, Chie; Tsubota, Ken'ichi; Liu, Hao; Okumura, Kenichiro; Masuda, Yoshitada; Haneishi, Hideaki

    2016-07-01

    Although abdominal aortic aneurysms (AAAs) occur mostly inferior to the renal artery, the mechanism of the development of AAA in relation to its specific location is not yet clearly understood. The objective of this study was to evaluate the hypothesis that even healthy volunteers may manifest specific flow characteristics of blood flow and alter wall shear or oscillatory shear stress in the areas where AAAs commonly develop. Eight healthy male volunteers were enrolled in this prospective study, aged from 24 to 27. Phase-contrast magnetic resonance imaging (MRI) was performed with electrocardiographic triggering. Flow-sensitive four-dimensional MR imaging of the abdominal aorta, with three-directional velocity encoding, including simple morphological image acquisition, was performed. Information on specific locations on the aortic wall was applied to the flow encodes to calculate wall shear stress (WSS) and oscillatory shear index (OSI). While time-framed WSS showed the highest peak of 1.14 ± 0.25 Pa in the juxtaposition of the renal artery, the WSS plateaued to 0.61 Pa at the anterior wall of the abdominal aorta. The OSI peaked distal to the renal arteries at the posterior wall of the abdominal aorta of 0.249 ± 0.148, and was constantly elevated in the whole abdominal aorta at more than 0.14. All subjects were found to have elevated OSI in regions where AAAs commonly occur. These findings indicate that areas of constant peaked oscillatory shear stress in the infra-renal aorta may be one of the factors that lead to morphological changes over time, even in healthy individuals.

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

    Patrick Bastos Metzger

    2014-03-01

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

  10. Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast en-hanced images

    Alomary Mahfooz-Naef; Vikash; Wang Qiu-xia; Zhang Jin-hua; Hu Dao-yu

    2015-01-01

    Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cor-tex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96 patients (50 men and 46 women;16~74 years)with normal kidney function,which was confirmed by kidney function test were enrolled in this stud-y,including bilateral kidneys of 92 cases and unilateral kidney of 4 cases (total of 188 kidneys;92 left,96 right).After intra-venous (IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were per-formed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5 software.Quantitative data were presented as mean ± standard deviation,while qualitative data were presented as frequency (%).P<0.05 was considered to be statistically significant.Results:The mean renal cortex thickness was (5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correla-tion between renal cortex CT values and abdominal aortic CT values was showed (r= 0.584;P<0.001).A statistically sig-nificant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated (r= 0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values (r= 0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

  11. Comparison of ultrasonography, computed tomography and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms; Comparacao entre ultrassonografia, tomografia computadorizada e ressonancia nuclear magnetica com medidas intra-operatorias na avaliacao dos aneurismas de aorta abdominal

    Azevedo, Francisco das Chagas de; Zerati, Antonio Eduardo; Blasbalg, Roberto; Wolosker, Nelson; Puech-Leao, Pedro [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital das Clinicas]. E-mail: nwolosker@yahoo.com.br

    2005-01-15

    Purpose: To study the imaging exams more commonly used for abdominal aortic aneurysms evaluation - ultrasonography, conventional computerized tomography, helical computerized tomography and nuclear magnetic angio resonance - comparing the preoperative measurements reached by those radiological methods with the measurements made during the surgical procedures. Methods: Patients who had indication of elective transperitoneal surgical treatment for their abdominal aortic aneurysms were included in the study. The initial diagnosis of the aortic dilatation was made by ultrasonography and, after the surgical treatment was indicated, the patient was submitted to another imaging method.Sixty patients were divided into 3 groups according to the complementary imaging method (conventional computerised tomography, helical computerized tomography, nuclear magnetic angio resonance). The ultrasonography of the first 20 patients were joined in a fourth group. There were considered in the study the measurements of the transversal diameter of the proximal neck, maximum transversal diameter of the aneurysm, straight-line length and transversal diameter of the common iliac arteries given by the imaging methods. The same measurements were made by using a caliper during the surgical procedure, and then compared to the values obtained from the radiological exams.Results: The maximum transverse diameter had a range measurement variation of 4.5 to 13.6 cm in the intraoperative, with no statistically significant differences when compared with all the imaging tests. The ultrasonography, however, overestimated the measurements of the proximal neck and the common iliac arteries, in comparison with intraoperative measures. The length of the aorta aneurysm obtained by the conventional computerized tomography was significantly lower if compared to the measures done with the calliper during the operation. The helical computerized tomography and the nuclear magnetic angio resonance provided

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

    Diego G. D Christofaro

    2011-06-01

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

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

    Diego G. D Christofaro

    2011-06-01

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

  14. Serial angiographic appearance of segmental arterial mediolysis manifesting as vertebral, internal mammary and intra-abdominal visceral artery aneurysms in a patient presenting with subarachnoid hemorrhage and review of the literature.

    Cooke, Daniel L; Meisel, Karl M; Kim, Warren T; Stout, Charles E; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T

    2013-09-01

    Segmental arterial mediolysis (SAM) is a rare, non-inflammatory, non-atherosclerotic vasculopathy typically affecting the abdominal arteries although it may also affect the great vessels and cerebral vasculature. Diseased vessels manifest with aneurysms and/or dissections, often presenting clinically with catastrophic thromboembolic injury and less frequently with subarachnoid hemorrhage (SAH). The etiology of SAM remains indeterminate although there is evidence it may be an endogenous pathological response to vasospasm. The SAM literature is reviewed and a case of SAH related to a ruptured dissecting-type vertebral artery aneurysm is described. In addition to furthering awareness of SAM, this unique case offers insight into the acute phase of the disease and the potential role of vasospastic induction.

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

    Sérgio Luiz Rocha

    2007-03-01

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

  16. Synchronous infection of the aorta and the testis: emphysematous epididymo-orchitis, abdominal aortic mycotic aneurysm, and testicular artery pseudoaneurysm diagnosed by use of MDCT.

    Hegde, Rahul G; Balani, Ankit; Merchant, Suleman A; Joshi, Anagha R

    2014-07-01

    We report clinical details and imaging findings for a case of emphysematous epididymo-orchitis with co-existing mycotic abdominal aortic aneurysm and a testicular artery pseudoaneurysm in a diabetic 65-year-old male. We report imaging findings from ultrasonography (USG) and contrast-enhanced multidetector computed tomography (MDCT). Use of MDCT to identify, confirm, and define the extent of the disease, and its utility in understanding the pathogenesis of this rare condition are highlighted. For such lethal infections, early diagnosis and intervention can be lifesaving; imaging can be of crucial importance in this.

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

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

    2011-08-15

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

  18. Trunk muscle activities during abdominal bracing: comparison among muscles and exercises.

    Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki

    2013-01-01

    Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements. Key PointsTrunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences.Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements.Abdominal bracing should be

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

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

    2015-12-01

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

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

    C. Gray

    2014-01-01

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

  1. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

    Pia Møller Faaborg

    2013-01-01

    Full Text Available Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI. It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC. Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT were measured by radiopaque markers. Results. Seventeen (81% SCI and 14 (93% CIC patients reported abdominal pain or discomfort within the last month (. Pain was considered more intense by CIC than by SCI patients (. Only minor differences were found in patient’s qualitative description of abdominal pain or in the location of pain. In neither SCI nor CIC was pain associated with GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI.

  2. TRUNK MUSCLE ACTIVITIES DURING ABDOMINAL BRACING: COMPARISON AMONG MUSCLES AND EXERCISES

    Sumiaki Maeo

    2013-09-01

    Full Text Available Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench exercises. Surface electromyogram (EMG activities of the rectus abdominis (RA, external oblique (EO, internal oblique (IO, and erector spinae (ES muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax. The % EMGmax value during abdominal bracing was significantly higher in IO (60% than in the other muscles (RA: 18%, EO: 27%, ES: 19%. The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements

  3. Architectural and morphological assessment of rat abdominal wall muscles: comparison for use as a human model.

    Brown, Stephen H M; Banuelos, Karina; Ward, Samuel R; Lieber, Richard L

    2010-09-01

    The abdominal wall is a composite of muscles that are important for the mechanical stability of the spine and pelvis. Tremendous clinical attention is given to these muscles, yet little is known about how they function in isolation or how they interact with one another. Given the morphological, vascular, and innervation complexities associated with these muscles and their proximity to the internal organs, an appropriate animal model is important for understanding their physiological and mechanical significance during function. To determine the extent to which the rat abdominal wall resembles that of human, 10 adult male Sprague-Dawley rats were killed and formalin-fixed for architectural and morphological analyses of the four abdominal wall muscles (rectus abdominis, external oblique, internal oblique, and transversus abdominis). Physiological cross-sectional areas and optimal fascicle lengths demonstrated a pattern that was similar to human abdominal wall muscles. In addition, sarcomere lengths measured in the neutral spine posture were similar to human in their relation to optimal sarcomere length. These data indicate that the force-generating and length change capabilities of these muscles, relative to one another, are similar in rat and human. Finally, the fiber lines of action of each abdominal muscle were similar to human over most of the abdominal wall. The main exception was in the lower abdominal region (inferior to the pelvic crest), where the external oblique becomes aponeurotic in human but continues as muscle fibers into its pelvic insertion in the rat. We conclude that, based on the morphology and architecture of the abdominal wall muscles, the adult male Sprague-Dawley rat is a good candidate for a model representation of human, particularly in the middle and upper abdominal wall regions.

  4. Comparison of Intravenous Paracetamol and Tramadol in Children Undergoing Major Abdominal Surgery

    Aysu Aydogan

    2015-06-01

    Conclusion: It was concluded that, intravenous paracetamol was provided effective analgesia but it was not superior to intravenous tramadol in children undergoing major abdominal surgery. [Cukurova Med J 2015; 40(2.000: 275-281

  5. The relationship between aortic calcification volume and obstructive coronary artery disease: comparison with coronary calcification volume

    Kim, Dae Seok; Kim, Jeong Ho; Park, Chul Hi; Park, Seon Young; Choe, Soo Jin; Hwang, Hee Young; Kim, Hyung Sik [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2007-12-15

    We compared the diagnostic performance of aortic calcification volume with that of coronary artery calcification volume at CT in diagnosing obstructive coronary artery disease (OCAD). A total of 308 patients (M: F 141: 167) underwent coronary CT angiography using a 64-slice MDCT. We measured the calcification volume (mm{sup 3}) of coronary artery (CAC), thoracic aorta (TAC), abdominal aorta (AAC), and whole aorta (AC) at unenhanced CT. OCAD was defined as the significant stenosis ({>=} 50%) in any coronary artery at CT angiography. The diagnostic performance for OCAD was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. Among the 308 patients studied, 45 patients were diagnosed with OCAD. The mean volumes of TAC, AAC, AC, and CAC were 518.8 mm{sup 3}, 551.5 mm{sup 3}, 1069.9 mm{sup 3}, 57.6 mm{sup 3} respectively. The areas under the ROC curve of TAC, AAC, AC, and CAC for OCAD were 0.766 (0.694 < 95% confidence interval < 0.838), 0.837 (0.784 < 95% confidence interval < 0.892), 0.814 (0.755 < 95% confidence interval < 0.873), 0.871 (0.812 < 95% confidence interval < 0.930), respectively. The volume of aortic calcification as well as coronary artery calcification is associated with obstructive coronary artery disease.

  6. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

    Finnerup, Nanna Brix; Christensen, Peter

    2013-01-01

    Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI). It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC). Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT) were measured by radiopaque markers. Results. Seventeen (81%) SCI and 14 (93%) CIC patients reported abdominal pain or discomfort within the last month (P = 0.38). Pain was considered more intense by CIC than by SCI patients (P GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI. PMID:24159329

  7. Spiral CT angiography of renal arteries: comparison with angiography

    Wittenberg, G.; Kenn, W.; Tschammler, A.; Sandstede, J.; Hahn, D. [Inst. fuer Roentgendiagnostik der Universitaet Wuerzburg (Germany)

    1999-04-01

    A prospective study was carried out to determine the accuracy of spiral CT angiography (CTA) in the detection of renal artery stenosis (RAS). Eighty-two patients with arterial hypertension underwent CTA and digital subtraction angiography (DSA) to exclude RAS. For CTA a contrast medium bolus of 100-150 ml (flow rate 3 ml/s) was injected. A 24 or 40 s CTA was started at the origin of the superior mesenteric artery after a delay time determined by test bolus injection (collimation = 2 mm, pitch = 1/1.5). For stenosis detection transverse images supported by maximum intensity projections (MIP) or multiplanar reconstruction projections were used. Of 197 renal arteries examined (including 33 accessory arteries), 34 RAS were visualized using DSA. With CTA, one hemodynamic RAS was missed and one additional hemodynamic RAS was found. Sensitivity/specificity was calculated to be 94 %/98 %. For hemodynamically relevant RAS (> 50 %) the sensitivity/specificity was 96 %/99 %. CTA additionally depicted five adrenal masses. The high accuracy rate of RAS detection thus allows the use of CTA as a screening method in patients with arterial hypertension to exclude a renovascular cause. (orig.) With 2 figs., 1 tab., 25 refs.

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

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

    2015-02-15

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

  9. Transretroperitoneal CT-guided embolization of growing internal iliac artery aneurysm after repair of abdominal aortic aneurysm: a transretroperitoneal approach with intramuscular lidocaine injection technique.

    Park, Joon Young; Kim, Shin Jung; Kim, Hyoung Ook; Kim, Yong Tae; Lim, Nam Yeol; Kim, Jae Kyu; Chung, Sang Young; Choi, Soo Jin Na; Lee, Ho Kyun

    2015-02-01

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

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

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

    2011-07-15

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

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

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

    2016-05-01

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

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

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

    2016-03-15

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

  13. Hysterectomy and Lower Urinary Tract Symptoms : A Nonrandomized Comparison of Vaginal and Abdominal Hysterectomy

    Lakeman, M. M. E.; van der Vaart, C. H.; Roovers, J. P. W. R.

    2010-01-01

    Common adverse effects of hysterectomy include lower urinary tract symptoms (LUTS), especially urinary incontinence. A difference in the prevalence of LUTS between patients who have undergone vaginal and abdominal hysterectomy may be an additional factor in the choice between these 2 surgical approa

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

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

    2015-01-01

    prolapse, 3 day voiding diary and also filled out the pelvic floor distress inventory (PFDI-20) questionnaire. RESULTS: We included 100/304 (32.9%) women (subtotal hysterectomy: 53, total hysterectomy: 47) in the clinical examinations. The study questionnaire was answered by 197 (64.8%) (subtotal: 97......OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total...... abdominal hysterectomy with objective outcomes. All randomized women still alive and living in Denmark (n=304) were invited to answer a questionnaire and come for clinical examination consisting of 20-min pad weighing test, urinary flow, measurement of residual urine, POP-Q measurement for pelvic organ...

  15. Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis

    H. Krentel

    2012-01-01

    Full Text Available In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical differentiation between endometriosis and fibromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid fibromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid fibromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor.

  16. COMPARISON OF COMPUTED TOMOGRAPHY AND ABDOMINAL RADIOGRAPHY FOR DETECTION OF CANINE MECHANICAL INTESTINAL OBSTRUCTION.

    Drost, Wm Tod; Green, Eric M; Zekas, Lisa J; Aarnes, Turi K; Su, Lillian; Habing, Gregory G

    2016-07-01

    Vomiting, often caused by mechanical intestinal obstruction, is common in dogs. Equivocal radiographic signs often necessitate repeat radiographs or additional imaging procedures. For our prospective, case-controlled, accuracy study, we hypothesized the following: (1) using computed tomography (CT), radiologists will be more sensitive and specific for detecting mechanical intestinal obstruction and recommending surgery compared to using radiographs; and (2) using measurements, radiologists will be more sensitive and specific using radiographs or CT for detecting mechanical intestinal obstruction and recommending surgery. Twenty dogs had abdominal radiographs and abdominal CT. Seventeen dogs had abdominal surgery and three dogs were not obstructed based on clinical follow-up. Confidence levels (five-point scale) of three experienced radiologists for mechanical intestinal obstruction and recommending surgery were recorded before and after making selected measurements. Eight dogs had surgically confirmed mechanical intestinal obstruction, and 12 dogs did not have obstruction. For detecting mechanical intestinal obstruction, CT was more sensitive (95.8% vs. 79.2%) and specific (80.6% vs. 69.4%) compared to radiographs, but the difference was not statistically significant. For recommending surgery, radiography was more sensitive (91.7% vs. 83.3%) and specific (83.3% vs. 72.2%) than using CT, but differences were not statistically significant. We reported objective CT measurements for predicting small mechanical intestinal obstruction. By incorporating these objective data, the diagnosis of mechanical intestinal obstruction changed in five of 120 instances (radiographs and CT). In no instance (0/120), did the objective data change the recommendation for surgery. Using CT or abdominal radiographs for the detection of canine mechanical intestinal obstruction is sensitive and specific when evaluated by experienced veterinary radiologists.

  17. A COMPARISON OF KETOROLAC, DICLOFENAC AND PARACETAMOL FOR POSTOPERATIVE ANALGESIA FOLLOWING ABDOMINAL HYSTERECTOMY

    Gaurav

    2015-11-01

    Full Text Available BACKGROUND Abdominal hysterectomy is associated with moderate-to-severe postoperative pain. Among non-opioid analgesics diclofenac, paracetamol and ketorolac are most commonly used. OBJECTIVES: The aim of this study was to compare the analgesic duration, efficacy and side effect profile of paracetamol, diclofenac and ketorolac administered intravenously in patients who underwent abdominal hysterectomy. METHODS In a prospective double-blinded study, in which 90 women undergoing elective abdominal hysterectomy under spinal anesthesia were randomly selected and divided into 3 groups to receive 1ml (75mg Diclofenac (Group D, 1ml (30mg Ketorolac (Group K and 100ml (1000mg Paracetamol (Group P. Two hours post spinal anesthesia, irrespective of completion of surgery study drug was administered intravenously. In post-operative ward analgesic, efficacy was assessed hourly using a visual analog scale (VAS, duration of motor blockade due to spinal anesthesia (Modified Bromage scale, time for rescue analgesia (VAS>4 were compared and occurrence of adverse effects noted. STATICS Collected data was analyzed using ANOVA. RESULTS The time taken to administer the first dose of rescue analgesic was significantly (P <0.05 delayed in the group K (276mins. Overall, mean postoperative VAS scores were significantly better with (Group K and VAS scores were not significantly different between other (Group P and (Group D. CONCLUSION Ketorolac was a better post-operative analgesic compared to diclofenac and paracetamol.

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

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

    2013-11-15

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

  19. Comparison of three arterial pulse waveform classification techniques.

    Allen, J; Murray, A

    1996-01-01

    Peripheral pulse waveforms can become stretched and damped with increasing severity of peripheral vascular disease (PVD) and hence could provide valuable diagnostic information. This study compares the diagnostic performance of 3 established classification techniques (a linear discriminant classifier, a k-nearest neighbour classifier, and an artificial neural network) for the detection of lower limb arterial disease from pulse waveforms obtained using photoelectric plethysmography (PPG). Pulse waveforms and pre- and post-exercise Doppler ultrasound ankle to brachial pressure indices (ABPI) were obtained from patients attending a vascular measurement laboratory. A single PPG pulse from each big toe was recorded direct to computer, pre-processed, and then used as classifier input data. The correct classifier outputs were the corresponding ABPI diagnostic classification. Pulse and ABPI measurements from 100 legs were used as training data for each classifier, and the computed classifications for pulses from a further 266 legs were then compared with their ABPI diagnoses. The diagnostic accuracy of the artificial neural network (80%; was higher than for the optimized k-nearest neighbour classifier (k = 27, accuracy 76% and the linear discriminant classifier (71%). The Kappa measure of agreement which excludes chance was highest for the artificial neural network (57%) and significantly higher than that of the linear discriminant classifier (Kappa 40%, p < 0.05). The value of Kappa for the optimized k-nearest neighbour classifier (k = 27) was intermediate at 47%. This study has shown that classifiers can be taught to discriminate between small, and perhaps subtle, differences in features. We have demonstrated that artificial neural networks can be used to classify arterial pulse waveforms, and can perform better overall than k-nearest neighbour or linear discriminant classifiers for this application.

  20. Changes in Peripheral Hemodynamics and Clinical Symptoms in Patients With Arterial Hypertension and Abdominal Obesity Under the Influence of Treatment, Depending on Genes’ Polymorphism

    Alina Sokolenko

    2015-03-01

    Full Text Available In 110 patients with essential arterial hypertension (EAH and overweight or abdominal obesity (AO analyzed changes of peripheral hemodynamics and clinical signs under the influence of treatment, depending on genes’ polymorphism of the Angiotensin-converting enzyme (ACE, I/D and the Peroxisome proliferator-activated receptor gamma-2 (PPAR-2, Pro12Ala. Under the combined treatment the "target" office blood pressure (BP was achieved in 72.8 % subjects, the "adequate" reduction of BP – in 82.6 % patients. Depending on the EAH severity: "target" BP achieved in 100% patients with EAH I stage vs 76.2 % in person with EAH II stage (p=0.019 and 53.1 % – with EAH III stage (p=0.002. "Target" average daily BP24, daily BPd and nighttime BPn were achieved in 70.0 % patients (prevail those with EAH I-II stages by 47.1 % and 21.2 % (p=0.049, respectively, in I-allele carriers of ACE gene – by 17,9% (p=0.048 and Ala-allele carriers of PPAR-2 gene by 38.9 % (p=0.036.

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

    Zhengni Liu

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

  2. Comparison of Tubal Sterilization Procedures Performed by Keyless Abdominal Rope-Lifting Surgery and Conventional CO2 Laparoscopy: A Case Controlled Clinical Study

    Kahraman Ülker

    2013-01-01

    Full Text Available Objective. To evaluate the safety and efficacy of Keyless Abdominal Rope-Lifting Surgery (KARS, for tubal sterilization procedures in comparison with the conventional CO2 laparoscopy. Material and Methods. During a one-year period, 71 women underwent tubal ligation surgery. Conventional laparoscopy (N=38 and KARS (N=33 were used for tubal sterilization. In KARS, an abdominal access pathway through a single intra-abdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intraumbilical entry without the use of trocars. In CO2 laparoscopy, following the creation of the CO2 pneumoperitoneum a 10 mm trocar and two 5 mm trocars were introduced into the abdominal cavity. Tubal sterilizations were performed following the creation of the abdominal access pathways in both groups. The groups were compared with each other. Results. All operations could be performed by KARS without conversion to CO2 laparoscopy or laparotomy. The mean operative time of the two groups was not significantly different (P>0.05. Intra- and postoperative findings including complications, bleeding, and hospital stay time did not differ between groups (P>0.05. Conclusion. KARS for tubal sterilization seems safe and effective in terms of cosmesis, postoperative pain, and early hospital discharge.

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

    Ishida, Hiroshi; Hirose, Ryohei; Watanabe, Susumu

    2012-10-01

    The abdominal drawing-in maneuver (ADIM) is commonly used as a fundamental component of lumbar stabilization training programs. One potential limitation of lumbar stabilization programs is that it can be difficult and time consuming to train people to perform the ADIM. The transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles are the most powerful muscles involved in expiration. However, little is known about the differences in the recruitment of the abdominal muscles between the ADIM and breathe held at maximum expiratory level (maximum expiration). The thickness of the TrA and IO muscles was measured by ultrasound imaging, and the activity of the EO muscle was measured by electromyography (EMG) in 33 healthy male performing the ADIM and maximum expiration. Maximum expiration produced a significant increase in the thickness of the TrA and IO muscles compared to the ADIM (p muscle was significantly higher during maximum expiration than during the ADIM (p muscle was approximately 30% of the maximal voluntary contraction during maximum expiration. Thus, maximum expiration may be an effective method for training of co-activation of the lateral abdominal muscles.

  4. Comparison of neutral oral contrast versus positive oral contrast medium in abdominal multidetector CT

    Berther, Ralph; Eckhardt, Boris; Zollikofer, Christoph L. [Kantonsspital, Institute of Radiology, Winterthur (Switzerland); Patak, Michael A. [Kantonsspital, Institute of Radiology, Winterthur (Switzerland); Inselspital, University Hospital of Bern, Institute of Diagnostic, Interventional and Paediatric Radiology, Bern (Switzerland); Erturk, Sukru M. [Sisli Etfal Education and Research Hospital, Department of Radiology, Istanbul (Turkey)

    2008-09-15

    To determine whether neutral contrast agents with water-equivalent intraluminal attenuation can improve delineation of the bowel wall and increase overall image quality for a non-selected patient population, a neutral oral contrast agent (3% mannitol) was administered to 100 patients referred for abdominal multidetector row computed tomography (MDCT). Their results were compared with those of 100 patients given a positive oral contrast agent. Qualitative and quantitative measurements were done on different levels of the gastrointestinal tract by three experienced readers. Patients given the neutral oral contrast agent showed significant better qualitative results for bowel distension (P<0.001), homogeneity of the luminal content (P<0.001), delineation of the bowel-wall to the lumen (P<0.001) and to the mesentery (P<0.001) and artifacts (P<0.001), leading to a significant better overall image quality (P<0.001) than patients receiving positive oral contrast medium. The quantitative measurements revealed significant better distension (P<0.001) and wall to lumen delineation (P<0.001) for the patients receiving neutral oral contrast medium. The present results show that the neutral oral contrast agent (mannitol) produced better distension, better homogeneity and better delineation of the bowel wall leading to a higher overall image quality than the positive oral contrast medium in a non-selected patient population. (orig.)

  5. Comparison of abdominal ultrasonographic findings with endoscopic ultrasonographic findings of solid pseudopapillary neoplasms of the pancreas.

    Jung, Woo Sang; Kim, Jai Keun; Yu, Jeong-Sik; Kim, Joo Hee; Cho, Eun-Suk; Chung, Jae-Joon

    2014-09-01

    To compare abdominal ultrasonographic (AU) findings with endoscopic ultrasonographic (EUS) findings of solid pseudopapillary neoplasm (SPN) of the pancreas, 13 patients (male-to-female ratio, 3:10; mean age, 36 years) with surgically proven SPN who underwent both preoperative AU and EUS were included in the study. Ultrasonographic findings of the 2 modalities were compared according to internal echogenicity, calcification, demarcation, internal septum, and main pancreatic duct dilatation. Nine cases showed hypoechogenicity on both AU and EUS. The remaining 4 cases showed different echogenicity on both modalities as follows: hypoechogenicity (n = 2) and isoechogenicity (n = 2) on AU; and hyperechogenicity (n = 1), poor visualization of internal architecture due to dense rim calcification (n = 2), and isoechogenicity (n = 1) on EUS. In 2 cases with dense rim calcification, evaluation of the internal contents was more difficult on EUS compared with AU. In addition, central punctate calcifications of 2 cases were well visualized on both AU and EUS, but the 1 case of peripheral calcification was only seen on EUS. All cases showed good demarcation without main pancreatic ductal dilatation or internal septa. Endoscopic ultrasonography was superior to AU for the evaluation of internal echogenicity of pancreatic SPN; however, AU was superior at evaluating larger tumors and tumors with dense rim calcification.

  6. Niveles de presión arterial, circunferencia abdominal y sobrepeso/obesidad en los estudiantes universitarios de la Universidad Peruana Unión – Tarapoto

    Saulo Salinas

    2014-11-01

    Full Text Available El sobrepeso y la obesidad aumentan el riesgo de padecer enfermedades cardiovasculares y otras patologías que alteran significativamente la calidad y expectativa de vida. Estudios en otras poblaciones de América Latina y el Perú muestran que la prevalencia de obesidad viene aumentando en las últimas décadas, por otro lado la presión arterial es un indicador importante para conocer el desenvolvimiento del trabajo constante del corazón. Se desarrolló el estudio con 132 estudiantes distribuidos en las diferentes facultades, 82 mujeres y 50 varones. Las variables consideradas fueron Índice de Masa Corporal (IMC, Circunferencia Abdominal (CA, Presión Arterial Sistólica (PAS y diastólica (PAD. Se analizaron los datos mediante el software estadístico SPSS (20.0. Se realizó un análisis descriptivo de medias y desviación estándar de las variables, posteriormente se aplicó el Test de Kolmogorov – Smirnov y correlación de Pearson para IMC y CA. Entre los resultados se encontró que las medias del IMC fue de 22.3 ± 2.6 y CA de 77.9 ±6.4 dentro de los parámetros normales con diferencias mínimas entre géneros, asimismo la PAS y PAD fue de 96.9 ± 7.3- 58 ± 7.2 manteniendo las diferencias. La prueba de normalidad indicó que la distribución de los datos en cada género eran normales (p=0.2 con un nivel de significancia de 0.01. La correlación de Pearson r = 0.7 indica que las variables IMC y CA están asociadas positivamente con p = 0.0. Se concluye que los varones están expuestos a presentar PAS y PAD, mayores a los del género opuesto, asimismo el sobrepeso obtuvo el 12.9% de los estudiantes evaluados y que al evaluar el IMC, las mujeres presentan superioridad mínima que los varones. Estos datos demuestran que la obesidad puede ser progresiva si no se toman las precauciones necesarias

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

    V. R. Veber

    2008-01-01

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

  8. Comparison of abdominal skin temperature between fertile and infertile women by infrared thermography: A diagnostic approach.

    Jo, Junyoung; Kim, Hyunho

    2016-10-01

    This retrospective study aimed to evaluate the differences in abdominal temperature (AT) between fertile (n=206; age) and infertile (n=250) women between the ages of 30 and 39 years. We evaluated the differences in two distinctive skin temperatures by thermography: ΔT1 (CV8 index) - difference in temperature between the mid-abdomen (CV8 acupuncture area) and ventral upper arm (VUA) and ΔT2 (CV4 index) - difference in temperature between the lower abdomen (CV4 acupuncture area) and VUA. The results indicated that the ΔT1 and ΔT2 of infertile women were significantly lower (by 1.05°C and 0.79°C, respectively; p<0.001, both) compared to those of fertile women. Additionally, the area under the curve of ΔT1 (0.78) was greater compared to that of ΔT2 (0.736), and its threshold was set at 0.675°C, by which, the sensitivity and specificity of ΔT1 for determination of fertility were found to be 80.8% and 68.4%, respectively. In conclusion, infertility is associated with lower AT. The decrease in AT in infertile women might be due to poor blood perfusion to the core muscles and tissues of the body. These findings provide a basis for further research for evaluation of clinical feasibility of thermography for analysis of infertility in women. Further evaluation of the influence of AT on fertility outcomes is required to determine the causal relationship between AT and infertility.

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

    McGloughlin Timothy M

    2007-10-01

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

  10. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries

    Xiang HU; Qiang ZHAO

    2011-01-01

    Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left antetior descending coronary arteries is unclear.This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library.Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years,there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right intemal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery

  11. Complete abdominal aortic aneurysm thrombosis and obstruction of both common iliac arteries with intrathrombotic pressures demonstrating a continuing risk of rupture: a case report and review of the literature

    Kotzadimitriou Aikaterini

    2009-01-01

    Full Text Available Abstract Introduction Although mural thrombus in an abdominal aortic aneurysm is frequent and its role has been studied extensively, complete thrombosis of an abdominal aneurysm is extremely rare and its natural history in relation to the risk of rupture is not known. The case of a patient with a completely thrombosed infrarenal aneurysm is presented along with a literature review. Case presentation We report the case of a 56-year-old Caucasian man with an infrarenal abdominal aortic aneurysm, presenting at our hospital due to critical ischemia of his right lower limb. Computed tomography and angiography demonstrated complete aneurysm thrombosis and obstruction of both common iliac arteries. Conclusion During the operation, systolic and mean intrathrombotic pressures, measured in different levels, constituted 74.5-90.2% and 77.5-92.5% of systolic and mean intraluminal pressure and 73-88.4% and 76.5-91.3% of systemic pressure, respectively. Our findings show that there may be a continuing risk of rupture in cases of a thrombosed abdominal aortic aneurysm.

  12. Helical computed tomography in the assessment of abdominal aortic pathology

    Vicaretti, M.; Young, N.; Jenkins, J.; Fletcher, J. [Westmead Hospital, Westmead, NSW (Australia)

    1997-05-01

    A pilot study was undertaken to evaluate the role of helical computed tomography in the assessment of abdominal aortic pathology. A total of 17 patients underwent intra-arterial digital subtraction angiography (IADSA) and helical computed tomography, with eight patients undergoing subsequent operative intervention. A comparison of radiological findings between IADSA and helical computed tomography (CT) was made and, where applicable, a comparison was made with operative findings. Pathology included abdominal aortic aneurysm (AAA) (n=12), thoraco abdominal aneurysm (n=2) and dissection (n=1), graft distension following AAA repair (n=1) and plaque haemorrhage in the distal aorta following percutaneous transluminal angioplasty (PTA) of the iliac artery (n=1). Planned operative management as based on pre-operative helical CT imaging findings, in particular with reference to the type of graft used (straight or bifurcated) was not changed at operation. Our findings on helical CT in regards to AAA, thoraco-abdominal aneurysm and dissection correlated well with angiography and surgery findings. (authors). 26 refs., 2 tabs., 5 figs.

  13. Role of contrast enhanced ultrasound in detection of abdominal aortic abnormalities in comparison with multislice computed tomography

    Dirk-André Clevert; Kerstin Schick; CHEN Min-hua; ZHU Qing-li; Maximilian Reiser

    2009-01-01

    @@ dissection;abdominal aortic aneurysm;aorto-caval fistula;inflammatory abdominal aortic aneurysm Conventional ultrasound (US) is the most widely used imaging modality in routine clinical practice worldwide.The limitations of conventional ultrasound in the detection of aortic lesions versus multi-slice computed tomography angiography (MS-CTA) are well known.

  14. The performance of abdominal visceral artery aneurysm angiography with dual-source CT%腹部内脏动脉瘤双源CT血管造影表现

    岳学旺; 孔生; 孔淑红

    2015-01-01

    Objective To investigate the performance of abdominal visceral artery aneurysm in dual‐source CT angiogra‐phy (CTA) and to evaluate the clinical value of CTA in the diagnosis of abdominal visceral artery aneurysm .Methods Thirty patients of spontaneous abdominal visceral artery aneurysm were analyzed retrospectively and combined the original and post‐processing images (VR ,CPR ,MIP ,MPR) for diagnosis .Results 30 cases of patients with abdominal visceral artery aneurysm were successfully completed the CT angiography ,and the images were clear .CTA can clearly display the aneurysm ,including 3 polyarteritis nodosa patients who had multiple viscera aneurysm .Besides ,28 patients of solitary an‐eurysm included 12 cases of dplenic aneurysm ,3 cases of hepatic artery aneurysm ,8 cases of renal artery aneurysm (one of patients had aneurysm in bilateral respectively) ,1 case of celiac trunkaneurysm ,1 case of pseudoaneurysm of celiac trunk and 3 cases of superior mesenteric aneurysm .Conclusion Dual‐soure CT angiography and post‐processing technology have a good diagnostic valve for abdominal visceral artery aneurysm and relative disease and it provides the basis for clinical di‐agnosis and treatment .%目的:探讨腹部内脏动脉瘤双源CT血管造影(CTA)的表现。方法回顾性分析30例腹部内脏动脉瘤患者CT原始及后处理图像,主要应用容积显示(VR)、最大密度投影(MIP)、曲面重组(CPR)、多平面重组(MPR)等后处理技术,进行图像重建观察动脉瘤情况,并结合横断面图像对疾病进行诊断。结果30例腹部内脏动脉血管造影成功,图像清晰。CTA能清晰显示腹部内脏动脉瘤,包括3例结节性多动脉炎患者,均可见多发内脏动脉瘤,此外单发动脉瘤中包括:脾动脉瘤12例、肝动脉瘤3例、肾动脉瘤8例(1例患者双肾均可见一单发动脉瘤)、腹腔干动脉瘤1例、腹腔干假性动脉瘤1例、肠系

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

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

    2013-09-15

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

  16. Clinical features of multiple inflammatory abdominal aortic aneurysm originating from iliac artery in an elderly patient%老年髂动脉多发炎性动脉瘤的临床特点分析

    吴雪萍; 樊瑾; 曹剑; 朱剑; 朱平; 郭伟

    2012-01-01

    Objective To improve the understanding of multiple inflammatory abdominal aortic aneurysm originating from iliac artery and its drug therapy by investigating its clinical features. Methods Clinical data about an elderly patient with multiple inflammatory abdominal aortic aneurysm originating from iliac artery were analyzed with its related literature reviewed. Results Inflammatory abdominal aortic aneurysm usually occurred in elderly subjects aged about 70 years and was characterized by sudden abdominal or back pain, weight loss,increased C reactive protein and blood sedimentation level. CT and MRI showed thickened aneurysm wall with inflammation involving ureteral tract which could lead to hydronephorosis. It was usually treated by surgical resection. Early combined glucocorticoid and immunosuppressant therapy could avoid or delay its operation. Conclusion CT and MRI should be considered for abdominal aortic aneurysm patients with sudden severe abdominal pain. Thickened aneurysm wall and hydropherosis contribute to its diagnosis. Early combined glucocorticoid and immunosuppressant therapy can significantly alleviate its symptoms and ureteral tract obstruction.%目的 了解髂动脉多发炎性腹主动脉瘤的临床特点,提高对本病诊断及药物治疗的认识.方法 对1例发生于髂动脉的炎性腹主动脉瘤老年患者的临床资料进行分析,并复习有关文献.结果 炎性腹主动脉瘤好发于70岁左右老年人,临床表现为突发腹痛或背痛,体重下降,C反应蛋白和红细胞沉降率升高,影像学检查可见动脉瘤壁增厚,炎症累及输尿管可引起肾盂积水,常规治疗需手术,早期经糖皮质激素及免疫抑制剂联合治疗可避免或推迟手术.结论 突发严重腹痛的腹主动脉瘤患者,应尽早行影像学检查,发现动脉瘤壁增厚及肾盂积水支持本病诊断.早期糖皮质激素及免疫抑制剂治疗能显著缓解症状,并消除尿路梗阻.

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

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

    2015-04-01

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

  18. Celiac Artery Compression Syndrome

    Mohammed Muqeetadnan

    2013-01-01

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

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

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

    2007-07-15

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

  20. 老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系%Relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women

    许建超; 刘振东; 路方红; 刁玉涛; 张华; 赵颖馨; 孙尚文; 王舒建

    2014-01-01

    Objective To study the relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women .Methods Three hundred and fifty-three elderly women were divided into non-abdominal obesity group (n= 160) and abdominal obesity group (n=193)according to their waist circumference .Their carotid radial pulse wave velocity(crPWV) and 24 h ambulatory blood pressure were monitored .Results The non-dipper blood pressure , crPWV and symmetric AASI were significantly higher in abdominal obesity group than in non-abdominal obesity group (32 .6% vs 10 .0% ,11 .83 ± 1 .19 m/s vs 10 .90 ± 1 .04 m/s ,0 .31 ± 0 .15 vs 0 .24 ± 0 .17 ,P<0 .05) wile the nocturnal systolic and diastolic blood pressure were significantly lower in abdominal obesity group than in non-abdominal obesity group (P<0 .01) .Multiple linear regression analysis showed that waist circumference was the main risk factor for crPWV and sym-metric AASI after adjustment for age ,blood lipid and BMI (P<0 .05) .Logistic regression analysis revealed that abdominal obesity was the main risk factor for circadian blood pressure rhythm (OR=1 .104 ,95% CI:1 .074 -1 .134 ,P<0 .05) .Conclusion Abdominal fat deposit can signifi-cantly affect circadian blood pressure rhythm and arterial stiffness in elderly women .It is of great importance to control waist circumference in preventing arteriosclerosis .%目的:探讨老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系。方法选择老年女性353例,根据腰围将受试者分为2组,即非腹型肥胖组160例,腹型肥胖组193例。所有受试者监测颈桡动脉脉搏波传导速度(crPWV)、24 h动态血压。结果腹型肥胖组非杓型血压(32.6% vs 10.0%)、crPWV [(11.83±1.19)m/s vs (10.90±1.04)m/s]、对称动态动脉硬化指数[(0.31±0.15) vs (0.24±0.17)]显著高于非腹型肥胖组,夜间收缩压下降率、夜间舒张压下降率显著

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

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

    2013-03-15

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

  2. 超声检测股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性%Ultrasound study on correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis

    孙建群; 刘颖

    2012-01-01

    目的:探讨股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性.方法:采用高频超声测量109例行冠状动脉造影术后1周的患者股动脉、腹主动脉及颈动脉的内-中膜厚度(IMT)、斑块积分及斑块数目.结果:股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化呈正相关(P<0.01、P<0.05);股动脉斑块预测冠状动脉粥样硬化的灵敏度为89%,特异度为77%,准确度84%;腹主动脉斑块预测冠状动脉粥样硬化的灵敏度为73%,特异度为72%,准确度72%;颈动脉斑块预测冠状动脉粥样硬化的灵敏度为83%,特异度为79%,准确度82%.结论:超声检查股动脉、腹主动脉及颈动脉IMT及斑块可间接预测不同程度的冠状动脉粥样硬化;股动脉的灵敏度与准确度较腹主动脉更好.%AIM; To explore the correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis using ultrasound. METHODS; The film thickness within (IMT, intima-media thickness) , patch integral and plaque numbers of the femoral artery, abdominal aorta and carotid artery were measured by ultrasound in 109 patients 1 week after coronary angiography. RESULTS: Atherosclerosis of the femoral artery, abdominal aorta and carotid artery were positively correlated with coronary atherosclerosis (P <0. 01, P <0. 05) . Sensitivity of the femoral artery plaque and coronary atherosclerosis was 88. 6% and specificity was 76. 9%. Sensitivity of abdominal aorta plaque and coronary atherosclerosis was 72. 9% and specificity was 71. 8%. Sensitivity of carotid artery plaque and coronary atherosclerosis was 82. 9% and specificity was 79. 5%. CONCLUSION; Ultrasonic imaging and detection of the femoral artery, abdominal aorta and carotid artery IMT and plaque can indirectly predict the different degrees of coronary atherosclerosis.

  3. Prevalence of risk factors, coronary and systemic atherosclerosis in abdominal aortic aneurysm: Comparison with high cardiovascular risk population

    Alberto Palazzuoli

    2008-08-01

    Full Text Available Alberto Palazzuoli, Maddalena Gallotta, Giuseppe Guerrieri, Ilaria Quatrini, Beatrice Franci, et alDepartment of Internal Medicine and Metabolic Diseases, Unit of Aortic Surgery, University of Siena, ItalyBackground: Abdominal aortic aneurysm (AAA is considered a manifestation of atherosclerosis, however there are epidemiologic, biochemical, and structural differences between occlusive atherosclerosis and AAA. The pathogenesis of AAA involves several factors, first of all destruction of collagen and elastin in the aortic wall. Classical risk factors may influence the evolution and development of AAA, though no consistent association has been found. Aims of the study were to evaluate associations between risk factors and to establish the prevalence of carotid, peripheral vascular and coronary atherosclerosis in patients with AAA.Methods: We studied 98 patients with AAA (Group 1 awaiting surgery compared with high cardiovascular risk population having two or more risk factors (n = 82 Group 2. We evaluated traditional risk factors and we studied by eco-doppler and echocardiography the presence of carotid peripheral and coronaric atherosclerosis in two groups.Results: We found a higher incidence of AAA in males (p < 0.01. The prevalence of infrarenal AAA was significantly higher than suprarenal AAA (81 vs 17 p < 0.001. No differences in total cholesterol (199 ± 20 vs. 197 ± 25 mg/dl, low-density lipoprotein (142 ± 16 vs. 140 ± 18 mg/dl, triglycerides (138 ± 45 vs. 144 ± 56 mg/dl, glycemia (119 ± 15 vs. 122 ± 20 mg/dl, and fibrinogen (388 ± 154 vs. 362 ± 92 mg/dl were found between groups. We demonstrated significant differences for cigarette smoking (p < 0.002, systolic and diastolic blood pressure (150 ± 15 vs. 143 ± 14 mmHg and 88 ± 6 vs. 85 ± 7 mmHg, p < 0.0001 and p < 0.05, respectively and high sensititivity C reactive protein (2.8 ± 1.3 vs. 1.3 ± 0.7 mg/dl, p < 0.001. High-density lipoprotein (HDL cholesterol levels were

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

    Kotronen, Anna; Yki-Järvinen, Hannele; Sevastianova, Ksenia

    2011-01-01

    Abdominally obese individuals with the metabolic syndrome often have excess fat deposition both intra-abdominally (IA) and in the liver, but the relative contribution of these two deposits to variation in components of the metabolic syndrome remains unclear. We determined the mutually independent...... quantitative contributions of IA and liver fat to components of the syndrome, fasting serum (fS) insulin, and liver enzymes and measures of hepatic insulin sensitivity in 356 subjects (mean age 42 years, mean BMI 29.7 kg/m²) in whom liver fat and abdominal fat volumes were measured. IA and liver fat contents...... were correlated (r = 0.65, P fat, liver fat or IA fat explained variation in fS-triglyceride (TG) and high-density lipoprotein (HDL) cholesterol, plasma glucose, insulin and liver enzyme concentrations, and hepatic...

  5. Multi-parametric ultrasound criteria for internal carotid artery disease - comparison with CT angiography

    Barlinn, Kristian; Kepplinger, Jessica; Siepmann, Timo; Pallesen, Lars-Peder; Bodechtel, Ulf; Reichmann, Heinz; Puetz, Volker [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neurology, Dresden (Germany); Floegel, Thomas [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neurology, Dresden (Germany); Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neuroradiology, Dresden (Germany); Kitzler, Hagen H. [Carl Gustav Carus University Hospital, Technische Universitaet Dresden, Department of Neuroradiology, Dresden (Germany); Alexandrov, Andrei V. [The University of Tennessee Health Science Center, Department of Neurology, Memphis, TN (United States)

    2016-09-15

    The German Society of Ultrasound in Medicine (known by its acronym DEGUM) recently proposed a novel multi-parametric ultrasound approach for comprehensive and accurate assessment of extracranial internal carotid artery (ICA) steno-occlusive disease. We determined the agreement between duplex ultrasonography (DUS) interpreted by the DEGUM criteria and CT angiography (CTA) for grading of extracranial ICA steno-occlusive disease. Consecutive patients with acute cerebral ischemia underwent DUS and CTA. Internal carotid artery stenosis was graded according to the DEGUM-recommended criteria for DUS. Independent readers manually performed North American Symptomatic Carotid Endarterectomy Trial-type measurements on axial CTA source images. Both modalities were compared using Spearman's correlation and Bland-Altman analyses. A total of 303 acute cerebral ischemia patients (mean age, 72 ± 12 years; 58 % men; median baseline National Institutes of Health Stroke Scale score, 4 [interquartile range 7]) provided 593 DUS and CTA vessel pairs for comparison. There was a positive correlation between DUS and CTA (r{sub s} = 0.783, p < 0.001) with mean difference in degree of stenosis measurement of 3.57 %. Bland-Altman analysis further revealed widely varying differences (95 % limits of agreement -29.26 to 22.84) between the two modalities. Although the novel DEGUM criteria showed overall good agreement between DUS and CTA across all stenosis ranges, potential for wide incongruence with CTA underscores the need for local laboratory validation to avoid false screening results. (orig.)

  6. A STUDY ON DIAGNOSTIC ACCURACY OF BIOCHEMICAL MARKERS AND TRANS–ABDOMINAL ULTRASONOGRAPHY IN COMPARISON TO MULTI-DETECTOR COMPUTED TOMOGRAPHY IN DETECTION OF ACUTE PANCREATITIS

    Biplab Debbarma

    2016-07-01

    Full Text Available Acute pancreatitis is an acute, mainly diffuse, inflammatory process of the pancreas. Computed Tomography (CT scan is the modality of choice for diagnosis of acute pancreatitis. But non-availability of Computed Tomography (CT scan in all health facilities made detection of acute pancreatitis is problemsome. OBJECTIVES 1. To assess the diagnostic accuracy of Biochemical Markers and Trans-Abdominal Ultrasonography in comparison to Multidetector Computed Tomography in diagnosis of acute pancreatitis. 2. To compare the findings of Trans-Abdominal Ultrasonography with Multidetector Computed Tomography. MATERIALS AND METHODS 100 clinically suspected for acute pancreatitis patients were tested for abnormal biochemical markers, followed by examined by USG and then by MDCT in Radiodiagnosis Department of AGMC and GBP Hospital and findings were compared. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. RESULTS The sensitivity and specificity of trans-abdominal ultrasonography was calculated as 75% (CI 64.06% - 84.01% and 100% (CI 83.16%-100%. CONCLUSION USG had similar sensitivity, but higher specificity value than serum markers (Amylase and Lipase.

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

    Marjanović Ivan

    2011-01-01

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

  8. Comparison of Robotic vs. Standard Surgical Procedure on Postoperative Nursing Care of Women Undergoing Total Abdominal Hysterectomy.

    Best, Janie; Day, Luanne; Ingram, Lori; Musgrave, Barbara; Rushing, Holli; Schooley, Brenda

    2014-01-01

    This exploratory study was conducted to determine if the postoperative course is different for women undergoing robotic-assisted total abdominal hysterectomy (TAH) compared to women undergoing traditional (open) TAH. This study adds to the evidence regarding potential benefits and complications of robotic-assisted gynecologic surgery, and identifies specific areas for further research.

  9. Women's sexual behavior, body image and satisfaction with surgical outcomes after hysterectomy: a comparison of vaginal and abdominal surgery.

    Gütl, P; Greimel, E R; Roth, R; Winter, R

    2002-03-01

    The aim of this study was to investigate the impact of vaginal and abdominal hysterectomy on women's sexual behavior, sexual dysfunction, body image and satisfaction with surgery. A prospective study was conducted on 90 women to evaluate the outcomes of hysterectomy. Data were collected prior to surgery, three months and two years after surgery, using self-report questionnaires. The results showed significant differences in women's sexual behavior and sexual dysfunction before and after hysterectomy, independent of the surgical procedure performed. Women in both groups reported improvements in sexual desire, sexual activity and sexual intercourse three months and two years after surgery. Sexual dysfunction such as dyspareunia, vaginismus, lack of orgasm and loss of sexual interest diminished significantly after surgery. Regression analyses revealed that postmenopausal status, severity of gynecological complaints and frequency of sexual intercourse were the most important factors for improved sexual outcomes. Women in the abdominal group were dissatisfied with their body image because of the abdominal scar, experienced more pain and had a longer period of recovery from surgery compared to women in the vaginal group. According to the results, sexual behavior alone is not an important factor in choosing vaginal or abdominal hysterectomy. However, sexual behavior was important in both groups when evaluating outcomes after hysterectomy.

  10. 腹主动脉瘤腔内隔绝术中髂动脉的处理%Management of iliac arteries in endovascular graft exclusion of abdominal aortic aneurysm

    何玉祥; 种振岳; 王默; 高培显; 韩宗霖; 刘洋; 金星

    2011-01-01

    Objective To summarize our experiences of management for iliac artery in endovascular graft exclusion (EVGE) of abdominal aortic aneurysm (AAA). Methods From July 2004 to November 2010, EVGE were performed in 43 patients with AAAs,including 27 cases involving unilateral and 16 cases of bilateral iliac bifurcations. Various techniques including simple coverage by stent-graft, embolization of the internal iliac artery trunk combined with stent-graft covering,ligation of common iliac artery,reconstruction of the internal iliac artery and combination of the above techniques were applied according to the different conditions of the iliac arterial system involved. Results The procedures were all technically successful in 43 patients without the occurrence of type I endoleakage. Claudication due to gluteus ischemia occurred in 6 cases(14.0%) and bloody stool in 1 case(2.3%); no patient developed buttock, perineal region, and colorectal necrosis; and no patient died. Conclusions It is important to preserve the patency of one of the internal iliac arteries and avoid occlusion of both internal iliac arteries in EVGE of AAA.%目的:总结腹主动脉瘤(AAA)行腔内隔绝术时髂动脉的处理方式.方法:2004年7月至2010年11月共对43例瘤体累及单侧或双侧髂动脉分叉的AAA行腔内隔绝术,其中单侧髂动脉分叉受累27例,双侧髂动脉分叉受累16例.根据髂动脉病变情况,分别采取髂内动脉单纯覆盖、髂内动脉栓塞后覆盖、髂动脉外环结扎、一侧髂内动脉重建等不同的处理方法.结果:所有病例均操作成功,手术结束时无I型内漏存在.术后出现臀部间歇性跛行6例(14.0%),便血1例(2.3%),无病例发生臀部或会阴部皮肤坏死、肠坏死及死亡.结论:术中避免同时封闭双侧髂内动脉,尽量保留一侧髂内动脉是很重要的.

  11. Abdominal pain

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  12. Abdominal actinomycosis.

    Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K

    2003-08-01

    Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.

  13. A comparison of central venous-arterial and mixed venous-arterial carbon dioxide tension gradient in circulatory failure.

    Ho, K M; Harding, R; Chamberlain, J

    2007-10-01

    The arterial and mixed venous carbon dioxide tension gradient has been shown to increase when there is a decrease in cardiac output. Monitoring central venous gases is an attractive alternative to monitoring mixed venous gases in circulatory failure because central venous catheterisation is a less invasive procedure than pulmonary artery catheterisation. This study aims to evaluate the agreement between central venous-arterial carbon dioxide (CVA-CO2) and mixed venous-arterial carbon dioxide (SVA-CO2) tension gradients and assess whether CVA-CO2 tension gradient can be used to predict cardiac output in circulatory failure. Samples of arterial, central venous and mixed venous blood were obtained from 16 patients with circulatory failure at different inspired oxygen concentrations and cardiac indexes within 24 hours of study enrolment. CVA-CO2 and SVA-CO2 tension gradient were not interchangeable numerically (bias = 0.14 mmHg, 95% limits of agreement: -3.0 to 3.2 mmHg). CVA-CO2 (Spearman correlation coefficient r = -0.385) and SVA-CO, (r = -0.578) tension gradient were significantly correlated with the cardiac index but the cardiac index only accounted for 21% and 32% of the variability of CVA-CO, and SVA-CO2 tension gradient, respectively. The ability of CVA-CO2 tension gradient (area under the ROC curve = 0.77, 95% confidence interval [CI]: 0.49-0.99; P = 0.08) to predict a low cardiac output state (cardiac index tension gradient appeared to be limited to their negative predictive value to exclude a low cardiac output state when CVA-CO, or SVA-CO, tension gradient was normal (< or =5 mmHg).

  14. Comparison of EMG activity on abdominal muscles during plank exercise with unilateral and bilateral additional isometric hip adduction.

    Kim, Soo-Yong; Kang, Min-Hyeok; Kim, Eui-Ryong; Jung, In-Gui; Seo, Eun-Young; Oh, Jae-Seop

    2016-10-01

    The aim of this study was to investigate the effects of additional isometric hip adduction during the plank exercise on the abdominal muscles. Twenty healthy young men participated in this study. Surface electromyography (EMG) was used to monitor the activity of the bilateral rectus abdominis (RA), the internal oblique (IO), and the external oblique (EO) muscles. The participants performed three types of plank exercise; the standard plank exercise, the plank exercise with bilateral isometric hip adduction, and the plank exercise with unilateral isometric hip adduction. All abdominal muscle activity was significantly increased during the plank exercise combined with the bilateral and unilateral isometric hip adduction compared with the standard plank exercise (pmuscle activity was significantly increased during the unilateral isometric hip adduction compared with the bilateral isometric hip adduction (pabdominal muscle activity. In particular, the unilateral isometric hip adduction is a more beneficial exercise than the bilateral isometric hip adduction.

  15. Surgery of gigantic infrarenal aneurysm of abdominal aorta

    N. Rustempašić

    2005-08-01

    Full Text Available The case shows gigantic aneurysm of abdominal aorta, localized infrarenally, as well as aneurysms of bilateral iliac arteries, which were solved successfully by resection of aneurism of abdominal aorta, closure of iliac arteries near aortic bifurcation, and interposition of aorta-bifemural vascular graft. There were no postoperative complications,and final outcome was fully satisfactory.

  16. Rare anatomic variation of left gastric artery and right hepatic artery in a female cadaver.

    Troupis, Theodore; Chatzikokolis, Stamatis; Zachariadis, Michael; Troupis, George; Anagnostopoulou, Sofia; Skandalakis, Panayiotis

    2008-05-01

    The present report describes a rare case in which the left gastric artery arises directly from the abdominal aorta and the right hepatic artery from the superior mesenteric artery, as observed during the dissection of a female cadaver. The left gastric artery usually rises as one of the three branches of the celiac trunk, which was originally described by Haller in 1756, whereas the right hepatic artery usually originates from the proper hepatic artery. The knowledge of the typical anatomy of the abdominal arteries, and their variations, is especially important due to the numerous interventions performed in the abdominal area.

  17. Abdominal Sepsis.

    De Waele, Jan J

    2016-08-01

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

  18. A case report: accessory right renal artery

    Patasi B

    2009-10-01

    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

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

    Manzar Vakili

    2015-01-01

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

  20. Comparison of the Perioperative Outcomes of a Vessel Sealing Instrument-Assisted Technique with a Conventional Technique in Abdominal Myomectomy

    Öztürk, Mustafa; Firatligil, Fahri Burçin; Fidan, Ulas; Keskin, Ugur; Dede, Murat; Yenen, Müfit Cemal

    2016-01-01

    Introduction In gynaecologic practice, LigaSure PreciseTM is generally used in endoscopic and open surgeries, such as hysterectomy, adnexectomy, and cancer surgery. However, there is no case report or main research article where LigaSure PreciseTM has been used for myomectomy. We want to compare a technique using a vessel sealing instrument with a conventional technique in abdominal myomectomy. Materials and Methods Fifty-five women who underwent abdominal myomectomy were divided two groups: (1) a vessel sealing instrument-assisted technique (24 patients); and (2) a conventional technique (31 patients) between January 2011 and December 2014 at the Department of Gynaecology and Obstetrics, Gulhane Military Medical Academy, Ankara, Turkey. The data for the operation times, the occurrence of perioperative complications, the hospitalization times, and changes in haemaglobin and haematocrit levels for the two techniques were collected and compared. Results The mean operation time was 48 minutes for the vessel sealing instrument-assisted technique and 54 minutes for the conventional technique. No statistically significant differences were determined for haemoglobin and haematocrit changes, hospital stay and perioperative complications. Conclusion We did not find any difference in the occurrence of complications, changes in haemoglobin or haematocrit levels, or hospital stay. The vessel sealing instrument-assisted technique is feasible and effective in reducing operation times. PMID:26894124

  1. Comparison of ultrasonography, computed tomography and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms Comparação entre ultrassonografia, tomografia computadorizada e ressonância nuclear magnética com medidas intra-operatórias na avaliação dos aneurismas de aorta abdominal

    Francisco das Chagas de Azevedo

    2005-02-01

    Full Text Available PURPOSE: To study the imaging exams more commonly used for abdominal aortic aneurysms evaluation - ultrasonography, conventional computerized tomography, helical computerized tomography and nuclear magnetic angioresonance - comparing the preoperative measurements reached by those radiological methods with the measurements made during the surgical procedures. METHODS: Patients who had indication of elective transperitoneal surgical treatment for their abdominal aortic aneurysms were included in the study. The initial diagnosis of the aortic dilatation was made by ultrasonography and, after the surgical treatment was indicated, the patient was submitted to another imaging method. Sixty patients were divided into 3 groups according to the complementary imaging method (conventional computerised tomography, helical computerized tomography, nuclear magnetic angioresonance. The ultrasonography of the first 20 patients were joined in a fourth group. There were considered in the study the measurements of the transversal diameter of the proximal neck, maximum transversal diameter of the aneurysm, straight-line length and transversal diameter of the common iliac arteries given by the imaging methods. The same measurements were made by using a caliper during the surgical procedure, and then compared to the values obtained from the radiological exams. RESULTS: The maximum transverse diameter had a range measurement variation of 4.5 to 13.6 cm in the intraoperative, with no statistically significant differences when compared with all the imaging tests. The ultrasonography, however, overestimated the measurements of the proximal neck and the common iliac arteries, in comparison with intraoperative measures. The length of the aorta aneurysm obtained by the conventional computerized tomography was significantly lower if compared to the measures done with the calliper during the operation. The helical computerized tomography and the nuclear magnetic

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

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

    2006-01-01

    ATP-sensitive potassium (K(ATP)) channels play an important role in the regulation of cerebral vascular tone. In vitro studies using synthetic K(ATP) channel openers suggest that the pharmacological profiles differ between rat basilar arteries and rat middle cerebral arteries. To address this issue....... Densitometric measurements of the Western blot signals further showed higher expression levels of Kir6.1 and SUR2B proteins in rat middle cerebral arteries than was found in rat basilar arteries. In conclusion, our in vitro pharmacological studies showed no evidence for functional endothelial K(ATP) channels...

  3. Incidence of periodontitis in Japanese patients with cardiovascular diseases: a comparison between abdominal aortic aneurysm and arrhythmia.

    Suzuki, Jun-Ichi; Aoyama, Norio; Aoki, Mieko; Tada, Yuko; Wakayama, Kouji; Akazawa, Hiroshi; Shigematsu, Kunihiro; Hoshina, Katsuyuki; Izumi, Yuichi; Komuro, Issei; Miyata, Tetsuro; Hirata, Yasunobu; Isobe, Mitsuaki

    2015-07-01

    Although there is a link between periodontitis and cardiovascular disease (CVD), the influence of periodontitis on CVD is unclear. The aim of this study was to assess the relationship between periodontal bacterial burden and CVD. We studied 142 patients with tachyarrhythmia (TA) and 25 patients with abdominal aortic aneurysm (AAA). We examined periodontitis and the presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Prevotella intermedia in the patients' saliva and subgingival plaque using PCR. We also measured serum antibody titers against the pathogens using ELISA. We found that the patients with AAA had fewer remaining teeth (14.6 ± 2.0 vs. 20.9 ± 0.7, P periodontal bacterium in their saliva or subgingival plaque and serum antibody titers was comparable between the two groups. Periodontitis may have a larger affect on aneurysm progression compared to arrhythmia.

  4. Energy Limits in Second Generation High-pitch Dual Source CT - Comparison in an Upper Abdominal Phantom

    Martin Beeres

    2015-01-01

    Full Text Available Objectives: The aim of our study was to find out how much energy is applicable in second-generation dual source high-pitch computed tomography (CT in imaging of the abdomen. Materials and Methods: We examined an upper abdominal phantom using a Somatom Definition Flash CT-Scanner (Siemens, Forchheim, Germany. The study protocol consisted of a scan-series at 100 kV and 120 kV. In each scan series we started with a pitch of 3.2 and reduced it in steps of 0.2, until a pitch of 1.6 was reached. The current was adjusted to the maximum the scanner could achieve. Energy values, image noise, image quality, and radiation exposure were evaluated. Results: For a pitch of 3.2 the maximum applicable current was 142 mAs at 120 kV and in 100 kV the maximum applicable current was 114 mAs. For conventional abdominal imaging, current levels of 200 to 260 mAs are generally used. To achieve similar current levels, we had to decrease the pitch to 1.8 at 100 kV - at this pitch we could perform our imaging at 204 mAs. At a pitch of 2.2 in 120 kV we could apply a current of 206 mAs. Conclusion: We conclude our study by stating that if there is a need for a higher current, we have to reduce the pitch. In a high-pitch dual source CT, we always have to remember where our main focus is, so we can adjust the pitch to the energy we need in the area of the body that has to be imaged, to find answers to the clinical question being raised.

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

    H. Mazaher

    2007-05-01

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

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

    Jung, Seung Eun; Shinn, Kyung Sub; Kim, Hak Hee; Mun, Seok Hwan; Lee, Young Joon; Lee, Bae Young; Choi, Byung Gil; Lee, Jae Mun; Lee, Hee Jeong [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

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

  7. A comparison of ballon injury models of endovascular lesions in rat arteries

    E.E.E. Gabeler; R. van Hillegersberg (Richard); R.G. Statius van Eps (Randolph); W.J. Sluiter (Wim); E.J. Gussenhoven (Elma); P.G.H. Mulder (Paul); H. van Urk (Hero)

    2002-01-01

    textabstractBackground: Balloon injury (BI) of the rat carotid artery (CCA) is widely used to study intimal hyperplasia (IH) and decrease in lumen diameter (LD), but CCA's small diameter impedes the evaluation of endovascular therapies. Therefore, we validated BI in the aorta (AA) and iliac artery (

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

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

    2006-01-01

    ATP-sensitive potassium (K(ATP)) channels play an important role in the regulation of cerebral vascular tone. In vitro studies using synthetic K(ATP) channel openers suggest that the pharmacological profiles differ between rat basilar arteries and rat middle cerebral arteries. To address this issue...

  9. Comparison of P2X receptors in rat mesenteric, basilar and septal (coronary) arteries.

    Lewis, C J; Evans, R J

    2000-07-01

    alpha beta meATP-evoked concentration-dependent, PPADS-sensitive, desensitising, P2X receptor-mediated, constrictions of mesenteric, basilar and septal artery rings with EC(50) values of 1, 1 and 30 microM, respectively. In patch clamp studies on acutely dissociated artery smooth cells alpha beta meATP-evoked transient inward currents (tau approximately 100 ms) with mean current densities of approximately 340, 175 and 120 pA/pF, respectively. P2X(1) receptor immunoreactivity was expressed in mesenteric and basilar arteries and this receptor subunit appears to dominate the P2X receptor phenotype in these vessels. In contrast P2X(1) receptor immunoreactivity was not detected in septal arteries and the alpha beta meATP sensitivity of constriction was not consistent with the involvement of P2X(1) receptors. These results suggest that not all arteries share a common P2X receptor phenotype.

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

    Moore, R.K.G. [Cardiothoracic Centre, Liverpool (United Kingdom)]. E-mail: moore@roger.go-legend.net; Sampson, C. [Cardiothoracic Centre, Liverpool (United Kingdom); MacDonald, S. [Cardiothoracic Centre, Liverpool (United Kingdom); Moynahan, C. [Cardiothoracic Centre, Liverpool (United Kingdom); Groves, D. [National Refractory Angina Centre, Liverpool (United Kingdom); Chester, M.R. [National Refractory Angina Centre, Liverpool (United Kingdom)

    2005-09-01

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

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

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

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV).

  12. Role of Ryanodine Receptor Subtypes in Initiation and Formation of Calcium Sparks in Arterial Smooth Muscle: Comparison with Striated Muscle

    Maik Gollasch

    2009-01-01

    Full Text Available Calcium sparks represent local, rapid, and transient calcium release events from a cluster of ryanodine receptors (RyRs in the sarcoplasmic reticulum. In arterial smooth muscle cells (SMCs, calcium sparks activate calcium-dependent potassium channels causing decrease in the global intracellular [Ca2+] and oppose vasoconstriction. This is in contrast to cardiac and skeletal muscle, where spatial and temporal summation of calcium sparks leads to global increases in intracellular [Ca2+] and myocyte contraction. We summarize the present data on local RyR calcium signaling in arterial SMCs in comparison to striated muscle and muscle-specific differences in coupling between L-type calcium channels and RyRs. Accordingly, arterial SMC Cav1.2 L-type channels regulate intracellular calcium stores content, which in turn modulates calcium efflux though RyRs. Downregulation of RyR2 up to a certain degree is compensated by increased SR calcium content to normalize calcium sparks. This indirect coupling between Cav1.2 and RyR in arterial SMCs is opposite to striated muscle, where triggering of calcium sparks is controlled by rapid and direct cross-talk between Cav1.1/Cav1.2 L-type channels and RyRs. We discuss the role of RyR isoforms in initiation and formation of calcium sparks in SMCs and their possible molecular binding partners and regulators, which differ compared to striated muscle.

  13. COMPARISON OF 0.5% ROPIVACAINE & 0.5% BUPIVACAINE IN EPIDURAL ANAESTHESIA FOR PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY

    Durga Shankar

    2015-07-01

    Full Text Available Ropivacaine is a new intermediate - acting amide local anesthetic which is structurally closely related to a chemical group of amino amides in present clinical use e.g. bupivacaine and mepivacaine . Ropivacaine has pharmacodynamic and pharmacokinetic properties in animals resembling those of bupivacaine. 1 - 3 In human volunteers, ropivacaine has been shown to be less prone than bupivacaine to produce mild central nervous system and cardiovascular changes after intravenous infusion Hence we designed a study to compare ropivacaine 0.5% with bupivacaine 0.5% for epidural anesthesia fo r abdominal hysterectomy. Healthy women, scheduled for elective abdominal hysterectomy were enrolled into this randomized, double - blind, parallel - group study. Epidural block was obtained with 20 ml of ropivacaine (group R or bupivacaine (group B and surgery started when anesthesia reached T6. Heart rate and blood pressure were assessed before the test dose and at five minute intervals for initial 30mins and then every 10mins until the full recovery. At the same intervals, sensory and motor block characteristics were determined. Adverse events were recorded. Sixty patients were enrolled and data available for analysis was 30 ropivacaine and 30 bupivacaine. Mean duration for total sensory blockade was 323.50±39.33mins for R group as compared to 312.0 ± 30.36mins for B group (p>0.05 . Motor onset time in group R was 17.26 ± 1.78 , 25.44 ± 1.79 and 28.28 ± 1.79mins for grade 1, 2 and 3 motor block respectively, compared to 16.73 ± 1.99 , 25.14 ± 2.05 and 28.66 ± 2.82mins for group B (p>0.05 . Duration of motor block in group R was 211.66 ± 32.91mins as compared to 288.66 ± 36.99mins in group B . (P value < 0.0001 . Analgesia was excellent in 83.33% cases and satisfactory in 10 % cases in group R as compared to 86.66% and 3.33% in group B respectively. 6.66% patients in group R and 10% patients in group B required intravenous fentanyl supplement and were

  14. Comparison between absorbable and nonabsorbable sutures in arterial anastomoses in growing dogs.

    Gersak, B

    1991-01-01

    Five dogs, 10 weeks old, underwent operation using ketamin-HCl anesthesia and end-to-end anastomoses of the femoral and brachial arteries were made using polyfilament nonabsorbable material (Ethibond), monofilament nonabsorbable material (Prolene), polyfilament absorbable material (Vicryl) and monofilament absorbable material (PDS). The arterial diameter using a micrometer and blood flow using an electromagnetic flow meter were determined. After six months another operation was performed and diameter and blood flow were measured again. No statistically significant differences were found between the different materials used with respect to growth related increases either in arterial diameter or blood flow.

  15. Comparison of dexmedetomidine and clonidine as an adjuvant to ropivacaine for epidural anesthesia in lower abdominal and lower limb surgeries

    Sruthi Arunkumar

    2015-01-01

    Full Text Available Background: The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Though, the effects of clonidine on local anesthetics have been extensively studied, there are limited studies demonstrating the effects of epidural dexmedetomidine on local anesthetics. The aim of our study is to compare the effect of clonidine and dexmedetomidine when used as an adjuvant to epidural ropivacaine in lower abdominal and lower limb surgeries. Materials and Methods: Patients were randomized into two groups-group ropivacaine with clonidine (RC received 15 ml of 0.75% ropivacaine with 1 μg/kg clonidine and group ropivacaine with dexmedetomidine (RD received 15 ml of 0.75% ropivacaine with 1 μg/kg dexmedetomidine epidurally. Onset of sensory analgesia using cold swab, onset of motor blockade using Bromage scale, time to 2 dermatome regression of sensory level, time to first demand for analgesia, sedation using Ramsay sedation scale, intra operative hemodynamic parameters and complications were assessed. Results: The onset (RD-8.53 ± 1.81, RC-11.93 ± 1.96 and duration of sensory blockade (RD-316 ± 31.5, RC-281 ± 37, sedation were found to be significantly better in the dexmedetomidine group. No significant difference was found in terms of onset of motor blockade and hemodynamic changes. Conclusion: Dexmedetomidine at doses of 1 μg/kg is an effective adjuvant to ropivacaine for epidural anesthesia, which is comparable to clonidine.

  16. Physicians' Abdominal Auscultation

    John, Gade; Peter, Kruse; Andersen, Ole Trier

    1998-01-01

    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...

  17. Altered Daytime Fluctuation Pattern of Plasminogen Activator Inhibitor 1 in Type 2 Diabetes Patients with Coronary Artery Disease: A Strong Association with Persistently Elevated Plasma Insulin, Increased Insulin Resistance, and Abdominal Obesity

    Katarina Lalić

    2015-01-01

    Full Text Available This study was aimed at investigating daily fluctuation of PAI-1 levels in relation to insulin resistance (IR and daily profile of plasma insulin and glucose levels in 26 type 2 diabetic (T2D patients with coronary artery disease (CAD (group A, 10 T2D patients without CAD (group B, 12 nondiabetics with CAD (group C, and 12 healthy controls (group D. The percentage of PAI-1 decrease was lower in group A versus group B (4.4 ± 2.7 versus 35.0 ± 5.4%; P<0.05 and in C versus D (14.0 ± 5.8 versus 44.7 ± 3.1%; P<0.001. HOMA-IR was higher in group A versus group B (P<0.05 and in C versus D (P<0.01. Simultaneously, AUCs of PAI-1 and insulin were higher in group A versus group B (P<0.05 and in C versus D (P<0.01, while AUC of glucose did not differ between groups. In multiple regression analysis waist-to-hip ratio and AUC of insulin were independent determinants of decrease in PAI-1. The altered diurnal fluctuation of PAI-1, especially in T2D with CAD, might be strongly influenced by a prolonged exposure to hyperinsulinemia in the settings of increased IR and abdominal obesity, facilitating altogether an accelerated atherosclerosis.

  18. Bilateral internal carotid artery occlusion. Comparison among MRI, hemodynamics and clinical feature

    Yamamoto, Yasumasa; Tsuda, Harumi; Nabatame, Hidehiko; Akiguchi, Ichiro; Kameyama, Masakuni

    1987-10-01

    Four cases of bilateral internal carotid occlusion are reported with respect to clinical features, hemodynamics and various image diagnosis. MRI is applied to three cases. The patients comprised 2.08 % of all cerebral occlusive diseases treated during the past five years at our clinic. One case is of abrupt onset and three cases are progressing profiles. In one of these cases, collateral circulation is supplied mainly by leptomeningeal anastomosis of the posterior cerebral artery and posterior pericallosal artery branching from the basilar artery. In two of them, they are supplied through the circle of Willis. Middle cerebral artery occlusion, occlusion supra occlusionem, however, causes decisive ischemic lesion in its teritory. Applying MRI, complicated ischemic lesions, such as lacunar infarction, paraventricular lesion, deep white matter lesion and border zone infarction can clearly be identified. In the case of total aphasia, the lesions responsible are demonstrated clearly by MRI, but only vaguely by X-ray CT.

  19. Delivery efficiency of periadventitial approach in comparison of intravascular delivery: an assessment of pharmacokinetics in porcine arteries

    Yong-hua Xu; Gordon McLennan

    2005-01-01

    Objective To investigate the delivery efficacy of periadventitial delivery of 125I-iododeoxyuridine (125I-IUdR) in comparison of intravascular delivery to determine the optimal delivery method for inhibiting post-angioplasty restenosis. Methods In 8 pigs, one side carotid, subclavian and iliac arteries of each pig were injured by balloon angioplasty with a 20% overstretches. Then, 4 mCi of 125I-IUdR was delivered at each targeted vessel with periadventitial method in 4 pigs (periadventitial group) and with intravascular method via a porous balloon catheter in other 4 pigs (intravascular group). The animals survived for 5 hours and the blood radioactivity was investigated prior to and hourly after procedure until sacrifice. The targeted vessels and renal arteries (for control) were harvested for gamma-counting and histological observation. Meanwhile, the radioactivity in thyroid, liver, bladder, small bowel and each kidney also were measured to determine the biodistribution of 125I. The activities of 125I presented in arterial and tissue specimens were compared between the two delivery groups. The targeted arteries were histologically observed and the ratio of intima to media (I∶M ratio) was calculated. Results The target arterial walls in the periadventitial group had 3.4 times as much of 125I radioactivity as in the intravascular group, respectively (P=0.038); the blood activity in intravascular group was significantly higher than periadventitial group immediate after procedure (P0.05). The mean I: M ratios in both groups were 0.05 without additional injury at the vessel wall. Conclusion The periadventitial delivery offered substantial advantage over intravascular approach with high local delivery efficacy. The apparent redistribution rate is more rapid following intravascular delivery.

  20. Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization Aneurisma de artéria hepática: diagnóstico incidental com ultrassonografia do abdome e tratamento por embolização com molas

    Luis Jesuino de Oliveira Andrade; Antonio Carlos Botelho da Silva; Larissa Santos França; Luciana Santos França; José Rebouças de Souza

    2012-01-01

    Hepatic artery aneurysm (HAA) was first reported at autopsy in 1809, represents one fifth of visceral aneurysms and the mortality from spontaneous rupture is high in most of cases. We are reporting a case of an asymptomatic 48-year-old woman with an extrahepatic HAA, diagnosed initially and incidentally with abdominal ultrasonography, confirmed by a three-dimensional contrast-enhanced magnetic resonance imaging and angiography. Endovascular treatment was considered feasible and was successful...

  1. Comparison of how well conscious cats tolerate blood pressure measurement from the radial and coccygeal arteries.

    Cannon, Martha J; Brett, Jo

    2012-12-01

    Hypertension is a common condition of older cats and acquiring clinically relevant and repeatable blood pressure (BP) measurements in conscious cats is important in its diagnosis and management. The most common sites for indirect BP measurement in the cat are the radial artery (RA) and the coccygeal artery (CA) but, to date, there are no published data comparing how conscious cats tolerate BP measurements from these sites. A high-definition oscillometric BP monitor was used to measure BP in 30 cats admitted to a cat-only veterinary clinic for reasons other than hypertension. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were measured using the RA and CA, alternating which site was used first. The number of failed attempts and total time to achieve six measurements was recorded. Measurement of BP using the CA was better tolerated than the RA, resulting in fewer failures and shorter total time required. SAP measurements were slightly higher from the CA compared with the RA, irrespective of which site was used first. There were no significant differences in MAP and DAP. The coccygeal artery appears to be the more appropriate site to use when measuring BP in conscious cats using this oscillometric machine. Further studies are required using alternative BP monitors, including Doppler machines, to establish whether this is a consistent finding. When measuring BP in cats the site used should be recorded and the same site used for all subsequent measurements from the same cat.

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

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

    2012-01-01

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

  3. UTILIDAD DEL PERÍMETRO ABDOMINAL COMO MÉTODO DE CRIBAJE DEL SÍNDROME METABÓLICO EN LAS PERSONAS CON HIPERTENSIÓN ARTERIAL

    Roberto Genique Martínez

    2010-01-01

    Full Text Available Fundamento: Para el diagnóstico de Síndrome Metabólico (SM los criterios mas utilizados son los propuestos, por el ATP-III del NCEP de 2001, actualizados posteriormente en 2005. El perímetro de cintura es uno de los cinco criterios utilizados para su diagnóstico. Dada la elevada incidencia ajustada de enfermedad coronaria atribuible a este factor de riesgo, el objetivo de este trabajo es valorar la utilidad del perímetro de cintura como método de cribaje único de SM en la población con otros factores de riesgo muy prevalentes, como la HTA. Método: Estudio de casos (pacientes hipertensos con SM y controles (pacientes hipertensos sin SM. Mediante muestreo sistemático de la totalidad de individuos hipertensos de un cupo de Atención Primaria con resultados de al menos una analítica sanguínea desde el 1/07/2007 hasta 31/12/2007. El tamaño muestral fue de 137 individuos (casos = pacientes hipertensos con SM = 60 y controles = pacientes hipertensos sin SM=77. Se utilizó el test de regresión logística para el cálculo de la probabilidad de SM disponiendo únicamente del perímetro abdominal. Resultados: Los resultados para el objetivo principal fueron: Probabilidad de SM en población hipertensa=1/(1+2,718281828-(-10+ (perímetro x 0,097, Probabilidad de SM en mujeres hipertensas=1/ (1+2,718281828-(-10+ (perímetro x 0,099, Probabilidad de SM en varones hipertensos=1/(1+2,718281828-(-10+ (perímetro x 0,105. Conclusiones: Utilizando una calculadora podría predecirse la probabilidad de SM en personas hipertensas con el perímetro de cintura como única variable, priorizando mejor a los pacientes con más necesidad preventiva y mayor riesgo cardiovascular. Se propone una tabla con los cálculos ya realizados.

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

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

    2015-10-15

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

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

    Jasleen Kaur

    2014-01-01

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

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

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

    2016-01-01

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

  7. Marital Discord and Coronary Artery Disease: A Comparison of Behaviorally Defined Discrete Groups

    Smith, Timothy W.; Uchino, Bert N.; Berg, Cynthia A.; Florsheim, Paul

    2012-01-01

    Objective: Marital difficulties can confer risk of coronary heart disease, as in a study of outwardly healthy couples (T. W. Smith et al., 2011) where behavioral ratings of low affiliation and high control during marital disagreements were associated with asymptomatic coronary artery disease (CAD). However, taxometric studies suggest that marital…

  8. Comparison of noninvasive blood pressure measurement techniques via the coccygeal artery in anesthetized cheetahs (Acinonyx jubatus).

    Sadler, Ryan A; Hall, Natalie H; Kass, Philip H; Citino, Scott B

    2013-12-01

    Two indirect blood pressure measurement techniques, Doppler (DOP) sphygmomanometry and oscillometry, applied at the ventral coccygeal artery were compared with simultaneous direct blood pressure measurements at the dorsal pedal artery in 10 anesthetized, captive cheetahs (Acinonyx jubatus). The DOP method was moderately accurate, with relatively little bias (mean difference 3.8 mmHg) and 88.6% of the DOP systolic arterial pressure measurements being within 10 mmHg of the direct systolic arterial measurement. With the oscillometric (OM) method, 89.2% of the mean arterial pressure measurements were within 10 mmHg of the direct measurement and had the least bias (mean difference 2.3 mmHg), 80.7% of the systolic measurements were within 10 mmHg of the direct measurement and had the second least bias (mean difference 2.3 mmHg), and 59% of the diastolic measurements were within 10 mmHg of the direct measurement and had significant bias (mean difference 7.3 mmHg). However, DOP showed relatively poor precision (SD 11.2 mmHg) compared with OM systolic (SD 8.0 mmHg), diastolic (SD 8.6 mmHg), and mean (SD 5.7 mmHg). Both techniques showed a linear relationship with the direct technique measurements over a wide range of blood pressures. The DOP method tended to underestimate systolic measurements below 160 mmHg and overestimate systolic measurements above 160 mmHg. The OM method tended to underestimate mean pressures below 160 mm Hg, overestimate mean pressures above 160 mmHg, underestimate systolic pressures below 170 mmHg, overestimate systolic pressures above 170 mmHg, and underestimate diastolic pressures throughout the measured blood pressure range. Indirect blood pressure measurement using the ventral coccygeal artery, particularly when using an OM device for mean and systolic arterial pressure, may be useful in the clinical assessment of cheetahs when monitoring trends over time, but caution should be taken when interpreting individual values.

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

    Alireza Mahoori

    2013-08-01

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

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

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

    2015-11-15

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

  11. Management of Abdominal Wounds in Thermally Injured Patients

    1982-01-01

    Acute inflammatory disease 5 Superior mesenteric artery syndrome 4 Biliary tract disease 4 surface in the patients with abdominal burns, and only...ity of these critically ill patients were equally affected by polypropylene was used for fascial closure, the wound ileus , sepsis, abdominal distention

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

    C S Horjus Talabur Horje

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

  13. Ramos colaterais parietais e terminais da aorta abdominal em Myocastor coypus (nutria Terminal and parietal colateral branches of the abdominal aorta in Myocastor coypus (nutria

    Paulete de Oliveira Vargas Culau

    2008-08-01

    Full Text Available Neste estudo, utilizaram-se 30 nutrias, 15 fêmeas e 15 machos, com o sistema arterial aórtico-abdominal preenchido com látex 603, pigmentado em vermelho, e fixado em uma solução aquosa de formaldeído a 20%. A aorta abdominal emitiu de sua superfície dorsal de 6 a 8 artérias lombares únicas. Das artérias renais, direita e esquerda, originaram-se as artérias frênico-abdominal para irrigar parte do diafragma e da parede abdominal lateral cranial. A aorta abdominal lançou dorsalmente, a artéria sacral mediana, cranialmente a sua bifurcação em artérias ilíacas comuns. As artérias ilíacas comuns, ramos terminais da aorta abdominal, originaram as artérias ilíacas interna e externa. A artéria ilíaca interna distribuiu-se nas vísceras da cavidade pélvica. A artéria ilíaca externa emitiu uma artéria umbilical e, antes de alcançar o anel femoral, lançou a artéria circunflexa ilíaca profunda para a parede abdominal lateral, em seus dois terços caudais. A artéria ilíaca externa lançou o tronco pudendo-epigástrico, que originou a artéria epigástrica caudal, para a parede abdominal ventral e a artéria pudenda externa, que saiu pelo canal inguinal, para irrigar a genitália externa. Os ramos parietais diretos da aorta abdominal foram as artérias lombares e a artéria sacral mediana, enquanto as artérias frênico-abdominal, circunflexa ilíaca profunda e epigástrica caudal, foram ramos colaterais parietais indiretos. Os ramos terminais da artéria aorta abdominal foram as artérias ilíacas comuns com seus ramos, as artérias ilíacas interna e externa.For this study it was used 30 nutria, 15 females and 15 males, with its abdominal aorta system full filled with latex 603, stained in red, and fixed in an aqueous solution of formaldehyde 20%. The abdominal aorta emitted from its dorsal surface 6 to 8 single lumbar arteries. From the renal arteries, left and right, it has been originated the phrenicoabdominal arteries

  14. A comparison of blood gases and acid-base measurements in arterial, arterialized venous, and venous blood during short-term maximal exercise.

    Linderman, J; Fahey, T D; Lauten, G; Brooker, A S; Bird, D; Dolinar, B; Musselman, J; Lewis, S; Kirk, L

    1990-01-01

    The purpose of this study was to determine the relationship between blood gases and acid-base measurements in arterial, arterialized venous, and venous blood measured simultaneously during short-term maximal exercise. Ten well-trained male cyclists performed a graded maximal exercise test on a cycle ergometer to determine the power output corresponding to their peak oxygen consumption (test I), and a short-term maximal test on a cycle ergometer at peak power output (test II). During test II arterial, arterialized venous and venous blood were sampled simultaneously for determination of partial pressures of oxygen and carbon dioxide, pH, bicarbonate (HCO3-), base excess (BE), and lactate (La). Samples were taken at rest, the end of 1 min of exercise (1 ME), at the end of exercise (EE), and at 2 min of recovery (REC). During test II, subjects maintained a peak power output of 370.6 (62.1) W [mean (SD)] for 4.5, SD 1.6 min. Except at rest venous and arterialized venous measurements tended to be the same at all sampling intervals, but differed significantly from measurements in arterial blood (P less than 0.05). BE was the only variable that rendered consistently significant correlations between arterial and arterialized venous blood at each sampling interval. The pooled correlation coefficient between arterial and arterialized venous BE was r = 0.83 [regression equation: BEa = (0.84 BEav)-0.51]. Arterial La was significantly higher than venous La at 1 ME (2.8, 0.7 vs 0.8, 0.3 mmol.l-1) and higher than both venous and arterialized venous La at EE.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. 急性腹主动脉闭塞合并双肾动脉闭塞1例临床分析%Clinical Analysis on One Case of Acute Occlusion of the Abdominal Aorta with Concomitant Bilateral Renal Artery Occlusion

    刘同库; 汪建中; 盖越

    2014-01-01

    目的:探讨急性腹主动脉闭塞合并双肾动脉闭塞的病因与抢救措施。方法对突然出现腰腹痛和双下肢疼痛伴麻木4h的患者行腹主动脉造影,造影证实该患者为腹主动脉合并双肾动脉完全闭塞,行介入治疗和清栓术治疗。结果清除部分血栓,患者恢复血流5 min后发生高血钾,引发心脏骤停死亡。结论急性腹主动脉闭塞合并双肾动脉闭塞死亡率高,主要死因是心脏毒性物质的吸收、高血钾、酸中毒、肾衰竭致心脏骤停,抢救成功的关键是尽早开通患者闭塞血管。%Objective To investigate the cause and rescue measures of the acute abdominal aorta occlusion with bilateral renal artery occlusion. Method The patient suffered suddenly from lumbar and abdominal pain and the lower limbs pain with numbness lasting for 4 hours,and was confirmed to be the acute occlusion of the abdominal aorta and bilateral renal artery by abdominal aorta angiography. The patient was treated by interventional therapy. Results The part of blood clots were removed from the abdominal aorta lesions. The blood flow was restored after 5 mins, the patient died of hyperkalemia and cardiac arrest. Conclusion The mortality rate of the acute abdominal aorta occlusion with bilateral renal artery occlusion is very high. The main cause of death is the cardiac arrest caused by the absorption of toxic substances, hyperkalemia, acidosis and renal failure. It is the key of successful rescue to open the occluded blood vessels as soon as possible.

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

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

    2010-01-01

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

  17. A comparison of pulmonary arterial occlusion algorithms for estimation of pulmonary capillary pressure.

    Pellett, A A; Johnson, R W; Morrison, G G; Champagne, M S; deBoisblanc, B P; Levitzky, M G

    1999-07-01

    Using the arterial occlusion method, we compared five literature-based estimates of pulmonary capillary pressure (Ppc) with the corresponding double occlusion pressures (Pdo) in anesthetized dogs whose chests had been closed after sternotomy for instrumentation. Arterial occlusions were performed with a balloon-tipped pulmonary artery catheter that housed pressure transducers immediately proximal and distal to the balloon. Separation of the proximal and distal pressure waveforms during balloon inflation allowed us to precisely define the moment of occlusion. We fit a monoexponential curve to pressure data beginning 200 ms after the onset of occlusion and a biexponential curve to data beginning at the instant of occlusion, with data obtained over a range of vascular states (control, serotonin infusion, histamine infusion). In addition, we investigated the use of sampling of the raw data to estimate capillary pressure. Three of the five literature-based estimates of Ppc yielded values similar to Pdo. The optimal (least average difference from Pdo) interpolation/extrapolation time points of the curve fits varied, depending on the type of curve fitting and the state of the pulmonary vasculature. We also determined that a close approximation of Pdo may be derived from the raw data, as an alternative to exponential curve fitting.

  18. Isolated superior mesenteric artery dissection

    Lalitha Palle

    2010-01-01

    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

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

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

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (PPregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy.

  20. COMPARISON OF EPIDURAL BUPIVACAINE; FENTANYL AND THEIR COMBINATION FOR POSTOPERATIVE ANALGESIA IN LOWER ABDOMINAL AND LOWER EXTREMITY SURGERY: A PROSPECTIVE, RANDOMIZED, DOUBLE BLIND CONTROLLED TRIAL

    Purba

    2016-03-01

    Full Text Available BACKGROUND Epidural analgesia with local anaesthetics and opioids provide good control of postoperative pain in lower abdominal and lower extremity surgery. AIM To evaluate and compare the analgesic action and adverse effects of epidural bupivacaine, fentanyl and their combination in postoperative period. METHODS 75 patients undergoing elective infraumbilical surgery were allocated in three groups in a randomized double blinded fashion. Postoperative analgesia was maintained with continuous infusion of epidural drug in the following manner: Group B: Injection Bupivacaine 0.125% @ 0.1mL/kg/hr through epidural route; Group F: Injection Fentanyl 4µg/mL @ 0.1mL/kg/hr through epidural route; Group BF: Injection Bupivacaine 0.0625% and Fentanyl 2µ/mL @ 0.1mL/kg/hr through epidural route. RESULTS VAS score were almost similar in all three groups at 00, 04, 08hrs and not clinically significant at that point of time. VAS score showed significant difference at 12, 20 and 24 hrs, being persistently lower in Gr BF than Gr B and Gr F. According to VRS Scale Score at 04 hrs majority of patients of all three groups had mild-to-moderate pain (p=0.278. At 08 hrs, 24% (p=0.082, 12 hrs 60% (<0.001, 16 hrs 68% (<0.001, 20 hrs 88% (<0.001 and 24 hrs 84% (<0.001 of Gr BF patients were pain free which are clinically significant. At the end of 08, 12, 16, 20, 24 postoperative hours, no patients of any groups had residual motor paralysis. Rescue analgesic needed in Gr BF patients were significantly less than other two groups. CONCLUSION Combined bupivacaine and fentanyl infusion through an epidural route provides better analgesia in comparison to bupivacaine and fentanyl alone. Total drug, rescue analgesic requirement and adverse effects are much lower in combined group.

  1. Comparison of dobutamine and exercise using technetium-99m sestamibi imaging for the evaluation of coronary artery disease.

    Herman, S D; LaBresh, K A; Santos-Ocampo, C D; Garber, C E; Barbour, M M; Messinger, D E; Cloutier, D J; Ahlberg, A W; Heller, G V

    1994-01-15

    Studies using dobutamine thallium-201 myocardial perfusion imaging have suggested a high sensitivity and specificity for the detection of coronary artery disease. However, few data are available comparing dobutamine with exercise stress for the detection and localization of perfusion defects. This study compared the effects of dobutamine and exercise stress using technetium-99m sestamibi single-photon emission computed tomographic imaging in the same patients in a prospective crossover trial. Twenty-four patients with a high likelihood of coronary artery disease underwent tomographic myocardial imaging at rest, after symptom-limited treadmill exercise, and after intravenous dobutamine (maximum 30 micrograms/kg/min). Tomograms of the left ventricle were divided into 20 segments and were interpreted without knowledge of patient identity or stress protocol. Dobutamine was well tolerated by all patients. Segment-by-segment concordance between exercise and dobutamine images was highly significant (kappa = 0.56, p < 0.0001). Global first-order agreement (normal vs abnormal) between exercise and dobutamine studies was 96% (kappa = 0.65, p = 0.02); global second-order agreement (normal vs fixed vs ischemic defect) was 88% (kappa = 0.45, p = 0.02). Regional first- and second-order agreement were 96 and 93%, respectively (p < 0.001 for both). Twenty patients underwent coronary angiography. Comparisons between exercise and angiography and between dobutamine and angiography were similar for both global agreement (95 vs 100%, p = NS) and regional agreement (77 vs 72%, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Diagnostic accuracy of ultrasonography in detection of blunt abdominal trauma and comparison of early and late ultrasonography 24 hours after trauma

    Feyzi, Ali; Rad, Masoud Pezeshki; Ahanchi, Navid; Firoozabadi, Jalil

    2015-01-01

    Objective: Despite the advantages of ultrasound scan, its use as a screening tool in blunt abdominal trauma is controversial. The aim of this study was to evaluate the diagnostic value of early and late ultrasound in patients with blunt abdominal trauma (BAT). Methods: In this study which was performed in a level I trauma center, firstly, 2418 patients with BAT had ultrasound (US) examination by two trauma expert radiologists. Results were compared with the best available gold standards such ...

  3. Comparison of partial volume effects in arterial and venous contrast curves in CT brain perfusion imaging.

    Alan J Riordan

    Full Text Available PURPOSE: In brain CT perfusion (CTP, the arterial contrast bolus is scaled to have the same area under the curve (AUC as the venous outflow to correct for partial volume effects (PVE. This scaling is based on the assumption that large veins are unaffected by PVE. Measurement of the internal carotid artery (ICA, usually unaffected by PVE due to its large diameter, may avoid the need for partial volume correction. The aims of this work are to examine i the assumptions behind PVE correction and ii the potential of selecting the ICA obviating correction for PVE. METHODS: The AUC of the ICA and sagittal sinus were measured in CTP datasets from 52 patients. The AUCs were determined by i using commercial CTP software based on a Gaussian curve-fitting to the time attenuation curve, and ii by simple integration of the time attenuation curve over a time interval. In addition, frames acquired up to 3 minutes after first bolus passage were used to examine the ratio of arterial and venous enhancement. The impact of selecting the ICA without PVE correction was illustrated by reporting cerebral blood volume (CBV measurements. RESULTS: In 49 of 52 patients, the AUC of the ICA was significantly larger than that of the sagittal sinus (p = 0.017. Measured after the first pass bolus, contrast enhancement remained 50% higher in the ICA just after the first pass bolus, and 30% higher 3 minutes later. CBV measurements were significantly lowered when the ICA was used without PVE correction. CONCLUSIONS: Contradicting the assumptions underlying PVE correction, contrast in the ICA was significantly higher than in the sagittal sinus, even 3 minutes after the first pass of the contrast bolus. PVE correction might lead to overestimation of CBV if the CBV is calculated using the AUC of the time attenuation curves.

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

    Samaneh Kouzehgaran

    2015-07-01

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

  5. Cardiac Organ Damage and Arterial Stiffness in Autonomic Failure: Comparison With Essential Hypertension.

    Milazzo, Valeria; Maule, Simona; Di Stefano, Cristina; Tosello, Francesco; Totaro, Silvia; Veglio, Franco; Milan, Alberto

    2015-12-01

    Autonomic failure (AF) is characterized by orthostatic hypotension, supine hypertension, and increased blood pressure (BP) variability. AF patients develop cardiac organ damage, similarly to essential hypertension (EH), and have higher arterial stiffness than healthy controls. Determinants of cardiovascular organ damage in AF are not well known: both BP variability and mean BP values may be involved. The aim of the study was to evaluate cardiac organ damage, arterial stiffness, and central hemodynamics in AF, compared with EH subjects with similar 24-hour BP and a group of healthy controls, and to evaluate determinants of target organ damage in patients with AF. Twenty-seven patients with primary AF were studied (mean age, 65.7±11.2 years) using transthoracic echocardiography, carotid-femoral pulse wave velocity, central hemodynamics, and 24-hour ambulatory BP monitoring. They were compared with 27 EH subjects matched for age, sex, and 24-hour mean BP and with 27 healthy controls. AF and EH had similar left ventricular mass (101.6±33.3 versus 97.7±28.1 g/m(2), P=0.59) and carotid-femoral pulse wave velocity (9.3±1.8 versus 9.2±3.0 m/s, P=0.93); both parameters were significantly lower in healthy controls (Phypertensive heart disease and increased arterial stiffness, similar to EH with comparable mean BP values. Twenty-four-hour and nighttime systolic BP were determinants of cardiovascular damage, independent of BP variability.

  6. [Traumatic and iatrogenic lesions of abdominal vessels].

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H

    1997-01-01

    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  7. Temperature measurement in pediatrics: a comparison of the rectal method versus the temporal artery method.

    Bahorski, Jessica; Repasky, Terri; Ranner, Donna; Fields, Ally; Jackson, Michelle; Moultry, Lucy; Pierce, Karen; Sandell, Mary

    2012-06-01

    The purpose of this study was to determine if there is a difference between temperature readings obtained using two different electronic temperature devices: one measuring temporal artery temperature (TAT) and one measuring rectal temperature (RT). A comparative single-group design was used with each participant acting as his or her control. The sample consisted of 47 pediatric patients between 3 and 36 months of age. Data analysis revealed no statistically significant differences between TAT and RT; however, concerns related to statistical significance versus clinical significance are discussed.

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

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

    2002-01-01

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

  9. Comparison of the renal hyperemic effects of papaverine and dopamine in patients with renal artery stenosis.

    Protasiewicz, Marcin; Początek, Karol; Poręba, Rafał; Derkacz, Arkadiusz; Podgórski, Maciej; Gosławska, Katarzyna; Szymańska-Chabowska, Anna; Mazur, Grzegorz; Mysiak, Andrzej; Witkowski, Adam

    2015-01-01

    The purpose of this study was to assess the hyperemic effects of papaverine and dopamine in the renal microcirculation of hypertensive patients with renal artery stenosis (RAS). Although a poor correlation between angiographic lesion assessment and its hemodynamic significance is known, angiography is a major criterion for the decision of renal artery stenting. Assessment of the hyperemic translesional pressure gradient was recently shown to be conducive in identifying patients who may benefit from renal revascularization. The study included 14 patients (mean age, 66 ± 11.2 years) with resistant hypertension and moderate RAS. Using a pressure-sensing catheter, systolic, diastolic, and mean translesional pressure gradients, and the distal pressure (Pd):aortic pressure (Pa) ratio (Pd/Pa) were analyzed at baseline and after administration of 40 mg papaverine and 50 μg/kg dopamine. We did not observe significant changes in DG. Dopamine administration resulted in significant changes in systolic and mean translesional pressure gradients and Pd/Pa when compared with baseline (P dopamine or papaverine bolus administration.This study indicates that, compared with papaverine, the intrarenal bolus of dopamine in hypertensive patients with RAS remains a more powerful hyperemic agent.

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

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

    2009-04-15

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

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

    Sören Johst

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

  12. Comparison of Sympathomimetics in the Correction of Arterial Hypotension during Combined Anesthesia

    D. B. Borisov

    2012-01-01

    Full Text Available Objective: to make a comparative assessment of hemodynamic parameters when correcting combined anesthesia-induced arterial hypotension with dopamine, adrenaline, mesatone, or noradrenaline. Subjects and methods. A prospective study enrolled patients who had undergone prosthetic hip replacement under combined lumbar epidural (ropivacaine/general (sevoflurane anesthesia. Intravenous sympathomimetic infusion was initiated when the mean blood pressure decreased below 55 Hg mm. Cardiac index (CI and systemic vascular resistance index (SVRI were calculated by impedance cardiography. Fifty-six subjects (14 in each group were selected for analysis. Results. During the study, CI remained in the normal range for all sympathomimetics. When adrenaline was administered, there was an obvious tendency to maintain blood pressure due to heart rate (HR with preserved low SVRI. The use of mesatone caused a considerable reduction in HR. No statistically significant differences were found between the dopamine and noradrenaline groups in any of the study stages. The start of infusion of these agents was attended by SVRI normalization and HR maintenance within 60—70 beats per minute. Conclusion. The infusion of dopamine, adrenaline, mesatone, or noradrenaline to correct arterial hypotension resulting from combined epidural block/general anesthesia with sevoflurane ensures maintenance of CI within the normal range. That of noradrenaline and dopamine was ascertained to have a more balanced impact on HR and systemic vascular resistance. Key words: combined anesthesia, epidural block, hemodynamics, sympathomimetics, adrenaline, dopamine, mesatone, noradrenaline.

  13. Ranking of magnetic resonance tomography of the infrarenal abdominal aorta aneurysms. Comparison with sonography, computed tomography, and angiography. Stellenwert der Kernspintomographie in der Diagnostik der infrarenalen Bauchaortenaneurysmen. Vergleich mit Sonographie, Computertomographie und Angiographie

    Rieber, A.; Wrazidlo, W.; Brambs, H.J. (Heidelberg Univ. (Germany, F.R.). Radiologische Klinik); Allenberg, J.R. (Heidelberg Univ. (Germany, F.R.). Chirurgische Universitaetsklinik)

    15 patients with asymptomatic abdominal aortic aneurysms were evaluated with magnetic resonance imaging. The results were compared to the sonographic findings in 12, the computed tomographic in 14 and the angiographic findings in 14 cases. 14 patients were operated and the diagnostic results were verified. The advantage of MRI in comparison with the other diagnostic methods is the visualization of an infrarenal segment on the coronal images, which can be anastomized with the vascular prothesis. The evidence of this segment is important to know for the vascular surgeon to plan the operation technique. The disadvantage of MRI ist that thrombotic material and arterosclerotic plaques were bad or not visualized. We try to estimate, which importance the MRI will get in further times in the preoperative diagnosis of abdominal aortic aneurysms. (orig.).

  14. Comparison of application of transthoracic abdominal wall vein and peripheral vein indwelling needleplacement%经胸腹壁静脉与外周静脉置入留置针的应用比较

    魏彬彬; 靳亚斌; 陈燕玲

    2015-01-01

    Objective To investigate the in peripheral venous puncture difficulties,through the comparison of thoracic and abdominal wall vein puncture effect. Methods 80 cases of neonatal routinely using the peripheral vein group ( scalp vein,limbs vein indwelling needle ) set,chest and abdominal wall vein group ( thoraco abdominal wall vein indwelling needle ) implantation,compared two groups of vein one-time success rate, incidence of complications, indwelling time. Results The chest and abdominal wall vein puncture success rate and retention time was significantly better than that of peripheral vein group two (Note:one time puncture success rate comparison,χ2=9.038,P<0.01). Conclusion the thoracic and abdominal wall vein puncture success rate high,vascular retention time is long, the peripheral group venous retention time of (2+1)days,thoracic and abdominal group venous retention time was(2.5+1.5) days,vascular complications and low. Ensure NICU in neonatal venous channels unblocked,the various drugs and nutrition can timely input.%目的:比较外周静脉穿刺与经胸腹壁静脉穿刺的应用效果。方法将80例新生儿按常规采用外周静脉组(头皮静脉、四肢静脉等)置留置针,胸腹壁静脉组(胸腹壁静脉)置入留置针,比较2组的一次性成功率、留置时间、并发症发生率。结果胸腹壁静脉穿刺成功率及保留时间显著优于外周静脉组(P<0.01),并发症少于外周静脉组(P<0.01)。结论经胸腹壁静脉穿刺成功率高,血管保留时间长,并发症发生率低,保证了新生儿重症监护室(NICU)新生儿静脉通道的畅通,使各种药物及营养成分能及时输入。

  15. Comparison of Voltage Gated K(+) Currents in Arterial Myocytes with Heterologously Expressed K v Subunits.

    Cox, Robert H; Fromme, Samantha

    2016-12-01

    We have shown that three components contribute to functional voltage gated K(+) (K v) currents in rat small mesenteric artery myocytes: (1) Kv1.2 plus Kv1.5 with Kvβ1.2 subunits, (2) Kv2.1 probably associated with Kv9.3 subunits, and (3) Kv7.4 subunits. To confirm and address subunit stoichiometry of the first two, we have compared the biophysical properties of K v currents in small mesenteric artery myocytes with those of Kv subunits heterologously expressed in HEK293 cells using whole cell voltage clamp methods. Selective inhibitors of Kv1 (correolide, COR) and Kv2 (stromatoxin, ScTx) channels were used to separate these K v current components. Conductance-voltage and steady state inactivation data along with time constants of activation, inactivation, and deactivation of native K v components were generally well represented by those of Kv1.2-1.5-β1.2 and Kv2.1-9.3 channels. The slope of the steady state inactivation-voltage curve (availability slope) proved to be the most sensitive measure of accessory subunit presence. The availability slope curves exhibited a single peak for both native K v components. Availability slope curves for Kv1.2-1.5-β1.2 and Kv2.1-9.3 channels expressed in human embryonic kidney cells also exhibited a single peak that shifted to more depolarized voltages with increasing accessory to α subunit transfection ratio. Availability slope curves for SxTc-insensitive currents were similar to those of Kv1.2-1.5 expressed with Kvβ1.2 at a 1:5 molar ratio while curves for COR-insensitive currents closely resembled those of Kv2.1 expressed with Kv9.3 at a 1:1 molar ratio. These results support the suggested Kv subunit combinations in small mesenteric artery, and further suggest that Kv1 α and Kvβ1.2 but not Kv2.1 and Kv9.3 subunits are present in a saturated (4:4) stoichiometry.

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

    徐希奇

    2014-01-01

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

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

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

    2013-04-15

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

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

    Verma Yashwant

    2010-01-01

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

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

    Sandeep G Jakhere

    2011-01-01

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

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

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

    2015-06-15

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

  1. Comparison of short-term outcomes after carotid artery stenting according to different stent designs

    Açar, Göksel; Özkan, Birol; Alıcı, Gökhan; Yazıcıoglu, Mehmet Vefik; Bulut, Mustafa; Kalkan, Mehmet Emin; Demir, Serdar; Acar, Rezzan Deniz; Boztosun, Bilal

    2013-01-01

    Introduction In the developed countries, stroke is the third most common cause of death. There are many data indicating that stents reduce the risk of embolism but there are few publications assessing whether different stent designs can influence the periprocedural complications. Aim To determine the effects of open- and closed-cell stent designs on 1-month results of carotid artery stenting (CAS). Material and methods The study group consisted of 290 consecutive patients (216 men and 74 women, mean age 66.6 ±8.7 years). Neuroprotection with a distal protection device was used in all cases. The patients were divided into two groups: the open-cell stent group (n = 144) and the closed-cell stent group (n = 138). Major adverse cardiac and cerebrovascular events (MACCE) described as myocardial infarction, stroke and death within 1 month were recorded and analysed subsequently. Periprocedural hypotension and transient cerebral ischaemia at 1 month after the CAS procedure were also assessed. Results We treated 290 carotid stenoses and stents were implanted in all patients. Fifteen patients (5.5%) were treated by staged CAS due to bilateral carotid artery disease. The technical success rate was 97.2%. There was no difference in the MACCE and transient cerebral ischaemia rate at 1 month between the two groups (p = 0.44 and p = 0.94, respectively). The incidence of ischaemic stroke was lower in the closed-cell stent group (2.77% vs. 0%; p = 0.04). The periprocedural rate of hypotension was higher in the closed-cell stent group (2.1% vs. 7.2%; p = 0.04). Conclusions Closed-cell stents are associated with a low rate of ischaemic stroke. We think that closed-cell stents may be preferred in patients at high risk of embolism. PMID:24570703

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

    Yu Chen

    2014-01-01

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

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

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

    2012-09-15

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

  4. 5-HT1D receptor agonists and human coronary artery reactivity in vitro: crossover comparisons of 5-HT and sumatriptan with rizatriptan and L-741,519.

    Longmore, J; Boulanger, C M; Desta, B; Hill, R G; Schofield, W N; Taylor, A A

    1996-10-01

    1. Rizatriptan (MK-462, (N,N-dimethyl-2-[5-(1,2,4-triazol-1-ylmethyl)-1H-indol-3-yl] ethylamine)) and its structurally related analogue L-741,519 (N-methyl-4-[5-(1,2,4-triazol-4-yl)-1H-indol-3-yl]piperidine) are novel 5-HT1D-receptor agonists. Rizatriptan has shown efficacy as an anti-migraine agent in clinical trials. Since angiographic studies in patients have shown that sumatriptan (an established 5-HT1D-receptor agonist) can cause coronary artery vasoconstriction, we compared the effects of rizatriptan and L-741,519 with those of 5-HT and sumatriptan on endothelium-denuded segments of human coronary artery in vitro. 2. Coronary arteries were obtained from explanted hearts from patients undergoing cardiac transplantation (n = 16 viable arteries from 13 males, 3 females, aged 38-68 years) and arterial segments (5-6 mm in length) were mounted in organ baths for isometric tension recording. Each segment was first exposed to 45mM KCl and then to 5-HT (1 nM-100 microM). Concentration-effect curves to rizatriptan and sumatriptan (Study 1, n = 6 or 7 arteries) or sumatriptan and L-741,519 (Study 2, n = 8 arteries) were then performed in a consecutive and random manner. The response to repeated application of 5-HT was obtained in separate segments. 3. One artery showed severe atheroma and was not included in the analysis. ANOVA showed that 5-HT responsiveness varied significantly between arteries from different patients; but not between arterial segments from the same patient. Desensitization was seen consistently across all agonists but did not significantly affect inter-agonist comparisons. 4. There was graded effectiveness in the ability of the agonists to cause contraction with the rank order of Emax values being 5-HT > sumatriptan > L-741,519 > rizatriptan. In terms of EC50 values, L-741,519 was significantly more potent than sumatriptan. 5. The present study (using a 'cross-over' experimental protocol) confirms our previous observation that rizatriptan is less

  5. Abdominal radiation - discharge

    Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...

  6. Abdominal aortic aneurysm

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  7. Abdominal and Pelvic CT

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  8. Post trauma abdominal cocoon.

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

    2015-01-01

    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  9. Comparison of health-related quality of life after percutaneous coronary intervention and coronary artery bypass surgery

    Yazdani-Bakhsh, Razieh; Javanbakht, Mehdi; Sadeghi, Masoumeh; Mashayekhi, Atefeh; Ghaderi, Hossein; Rabiei, Katayoun

    2016-01-01

    BACKGROUND Health-related quality of life (HRQOL) evaluation is an important measure of the impact of the disease. As more people with coronary heart disease (CHD) live longer, doctors and researchers want to know how they manage in day to day life. It looked like adults with CHD had a decrease QOL. The aim of this study was to comparison of HRQOL of patients who underwent percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) and to assess its main determinants in the whole sample of coronary artery disease (CAD) patients. METHODS The study was carried out to estimate HRQOL of 109 patients who underwent invasive coronary revascularization [PCI (n = 75) and CABG (n = 34)]. We applied HRQOL after 6 months and 2 years in both groups and scores were compared. The HRQOL data were obtained using MacNew Heart Disease questionnaire with dimensions emotional, physical and social that estimated. Data entry and analysis were performed by SPSS. RESULTS A total MacNew scale in CABG and PCI group in 6 months after treatment were 45.32 ± 13.75 and 53.52 ± 15.63, respectively (P = 0.010). After 2 years HRQOL mean changed to 51.176 ± 14.80 and 49.55 ± 16.22, respectively, in CABG and PCI group (P = 0.428). Our results in within-group analysis showed total MacNew scale and its subscales were changed significantly after 2 years in CABG and PCI group’s scores were detected. We found in the whole sample of CAD patients those who had a higher level of income and education and were not either overweight or obese experienced better HRQOL. CONCLUSION Our results showed that patients who underwent PCI experienced significantly higher HRQOL in 6 months after revascularization but over 24 months follow-up no difference was observed between the two groups.

  10. Assessment of coronary artery lesions in children with Kawasaki disease: evaluation of MSCT in comparison with 2-D echocardiography

    Xing, Yanlin; Wang, Hong; Yu, Xianyi; Chen, Rui [Shengjing Hospital of China Medical University, Department of Pediatrics, Shenyang (China); Hou, Yang [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China)

    2009-11-15

    Transthoracic two-dimensional echocardiography is an effective method for detecting coronary arterial injury in Kawasaki disease. However, its accuracy in the diagnosis of coronary arterial lesions is limited. To investigate the value of multislice spiral CT for coronary angiography for observing the coronary arterial injury caused by infantile Kawasaki disease. Coronary angiography, using a 64-slice spiral CT scanner, and 2-D echocardiography were performed in 48 children with Kawasaki disease in whom the position, internal diameter, and length of each coronary artery were measured. MSCT showed coronary artery injury in 15 of the 48 children. Among these 15 children, 20 coronary artery branches showed complications, including the left coronary artery branches in 15 (31.2%) and the right coronary artery branches in 5 (10.4%). Complications in the left coronary artery branches included dilation in 12 (25.0%) and stenosis, calcification and the combination of the two in one each, and the right coronary artery branches showed dilation; two branches also showed beaded changes. MSCT also showed dilation in the left anterior descending arteries in two children. These children showed no abnormality on 2-D echocardiography. MSCT is a valuable examination method for detecting coronary artery injury in Kawasaki disease. (orig.)

  11. Comparison of coronary artery specific leukocyte-platelet conjugate formation in unstable versus stable angina pectoris.

    Patel, Parag B; Pfau, Steven E; Cleman, Michael W; Brennan, Joseph J; Howes, Christopher; Remetz, Michael; Cabin, Henry S; Setaro, John F; Rinder, Henry M

    2004-02-15

    This study evaluates transcoronary changes in neutrophil and platelet activation and conjugate formation in patients with angina pectoris secondary to coronary artery disease. We examined parameters of neutrophil and platelet activation as well as the neutrophil-platelet conjugate formation in patients who underwent diagnostic coronary angiography. Thirty-nine patients with chest pain referred for cardiac catheterization were studied (23 patients with unstable angina pectoris [UAP] and 16 with stable angina pectoris [SAP]). Before coronary angiography, blood samples were obtained simultaneously from the aortic root and coronary sinus to assess leukocyte (CD11b) and platelet (CD62P) activation and leukocyte-platelet conjugates. There was a 94% increase in CD62-expressing platelets from the aorta to the coronary sinus in patients with UAP compared with a 49% increase in patients with SAP. The percentage of neutrophil-platelet conjugates increased by 22% in patients with UAP compared with a 16% decrease in those with SAP (p <0.01). In contrast, monocyte-platelet binding across the coronary bed increased to a similar degree in both groups. This study demonstrates an increase in neutrophil-platelet conjugates across the coronary circulation in UAP, compatible with a higher activation state in both cell types.

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

    Higuchi Maria L.

    2002-01-01

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

  13. Resistive index(RI) of the intratesticular artery in orchitis: comparison with normal testis

    Yang, Dal Mo; Kim, Hyung Sik; Lee, Young Seok; Yoon, Myung Hwan; Lee, Jong Bouk; Yun, Jung Chul [Chung Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-12-15

    Color doppler ultrasound is ideally suited for diagnosing acute scrotal disease as it provides simultaneous display of tissue morphology and blood flow. This study was performed in order to evaluate the utility of resistive index(RI) of intratesticular arteries in orchitis. We retrospectively analyzed 18 testes of 15 patients confirmed by means of appropriate response to antibiotic treatment and 20 testes of 10 asymptomatic volunteers.The resistive indexes ranged from 0.25 to 0.60 (mean, 0.48) in orchitis, and from 0.50 to 0.71 (mean, 0.62) in volunteers. Thus, the resistive index in orchitis is significantly lower than that of the volunteers (p<0.05).With a cut-off point of resistive index at 0.6, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 94%, 90%, 89%, 95% and 92%m respectively. We conclude that decreased resistive index is a helpful finding in the diagnosis of orchitis, and we suggest the resistive index of 0.6 as a cut-off point

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

    A. A. Anderzhanova

    2016-01-01

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

  15. A Prospective Comparison of Duplex Ultrasonography, Captopril Renography, MRA, and CTA in Assessing Renal Artery Stenosis

    Ekloef, H.; Ahlstroem, H.; Magnusson, A.; Andersson, L.G.; Andren, B.; Haegg, A.; Bergqvist, D.; Nyman, R. [Uppsala Univ. Hospital (Sweden). Depts. of Radiology, Clinical Physiology, Medicine, and Surgery

    2006-10-15

    Purpose: To prospectively compare the diagnostic accuracy of duplex ultrasonography, captopril renography, computed tomography angiography (CTA), and 3D Gd magnetic resonance angiography (MRA) in diagnosing hemodynamically significant renal artery stenosis (RAS). Material and Methods: The standard of reference was measurement of transstenotic pressure gradient. Fifty-eight hypertensive patients with suspicion of RAS were evaluated, when possible, by all five techniques. Sensitivity and specificity to detect RAS were compared for each technique on both a patient and kidney basis. Discrepancies were evaluated separately and classified as borderline, method dependent, or operator dependent. Results: The prevalence of RAS was 77%. The sensitivity/specificity of ultrasonography, captopril renography, CTA, and MRA in detecting kidneys with RAS was 73/71%, 52/63%, 94/62%, and 93/91%, respectively. Ultrasonography had a significantly lower sensitivity than CTA and MRA (P <0.001) but higher than captopril renography (P = 0.013). Borderline RAS was the main cause for discrepancies. Conclusion: MRA and CTA were significantly better than duplex ultrasonography and captopril renography in detecting hemodynamically significant RAS. The ultrasonography criteria for RAS based on the evaluation of renal peak systolic velocity and renal/aortic ratio are questionable. Captopril renography cannot be recommended for assessing RAS.

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

    Baerlocher, M.O.; Asch, M.R.; Hayeems, E.Z.; Rajan, D.K. [Univ. of Toronto, Radiology Residency Training Program, Toronto, Ontario (Canada)]. E-mail: mark.baerlocher@utoronto.ca

    2006-04-15

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

  17. A Rare Cause of Abdominal Pain; Celiac Truncus Aneurysm

    Zulfu Birkan

    2016-01-01

    In this case we presented a patient who were admitted to surgery department with complaints of abdominal pain and nausea. There were no pathological findings on physical examination, direct abdominal x-ray, chest radiograph and biochemical parameters. At proximal of the celiac trunk, it was shown approximately 3x2 cm in size fusiform aneurysmal dilatation on the patient%u2019s abdominal ultrasonography and turbulence, arterial flow on the patient%u2019s abdominal doppler ultrasonography subsequently. In abdominal computed tomography we detected dense calcifications, dilatation and hypodensities that may belong to a thrombus in the lumen superior mesenteric vein (SMV. At the same time, approximately 3.5 cm segment of trunk celiak we observed aneurysm dilatation which reaching 2 cm at the widest point. Celiac trunk aneurysm is a rare cause of abdominal pain and often noticed after the complicated, thus it must always be kept in mind in the differential diagnosis.

  18. Comparação entre os tratamentos aberto e endovascular dos aneurismas da aorta abdominal em pacientes de alto risco cirúrgico Comparison between open and endovascular treatment of abdominal aortic aneurysms in high surgical risk patients

    Célio Teixeira Mendonça

    2005-09-01

    Full Text Available OBJETIVO: Comparar os resultados dos tratamentos aberto e endovascular de aneurismas da aorta abdominal em pacientes de alto risco cirúrgico. MÉTODOS: O tratamento aberto foi realizado em 31 pacientes, e o endovascular, em 18. Sucesso no tratamento endovascular foi definido como perviedade da endoprótese sem endoleaks ou conversão para tratamento aberto. RESULTADOS: Não houve diferença na mortalidade perioperatória entre o tratamento aberto (dois óbitos [6,45%] em 31 e o endovascular (um óbito [5,55%] em 18 (P = 0,899; também não houve diferença entre a mortalidade tardia no tratamento aberto (dois óbitos [6,9%] em 29 e no endovascular (dois óbitos [11,7%] em 17 (P = 0,572. A taxa de sucesso imediato foi de 100% (31/31 no tratamento aberto e de 66,7% (12/18 no endovascular (P = 0,0006; a taxa de sucesso tardio foi de 100% (27/27 no tratamento aberto e de 73,3% (11/15 no endovascular (P = 0,0047. Os valores médios do tempo de internação na UTI, tempo de internação hospitalar e da perda de sangue para os grupos dos tratamentos aberto e endovascular foram: 65,6 versus 34,1 horas*, 9 versus 5,6 dias* e 932 versus 225 ml*, respectivamente (*P OBJECTIVE: To compare the results of open repair and endoluminal repair of abdominal aortic aneurysms in high surgical risk patients. METHODS: Open repair was performed in 31 patients, and endoluminal repair was performed in 18. Success in the endoluminal repair group was defined as continuing graft function without endoleak or conversion to open repair. RESULTS: No significant difference was found between the perioperative mortality rate for open repair (two deaths [6.45%] in 31 patients and endoluminal repair (one death [5.55%] in 18 patients (P = 0.899; similarly, no significant difference was seen in late mortality between open repair (two deaths [6.9%] in 29 patients and endoluminal repair (two deaths [11.7%] in 17 patients (P = 0.572; The rate of immediate success was 100% (31/31 for

  19. The Treatment of Recurrent Abdominal Pain in Children: A Controlled Comparison of Cognitive-Behavioral Family Intervention and Standard Pediatric Care.

    Sanders, Matthew R.; And Others

    1994-01-01

    Conducted controlled clinical trial involving 44 children with recurrent abdominal pain randomly assigned to cognitive-behavioral family intervention (CBFI) or standard pediatric care (SPC). Both treatments resulted in significant improvements on measures of pain intensity and pain behavior. CBFI group had higher rate of complete elimination of…

  20. Myocardial imaging in patients with transposition of the great arteries. Comparison between Mustard and Rastelli operations

    Ono, Yasuo; Tanimoto, Takeshi (National Cardiovascular Center, Suita, Osaka (Japan)); Kohata, Tohru

    1982-12-01

    Thallium-201 myocardial imaging was performed in 21 patients with transposition of the great arteries (TGA). In the 13 patients with preoperative TGA, it was possible to differentiate TGA with the intact ventricular septum from TGA with associated anomalies such as patent ductus arteriosus or ventricular septal defect, and also TGA with pulmonary hypertension or pulmonary stenosis from TGA without them by evaluating the degree of thallium uptake in the free wall of the pulmonary ventricle (anatomical left ventricle). The degree of thallium uptake was well correlated with systolic pressure of the pulmonary ventricle (r = 0.98). In the 13 patients with postoperative TGA, it was less correlated with the pulmonary ventricular systolic pressure (r = 0.83). Four cases sequentially studied showed a marked decrease in thallium uptake in the pulmonary ventricle 10 to 16 months after Rastelli operation. But the corrected thallium uptake (thallium activity/ventricular systolic pressure) was more increased compared with the uptake of the systemic ventricle after the surgery. This was probably related to a decrease of the pressure load to the pulmonary ventricle following the surgery and to the fact that there should be some delay of a decrease of the ventricular mass. An increased lung uptake of thallium was noted in the cases of tricuspid regurgitation after Mustard operation, but the degree of regurgitation was not clearly correlated with the increase of thallium uptake in the lung. In five cases after Rastelli operation, one patient showed a high degree of thallium uptake of the pulmonary ventricle (anatomical right ventricle), and the conduit valve calcification and severe pulmonary stenosis were confirmed by cardiac catheterization and angiography. Thus myocardial imaging provides a reliable means for the qualitative and quantitative assessment of TGA before and after operation.

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

    Yen-Chu Huang

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

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

    Masoud Amiri

    2012-01-01

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

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

    Ashraf Abualhassan Abdellatif

    2011-01-01

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

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

    Hambali, Ahmad Shariff; Ng, Kwan-Hoong; Abdullah, Basri Johan Jeet; Wang, Hwee-Beng; Jamal, Noriah; Spelic, David C; Suleiman, Orhan H

    2009-01-01

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

  5. Activation amplitude and temporal synchrony among back extensor and abdominal muscles during a controlled transfer task: comparison of men and women.

    Hubley-Kozey, Cheryl L; Butler, Heather L; Kozey, John W

    2012-08-01

    Muscle synergies are important for spinal stability, but few studies examine temporal responses of spinal muscles to dynamic perturbations. This study examined activation amplitudes and temporal synergies among compartments of the back extensor and among abdominal wall muscles in response to dynamic bidirectional moments of force. We further examined whether responses were different between men and women. 19 women and 18 men performed a controlled transfer task. Surface electromyograms from bilateral sites over 6 back extensor compartments and 6 abdominal wall muscle sites were analyzed using principal component analysis. Key features were extracted from the measured electromyographic waveforms capturing amplitude and temporal variations among muscle sites. Three features explained 97% of the variance. Scores for each feature were computed for each measured waveform and analysis of variance found significant (pmuscle main effects and a sex by muscle interaction. For the back extensors, post hoc analysis revealed that upper and more medial sites were recruited to higher amplitudes, medial sites responded to flexion moments, and the more lateral sites responded to lateral flexion moments. Women had more differences among muscle sites than men for the lateral flexion moment feature. For the abdominal wall muscles the oblique muscles responded with synergies related to fiber orientation, with women having higher amplitudes and more responsiveness to the lateral flexion moment than men. Synergies between the abdominal and back extensor sites as the moment demands change are discussed. These findings illustrate differential activation among erector spinae compartments and abdominal wall muscle sites supporting a highly organized pattern of response to bidirectional external moments with asynchronies more apparent in women.

  6. Comparison of arterial pressure and plethysmographic waveform-based dynamic preload variables in assessing fluid responsiveness and dynamic arterial tone in patients undergoing major hepatic resection

    Vos, J. J.; Kalmar, A. F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    2013-01-01

    Dynamic preload variables to predict fluid responsiveness are based either on the arterial pressure waveform (APW) or on the plethysmographic waveform (PW). We compared the ability of APW-based variations in stroke volume (SVV) and pulse pressure (PPV) and of PW-based plethysmographic variability in

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

    Flávio Sarno

    2007-10-01

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

  8. Reproducibility of Middle Cerebral Artery Stenosis Measurements by DSA: Comparison of the NASCET and WASID Methods.

    Luguang Chen

    Full Text Available To evaluate the intra- and inter-observer variability of the North American Symptomatic Carotid Endarterectomy Trial (NASCET and Warfarin-Aspirin Symptomatic Intracranial Disease (WASID criteria for the evaluation of middle cerebral artery (MCA stenosis using digital subtraction angiography (DSA.DSA images of 114 cases with 131 stenotic MCAs were retrospectively analyzed. Two radiologists and a researcher measured the degree of MCA stenosis independently using both NASCET and WASID methods. To determine intra-observer agreement, all the observers reevaluated the degree of MCA stenosis 4 weeks later. The linear relation and coefficient of variation (CV between the measurements made by the two methods were assessed by correlation coefficient and multi-factor analysis of variance (ANOVA, respectively. Intra- and inter-observer variability of the two methods was evaluated by intraclass correlation coefficient (ICC, Spearman's R value, Pearson correlation coefficient and Bland-Altman plots.Despite the fact that the degree of MCA stenosis measured by NASCET was lower than measured using the WASID method, there was good linear correlation between the measurements made by the two methods (for the mean measurements of the 3 observers, NASCET% = 0.891 × WASID% - 1.89%; ICC, Spearman's R value and Pearson correlation were 0.874, 0.855, and 0.874, respectively. The CVs of both intra- and inter-observer measurements of MCA stenosis using WASID were significantly lower than that using NASCET confirmed by the multi-factor ANOVA results, which showed only the measurement methods of MCA stenosis had significant effects on the CVs both in intra- and inter-observer measurements (both P values < 0.001. Intra-observer measurements showed good or excellent agreement with respect to WASID and NASCET evaluation (ICC, 0.656 to 0.817 and 0.635 to 0.761, respectively. Good agreement for the WASID evaluation (ICC, 0.592 to 0.628 and for the NASCET evaluation (ICC, 0

  9. Pressão arterial: efeito do índice de massa corporal e da circunferência abdominal em adolescentes Blood pressure: effect of body mass index and of waist circumference on adolescents

    Isabel Cristina Britto Guimarães

    2008-06-01

    Full Text Available FUNDAMENTO: Aumento do índice de massa corporal (IMC e da circunferência abdominal (CA tem sido associado a elevação da pressão arterial. OBJETIVO: Avaliar o efeito do IMC e da CA sobre a pressão arterial (PA de adolescentes. MÉTODOS: Estudo analítico de corte transversal. Selecionados 536 adolescentes, alunos de escolas públicas e privadas. Foram calculados IMC, classificado como normal alto (>p50 p85 p95. Mediu-se a CA, aumentada se>p75 e a PA, elevada se >p90. RESULTADOS: Trezentos e dezenove (59,5% indivíduos eram meninas, idade de 14,0± 1,99 anos, peso normal alto em 39,6%, sobrepeso em 37,1% e obesidade em 23,3%. O percentual de PAS e PAD elevadas acompanhou a elevação do IMC (p=0,000, alcançando 46,4% nos meninos e 39,3% nas meninas obesas (PAS e 42,0% e 44,6% (PAD, respectivamente. PAS e PAD elevadas foram 3,9 a 3,4 vezes mais freqüente nos meninos, e 2,2 a 2,0 vezes mais nas meninas com CA > p75, respectivamente. Pela análise de regressão linear simples cada aumento no IMC aumentaria a PAS em 1,198 mmHg e da CA em 0,622 mmHg. A razão de prevalência (RP de PAS e PAD elevadas em razão do IMC>p85 foi 3,9(I.C. 95% 2,0-7,4[p=0,000] e 4,3(I.C. 95% 2,2-8,5[p=0,000], respectivamente, e em razão da CA>p75 de 1,8(IC 95% 1,0 a 3,0 [p=0,036] e 1,4(IC 95% 0,8 a 2,4. Encontrou-se em 16/181(8,8% dos adolescentes com peso normal alto, PA>P90 com CA>p75. CONCLUSÃO: Os valores do IMC e da CA têm forte influência sobre os valores da PA de adolescentes.BACKGROUND: Increased body mass index (BMI and waist circumference (WC have been associated with blood pressure elevation. OBJECTIVE: To evaluate the effect of BMI and WC on blood pressure (BP of adolescents. METHODS: Cross-sectional analytical study including 536 adolescents from public and private schools. BMI was calculated and classified as high-normal (> 50th p and 85th p and 95th p. WC was measured and considered increased if > 75th p. BP was considered elevated if > 90th p

  10. Abdominal epilepsy in chronic recurrent abdominal pain

    V Y Kshirsagar

    2012-01-01

    Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9

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

    P Jyothsna

    2012-01-01

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

  12. CHIMNEY TECHNOLOGY IN STANFORDB TYPE OF ABDOMINAL AORTIC ANEURYSM AND AORTIC DISSECTION INVOLVING THE CLINICAL APPLICATION OF RENAL ARTERY PROSTHESIS%烟囱技术在 StanfordB 型主动脉夹层和腹主动脉瘤累及肾动脉修复术的临床应用

    王厚生

    2015-01-01

    Objective Type chimney technology in StanfordB abdominal aortic aneurysm and aortic dis‐section involving the renal artery (juxtarenal aortic aneurysms ,JAA) application feasibility and safety of repair .Methods Jan 2010 to jan 2013 ,21 cases of diagnosis and treatment of abdominal aortic aneurysm and aortic dissection StanfordB type involving patients with renal artery ,w hich StanfordB type ,including 13 cases of aortic dissection ,abdominal aortic aneurysm involvement of 8 cases of renal artery .All patients were performed CT enhanced scan ,before they are confirmed by femoral artery puncture aortic angiogra‐phy ,coated stents improperness internal isolation in parallel "chimney" technology to protect important branch artery .Results All patients were successfully repair the aorta and guarantee important branch such as subclavian artery and renal artery flow .Conclusion The clinical application of "chimney" technology solves the lumen of isolated from surgery to repair the aortic lesions at the same time avoid the other im‐portant branch of isolated vascular perfusion ,and to solve the primary disease of coated stent provides ef‐fective proximal anchoring area , even can help eliminate the leakage , to ensure the operation curative effect .%目的:探讨烟囱技术在StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉(juxtarenal aortic aneurysms ,JAA)修复术的应用的可行性和安全性。方法2010年01月至2013年01月诊治21例StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉的患者,其中StanfordB型主动脉夹层13例,腹主动脉瘤累及肾动脉8例。所有患者均行先C T 增强扫描,后经股动脉穿刺主动脉造影证实,植入覆膜支架行腔内隔绝术并行“烟囱”技术保护重要分支动脉。结果所有患者均成功修复主动脉并保证重要分支动脉如锁骨下动脉和肾动脉通畅。结论“烟囱”技术的临床应用解决了腔内隔绝术修复主动

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

    Yue Jiao

    2015-01-01

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

  14. Comparison of Muscle Activities Using a Pressure Biofeedback Unit during Abdominal Muscle Training Performed by Normal Adults in the Standing and Supine Positions.

    Jung, Da-Eun; Kim, Kyoung; Lee, Su-Kyoung

    2014-02-01

    [Purpose] The purpose of this study was to assess the effects of draw-in exercise on abdominal muscle activity in the standing and supine positions. [Methods] Twenty healthy women participated in this study. The subjects were required to complete two draw-in exercises (standing and supine positions) using a biofeedback pressure unit. The root mean square (RMS) values of the EMG data were expressed as a percentage of the resting contraction. The data were analyzed using the independent t-test. [Results] According to the changes in the activities of the abdominal muscles, the draw-in exercise in the standing position produced the most significant increase in the activities of the rectus abdominis, the transverse abdominis, the internal oblique, and the external oblique muscles. [Conclusion] The activities of the trunk stability muscles (rectus abdominis, transverse abdominis, internal oblique, and external oblique) increased more in the standing than in the supine position, enabling the subjects to overcome gravity. Therefore, to strengthen the activation of the abdominal muscles, a standing position seems to be more effective than a supine position for draw-in exercises.

  15. Endovascular repair for abdominal aortic aneurysm followed by type B dissection.

    Shingaki, Masami; Kato, Masaaki; Motoki, Manabu; Kubo, Yoji; Isaji, Toshihiko; Okubo, Nobukazu

    2016-10-01

    An 86-year-old man with an abdominal aortic aneurysm was diagnosed with type B aortic dissection accompanied by a patent false lumen that started at the distal arch of the thoracic aorta and terminated at the left common iliac artery. Meticulous preoperative assessment detected 3 large intimal tears in the descending aorta, abdominal aortic aneurysm, and left common iliac artery. We performed single-stage thoracic and abdominal endovascular aneurysm repair and concomitant axillary-axillary bypass. The abdominal aortic aneurysm with type B aortic dissection was successfully treated using a single-stage endovascular stent graft, without any complications due to the careful preoperative examinations.

  16. Abdominal Decompression in Children

    J. Chiaka Ejike

    2012-01-01

    Full Text Available Abdominal compartment syndrome (ACS increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH by intra-abdominal pressure (IAP monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

  17. Clinical Comparison of Outcomes of Early versus Delayed Carotid Artery Stenting for Symptomatic Cerebral Watershed Infarction due to Stenosis of the Proximal Internal Carotid Artery

    Huakun Liu

    2016-01-01

    Full Text Available The aim of this study was to compare the clinical outcomes of early versus delayed carotid artery stenting (CAS for symptomatic cerebral watershed infarction (sCWI patients due to stenosis of the proximal internal carotid artery. We retrospectively collected clinical data of those who underwent early or delayed CAS from March 2011 to April 2014. The time of early CAS and delayed CAS was within a week of symptom onset and after four weeks from symptom onset. Clinical data such as second stroke, the National Institutes of Health Stroke Scale (NHISS score, and modified Rankin Scale (mRS score and periprocedural complications were collected. The rate of second stroke in early CAS group is lower when compared to that of delayed CAS group. There was no significant difference regarding periprocedural complications in both groups. There was a significant difference regarding mean NHISS score 90 days after CAS in two groups. Early CAS group had a significant better good outcome (mRS score ≤ 2 than delayed CAS group. We suggest early CAS for sCWI due to severe proximal internal carotid artery stenosis as it provides lower rate of second stroke, comparable periprocedural complications, and better functional outcomes compared to that of delayed CAS.

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

    Beirne, Christopher

    2008-07-01

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

  19. Abdominal Compartment Syndrome

    Ovchinnikov V.А.; Sokolov V.А.

    2013-01-01

    We considered one of the most complicated problems of surgery and intensive care — abdominal compartment syndrome. It is a severe, and in some cases lethal complication developing in major injuries and pathology of abdominal cavity and retroperitoneal space, as well as in extra-abdominal pathology. In addition, compartment syndrome can be the complication of a number of surgical procedures accompanied primarily by laparotomy wound closure with tissue tension. We demonstrated the classificatio...

  20. Abdominal Compartment Syndrome

    Pınar Zeyneloğlu

    2015-04-01

    Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

  1. Post trauma abdominal cocoon

    Supreet Kaur

    2015-01-01

    Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

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

    Stagnitti, Franco

    2009-01-01

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

  3. Liver CT for vascular mapping during radioembolisation workup: comparison of an early and late arterial phase protocol

    Hoven, Andor F. van den; Braat, Manon N.G.J.A.; Prince, Jip F.; Doormaal, Pieter J. van; Leeuwen, Maarten S. van; Lam, Marnix G.E.H.; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands)

    2017-01-15

    To compare right gastric (RGA) and segment 4 artery (A4) origin detection rates during radioembolisation workup between early and late arterial phase liver CT protocols. 100 consecutive patients who underwent liver CT between May 2012-January 2015 with early or late arterial phase protocol (n = 50 each, 10- vs. 20-s post-threshold delay) were included. RGA/A4 origin detection rates, assessed by two raters, and contrast-to-noise ratio (CNR) of the hepatic artery relative to the portal vein were compared between the protocols. The first-second rater scored the RGA origin as visible in 58-65 % (specific proportion of agreement 82 %, κ = 0.62); A4 origin in 96-89 % (94 %, κ = 0.54). Thirty-six percent of RGA origins not detectable by DSA were identified on CT. Origin detection rates were not significantly different for early/late arterial phases. Mean CNR was higher in the early arterial phase protocol (1.7 vs. 1.2, p < 0.001). A 10-s delay arterial phase CT protocol does not significantly improve detection of small intra- and extrahepatic branches. RGA origin detection requires further optimization, whereas A4/MHA origin detection is adequate, with good inter-rater reproducibility. CT remains important for preprocedural planning, because it may reveal arterial anatomy not discernible on DSA. (orig.)

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

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

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of 18F-FDG. PET/MR was performed a median of 131 ...

  5. Abdominal aorta transplantation after programmed cryopreservation

    Song Gu; Chang-Jian Liu; Tong Qiao; Xue-Mei Sun; Jun-Hao Chen

    2004-01-01

    AIM: To study the morphologic and cellular immunologic changes after homologous transplantation of the abdominal aorta in rats after programmed cryopreservation (-196°C).METHODS: Abdominal aorta was harvested from anesthetized Spraque Dawley (SD) rats for cryopreservation (group B) or immediate implantation (group A). The survival rates and apoptotic rates of aortic endothelial cells (ECs)were examined. The patency rates, histology and cellular immunologic changes of the abdominal aorta were examined on days 1, 3, 7, 14, 30, 60 after transplantation respectively.RESULTS: The survival rate of ECs after programmed cryopreservation was 90.1±1.79%, about 3.4% lower than that of uncryopreservation (93.5±1.96%). The apoptotic rates of ECs was increased after cryopreservation (7.15%vs 4.86%, P<0.05). The patency rate of group B was significantly higher than that of group A (91.6±12.9% vs 62.5±26.2%, P<0.01). CD4/CD8 ratio, TCR αβ and CD11b/CD18 ratio of group B were significantly lower than those of group A (P<0.05). Revivification of the cryopreserved abdominal aorta showed normal adventitia and intact smooth muscle cells.CONCLUSION: Cryopreservation can reduce homologous abdominal aortic antigenecity. Even if without administration of immunosuppressive agents, it is still feasible to implement homologous artery grafting in rats.

  6. Comparison of exercise, dobutamine-atropine and dipyridamole-atropine stress echocardiography in detecting coronary artery disease

    Nedeljkovic, Ivana; Ostojic, Miodrag; Beleslin, Branko; Djordjevic-Dikic, Ana; Stepanovic, Jelena; Nedeljkovic, Milan; Stojkovic, Sinisa; Stankovic, Goran; Saponjski, Jovica; Petrasinovic, Zorica; Giga, Vojislav; Mitrovic, Predrag

    2006-01-01

    Background Dipyridamole and dobutamine stress echocardiography testing are most widely utilized, but their sensitivity remained suboptimal in comparison to routine exercise stress echocardiography. The aim of our study is to compare, head-to-head, exercise, dobutamine and dipyridamole stress echocardiography tests, performed with state-of-the-art protocols in a large scale prospective group of patients. Methods Dipyridamole-atropine (Dipatro: 0.84 mg/kg over 10 min i.v. dipyridamole with addition of up to 1 mg of atropine), dobutamine-atropine (Dobatro: up to 40 mcg/kg/min i.v. dobutamine with addition of up to 1 mg of atropine) and exercise (Ex, Bruce) were performed in 166 pts. Of them, 117 pts without resting wall motion abnormalities were enrolled in study (91 male; mean age 54 ± 10 years; previous non-transmural myocardial infarction in 32 pts, angina pectoris in 69 pts and atypical chest pain in 16 pts). Tests were performed in random sequence, in 3 different days, within 5 day period under identical therapy. All patients underwent coronary angiography. Results Significant coronary artery disease (CAD; ≥50% diameter stenosis) was present in 69 pts (57 pts 1-vessel CAD, 12 multivessel CAD) and absent in 48 pts. Sensitivity (Sn) was 96%, 93% and 90%, whereas specificity (Sp) was 92%, 92% and 87% for Dobatro, Dipatro and Ex, respectively (p = ns). Concomitant beta blocker therapy did not influence peak rate-pressure product and Sn of Dobatro and Dipatro (p = ns). Conclusion When state-of-the-art protocols are used, dipyridamole and dobutamine stress echocardiography have comparable and high diagnostic accuracy, similar to maximal post-exercise treadmill stress echocardiography. PMID:16672046

  7. Comparison of exercise, dobutamine-atropine and dipyridamole-atropine stress echocardiography in detecting coronary artery disease

    Petrasinovic Zorica

    2006-05-01

    Full Text Available Abstract Background Dipyridamole and dobutamine stress echocardiography testing are most widely utilized, but their sensitivity remained suboptimal in comparison to routine exercise stress echocardiography. The aim of our study is to compare, head-to-head, exercise, dobutamine and dipyridamole stress echocardiography tests, performed with state-of-the-art protocols in a large scale prospective group of patients. Methods Dipyridamole-atropine (Dipatro: 0.84 mg/kg over 10 min i.v. dipyridamole with addition of up to 1 mg of atropine, dobutamine-atropine (Dobatro: up to 40 mcg/kg/min i.v. dobutamine with addition of up to 1 mg of atropine and exercise (Ex, Bruce were performed in 166 pts. Of them, 117 pts without resting wall motion abnormalities were enrolled in study (91 male; mean age 54 ± 10 years; previous non-transmural myocardial infarction in 32 pts, angina pectoris in 69 pts and atypical chest pain in 16 pts. Tests were performed in random sequence, in 3 different days, within 5 day period under identical therapy. All patients underwent coronary angiography. Results Significant coronary artery disease (CAD; ≥50% diameter stenosis was present in 69 pts (57 pts 1-vessel CAD, 12 multivessel CAD and absent in 48 pts. Sensitivity (Sn was 96%, 93% and 90%, whereas specificity (Sp was 92%, 92% and 87% for Dobatro, Dipatro and Ex, respectively (p = ns. Concomitant beta blocker therapy did not influence peak rate-pressure product and Sn of Dobatro and Dipatro (p = ns. Conclusion When state-of-the-art protocols are used, dipyridamole and dobutamine stress echocardiography have comparable and high diagnostic accuracy, similar to maximal post-exercise treadmill stress echocardiography.

  8. Extra-anatomic endovascular repair of an abdominal aortic aneurysm with a horseshoe kidney supplied by the aneurysmal aorta.

    Rey, Jorge; Golpanian, Samuel; Yang, Jane K; Moreno, Enrique; Velazquez, Omaida C; Goldstein, Lee J; Chahwala, Veer

    2015-07-01

    Abdominal aortic aneurysm complicated by a horseshoe kidney (HSK, fused kidney) represents a unique challenge for repair. Renal arteries arising from the aneurysmal aorta can further complicate intervention. Reports exist describing the repair of these complex anatomies using fenestrated endografts, hybrid open repairs (debranching), and open aneurysmorrhaphy with preservation of renal circulation. We describe an extra-anatomic, fully endovascular repair of an abdominal aortic aneurysm with a HSK partially supplied by a renal artery arising from the aneurysm. We successfully applied aortouni-iliac endografting, femorofemoral bypass, and retrograde renal artery perfusion via the contralateral femoral artery to exclude the abdominal aortic aneurysm and preserve circulation to the HSK.

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

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

    2002-07-01

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

  10. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard

    1995-01-01

    A randomized study of abdominal fascial closure using interrupted polyglyconate and polyglycolic acid sutures after laparotomy was carried out in 204 consecutive patients with suspected impaired wound healing. There were no statistically significant differences between the two sutures with regard...... to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the incidence...

  11. Branches of the abdominal aorta in Aotus azarae infulatus

    Bianca Mendonça Faria

    2016-05-01

    Full Text Available The genus Aotus is found in South America and is known for its nocturnal habit. The morphology of the genus is poorly understood even though it is used in biomedical research. The objective of this study was to identify the collateral branches of the abdominal aorta of two females and one male Aotus azarae infulatus (commonly known as the night monkey. The vessels were observed and stained with Neoprene latex and radiopaque contrast. The animals were fixed in an aqueous solution of 10% formaldehyde via intramuscular and intracavitary routes, dissected and radiographed. It was observed that the celiac artery was divided into three subjacent branches, the gastric, hepatic and splenic arteries. The left and right renal arteries originated from a common trunk in two animals (animals 1 and 2, while the adrenal artery in one of the animals was derived from the celiac trunk and renal artery (animal 2. In one animal the mesenteric artery flow gave rise to individual cranial rectal, sigmoid and left colic arteries (animal 3. In the three animals the abdominal aorta bifurcated in the final portion of the abdomen, with the external and internal iliac artery on each side, and then the median sacral artery. These anatomical variations need to be identified and reported because these animals are frequently used in clinical and surgical, veterinary practices.

  12. Hepatic infarction following abdominal interventional procedures.

    Fujiwara H

    2004-04-01

    Full Text Available To clarify the incidence, background, and progress of hepatic infarction following interventional procedures, cases of hepatic infarction following interventional procedures at our department during the last decade were identified by reviewing the clinical records of 1982 abdominal angiography and interventional procedures and records of abdominal CT. Nine episodes (0.5% in 8 patients were identified as hepatic infarction following an interventional procedure. Five episodes were preceded by embolization of the hepatic or celiac artery at emergency angiography for postoperative bleeding with hemorrhagic shock. Three episodes followed the elected interventional procedure for hepatocellular carcinoma, and the remaining episode occurred after 12 months of chemoinfusion through an indwelling catheter in the hepatic artery and portal vein. Hepatic arterial occlusion in all episodes and portal venous flow abnormality in 5 episodes were observed on angiography. Four patients whose liver function was initially impaired died of hepatic infarction, although the extent of the disease on CT did not appear to be related to the mortality. Multiple risk factors, including arterial insufficiency, were observed in each patient. The incidence of hepatic infarction following interventional procedures in this series was low but sometimes fatal, and occurred most frequently in emergency embolization in hemorrhagic shock.

  13. MR angiography in abdominal neoplasms

    Squillaci, E. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Crecco, M. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Grandinetti, M.L. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Maspes, F. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Lo Presti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Squillaci, S. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Simonetti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy)

    1994-10-01

    The role of magnetic resonance angiography (MRA) in the evaluation of vascular involvement was studied in 55 patients with abdominal neoplasms. A 2-D time-of-flight (TOF) technique was used in all patients. All patients underwent CT and MR examinations before MRA. Also, MR angiograms were compared with digital subtraction angiography in 22 cases, with Doppler US in 13 cases, and with surgical findings in 20 cases. In all patients with liver neoplasms (n=29) MRA demonstrated the absence of flow in the infiltrated segments. Pericapsular neovascularization was observed in 12 patients. Portal vein involvement was correctly detected in 27 patients. In all cases MRA demonstrated in relationship between the tumor and venous structures. Portosystemic shunts were visualized in 20 of 21 patients with portal hypertension. Vena cava thrombosis (3 cases), compression (5 cases), and displacement (2 cases) were correctly demonstrated. In renal (n=6) and adrenal gland (n=3) tumors renal vein compression was correctly detected in 2 cases, displacement in 1 case, and thrombosis in 3 cases, with only 1 false-positive finding. In 7 patients with pancreatic tumors MRA demonstrated splenic vein thrombosis in 2 cases and compression in 2 cases, with one false-positive finding. Our results indicate that MRA provides precise information regarding venous vascular involvement in abdominal neoplasms, but preoperative arterial mapping is still problematic. (orig.)

  14. Recurrent Abdominal Pain

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  15. [Abdominal pregnancy, institutional experience].

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

    1998-07-01

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

  16. A comparison of estimation methods for computational fluid dynamics outflow boundary conditions using patient-specific carotid artery.

    Lee, Chang-Joon; Uemiya, Nahoko; Ishihara, Shoichiro; Zhang, Yu; Qian, Yi

    2013-06-01

    Computational fluid dynamics simulations can provide important hemodynamic insights for investigating the effectiveness of carotid artery stenting, but its accuracy is dependent on the boundary conditions such as the outflow pressure, which is difficult to obtain by measurements. Many computational fluid dynamics simulations assume that the outflow pressure is constant (P = 0), but this method is likely to produce different results compared to clinical measurements. We have developed an alternative estimation method called the minimum energy loss method based on the concept of energy loss minimization at flow bifurcation. This new method has been tested on computational fluid dynamics simulation of two patients treated with carotid artery stenting, and its flow ratio at internal carotid artery and wall shear stress distribution was compared with the constant zero outlet pressure method. Three different procedure stages (prestent, poststent, and follow-up) were analyzed. The internal carotid artery flow ratio using the minimum energy loss method generally matched well with ultrasound measurements, but the internal carotid artery flow ratio based on zero outlet pressure method showed a large difference. Wall shear stress distributions varied between methods in response to the change in internal carotid artery flow rate. This study demonstrates the importance of accurate outlet boundary condition for assessing the long-term efficacy of carotid artery stenting and the risk of restenosis in treated patients.

  17. Abdominal aorta morphometric study for endovascular treatment of aortic aneurysms: comparison between spiral CT and angiography Estudo morfométrico da aorta abdominal para tratamento endovascular dos aneurismas aórticos: comparação entre tomografia helicoidal e angiografia

    Gaudencio Espinosa

    2002-12-01

    Full Text Available PURPOSE: To compare the computed tomography and angiography study of abdominal aortic aneurysms for posterior endograft implant. METHOD: From June 1997 to March 2001, 113 patients with abdominal aortic aneurysm were submitted to study of the aorto-iliac axis with abdominal spiral computed tomography and angiography with calibrated catheter. The patient's ages ranged from 51 and 88 years (mean: 69. There were 104 males and nine females. RESULTS: When comparing the mean computed tomography and angiography diameters, we observed that there was a statistical difference for the infra-renal neck (p0.05. When comparing the mean lengths, we observed that there was a statistical difference for the aortic infra-renal neck (pOBJETIVOS: Este trabalho visa comparar a acurácia da tomografia computadorizada e da angiografia para avaliar os aneurismas de aorta abdominal (AAA para posterior implante de endoprótese vascular. MÉTODO: De junho de 1997 até março de 2001, foram atendidos 113 pacientes portadores de AAA, tendo sido submetidos a estudo por tomografia helicoidal computadorizada de abdome e pelve e angiografia com cateter centimetrado do eixo arterial aorto-ilíaco. A idade dos pacientes variou entre 51 e 88 anos (S:69a., sendo 104 do sexo masculino e nove do feminino. RESULTADOS: Quando comparadas as médias dos diâmetros aferidas pela tomografia computadorizada e pela angiografia, notou-se que a diferença do diâmetro foi significativa para o colo aórtico infra-renal (r 0,05. Quando comparadas as médias das extensões aferidas pela tomografia computadorizada e pela angiografia, notou-se que a diferença das extensões foi significativa para o colo aórtico infra-renal (r < 0,05, para a distância entre a artéria renal e a bifurcação aórtica (r < 0,05 e para as artérias ilíacas comuns (r < 0,05. A comparação entre as médias também foi significativa para a extensão entre a artéria renal e a artéria ilíaca interna (r < 0

  18. Comparison of the Effect of Two Left Internal Mammary Artery Harvesting Techniques (Skeletonization and Pedicled on Post Coronary Artery Bypass Surgery Pain and Bleeding

    Derakhshan

    2016-08-01

    Full Text Available Background Recent evidence suggests that skeletonization of the left internal mammary artery (LIMA can improve the flow and length of the flow, reduce deep sternal infections and postoperative pain. Objectives The present study aimed to investigate the effect of two LIMA harvesting techniques (skeletonization and pedicled on postoperative pain and bleeding. Methods This randomized double blind clinical trial study on patients undergoing LIMA harvest in Birjand was conducted during years 2012 to 2014. The patients were divided to two (skeletonization N: 30 and pedicled N: 30 groups according to the LIMA harvesting method. Their demographic information and other relevant data were collected by means of a questionnaire. Results In total, 60 cases, who were candidates for coronary artery bypass grafting (CABG at the cardiac surgery department of Valiasr hospital in Birjand, were studied. In the skeletonized group, the conduit length was significantly longer (17.96 vs. 17.27, P < 0.001, yet there was no significant difference between early and mid-term pain scores (P values: 0.32 and 1.0, respectively and early postoperative bleeding (782.26 vs. 903.16, P = 0.657. Conclusions The IMA skeletonized collection resulted in the reduction of postoperative pain and increased conduit length. Skeletonization could not decrease postoperative bleeding.

  19. Gastrointestinal causes of abdominal pain.

    Marsicano, Elizabeth; Vuong, Giao Michael; Prather, Charlene M

    2014-09-01

    Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.

  20. Functional Abdominal Pain in Children

    ... functional abdominal pain. Functional abdominal pain can be intermittent (recurrent abdominal pain or RAP) or continuous. Although ... tests are needed or whether a trial of diet changes, stress management or medication may be started. ...

  1. Effect of oxygen treatment on heart rate after abdominal surgery

    Rosenberg-Adamsen, S; Lie, C; Bernhard, A;

    1999-01-01

    . METHODS: The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. RESULTS: The median arterial...... supplementation were found between patients with or without an epidural catheter or between the postoperative day studied. CONCLUSION: Postoperative oxygen therapy increased arterial oxygen saturation and decreased heart rate after uncomplicated abdominal surgery in a consecutive unselected group of patients who......BACKGROUND: Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate...

  2. Comparison of image quality from filtered back projection, statistical iterative reconstruction, and model-based iterative reconstruction algorithms in abdominal computed tomography.

    Kuo, Yu; Lin, Yi-Yang; Lee, Rheun-Chuan; Lin, Chung-Jung; Chiou, Yi-You; Guo, Wan-Yuo

    2016-08-01

    The purpose of this study was to compare the image noise-reducing abilities of iterative model reconstruction (IMR) with those of traditional filtered back projection (FBP) and statistical iterative reconstruction (IR) in abdominal computed tomography (CT) imagesThis institutional review board-approved retrospective study enrolled 103 patients; informed consent was waived. Urinary bladder (n = 83) and renal cysts (n = 44) were used as targets for evaluating imaging quality. Raw data were retrospectively reconstructed using FBP, statistical IR, and IMR. Objective image noise and signal-to-noise ratio (SNR) were calculated and analyzed using one-way analysis of variance. Subjective image quality was evaluated and analyzed using Wilcoxon signed-rank test with Bonferroni correction.Objective analysis revealed a reduction in image noise for statistical IR compared with that for FBP, with no significant differences in SNR. In the urinary bladder group, IMR achieved up to 53.7% noise reduction, demonstrating a superior performance to that of statistical IR. IMR also yielded a significantly superior SNR to that of statistical IR. Similar results were obtained in the cyst group. Subjective analysis revealed reduced image noise for IMR, without inferior margin delineation or diagnostic confidence.IMR reduced noise and increased SNR to greater degrees than did FBP and statistical IR. Applying the IMR technique to abdominal CT imaging has potential for reducing the radiation dose without sacrificing imaging quality.

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

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

    2010-07-15

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

  4. Aneurisma de aorta abdominal na infância Abdominal aortic aneurism in childhood

    Abdo Farret Neto

    1998-04-01

    Full Text Available The authors report a case of an abdominal aortic aneurism involving all visceral branches minus the Inferior Mesenteric artery in a 4-year-old girl. There was sugestive evidence that the arterial disease had an inflamatory or infectious etiologic factor. The most probable etiological factors could be salmonelas infection of the arterial wall or Takayasu's disease secondary to tuberculosis. The treatment with antibiotic to salmonelas infection during ten days, followed by tuberculostatic therapy for six months was chosen. Concerning the age, the arteries involved and the inflamatory aspect of the aneurysm, the surgical option became an alternative to the clinic treatment in case of any future evidence of the aneurysm enlargement. The patient became asymptomatic as soon as the antibiotic has been started. The control of the aneurysm evolution will be made by ecography each three months.

  5. Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization Aneurisma de artéria hepática: diagnóstico incidental com ultrassonografia do abdome e tratamento por embolização com molas

    Luis Jesuino de Oliveira Andrade

    2012-09-01

    Full Text Available Hepatic artery aneurysm (HAA was first reported at autopsy in 1809, represents one fifth of visceral aneurysms and the mortality from spontaneous rupture is high in most of cases. We are reporting a case of an asymptomatic 48-year-old woman with an extrahepatic HAA, diagnosed initially and incidentally with abdominal ultrasonography, confirmed by a three-dimensional contrast-enhanced magnetic resonance imaging and angiography. Endovascular treatment was considered feasible and was successfully treated with coil embolization.Aneurisma da artéria hepática (AAH foi relatado pela primeira vez através de autópsia em 1809, representa um quinto dos aneurismas viscerais, e a mortalidade por ruptura espontânea é alta na maioria dos casos. Relatamos o caso de uma mulher de 48 anos de idade com um AAH extra-hepático assintomático, diagnosticado inicialmente, e incidentalmente, com ultrassonografia abdominal e confirmado através de angiorressonância tridimensional e angiografia contrastada. O tratamento endovascular foi considerado viável, sendo tratada com sucesso através de embolização com molas.

  6. Embolisation of acute abdominal and thoracal bleeding with ethylene-vinyl-alcohol copolymer (Onyx {sup registered}); Embolisation akuter abdomineller und thorakaler Blutungen mit Ethylen-Vinyl-Alkohol-Kopolymer (Onyx {sup registered}). Erste Erfahrungen im arteriellen Gefaessgebiet des Koerperstamms

    Adamus, R.; Uder, M.; Kleinschmidt, T.; Detmar, K.; Bolte, R.; Stein, H.; Loose, R.W.

    2010-10-15

    During the last years most embolizations with the liquid agent Onyx have been performed in the field of neuroradiological interventions. There is minimal experience with arterial embolizations of the body trunk. 23 patients suffering from acute abdominal or thoracic bleeding underwent 28 embolizations with Onyx (17 male, 6 female, mean age 69 years). 27 interventions were technically and clinically successful. One patient with rebleeding from a jejunal artery aneurysm underwent surgery. Onyx embolizations were performed in renal, hepatic, iliac and bronchial arteries and esophageal varices. Compared with prior embolisation agents Onyx offers advantages due to good controllability. Fast arterial occlusion improves time management of patients. In comparison with prior techniques we observed a significant reduction of fluoroscopy time. Quantitative measurements demonstrated a significant higher embolisation agent contrast. (orig.)

  7. Intracranial artery velocity measurement using 4D PC MRI at 3 T: comparison with transcranial ultrasound techniques and 2D PC MRI

    Meckel, Stephan [University Hospital Freiburg, Department of Neuroradiology, Freiburg (Germany); Leitner, Lorenz; Schubert, Tilman [University Hospital Basel, Institute of Radiology, Basel (Switzerland); Bonati, Leo H.; Lyrer, Philippe [University Hospital Basel, Department of Neurology, Basel (Switzerland); Santini, Francesco [University Hospital Basel, Department of Radiological Physics, Institute of Radiology, Basel (Switzerland); Stalder, Aurelien F. [Xuanwu Hospital - Capital Medical University, Department of Radiology, Beijing (China); Markl, Michael [Northwestern University Feinberg School of Medicine, Departments of Radiology and Biomedical Engineering, Chicago (United States); Wetzel, Stephan G. [Neuroradiology, Swiss Neuro Institute, Klinik Hirslanden, Zurich (Switzerland)

    2013-04-15

    4D phase contrast MR imaging (4D PC MRI) has been introduced for spatiotemporal evaluation of intracranial hemodynamics in various cerebrovascular diseases. However, it still lacks validation with standards of reference. Our goal was to compare blood flow quantification derived from 4D PC MRI with transcranial ultrasound and 2D PC MRI. Velocity measurements within large intracranial arteries [internal carotid artery (ICA), basilar artery (BA), and middle cerebral artery (MCA)] were obtained in 20 young healthy volunteers with 4D and 2D PC MRI, transcranial Doppler sonography (TCD), and transcranial color-coded duplex sonography (TCCD). Maximum velocities at peak systole (PSV) and end diastole (EDV) were compared using regression analysis and Bland-Altman plots. Correlation of 4D PC MRI measured velocities was higher in comparison with TCD (r = 0.49-0.66) than with TCCD (0.35-0.44) and 2D PC MRI (0.52-0.60). In mid-BA and ICA C7 segment, a significant correlation was found with TCD (0.68-0.81 and 0.65-0.71, respectively). No significant correlation was found in carotid siphon. On average over all volunteers, PSVs and EDVs in MCA were minimally underestimated compared with TCD/TCCD. Minimal overestimation of velocities was found compared to TCD in mid-BA and ICA C7 segment. 4D PC MRI appears as valid alternative for intracranial velocity measurement consistent with previous reference standards, foremost with TCD. Spatiotemporal averaging effects might contribute to vessel size-dependent mild underestimation of velocities in smaller (MCA), and overestimation in larger-sized (BA and ICA) arteries, respectively. Complete spatiotemporal flow analysis may be advantageous in anatomically complex regions (e.g. carotid siphon) relative to restrictions of ultrasound techniques. (orig.)

  8. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group.

    Serruys, P.W.; de Jaegere, P; Kiemeneij, F.; Macaya, C; Rutsch, W; Heyndrickx, G.; Emanuelsson, H.; Marco, J.; Legrand, Victor; Materne, P.

    1994-01-01

    BACKGROUND: Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. METHODS: A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned to either stent implantation (262 patients)...

  9. Ultrasound Evaluation of an Abdominal Aortic Fluid-Structure Interaction Model

    Traberg, Marie Sand; Jensen, Jørgen Arendt

    2014-01-01

    Ultrasound measurements are used for evaluating biomechanics of the abdominal aorta (AA) predicted by a fluid- structure interaction (FSI) simulation model. FSI simulation models describe the complete arterial physiology by quantify- ing the mechanical response in the vessel wall caused by the pe......Ultrasound measurements are used for evaluating biomechanics of the abdominal aorta (AA) predicted by a fluid- structure interaction (FSI) simulation model. FSI simulation models describe the complete arterial physiology by quantify- ing the mechanical response in the vessel wall caused...... by the percolating pulsating blood. But the predictability of FSI models needs validation for these to be usable for diagnostic purposes. Ultrasound measurements are suitable for such an evaluation as the wall displacement can be measured in vivo and compared to the wall displacement simulated in the FSI model....... Spectral Doppler velocity data from 3 healthy male volunteers were used to construct inlet profiles for the FSI model. Simultaneously, wall movement was tracked and used for comparison to FSI model results. Ultrasound data were acquired using a scanner equipped with a research interface. The wall...

  10. Comparison of Parameter Estimations Using Dual-Input and Arterial-Input in Liver Kinetic Studies of FDG Metabolism.

    Cui, Yunfeng; Bai, Jing

    2005-01-01

    Liver kinetic study of [18F]2-fluoro-2-deoxy-D-glucose (FDG) metabolism in human body is an important tool for functional modeling and glucose metabolic rate estimation. In general, the arterial blood time-activity curve (TAC) and the tissue TAC are required as the input and output functions for the kinetic model. For liver study, however, the arterial-input may be not consistent with the actual model input because the liver has a dual blood supply from the hepatic artery (HA) and the portal vein (PV) to the liver. In this study, the result of model parameter estimation using dual-input function is compared with that using arterial-input function. First, a dynamic positron emission tomography (PET) experiment is performed after injection of FDG into the human body. The TACs of aortic blood, PV blood, and five regions of interest (ROIs) in liver are obtained from the PET image. Then, the dual-input curve is generated by calculating weighted sum of both the arterial and PV input curves. Finally, the five liver ROIs' kinetic parameters are estimated with arterial-input and dual-input functions respectively. The results indicate that the two methods provide different parameter estimations and the dual-input function may lead to more accurate parameter estimation.

  11. [Inflammatory abdominal aortic aneurysm].

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  12. Abdominal CT: An intra-individual comparison between virtual monochromatic spectral and polychromatic 120-kVp images obtained during the same examination

    Yamada, Yoshitake, E-mail: yamada@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Jinzaki, Masahiro, E-mail: jinzaki@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Hosokawa, Takahiro, E-mail: snowglobe@infoseek.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Tanami, Yutaka, E-mail: tanami@rad.med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Abe, Takayuki, E-mail: tabe@z5.keio.jp [Center for Clinical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Kuribayashi, Sachio, E-mail: skuribay@med.keio.ac.jp [Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan)

    2014-10-15

    Highlights: • We compared virtual monochromatic spectral (VMS) images with 120-kVp images. • VMS images are generated using accurate two-material beam-hardening correction. • Abdominal 70-keV VMS images provide better image quality than 120-kVp images. • Iterative reconstruction can further improve the image quality of VMS images. - Abstract: Objectives: To compare quantitative and subjective image quality between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp imaging performed during the same abdominal computed tomography (CT) examination. Materials and methods: Our institutional review board approved this prospective study; each participant provided written informed consent. 51 patients underwent sequential fast kVp-switching dual-energy (80/140 kVp, volume CT dose index: 12.7 mGy) and single-energy (120-kVp, 12.7 mGy) abdominal enhanced CT over an 8 cm scan length with a random acquisition order and a 4.3-s interval. VMS images with filtered back projection (VMS-FBP) and adaptive statistical iterative reconstruction (so-called hybrid IR) (VMS-ASIR) (at 70 keV), as well as 120-kVp images with FBP (120-kVp-FBP) and ASIR (120-kVp-ASIR), were generated from dual-energy and single-energy CT data, respectively. The objective image noises, signal-to-noise ratios and contrast-to-noise ratios of the liver, kidney, pancreas, spleen, portal vein and aorta, and the lesion-to-liver and lesion-to-kidney contrast-to-noise ratios were measured. Two radiologists independently and blindly assessed the subjective image quality. The results were analyzed using the paired t-test, Wilcoxon signed rank sum test and mixed-effects model with Bonferroni correction. Results: VMS-ASIR images were superior to 120-kVp-FBP, 120-kVp-ASIR and VMS-FBP images for all the quantitative assessments and the subjective overall image quality (all P < 0.001), while VMS-FBP images were superior to 120-kVp-FBP and 120-kVp-ASIR images (all P < 0.004). Conclusions: VMS

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

    Breno Costa Macedo

    2013-03-01

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

  14. Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report.

    Olson, M; Posniak, H; Gomes, G

    1992-01-01

    Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

  15. Comparison of myocardial infarction with sequential ligation of the left anterior descending artery and its diagonal branch in dogs and sheep.

    Kim, W G; Shin, Y C; Hwang, S W; Lee, C; Na, C Y

    2003-04-01

    We report a comparison of the effects of myocardial infarction in dogs and sheep using sequential ligation of the left anterior descending artery (LAD) and its diagonal branch (DA), with hemodynamic, ultrasonographic and pathological evaluations. Five animals were used in each group. After surgical preparation, the LAD was ligated at a point approximately 40% of the distance from the apex to the base of the heart, and after one hour, the DA was ligated at the same level. Hemodynamic and ultrasonographic measurements were performed preligation, 30 minutes after LAD ligation, and 1 hour after DA ligation. As a control, two animals in each group were used for the simultaneous ligation of the LAD and the DA. Two months after the coronary ligation, the animals were evaluated as previously, and killed for postmortem examination of their hearts. All seven animals in the dog group survived the experimental procedures, while in the sheep group only animals with sequential ligation of the LAD and DA survived. Statistically significant decreases in systemic arterial blood pressure and cardiac output, and an increase in the pulmonary artery capillary wedge pressure (PACWP) were observed one hour after sequential ligation of the LAD and its DA in the sheep, while only systemic arterial pressures decreased in the dog. Ultrasonographic analyses demonstrated variable degrees of anteroseptal dyskinesia and akinesia in all sheep, but in no dogs. Data two months after coronary artery ligation showed significant increases in central venous pressure, pulmonary artery pressure, and PACWP in the sheep, but not in the dog. Left ventricular end-diastolic dimension and left ventricular end-systolic dimension in ultrasonographic studies were also increased only in the sheep. Pathologically, the well-demarcated thin-walled transmural anteroseptal infarcts with chamber enlargement were clearly seen in all specimens of sheep, and only-mild-to-moderate chamber enlargements with endocardial

  16. Abdominal wall endometriosis.

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S

    2010-01-01

    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  17. Congenital Abdominal Wall Defects

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  18. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    Servaes, Sabah [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Khanna, Geetika [Washington University School of Medicine, Pediatric Radiology, St. Louis Children' s Hospital, Mallinckrodt Institute for Radiology, 510 S. Kingshighway, Campus Box 8131-MIR, St. Louis, MO (United States); Naranjo, Arlene [University of Florida, Department of Biostatistics, Gainesville, FL (United States); Geller, James I. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cincinnati, OH (United States); Ehrlich, Peter F. [University of Michigan, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Gow, Kenneth W. [Seattle Children' s Hospital, Pediatric Surgery, Seattle, WA (United States); Perlman, Elizabeth J. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Pathology, Chicago, IL (United States); Dome, Jeffrey S. [Children' s National Medical Center, Center for Cancer and Blood Disorders, Washington, DC (United States); Gratias, Eric; Mullen, Elizabeth A. [Harvard University, Dana Farber Cancer Institute and Boston Children' s Hospital, Boston, MA (United States)

    2014-08-19

    CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P = 0.73), while specificity was 86.5% and 83.8% (P = 1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P = 0.22), and specificity was 90.4% and 92.3% (P = 1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco-regional staging of pediatric renal tumors. (orig.)

  19. Comparison of intragastric balloon therapy and intensive lifestyle modification therapy with respect to weight reduction and abdominal fat distribution in super-obese Japanese patients.

    Takihata, Masahiro; Nakamura, Akinobu; Aoki, Kazutaka; Kimura, Mari; Sekino, Yusuke; Inamori, Masahiko; Maeda, Shin; Gotoh, Eiji; Nakajima, Atsushi; Terauchi, Yasuo

    2014-01-01

    This study compared the impacts of intragastric balloon (IGB) therapy and intensive lifestyle modification therapy on abdominal fat distribution. Sixteen extremely obese Japanese patients were assigned to an intensive lifestyle modification therapy group with educational hospitalisation (8 patients) or an IGB therapy group (8 patients) and were followed up for 6 months. The main outcome measures were the differences at 6 months, relative to the baseline values, in the visceral fat area (VFA), subcutaneous fat area (SFA), and liver volume as measured using computed tomography. At 0 month, the body weights (BWs) were 121.3±19.0 kg and 127.1±24.4 kg and the VFAs were 299±55 cm2 and 257±56 cm2 in the intensive lifestyle modification therapy group and the IGB therapy group, respectively. No statistically significant differences in the baseline characteristics were observed between these two groups. At 6 months, no difference in the changes in BW from the baseline value (-11.5 [-16.4, -6.6] kg vs. -11.2 [-18.9, -3.4] kg) was seen between the two groups. However, a statistically significant difference in the change in the VFA (-66 [-87, -44] cm2 vs. -22 [-70, 26]cm(2) [P=0.027]) was observed; no significant changes in the SFA or liver volume were seen. In conclusion, IGB therapy was as effective as intensive lifestyle modification therapy for weight reduction but was less effective with respect to the improvement in abdominal visceral fat accumulation and liver steatosis in super-obese Japanese patients.

  20. Comparison of exercise electrocardiography and stress perfusion CMR for the detection of coronary artery disease in women

    Greulich Simon

    2012-06-01

    Full Text Available Abstract Background Exercise electrocardiography (ECG is frequently used in the work-up of patients with suspected coronary artery disease (CAD, however the accuracy is reduced in women. Cardiovascular magnetic resonance (CMR stress testing can accurately diagnose CAD in women. To date, a direct comparison of CMR to ECG has not been performed. Methods and results We prospectively enrolled 88 consecutive women with chest pain or other symptoms suggestive of CAD. Patients underwent a comprehensive clinical evaluation, exercise ECG, a CMR stress test including perfusion and infarct imaging, and x-ray coronary angiography (CA within 24 hours. CAD was defined as stenosis ≥70% on quantitative analysis of CA. Exercise ECG, CMR and CA was completed in 68 females (age 66.4 ± 8.8 years, number of CAD risk factors 3.5 ± 1.4. The prevalence of CAD on CA was 29%. The Duke treadmill score (DTS in the entire group was −3.0 ± 5.4 and was similar in those with and without CAD (−4.5 ± 5.8 and −2.4 ± 5.1; P = 0.12. Sensitivity, specificity and accuracy for CAD diagnosis was higher for CMR compared with exercise ECG (sensitivities 85% and 50%, P = 0.02, specificities 94% and 73%, P = 0.01, and accuracies 91% and 66%, P = 0.0007, respectively. Even after applying the DTS the accuracy of CMR was higher compared to exercise ECG (area under ROC curve 0.94 ± 0.03 vs 0.56 ± 0.07; P = 0.0001. Conclusions In women with intermediate-to-high risk for CAD who are able to exercise and have interpretable resting ECG, CMR stress perfusion imaging has higher accuracy for the detection of relevant obstruction of the epicardial coronaries when directly compared to exercise ECG.

  1. Endovascular repair of ruptured abdominal aortic aneurysm

    Šarac Momir

    2014-01-01

    Full Text Available Introduction. Rupture of an abdominal aortic aneurysm (AAA is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR. We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. Case report. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient’s comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80% it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. Endovascular grafting was achieved with aorto-bi-iliac bifurcated excluder endoprosthesis with complete exclusion of the aneurysmal sac, without further enlargment of haemathoma and no contrast leakage. The postoperative course of the patient was eventless, without complications. On recall examination 3 months after, the state of the patient was well. Conclusion. The alternative for open reconstruction of ruptured AAA in haemodynamically stable patients with suitable anatomy and comorbidities could be emergency EVAR in local anesthesia. This technique could provide greater chances for survival with lower intraoperative and postoperative morbidity and mortality, as shown in the presented patient.

  2. Right iliac arterial aneurysm in a 4-year-old girl who does not have a right external iliac artery.

    Lee, Jeong-Hwan; Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Kim, Hyun-Young; Jung, Sung-Eun

    2016-11-01

    Pediatric arterial aneurysm is rare disease. Among them, idiopathic-congenital arterial aneurysm is extremely rare. This is a case report of right common iliac artery idiopathic aneurysm with absence of right external iliac artery. A 4-year-old girl who had been complaining of intermittent abdominal pain since 2 years prior presented with a right lower abdominal mass that had been palpable since 6 months prior. Abdominal CT revealed a 5.2 cm × 4.5 cm × 5.1 cm, right-sided, partially thrombosed, saccular, iliac artery aneurysm. She underwent to operation, aneurismal resection. A pathological examination confirmed that it was a true aneurysm, considering that all layers of the vascular wall were stretched with no deficit. The patient was discharged 3 days after the surgery without any complication. Five months passed since the surgery, and the patient is doing well without any abdominal or leg pain.

  3. COMPARISON OF HIGH-DEFINITION OSCILLOMETRIC AND DIRECT ARTERIAL BLOOD PRESSURE MEASUREMENT IN ANESTHETIZED CHEETAHS (ACINONYX JUBATUS).

    Sant Cassia, Emma V; Boswood, Adrian; Tordiffe, Adrian S W

    2015-09-01

    Blood pressure measurement reveals important insights into the health of conscious and anesthetized individuals. This is of particular interest in cheetahs (Acinonyx jubatus), which in captivity are known to suffer from chronic diseases that may be associated with hypertension and which often require immobilization for transport or veterinary treatment. Invasive testing methods are considered the gold standard but are not practical in many settings. Consequently, it is important to evaluate the use of noninvasive methods in this species. Measurements for systolic, diastolic, and mean arterial pressure obtained using high-definition oscillometry (HDO) at the coccygeal artery were compared to simultaneous direct measurements obtained via catheterization of the femoral or dorsal pedal artery in eight anesthetized captive cheetahs during nine anesthetic events. Overall, HDO and direct measurements agreed most closely for mean arterial pressure, and the poorest agreement was observed for systolic pressure. There was a tendency for low diastolic pressures to be underestimated and for high diastolic pressures to be overestimated. Across all three parameters, HDO measurements from the tail overestimated directly measured pressures in the femoral artery and underestimated those in the dorsal pedal artery. HDO agreed most closely with directly measured dorsal pedal pressures. Mean arterial pressure showed the greatest precision (standard deviation of 10.2 mm Hg) and lowest bias (-1.2 mm Hg), with 75.9% of readings within 10 mm Hg of the direct dorsal pedal pressure. Agreement with systolic pressure was hindered by a high bias (-10.4 mm Hg), but if a correction factor of +10 mm Hg was applied to all systolic measurements, agreement was improved and 65.7% of readings were within 10 mm Hg of the direct pressure. When compared to criteria defined by the American College of Veterinary Internal Medicine for validation of blood pressure devices, results were favorable, but a

  4. Circulating oxidized low-density lipoproteins and arterial elasticity: comparison between men with metabolic syndrome and physically active counterparts

    Pohjantähti-Maaroos Hanna

    2010-08-01

    Full Text Available Abstract Background Accumulation of oxidized low-density lipoproteins in the intimae of arteries and endothelial dysfunction are key events in the development of atherosclerosis. Patients with metabolic syndrome are at high risk for cardiovascular diseases but the linkage between metabolic syndrome and atherosclerosis is incompletely understood. We studied whether the levels of oxidized LDL and arterial elasticity differ between metabolic syndrome patients and physically active controls. Methods 40 men with metabolic syndrome and 40 physically active controls participated in this cross-sectional study. None of the study subjects had been diagnosed with cardiovascular disease. Levels of oxidized LDL were assessed by a two-site ELISA immunoassay. Arterial elasticity was assessed non-invasively by the HDI/PulseWave™ CR-2000 arterial tonometer. Results Levels of oxidized LDL were 89.6 ± 33.1 U/L for metabolic syndrome subjects and 68.5 ± 23.6 U/L for controls (p = 0.007. The difference remained significant after adjustment for LDL cholesterol. Large artery elasticity index (C1 was 16.2 ± 4.1 mL/mmHgx10 for metabolic syndrome subjects and 19.4 ± 3.7 mL/mmHgx10 for controls (p = 0.001, small artery indices (C2 were 7.0 ± 3.2 mL/mmHgx100 and 6.5 ± 2.9 mL/mmHgx100 (NS, respectively. Conclusions Subjects with metabolic syndrome had elevated levels of oxidized LDL and reduced large arterial elasticity compared to controls. This finding may partly explain the increased risk for cardiovascular diseases among metabolic syndrome patients. Trial registration ClinicalTrials.gov NCT01114763

  5. Abdominal tuberculosis: Imaging features

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

    2005-08-01

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.

  6. Abdominal and Pelvic CT

    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  7. [The abdominal catastrophe].

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  8. Abdominal ultrasound (image)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  9. Abdominal x-ray

    ... are, or may be, pregnant. Alternative Names Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also ...

  10. Linear abdominal trauma.

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  11. Change in abdominal obesity and risk of coronary calcification

    Sabour, S.; Grobbee, D.E.; Prokop, M.; Schouw, Y.T. van der; Bots, M.L.

    2011-01-01

    BACKGROUND: A prospective follow-up study was conducted to examine the relationship between 9 year change in abdominal obesity and risk of coronary artery calcification (CAC). METHODS: Data on coronary risk factors for 573 postmenopausal women were collected at baseline (1993-1997) and follow

  12. Ischemic colitis complicating reconstruction of the abdominal aorta

    Schroeder, T V; Christoffersen, J K; Andersen, J

    1985-01-01

    A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence...

  13. Usefulness of helical CT angiography for diagnosis of anomalous origin of coronary artery. Comparison with coronary angiography

    Shinozaki, Hitoshi; Kondo, Takeshi; Ishikawa, Emiko [Fujita Health Univ., Toyoake, Aichi (Japan)] [and others

    1998-07-01

    Usefulness of helical CT angiography with reconstruction image of diastolic phase synchronized with electrocardiogram was compared with that of coronary angiography for diagnosis of anomalous origin of coronary artery. Patients were 2 males and 3 females, and average age was 66.4 year. Three cardiologists judged images and did not confirmed the origin and direction of coronary artery in 60% of cases. Helical CT was carried out with heartbeat <60/min by oral administration of propranolol (10-20 mg) one hour before the test. Half image was reconstructed by using data of diastolic phase which is 600 msec back from R-wave of an electrocardiogram. Multiplanar reconstruction (MPR) image and 3D image were provided. Two radiologists judged these images. A judgment was completed with 4 cases among 5 cases, and two judgments agreed well. For diagnosis of anomalous origin of coronary artery, helical CT had good accuracy and was more sensitive than coronary angiography. (K.H.)

  14. Arterial elasticity imaging: comparison of finite-element analysis models with high-resolution ultrasound speckle tracking

    Park Dae

    2010-06-01

    Full Text Available Abstract Background The nonlinear mechanical properties of internal organs and tissues may be measured with unparalleled precision using ultrasound imaging with phase-sensitive speckle tracking. The many potential applications of this important noninvasive diagnostic approach include measurement of arterial stiffness, which is associated with numerous major disease processes. The accuracy of previous ultrasound measurements of arterial stiffness and vascular elasticity has been limited by the relatively low strain of nonlinear structures under normal physiologic pressure and the measurement assumption that the effect of the surrounding tissue modulus might be ignored in both physiologic and pressure equalized conditions. Methods This study performed high-resolution ultrasound imaging of the brachial artery in a healthy adult subject under normal physiologic pressure and the use of external pressure (pressure equalization to increase strain. These ultrasound results were compared to measurements of arterial strain as determined by finite-element analysis models with and without a surrounding tissue, which was represented by homogenous material with fixed elastic modulus. Results Use of the pressure equalization technique during imaging resulted in average strain values of 26% and 18% at the top and sides, respectively, compared to 5% and 2%, at the top and sides, respectively, under physiologic pressure. In the artery model that included surrounding tissue, strain was 19% and 16% under pressure equalization versus 9% and 13% at the top and sides, respectively, under physiologic pressure. The model without surrounding tissue had slightly higher levels of strain under physiologic pressure compared to the other model, but the resulting strain values under pressure equalization were > 60% and did not correspond to experimental values. Conclusions Since pressure equalization may increase the dynamic range of strain imaging, the effect of the

  15. Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent

    Koul Parvaiz

    2011-01-01

    Full Text Available Background: Arterial blood gas (ABG analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding. Objective: To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO 2 , pO 2 , and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients. Setting: Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m. Methods: One hundred patients who required ABG analysis were admitted. Peripheral venous blood was drawn within 5 min of an ABG measurement, and the samples analyzed immediately on a point of care automated ABG analyzer. Finger pulse oximetry was used to obtain oxygen (SpO 2 saturation. Data were analyzed using Pearson correlation and bias (Bland Altman methods. Results: The venous measurements of pH, pCO 2 , pO 2 and bicarbonate, and the digital oxygen saturation were highly correlated with their corresponding arterial measurements. Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements with clinically acceptable differences. The difference in pO 2 measurements was, however, higher (-22.34 ± 15.23 although the arterial saturation and finger oximetry revealed a good degree of agreement with clinically acceptable bias. Conclusion: Peripheral venous blood gas assessment in conjunction with finger pulse oximetry can obviate the routine use of arterial puncture in patients requiring ABG analysis.

  16. Population distribution of the sagittal abdominal diameter (SAD from a representative sample of US adults: comparison of SAD, waist circumference and body mass index for identifying dysglycemia.

    Henry S Kahn

    Full Text Available The sagittal abdominal diameter (SAD measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ("abdominal height" between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥ 20; response rate 88% we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95% confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC, and body mass index (BMI, kg/m(2 to identify prevalent dysglycemia (HbA1c ≥ 5.7%. For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1 and 4 (p<0.001 vs quartile 1 remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC indicated that the dysglycemia model fit for SAD (age-adjusted was 0.734 for men (greater than the AUC for WC, p<0.001 and 0.764 for women (greater than the AUC for WC or BMI, p<0.001.Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.

  17. Obesity and arterial compliance alterations.

    Seifalian, Alexander M; Filippatos, Theodosios D; Joshi, Jatin; Mikhailidis, Dimitri P

    2010-03-01

    Obesity is associated with increased cardiovascular disease (CVD) risk, especially when excess body fat is distributed preferentially within the abdominal region. Obese subjects usually have increased arterial stiffness compared with non-obese subjects of similar age. The factors associated with increased arterial stiffness in obesity include endothelial dysfunction (decreased nitric oxide bioavailability), impaired smooth muscle cell function, insulin resistance, as well as elevated cholesterol and C-peptide levels. Furthermore, visceral fat, the adipose tissue-related renin-angiotensin-aldosterone system and hyperleptinaemia contribute to the obesity-associated impaired arterial compliance. Weight loss improves CVD risk factors and arterial compliance. Because increased arterial stiffness is a marker of CVD risk these findings support the concept that the presence of obesity has vascular implications.

  18. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension.

    Mackenzie, Isla S; McEniery, Carmel M; Dhakam, Zahid; Brown, Morris J; Cockcroft, John R; Wilkinson, Ian B

    2009-08-01

    Isolated systolic hypertension is an important risk factor for cardiovascular disease and results primarily from elastic artery stiffening. Although various drug therapies are used to lower peripheral blood pressure (BP) in patients with isolated systolic hypertension, the effects of the 4 major classes of antihypertensive agents on central BP, pulse pressure (PP) amplification, and arterial stiffness in this condition are not clear. Fifty-nine patients over the age of 60 years with untreated isolated systolic hypertension (systolic BP > or =140 mm Hg and diastolic BP hypertension, the choice of therapy may be influenced by these findings in the future.

  19. Comparison between capillary, venous and arterial levels of protein S100B in patients with severe brain pathology

    Astrand, Ramona; Romner, Bertil; Reinstrup, Peter

    2012-01-01

    Protein S100B is soon in clinical use as a sensitive marker after mild traumatic head injury in adults. Initial studies of S100B in pediatric head injury have shown promising results. Venous sampling can be challenging in children and capillary samples are often a preferred option. The aim...... of the study was to investigate the relation between capillary, venous and arterial measurements of protein S100B, primarily by determining whether capillary S100B differ from venous and if capillary S100B can predict venous S100B levels, and secondarily, if arterial S100B samples can substitute venous samples...

  20. The Study of Relationship between Inferior Phrenic Artery Originated from Abdominal Aorta and Celiac Trunk by Using Multi-Slice Helical CT%起源于腹主动脉的膈下动脉与腹腔干关系的多层螺旋CT研究

    宫凤玲; 于鹏; 张惠英; 李盖; 赵鹤亮; 孙凤涛

    2011-01-01

    Purpose To explore whether there are some rules in the relationship between inferior phrenic artery (IPA) originated from the abdominal aorta and the celiac trunk. Materials and Methods The origin of IPA in 200 patients (174 with abdomen scan and 26 with chest-abdomen scan) who underwent two-phase enhanced CT scan at Philips 256-slice helical CT were respectively observed. The relationship of the orifice position between IPA originated from the abdominal aorta and the celiac trunk was analysed. Results RIPA was shown in 200 cases with total 201 branches. LIPA was shown in 198 cases with total 203 branches. 2 cases of LIPA were not shown. Bilateral IPA originated from a common stem was seen in 48 of 200 cases (24%). RIPA originated from the celiac trunk in 70/201 cases(34.8%) , from the aorta in 82/201 cases(40.8%), from the right renal artery in 37/201cases (18.4%), from the right accessory renal artery in 4/201cases (2.0%) and from the lefi gastric artery in 8/201 cases (4%). LIPA originated from the celiac trunk in 113/203 cases (55.7%), from the aorta in 77/203 cases (37.g%), from the left gastric artery in 11/203 cases(5.4%) and from the spleen artery in 2/203 cases (1.0%). There are some rules in the relationship between the origin of IPA originated from the abdominal aorta (135cases) and the celiac trunk: ① 98.3% of RIPA located in the 9-12 o'clock position relative to the wall of the aorta. LIPA and IPA which originated from a common stem located in the 12-3 o'clock position relative to the wall of aorta ; ② 80.0% of IPA had orifice located 10mm upper or lower of the orifice of the celiac trunk and the remaining located 10mm lower than the orifice of the celiac trunk.③ 63.8% of RIPA had the orifice located under the orifice of the celiac trunk. 43.4% of LIPA and 54.2% of IPA which originated from a common stem located upper than the orifice of the celiac trunk. ④ 86.8% of IPA had the orifice located under the orifice

  1. Quantitative and qualitative comparison of 0.025 mmol/kg gadobenate dimeglumine for abdominal MRI at 1.5 T and 3 T MRI in patients with low estimated glomerular filtration rate

    Ramalho, Miguel; AlObaidy, Mamdoh; Busireddy, Kiran K.; Altun, Ersan; Liu, Baodong; Semelka, Richard C., E-mail: richsem@med.unc.edu

    2015-01-15

    Highlights: • Efficacy and adequacy of enhancement using quarter dose gadobenate dimeglumine at 1.5 T was studied in patients with low GFR. • A dose of 0.025 mmol/kg of gadobenate dimeglumine at 1.5 T showed diagnostic enhancement quality in the majority of patients. • There were no significant differences between the qualitative perception of enhancement between 1.5 T and 3 T. • Patients who have renal impairment may still be able to receive GBCAs, while maintaining adequate enhancement at 1.5 T. - Abstract: Purpose: To investigate the efficacy and adequacy of enhancement employing 0.025 mmol/kg of gadobenate dimeglumine at 1.5 Tesla (T), and to compare the extent of enhancement of this dosage between 1.5 T and 3 T systems. Materials and methods: Our final population included 116 consecutive patients who underwent 0.025 mmol/kg gadobenate dimeglumine-enhanced abdominal MRI (78 men and 38 women; age, 64.1 ± 13.6 years). Sixty patients underwent imaging at 1.5 T and 56 patients underwent imaging at 3 T. Abdominal enhancement was evaluated qualitatively and quantitatively. The quality of enhancement was compared using Mann–Whitney U test. The percentage of enhancement of each organ was compared using Student t-test. Results: The mean quality rating of enhancement was at least “good” in all phases of enhancement for both 1.5 T and 3 T. There was a non-significant trend to higher mean ratings at 3 T. The liver showed a 1.3-fold higher arterial-phase percentage of enhancement at 3 T (p = 0.0138). There were no differences between the mean relative enhancement of the pancreas and aorta throughout all phases of enhancement. The percentage of enhancement of the renal cortex was significantly higher at 3 T (p < 0.0001 to p = 0.0293). Conclusion: A dose of 0.025 mmol/kg of gadobenate dimeglumine demonstrates diagnostic enhancement in the majority of patients at 1.5 T, without significant differences on qualitative evaluation compared to 3 T.

  2. Comparison of drug eluting stent implantation with coronary artery bypass surgery in the treatment of patients with chronic total occlusion and multiple vessel disease

    LIU Wei; ZHU Xiao-Ling; MA Chang-sheng; KANG Jun-ping; DU Xin; CHEN Fang; ZHOU Yu-jie; L(U) Shu-zheng; HUANG Fang-jiong; GU Cheng-xiong

    2011-01-01

    Background In patients with chronic total occlusion (CTO) and multivessel coronary artery disease, the comparison of surgical and the percutaneous revascularization strategies has rarely been conducted. The aim of this study was to compare long term clinical outcomes of drug eluting stent (DES) implantation with coronary artery bypass surgery (CABG)in the patients with CTO and multivessel disease.Methods From a prospective registry of 6000 patients in our institution, we included patients with CTO and multivessel coronary artery disease who underwent either CABG (n=679) or DES (n=267) treatment. Their propensity risk score was used for adjusting baseline differences.Results At a median follow-up of three years, propensity score adjusted Cox regression analysis showed that the rate of major adverse cardiac cerebrovascular events (MACCE) was lower in CABG group (12.7% vs. 24.3%, hazard ratio (HR) 1.969, 95% Cl 1.219-3.179, P=0.006) mainly due to lower rate of target vessel revascularization in CABG group than in DES group (3.1% vs. 17.2%, HR 16.14, 95% CI 5.739-45.391, P <0.001). The incidence of cardiac death or myocardial infarction (composite end point) was not significantly different between these two groups. On multivariate analysis, the significant predictors of MACCE were only the type of revascularization. Age, left ventricular ejection fraction (LVEF), and complete revascularization were identified as significant predictors of composite end points.Conclusions Our study shows that in patients with CTO and multivessel coronary disease, DES can offer comparable long term outcomes in cardiac death and myocardial infraction free survival in comparison with CABG. However, there is an increased rate of MACCE which results from more repeat revascularizations. Obtaining a complete revascularization is crucial for decreasing adverse cardiac events.

  3. Three-dimensional reconstruction of coronary arteries and plaque morphology using CT angiography - comparison and registration with IVUS

    L.S. Athanasiou (Lambros S.); G. Rigas (George); A.I. Sakellarios (Antonis); T.P. Exarchos (Themis); P.K. Siogkas (Panagiotis); C.V. Bourantas (Christos); H.M. Garcia-Garcia (Hector); P.A. Lemos Neto (Pedro); B.A. Falcao (Breno A.); L.K. Michalis (Lampros); O. Parodi (Oberdan); F. Vozzi (Federico); D.I. Fotiadis (Dimitrios)

    2016-01-01

    textabstractBackground: The aim of this study is to present a new methodology for three-dimensional (3D) reconstruction of coronary arteries and plaque morphology using Computed Tomography Angiography (CTA). Methods: The methodology is summarized in six stages: 1) pre-processing of the initial raw i

  4. Caloric restriction increases internal iliac artery and penil nitric oxide synthase expression in rat: Comparison of aged and adult rats

    Emin Ozbek

    2013-09-01

    Full Text Available Because of the positive corelation between healthy cardiovascular system and sexual life we aimed to evaluate the effect of caloric restriction (CR on endothelial and neuronal nitric oxide synthase (eNOS, nNOS expression in cavernousal tissues and eNOS expression in the internal iliac artery in young and aged rats. Young (3 mo, n = 7 and aged (24 mo, n = 7 male Sprague-Dawley rats were subjected to 40% CR and were allowed free access to water for 3 months. Control rats (n = 14 fed ad libitum had free access to food and water at all times. On day 90, rats were sacrified and internal iliac arteries and penis were removed and parafinized, eNOS and nNOS expression evaluated with immunohistochemistry. Results were evaluated semiquantitatively. eNOS and nNOS expression in cavernousal tis- sue in CR rats were more strong than in control group in both young and old rats. eNOS expression was also higher in the internal iliac arteries of CR rats than in control in young and old rats. As a result of our study we can say that there is a positive link between CR and neurotransmitter of erection in cavernousal tissues and internal iliac arteries. CR has beneficial effect to prevent sexual dysfunction in young and old animals and possible humans.

  5. Comparison of mesenchymal stromal cells from young healthy donors and patients with severe chronic coronary artery disease

    Friis, Tina; Haack-Sørensen, Mandana; Hansen, Susanne Kofoed;

    2011-01-01

    It has been questioned whether bone marrow-derived mesenchymal stromal cells (MSCs) from patients with ischemic heart disease are suitable for use in regenerative stem cell therapy. We compared MSCs from patients with chronic coronary artery disease (CAD) and MSCs from young healthy donors...

  6. Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation

    van den Wijngaard, J.P.H.M.; Siebes, M.; Westerhof, B.E.

    2009-01-01

    Coarctation of the aorta may develop during fetal life and impair quality of life in the adult because upper body hypertension and aneurysm formation in the descending aorta may develop. We used our computational model of the young adult arterial circulation, incorporated aorta coarctation over a ra

  7. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease

    P.W.J.C. Serruys (Patrick); P.P.T. de Jaegere (Peter); F. Kiemeneij (Ferdinand); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); G.R. Heyndrickx (Guy); H.U. Emanuelsson (Hakan); J. Marco (Jean); V.M.G. Legrand (Victor); P.H. Materne (Phillipe); J.A. Belardi (Jorge); U. Sigwart (Ulrich); A. Colombo (Antonio); J-J. Goy (Jean-Jacques); P.A. van den Heuvel (Paul); J. Delcan; M-A.M. Morel (Marie-Angèle)

    1994-01-01

    textabstractBalloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as c

  8. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease.

    P.W.J.C. Serruys (Patrick); P.P.T. de Jaegere (Peter); F. Kiemeneij (Ferdinand); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); G.R. Heyndrickx (Guy); H.U. Emanuelsson (Hakan); J. Marco (Jean); V.M.G. Legrand (Victor); P.H. Materne (Phillipe); J.A. Belardi (Jorge); U. Sigwart (Ulrich); A. Colombo (Antonio); J-J. Goy (Jean-Jacques); P. van den Heuvel; J. Delcan; M-A.M. Morel (Marie-Angèle)

    1994-01-01

    textabstractBACKGROUND. Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical o

  9. Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture.

    Kontopodis, Nikolaos; Metaxa, Eleni; Papaharilaou, Yannis; Tavlas, Emmanouil; Tsetis, Dimitrios; Ioannou, Christos

    2015-02-01

    Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it. The peak wall stress, the role of the unique geometry of every individual abdominal aortic aneurysm as well as the mechanical properties and the local strength of the degenerated aneurysmal wall, all confer to rupture risk. In this review article, the assessment of these variables through mechanical testing, advanced imaging and computational modeling is reviewed and the clinical perspective is discussed.

  10. Detection of unruptured cerebral artery aneurysms by MRA at 3.0 tesla: comparison with multislice helical computed tomographic angiography

    Numminen, Jussi; Porras, Matti; Kangasniemi, Marko (Dept. of Radiology, Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital, Helsinki (Finland)), email: jussi.numminen@hus.fi; Tarkiainen, Antti (Advanced Magnetic Imaging Center, Helsinki Univ. of Technology, Espoo (Finland)); Niemelae, Mika; Hernesniemi, Juha (Dept. of Neurosurgery, Helsinki Univ. Central Hospital, Helsinki (Finland))

    2011-07-15

    Background: Computed tomographic angiography (CTA) has become the primary non-invasive method for detection of cerebral artery aneurysms in many neurovascular centers. Purpose: To compare MR-angiography at a 3.0 tesla (3T) scanner to CTA in the detection of unruptured intracranial aneurysms. Material and Methods: CTA and 3T MRA data from 60 patients were evaluated. CTA was obtained with a 4-16-row helical CT-scanner after administration of 120 cc intravenous contrast agent, MRA was performed by a 3T MR-scanner using time-of-flight pulse sequence. Results: Fifty-five cerebral artery aneurysms were detected by MRA and 47 aneurysms by CTA. Most of the aneurysms detected by MRA but not by CTA were small internal carotid artery (ICA) aneurysms. Bone structures and venous enhancement deteriorated CTA accuracy, especially in skull base. In one patient a fairly large anterior communicating artery aneurysm was not visible in MRA due to spin saturation, although it was clearly visualized in CTA. After contrast injection the aneurysm was also seen in MRA. Although the overall image quality of MRA and CTA were comparable, MRA was more susceptible to artifacts and thus re-formatted surface-shaded volume rendered 3-dimensional images of aneurysms from MRA were inferior compared to those from CTA. Conclusion: MRA at 3T appears to be at least as sensitive as CTA in the detection of unruptured cerebral artery aneurysms, however image quality control is crucial and contrast agent enhances visualization of complex and large aneurysms

  11. Losartan renography for the detection of renal artery stenosis: comparison with captopril renography and evaluation of dose and timing

    Guenay, Emel Ceylan; Erguen, Eser Lay; Salanci, Bilge Volkan; Ugur, Oemer; Caner, Biray [Hacettepe University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Oeztuerk, M. Halil; Hekimoglu, Baki [Social Security Hospital Clinic of Radiology, Ankara (Turkey); Altun, Buelent [Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara (Turkey); Cil, Barbaros [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2005-09-01

    Radionuclide renography with angiotensin converting enzyme (ACE) inhibition plays an important role in the diagnosis of haemodynamically significant renal artery stenosis. Angiotensin receptor antagonists inhibit the renin angiotensin system at different levels from ACE inhibitors by selectively blocking the binding of angiotensin II to AT1 receptors. The AT1 angiotensin receptor antagonist losartan has recently been used clinically in the treatment of hypertension. However, the available data on the use of losartan with renography for the detection of renovascular hypertension are limited and contradictory. The purpose of this prospective study was to compare the effectiveness of losartan renography and captopril scintigraphy in revealing renal artery stenosis. A total of 61 renal units in 32 patients with hypertension were studied in two groups based on the losartan dosage (50 mg in group A and 100 mg in group B). Group A consisted of 17 patients, in whom 19 renal units had angiographically proven renal artery stenosis ({>=}50%). In group B, there were 15 patients, in whom 20 renal arteries were stenotic. All of the patients underwent three renographies (baseline, captopril renography and early losartan renography). Early losartan renography was performed at 1 h after oral losartan administration in both groups. In group B, seven patients underwent additional losartan renography (late losartan) performed 3 h after oral losartan administration; these patients composed group B1. The sensitivities of captopril and losartan studies were 63.2% and 42% in group A, 65% and 65% in group B and 55.6% and 66.6% in group B1, respectively. From our preliminary results, we conclude that losartan is not superior to captopril renography for the detection of haemodynamically significant renal artery stenosis. However, a high dose (100 mg) of losartan provided higher sensitivity than the lower dose (50 mg). Late losartan scintigraphy provided similar diagnostic efficacy to early

  12. Intra-Arterial MR Perfusion Imaging of Meningiomas: Comparison to Digital Subtraction Angiography and Intravenous MR Perfusion Imaging

    Martin, Alastair J.; Alexander, Matthew D.; McCoy, David B.; Cooke, Daniel L.; Lillaney, Prasheel; Moftakhar, Parham; Amans, Matthew R.; Settecase, Fabio; Nicholson, Andrew; Dowd, Christopher F.; Halbach, Van V.; Higashida, Randall T.; McDermott, Michael W.; Saloner, David; Hetts, Steven W.

    2016-01-01

    Background and Purpose To evaluate the ability of IA MR perfusion to characterize meningioma blood supply. Methods Studies were performed in a suite comprised of an x-ray angiography unit and 1.5T MR scanner that permitted intraprocedural patient movement between the imaging modalities. Patients underwent intra-arterial (IA) and intravenous (IV) T2* dynamic susceptibility MR perfusion immediately prior to meningioma embolization. Regional tumor arterial supply was characterized by digital subtraction angiography and classified as external carotid artery (ECA) dural, internal carotid artery (ICA) dural, or pial. MR perfusion data regions of interest (ROIs) were analyzed in regions with different vascular supply to extract peak height, full-width at half-maximum (FWHM), relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and mean transit time (MTT). Linear mixed modeling was used to identify perfusion curve parameter differences for each ROI for IA and IV MR imaging techniques. IA vs. IV perfusion parameters were also directly compared for each ROI using linear mixed modeling. Results 18 ROIs were analyzed in 12 patients. Arterial supply was identified as ECA dural (n = 11), ICA dural (n = 4), or pial (n = 3). FWHM, rCBV, and rCBF showed statistically significant differences between ROIs for IA MR perfusion. Peak Height and FWHM showed statistically significant differences between ROIs for IV MR perfusion. RCBV and MTT were significantly lower for IA perfusion in the Dural ECA compared to IV perfusion. Relative CBF in IA MR was found to be significantly higher in the Dural ICA region and MTT significantly lower compared to IV perfusion. PMID:27802268

  13. Abdominal emergencies in pediatrics.

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  14. Abdominal vascular syndromes: characteristic imaging findings

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D' Ippolito, Giuseppe, E-mail: leandrocleite@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Mediciana. Departmento de Diagnostico por Imagem

    2016-07-15

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital - including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) - compressive - including 'nutcracker' syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. (author)

  15. Faster pediatric 3-T abdominal magnetic resonance imaging: comparison between conventional and variable refocusing flip-angle single-shot fast spin-echo sequences

    Ruangwattanapaisarn, Nichanan [Mahidol University, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Bangkok (Thailand); Stanford University, LPCH Department of Radiology, Stanford, CA (United States); Loening, Andreas M.; Saranathan, Manojkumar; Vasanawala, Shreyas S. [Stanford University, LPCH Department of Radiology, Stanford, CA (United States); Litwiller, Daniel V. [GE Healthcare, Rochester, MN (United States)

    2015-06-15

    Single-shot fast spin echo (SSFSE) is particularly appealing in pediatric patients because of its motion robustness. However radiofrequency energy deposition at 3 tesla forces long pauses between slices, leading to longer scans, longer breath-holds and more between-slice motion. We sought to learn whether modulation of the SSFSE refocusing flip-angle train could reduce radiofrequency energy deposition without degrading image quality, thereby reducing inter-slice pauses and overall scan times. We modulated the refocusing flip-angle train for SSFSE to minimize energy deposition while minimizing blurring and motion-related signal loss. In a cohort of 50 consecutive patients (25 boys, mean age 5.5 years, range 1 month to 17 years) referred for abdominal MRI we obtained standard SSFSE and variable refocusing flip-angle (vrfSSFSE) images and recorded sequence scan times. Two readers independently scored the images in blinded, randomized order for noise, tissue contrast, sharpness, artifacts and left lobe hepatic signal uniformity on a four-point scale. The null hypothesis of no difference between SSFSE and vrfSSFSE image-quality was assessed with a Mann-Whitney U test, and the null hypothesis of no scan time difference was assessed with the paired t-test. SSFSE and vrfSSFSE mean acquisition times were 54.3 and 26.2 s, respectively (P-value <0.0001). For each reader, SSFSE and vrfSSFSE noise, tissue contrast, sharpness and artifacts were not significantly different (P-values 0.18-0.86). However, SSFSE had better left lobe hepatic signal uniformity (P < 0.01, both readers). vrfSSFSE is twice as fast as SSFSE, with equivalent image quality with the exception of left hepatic lobe signal heterogeneity. (orig.)

  16. Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography

    Khoss, A.E.; Ponhold, W.; Pollak, A.; Schlemmer, M.; Weninger, M.

    1985-09-01

    When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries.

  17. Childhood abdominal cystic lymphangioma

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  18. Abdominal paracentesis and thoracocentesis.

    Lee, Ser Yee; Pormento, James G; Koong, Heng Nung

    2009-04-01

    Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.

  19. [Abdominal actinomycosis with IUD].

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  20. Comparison of continuous thoracic epidural and paravertebral block for postoperative analgesia after robotic-assisted coronary artery bypass surgery

    Mehta Yatin

    2008-01-01

    Full Text Available Minimally invasive surgery with robotic assistance should elicit minimal pain. Regional analgesic techniques have shown excellent analgesia after thoracotomy. Thus the aim of this study was to compare thoracic epidural analgesia (TEA technique with paravertebral block (PVB technique in these patients with regard to quality of analgesia, complications, and haemodynamic and respiratory parameters. This was a prospective randomised study involving 36 patients undergoing elective robotic-assisted coronary artery bypass grafting (CABG. TEA or PVB were administered in these patients. The results revealed no significant differences with regard to demographics, haemodynamics, and arterial blood gases. Pulmonary functions were better maintained in PVB group postoperatively; however, this was statistically insignificant. The quality of analgesia was also comparable in both the groups. We conclude that PVB is a safe and effective technique for postoperative analgesia after robotic-assisted CABG and is comparable to TEA with regard to quality of analgesia.

  1. [Comparison of the effectiveness of moxonidine and prestarium in postmenopausal women with mild and moderate arterial hypertension].

    Bakhshaliev, A B; Sabzalieva, G M

    2006-01-01

    The subjects of this randomized comparative study were 36 postmenopausal women aged 53.7 +/- 1.4 years, suffering from arterial hypertension (AH). The aim was to evaluate the clinical effectiveness of moxonidine, an imidazoline receptor agonist, and prestarium, an angiotensin converting enzyme (ACE) inhibitor, and their effects on target organs and lipid metabolism. The groups were comparable in age, sex, AH duration, as well as office systolic and diastolic arterial pressure. The study demonstrated comparable hypotensive effects of both pharmaceuticals, although moxonidine had an effect on target organs (left ventricular myocardial hypertrophy). After 6 months of treatment moxonidine significantly lowered left ventricular myocardial mass (12.7% on the average, p < 0.05). The study also revealed a positive effect of moxonidine on lipid exchange variables.

  2. Effects of wall condition on flow distributions in arterial modeling: comparison of rigid, dynamic, and compliant walls

    He, Fan [Beijing University of Civil Engineering and Architecture, Beijing (China); Hua, Lu; Gao, Li jian [Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China)

    2016-03-15

    Blood flow distributions were evaluated using various computational strategies. Three commonly used wall conditions in arterial modeling were employed, namely rigid, dynamic and compliant walls. The results show that the velocity distributions are similar under rigid and dynamic walls, developing into the Poiseuille flow, but they are blunt under compliant walls. The peak pressure under rigid walls is highest, but the model of dynamic walls has a good approximation of pressure against the model of compliant walls. The results indicate that a model of compliant walls appears to be a computationally and reasonably accurate approximation of blood velocity distributions compared with the analysis under rigid or dynamic walls. Introducing fluid-structure interaction into arterial modeling is necessary to ensure reliable results and information. However, a model of dynamic walls seems to be a computationally inexpensive yet reasonably accurate approximation for pressure.

  3. Three-band decomposition analysis in multiscale FSI models of abdominal aortic aneurysms

    Nestola, Maria G. C.; Gizzi, Alessio; Cherubini, Christian; Filippi, Simonetta

    2016-07-01

    Computational modeling plays an important role in biology and medicine to assess the effects of hemodynamic alterations in the onset and development of vascular pathologies. Synthetic analytic indices are of primary importance for a reliable and effective a priori identification of the risk. In this scenario, we propose a multiscale fluid-structure interaction (FSI) modeling approach of hemodynamic flows, extending the recently introduced three-band decomposition (TBD) analysis for moving domains. A quantitative comparison is performed with respect to the most common hemodynamic risk indicators in a systematic manner. We demonstrate the reliability of the TBD methodology also for deformable domains by assuming a hyperelastic formulation of the arterial wall and a Newtonian approximation of the blood flow. Numerical simulations are performed for physiologic and pathologic axially symmetric geometry models with particular attention to abdominal aortic aneurysms (AAAs). Risk assessment, limitations and perspectives are finally discussed.

  4. Analysis of deep inferior epigastric perforator (DIEP) arteries by using MDCTA: Comparison between 2 post-processing techniques

    Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Atzeni, Matteo; Ribuffo, Diego [Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Mallarini, Giorgio [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Suri, Jasjit S. [Biomedical Technologies Inc., Denver, CO (United States); Idaho State University (Aff.), ID (United States)

    2012-08-15

    Purpose: Our purpose was to compare two post-processing techniques, Maximum-Intensity-Projection (MIP) and Volume Rendering (VR) for the study of perforator arteries. Methods: Thirty patients who underwent Multi-Detector-Row CT Angiography (MDCTA) between February 2010 and May 2010 were retrospectively analyzed. For each patient and for each reconstruction method, the image quality was evaluated and the inter- and intra-observer agreement was calculated according to the Cohen statistics. The Hounsfield Unit (HU) value in the common femoral artery was quantified and the correlation (Pearson Statistic) between image quality and HU value was explored. Results: The Pearson r between the right and left common femoral artery was excellent (r = 0.955). The highest image quality score was obtained using MIP for both observers (total value 75, with a mean value 2.67 for observer 1 and total value of 79 and a mean value of 2.82 for observer 2). The highest agreement between the two observers was detected using the MIP protocol with a Cohen kappa value of 0.856. The ROC area under the curve (Az) for the VR is 0.786 (0.086 SD; p value = 0.0009) whereas the ROC area under the curve (Az) for the MIP is 0.0928 (0.051 SD; p value = 0.0001). Conclusion: MIP showed the optimal inter- and intra-observer agreement and the highest quality scores and therefore should be used as post-processing techniques in the analysis of perforating arteries.

  5. Comparison of two methods of dental prophylaxis: evaluation of arterial pressure and patient comfort in a clinical randomized controlled trial

    Camila Lopes FERREIRA

    Full Text Available Abstract Introduction The number of hypertensive patients is increasing and prophylaxis with bicarbonate jet are widely performed in clinical practice using large amounts of this substance in a short period of time, which may lead to increased arterial pressure. In the literature there are several studies that analyze the effect of sodium bicarbonate jet on the biofilm and dental structures, but not report the effect on arterial pressure. Aim Evaluated the change in arterial pressure before and after two procedures of dental prophylaxis, jet baking soda application and conventional prophylaxis, and patient opinion of the comfort of each system was obtained. Material and method We selected 20 patients aged 18 to 30 in need of prophylaxis to remove biofilm. The patients were placed into three different treatment groups: sodium bicarbonate jet (G1, conventional prophylaxis (G2 and control (G3, with a one month interval between treatments. Patients were divided into groups randomly. Measurements were performed immediately before and after the procedure, 15 and 30 minutes after the end of treatment. Patient comfort was measured using a Visual Analog Scale (VAS at the end of each treatment. Data were analyzed by analysis of variance. Result There was a statistically significant difference in the comfort of the procedures, with G2 and G3 being better than G1. Additionally, an increase in the diastolic blood pressure was observed in sodium bicarbonate jet group evaluated just after the procedure. Conclusion The conventional prophylaxis is more comfortable from the patient stand point and does not alter arterial pressure.

  6. Comparison of Three-Dimensional (3D) Conformal Proton Radiotherapy (RT), 3D Conformal Photon RT, and Intensity-Modulated RT for Retroperitoneal and Intra-Abdominal Sarcomas

    Swanson, Erika L. [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Louis, Debbie; Flampouri, Stella; Li, Zuofeng [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Morris, Christopher G.; Paryani, Nitesh [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Slopsema, Roelf [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)

    2012-08-01

    Purpose: To compare three-dimensional conformal proton radiotherapy (3DCPT), intensity-modulated photon radiotherapy (IMRT), and 3D conformal photon radiotherapy (3DCRT) to predict the optimal RT technique for retroperitoneal sarcomas. Methods and Materials: 3DCRT, IMRT, and 3DCPT plans were created for treating eight patients with retroperitoneal or intra-abdominal sarcomas. The clinical target volume (CTV) included the gross tumor plus a 2-cm margin, limited by bone and intact fascial planes. For photon plans, the planning target volume (PTV) included a uniform expansion of 5 mm. For the proton plans, the PTV was nonuniform and beam-specific. The prescription dose was 50.4 Gy/Cobalt gray equivalent CGE. Plans were normalized so that >95% of the CTV received 100% of the dose. Results: The CTV was covered adequately by all techniques. The median conformity index was 0.69 for 3DCPT, 0.75 for IMRT, and 0.51 for 3DCRT. The median inhomogeneity coefficient was 0.062 for 3DCPT, 0.066 for IMRT, and 0.073 for 3DCRT. The bowel median volume receiving 15 Gy (V15) was 16.4% for 3DCPT, 52.2% for IMRT, and 66.1% for 3DCRT. The bowel median V45 was 6.3% for 3DCPT, 4.7% for IMRT, and 15.6% for 3DCRT. The median ipsilateral mean kidney dose was 22.5 CGE for 3DCPT, 34.1 Gy for IMRT, and 37.8 Gy for 3DCRT. The median contralateral mean kidney dose was 0 CGE for 3DCPT, 6.4 Gy for IMRT, and 11 Gy for 3DCRT. The median contralateral kidney V5 was 0% for 3DCPT, 49.9% for IMRT, and 99.7% for 3DCRT. Regardless of technique, the median mean liver dose was <30 Gy, and the median cord V50 was 0%. The median integral dose was 126 J for 3DCPT, 400 J for IMRT, and 432 J for 3DCRT. Conclusions: IMRT and 3DCPT result in plans that are more conformal and homogenous than 3DCRT. Based on Quantitative Analysis of Normal Tissue Effects in Clinic benchmarks, the dosimetric advantage of proton therapy may be less gastrointestinal and genitourinary toxicity.

  7. In-phase and out-of-phase gradient-echo imaging in abdominal studies: intra-individual comparison of three different techniques

    Ramalho, Miguel; Heredia, Vasco; Campos, Rafael O. P. de; Azevedo, Rafael M.; Semelka, Richard C. (Dept. of Radiology, Univ. of North Carolina at Chapel Hill (United States)); Dale, Brian M. (Siemens Medical Systems, Morrisville (United States)), email: richsem@med.unc.edu

    2012-05-15

    Background: T1-weighted gradient-echo in-phase and out-of-phase imaging is an essential component of comprehensive abdominal MR exams. It is useful for the study of fat-containing lesions and to identify various disease states related to the presence of fat in the liver. Purpose: To compare three T1-weighted in-phase and out-of-phase (IP/OP) gradient-echo imaging sequences in an intra-individual fashion, and to determine whether advantages exist for each of these sequences for various patient types. Material and Methods: One hundred and eighteen consecutive subjects (74 men, 44 women; mean age 53.9 +- 13.8 years) who had MRI examinations containing all three different IP/OP sequences (two-dimensional spoiled gradient-echo [2D-GRE], three-dimensional gradient-echo [3D-GRE], and magnetization-prepared gradient-recall echo [MP-GRE]) were included. Two different reviewers independently and blindly qualitatively evaluated IP/OP sequences to determine image quality, extent of artifacts, lesion detectability and conspicuity, and subjective grading of liver steatosis for the various sequences. Quantitative analysis was also performed. Qualitative and quantitative data were subjected to statistical analysis. Results: Respiratory ghosting, parallel imaging, and truncation artifacts as well as shading and blurring were more pronounced with 3D-GRE IP/OP imaging. Overall image quality was higher with 2D-GRE (P < 0.05). Detectability of low-fluid content lesions was lower with IP/OP MP-GRE sequences. MP-GRE sequences had the lowest SNRs (P < 0.001). Liver-to-spleen and liver-to-lesion CNRs were significantly lower with 3D-GRE and MP-GR, respectively (P < 0.001). Fat liver indexes showed strongly positive correlation between all sequences. Conclusion: Currently, 2D-GRE remains the best approach for clinical IP/OP imaging. The good image quality of MP-GRE sequences acquired in a free-breathing manner should recommend its use in patients unable to suspend breathing

  8. Comparison between the Effects of Intraperitoneal Injection of LDL and Intravenous Injection of LDL on Arterial Endothelial Cells Apoptosis

    王丽; 秦瑾; 刘正湘

    2003-01-01

    Summary: To observe the effect of oxidized low density lipoprotein (OxLDL) on arterial endothelialcells apoptosis in vivo, we established a model in which Sprague-Dawley rats were given intraperi-toneal and intravenous injection of unmodified LDL (8 mg/kg every day) via the tail vein. Sevendays after the injection, the aortic endothelial cells specimens were prepared by an en face preparationof rat aorta. The apoptotic cells were identified and counted by in situ nick and labelling (TUNEL)method and light microcopy. The numbers of the apoptotic cells were 12.52±4.71/field in the in-traperitoneal injection control group, 11.41±2.94/field in the intravenous injection control group,22.98±8. 01/field in the intraperitoneal injection LDL group and 103. 8 ± 11.5/field in the intra-venous injection LDL group, respectively. The difference was significant between injection LDLgroup and control (P<0. 01), and the difference was also significant between two LDL injectiongroups (P<0. 01). These findings suggest that injection of LDL can induce apoptosis in arterial en-dothelial cells and the effect is especially significant with intravenous injection LDL. After injection,oxidative modification of LDL may occur in local arteries and causes injury to the endothelial cells.

  9. Comparison of the Postprocedural Quality of Life between Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention: A Systematic Review

    Kaneez Fatima

    2016-01-01

    Full Text Available The treatment of choice between coronary artery bypass graft surgery (CABG and percutaneous coronary intervention (PCI has remained unclear. Considering quality of life (QOL increases life expectancy, we believe QOL should be important in determining the optimum treatment. Thus the objective of this review was to illustrate the comparative effects of CABG and PCI on postprocedural QOL. Methods. We searched PubMed (Medline and Embase from inception of the databases to May 2014 using “PCI versus CABG quality of life”, “Percutaneous Coronary intervention versus Coronary artery bypass graft surgery Quality of life”, “PCI versus CABG health status”, “Angioplasty versus CABG”, “Percutaneous coronary intervention versus coronary artery bypass surgery health status”, and different combinations of the above terms. 447 articles were found. After applying strict exclusion criteria, we included 13 studies in this review. Results. From the 9 studies that compared QOL scores at 6 months after procedure, 5 studies reported CABG to be superior. From the 10 studies that compared QOL among patients at 1 year after procedure, 9 reported CABG to be superior. Conclusion. It can be established that CABG is superior to PCI in improving patient’s QOL with respect to all scales used to determine quality of life.

  10. 依折麦布辛伐他汀片对兔腹主动脉粥样硬化斑块逆转作用的实验研究%Effects of ezetimibe/simvastatin tablets on atherosclerotic plaque regression of abdominal arteries in rabbits

    于熙滢; 周大亮; 郭颖; 吕建; 魏林; 曹海利

    2014-01-01

    ObjectiveTo observe the efficiency of ezetimibe/simvastatin (ES) tablets on the regression of atherosclerotic plaque of abdominal arteries in rabbits.Methods Twenty-four healthy male New Zealand rabbits were randomly divided into 2 groups: control group (n=8) and hypercholesterolemia group (n=16). Control group was fed with normal diet for 12 weeks. The other group animals were given a cholesterol-supplemented diet (normal diet+15g/L cholesterol+100g/L lard+150g/L egg yolk powder) for 2 weeks, and underwent catheter-induced arterial wall injury. These rabbits were then randomized to model subgroup (n=8, for another 10 weeks of hypercholesterol diet) and ES treatment subgroup [n=8, 5/10mg/(kg·d) for another 10 weeks]. Chinese russell’sviper venom was intra-peritoneally injected to trigger plaque rupture. Abdominal aortagraphy was carried out to measure the aorta stenosis. After 12 weeks’ feeding, all rabbits were sacrificed, and their abdominal arteries were isolated, paraffin-embedded and then sectioned. Blood lipid and lipoproteins were detected. The development of the atherosclerotic plaques was evaluated through the light microscopy. Finally, the expression of macrophage and smooth muscle actin in the abdominal arteries was measured by immunohistochemical analysis.Results The serum levels of total cholesterol (TC), triglycerides (TG) and low density lipoprotein-cholesterol (LDL-C) were significantly lower in the ES treatment subgroup than in the hypercholesterolemia model group (P<0.01). One-way analysis of variance indicated that significant differences were found in the plaque diameter, plaque thickness and the intimal-medial thickness between the ES subgroup and hypercholesterolemia model subgroup by morphological observation (P<0.05). Immunohistochemical analysis showed that lesser macrophages (P<0.05) but more smooth muscle cells (P<0.01) were found in the ES treatment subgroup than in the model group.Conclusion It may be through reducing the

  11. Adult abdominal hernias.

    Murphy, Kevin P

    2014-06-01

    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  12. Comparison of end-tidal carbon dioxide and arterial blood bicarbonate levels in patients with metabolic acidosis referred to emergency medicine

    Taghizadieh, Ali; Pouraghaei, Mahboub; Moharamzadeh, Payman; Ala, Alireza; Rahmani, Farzad; Basiri Sofiani, Karim

    2016-01-01

    Introduction: The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated. Results: Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15 and 12.78 ± 3.83, respectively. In all patients, the significant direct linear relationship was found between ETco2 with Hco3 (r = 0.553, P < 0.001). We had 4 groups of patients with metabolic acidosis, also there is a significant direct linear relationship between the ETCo2 and the Hco3 level of arterial blood in patients with renal failure (P < 0.001 and r = 0.551), sepsis (P < 0.001 and r = 0.431), drug toxicity (P < 0.001 and r = 0.856), and ketoacidosis (DKA) (P < 0.001 and r = 0.559). Conclusion: According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment. PMID:27777693

  13. Screening for Abdominal Aortic Aneurysm

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...

  14. Abdominal aortic aneurysm repair - open

    ... this page: //medlineplus.gov/ency/article/007392.htm Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  15. Triple Arterial Phase MR Imaging with Gadoxetic Acid Using a Combination of Contrast Enhanced Time Robust Angiography, Keyhole, and Viewsharing Techniques and Two-Dimensional Parallel Imaging in Comparison with Conventional Single Arterial Phase

    Yoon, Jeong Hee [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine, Seoul 03087 (Korea, Republic of); Lee, Jeong Min [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine, Seoul 03087 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03087 (Korea, Republic of); Yu, Mi Hye [Department of Radiology, Konkuk University Medical Center, Seoul 05030 (Korea, Republic of); Kim, Eun Ju [Philips Healthcare Korea, Seoul 04342 (Korea, Republic of); Han, Joon Koo [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine, Seoul 03087 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03087 (Korea, Republic of)

    2016-11-01

    To determine whether triple arterial phase acquisition via a combination of Contrast Enhanced Time Robust Angiography, keyhole, temporal viewsharing and parallel imaging can improve arterial phase acquisition with higher spatial resolution than single arterial phase gadoxetic-acid enhanced magnetic resonance imaging (MRI). Informed consent was waived for this retrospective study by our Institutional Review Board. In 752 consecutive patients who underwent gadoxetic acid-enhanced liver MRI, either single (n = 587) or triple (n = 165) arterial phases was obtained in a single breath-hold under MR fluoroscopy guidance. Arterial phase timing was assessed, and the degree of motion was rated on a four-point scale. The percentage of patients achieving the late arterial phase without significant motion was compared between the two methods using the χ{sup 2} test. The late arterial phase was captured at least once in 96.4% (159/165) of the triple arterial phase group and in 84.2% (494/587) of the single arterial phase group (p < 0.001). Significant motion artifacts (score ≤ 2) were observed in 13.3% (22/165), 1.2% (2/165), 4.8% (8/165) on 1st, 2nd, and 3rd scans of triple arterial phase acquisitions and 6.0% (35/587) of single phase acquisitions. Thus, the late arterial phase without significant motion artifacts was captured in 96.4% (159/165) of the triple arterial phase group and in 79.9% (469/587) of the single arterial phase group (p < 0.001). Triple arterial phase imaging may reliably provide adequate arterial phase imaging for gadoxetic acid-enhanced liver MRI.

  16. Triple arterial phase MR imaging with gadoxetic acid using a combination of contrast enhanced time robust angiography, keyhole, and viewsharing techniques and two-dimensional parallel imaging in comparison with conventional single arterial phase

    Yoon, Jeong Hee; Lee, Jeong Min; Han, Joon Koo [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Yu, Mi Hye [Dept. of Radiology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, Eun Ju [Philips Healthcare Korea, Seoul (Korea, Republic of)

    2016-07-15

    To determine whether triple arterial phase acquisition via a combination of Contrast Enhanced Time Robust Angiography, keyhole, temporal viewsharing and parallel imaging can improve arterial phase acquisition with higher spatial resolution than single arterial phase gadoxetic-acid enhanced magnetic resonance imaging (MRI). Informed consent was waived for this retrospective study by our Institutional Review Board. In 752 consecutive patients who underwent gadoxetic acid-enhanced liver MRI, either single (n = 587) or triple (n = 165) arterial phases was obtained in a single breath-hold under MR fluoroscopy guidance. Arterial phase timing was assessed, and the degree of motion was rated on a four-point scale. The percentage of patients achieving the late arterial phase without significant motion was compared between the two methods using the χ2 test. The late arterial phase was captured at least once in 96.4% (159/165) of the triple arterial phase group and in 84.2% (494/587) of the single arterial phase group (p < 0.001). Significant motion artifacts (score ≤ 2) were observed in 13.3% (22/165), 1.2% (2/165), 4.8% (8/165) on 1st, 2nd, and 3rd scans of triple arterial phase acquisitions and 6.0% (35/587) of single phase acquisitions. Thus, the late arterial phase without significant motion artifacts was captured in 96.4% (159/165) of the triple arterial phase group and in 79.9% (469/587) of the single arterial phase group (p < 0.001). Triple arterial phase imaging may reliably provide adequate arterial phase imaging for gadoxetic acid-enhanced liver MRI.

  17. Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery

    Udompunturak Suthipol

    2008-09-01

    Full Text Available Abstract Background The objective was to compare the value of late gadolinium enhancement (LGE and end-diastolic wall thickness (EDWT assessed by cardiovascular magnetic resonance (CMR in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG. Methods We enrolled patients with coronary artery disease and left ventricular ejection fraction Results We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 ± 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6% and 1,196 segments (59.2% respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2% that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC curves demonstrated that the LGE area was the most important predictor (p Conclusion LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.

  18. Epigenetics and Peripheral Artery Disease.

    Golledge, Jonathan; Biros, Erik; Bingley, John; Iyer, Vikram; Krishna, Smriti M

    2016-04-01

    The term epigenetics is usually used to describe inheritable changes in gene function which do not involve changes in the DNA sequence. These typically include non-coding RNAs, DNA methylation and histone modifications. Smoking and older age are recognised risk factors for peripheral artery diseases, such as occlusive lower limb artery disease and abdominal aortic aneurysm, and have been implicated in promoting epigenetic changes. This brief review describes studies that have associated epigenetic factors with peripheral artery diseases and investigations which have examined the effect of epigenetic modifications on the outcome of peripheral artery diseases in mouse models. Investigations have largely focused on microRNAs and have identified a number of circulating microRNAs associated with human peripheral artery diseases. Upregulating or antagonising a number of microRNAs has also been reported to limit aortic aneurysm development and hind limb ischemia in mouse models. The importance of DNA methylation and histone modifications in peripheral artery disease has been relatively little studied. Whether circulating microRNAs can be used to assist identification of patients with peripheral artery diseases and be modified in order to improve the outcome of peripheral artery disease will require further investigation.

  19. Comparison of intima-media thickness of common and internal carotid arteries of patients with ischemic stroke and intracerebral hemorrhage.

    Ali Moghtaderi

    2014-12-01

    Full Text Available Role of atherosclerosis in the pathogenesis of ischemic and hemorrhagic infarctions is still matter of debate. Intima-media thickness (IMT of the common carotid artery (CCA and internal carotid artery (ICA are markers of atherosclerosis. The aim of this study was to compare CCA IMT and ICA IMT of patients with ischemic and hemorrhagic infarction.Two equal groups of 80 patients with small and large vessel ischemic stroke and 80 patients with non-traumatic intracerebral hemorrhage (ICH who referred to our central teaching hospital of Zahedan were assessed in this descriptive study. IMT of four arteries (right and left CCA and ICA were measured, and collected data were analysis using Student's t-test.There were 137 males (57.1% and 103 (42.9% female with mean age of 62.7 ± 11.7. Mean right CCA IMT of patients with small vessel diseases (SVD, large vessel diseases (LVD, and ICH were 0.564 ± 0.130, 0.623 ± 0.150, and 0.580 ± 0.140 mm, respectively (P = 0.032. Mean left CCA IMT of patients with SVD, LVD, and ICH were 0.569 ± 0.120, 0.618 ± 0.120, and 0.573 ± 0.130 mm, respectively (P = 0.039. The above findings for right ICA were 0.572 ± 0.120, 0.569 ± 0.140, and 0.522 ± 0.130 mm, respectively (P = 0.145. Those findings for left ICA IMT were 0.525 ± 0.110, 0.554 ± 0.120, and 0.527 ± 0.120 mm, respectively (P = 0.257.Our findings showed that by using CCA IMT, differentiation between small and large vessel infarctions and hemorrhagic infarctions can be made.

  20. Comparison of ultrasound-guided thrombin injection and compression repair in treatment of iatrogenic femoral arterial pseudoaneurysms

    QIN Jun; GAO Yun-hua; ZHUO Zhong-xiong; HUANG Lan; LI Ai-min; SONG Yao-ming; JIN Jun; YU Xue-jun; GENG Zhao-hua; ZHOU Xia-bo; LIN Chun-mei

    2006-01-01

    Objective:To retrospectively compare the efficacy and safety of ultrasound-guided thrombin injection (UGTI) with ultrasound-guided compression repair (UGCR) in patients with postcatheterizational femoral arterial pseudoaneurysms (PSA). Methods: Thirty patients of this iatrogenic PSA [8males, 22 females, average age (66.5± 5.2) years] in our nstitution from 1997 to 2004 were retrospectively analyzed. Among them, 11 patients were treated with UGCR, 2 under continuous ultrasonographic (US) guidance and 9 under the guidance of femoral arterial bruit auscultation and dorsalis pedis artery palpation. Because UGCR was failed in 5 patients, consecutively 24 patients were treated with UGTI. Wine thrombin solution at a concentration of 200 U/ml was injected percutaneously using 22-25 gauge needles under color Doppler US. Demographics, clinical variables, pseudoaneurysm characteristics, and results of the 2 groups were compared by using Fisher's exact test and Student's t test. Results: The initial success rate of UGCR was 36.4% (4/11) nd the overall success rate was 45.5% (5/11). Ten of 11 patients suffered from local pain during the compression, but there was no any complication in UGTI group. The average dose of injected thrombin was (180±82) U for PSA of a single loculus and (315±150) U for multiloculated PSA. The initial success rate of UGTI was 89.5% (17/19) and the verall uccess rate was 100% (24/24). Conclusion:UGTI offers a safe, quick and effective means of definitively treating femoral pseudoaneurysms and seems superior to UGCR. The amount of thrombin applied on our people seems smaller compared with others' work.

  1. Very rapid effect of pitavastatin on microvascular function in comparison to rosuvastatin: reactive hyperemia peripheral arterial tonometric study

    Kono Y

    2013-05-01

    Full Text Available Yasushi Kono,1 Shota Fukuda,1 Kenei Shimada,2 Koki Nakanishi,2 Kenichiro Otsuka,2 Tomoichiro Kubo,1 Satoshi Jissho,1 Haruyuki Taguchi,1 Junichi Yoshikawa,3 Minoru Yoshiyama21Department of Medicine, Osaka Ekisaikai Hospital, Nishi-ku, Osaka, Japan; 2Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, Abeno-ku, Osaka, Japan; 3Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, JapanBackground: It has been reported that pitavastatin improves endothelial function faster than other statins. Recently introduced reactive hyperemia peripheral arterial tonometry (RH-PAT provides objective and quantitative assessment of peripheral microvascular function.Purpose: This study aimed to investigate whether peripheral microvascular function improved 2 hours after pitavastatin in subjects with coronary artery disease (CAD using RH-PAT, and the results were compared with those of rosuvastatin.Methods: This study included 94 subjects with CAD, assigned to a group given 2 mg of pitavastatin (n = 36, a group given 2.5 mg of rosuvastatin (n = 38, and a control group (n = 20. RH-PAT examinations were performed before and 2 hours after statin administration.Results: The RH-PAT index increased 2 hours after pitavastatin administration from 1.82 ± 0.45 to 2.16 ± 0.62 (P = 0.02, whereas there were no differences in the RH-PAT index in the rosuvastatin group (1.79 ± 0.71 to 1.91 ± 0.53, P = 0.09 and the control group (1.68 ± 0.36 to 1.84 ± 0.58, P = 0.4. No significant changes were observed at 2 hours in serum cholesterol levels in each group.Conclusion: The present study demonstrated that peripheral microvascular function improved 2 hours after a single clinical dose of pitavastatin, but not after rosuvastatin.Keywords: coronary artery disease, statin, microvascular function

  2. Infected abdominal aortic aneurysm due to Morganella morganii: CT findings.

    Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan

    2011-02-01

    An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.

  3. Comparison of vertebral artery velocity and flow volume measurements for diagnosis of vertebrobasilar insufficiency using color duplex sonography

    Acar, Murat [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey)]. E-mail: drmacar@hotmail.com; Degirmenci, Bumin [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Yucel, Aylin [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Albayrak, Ramazan [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Haktanir, Alpay [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Yaman, Mehmet [Department of Neurology, Faculty of Medicine, Afyon Kocatepe University, 03200 Afyon (Turkey)

    2005-05-01

    Introduction: The aim of this study was to compare the measurements of vertebral artery (VA) systolic flow velocity and flow volume for diagnosis of vertebrobasilar insufficiency (VBI). Material and methods: We examined 96 patients who were referred for evaluation of VBI. Net vertebral artery flow volume and mean systolic flow velocity were determined by using color duplex sonography. We had grouped the patients into three according to VA flow volume: group 1 was consisted of patients with severely damped VA flow volume (lower than 120 mL/min), group 2 was consisted of patients with moderately damped VA flow volume (120-200 mL/min), group 3 was consisted of patients with normal VA flow volume (>200 mL/min). The mean systolic flow velocities in each group were compared by one-way ANOVA. Results: Mean VA systolic flow velocities of groups 1, 2 and 3 were 32 {+-} 12, 42 {+-} 10 and 46 {+-} 8 cm/s, respectively. Mean VA systolic flow velocity in group 1 was significantly lower than that of group 2 (P = 0.001). However, there were no significant differences between VA systolic flow velocities in groups 2 and 3 (P = 0.2). Conclusions: According to our findings, measurement of volume in addition to velocity is more valuable in detection of moderately damped VA flow volumes in diagnosis of VBI.

  4. Noninvasive Detection of Coronary Artery Stenosis Using 16-slice Spiral CT: a Comparison with Selective X-ray Coronary Angiography

    SHI Heshui; HAN Ping; KONG Xiangquan; FENG Gansheng; Martin HK Hoffmann

    2006-01-01

    The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given β-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter ≥1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94 % main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of β-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.

  5. Morphological, physical and chemical evaluation of the Vascugraft arterial prosthesis: comparison of a novel polyurethane device with other microporous structures.

    Zhang, Z; King, M W; Guidoin, R; Therrien, M; Pezolet, M; Adnot, A; Ukpabi, P; Vantal, M H

    1994-06-01

    In this study the morphology, physical properties, surface chemical characteristics and microstructure of the Vascugraft arterial prosthesis have been investigated. This is a novel microporous polyurethane device, recently developed by the company Braun-Melsungen AG in Germany for use as a small calibre arterial substitute. This comparative study included two other synthetic grafts: the Mitrathane prosthesis, a hydrophilic prototype polyetherurethane urea graft with closed internal pores, and the commercially successful expanded polytetrafluoroethylene reinforced Goretex prosthesis with an open microporous structure. The Vascugraft prosthesis contains a network of fused microfibres of varying thickness and orientation which provide open and communicating pores similar in size to those in the Goretex material. In addition, they extend from one side of the graft wall to the other. As well as having superior longitudinal and radial compliance to the reinforced Goretex device, the Vascugraft prosthesis has more than adequate bursting and suture retention strengths. Through the use of contact angle measurements, electron spectroscopy for chemical analysis, Fourier transform infrared spectroscopy, differential scanning calorimetry and molecular weight analysis by size exclusion chromatography, the surface of the Vascugraft prosthesis has been shown to be uniquely hydrophobic, as well as containing carbonate groups within an aliphatic polyesterurethane polymer. In addition, variations in micro-phase separation structure of hard and soft segment domains between different sizes and batches of product are marginal. Because of the interesting physical and chemical properties, it is recommended that in vitro biocompatibility and biostability studies be undertaken prior to using the prosthesis in animal or clinical trials.

  6. Searching the perfect ultrasonic classification in assessing carotid artery stenosis: comparison and remarks upon the existing ultrasound criteria.

    Mozzini, Chiara; Roscia, Giuseppe; Casadei, Alder; Cominacini, Luciano

    2016-01-01

    Doppler ultrasound scanning is the first line investigation for quantifying the internal carotid artery stenosis. Nevertheless, the lack of internationally accepted ultrasound criteria for describing the degree of stenosis has contributed to the different and confusing measurements ranges. The use of two different angiographic methods, the North American Symptomatic Carotid Endoarterectomy Study and the European Carotid Surgery Trial was probably the major initial source of confusion in deriving valid and reliable duplex ultrasound criteria worldwide. The consensus proposed in 2003 by the Society of Radiologists in Ultrasound has been a great attempt to create a conformity document, establishing grey scale and Doppler criteria in considering the different degrees of stenosis. According to this attempt, in 2010, the multi-parametric Deutsche Gesellschaft für Ultraschall in der Medizin ultrasound criteria have been proposed with a precise differentiation between main and additional criteria and depicted a different peak systolic velocity (PSV) threshold. In 2012, these criteria have been implemented, focusing on the multi-parametric approach, re-defining the PSV values and clearly introducing the concept of PSV average. Despite these attempts, a wide range of practice patterns still exists, with consistent disparities in patients' care. This paper collects these previous experiences and summarizes their strengths and weaknesses, to give a contribution in the carotid artery stenosis grading standardization using ultrasonic methods. Carotid ultrasound as the only diagnostic tool for the selection of patients for carotid surgery or stenting will be possible only with internationally accepted criteria.

  7. Comparison of the standard roller pump and a pulsatile centrifugal pump for extracorporeal circulation during routine coronary artery bypass grafting.

    Driessen, J J; Fransen, G; Rondelez, L; Schelstraete, E; Gevaert, L

    1991-01-01

    The present prospective study compared the standard nonpulsatile twin roller pump with the Sarns centrifugal pump, in the pulsatile mode, as arterial pumps for extracorporeal circulation during coronary artery bypass grafting (CABG). The study was conducted in two consecutive groups of 25 patients receiving a standard anaesthetic and surgical protocol. The investigated parameters included haemodynamic profiles, oxygen exchange, blood gas and acid-base homeostasis, haematology, coagulation and complement consumption. With comparable settings for pump flow, gas flow and delivered oxygen concentrations, there was no difference between the groups in the main haemodynamic parameters during cardiopulmonary bypass (CPB). However, a tenfold lower dose of sodium nitroprusside was required to keep systemic vascular resistance within physiologic limits during CPB in the centrifugal group (C group) compared with the roller group (R group). During rewarming oxygen extraction was higher in the C group than in the R group. During the first eight hours after CPB no differences in haemodynamics, oxygenation parameters and pulmonary shunt between the groups were observed. During, as well as after, CPB there was no significant difference in blood gas and acid-base homeostasis between either group. Average postoperative blood loss via chest tubes, total transfusions of blood products, haemoglobin and coagulation did not differ between the two groups. However, the white blood cell count, corrected for changes in haematocrit, decreased during the early phase of CPB in the R group, but not in the C group.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Screening for abdominal aortic aneurysms Rastreamento de aneurismas da aorta abdominal

    Telmo Pedro Bonamigo

    2003-01-01

    Full Text Available OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.OBJETIVO E MÉTODOS: O rastreamento de aneurisma da aorta abdominal infra-renal é importante pois pode diminuir a mortalidade relacionada à ruptura. Realizamos um estudo para definir a prevalência desses aneurismas em diversos segmentos da população em nossa região do Brasil. O rastreamento foi realizado utilizando-se a ecografia de abdômen. Tr

  9. Ruptured abdominal aortic aneurysm.

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  10. Inferior epigastric artery: Surface anatomy, prevention and management of injury.

    Wong, Clare; Merkur, Harry

    2016-04-01

    The anatomical position of the inferior epigastric artery (IEA) subjects it to risk of injury during abdominal procedures that are close to the artery, such as laparoscopic trocar insertion, insertion of intra-abdominal drains, Tenckhoff(®) catheter (peritoneal dialysis catheter) and paracentesis. This article aims to raise the awareness of the anatomical variations of the course of the IEA in relation to abdominal landmarks in order to define a safer zone for laparoscopic ancillary trocar placement. Methods of managing the IEA injury as well as techniques to minimise the risk of injury to the IEA are reviewed and discussed.

  11. Abdominal aspergillosis: CT findings

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  12. Comparison of the vasodilator responses of isolated human and rat middle meningeal arteries to migraine related compounds

    Grände, Gustaf; Labruijere, Sieneke; Haanes, Kristian Agmund

    2014-01-01

    and the ability to artificially induce migraine or the mechanism of action. Vasodilatation could be an essential trigger, but only in conjunction with other unknown factors. The vasculature of the meninges likely contributes to the propagation of the migrainal cascade of symptoms, but more research is needed......BACKGROUND: Migraine attacks occur spontaneously in those who suffer from the condition, but migraine-like attacks can also be induced artificially by a number of substances. Previously published evidence makes the meninges a likely source of migraine related pain. This article investigates...... the effect of several vasodilators on meningeal arteries in order to find a connection between the effect of a substance on a meningeal vessel and its ability to artificially induce migraine. METHODS: A myograph setup was used to test the vasodilator properties of the substances acetylcholine (ACh), sodium...

  13. Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department.

    He, Lulu; Park, Ellen; Vachhani, Neil; Vogelius, Esben; Thupili, Chakradhar; Udayasankar, Unni

    2016-10-01

    Diagnostic imaging is often an integral component in the workup of a pediatric patient with acute abdominal pain. The purpose of this study was to compare the diagnostic value of a three-view acute abdominal series (AAS) with that of a single supine view (SSV) in children with acute abdominal pain. All subjects aged ≤18 years that underwent an emergency three-view AAS examination for acute abdominal pain at a single urban hospital system were included. Retrospective evaluation of radiological diagnosis, number of radiological images, further imaging, management, and clinical outcomes was performed. "Positive" AAS studies were compared with corresponding SSV images for direct comparison of diagnostic value. Standard nonparametric statistical evaluation was performed. Five hundred forty-one AAS studies were included in the study. Greater than three radiographs were acquired in 29 % (153/541) of the subjects. Two hundred ninety-nine out of 541 AAS studies included a technically adequate SSV of the abdomen and pelvis. Most AAS examinations were categorized as negative (n = 485; 90 %). Of the 56 examinations initially classified as positive, there was no significant statistical difference between diagnostic accuracy between the AAS and SSV on retrospective evaluation. For pediatric subjects with nontraumatic acute abdominal pain, the yield of conventional radiographic study is exceedingly low. If required, a technically adequate single supine anteroposterior (AP) view of the abdomen and pelvis is sufficient for initial radiographic evaluation while reducing unnecessary radiation exposure to the patient.

  14. Comparison of Flow Impairment during Carotid Artery Stenting Using Two Types of Eccentric Filter Embolic Protection Devices

    NII, Kouhei; TSUTSUMI, Masanori; MAEDA, Hitoshi; AIKAWA, Hiroshi; INOUE, Ritsuro; ETO, Ayumu; SAKAMOTO, Kimiya; MITSUTAKE, Takafumi; HANADA, Hayatsura; KAZEKAWA, Kiyoshi

    2016-01-01

    We investigated the angiographic findings and the clinical outcomes after carotid artery stenting (CAS) using two different, eccentric filter embolic protection devices (EPDs). Between July 2010 and August 2015, 175 CAS procedures were performed using a self-expandable closed-cell stent and a simple eccentric filter EPD (FilterWire EZ in 86 and Spider FX in 89 procedures). The angiographic findings (i.e., flow impairment and vasospasm) at the level of EPDs, neurologic events, and post-operative imaging results were compared between the FilterWire EZ and the Spider FX groups. The CAS was angiographically successful in all 175 procedures. However, the angiographs were obtained immediately after CAS-detected flow impairment in the distal internal carotid artery (ICA) in 11 (6.3%) and ICA spasms at the level of the EPD in 40 cases (22.9%). The incidence of these complications was higher with FilterWire EZ than Spider FX (ICA flow impairment of 10.5% vs. 2.2%, P = 0.03; vasospasm 30.2% vs. 15.7%, P = 0.03). There were nine neurologic events (5.1%); five patients were presented with transient ischemic attacks, three had minor strokes, and one had a major stroke. New MRI lesions were seen in 25 (29.1%) FilterWire-group and in 36 (40.4%) Spider-group patients. The neurologic events and new MRI lesions were not associated with the type of EPD used. Although the ICA flow impairment may result in neurologic events, there was no significant association between the FilterWire EZ and the Spider FX CAS with respect to the incidence of neurologic events by the prompt treatment such as catheter aspiration. PMID:27319302

  15. A comparison of high-dose and low-dose tranexamic acid antifibrinolytic protocols for primary coronary artery bypass surgery

    Stephen M McHugh

    2016-01-01

    Full Text Available Background and Aims: Tranexamic acid (TA is used for prophylactic antifibrinolysis in coronary artery bypass surgeries to reduce bleeding. We evaluated the efficacy of two different doses of TA for prophylactic antifibrinolysis in patients undergoing primary coronary artery bypass grafting (CABG surgery in this retrospective cohort study at a tertiary care referral centre. Methods: One-hundred eighty-four patients who underwent primary CABG with cardiopulmonary bypass (CPB via sternotomy between January 2009 and June 2011 were evaluated. Pre-operative patient characteristics, intraoperative data, post-operative bleeding, transfusions, organ dysfunction and 30-day mortality were compared between high-dose TA (30 mg/kg loading dose followed by infusion of 15 mg/kg/h until the end of surgery along with 2 mg/kg priming dose in the bypass circuit and low-dose TA (15 mg/kg loading dose followed by infusion of 6 mg/kg/h until the end of surgery along with 1 mg/kg priming dose in the bypass circuit groups. Univariate comparative analysis of all categorical and continuous variables was performed between the two groups by appropriate statistical tests. Linear and logistic regression analyses were performed to control for the effect of confounding on the outcome variables. Results: Chest tube output, perioperative transfusion of blood products and incidence of re-exploration for bleeding did not differ significantly (P> 0.05 between groups. Post-operative complications and 30-day mortality were comparable between the groups. The presence of cardiogenic shock and increased pre-operative creatinine were found to be associated with increased chest tube output on the post-operative day 2 by multivariable linear regression model. Conclusions: Low-dose TA protocol is as effective as high-dose protocol for antifibrinolysis in patients undergoing primary CABG with CPB.

  16. Left bronchial artery arising from a replaced left hepatic artery in a patient with massive hemoptysis

    Khil, Eun Kyung; Lee, Jae Myung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-09-15

    A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

  17. Deep Circumflex Iliac Artery Pseudoaneurysm as a Complication of Paracentesis

    Bhawna Satija

    2012-01-01

    Full Text Available We report a case of a pseudoaneurysm arising from the deep circumflex iliac artery, in an end-stage renal disease patient with gross ascitis, presenting with an anterior abdominal wall hematoma following paracentesis. Duplex Doppler sonography confirmed the presence of the pseudoaneurysm and multidetector computed tomography angiography delineated the detailed arterial anatomy.

  18. Relationship between Abdominal Obesity Indexes and Arterial Stiffness in Adult Chinese of Beijing%腹型肥胖测量指标与动脉硬化的相关性分析

    王凡; 郑延松; 赛晓勇; 赵威; 李磊

    2011-01-01

    check-up during Jan 2005 to May 2010 in the health screening center of the hospital were analyzed. Obesity was evaluated by BMI, WHR and percentage of body fat (FAT%). Arterial stiffness was determined by measuring carotid-femoral (cfPWV) and carotid-radial pulse wave velocity (crPWV). Results Pearson's correlation coefficients showed that WHR was associated with cfPWV in young men and young women (r=0.191, P=0.005 vs. R=0.306, P<0.001), in middle-aged men and women (r=0.239, P<0.001 vs. R=0.189, P<0.001) and in older women (r=0.093, P=0.017), while with cfPWV and crPWV in old men (r=0.134, P=0.011 ;r=0.145, P=0.001). BMI was associated with cfPWV (r=0.175, P=0.006) in young women. FAT% was associated with crPWV in middle-aged men (r=0.186, P=0.001) and in old men (r=0.168, P=0.003), but with cfPW V and crPWV in middle-aged women (r=0.050, P=0.032; r=0.174, P=0.001) and in old women (r=0.111, P=0.009; r=0.116, P=0.015). After adjusted for blood pressure, lipids, serum sugar and uric acid, the results of multiple linear regression showed WHR was independently associated with cfPWV in middle-aged men and with cfPWV and crPWV in older men (all P<0.05). WHR was independently associated with cfPWV in different age women and FAT% was only independently associated with crPWV in older women (all P<0.05). Conclusion The results show WHR is an independent related factor for arterial stiffness in adult Chinese, whereas the BMI isn' t. And FAT% is an independent related factor for crPW V in aged women.

  19. Comparison of CT-Determined Pulmonary Artery Diameter, Aortic Diameter, and Their Ratio in Healthy and Diverse Clinical Conditions.

    Sang Hoon Lee

    Full Text Available The main pulmonary artery diameter (mPA, aortic diameter (Ao, and the mPA/Ao ratio, easily measured using chest computed tomography (CT, provide information that enables the diagnosis and evaluation of cardiopulmonary diseases. Here, we used CT to determine the sex- and age-specific distribution of normal reference values for mPA, Ao, and mPA/Ao ratio in an adult Korean population.Data from non-contrast, ECG-gated, coronary-calcium-scoring CT images of 2,547 individuals who visited the Health Screening Center of the Severance Hospital were analyzed. Healthy individuals (n = 813 included those who do not have hypertension, diabetes, asthma, obstructive lung disease, ischemic heart disease, stroke, smoking, obesity, and abnormal CT findings. Both mPA and Ao were measured at the level of bifurcation of the main pulmonary artery.The mean mPA and Ao were 25.9 mm and 30.0 mm in healthy participants, respectively, while the mean mPA/Ao ratio was 0.87. Medical conditions associated with a larger mPA were male, obesity, smoking history, hypertension, and diabetes. A larger mPA/Ao ratio was associated with female, the obese, non-smoker, normotensive, and normal serum level of lipids, while a smaller mPA/Ao ratio was associated with older age. In healthy individuals, the 90th percentile sex-specific mPA, Ao, and mPA/Ao ratio were, 31.3 mm (95% CI 29.9-32.2, 36.8 mm (95% CI 35.7-37.5, and 1.05 (95% CI 0.99-1.07 in males, and 29.6 mm (95% CI 29.1-30.2, 34.5 mm (95% CI 34.1-34.9, and 1.03 (95% CI 1.02-1.06 in females, respectively.In the Korean population, the mean mPA reference values in male and female were 26.5 mm and 25.8 mm, respectively, while the mean mPA/Ao ratio was 0.87. These values were influenced by a variety of underlying medical conditions.

  20. Spontaneous renal artery dissection complicating with renal infarction.

    Tsai, Tsung-Han; Su, Jung-Tsung; Hu, Sung-Yuan; Chao, Chih-Chung; Tsan, Yu-Tse; Lin, Tzu-Chieh

    2010-12-01

    Spontaneous renal artery dissection (SRAD) is a rare entity. We reported a 30-year-old healthy man presenting with sudden onset of left flank pain. Abdominal plain film and sonography were unremarkable. The contrast-enhanced abdominal computed tomographic (CT) scan demonstrated a dissecting intimal flap of the left distal renal artery (RA) complicating infarction. Selective angiography of the renal artery disclosed a long dissection of left distal RA with a patent true lumen and occlusion of left accessory RA. Conservative treatment with control of blood pressure and antiplatelet agent was prescribed. The patient was discharged with an uneventful condition on day 5.

  1. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-12-15

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

  2. A comparison of two methods for calculating CR (time constant) during studies of arterial blood flow in rats.

    Sasaoka, K; Ogawa, K

    1990-11-01

    Some of our earlier reports have dealt with experiments on the central caudal arteries of a series of anesthetized rats. The results of these experiments were expressed by a relationship derived from the Windkessel theory where f(t) = alpha dz(t)/dt + beta z(t). When this theory is used, the measured blood flow forms f(t) and calculated wave forms alpha dz(t)/dt + beta z(t) agree closely. In these studies, we discovered that, when blood flow adz(t)/dt + beta z(t) agree closely. In these studies, we discovered that, when blood flow decreases, CR (time constant tau, the product of the blood vessel compliance C and the peripheral resistance R) values increase and vary widely. In the present study, 1) we investigated changes in CR when blood flow increases, and, 2) the method of least squares was used in calculating the formula given above. We achieved a better conformity between measured blood flow and calculated blood flow and perceived a clearer relationship between mean blood flow and CR than when they were calculated by the old method.

  3. Comparison of Triggering and Nontriggering Factors in ST-Segment Elevation Myocardial Infarction and Extent of Coronary Arterial Narrowing.

    Ben-Shoshan, Jeremy; Segman-Rosenstveig, Yafit; Arbel, Yaron; Chorin, Ehud; Barkagan, Michael; Rozenbaum, Zach; Granot, Yoav; Finkelstein, Ariel; Banai, Shmuel; Keren, Gad; Shacham, Yacov

    2016-04-15

    Various physical, emotional, and extrinsic triggers have been attributed to acute coronary syndrome. Whether a correlation can be drawn between identifiable ischemic triggers and the nature of coronary artery disease (CAD) still remains unclear. In the present study, we evaluated the correlation between triggered versus nontriggered ischemic symptoms and the extent of CAD in patients with ST-segment elevation myocardial infarction (STEMI). We conducted a retrospective, single-center observational study including 1,345 consecutive patients with STEMI, treated with primary percutaneous coronary intervention. Acute physical and emotional triggers were identified in patients' historical data. Independent predictors of multivessel CAD were determined using a logistic regression model. A potential trigger was identified in 37% of patients. Physical exertion was found to be the most dominant trigger (65%) followed by psychological stress (16%) and acute illness (12%). Patients with nontriggered STEMI tended to be older and more likely to have co-morbidities. Patients with nontriggered STEMI showed a higher rate of multivessel CAD (73% vs 30%, p <0.001). In a multivariate regression model, nontriggered symptoms emerged as an independent predictor of multivessel CAD (odds ratio 8.33, 95% CI 5.74 to 12.5, p = 0.001). No specific trigger was found to predict independently the extent of CAD. In conclusion, symptoms onset without a recognizable trigger is associated with multivessel CAD in STEMI. Further studies will be required to elucidate the putative mechanisms underlying ischemic triggering.

  4. A Comparison of Third-Generation Semi-Invasive Arterial Waveform Analysis with Thermodilution in Patients Undergoing Coronary Surgery

    Ole Broch

    2012-01-01

    Full Text Available Uncalibrated semi-invasive continous monitoring of cardiac index (CI has recently gained increasing interest. The aim of the present study was to compare the accuracy of CI determination based on arterial waveform analysis with transpulmonary thermodilution. Fifty patients scheduled for elective coronary surgery were studied after induction of anaesthesia and before and after cardiopulmonary bypass (CPB, respectively. Each patient was monitored with a central venous line, the PiCCO system, and the FloTrac/Vigileo-system. Measurements included CI derived by transpulmonary thermodilution and uncalibrated semi-invasive pulse contour analysis. Percentage changes of CI were calculated. There was a moderate, but significant correlation between pulse contour CI and thermodilution CI both before (2=0.72, <0.0001 and after (2=0.62, <0.0001 CPB, with a percentage error of 31% and 25%, respectively. Changes in pulse contour CI showed a significant correlation with changes in thermodilution CI both before (2=0.52, <0.0001 and after (2=0.67, <0.0001 CPB. Our findings demonstrated that uncalibrated semi-invasive monitoring system was able to reliably measure CI compared with transpulmonary thermodilution in patients undergoing elective coronary surgery. Furthermore, the semi-invasive monitoring device was able to track haemodynamic changes and trends.

  5. Gadofosveset-enhanced MR angiography of the pedal arteries in patients with diabetes mellitus and comparison with selective intraarterial DSA

    Roehrl, Boris; Kunz, Rainer Peter; Oberholzer, Katja; Pitton, Michael Bernhard; Dueber, Christoph; Kreitner, Karl-Friedrich [Johannes Gutenberg University Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Neufang, Achim [Johannes Gutenberg University Mainz, Department of Cardiothoracic and Vascular Surgery, Mainz (Germany)

    2009-12-15

    To compare gadofosveset-enhanced magnetic resonance angiography (MRA) of the pedal vasculature with selective intraarterial DSA. Eighteen patients with PAOD and type II diabetes were prospectively examined at 1.5 T. For contrast enhancement, 0.03 mmol/kg body weight gadofosveset was used. MR imaging consisted of dynamic and of high-resolution steady-state imaging. Selective digital subtraction angiography (DSA) was performed within 5 days and served as standard of reference. Image analysis was done by two observers. There were no differences between MRA and DSA regarding overall image quality. First-pass MRA detected significantly more patent vessel segments than did DSA (P < 0.001, kappa = 0.46). Interobserver agreement of MRA was very good with respect to the detection of patent vessel segments and the assessment of hemodynamically relevant stenoses (kappa = 0.97 and 0.89, respectively). Steady-state imaging depicted significantly more patent metatarsal arteries than did dynamic imaging, and delineated inflammatory complications including osteomyelitis, soft-tissue abscesses, and fistulas related to the diabetic foot. Gadofosveset-enhanced MRA of the pedal vasculature proved to be superior to DSA. It offered a long imaging time window, and allowed for better depiction of the pedal outflow. Steady-state imaging delineated inflammatory complications associated with the diabetic foot. (orig.)

  6. Automatic determination of the arterial input function in dynamic susceptibility contrast MRI: comparison of different reproducible clustering algorithms

    Yin, Jiandong; Yang, Jiawen; Guo, Qiyong [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China)

    2015-05-01

    Arterial input function (AIF) plays an important role in the quantification of cerebral hemodynamics. The purpose of this study was to select the best reproducible clustering method for AIF detection by comparing three algorithms reported previously in terms of detection accuracy and computational complexity. First, three reproducible clustering methods, normalized cut (Ncut), hierarchy (HIER), and fast affine propagation (FastAP), were applied independently to simulated data which contained the true AIF. Next, a clinical verification was performed where 42 subjects participated in dynamic susceptibility contrast MRI (DSC-MRI) scanning. The manual AIF and AIFs based on the different algorithms were obtained. The performance of each algorithm was evaluated based on shape parameters of the estimated AIFs and the true or manual AIF. Moreover, the execution time of each algorithm was recorded to determine the algorithm that operated more rapidly in clinical practice. In terms of the detection accuracy, Ncut and HIER method produced similar AIF detection results, which were closer to the expected AIF and more accurate than those obtained using FastAP method; in terms of the computational efficiency, the Ncut method required the shortest execution time. Ncut clustering appears promising because it facilitates the automatic and robust determination of AIF with high accuracy and efficiency. (orig.)

  7. Multi-delay arterial spin labeling perfusion MRI in moyamoya disease-comparison with CT perfusion imaging

    Wang, Rui [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); University of Chinese Academy of Sciences, Graduate School, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States); Yu, Songlin [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); University of California Los Angeles, Department of Neurology, Los Angeles (United States); Alger, Jeffry R.; Wang, Danny J.J. [University of California Los Angeles, Department of Neurology, Los Angeles (United States); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States); Zuo, Zhentao; Wang, Bo [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); Chen, Juan [Beijing Hospital, Department of Radiology, Beijing (China); Wang, Rong; Zhao, Jizong [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); An, Jing [Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen (China); Xue, Rong [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States)

    2014-05-15

    To present a multi-delay pseudo-continuous ASL (pCASL) protocol that offers simultaneous measurements of cerebral blood flow (CBF) and arterial transit time (ATT), and to study correlations between multi-delay pCASL and CT perfusion in moyamoya disease. A 4 post-labeling delay (PLD) pCASL protocol was applied on 17 patients with moyamoya disease who also underwent CT perfusion imaging. ATT was estimated using the multi-delay protocol and included in the calculation of CBF. ASL and CT perfusion images were rated for lesion severity/conspicuity. Pearson correlation coefficients were calculated across voxels between the two modalities in grey and white matter of each subject respectively and between normalized mean values of ASL and CT perfusion measures in major vascular territories. Significant associations between ASL and CT perfusion were detected using subjective ratings, voxel-wise analysis in grey and white matter and region of interest (ROI)-based analysis of normalized mean perfusion. The correlation between ASL CBF and CT perfusion was improved using the multi-delay pCASL protocol compared to CBF acquired at a single PLD of 2 s (P < 0.05). There is a correlation between perfusion data from ASL and CT perfusion imaging in patients with moyamoya disease. Multi-delay ASL can improve CBF quantification, which could be a prognostic imaging biomarker in patients with moyamoya disease. (orig.)

  8. [Differential diagnosis of abdominal pain].

    Frei, Pascal

    2015-09-02

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  9. Abdominal aortic aneurysm surgery

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  10. Lower Abdominal Pain.

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.

  11. Dolor abdominal recurrente .

    Rodrigo De Vivero

    2009-11-01

    Full Text Available El dolor abdominal recurrente (DAR es un problema frecuente en la consulta médica y en la subespecialidad médica y quirúrgica. El DAR es frecuentemente funcional, es decir, sin una causa orgánica aparente. El diagnóstico diferencial debe incluir pérdida de peso, sangrado gastrointestinal, fiebre persistente, diarrea crónica y vómito importante. En este artículo se revisa el diagnóstico y tratamiento, pruebas diagnósticas y manejo farmacológico y ambiental.

  12. Abdominal perfusion computed tomography.

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  13. Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.

    O'Connor, T M

    2012-01-31

    BACKGROUND: Arterial blood gases (ABGs) are often sampled incorrectly, leading to a \\'mixed\\' or venous sample. Delays in analysis and air contamination are common. OBJECTIVES: We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. METHODS: Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. RESULTS: Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 . venous pH. There were no clinically significant differences in arterial PO associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO in all samples, including those that were immediately analyzed. CONCLUSIONS: Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO, indicating that air-contaminated ABGs should be discarded.

  14. Abdominal pregnancy- a case report.

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  15. Acute arterial occlusion - kidney

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  16. Embolisation of Posttraumatic Superior Mesenteric Artery Pseudoaneurysm in a Patient with Short Bowel Syndrome Preceding Bowel Transplantation

    Vinko Vidjak

    2011-01-01

    Full Text Available Penetrating abdominal trauma often causes bowel injuries which may lead to “short bowel syndrome” which is a potential indication for bowel transplantation. Posttraumatic pseudoaneurysms of abdominal arteries are often a result of penetrating abdominal trauma. We report a successful embolisation of posttraumatic superior mesenteric artery (SMA branch pseudoaneurysm using microcoil, in a patient with short bowel syndrome who was successfully transplanted three months after embolisation.

  17. Prosthetics and Techniques in Repair of Animal's Abdominal Wall.

    Karrouf, Gamal; Zaghloul, Adel; Abou-Alsaud, Mohamed; Barbour, Elie; Abouelnasr, Khaled

    2016-01-01

    The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.

  18. Removal of Gross Air Embolization from Cardiopulmonary Bypass Circuits with Integrated Arterial Line Filters: A Comparison of Circuit Designs.

    Reagor, James A; Holt, David W

    2016-03-01

    Advances in technology, the desire to minimize blood product transfusions, and concerns relating to inflammatory mediators have lead many practitioners and manufacturers to minimize cardiopulmonary bypass (CBP) circuit designs. The oxygenator and arterial line filter (ALF) have been integrated into one device as a method of attaining a reduction in prime volume and surface area. The instructions for use of a currently available oxygenator with integrated ALF recommends incorporating a recirculation line distal to the oxygenator. However, according to an unscientific survey, 70% of respondents utilize CPB circuits incorporating integrated ALFs without a path of recirculation distal to the oxygenator outlet. Considering this circuit design, the ability to quickly remove a gross air bolus in the blood path distal to the oxygenator may be compromised. This in vitro study was designed to determine if the time required to remove a gross air bolus from a CPB circuit without a path of recirculation distal to the oxygenator will be significantly longer than that of a circuit with a path of recirculation distal to the oxygenator. A significant difference was found in the mean time required to remove a gross air bolus between the circuit designs (p = .0003). Additionally, There was found to be a statistically significant difference in the mean time required to remove a gross air bolus between Trial 1 and Trials 4 (p = .015) and 5 (p =.014) irrespective of the circuit design. Under the parameters of this study, a recirculation line distal to an oxygenator with an integrated ALF significantly decreases the time it takes to remove an air bolus from the CPB circuit and may be safer for clinical use than the same circuit without a recirculation line.

  19. Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

    Park, Keun Young; Kim, Dong Joon

    2016-01-01

    Purpose To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). Materials and Methods A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. Results Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (p resulting in a modified Rankin scale score of 4. Thus, overall treatment-related morbi-mortality rates were 1.7% in BAC and 2.9% in SAC. At imaging follow-up (BAC, 135 aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively. Conclusion Both BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups. PMID:27621946

  20. Contrast-enhanced MRA of the renal and aorto-iliac-femoral arteries: Comparison of gadobenate dimeglumine and gadofosveset trisodium

    Iezzi, Roberto [Department of Radiology, Universita G. D' Annunzio, Chieti (Italy); Soulez, Gilles [Centre Hospitalier de L' Universite De Montreal, Montreal (Quebec) (Canada); Thurnher, Siegfried [Department of Radiology, Hospital Brothers of St. John of God, Vienna (Austria); Schneider, Guenther [Department of Diagnostic and Interventional Radiology, University Hospital of Saarland, Homburg/Saar (Germany); Kirchin, Miles A., E-mail: miles.kirchin@bracco.com [Worldwide Medical and Regulatory Affairs, Bracco Imaging SpA, Via E. Folli, 50, Milan 20134 (Italy); Shen, Ningyan; Pirovano, Gianpaolo; Spinazzi, Alberto [Worldwide Medical and Regulatory Affairs, Bracco Diagnostics, Princeton, NJ (United States)

    2011-02-15

    Rationale and objectives: Dedicated contrast agents are now available for contrast-enhanced magnetic resonance angiography (CE-MRA). This study retrospectively compares the safety and diagnostic performance data from Phase III regulatory trials performed to evaluate gadobenate dimeglumine (MultiHance) and gadofosveset trisodium (Vasovist) for renal and peripheral CE-MRA. Materials and methods: Similar examination and blinded assessment methodology was utilized in all studies to determine the safety and diagnostic performance of the agents for detection of significant (>50%) steno-occlusive disease. Digital Subtraction Angiography (DSA) was used as the standard of truth. Diagnostic performance data (sensitivity, specificity, predictive values [PVs], and likelihood ratios [LRs]) were compared (Chi-square test). Results: CE-MRA with gadobenate dimeglumine was more specific (92.4% vs. 80.5%, p < 0.0001) and accurate (83.6% vs. 77.1%, p = 0.022) than CE-MRA with gadofosveset in the detection of significant renal artery stenosis. The average sensitivity was higher for gadofosveset (74.4% vs. 67.3%, p = 0.011) in peripheral vessels although gadobenate dimeglumine was more specific (93.0% vs. 88.2%, p < 0.0001) with no difference in accuracy (86.6% vs. 86.3%, p = 0.66). PPVs were higher (p < 0.0001) for gadobenate dimeglumine in both vascular territories. Pre- to post-test shifts in the probability of detecting significant disease were greater after gadobenate dimeglumine. Adverse events in the renal and peripheral studies were reported by 9.2% and 7.7% of patients after gadobenate dimeglumine compared with 30.3% and 22.1% of patients after gadofosveset. Conclusion: The diagnostic performance of CE-MRA for the detection of significant steno-occlusive disease is similar with gadofosveset and gadobenate dimeglumine although the rate of adverse events appears higher with gadofosveset.

  1. Comparison of the therapeutic and side effects of tadalafil and sildenafil in children and adolescents with pulmonary arterial hypertension.

    Sabri, Mohammad Reza; Beheshtian, Elham

    2014-04-01

    Pulmonary arterial hypertension (PAH) is a progressive disease. In recent years, phosphodiesterase type 5 inhibitors such as sildenafil have been used to treat this disease in children. Recently, tadalafil has been used in adults with similar efficacy but it has been used less often in children. This experimental study was carried out in 18 known patients aged 4-24 years in the Emam Hossein Hospital of Isfahan, Iran. All patients had been taking sildenafil for a few months to years. Patients underwent echocardiographic study, the 6-minute walk test (6MWT), and non-invasive pulse oximetry before and after the 6MWT. These tests were repeated again after sildenafil had been switched to tadalafil for 6 weeks. After 6 weeks of tadalafil prescription, the severity of some of the patients' symptoms decreased, but the New York Heart Association class of the patients did not change more. Mean ± standard deviation (SD) oxygen saturation while taking sildenafil and after 6 weeks of tadalafil were significantly different (p = 0.005). Furthermore, mean ± SD oxygen saturation after the 6MWT while taking sildenafil and after 6 weeks of tadalafil were significantly different (p = 0.036). The mean ± SD distances walked in this test while taking sildenafil and tadalafil were significantly different (p = 0.005). No significant side effects were seen; 15 patients continued tadalafil. Tadalafil may be a safe drug to treat children and young adults with PAH. We did not observe any significant side effects during usage; it improves functional capacity and oxygen saturation better than sildenafil in these patients, and requires fewer daily doses than sildenafil.

  2. Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease: comparison with dynamic susceptibility contrast MRI

    Goetti, Robert [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); O' Gorman, Ruth [University Children' s Hospital Zurich, Center for MR Research, Zurich (Switzerland); Khan, Nadia [University Children' s Hospital Zurich, Moyamoya Center, Division of Neurosurgery, Department of Surgery, Zurich (Switzerland); Kellenberger, Christian J.; Scheer, Ianina [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland)

    2013-05-15

    This study seeks to evaluate the diagnostic accuracy of cerebral perfusion imaging with arterial spin labelling (ASL) MR imaging in children with moyamoya disease compared to dynamic susceptibility contrast (DSC) imaging. Ten children (7 females; age, 9.2 {+-} 5.4 years) with moyamoya disease underwent cerebral perfusion imaging with ASL and DSC on a 3-T MRI scanner in the same session. Cerebral perfusion images were acquired with ASL (pulsed continuous 3D ASL sequence, 32 axial slices, TR = 5.5 s, TE = 25 ms, FOV = 24 cm, matrix = 128 x 128) and DSC (gradient echo EPI sequence, 35 volumes of 28 axial slices, TR = 2,000 ms, TE = 36 ms, FOV = 24 cm, matrix = 96 x 96, 0.2 ml/kg Gd-DOTA). Cerebral blood flow maps were generated. ASL and DSC images were qualitatively assessed regarding perfusion of left and right ACA, MCA, and PCA territories by two independent readers using a 3-point-Likert scale and quantitative relative cerebral blood flow (rCBF) was calculated. Correlation between ASL and DSC for qualitative and quantitative assessment and the accuracy of ASL for the detection of reduced perfusion per territory with DSC serving as the standard of reference were calculated. With a good interreader agreement ({kappa} = 0.62) qualitative perfusion assessment with ASL and DSC showed a strong and significant correlation ({rho} = 0.77; p < 0.001), as did quantitative rCBF (r = 0.79; p < 0.001). ASL showed a sensitivity, specificity and accuracy of 94 %, 93 %, and 93 % for the detection of reduced perfusion per territory. In children with moyamoya disease, unenhanced ASL enables the detection of reduced perfusion per vascular territory with a good accuracy compared to contrast-enhanced DSC. (orig.)

  3. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  4. Abdominal vascular syndromes: characteristic imaging findings*

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe

    2016-01-01

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. PMID:27777480

  5. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

    Jang, Jin Hee; Lim, Yeon Soo; Lee, Youn Joo; Yoo, Won Jong; Sung, Mi Sook (Dept. of Radiology, Bucheon St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Bucheon (Korea, Republic of)), email: wjyu@catholic.ac.kr; Kim, Bum Soo (Dept. of Radiology, Seoul St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

    2012-05-15

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 +- 0.31 mm on digital subtraction angiography (DSA), 0.93 +- 0.20 mm on CTA using B30, 1.18 +- 0.27 mm on CTA using B50, and 1.29 +- 0.29 mm on CTA using B60. The mean ALN was 55.7 +- 6.0% on CTA using B30, 43.8 +- 7.5% on CTA using B50, and 38.7 +- 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  6. Analysis of Arterial Blood Gas Report in Chronic Kidney Diseases – Comparison between Bedside and Multistep Systematic Method

    Dhat, Vaishali; Tilak, Mona A; Roy, Indranath

    2016-01-01

    Introduction Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients. Aim The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients. Materials and Methods The initial ABG reports of 31 consecutive CKD patients were analysed by two methods. Medica Easy stat analyser was the equipment for analysis with Principle of potentiometry and ion selective electrode for pH and pCO2 and amperometry for pO2. Serum albumin was also measured by Bromocresol green dye binding method using liquixx albumin kit in Erba XL 300 autoanalyser. Statistical Analysis Chi-square test was used for statistical analysis using Epi Info version 3.5.4 and SPSS 14.0 softwares. Results The systematic method showed a significantly higher prevalence of mixed disorders (50%) compared to bedside method (12.9%). Most prevalent disorder by bedside method was metabolic acidosis in 15 cases (48.39%). By the systematic method, 3 reports were invalid. As a single category, most prevalent type was both simple respiratory alkalosis and mixed metabolic acidosis with respiratory alkalosis- 6 of 31 cases in each type (19.36% each). As a whole, metabolic acidosis (including both High Anion Gap Metabolic Acidosis or HAGMA and Non Anion Gap Metabolic Acidosis or NAGMA with 4 in each type) was most prevalent- 8 of 31(25.8%). Conclusion Systematic approach was more effective in diagnosing mixed acid base disorders. By systematic method the findings of analysis in most cases could be correlated with the clinical condition and provisional diagnosis. Thus interpretation of ABDs by using stepwise approach could be useful to the

  7. Comparison of benazepril plus amlodipine or hydrochlorothiazide in high-risk patients with hypertension and coronary artery disease.

    Bakris, George; Briasoulis, Alexandros; Dahlof, Bjorn; Jamerson, Kenneth; Weber, Michael A; Kelly, Roxzana Y; Hester, Allen; Hua, Tsushung; Zappe, Dion; Pitt, Bertram

    2013-07-15

    Combination therapy with benazepril 40 mg and amlodipine 10 mg (B+A) has been shown to be more effective than benazepril 40 mg and hydrochlorothiazide (HCTZ) 25 mg (B+H) in reducing cardiovascular (CV) events in high-risk patients with stage 2 hypertension with similar blood pressure reductions. In the present post hoc analysis, we evaluated whether B+A is more effective than B+H for reducing CV events in patients with known coronary artery disease (CAD) at baseline in a subgroup analysis of the Avoiding Cardiovascular events through COMbination therapy in Patients LIving with Systolic Hypertension (ACCOMPLISH) study. The main trial randomized 11,506 patients. Of those, 5,744 received B+A and 5,762 received B+H. Of the 11,506 patients, 5,314 (46%) were classified as having CAD at baseline. The mean patient follow-up period was 35.7 months for the B+A group and 35.6 months for the B+H group. The primary end point was the interval to the first event of composite CV morbidity and mortality. At baseline, significant differences were present between the 5,314 with CAD and the 6,192 without CAD. The patients with CAD had a lower systolic blood pressure and heart rate, a lower incidence of diabetes, and greater incidence of dyslipidemia. However, no baseline differences were found between the randomized B+A and B+H groups. In the patients with CAD, an 18% reduction occurred in the hazard ratio for CV events (primary end point) with B+A versus B+H (p = 0.0016). In a prespecified secondary analysis of the composite end point, including only CV death, myocardial infarction, and stroke, the hazard ratio in the patients with CAD was reduced by 25% (p = 0.0033) in the B+A group compared with the B+H group. B+A was more effective than B+H at comparable blood pressure reductions for reducing CV events in patients, regardless of the presence of CAD. In conclusion, our findings suggest that the combination of B+A should be preferentially used for older patients with high

  8. Comparison of transthoracic electrical bioimpedance cardiac output measurement with thermodilution method in post coronary artery bypass graft patients.

    Sharma, Vikas; Singh, Ajmer; Kansara, Bhuvnesh; Karlekar, Anil

    2011-01-01

    Transthoracic electrical bioimpedance (TEB) has been proposed as a non-invasive, continuous, and cost-effective method of cardiac output (CO) measurement. In this prospective, non-randomized, clinical study, we measured CO with NICOMON (Larsen and Toubro Ltd., Mysore, India) and compared it with thermodilution (TD) method in patients after off-pump coronary artery bypass (OPCAB) graft surgery. We also evaluated the effect of ventilation (mechanical and spontaneous) on the measurement of CO by the two methods. Forty-six post-OPCAB patients were studied at five predefined time points during controlled ventilation and at five time points when breathing spontaneously. A total of 230 data pairs of CO were obtained. During controlled ventilation, TD CO values ranged from 2.29 to 6.74 L/min (mean 4.45 ± 0.85 L/min), while TEB CO values ranged from 1.70 to 6.90 L/min (mean 4.43 ± 0.94 L/min). The average correlation (r) was 0.548 (P = 0.0002), accompanied by a bias of 0.015 L/min and precision of 0.859 L/min. In spontaneously breathing patients, TD CO values ranged from 2.66 to 6.92 L/min (mean 4.66 ± 0.76 L/min), while TEB CO values ranged from 3.08 to 6.90 L/min (mean 4.72 ± 0.82 L/min). Their average correlation was relatively poor (r = 0.469, P= 0.002), accompanied by a bias of -0.059 L/min and precision of 0.818 L/min. The overall percent errors between TD CO and TEB CO were 19.3% (during controlled ventilation) and 17.4% (during spontaneous breathing), respectively. To conclude, a fair correlation was found between TD CO and TEB CO measurements among post-OPCAB patients during controlled ventilation. However, the correlation was weak in spontaneously breathing patients.

  9. Comparison of transthoracic electrical bioimpedance cardiac output measurement with thermodilution method in post coronary artery bypass graft patients

    Sharma Vikas

    2011-01-01

    Full Text Available Transthoracic electrical bioimpedance (TEB has been proposed as a non-invasive, continuous, and cost-effective method of cardiac output (CO measurement. In this prospective, non-randomized, clinical study, we measured CO with NICOMON (Larsen and Toubro Ltd., Mysore, India and compared it with thermodilution (TD method in patients after off-pump coronary artery bypass (OPCAB graft surgery. We also evaluated the effect of ventilation (mechanical and spontaneous on the measurement of CO by the two methods. Forty-six post-OPCAB patients were studied at five predefined time points during controlled ventilation and at five time points when breathing spontaneously. A total of 230 data pairs of CO were obtained. During controlled ventilation, TD CO values ranged from 2.29 to 6.74 L/min (mean 4.45 ± 0.85 L/min, while TEB CO values ranged from 1.70 to 6.90 L/min (mean 4.43 ± 0.94 L/min. The average correlation (r was 0.548 (P = 0.0002, accompanied by a bias of 0.015 L/min and precision of 0.859 L/min. In spontaneously breathing patients, TD CO values ranged from 2.66 to 6.92 L/min (mean 4.66 ± 0.76 L/min, while TEB CO values ranged from 3.08 to 6.90 L/min (mean 4.72 ± 0.82 L/min. Their average correlation was relatively poor (r = 0.469, P= 0.002, accompanied by a bias of −0.059 L/min and precision of 0.818 L/min. The overall percent errors between TD CO and TEB CO were 19.3% (during controlled ventilation and 17.4% (during spontaneous breathing, respectively. To conclude, a fair correlation was found between TD CO and TEB CO measurements among post-OPCAB patients during controlled ventilation. However, the correlation was weak in spontaneously breathing patients.

  10. Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke

    Benson, John; Payabvash, Seyedmehdi [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States); Salazar, Pascal [Vital Images, A Division of Toshiba Medical, Minnetonka, MN (United States); Jagadeesan, Bharathi; Palmer, Christopher S.; Truwit, Charles L. [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States); McKinney, Alexander M., E-mail: mckinrad@umn.edu [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States)

    2015-04-15

    Objectives: To assess the accuracy and reliability of one vendor's (Vital Images, Toshiba Medical, Minnetonka, MN) automated CT perfusion (CTP) summary maps in identification and volume estimation of infarcted tissue in patients with acute middle cerebral artery (MCA) distribution infarcts. Subjects and methods: From 1085 CTP examinations over 5.5 years, 43 diffusion-weighted imaging (DWI)-positive patients were included who underwent both CTP and DWI <12 h after symptom onset, with another 43 age-matched patients as controls (DWI-negative). Automated delay-corrected postprocessing software (DC-SVD) generated both infarct “core only” and “core + penumbra” CTP summary maps. Three reviewers independently tabulated Alberta Stroke Program Early CT scores (ASPECTS) of both CTP summary maps and coregistered DWI. Results: Of 86 included patients, 36 had DWI infarct volumes ≤70 ml, 7 had volumes >70 ml, and 43 were negative; the automated CTP “core only” map correctly classified each as >70 ml or ≤70 ml, while the “core + penumbra” map misclassified 4 as >70 ml. There were strong correlations between DWI volume with both summary map-based volumes: “core only” (r = 0.93), and “core + penumbra” (r = 0.77) (both p < 0.0001). Agreement between ASPECTS scores of infarct core on DWI with summary maps was 0.65–0.74 for “core only” map, and 0.61–0.65 for “core + penumbra” (both p < 0.0001). Using DWI-based ASPECTS scores as the standard, the accuracy of the CTP-based maps were 79.1–86.0% for the “core only” map, and 83.7–88.4% for “core + penumbra.” Conclusion: Automated CTP summary maps appear to be relatively accurate in both the detection of acute MCA distribution infarcts, and the discrimination of volumes using a 70 ml threshold.

  11. Comparison of glycemic variability and glycated hemoglobin as risk factors of coronary artery disease in patients with undiagnosed diabetes

    MI Shu-hua; SU Gong; LI Zhao; YANG Hong-xia; ZHENG Hong; TAO Hong; ZHOU Yun; TIAN Lei

    2012-01-01

    Background The role of chronic hyperglycaemia as a coronary artery disease (CAD) risk factor is well-known,and the glycemic variability is still a matter of debate.The aim of this study was to investigate the association of admission glycemic excursion and hemoglobin A1c (HbA1c) with the presence and severity of CAD in patients with undiagnosed diabetes mellitus (DM).Methods We studied 286 newly diagnosed DM patients without prior revascularization undergoing coronary angiography for suspected ischaemic chest pain.Patients were grouped into those with CAD and without CAD according to angiographic results.The severity of CAD was assessed using the Gensini score.Glycemic variability,indicated as the mean amplitude of glycemic excursions (MAGE),was determined by a continuous glucose monitoring system.Serum levels of HbA1c and high-sensitive C-reactive protein (hs-CRP) as well as plasma concentrations of fasting glucose,lipids and creatinine were measured in all patients.Predictors of CAD were determined using multivariate Logistic regression model and receiver-operating characteristic (ROC) curves.Results The newly diagnosed DM patients with CAD were older,and more were male and current cigarette smokers compared with the patients without CAD.The CAD group had significantly higher levels of MAGE and HbA1c.Individuals with high levels of HbA1c (>7%) or MAGE (>3.4 mmol/L) had also significantly higher CAD prevalence.Logistic regression analysis revealed that high MAGE level and high HbA1c level were independent predictors for CAD.The area under the receiver-operating characteristic curve for MAGE (0.606,P=0.005) was superior to that for HbA1c (0.582,P=0.028).Gensini score closely correlated with age,MAGE,HbA1c,hs-CRP,creatinine and total cholesterol.Multivariate analysis indicated that age (P <0.001),MAGE (P <0.001),HbA1c (P=0.022) and hs-CRP (P=0.005) were independent determinants for Gensini score.Conclusions Both admission glycemic excursion and chronic

  12. Plasma levels of cathepsins L, K, and V and risks of abdominal aortic aneurysms

    Lv, Bing-Jie; Lindholt, Jes S; Wang, Jing;

    2013-01-01

    Cathepsin L (CatL), cathepsin K (CatK), and cathepsin V (CatV) are potent elastases implicated in human arterial wall remodeling. Whether plasma levels of these cathepsins are altered in patients with abdominal aortic aneurysms (AAAs) remains unknown.......Cathepsin L (CatL), cathepsin K (CatK), and cathepsin V (CatV) are potent elastases implicated in human arterial wall remodeling. Whether plasma levels of these cathepsins are altered in patients with abdominal aortic aneurysms (AAAs) remains unknown....

  13. Comparisons between Garcia, Modo, and Longa rodent stroke scales: Optimizing resource allocation in rat models of focal middle cerebral artery occlusion.

    Bachour, Salam P; Hevesi, Mario; Bachour, Ornina; Sweis, Brian M; Mahmoudi, Javad; Brekke, Julia A; Divani, Afshin A

    2016-05-15

    The use of rodent stroke models allow for the understanding of stroke pathophysiology. There is currently no gold standard neurological assessment to measure deficits and recovery from stroke in rodent models. Agreement on a universal preclinical stroke scale allows for comparison of the outcomes among conducted studies. The present study aimed to compare three routinely used neurological assessments in rodent studies (i.e., Garcia, Modo, and Longa) to determine which is most effective for accurately and consistently quantifying neurological deficits in the context of focal middle cerebral artery occlusion (MCAo) in rats. Focal MCAo was induced in 22 male Wistar rats using a novel transfemoral approach. Rodents were assessed for neurological deficit pre-injury as well as 3 and 24h post-injury. Data was analyzed to determine Pearson correlation coefficients in addition to McNemar's χ(2) values between each pair of neurological assessments. All three stroke scales, Garcia, Modo, and Longa, showed statistically significant changes between the baseline and the 3-hour neurological assessments. A trend towards neurological recovery was observed in all three stroke scales between the 3 and 24-hour endpoints. The three scales were highly correlated with each other, with Garcia and Modo having the strongest correlation. Of the three pairwise analyses, the comparison between the Garcia and Longa tests demonstrated the highest McNemar's χ(2) value, indicating least marginal homogeneity between these two tests. The combination of high correlation between Garcia and Modo tests along with greatest marginal heterogeneity observed between the Garcia and Longa test lead us to recommend the use of Garcia and Longa neurological scales when researchers are hoping to capture the broadest range of neurological factors using only two stroke scales.

  14. Comparação entre pericárdio bovino preservado em glicerina e malha de poliéster no reparo de falhas da parede abdominal em ratos Comparison of glycerin preserved bovine pericardium and a polyester mesh for the repair of abdominal wall defects in rats

    Juliany Gomes Quitzan

    2003-08-01

    Full Text Available OBJETIVO: Comparar uma malha comercial de poliéster com o pericárdio bovino preservado em glicerina na reconstituição de defeitos da parede abdominal. MÉTODOS: Foram utilizados 30 ratos, divididos em dois grupos eqüitativos. Efetuou-se uma excisão retangular de 2,5 x 2 cm, incluindo toda a musculatura abdominal e peritônio. No grupo I a parede abdominal foi reparada com malha de poliéster e no grupo II com pericárdio bovino conservado em glicerina. Os animais foram sacrificados aos 15, 60 e 90 dias de pós-operatório, sendo o local cirúrgico avaliado macroscópica e histologicamente. RESULTADOS: Os animais do grupo I apresentaram aderências mais severas e em maior número quando comparados aos do grupo II; porém, sem comprometimento funcional. A análise histológica revelou incorporação dos tecidos aos implantes, com maior resposta fibroblástica nos animais do grupo I. CONCLUSÃO: A malha de poliéster oferece maior resistência estrutural e resposta fibroblástica mais intensa; contudo, promove grande quantidade de aderências às vísceras abdominais, quando comparada ao pericárdio bovino.PURPOSE: The aim of the study was to compare polyester mesh and glycerin preserved bovine pericardium for the repair of abdominal wall defects. METHODS: Thirty rats divided into two equal experimental groups were used. A 2.5 x 2 cm rectangular defect including all abdominal muscles and peritoneum was performed. The defect was reconstructed using polyester mesh in group I and glycerin preserved bovine pericardium in group II. The animals were submitted to euthanasia at 15, 60 and 90 days postoperatively, and the surgical area was evaluated by macroscopic and microscopic examination. RESULTS: The animals of the Group I had more abdominal adhesions and those were more severe than the animals of the Group II. The microscopic examination showed incorporation of the tissues in the implants with accentuated fibroblastic reaction in the animals of

  15. Endovascular Aneurysm Repair in HIV Patients with Ruptured Abdominal Aneurysm and Low CD4

    Saranat Orrapin

    2016-01-01

    Full Text Available We report two HIV infected patients with ruptured abdominal aneurysm by using endovascular aneurysm repair (EVAR technique. A 59-year-old Thai man had a ruptured abdominal aortic aneurysm and a 57-year-old man had a ruptured iliac artery aneurysm. Both patients had a CD4 level below 200 μ/L indicating a low immune status at admission. They were treated by EVAR. Neither patient had any complications in 3 months postoperatively. EVAR may have a role in HIV patients with ruptured abdominal aneurysm together with very low immunity.

  16. Comparison between positron emission tomography myocardial perfusion imaging and intracoronary Doppler flow velocity measurements at rest and during cold pressor testing in angiographically normal coronary arteries in patients with one-vessel coronary artery disease

    Meeder, JG; Blanksma, PK; Tan, ES; Pruim, J; vanderWall, EE; Vaalburg, W; Lie, KI

    1996-01-01

    With use of invasive methods, coronary endothelial function is generally studied by examining the response of epicardial coronary arteries to intracoronary administered acetylcholine or to cold presser testing. Because invasive methods have substantial inherent limitations, studies should attempt to

  17. Subtotal versus total abdominal hysterectomy

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION: Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women...

  18. Abdominal Complications after Severe Burns

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  19. Abdominal aortic aneurysms

    Lindholt, Jes Sanddal

    2010-01-01

    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective....... The acceptance rate was 77%, and 95% accept control scans. Furthermore, persons at the highest risk of having an AAA attend screening more frequently. We found that 97% of the interval cases developed from aortas that initially measured 2.5-2.9 cm - i.e. approx. only 5% attenders need re-screening at 5-year...... methods for measuring the degree of wall calcification must be developed and validated....

  20. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.

  1. Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry

    de Souza Rodrigues Erenaldo

    2011-05-01

    Full Text Available Abstract Background Measurement of vital capacity (VC by spirometry is the most widely used technique for lung function evaluation, however, this form of assessment is costly and further investigation of other reliable methods at lower cost is necessary. Objective: To analyze the correlation between direct vital capacity measured with ventilometer and with incentive inspirometer in patients in pre and post cardiac surgery. Methodology Cross-sectional comparative study with patients undergoing cardiac surgery. Respiratory parameters were evaluated through the measurement of VC performed by ventilometer and inspirometer. To analyze data normality the Kolmogorov-Smirnov test was applied, for correlation the Pearson correlation coefficient was used and for comparison of variables in pre and post operative period Student's t test was adopted. We established a level of ignificance of 5%. Data was presented as an average, standard deviation and relative frequency when needed. The significance level was set at 5%. Results We studied 52 patients undergoing cardiac surgery, 20 patients in preoperative with VC-ventilometer: 32.95 ± 11.4 ml/kg and VC-inspirometer: 28.9 ± 11 ml/Kg, r = 0.7 p Conclusion There was a high correlation between DVC measures with ventilometer and incentive spirometer in pre and post CABG surgery. Despite this, arises the necessity of further studies to evaluate the repercussion of this method in lowering costs at hospitals.

  2. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Nevein Mohammed Mohammed Gharib

    2016-06-01

    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  3. Management of multiple type Ⅱ endoleaks detected by duplex ultrasound after endovascular abdominal aneurysm repair

    GUO Da-qiao; LI Wei-miao; JIANG Jun-hao; SHI Zhen-yu; WANG Yu-qi; FU Wei-guo

    2012-01-01

    We reported a case of multiple type Ⅱ endoleaks detected by duplex ultrasound after endovascular abdominal aneurysm repair.The patient was undergoing warfarin therapy.Duplex ultrasound was applied as the sole surveillance method during follow-up and provided the concerned information for reintervention.The endoleaks were successfully repaired by coil embolization of the collaterals from the internal iliac artery feeding the fourth lumbar artery.

  4. Mesenteric Ischemia:An unusual presentation of fistula between superior mesenteric artery and common hepatic artery

    Ertugrul Kayacetin; Serdar Karak(o)se; Aydin Karabacakoglu; Dilek Emlik

    2004-01-01

    Chronic mesenteric ischemia is an uncommon condition associated with a high morbidity and mortality. We reported a 36-year old women with postprandial abdominal pain due to chronic mesenteric ischemia caused by a fistula between superior mesenteric and common hepatic artery.

  5. Classification of primary and incisional abdominal wall hernias

    F.E. Muysoms (Filip); M. Miserez; F. Berrevoet; G. Campanelli (Giampiero); G.G. Champault; E. Chelala; U.A. Dietz; H.H. Eker (Hasan); I. El Nakadi; P. Hauters; M. Hidalgo Pascual; A. Hoeferlin; U. Klinge; A. Montgomery; R.K.J. Simmermacher; M.P. Simons; M. Śmietański; C. Sommeling; T. Tollens; T. Vierendeels; A. Kingsnorth

    2009-01-01

    textabstractPurpose: A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable. Methods: Several membersof the EHS

  6. Comparison of contrast-enhanced MR angiography of the aortoiliac vessels using a 1.0 molar contrast agent at 1.0T with intra-arterial digital subtraction angiography; Ergebnisse der kontrastverstaerkten MR-Angiographie der aortoiliakalen Gefaesse mit einem 1-molaren Kontrastmittel bei 1,0 T; Vergleich zur i.a. DSA

    Mohrs, O.K. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Univ. Mainz (Germany); Cardioangiologisches Centrum Bethanien, Frankfurt/Main (Germany); Oberholzer, K.; Bernhard, S.; Kalden, P.; Thelen, M.; Kreitner, K.F. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Univ. Mainz (Germany); Krummenauer, F. [Inst. fuer Med. Biometrie, Epidemiologie und Informatik, Johannes Gutenberg-Univ. Mainz (Germany); Neufang, A. [Klinik fuer Herz- und Thoraxchirurgie, Johannes Gutenberg-Univ. Mainz (Germany)

    2004-07-01

    Purpose: To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) using a 1.0 molar contrast agent at 1.0 T for the diagnosis of abdominal aortic aneurysms and stenoses of renal or iliac arteries in comparison to intraarterial digital subtraction angiography (DSA). Materials and Methods: A total of 19 patients with the suspicion of abdominal aortic aneurysm or stenosis of renal or iliac arteries were examined with CE-MRA at 1.0 T. Intra-arterial DAS served as reference in all cases. After test bolus tracking, 10 or 8 ml of the 1.0 molar contrast agent Gadobutrol corresponding to a dose of 0.1-0.15 mmol/kg bw were injected and imaging performed using a FLASH-3D sequence. To evaluate the interobserver-variability, the blinded images were analyzed by two radiologists. Besides the rating of overall image quality on a 4-point-scale, the images were evaluated for aneurysms and arteriosclerotic lesions with a stenosis of < 50% or > 50% or occlusion. Results: A total of 144 segments were analyzed. The mean value of the CE-MRA image quality was 3.4 on a 4-point scale. The sensitivity of CE-MRA in depicting relevant pathological findings was 96% and the specifity 99%. The positive predictive value was 96% and the negative predictive value 99%. Inter-observer variability was low with a kappa value of 0.82. Conclusion: CE-MRA using a 1.0 molar contrast agent at 1.0 Tenables an excellent diagnosis or exclusion of pathologies of the aortoiliac vessels. (orig.) [German] Ziel: Vergleich der MR-Angiographie (ce-MRA) der aortoiliakalen Gefaesse unter Verwendung eines 1-molaren, paramagnetischen Kontrastmittels bei 1,0 T zur intraarteriellen digitalen Subtraktionsangiographie (i.a. DSA). Material und Methoden: Es wurden 19 Patienten mit Verdacht auf ein infrarenales Aortenaneurysma bzw. eine Stenose der Nieren- oder Iliakalarterien untersucht. Die Messungen erfolgten bei 1,0 T unter Verwendung des 1-molaren, paramagnetischen Kontrastmittels Gadobutrol

  7. Percutaneous Zenith endografting for abdominal aortic aneurysms.

    Heyer, Kamaldeep S; Resnick, Scott A; Matsumura, Jon S; Amaranto, Daniel; Eskandari, Mark K

    2009-03-01

    A completely percutaneous approach to infrarenal abdominal aortic aneurysm (AAA) endografting has the theoretic benefits of being minimally invasive and more expedient. Our goal was to demonstrate the utility of this approach using a suprarenal fixation device and a suture-mediated closure system. We conducted a single-institution, retrospective review of 14 patients who underwent percutaneous AAA repair with the Zenith device between August 2003 and March 2007. Immediate and delayed access-related outcomes were examined over a mean follow-up of 12.1+/-2.0 months. Mean AAA size was 5.6 cm. Immediate arterial closure and technical success rate was 96% (27/28 vessels). One immediate hemostatic failure required open surgical repair. Over follow-up, one vessel required operative repair for new-onset claudication. No other immediate or delayed complications (thrombosis, pseudoaneurysm, infection, or deep venous thrombosis) were detected. A percutaneous approach for the treatment of AAA has several advantages over femoral artery cutdown but also has its own unique set of risks in the immediate and late postoperative period. Ultimately, the "preclose technique" can be safely applied for the Zenith device despite its large-bore delivery system.

  8. COMPARISON OF PHARMACOKINETICS AND PHARMACODYNAMICS OF THE ORIGINAL AND GENERIC ENALAPRIL IN THE ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION

    O. P. Bobrova

    2012-01-01

    Full Text Available Aim. To study the pharmacokinetic, pharmacodynamic and pharmacoeconomic parameters of the original and generic enalaprils in the treatment of the elderly patients with hypertension (HT. Material and Methods. Patients (n=40 75–90 years with HT were included in the open randomized comparative study. Patients were randomized into two groups. Patients of the group 1 received generic enalapril, patients of the group 2 — the original enalapril consisting of combined therapy. Pharmacokinetic single-dose study of original and generic enalapril were carried out with high-performance liquid chromatography. Pharmacodynamic study was carried out in single-dose administration as well as after 2 and 4 weeks of treatment with original and generic enalapril. Pharmacoeconomic evaluation of antihypertensive drugs was carried out on the basis of cost minimization analysis. Results. Original enalapril dose necessary to achieve the target blood pressure (BP was 10 mg/day as a part of two-component therapy. This for generic enalapril was 20 mg/day consisting of three- or four-component therapy. Both drugs have shown an acceptable safety profile. Pharmacokinetic differences were revealed between original and generic enalapril: area under pharmacokinetic curve 204.14 (202.25–206.05 vs 136.23 (134.17–137.65 ng*h/ml, respectively; time of the drug retention in the blood plasma 5.42 (5.26–5.76 vs 4.88 (4.86–4.94 hours, respectively; p<0.001. Original enalapril demonstrated more stable 24-hour antihypertensive effect in once daily administration in comparison with this in generic enalapril: trough/peak ratio 78.67% (47.61–91.35% vs 44.96% (32.44–55.49%, respectively , p<0.01. The average daily cost of combined therapy containing generic enalapril was 15.91 rubles per patient, while this in combined therapy containing original enalapril — 13.78 rubles per patient. Conclusion. Medicines on the basis of original and generic enalapril have pharmacokinetic

  9. COMPARISON OF PHARMACOKINETICS AND PHARMACODYNAMICS OF THE ORIGINAL AND GENERIC ENALAPRIL IN THE ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION

    O. P. Bobrova

    2015-12-01

    Full Text Available Aim. To study the pharmacokinetic, pharmacodynamic and pharmacoeconomic parameters of the original and generic enalaprils in the treatment of the elderly patients with hypertension (HT. Material and Methods. Patients (n=40 75–90 years with HT were included in the open randomized comparative study. Patients were randomized into two groups. Patients of the group 1 received generic enalapril, patients of the group 2 — the original enalapril consisting of combined therapy. Pharmacokinetic single-dose study of original and generic enalapril were carried out with high-performance liquid chromatography. Pharmacodynamic study was carried out in single-dose administration as well as after 2 and 4 weeks of treatment with original and generic enalapril. Pharmacoeconomic evaluation of antihypertensive drugs was carried out on the basis of cost minimization analysis. Results. Original enalapril dose necessary to achieve the target blood pressure (BP was 10 mg/day as a part of two-component therapy. This for generic enalapril was 20 mg/day consisting of three- or four-component therapy. Both drugs have shown an acceptable safety profile. Pharmacokinetic differences were revealed between original and generic enalapril: area under pharmacokinetic curve 204.14 (202.25–206.05 vs 136.23 (134.17–137.65 ng*h/ml, respectively; time of the drug retention in the blood plasma 5.42 (5.26–5.76 vs 4.88 (4.86–4.94 hours, respectively; p<0.001. Original enalapril demonstrated more stable 24-hour antihypertensive effect in once daily administration in comparison with this in generic enalapril: trough/peak ratio 78.67% (47.61–91.35% vs 44.96% (32.44–55.49%, respectively , p<0.01. The average daily cost of combined therapy containing generic enalapril was 15.91 rubles per patient, while this in combined therapy containing original enalapril — 13.78 rubles per patient. Conclusion. Medicines on the basis of original and generic enalapril have pharmacokinetic

  10. Exercise-related transient abdominal pain (ETAP).

    Morton, Darren; Callister, Robin

    2015-01-01

    Exercise-related transient abdominal pain (ETAP), commonly referred to as 'stitch', is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours

  11. Economics of abdominal wall reconstruction.

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias.

  12. Computed tomography angiography in the evaluation of carotid artery bifurcation stenosis: comparison with intraarterial digital subtraction angiography; Angio-TC en la evaluacion de estenosis de la bifurcacion arterial carotidea: comparacion con arteriografia por sustraccion digital intraarterial

    Santos, A. L.; Ramos, M.; Delgado, F.; Cano, A.; Bravo, F. [Hospital Universitario Reina Sofia. Cordoba (Spain)

    2001-07-01

    To determine the value of computed tomography (CT) angiography in grading cervical carotid artery stenosis, comparing it with that of intraarterial digital subtraction angiography (IADSA), and to demonstrate the utility of CT angiography, under certain circumstances, as an alternative to carotid angiography in the diagnosis of arterial disease. Of the 428 patients who underwent CT andiography of the supraaortic trunk in our hospital between lily 1998 and September 2000, the results in the first 55 in whom Id's was performed concomitantly were reviewed, and the findings with two techniques compared. In the discrimination of stenosis >70%, CT angiography showed a sensitivity of 92%, a specificity of 98% and an overall precision of 95% with respect to IADSA. The good correlation of the grading of carotid artery stenosis by CT angiography with that of IADSA suggests its high diagnostic reliability. (Author) 38 refs.

  13. The role of whole body spiral CT in the primary work-up of polytrauma patients - comparison with conventional radiography and abdominal sonography; Die Rolle der Ganzkoerper-Spiral-CT bei der Primaerdiagnostik polytraumatisierter Patienten - Vergleich mit konventioneller Radiographie und Abdomensonographie

    Albrecht, T.; Schlippenbach, J. von; Wolf, K.J. [Klinik und Poliklinik fuer Radiologie und Nuklearmedizin, Charite - Campus Benjamin Franklin (Germany); Stahel, P.F.; Ertel, W. [Klinik fuer Unfall- und Wiederherstellungschirurgie, Charite - Campus Benjamin Franklin (Germany)

    2004-08-01

    Purpose: To evaluate the role of routine 'whole body spiral CT' in the primary work-up of polytrauma patients for injuries of the thorax, abdomen and spine, and to compare the results with those of conventional radiography of the chest and spine and abdominal ultrasound. Materials and Methods: Fifty consecutive polytrauma patients underwent contrast-enhanced single slice spiral CT (5 mm collimation) from the vertex to the floor of the pelvis as part of the primary work-up after emergency room admission. Overlapping high resolution sections and sagittal reformations of the spine were obtained. Reports of additional chest radiographs (n=43), abdominal ultrasound examinations (n=47) and spine radiographs (n=36) performed in the emergency room were available for retrospective comparison. The 'final diagnoses', which served as the standard of reference, were taken from the patients' records using all information that became available until discharge or death, such as findings from further imaging, surgery and autopsy. Results: CT showed 109 (97%) of 112 thoracic and abdominal soft-tissue injuries. Relevant injuries missed were an early splenic laceration and an early pelvic hematoma, both of which became clinically apparent several hours later. There were 4 false positive CT findings. Conventional chest radiography demonstrated only 20% of thoracic and sonography 22% of abdominal injuries. Chest radiography and sonography produced 2 false-positive findings each. CT showed 66 (87%) of 76 vertebral fractures including all 19 unstable ones. CT missed 5 anterior vertebral body and 5 spinous/transverse process fractures. Conventional radiography found 71% of vertebral fractures including only 50% of the unstable one. (orig.)

  14. Micromanaging Abdominal Aortic Aneurysms

    Lars Maegdefessel

    2013-07-01

    Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to “fine tune” the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.

  15. Abdominal aortic feminism.

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  16. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study

    OBJECTIVES: The aim of this study was to examine whether magnesium intake is associated with coronary artery calcification (CAC) and abdominal aortic calcification (AAC). BACKGROUND: Animal and cell studies suggest that magnesium may prevent calcification within atherosclerotic plaques underlying c...

  17. [Abdominal aortic aneurysm treated by endovascular surgery: a case report].

    Alconero-Camarero, Ana Rosa; Cobo-Sánchez, José Luis; Casaus-Pérez, María; García-Campo, María Elena; García-Zarrabeitia, María José; Calvo-Diez, Marta; Mirones-Valdeolivas, Luz Elena

    2008-01-01

    An aneurysm is an abnormal dilation or irreversible convex of a portion of an artery. The most common site of aneurysms is the abdominal aorta and their appearance is often due to degeneration of the arterial wall, associated with atherosclerosis and favored by risk factors such as smoking and hypertension, among others. Left untreated, aneurysm of the abdominal aorta usually leads to rupture. Treatment is surgical, consisting of the introduction of a prosthesis, composed basically of a stent and an introducer, into the aorta. We report the case of a person diagnosed with abdominal aortic aneurysm in a routine examination who was admitted for ambulatory surgical treatment. We designed a nursing care plan, following Virginia Henderson's conceptual model. The care plan was divided into 2 parts, a first preoperative phase and a second postimplantation or monitoring phase. The care plan contained the principal nursing diagnoses, based on the taxonomies of the North American Nursing Diagnosis Association (NANDA), nursing interventions classification (NIC) and nursing outcomes classifications (NOC), and collaboration problems/potential complications. The patient was discharged to home after contact was made with his reference nurse in the primary health center, since during the hospital phase, some NOC indicators remained unresolved.

  18. Intra-abdominal tuberculous peritonitis

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)

    2001-07-01

    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  19. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of ... examinations do not use ionizing radiation (as used in x-rays ), thus there is no radiation exposure ...

  20. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...

  1. Children's (Pediatric) Abdominal Ultrasound Imaging

    Full Text Available ... of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed to evaluate ... for ultrasound examinations. top of page What does the equipment look like? Ultrasound scanners consist of a ...

  2. Segmental arterial mediolysis accompanied by renal infarction and pancreatic enlargement: a case report

    Ito Nobuhisa

    2012-09-01

    Full Text Available Abstract Introduction Due to recent advances in imaging diagnostic techniques, there are an increasing number of case reports of segmental arterial mediolysis. However, there are only a limited number of reports on segmental arterial mediolysis-related abnormalities of abdominal organs other than the intestine. This report describes a case of segmental arterial mediolysis accompanied by abnormalities of abdominal organs without clinical symptoms. Case presentation A 52-year-old Japanese man with hematuria and no prior medical history was referred to a urologist and was diagnosed as having urinary bladder cancer. He underwent trans-urethral resection of the bladder tumor and intra-vesical instillation therapy, which was followed by observation. During follow-up, although no abdominal symptoms were observed, an abdominal computed tomography scan revealed a dissection of the superior mesenteric artery. A false lumen partially occluded by a thrombus was located distal to this occlusion. The lumen was irregularly shaped with narrow and wide sections. Similar irregularities were also observed in the wall of the inferior mesenteric artery. Arterial dissection with thromboembolism in the left renal artery and renal infarction was also observed. Follow-up computed tomography after two months revealed an enlargement of the pancreatic tail adjacent to the splenic artery. Follow-up three-dimensional computed tomography showed gradual re-expansion of the true lumen of the superior mesenteric artery, improvement in arterial wall irregularities, and a reduction in the pancreas enlargement and renal infarction. Over the following 15 months, these changes gradually normalized. On the basis of the vascular changes in multiple arterial systems that resolved spontaneously, we considered that the lesions were associated with segmental arterial mediolysis. Conclusions We present a rare case of segmental arterial mediolysis accompanied by abnormalities of abdominal

  3. Updates on abdominal desmoid tumors

    2007-01-01

    Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequentiy after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.

  4. Computational fluid dynamics comparisons of wall shear stress in patient-specific coronary artery bifurcation using coronary angiography and optical coherence tomography

    Poon, Eric; Thondapu, Vikas; Chin, Cheng; Scheerlinck, Cedric; Zahtila, Tony; Mamon, Chris; Nguyen, Wilson; Ooi, Andrew; Barlis, Peter

    2016-11-01

    Blood flow dynamics directly influence biology of the arterial wall, and are closely linked with the development of coronary artery disease. Computational fluid dynamics (CFD) solvers may be employed to analyze the hemodynamic environment in patient-specific reconstructions of coronary arteries. Although coronary X-ray angiography (CA) is the most common medical imaging modality for 3D arterial reconstruction, models reconstructed from CA assume a circular or elliptical cross-sectional area. This limitation can be overcome with a reconstruction technique fusing CA with intravascular optical coherence tomography (OCT). OCT scans the interior of an artery using near-infrared light, achieving a 10-micron resolution and providing unprecedented detail of vessel geometry. We compared 3D coronary artery bifurcation models generated using CA alone versus OCT-angiography fusion. The model reconstructed from CA alone is unable to identify the detailed geometrical variations of diseased arteries, and also under-estimates the cross-sectional vessel area compared to OCT-angiography fusion. CFD was performed in both models under pulsatile flow in order to identify and compare regions of low wall shear stress, a hemodynamic parameter directly linked with progression of atherosclerosis. Supported by ARC LP150100233 and VLSCI VR0210.

  5. Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography

    Chu, W.C.W.; Lam, W.W.M. [Department of Diagnostic Radiology and Organ Imaging, Chinese Univ. of Hong Kong, Shatin (China); Mok, G.C.F.; Yam, M.; Sung, R.Y.T. [Dept. of Pediatrics, Chinese Univ. of Hong Kong, Shatin (China)

    2006-11-15

    Transthoracic ECHO is the locally accepted method for coronary surveillance of patients with Kawasaki disease but it may have limited visualization in the older child. To assess the feasibility of multidetector CT (MDCT) angiography in the follow-up of coronary artery aneurysms in children with previous Kawasaki disease. Six children (5 boys, 1 girl; mean age 11.5 years) with known Kawasaki disease and coronary artery involvement underwent CT coronary angiography using 16-detector MDCT. The visualized lengths and diameter of all coronary segments were measured. The number, size and location of coronary artery aneurysms were recorded and compared with recent ECHO. Twelve coronary artery aneurysms (seven saccular, five fusiform) were identified by MDCT angiography. One saccular aneurysm at the junction of the distal right coronary artery and posterior descending artery was not detected by ECHO while the remaining six in proximal segments were detected by both modalities. Two of five fusiform aneurysms were not detected by ECHO due to their small sizes. Excellent agreement was found between CT and ECHO for maximal diameter and length of the visualized aneurysms. MDCT angiography accurately defines coronary artery aneurysms. It is more sensitive for detecting aneurysms at distal coronary segments and fusiform aneurysms of small size.

  6. Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Comparison with angiographic results

    Sato, Yuichi; Matsumoto, Naoya; Kato, Masahiko [Nihon Univ., Tokyo (Japan). Surugadai Hospital] [and others

    2003-04-01

    The present study was designed to investigate the accuracy of multislice spiral computed tomography (MSCT) in detecting coronary artery disease, compared with coronary angiography (CAG), using a new retrospectively ECG-gated reconstruction method that reduced cardiac motion artifact. The study group comprised 54 consecutive patients undergoing MSCT and CAG. MSCT was performed using a SOMATOM Volume Zoom (4-detector-row, Siemens, Germany) with slice thickness 1.0 mm, pitch 1.5 (table feed: 1.5 mm per rotation) and gantry rotation time 500 ms. Metoprolol (20-60 mg) was administered orally prior to MSCT imaging. ECG-gated image reconstruction was performed with the reconstruction window (250 ms) positioned immediately before atrial contraction in order to reduce the cardiac motion artifact caused by the abrupt diastolic ventricular movement occurring during the rapid filling and atrial contraction periods. Following inspection of the volume rendering images, multiplanar reconstruction images and axial images of the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) were obtained and evaluated for luminal narrowing. The results were compared with those obtained by CAG. Of 216 coronary arteries, 206 (95.4%) were assessable; 10 arteries were excluded from the analysis because of severe calcification (n=4), stents (n=3) or insufficient contrast enhancement (n=3). The sensitivity to detect coronary stenoses {>=}50% was 93.5% and the specificity to define luminal narrowing <50% was 97.2%. The positive predictive value and the negative predictive value were 93.5% and 97.2%, respectively. The sensitivity was still satisfactory (80.6%) even when non-assessable arteries were included in the analysis. The new retrospectively ECG-gated reconstruction method for MSCT has excellent diagnostic accuracy in detecting significant coronary artery stenoses. (author)

  7. Very-high-flow injection rate for upper abdominal CT angiography

    Kimura, Masashi; Minamiguti, Hiroki; Hagihira, Takami; Kishi, Kazushi; Sato, Morio [Wakayama Medical Coll. (Japan); Shioyama, Yasukazu; Okumura, Toshiyuki; Yamada, Kouji; Kawashima, Michihisa [Central Hospital and Cancer Center of Ibaraki Prefecture, Tomobe (Japan)

    2002-06-01

    The purpose of this study was to compare a very-high-flow injection-rate method (group A) and a conventional injection-rate method (group B) for visualization of upper abdominal arteries by multidetector helical computed tomography (MDHCT). The subjects were 240 patients suspected to have abdominal lesions. They were randomly assigned to group A (120 patients) and group B (120 patients). In group A, the bilateral medial cubital veins were punctured, and contrast medium was infused at a rate of 8.6-9.6 ml/s. In group B, the unilateral medial cubital vein was punctured, and contrast medium was infused at a rate of 2.0-3.0 ml/s. The quality of vascular visualization was graded as poor, good, or excellent by three radiologists. All visualizations of the celiac trunk (CE) and superior mesenteric artery (SMA) were graded as excellent in both group A and group B. Visualization grades of the subsegmental branches of the hepatic artery (HA), right gastric artery (RGA), cystic artery, dorsal pancreatic artery (DPA), and superior pancreaticoduodenal artery (SPDA) were good or excellent in 75% (paging method)/53.3% (three-dimensional method), 85%/30%, 77.7%/18.3%, 76.7%/28.3%, and 88.3%/42.5%, respectively, in group A, and 33.3%/11.7%, 46.7%/3.4%, 41.6%/5%, 55%/4.2%, and 72.5%/14.2%, respectively, in group B. The appearance rate of intrahepatic portal branches was 28.3% in group A and 66.7% in group B in the arterial dominant phase. Group A showed better visualization results than Group B in upper abdominal arteries according to MDHCT. (author)

  8. Common abdominal emergencies in children.

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  9. Application of PTCA steerable guide wire for abdominal and peripheral interventional angiography

    Kuribayashi, Sachio; Ootaki, Makoto; Iwata, Yoshirou; Harada, Tsumio; Tsuji, Makoto; Matsuyama, Seiya

    1988-06-01

    Steerable guide wire used in PTCA was applied for various abdominal and peripheral interventional angiographies in eight patients. In embolization procedures, this wire was used with coaxial catheter system. The steerable wire facilitated superselective catheterization of distal branches in mesenteric, renal and hepatic artery embolizations. This wire was also useful for traversing severe stenoses in renal and peripheral angioplasties.

  10. MR angiography of collateral arteries in a hind limb ischemia model: comparison between blood pool agent Gadomer and small contrast agent Gd-DTPA.

    Karolien Jaspers

    Full Text Available The objective of this study was to compare the blood pool agent Gadomer with a small contrast agent for the visualization of ultra-small, collateral arteries (diameter0.10. Inter-observer variation was 24% and 18% for Gadomer and Gd-DTPA, respectively. In conclusion, blood pool agent Gadomer improved vessel conspicuity compared to Gd-DTPA. Steady-state MRA can be considered as an excellent non-invasive alternative to intra-arterial XRA for the visualization of ultra-small collateral arteries.

  11. Parameters of Blood Flow in Great Arteries in Hypertensive ISIAH Rats with Stress-Dependent Arterial Hypertension.

    Seryapina, A A; Shevelev, O B; Moshkin, M P; Markel', A L

    2016-08-01

    Magnetic resonance angiography was used to examine blood flow in great arteries of hypertensive ISIAH and normotensive Wistar rats. In hypertensive ISIAH rats, increased vascular resistance in the basin of the abdominal aorta and renal arteries as well as reduced fraction of total renal blood flow were found. In contrast, blood flow through both carotid arteries in ISIAH rats was enhanced, which in suggests more intensive blood supply to brain regulatory centers providing enhanced stress reactivity of these rats characterized by stress-dependent arterial hypertension.

  12. [Ruptured pseudoaneurysm of the renal artery associated with segmental arterial mediolysis].

    Mizutani, Kosuke; Kikuchii, Mina; Kondo, Hiroshi; Moriyama, Yoji; Tsuchiya, Tomohiro; Masahiro, Nakano; Hidetoshi, Ehara; Deguchii, Takashi; Shinoda, Ikuo

    2008-07-01

    We present a 71-year-old woman with spontaneous perinephric hematoma due to a rupture of pseudoaneurysm of the right renal artery on the fourth day after radical cystectomy and bilateral ureterocutaneostomy for bladder cancer. This patient received steroid therapy for chronic rheumatoid arthritis for several years. The digital subtraction angiography of the right renal artery showed two pseudoaneurysms in the anterior inferior segmental branch and the posterior inferior segmental branch. Transarterial coil embolization of the right renal artery proximally and distally to the two aneurysms was performed without complications. Moreover, the additional angiography showed typical string-of-beads appearance and small aneurysms in abdominal visceral arteries, suggesting segmental arterial mediolysis (SAM) as a possible etiology. Differential diagnoses of SAM are discussed.

  13. Transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection: case report and review of literature

    MOCAN, MIHAELA; JEICAN, IONUŢ ISAIA; MOALE, MIHAI; CHIRA, ROMEO

    2017-01-01

    Acute abdominal pain is one of the most common conditions encountered in the emergency department. The differential diagnosis of acute abdominal pain is extensive and identifying the underlying etiology can be challenging. We report a case of acute transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection in a patient with no cardiovascular risk factors or autoimmune diseases. Symptomatic isolated superior mesenteric artery dissection is a rare cause of acute abdominal pain usually treated in the surgical department. The patient had criteria for conservative treatment and rapidly recovered. We highlight a rare condition which should be taken into account for the differential diagnosis of acute abdominal pain.

  14. A proposal for standardizing computed tomography reports on abdominal aortic aneurysms; Proposta para padronizacao do relatorio de tomografia computadorizada nos aneurismas da aorta abdominal

    Torlai, Fabiola Goda; Meirelles, Gustavo S. Portes [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil); Miranda Junior, Fausto; Fonseca, Jose Honorio A.P. da [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Cirurgia; Ajzen, Sergio; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: giuseppe_dr@uol.com.br

    2006-07-15

    Objective: to propose a model to standardize computed tomography reports on abdominal aortic aneurysms. Materials and methods: interviews were carried out with members of the Vascular Surgery Division of our institution, in the period between April and October 2004, aiming at developing a standardized model of computed tomography reports on abdominal aortic aneurysms. Based on this model, a questionnaire was elaborated and sent to other nine surgeons, all of them experienced in the field of abdominal aortic surgery. The questionnaires response rate was 55.5% (5/9). Results: the most frequently mentioned parameters of interest for evaluation of abdominal aortic aneurysms were: maximum diameter of proximal aortic neck, proximal aortic neck length to lower renal arteries, shape of proximal aortic neck, maximum diameter of the aneurysm and diameter of the common iliac arteries. These data allowed the development of a proposal for a model to standardize computed tomography reports. Conclusion: a model for standardized tomographic analysis of abdominal aortic aneurysms has met vascular surgeons' needs for following-up patients and planning their treatment. (author)

  15. 腹腔镜与开放式腹壁切口疝补片修补术的对比研究%Comparison study of open and laparoscope patch herniorrhaphy on abdominal wall incisional hernia

    白东; 张健; 周忠笑

    2011-01-01

    目的 比较开放手术及腹腔镜补片修补腹壁切口疝的手术效果,探讨腹腔镜腹壁切口疝修补术的价值.方法 回顾分析56例腹壁切口疝患者的临床资料.根据手术方式分为腹腔镜组(24例)和开放组(32例),对2组切口疝类型、腹壁缺损大小、手术时间、术后并发症、术后疼痛评分、术后住院时间、复发率等进行对比分析.结果 2组手术时间、术后并发症发生率、术后复发率比较均无显著性差异.腹腔镜组术后疼痛评分、术后住院时间和手术出血量均明显少于开放组.结论 腹腔镜腹壁切口疝修补术是安全可行的.它可以从腹腔内在原切口薄弱区添加一个MESH,修复缺损,加强腹壁,避免切开原切口,避免分离腹壁组织,具有创伤小、住院时间短、恢复快等优点,符合力学原理,是修补腹壁切口疝的理想术式,特别对于巨大腹壁切口疝优于开放式腹壁切口疝补片修补术.%Objective It is to compare the operation effect of open surgery and laparoscope patch herniorrhaphy on abdominal wall incisional hernia and approach the value of laparoscope abdominal wall incisional hernia herniorrhaphy. Methods The clinical data of 56 patients with abdominal wall incisional hernia who were in our hospital from January 2004 to January 2010 were analyzed retrospectively. The patients were divided into laparoscope group ( 24 cases ) and open group ( 32 cases ) according operation manner. The type of incisional hernia, abdominal wall defect size , operation time , postoperative complications, postoperative pain score, postoperative hospitalization time and recurrence rate of the two groups were compared and analyaed. Results There were all no significant differences on operation time, postoperative complications incidence rate and postoperative recurrence rate hetween the two groups. The postoperative pain score, postoperative hospitalization time and operation hemorrhage quantity in

  16. An unusual cause of dyspnoea complicating right upper abdominal swelling

    Sanjay Kumar Mandal; Partha Pratim Chakraborty; Rana Bhattacharjee; Subhasis Roy Chowdhury; Shounak Majumdar

    2006-01-01

    A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominentepigastric and back veins.Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava (IVC), middle and left hepatic veins.Arterial blood gas (ABG) documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome (HPS) was made with near normal liver function secondary to amebic liver abscess.It reversed completely following successful treatment of the liver abscess.

  17. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  18. Evaluation of the normal thoracic and abdominal aorta diameters by computerized tomography; Avaliacao dos diametros normais da aorta toracica e abdominal pela tomografia computadorizada

    Lucarelli, Claudio Luiz

    1995-07-01

    The study was undertaken to evaluate, through computerized tomography, the diameters of the normal thoracic and abdominal aorta, as well as they are connected to gender, age and body surface area; and the ratio between measurements obtained at the ascending and descending limbs of the thoracic aorta, and between the abdominal aortic diameters. For that reason, we measured the widest anteroposterior diameters of the thoracic aortas at the levels of the arch, the root, the pulmonary artery, and the thoracic-abdominal transition, as well as the level of the emergence of the superior mesenteric artery, of the renal hila and just cephalad to the bifurcation of the abdominal aortas of 350 patients without cardiovascular diseases who had undergone computerized tomography of the thorax and/or abdomen for any other reasons. Observation and statistic analyses led us to conclude that: 1) both the thoracic and abdominal aortic diameters are reduced from their proximal to their distal portions; 2) the body surface influences the size of the aorta, although only extreme variations alter the vessel's caliber; 3) vessel diameter was observed to gradually increase with age; 4) men were found to have larger diameters than age matched women; 5) the ratio between the ascending and descending aortic diameters varies according to gender and age; 6) the relations between abdominal aortic diameters measured at the level of renal hila and cephalad to the bifurcation are independent from gender and age. But the relation between those measured at the level of the superior mesenteric artery and cephalad to the bifurcation are linked to gender, but not to age. (author)

  19. Luciferase from Fulgeochlizus bruchi (Coleoptera:Elateridae), a Brazilian click-beetle with a single abdominal lantern: molecular evolution, biological function and comparison with other click-beetle luciferases.

    Amaral, Danilo T; Prado, Rogilene A; Viviani, Vadim R

    2012-07-01

    Bioluminescent click-beetles emit a wide range of bioluminescence colors (λ(Max) = 534-594 nm) from thoracic and abdominal lanterns, which are used for courtship. Only the luciferases from Pyrophorus and Pyrearinus species were cloned and sequenced. The Brazilian Fulgeochlizus bruchi click-beetle, which inhabits the Central-west Cerrado (Savannas), is noteworthy because, differently from other click-beetles, the adult stage displays only a functional abdominal lantern, which produces a bright green bioluminescence for sexual attraction purposes, and lacks functional thoracic lanterns. We cloned the cDNA for the abdominal lantern luciferase of this species. Notably, the primary sequence of this luciferase showed slightly higher identity with the green emitting dorsal lantern luciferases of the Pyrophorus genus instead of the abdominal lanterns luciferases. This luciferase displays a blue-shifted spectrum (λ(Max) = 540 nm), which is pH-insensitive from pH 7.5 to 9.5 and undergoes a slight red shift and broadening above this pH; the lowest K(M) for luciferin among studied click-beetle luciferases, and the highest optimum pH (9.0) ever reported for a beetle luciferase. At pH 9.0, the K(M) for luciferin increases, showing a decrease of affinity for this substrate, despite the higher activity. The slow luminescence decay rate of F. bruchi luciferase in vitro reaction could be an adaptation of this luciferase for the long and sustained in vivo luminescence display of the click-beetle during the courtship, and could be useful for in vivo intracellular imaging.

  20. Efficacy comparison of the treatment of vertebral artery ostium and intracranial vertebral artery stenosis with Apollo stents%Apollo支架治疗椎动脉起始部和颅内段狭窄的疗效比较

    李立; 李天晓; 薛绛宇; 朱良付; 王子亮; 白卫星; 赵同源; 李钊硕; 许岗勤

    2012-01-01

    目的 比较Apollo支架治疗椎动脉起始部和颅内段狭窄的安全性和有效性.方法 回顾性分析河南省人民医院介入科2010年1月-2011年12月使用Apollo支架治疗椎动脉单发狭窄103例患者的资料,共103处狭窄,根据狭窄部位分为椎动脉起始部组(33例)和椎动脉颅内段组(70例).比较两组患者的临床预后、再狭窄率及并发症.结果 ①支架到位率为100%.术后即刻造影显示,残余狭窄率<10%的有86处,其余16处的残余狭窄率均<20%,1处因出血用弹簧圈闭塞.② 有3例在围手术期出现并发症,占2.9%(3/103),其中1例并发脑出血,2例并发脑梗死,均为椎动脉颅内段组患者.椎动脉起始部组并发症的发生率(0/33)与颅内段组(3/70)比较,差异无统计学意义,P=0.549.③术后6个月影像学随访67例,其中13例发生支架内再狭窄,椎动脉起始部组再狭窄的发生率(32.1%,9/28)高于颅内段组(10.3%,4/39),差异有统计学意义,P=0.025.④术后临床随访 94例,平均9个月,无死亡病例.有8例再次发生后循环脑梗死,其中椎动脉起始部组3例(3/30,10.0%),颅内段组5例(5/64,7.8%),两组比较差异无统计学意义.结论 Apollo支架治疗椎动脉狭窄是安全、有效的.椎动脉颅内段组围手术期并发症的发生率高于起始部组,而椎动脉起始部组再狭窄的发生率高于颅内段组.%Objective To compare the safety and efficacy of Apollo stents in the treatment of vertebral artery ostium and intracranial vertebral artery stenosis. Methods A total of 103 patients with single vertebral artery stenosis treated with Apollo stents at the department of interventional radiology, Henan Provincial Peoples Hospital from January 2010 to December 2011 were analyzed retrospectively. The patients were divided into either a vertebral artery ostium group (n = 33) and an intracranial vertebral artery group ( n =70) according to the sites of stenosis. The clinical prognosis, in

  1. The arterial load in pulmonary hypertension

    A. Vonk-Noordegraaf

    2010-09-01

    Full Text Available The anatomical differences between the pulmonary and systemic arterial system are the main cause of the difference in distribution of compliance. In the pulmonary arterial system compliance is distributed over the entire arterial system, and stands at the basis of the constancy of the RC-time. This distribution depends on the number of peripheral vessels, which is ∼8–10 times more in the pulmonary system than the systemic tree. In the systemic arterial tree the compliance is mainly located in the aorta (80% of total compliance in thoracic-abdominal aorta. The constant RC-time in the pulmonary bed results in proportionality of systolic and diastolic pressure with mean pressure and, in turn, in the constant ratio of oscillatory and mean power.

  2. Direct comparison of local cerebral blood flow rates measured by MRI arterial spin-tagging and quantitative autoradiography in a rat model of experimental cerebral ischemia.

    Ewing, James R; Wei, Ling; Knight, Robert A; Pawa, Swati; Nagaraja, Tavarekere N; Brusca, Thomas; Divine, George W; Fenstermacher, Joseph D

    2003-02-01

    The present study determined cerebral blood flow (CBF) in the rat using two different magnetic resonance imaging (MRI) arterial spin-tagging (AST) methods and 14C-iodoantipyrine (IAP)-quantitative autoradiography (QAR), a standard but terminal technique used for imaging and quantitating CBF, and compared the resulting data sets to assess the precision and accuracy of the different techniques. Two hours after cerebral ischemia was produced in eight rats via permanent occlusion of one middle cerebral artery (MCA) with an intraluminal suture, MRI-CBF was measured over a 2.0-mm coronal slice using single-coil AST, and tissue magnetization was assessed by either a spin-echo (SE) or a variable tip-angle gradient-echo (VTA-GE) readout. Subsequently ( approximately 2.5 hours after MCA occlusion), CBF was assayed by QAR with the blood flow indicator 14C-IAP, which produced coronal images of local flow rates every 0.4 mm along the rostral-caudal axis. The IAP-QAR images that spanned the 2-mm MRI slice were selected, and regional flow rates (i.e., local CBF [lCBF]) were measured and averaged across this set of images by both the traditional approach, which involved reader interaction and avoidance of sectioning artifacts, and a whole film-scanning technique, which approximated total radioactivity in the entire MRI slice with minimal user bias. After alignment and coregistration, the concordance of the CBF rates generated by the two QAR approaches and the two AST methods was examined for nine regions of interest in each hemisphere. The QAR-lCBF rates were higher with the traditional method of assaying tissue radioactivity than with the MRI-analog approach; although the two sets of rates were highly correlated, the scatter was broad. The flow rates obtained with the whole film-scanning technique were chosen for subsequent comparisons to MRI-CBF results because of the similarity in tissue "sampling" among these three methods. As predicted by previous modeling, "true" flow rates

  3. A case of acute ischemic colitis after endovascular abdominal aortic aneurysm repair

    Grigorios Voulalas; Chrisostomos Maltezos

    2016-01-01

    Colonic ischemia is a recognized complication of either open or endovascular abdominal aortic aneurysm repair. The clinical difficulty in establishing the diagnosis, the severity of this complication and the patient's poor physiological status may lead to a fatal outcome. We presented a case of ischemic colitis in a patient with patent hypogastric arteries that occurred after an endovascular abdominal aortic aneurysm repair as well as a review of the available literature. The patient's preoperative, intraoperative and postoperative data were recorded. A thorough search through the Google data and Medline to review similar cases or any analyses that referred to ischemic colitis after endovascular abdominal aneurysm repair was conducted. A 76-year-old male was admitted to our department for an elective endovascular repair of an 8 cm in diameter abdominal aortic aneurysm. A Zenith bifurcation graft was implanted. The whole procedure was uneventful and the final angiogram showed an accurate deployment of the endograft without endoleaks and patency of both hypogastric arteries. During the 1st postoperative day, the patient developed symptoms of acute abdomen in combination with metabolic acidosis and oliguria. He underwent an exploratory laparotomy, which revealed necrosis of the sig-moid. A Hartmann's procedure was performed;the patient was transferred to the intensive care unit where he deceased after 24 h. Postoperative ischemic colitis has been described after open abdominal aneurysm repair. The description of this complication has been reported since the early phase of endovascular abdominal aneurysm repair development with a current incidence of 1.5%–3.0%. Possible mechanisms that may contribute to ischemic colitis in spite of the presence of patent hypogastric arteries include athe-roembolization, shock, vasopressive drugs and inferior mesenteric artery occlusion.

  4. MR angiography with parallel acquisition for assessment of the visceral arteries: comparison with conventional MR angiography and 64-detector-row computed tomography

    Sutter, Reto [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Heilmaier, Christina [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Lutz, Amelie M.; Willmann, Juergen K. [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Weishaupt, Dominik [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Hospital Triemli, Department of Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Biostatistics Unit, Institute of Social and Preventive Medicine, Zurich (Switzerland)

    2009-11-15

    The purpose of the study was to retrospectively compare three-dimensional gadolinium-enhanced magnetic resonance angiography (conventional MRA) with MRA accelerated by a parallel acquisition technique (fast MRA) for the assessment of visceral arteries, using 64-detector-row computed tomography angiography (MDCTA) as the reference standard. Eighteen patients underwent fast MRA (imaging time 17 s), conventional MRA (29 s) and MDCTA of the abdomen and pelvis. Two independent readers assessed subjective image quality and the presence of arterial stenosis. Data were analysed on per-patient and per-segment bases. Fast MRA yielded better subjective image quality in all segments compared with conventional MRA (P = 0.012 for reader 1, P = 0.055 for reader 2) because of fewer motion-induced artefacts. Sensitivity and specificity of fast MRA for the detection of arterial stenosis were 100% for both readers. Sensitivity of conventional MRA was 89% for both readers, and specificity was 100% (reader 1) and 99% (reader 2). Differences in sensitivity between the two types of MRA were not significant for either reader. Interobserver agreement for the detection of arterial stenosis was excellent for fast ({kappa} = 1.00) and good for conventional MRA ({kappa} = 0.76). Thus, subjective image quality of visceral arteries remains good on fast MRA compared with conventional MRA, and the two techniques do not differ substantially in the grading of arterial stenosis, despite the markedly reduced acquisition time of fast MRA. (orig.)

  5. Comparison of cerebral blood flow measurement with [15O]-water positron emission tomography and arterial spin labeling magnetic resonance imaging: A systematic review.

    Fan, Audrey P; Jahanian, Hesamoddin; Holdsworth, Samantha J; Zaharchuk, Greg

    2016-05-01

    Noninvasive imaging of cerebral blood flow provides critical information to understand normal brain physiology as well as to identify and manage patients with neurological disorders. To date, the reference standard for cerebral blood flow measurements is considered to be positron emission tomography using injection of the [(15)O]-water radiotracer. Although [(15)O]-water has been used to study brain perfusion under normal and pathological conditions, it is not widely used in clinical settings due to the need for an on-site cyclotron, the invasive nature of arterial blood sampling, and experimental complexity. As an alternative, arterial spin labeling is a promising magnetic resonance imaging technique that magnetically labels arterial blood as it flows into the brain to map cerebral blood flow. As arterial spin labeling becomes more widely adopted in research and clinical settings, efforts have sought to standardize the method and validate its cerebral blood flow values against positron emission tomography-based cerebral blood flow measurements. The purpose of this work is to critically review studies that performed both [(15)O]-water positron emission tomography and arterial spin labeling to measure brain perfusion, with the aim of better understanding the accuracy and reproducibility of arterial spin labeling relative to the positron emission tomography reference standard.

  6. Abdominal neurenteric cyst

    Radoje (C)olovi(c); MarJan Micev; Miodrag Jovanovi(c); Slavko Mati(c); Nikica Grubor; Henry Dushan E Atkinson

    2008-01-01

    immunoexpression, and the respiratory epithelium revealed a CK8 and CK18 immunoprofile without CK 10/13 positive elements, though neither CEA or AFP positive cells were found. To our knowledge, this is the first reported case of an abdominally located neurenteric cyst with no associated spinal anomalies.

  7. Electromyographic investigation of abdominal exercises and the effects of fatigue.

    Robinson, Mark; Lees, Adrian; Barton, Gabor

    Abdominal exercises are widely used to develop the anterior muscles of the trunk. These exercises can be undertaken without the aid of equipment, but increasingly manufacturers are developing equipment which purportedly enhances the training effect for abdominal muscles. As there are many different products and exercises used for abdominal muscle development, it is likely that some are more effective than others. This study aimed to investigate the effectiveness of five commonly performed abdominal exercises. A second aim was to investigate the effects of fatigue on these exercises. Five different types of abdominal exercise [standard crunch (sit-up) with bent knees, gym ball crunch, crunch with 5 kg weight held behind the head, legs raised crunch and a commercially manufactured roller crunch] were examined using integrated surface electromyography (IEMG). The lower rectus abdominis (LRA), upper rectus abdominis (URA) and obliquus externus abdominis (EO) of 15 healthy male participants [age (mean +/- SD) 22.2 +/- 6.8 years; height 1.77 +/- 0.06 m; mass 79.3 +/- 10.7 kg] were monitored using a four-channel special purpose EMG data logger. Three trials of each exercise were performed in random order and normalized to enable comparisons between muscles and exercises. At a later date, ten participants were then re-tested when fresh and after a 30 min whole-body fatigue protocol that specifically targeted the abdominal muscles. Two exercises were evaluated, the abdominal roller crunch and legs raised crunch, which were judged to be the least and most effective, respectively, of the five exercises previously used. The normalized IEMG showed significant (p crunch = 86.0 +/- 7.5%; legs raised crunch = 79.9 +/- 5.1%; 5 kg weight crunch = 65.1 +/- 13.4%; standard crunch = 56.2 +/- 3.2%; and roller crunch = 45.0 +/- 11.4%). Post-fatigue, the normalized mean IEMG for both exercises increased significantly (p 0.05). It was concluded that exercises can be constructed to provide

  8. Carotid artery surgery

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  9. A clinical dilemma: abdominal tuberculosis

    Oya Uygur-Bayramicli; G(u)l Dabak; Resat Dabak

    2003-01-01

    AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis.METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital,Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests,Mantoux skin test, chest X-ray and abdominal ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed.RESULTS: The median age of patients (14 females, 17males) was 34.2 years (range 15-65 years). The most frequent symptoms were abdominal pain and weight loss.Eleven patients had active pulmonary TB. The most common abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2 %). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 (45 %), nodules in 2 (10 %)and, stricture, polypoid lesions, granulomatous findings in terminal ileum and rectal fistula each in one patient (5 %).Laparoscopy on 4 patients showed dilated bowel loops,thickening in the mesentery, multiple ulcers and tubercles on the peritoneum. Patients with abdominal TB were divided into three groups according to the type of involvement.Fifteen patients (48 %) had intestinal TB, L1 patients (35.2 %) had tuberculous peritonitis and 5 (16.8 %)tuberculous lymphadenitis. The diagnosis of abdominal TB was confirmed microbiologically in 5 (16 %) and histopathologically in 19 patients (60.8 %). The

  10. [Abdominal pregnancy care. Case report].

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  11. Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification

    Malata, Charles M.; Nicholas Grant Rabey

    2015-01-01

    Introduction The deep inferior epigastric artery perforator free flap is the gold standard for autologous breast reconstruction. However, using a single vascular pedicle may not yield sufficient tissue in patients with midline scars or insufficient lower abdominal pannus. Double-pedicled free flaps overcome this problem using different vascular arrangements to harvest the entire lower abdominal flap. The literature is, however, sparse regarding technique selection. We therefore reviewed ou...

  12. Comparison of contrast and noncontrast magnetic resonance angiography for quantitative analysis of thoracic arteries in young patients with congenital heart defects

    Pasqua Alessia

    2011-01-01

    Full Text Available Background : Contrast MRA (C-MRA is the standard for quantitative analysis of thoracic vessels. We evaluated a noncontrast MRA (NC-MRA sequence (3-D EKG and navigator-gated SSFP for quantitative evaluation of the thoracic aorta and branch pulmonary arteries in young patients with congenital heart disease. Objective : To compare contrast and noncontrast magnetic resonance angiography for quantitative analysis of thoracic arteries in young patients with congenital heart defects. Methods : Measurements of thoracic aorta and branch pulmonary arteries were obtained from C-MRA and NC-MRA images in 51 patients, ages 2-35 years. Vessel diameters were compared using correlation and Bland-Altman analysis. Interobserver variability was assessed using percent variation. Results : C-MRA and NC-MRA measurements were highly correlated (r = 0.91-0.98 except for the right pulmonary artery (r = 0.74, 0.78. Agreement of measurements was excellent (mean difference -0.07 to -0.53 mm; mean % difference -1.8 to -4.9% except for the right pulmonary artery which was less good (mean difference 0.73, -1.38 mm; -3, -10%. Interobserver variability ranged from 5% to 8% for aortic and from 10% to 16% for pulmonary artery measures. The worse agreement and greater variability of the pulmonary artery measures appears due to difficulty standardizing the measurements in patients with abnormal and irregular vessels. Conclusion : These data indicate that C-MRA and NC-MRA measures are comparable and could be used interchangeably, avoiding administration of contrast in selected patients.

  13. A Rare Case of Aneurysm of Arc of Riolan Artery and Gastroduodenal Artery

    Athiyappan Kumaresh

    2014-01-01

    Full Text Available Arc of Riolan is a collateral channel that connects the proximal superior mesenteric artery (SMA or its middle colic branch and the proximal inferior mesenteric artery or its left colic branch in case of stenosis of either of the arteries. A 65-year-old diabetic female presented with vague abdominal pain. Ultrasonography showed a large aneurysm within the abdomen in the left lumbar region. Computed tomography (CT angiography done showed severe diffuse atherosclerotic calcification of the abdominal aorta with complete occlusion of the celiac trunk and mild stenosis of SMA origin. The arc of Riolan was seen between the middle colic artery and the ascending branch of the left colic artery, with a large saccular aneurysm in its mid section. No evidence of rupture or hematoma was visible. Another saccular aneurysm was also seen involving the gastro-duodenal and the pancreatico-duodenal collateral arcade. As far as we know, this is the first case of arc of Riolan artery aneurysm to be reported in English literature.

  14. Abdominal wall hernia and pregnancy

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-01-01

    PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  15. Abdominal actinomycosis mimicking acute appendicitis.

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  16. Comparison of Arterial Blood Collection at Different Needle Angle%不同进针角度采集动脉血的比较

    王晓颖

    2016-01-01

    血气分析是判定呼吸衰竭和各种抢救治疗措施是否有效的重要指标,而血气分析的最佳标本是动脉血,快速、准确地采集动脉血则是非常关键的。要快速准确地采集动脉血,减轻患者的痛苦,可根据动脉情况采取不同的进针角度进行穿刺,以提高动脉采血的成功率、准确率。本文分别介绍了桡动脉、股动脉、肱动脉、足背动脉不同进针角度采血的方法及结果,得出结论:在采集动脉的过程中应根据患者的不同情况选择不同的方法,从而提高穿刺采血的成功率及准确率,提高护理质量。%Blood gas analysis is an important index of respiratory failure and various treatment measures are effective, and the best specimens of blood gas analysis is blood, collected quickly and accurately is very important in arterial blood. To quickly and accurately collect arterial blood, reduce the pain of patients, according to the circumstances of the artery to take different angle of the needle to puncture, to improve the success rate of arterial blood collection, accuracy rate. This paper introduces the methods and results of blood sampling from different angles of the radial artery, femoral artery, brachial artery and dorsal artery of the foot: We should choose different methods according to the different situations of the patients in the process of collecting the artery, so as to improve the success rate and accuracy of puncture and blood collection, and improve the quality of nursing.

  17. [Surgical treatment of patients for abdominal sepsis].

    Kryvoruchko, I A; Usenko, O Iu; Andreieshchev, S A

    2014-08-01

    Results of surgical treatment of 201 patients, suffering abdominal sepsis (AS), which have occurred after operations on abdominal organs, were analyzed. Expediency of application of modern scales for the patients state severity estimation, prognostic sign-posts and dynamic of the pathological process course in every patient was substantiated. Existing systems of prognostication (APACHE II, SOFA, MODS) are applied restrictedly for diagnosis of infection in patients, what demands relaparotomy performance in presence of clinical signs of intraabdominal infection, which persists. For prognostication of the treatment result and determination of indications for relaparotomy conduction in patients, suffering severe AS and infectious-toxic shock (ITSH), the most informative is application of the Manheim's index of peritonitis together with analysis of clinico-laboratory indices for formation of groups of patients in risk, to whom reoperation is indicated. Advantages of relaparotomy "on demand" conduction were proved in comparison with "programmed" relaparotomy during the staged surgical treatment of patients, suffering severe AS and ITSH. Complex surgical treatment with substantiation of indications and choice of adequate method of intervention secures improvement of the treatment results in these severely ill patients.

  18. Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients – an observational study

    Ratanjee Sharad

    2009-03-01

    Full Text Available Abstract Background Patients on peritoneal and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. The atherosclerosis is associated with increased arterial stiffness, endothelial dysfunction and elevated oxidative stress and inflammation. The aims of this study are to investigate the effects of peritoneal and hemodialysis on arterial stiffness, vascular function, myocardial structure and function, oxidative stress and inflammation in incident patients with end stage kidney disease. Methods This is an observational study. Eighty stage five CKD patients will be enrolled and followed for one-year. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity, 2 oxidative stress assessed by plasma F2 isoprostanes and 3 inflammation measured by plasma pentraxin-3. Secondary outcomes will include additional measures of oxidative stress and inflammation, changes in vascular function assessed using the brachial artery reactivity technique, carotid artery intimal medial thickness, augmentation index and trans thoracic echocardiography to assess left ventricular geometry, and systolic and diastolic function. Patients will undergo these measures at baseline (6–8 weeks prior to starting dialysis therapy, then at six and 12 months after starting dialysis. Discussion The results of this study may guide the choice of dialysis modality in the first year of treatment. It may also lead to a larger study prospectively assessing the effect of dialysis modality on cardiovascular morbidity and mortality. Trial Registration ACTRN12609000049279

  19. Late diagnosis of Takayasu's arteritis with repeated attacks of heart failure and uncontrolled hypertension due to abdominal aortic thrombosis: case report and review of the literature.

    Wang, Huan; Lai, Baochun; Wu, Xiaoying; Han, Tao; Chen, Hui

    2015-01-01

    Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease affecting the aorta and its branches. To date, only one case involving abdominal aortic thrombosis due to TA has been reported. After bilateral artificial subclavian-iliac bypass, a case of abdominal aortic thrombosis due to TA received a delayed diagnosis in a 44-year-old Chinese male who experienced recurrent episodes of heart failure and uncontrolled hypertension with claudication of two extremities. Abdominal color Doppler sonography and computed tomography aortography (CTA) showed occlusion of the abdominal aorta and bilateral renal artery stenosis. After vascular bypass and during 1 year follow-up, his cardiac function improved and blood pressure was well controlled, with reduced serum creatinine. Postoperative CTA still showed abdominal aortic thrombosis resulting in arterial occlusion extending from the left renal artery initial segment level to the bilateral common iliac artery and the bifurcation of the renal artery, except for the vascular bypass. Abdominal aortic thrombosis due to TA is very rare and potentially life threatening, probably becoming an atherosclerosis risk factor. Doppler sonography and CTA results are important for diagnosis. Artificial vascular bypass can be used for TA in debilitated patients with diffuse aortic disease.

  20. Coronary artery fistula

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  1. Blunt abdominal trauma in sports.

    Rifat, Sami F; Gilvydis, Rimas P

    2003-04-01

    Abdominal injuries are rare in sports, but when they do occur it is important that the physician recognize the warning signs of potentially life-threatening injury to the liver, spleen, or hollow abdominal viscera. Though the sports medicine physician may not always provide definitive treatment of many of these conditions, he or she should be familiar with the preferred diagnostic modalities and latest treatment options. This information is not only essential to appropriately participate in treatment decisions, but is also important in order to make return-to-play determinations.

  2. [Gallstone ileus. Abdominal CT usefulness].

    Sukkarieh, F; Brasseur, P; Bissen, L

    2004-06-01

    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  3. CT appearances of abdominal tuberculosis

    Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

    2012-06-15

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  4. Effect Observation and Comparison of Different Tension Free Hernia Repair in the Treatment of Abdominal External Hernia%观察对比不同无张力疝修补手术治疗腹外疝的效果

    叶静凯

    2015-01-01

    目的:对比分析传统修补术与改进无张力疝修补手术在腹外疝的治疗中的应用价值。方法选取80例腹外疝患者,依据治疗方法的不同将其列入观察组与对照组,每组各为40例。对照组和观察组分别应用传统疝修补术与改进无张力疝修补术。结果两组手术及预后相关指标和并发症的发生率比较,差异均有统计学意义(P <0.05)。结论在腹外疝的治疗中,与传统修补术相比,改良后无张力疝修补术的效果更佳。%Objective To analyze and compare application value in the treatment of abdominal external hernia between traditional repair and improved without tension hernia repair surgery. Methods Chose 80 patients with abdominal external hernia,according to the different treatment methods,they were divided into observation group and control group,each group with 40 cases. The control group and observation group were applied traditional hernia repair and improved without tension hernia repair. Results Compared related index of prognosis and the incidence of complications in two groups of surgery,the difference had statistical significance(P < 0.05). Conclusion In the treatment of abdominal external hernia,compared with the traditional repair,modified without tension hernia repair’effect is better.

  5. Efficacy and safety comparison between liraglutide as add-on therapy to insulin and insulin dose-increase in Chinese subjects with poorly controlled type 2 diabetes and abdominal obesity

    Li Chun-jun

    2012-11-01

    Full Text Available Abstract Objective To assess the efficacy and safety of adding liraglutide to established insulin therapy in poorly controlled Chinese subjects with type 2 diabetes and abdominal obesity compared with increasing insulin dose. Methods A 12-week, randomized, parallel-group study was carried out. A total of 84 patients completed the trial who had been randomly assigned to either the liraglutide-added group or the insulin-increasing group while continuing current insulin based treatment. Insulin dose was reduced by 0-30% upon the initiation of liraglutide. Insulin doses were subsequently adjusted to optimized glycemic control. Glycosylated hemoglobin (HbA1c values, blood glucose, total daily insulin dose, body weight, waist circumference, and the number of hypoglycemic events and adverse events were evaluated. Results At the end of study, the mean reduction in HbA1c between the liraglutide-added group and the insulin-increasing group was not significantly different (1.9% vs. 1.77%, p>0.05. However, the percentage of subjects reaching the composite endpoint of HbA1c ≤ 7.0% with no weight gain and no hypoglycemia, was significantly higher in the liraglutide-added group than in the insulin-increasing group (67% vs. 19%, p2, p Conclusions Addition of liraglutide to abdominally obese, insulin-treated patients led to improvement in glycemic control similar to that achieved by increasing insulin dosage, but with a lower daily dose of insulin and fewer hypoglycemic events. Adding liraglutide to insulin also induced a significant reduction in body weight and waist circumference. Liraglutide combined with insulin may be the best treatment option for poorly controlled type 2 diabetes and abdominal obesity.

  6. Diagnosis in acute abdominal pain and ongoing abdominal sepsis

    Kiewiet, J.J.S.

    2016-01-01

    Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that surgeo

  7. Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

    Joseph, George, E-mail: joseph59@gmail.com; Chacko, Sujith Thomas [Christian Medical College, Department of Cardiology (India)

    2013-02-15

    A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.

  8. Left testicular artery arching over the ipsilateral renal vein

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  9. Endovascular aneurysm repair alters renal artery movement : A preliminary evaluation using dynamic CTA

    Muhs, Bart E.; Teutelink, Arno; Prokop, Matthias; Vincken, Koen L.; Moll, Frans L.; Verhagen, Hence J. M.

    2006-01-01

    Purpose: To observe the natural renal artery motion during cardiac cycles in patients with abdominal aortic aneurysm (AAA) and how the implantation of stent-grafts may distort this movement. Methods: Data on 29 renal arteries from 15 male patients (mean age 72.6 years, range 66-83) treated with Tale

  10. Comparison of intra-arterial chemoembolization with and without radiotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: a meta-analysis

    Zhao Q

    2016-12-01

    Full Text Available Qianqian Zhao,1,2 Kunli Zhu,2 Jinbo Yue,2 Zhonghua Qi,1,2 Shumei Jiang,2 Xiaoqing Xu,2 Rui Feng,2 Renben Wang2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, 2Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Jinan, People’s Republic of China Purpose: Numerous studies have tried to combine transarterial chemoembolization (TACE or hepatic arterial infusion chemotherapy (HAIC with radiotherapy (RT for the treatment of hepatocellular carcinoma (HCC patients with portal vein tumor thrombus (PVTT. However, the efficacy of TACE or HAIC combined with RT versus TACE or HAIC alone remains controversial. Thus, we performed a meta-analysis to compare the efficacy and safety of intra-arterial chemoembolization combined with RT versus intra-arterial chemoembolization alone for the treatment of HCC patients with PVTT.Methods: PubMed, Embase, and Cochrane Library databases were systematically searched for eligible studies. Two authors independently reviewed the abstracts, extracted relevant data and rated the quality of studies. The major end points were objective response rate (ORR, overall survival (OS, and adverse events.Results: Eight studies with a total of 1,760 patients were included in this meta-analysis. The pooled results showed that intra-arterial chemoembolization combined with RT significantly improved ORR of PVTT (OR, 4.22; 95% CI, 3.07–5.80; P<0.001 and OS (HR, 0.69; 95% CI, 0.57–0.83; P=0.001, but did not affect ORR of primary liver tumor (OR, 1.37; 95% CI, 0.67–2.79; P=0.390. The incidence of grade 3 or 4 leukopenia (OR, 5.80; 95% CI, 2.478–13.56; P<0.001 and thrombocytopenia (OR, 3.77; 95% CI, 1.06–13.43; P=0.041 was higher in the intra-arterial chemoembolization plus RT group than in the intra-arterial chemoembolization group.Conclusion: Combination therapy of intra-arterial chemoembolization and RT for HCC patients with PVTT could

  11. Heart transplantation and arterial elasticity

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  12. Damage control surgery for severe thoracic and abdominal injuries

    HUANG Xian-kai; ZHU Yu-jun; ZHANG Lian-yang

    2007-01-01

    Objective: To investigate the application of damage control surgery in treatment of patients with severe thoracic and abdominal injuries.Methods: A retrospective study was done on 37 patients with severe thoracic and abdominal injuries who underwent damage control surgery from January 2000 to October 2006 in our department. There were 8 cases of polytrauma ( with thoracic injury most commonly seen), 21 of polytrauma (with abdominal injury most commonly seen) and 8 of single abdominal trauma. Main organ damage included smashed hepatic injuries in 17 cases,posterior hepatic veins injuries in 8, pancreaticoduodenal injuries in 7, epidural or subdural hemorrhage in 4,contusion and laceration of brain in 5, severe lung and bronchus injuries in 4, pelvis and one smashed lower limb wound in 3 and pelvic fractures and retroperitoneal hemorrhage in 6. Injury severity score (ISS) was 28-45 scores (38.4 scores on average), abbreviated injury scale (ALS) ≥ 4.13. The patients underwent arteriography and arterial embolization including arteria hepatica embolization in 4 patients, arteria renalis embolization in 2 and pelvic arteria retroperitoneal embolization in 7. Once abbreviated operation finished, the patients were sent to ICU for resuscitation. Twenty-four cases underwent definitive operation within 48 hours after initial operation, 5 underwent definitive operation within 72 hours after initial operation, 2 cases underwent definitive operation postponed to 96 hours after initial operation for secondary operation to control bleeding because of abdominal cavity hemorrhea.Two cases underwent urgent laparotomy and decompression because of abdominal compartment syndrome and 2 cases underwent secondary operation because of intestinal fistulae (1 case of small intestinal fistula and 1 colon fistula) and gangrene of gallbladder.Results: A total of 28 patients survived, with a survival rate of 75.68%, and 9 died (4 died within 24 hours and 5 died 3-9 days after injury). The

  13. Topogram-based automated selection of the tube potential and current in thoraco-abdominal trauma CT - a comparison to fixed kV with mAs modulation alone

    Frellesen, Claudia; Stock, Wenzel; Kerl, J.M.; Lehnert, Thomas; Wichmann, Julian L.; Beeres, Martin; Schulz, Boris; Bodelle, Boris; Vogl, Thomas J. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Nau, Christoph; Geiger, Emanuel; Wutzler, Sebastian [Clinic of the Goethe University, Department of Trauma, Hand and Reconstructive Surgery, Frankfurt (Germany); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Bauer, Ralf W. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Klinikum der Goethe-Universitaet, Institut fuer Diagnostische und Interventionelle Radiologie, Frankfurt am Main (Germany)

    2014-07-15

    To investigate the impact of automated attenuation-based tube potential selection on image quality and exposure parameters in polytrauma patients undergoing contrast-enhanced thoraco-abdominal CT. One hundred patients were examined on a 16-slice device at 120 kV with 190 ref.mAs and automated mA modulation only. Another 100 patients underwent 128-slice CT with automated mA modulation and topogram-based automated tube potential selection (autokV) at 100, 120 or 140 kV. Volume CT dose index (CTDI{sub vol}), dose-length product (DLP), body diameters, noise, signal-to-noise ratio (SNR) and subjective image quality were compared. In the autokV group, 100 kV was automatically selected in 82 patients, 120 kV in 12 patients and 140 kV in 6 patients. Patient diameters increased with higher kV settings. The median CTDI{sub vol} (8.3 vs. 12.4 mGy; -33 %) and DLP (594 vs. 909 mGy cm; -35 %) in the entire autokV group were significantly lower than in the group with fixed 120 kV (p < 0.05 for both). Image quality remained at a constantly high level at any selected kV level. Topogram-based automated selection of the tube potential allows for significant dose savings in thoraco-abdominal trauma CT while image quality remains at a constantly high level. (orig.)

  14. Clinical management of abdominal trauma

    FANG Guo-en; LUO Tian-hang; DU Cheng-hui; BI Jian-wei; XUE Xu-chao; WEI Guo; WENG Zhao-zhang; MA Li-ye; HUA Ji-de

    2008-01-01

    Objective: To improve the prognosis of patients with abdominal trauma. Methods: Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years ranging from 3-82 years. All abdominal traumas consisted of closed traumas 360 cases, 86.7% and open traumas 55 cases, 13.3%. Results: Atotal of 407 cases 98.1% were fully recovered from trauma and the other 8 cases 1.9% died of multiple injuries. The mean injury severity score ISS of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds 6 cases, pancreatic fistula 2 cases and intestinal fistula 1 case. All these postoperative complications were cured by the conservative treatment. Conclusion: Careful case history inquisition and physical examination are the basic methods to diagnose abdomi- nal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.

  15. Chronic Abdominal Pain in Children

    C.F.M. Gijsbers (Carolien)

    2012-01-01

    textabstractRecurrent abdominal pain (RAP) was first defined in 1958 by Apley as “at least 3 bouts of pain, severe enough to affect activities, over a period of at least 3 months” (1). This was a landmark publication with great impact, showing, that emotional disturbances played a role in many patie

  16. Economic costs of abdominal obesity

    Højgaard, Betina; Olsen, Kim Rose; Søgaard, Jes

    2008-01-01

    BACKGROUND: To examine the relationship between waist circumference and future health care costs across a broad range of waist circumference values based on individual level data. METHOD: A prospective cohort of 31,840 subjects aged 50-64 years at baseline had health status, lifestyle and socio-e...... be a potential for significant resource savings through prevention of abdominal obesity....

  17. STUDY ON VARIATIONS OF INFERIOR SEGMENTAL BRANCH OF RENAL ARTERY

    Chandragirish S

    2014-11-01

    Full Text Available Background: The segmental arteries of the kidney supply the organ in such a way that, each renal pole receives its own artery while, the anterior portion between the poles is supplied by an upper and lower segmental vessel. These two arteries also include in their territory the lateral edge of the kidney and adjacent to the strip of parenchyma on the dorsal or posterior aspect of the organ. The knowledge of inferior segmental branch of renal artery is very important for surgeries in its distribution area in kidney. Materials and Methods: 100 kidneys (Fifty pairs intact with abdominal aorta were collected from department of Forensic medicine, JSS Medical College and Mysore Medical College. For study of segmental variation Corrosion cast technique method was used. The variations of inferior segmental branch of renal artery were observed and recorded. Results: In present study type I inferior segmental branch of renal artery were found in - 59% cases, type II in - 6% cases, type III in - 28% cases, type IV in - 2% cases. Conclusion: The inferior segmental artery from the anterior division of the renal artery is the commonest event –arising in 59%. This is Type I, the normal type. It arises from the renal artery (28% or from the posterior division (6% or from the aorta (2%. The knowledge of inferior segmental branch of renal artery helpful in kidney transplantation and renal surgery because these type of surgeries success mainly depends on arterial ligations.

  18. Abdominal aortic aneurysm repair - open - discharge

    ... this page: //medlineplus.gov/ency/patientinstructions/000240.htm Abdominal aortic aneurysm repair - open - discharge To use the sharing features ... References Orandi BJ, Black JH. Open repair of abdominal aortic aneurysms. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  19. Preoperative steroid in abdominal wall reconstruction

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  20. Postprandial lower limb pain: An unusual presentation of visceral arteries occlusion.

    Patelis, Nikolaos; Papoutsis, Konstantinos; Liakopoulos, Dimitrios; Koutsoumpelis, Andreas; Bakogiannis, Christos; Georgopoulos, Sotirios

    2015-06-01

    This case report describes an atypical and unique presentation of mesenteric arteries occlusive disease. The patient presented with typical symptoms of chronic mesenteric ischemia, as well as with an atypical new symptom; postprandial buttock and lower limbs pain. Pain followed the time curve of the postprandial abdominal discomfort, starting 30 min after meals and gradually resolving within 2 h. The patient had been tolerating the signs of chronic mesenteric ischemia quite well by adjusting the quantity of food per meal to relieve symptoms. Angiography showed that the celiac artery, the superior mesenteric artery, and distal aorta were occluded, leaving the inferior mesenteric artery as the only feeding vessel of all abdominal viscera and both the lower limbs. Since an English medical literature search returned only one marginally similar case, we consider this case of iliac arteries' "steal syndrome" from the inferior mesenteric artery unique.

  1. A comparison of the pH of arterial blood with arterialised blood from the ear-lobe with astrup's micro glasselectrode

    Maas, A.H.J.; Heijst, A.N.P. van

    1961-01-01

    The pH of arterial blood and the blood from an arterialised ear-lobe are compared. The small difference (± 0.002 pH) is not important in studying the changes of the acid-base balance. It is concluded that blood obtained by puncture of the arterialised earlobe is a good substitute for blood obtained

  2. Peripheral arterial disease: clinical and cost comparisons between duplex US and contrast-enhanced MR angiography--a multicenter randomized trial.

    Vries, M. de; Ouwendijk, R.; Flobbe, K.; Nelemans, P.J.; Kessels, A.G.H.; Schurink, G.H.; Vliet, J.A. van der; Heijstraten, F.M.J.; Cuypers, P.W.; Duijm, L.E.M.; Engelshoven, J.M. van; Hunink, M.G.M.; Haan, M.W. de

    2006-01-01

    PURPOSE: To prospectively determine the clinical and economic consequences of replacing duplex ultrasonography (US) with contrast material-enhanced magnetic resonance (MR) angiography for the initial imaging work-up of patients with peripheral arterial disease (PAD). MATERIALS AND METHODS: This rand

  3. Evaluation of intima media thickness of carotid arteries in 40-60 years old persons with type d personality and its comparison with normal ones

    Fariborz Khorvash

    2013-01-01

    Conclusions: We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction.

  4. Unusual origin of the artery of Adamkiewicz from the fourth lumbar artery

    Lo, D.; Vallee, J.N.; Spelle, L.; Cormier, E.; Chiras, J. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Saillant, G. [Service de Chirurgie Orthopedique et de Traumatologie, Hopital de la Salpetriere, Paris (France); Rancurel, G. [Service D' urgences Cerebro-Vasculaires, Hopital de la Salpetriere, Paris (France)

    2002-02-01

    The main arterial supply of the dorso-lumbar spinal cord is usually derived from a single anterior radiculo-medullary artery called the artery of Adamkiewicz and referred to as having a middle or low location. In some cases, the artery origin is higher, and a vessel which arises in the lower part of the region supplements the supply of the anterior spinal artery. In the literature, those arteries have been described as arising from L3 upwards, and have never been previously described angiographically, to our knowledge, below this level, although Suh and Alexander and Gililan have mentioned this eventuality. Of the 4,000 spinal cord angiographies performed in our institution, we report three cases in which the fourth lumbar artery flows into the anterior spinal artery of the conus medullaris. This anatomical variant may explain the sometimes devastating post-operative neurological complications from a spinal cord infarction on surgery of the lumbar spine or the abdominal aorta below L3. (orig.)

  5. Comparison of Heart and Coronary Artery Doses Associated With Intensity-Modulated Radiotherapy Versus Three-Dimensional Conformal Radiotherapy for Distal Esophageal Cancer

    Kole, Thomas P.; Aghayere, Osarhieme; Kwah, Jason [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Yorke, Ellen D. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Goodman, Karyn A., E-mail: goodmank@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-08-01

    Purpose: To compare heart and coronary artery radiation exposure using intensity-modulated radiotherapy (IMRT) vs. four-field three-dimensional conformal radiotherapy (3D-CRT) treatment plans for patients with distal esophageal cancer undergoing chemoradiation. Methods and Materials: Nineteen patients with distal esophageal cancers treated with IMRT from March 2007 to May 2008 were identified. All patients were treated to 50.4 Gy with five-field IMRT plans. Theoretical 3D-CRT plans with four-field beam arrangements were generated. Dose-volume histograms of the planning target volume, heart, right coronary artery, left coronary artery, and other critical normal tissues were compared between the IMRT and 3D-CRT plans, and selected parameters were statistically evaluated using the Wilcoxon rank-sum test. Results: Intensity-modulated radiotherapy treatment planning showed significant reduction (p < 0.05) in heart dose over 3D-CRT as assessed by average mean dose (22.9 vs. 28.2 Gy) and V30 (24.8% vs. 61.0%). There was also significant sparing of the right coronary artery (average mean dose, 23.8 Gy vs. 35.5 Gy), whereas the left coronary artery showed no significant improvement (mean dose, 11.2 Gy vs. 9.2 Gy), p = 0.11. There was no significant difference in percentage of total lung volume receiving at least 10, 15, or 20 Gy or in the mean lung dose between the planning methods. There were also no significant differences observed for the kidneys, liver, stomach, or spinal cord. Intensity-modulated radiotherapy achieved a significant improvement in target conformity as measured by the conformality index (ratio of total volume receiving 95% of prescription dose to planning target volume receiving 95% of prescription dose), with the mean conformality index reduced from 1.56 to 1.30 using IMRT. Conclusions: Treatment of patients with distal esophageal cancer using IMRT significantly decreases the exposure of the heart and right coronary artery when compared with 3D

  6. Comparison of intra-arterial chemoembolization with and without radiotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: a meta-analysis

    Zhao, Qianqian; Zhu, Kunli; Yue, Jinbo; Qi, Zhonghua; Jiang, Shumei; Xu, Xiaoqing; Feng, Rui; Wang, Renben

    2017-01-01

    Purpose Numerous studies have tried to combine transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) with radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). However, the efficacy of TACE or HAIC combined with RT versus TACE or HAIC alone remains controversial. Thus, we performed a meta-analysis to compare the efficacy and safety of intra-arterial chemoembolization combined with RT versus intra-arterial chemoembolization alone for the treatment of HCC patients with PVTT. Methods PubMed, Embase, and Cochrane Library databases were systematically searched for eligible studies. Two authors independently reviewed the abstracts, extracted relevant data and rated the quality of studies. The major end points were objective response rate (ORR), overall survival (OS), and adverse events. Results Eight studies with a total of 1,760 patients were included in this meta-analysis. The pooled results showed that intra-arterial chemoembolization combined with RT significantly improved ORR of PVTT (OR, 4.22; 95% CI, 3.07–5.80; P<0.001) and OS (HR, 0.69; 95% CI, 0.57–0.83; P=0.001), but did not affect ORR of primary liver tumor (OR, 1.37; 95% CI, 0.67–2.79; P=0.390). The incidence of grade 3 or 4 leukopenia (OR, 5.80; 95% CI, 2.478–13.56; P<0.001) and thrombocytopenia (OR, 3.77; 95% CI, 1.06–13.43; P=0.041) was higher in the intra-arterial chemoembolization plus RT group than in the intra-arterial chemoembolization group. Conclusion Combination therapy of intra-arterial chemoembolization and RT for HCC patients with PVTT could bring higher ORR of PVTT and better survival benefits. This combination therapy was also associated with a significantly increased risk of adverse events. However, they were mostly mild to moderate and successfully treated with conservative treatment. PMID:28053537

  7. Fornix Rupture in Duplex Kidney due to Internal Iliac Artery Aneurysm

    Phitsanu Mahawong

    2016-01-01

    Full Text Available A 70-year-old man presented with severe pain on the right side of the abdomen for 7 days. An abdominal CT angiographic scan showed an impending rupture of a large right internal iliac artery aneurysm which compressed to a right ureter causing hydroureteronephrosis. Fornix rupture of a right duplex kidney was also detected. Selective embolization of right gluteal arteries and then ligation of the right internal iliac artery and right ureterotomy with double J stenting were performed. At the 4-month follow-up appointment, an abdominal ultrasound demonstrated a decrease in the size of the aneurysm and no hydroureteronephrosis after the removal of double J stent.

  8. Trauma abdominal em grávidas Abdominal trauma in pregnant women

    Gustavo Pereira Fraga

    2005-09-01

    Full Text Available OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5. Seis mulheres (46,2% estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014. CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with

  9. Abdominal Compartment Syndrome: pathophysiology and definitions

    Cheatham Michael L

    2009-01-01

    Abstract "Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous ...

  10. [Changes of the intraabdominal pressure in patients with abdominal sepsis].

    Kursov, S V

    2013-01-01

    64 patients with abdominal sepsis were included in the study of the intraabdominal pressure changes before and after the operation. The study demonstrated that the use of the crystalloids alone leads to the development of the capillary leak syndrome in comparison with the therapy regimen using colloids. The aggressive fluid resuscitation, associated with high numbers of central venous pressure, increasing 1177Pa (120 mm H2O), was connected with the increase of the intraabdominal pressure.

  11. Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study.

    L Correa-Martín

    Full Text Available Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient's risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology.Fifteen pigs were divided into three groups: a control group (n = 5 and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min.Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05. In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours.The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction.

  12. A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

    Mansour Almoudi; Zhong-Hua Sun

    2012-01-01

    Objectives The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease. Methods A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease. Results Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPISPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification. Conclusions There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patients with suspected coronary artery disease.

  13. Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

    Zheng-gang WANG

    2012-02-01

    Full Text Available Objective  To observe the effect of vacuum sealing drainage (VSD assisted intra-abdominal volume increment (IAVI technique on the liver in the treatment of intra-abdominal hypertension (IAH following hemorrhagic shock resuscitation in pigs. Methods  Twelve healthy mini-pigs (Bama, Guangxi were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h, and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT group (n=4 and sham operation control (SC group (n=4. Vesical pressure (VP and inferior vena cava pressure (IVCP were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST and alanine aminotransferase (ALT were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results  The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions  The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.

  14. An unusual cause of acute abdominal pain in dengue fever.

    Waseem, Tariq; Latif, Hina; Shabbir, Bilquis

    2014-07-01

    Dengue fever is an acute febrile viral disease caused by the bite of Aedes aegypti mosquito. It is a major health problem especially in tropical and subtropical areas including South East Asia and Pakistan. In the past few years, dengue fever has been endemic in Northern Punjab. Physicians managing dengue fever come across varied and uncommon complications of dengue fever. We report a case of dengue fever that developed severe right upper quadrant abdominal pain and induration after extreme retching and vomiting for 2 days. A rectus sheath hematoma was confirmed on noncontrast computed tomography (CT). Rectus sheath hematoma as a complication of dengue fever has rarely been reported before and never from this part of the world. Rectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric artery or their branches or from a direct tear of the rectus muscle. It can mimic almost any abdominal condition (See Fig.) (See Table).

  15. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2008-05-15

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding.

  16. Allergic Lung Inflammation Aggravates Angiotensin II-Induced Abdominal Aortic Aneurysms in Mice

    Liu, Cong-Lin; Wang, Yi; Liao, Mengyang

    2016-01-01

    OBJECTIVE: Asthma and abdominal aortic aneurysms (AAA) both involve inflammation. Patients with asthma have an increased risk of developing AAA or experiencing aortic rupture. This study tests the development of one disease on the progression of the other. APPROACH AND RESULTS: Ovalbumin...... sensitization and challenge in mice led to the development of allergic lung inflammation (ALI). Subcutaneous infusion of angiotensin II into mice produced AAA. Simultaneous production of ALI in AAA mice doubled abdominal aortic diameter and increased macrophage and mast cell content, arterial media smooth...

  17. Superman play and pediatric blunt abdominal trauma.

    Machi, J M; Gyuro, J; Losek, J D

    1996-01-01

    Two pediatric patients with life-threatening intra-abdominal injuries associated with Superman play are presented. The cases illustrate the importance of knowing the mechanism of injury in the assessment of children with blunt abdominal trauma. The diagnostic value of liver enzymes and the controversies surrounding the radiographic assessment of pediatric blunt abdominal trauma are presented.

  18. Overexpression of Vascular Endothelial Growth Factor in Restenotic Abdominal Aorta of Rabbits

    尹瑞兴; 杨德寨; 吴海; 黄凯; 巫相宏; 陈宇明

    2002-01-01

    Objective To investigatethe expression of vascular endothelial growth factor (VEGF) in the wall of normal and restenotic abdominal aorta of rabbits. Methods Restenotic model was developed by balloon-injured abdominal aorta in eight male New Zealand White rabbits fed with a 2.0% cholesterol diet beginning two weeks before operation and continuing four weeks after procedure. At the end of 4 weeks after injury, the animals underwent total body perfusion fixation. Then, the abdominal aorta from iliac artery root to the diaphragm was harvested and post-fixed in 10 % neutral formalin for 16hours. Eight male animals fed with general diet were used for a normal control. The VEGF protein level in normal and restenotic abdominal aorta of rabbits was studied by means of immunohistochemistry. Results VEGF protein was detected in 5 (62.5 % ) of 8normal abdominal aorta, 3 showed faint staining, and the remaining 2 showed moderate VEGF expression.VEGF expression at the protein level was identified in all 8 restenotic specimens, 2 showed faint staining, 4showed moderate staining, and the remaining 2showed strong VEGF expression. In contrast to normal vessels, VEGF in restenotic specimens was distinctly expressed at sites that contained clustered macrophages and proliferating smooth muscle cells as well as endothelial cells. VEGF immunostaining was more extensive in restenotic specimens (2. 00 ± 0.76)than in normal vessels (0.82 ±0. 83, P < 0.01) .Microvessels were found in 7 of the 8 restenotic lesions, but only one lesion showed VEGF staining in endothelial cells of the microvessels. Conclusion VEGF expression is consistently more intense in sections of restenotic abdominal aorta than in those of normal abdominal aorta. The VEGF expressed by the smooth muscle cells and foamy macrophages in the restenotic arteries may act as a local and endogenous regulator of endothelial cell functions, including maintenance and repair of luminal endothelium, and formation of intimal

  19. [Intra-arterial thrombolysis of acute mesenteric ischemia].

    Nathan, N; Wintringer, P; Bregeon, Y; Cassat, C; Le Blanche, A; Boulanger, J P; Feiss, P

    1995-01-01

    A 73-year-old man with pre-existing cardiac failure, coronary artery and chronic obstructive pulmonary disease was presented for an acute mesenteric ischaemia, resulting from an embolic obstruction of the superior mesenteric artery. An intra-arterial fibrinolysis with a bolus of 250 000 units of streptokinase, followed by an infusion of 150 mg rtPA with adequate heparin dosage was performed 10 hours after the first symptoms. An abdominal guarding occurred 24 hours later, despite radiological improvement, justifying emergency surgery which confirmed the partial efficiency of the medical therapy. Unfortunately, a cardiogenic shock occurred preoperatively and the patient died five days later from intractable cardiovascular failure.

  20. Drug-Eluting Nitinol Stent Treatment of the Superficial Femoral Artery and Above-the-Knee Popliteal Artery (The Zilver PTX Single-Arm Clinical Study): A Comparison Between Diabetic and Nondiabetic Patients

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Primo, Massimiliano Di [Hopital Europeen Georges Pompidou, University Paris Descartes (France); Boatta, Emanuele [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Johnston, Krystal, E-mail: kjohnston@medinst.com [MED Institute, Inc (United States); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Hopital Europeen Georges Pompidou, University Paris Descartes (France)

    2013-10-15

    Purpose: To describe the 1-year results of drug-eluting nitinol stent placement in the femoropopliteal artery of diabetic and nondiabetic patients. Materials and Methods: All patients enrolled in this prospective, multicenter study underwent paclitaxel-eluting stent placement for de novo or restenotic lesions of the superficial femoral and/or popliteal artery. Baseline and follow-up walking impairment questionnaire (WIQ) scores, Rutherford classifications, and ankle-brachial index (ABI) measurements were obtained. Follow-up was completed at 1, 6, and 12 months. Results: There were 285 diabetic patients and 502 nondiabetic patients treated. There were no significant differences in mean lesion length or lesion calcification between patient groups. Procedural success in both treatment groups was >97 %. There were no significant differences between diabetic and nondiabetic groups in Kaplan-Meier estimates of patency, event-free survival (EFS), or freedom from target lesion revascularization (TLR) at 6 and 12 months. Both groups experienced a significant increase in ABI and WIQ values after treatment, and these improvements were sustained to 12-month follow-up; however, nondiabetic patients had significantly greater 6- and 12-month WIQ scores compared with diabetic patients. Based on covariate analysis, the only factors shown to be significant and to negatively influence patency were longer lesion length (p = 0.009), higher Rutherford classification (p = 0.02), and lack of hypertension (p = 0.02); diabetic status was not found to be a significant factor. Conclusion: Diabetic and nondiabetic patients had similar estimates of primary patency, EFS, and freedom from TLR; however, diabetic patients showed less improvement in WIQ scores compared with nondiabetic patients.

  1. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    Ali Ridha

    2017-01-01

    Full Text Available Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003. This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.

  2. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  3. Inter-individual, inter-vendor comparison of diffusion-weighted MR imaging of upper abdominal organs at 3.0 tesla with an emphasis on the value of normalization with the spleen

    Song, Ji Soo; Hwang, Seung Bae; Chung, Gyung Ho; Jin, Gong Yong [Dept. of Radiology, Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic o