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Sample records for aorta abdominal em

  1. Os ramos colaterais da aorta abdominal em jaguatirica (Leopardus pardalis

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    Luane L. Pinheiro

    2014-05-01

    Full Text Available A jaguatirica (Leopardus pardalis é uma das espécies de felino silvestre que pouco foi investigada quanto a sua morfologia. Assim, o estudo objetivou detalhar a origem e distribuição dos ramos colaterais da aorta abdominal deste animal. Avaliou-se dois exemplares, sendo um macho e uma fêmea, jovens, provenientes de Paragominas-PA, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA da Universidade Federal Rural da Amazônia (UFRA. O sistema arterial foi preenchido com látex pigmentado de vermelho e os cadáveres foram preservados com solução de formaldeído tamponado a 10%. A aorta abdominal do L. pardalis teve origem entre T12 e L1, sendo a artéria celíaca o primeiro ramo visceral no sentido crânio-caudal, resultando nas artérias hepática, gástrica esquerda e esplênica. A artéria mesentérica cranial surgiu como segundo ramo da aorta abdominal, originando as artérias jejunais. Na sequência localizamos artéria pancreáticoduodenal caudal, artérias ileais, artérias ileocólicas, artérias renais direita e esquerda, artérias adrenais direita e esquerda e artérias ováricas ou testiculares direita e esquerda. Parietalmente, a aorta abdominal originou em média seis ramos lombares, bem como a artéria frenicoabdominal, as artérias circunflexas ilíacas profundas e artérias ilíacas externa e interna. A aorta abdominal gerou ainda a artéria mesentérica caudal, a qual dividiu-se em artérias cólica esquerda e retal cranial. A artéria cólica esquerda seguiu cranialmente paralela ao cólon descendente irrigando-o, originando em média 18 ramos, e anastomosando-se com a artéria cólica média. A artéria retal cranial seguiu em direção caudal distribuindo oito ramos à porção final do cólon descendente e ao reto, e uniu-se com a artéria retal média. Por fim, a aorta abdominal emitiu como ramo terminal a artéria sacral mediana. A vascularização arterial abdominal desta espécie é bastante semelhante ao

  2. 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

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    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

  3. Ultra-sonografia da aorta abdominal e de seus ramos em cães Ultrasonography of abdominal aorta and its branches in dogs

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    Lilian Kamikawa

    2007-04-01

    Full Text Available O ultra-som bidimensional e o ultra-som Doppler foram utilizados para avaliar a biometria e a hemodinâmica da aorta abdominal e artérias ilíacas externas de 131cães clinicamente normais. Os resultados da avaliação biométrica da aorta abdominal indicaram um diâmetro médio de 0,80cm para o seu segmento diafragmático (AOD; 0,74cm para o seu segmento caudal às artérias renais (AOR e 0,69cm para o segmento cranial à sua bifurcação (AOT. A artéria ilíaca externa direita (AIED apresentou o diâmetro médio de 0,42cm e a artéria ilíaca externa esquerda (AIEE o diâmetro médio de 0,39. O estudo hemodinâmico da aorta abdominal apresentou velocidade de pico sistólico médio de 104,00cm/s para AOR; 99,61cm/s para AOT; 85,47cm/s para AIED e 99,51cm/s para AIEE. Verificaram-se correlações de diferentes intensidades entre os diâmetros vasculares em diferentes pontos de tomadas e os fatores biométricos corpóreos (CRL. Correlações baixas foram observadas quando esses diâmetros foram confrontados com a idade.A duplex ultrasound system incorporating a pulsed wave Doppler ultrasound probe with conventional B-mode real-time imaging was used to evaluate the biometric and the hemodynamic of abdominal aorta and external iliac arteries of a hundred and thirty one normal dogs. Results of biometrics of abdominal aorta, presented a mean diameter of 0.80cm in its diaphragmatic segment (AOD; 0.74cm in its segment caudal to the renal arteries (AOR and 0.69cm in the segment cranial to its termination (AOT. The right-external-iliac artery (AIED presented a mean diameter of 0.42cm and the left-external iliac artery (AIEE a mean diameter of 0.39cm. The hemodynamic study of the abdominal aorta presented a medium systolic peak velocity to AOR of 104cm per sec.; to AOT of 99.61cm per sec.; to AIED of 85.47cm per sec. and to AIEE of 99.51cm per sec. Correlations of different intensities between the vascular diameters have been verified between the

  4. Tratamento farmacológico e interações medicamentosas em pacientes com aneurisma da aorta abdominal

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    Heverton Alves Peres

    2015-01-01

    Full Text Available O aneurisma da aorta abdominal (AAA ocorre quando há uma dilatação anormal e irreversível da artéria superior a 50% do calibre esperado para o vaso e associa-se a uma mortalidade de 80 a 90%. O controle dos principais fatores de risco como a hipertensão, dislipidemia, tabagismo e doenças trombóticas em aneurismas pequenos é feito por vários medicamentos que evitam o desenvolvimento e ruptura do aneurisma, no entanto, o uso destes associados a outros medicamentos pode desencadear interações medicamentosas relevantes sendo crucial o conhecimento sobre estas. Atualmente, há poucos dados na literatura sobre o tratamento farmacológico e interações medicamentosas em pacientes com AAA, sendo o objetivo desta revisão, descrever a farmacoterapia e interações medicamentosas em pacientes com AAA.

  5. Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms Morfologia da deposição de trombos murais: trajeto da luz residual em aneurismas de aorta abdominal infra-renal

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    Thiago Adriano Silva Guimarães

    2008-01-01

    Full Text Available PURPOSE: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. METHODS: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. RESULTS: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. CONCLUSION: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall.OBJETIVOS: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. MÉTODOS: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. RESULTADOS: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. CONCLUSÃO: A formação do trombo mural predominou na parede

  6. Resultados da cirurgia do aneurisma da aorta abdominal em pacientes jovens Outcomes after surgical repair of abdominal aortic aneurysms in young patients

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    Telmo P. Bonamigo

    2009-06-01

    Full Text Available CONTEXTO: A presença de aneurisma da aorta abdominal (AAA é rara em pacientes jovens. OBJETIVO: Avaliar os resultados da cirurgia do AAA em pacientes com idade BACKGROUND: Abdominal aortic aneurysms (AAA are rare in young patients. OBJECTIVE: To evaluate outcomes after AAA repair in patients aged < 50 years. METHODS: Between June 1979 and January 2008, 946 patients underwent elective repair for an infrarenal AAA performed by the first author. Of these, 13 patients (1.4% were < 50 years old at surgery. Demographic characteristics and surgical data were analyzed, as well as early and late outcomes after surgical intervention. RESULTS: Mean age was 46±3.4 years (ranging from 43 to 50 years. Most patients were men (76.9%, hypertensive (76.9% and smokers (61.5%. Perioperative morbidity and mortality rates were low (15.4% and 0%, respectively; one patient had respiratory infection and another patient had unstable angina. Median follow-up was 85.5 months, and two patients died due to ischemic cardiopathy and cerebrovascular accident during the follow-up period. CONCLUSION: AAA repair in young patients is a safe procedure, with good long-term results. In our study, there were no perioperative deaths, and a good long-term survival was observed.

  7. Acute spontaneous isolated dissection of abdominal aorta

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    Ali Akbar beigi

    2009-09-01

    Full Text Available

    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  8. Tratamento endovascular de aneurisma de aorta abdominal em paciente com rim em ferradura: relato de caso Endovascular treatment of abdominal aortic aneurysm in patient with horseshoe kidney: a case report

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    José Manoel da Silva Silvestre

    2013-03-01

    Full Text Available O rim em ferradura é uma das anomalias urológicas congênitas mais comuns e está presente em cerca de 0,12% dos pacientes com aneurisma de aorta abdominal. O reparo cirúrgico convencional está associado a dificuldades técnicas que provavelmente aumentam a morbidade e a mortalidade, mas que podem ser evitadas com o tratamento endovascular. Relatamos um caso de um paciente de 64 anos com rim em ferradura e aneurisma de aorta abdominal, que foi submetido ao reparo endovascular do aneurisma com sucesso.The horseshoe kidney is one of the most common urologic anomalies and is present in about 0,12% of the patients with abdominal aortic aneurysm. The conventional surgical repair is associated with technical difficulties that probably increase morbidity and mortality, but can be averted by the endovascular treatment. We report a case of a 64-year-old patient with horseshoe kidney and abdominal aortic aneurysm, who underwent endovascular repair with success.

  9. Correção endovascular de aneurisma de aorta abdominal em paciente com rim em ferradura: relato de caso Endovascular repair of an abdominal aortic aneurysm in patient with horseshoe kidney: a case report

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    Eduardo Keller Saadi

    2008-09-01

    Full Text Available O rim em ferradura é uma anomalia congênita rara que pode causar várias dificuldades técnicas durante a correção convencional de aneurisma de aorta abdominal. Relatamos o caso de uma paciente de 68 anos com rim em ferradura, aneurisma de aorta abdominal sintomático e disfunção renal leve. A paciente foi submetida a correção endovascular, sendo utilizada uma endoprótese bifurcada. O pós-operatório foi livre de complicações. O diagnóstico e a técnica endovascular são discutidos, assim como a literatura revisada.Horseshoe kidney is a rare congenital anomaly that may cause various technical problems during conventional repairs of abdominal aortic aneurysms. We report the case of a 68-year-old woman with a horseshoe kidney, symptomatic abdominal aortic aneurysm and mild renal failure. The patient underwent endovascular repair using a bifurcated endoprosthesis. The postoperative was uneventful. We describe the diagnosis and the endovascular technique and literature review.

  10. Evaluation of personal dosimetry in abdominal aorta endo prosthesis procedures; Avaliacao da dosimetria pessoal em procedimentos de endoproteses de aorta abdominal

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    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Freitas, Carlos C.M. de; Pina, Diana R. [Universidade Estadual Paulista Julio de Mesquita Filho (FMB/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2016-07-01

    The objective of this paper is to evaluate the currently dosimetry technique employed in the medical staff during interventional radiology procedures. Thermoluminescent dosimeters were positioned in different regions of the primary interventionist during procedures of stent graft in abdominal aortic aneurysms. The equivalent dose rate profile shows a tendency of difference between dose rate found in the chest in relation to the abdomen, hands and feet. Statistically, dose rates found in the hands differ from those found in the chest with p=0.05. These results suggest that only a dosimeter placed on the chest does not describe faithfully the radiation doses to which these professionals are occupationally exposed. (author)

  11. Abdominal aorta transplantation after programmed cryopreservation

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    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.

  12. Modelo experimental de influência dos vasa vasorum na estrutura da parede de aorta abdominal em suínos

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    Alexandre Bueno da Silva

    2012-01-01

    Introdução A visão tradicional afirma que as células miointimais responsáveis pela hiperplasia intimal derivam das células musculares lisas da média e que, através da mudança de seu fenótipo para um estado proliferativo, migram para a região intimal Esta visão tem sido contestada em algumas publicações que tem demonstrado o importante papel da adventícia na fisiopatologia da hiperplasia intimal. Objetivo: Analisar as alterações da estrutura da parede da aorta abdominal de suínos secundária a ...

  13. Atrophic coarctation of the abdominal aorta.

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    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  14. Prevalência de dilatação da aorta abdominal em coronariopatas idosos Prevalence of abdominal aortic dilatation in patients aged 60 years or older with coronary disease

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    Guilherme Vieira Meirelles

    2007-06-01

    Full Text Available CONTEXTO: A realização de programas de triagem para o aneurisma da aorta abdominal de forma indiscriminada auxiliará uma pequena porcentagem de indivíduos, mas ao considerarmos grupos com fatores de risco relacionados à dilatação da aorta, aumentando a probabilidade da doença, este permitirá um direcionamento adequado dos recursos e um benefício maior à população. Programas direcionados pelas sociedades médicas, permitindo um diagnóstico precoce das doenças vasculares e conseqüentemente um melhor preparo do doente, promoveriam melhores taxas de sobrevida com menor morbidade. OBJETIVO: Avaliar a prevalência da dilatação da aorta abdominal em uma amostra de pacientes idosos com mais de 60 anos de idade, portadores de coronariopatia aterosclerótica diagnosticada por cineangiocoronariografia. MÉTODOS: Para a seleção dessa amostra, levou-se em consideração o fato de que a avaliação pré-operatória de cirurgia vascular não tenhasido a indicação do cateterismo. Procedeu-se então a avaliação, baseada na anamnese, exame físico e Doppler ultra-som da aorta abdominal. A análise estatística iniciou-se com o teste qui-quadrado, com a posterior análise de regressão logística multivariada e regressão logística univariada, considerando significativo um p BACKGROUND: Indiscriminate screening programs for abdominal aortic aneurysm will help a small percentage of individuals. However, when considering groups with risk factors associated with aortic dilatation, which increases the probability of the disease, such programs will provide an adequate allocation of resources and a greater benefit to the population. Programs guided by medical societies, providing an early diagnosis of vascular diseases and consequently a better preparation of patients, would result in better survival rates with lower morbidity. OBJECTIVE: To evaluate the prevalence of abdominal aortic dilatation in patients aged 60 years or older with

  15. Surgery of gigantic infrarenal aneurysm of abdominal aorta

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

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    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

  17. 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

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    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

  18. Lesão pulmonar de reperfusão por oclusão da aorta abdominal: modelo experimental em ratos

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    PINHEIRO BRUNO DO VALLE

    2000-01-01

    Full Text Available Introdução: Procedimentos cirúrgicos com oclusão da aorta têm sido associados a lesão pulmonar de reperfusão. O objetivo deste trabalho foi estudar a presença de edema pulmonar em um modelo de lesão de reperfusão por oclusão da aorta em ratos. Material e métodos: 33 ratos Wistar foram anestesiados com tiopental sódico (20mg/kg, via intraperitoneal, seguindo-se laparotomia por incisão mediana, para isolamento da aorta e cava inferior. A seguir, os animais foram randomizados em três grupos. Grupo isquemia-reperfusão (GIR, n = 5: animais submetidos a 30min de oclusão dos vasos, seguindo-se 120min de reperfusão. Grupo isquemia (GI, n = 5: animais submetidos a 30min de oclusão dos vasos. Grupo controle (GC, n = 5: animais submetidos apenas ao procedimento cirúrgico, sem oclusão dos vasos, acompanhados por 150min. Após o sacrifício, em 15 animais foram realizados estudos histopatológicos dos pulmões. Para caracterização de edema, foi realizada a análise morfométrica por contagem de pontos, determinando-se o índice de edema alveolar. Realizou-se também uma análise semiquantitativa da infiltração de polimorfonucleares nos pulmões. Em 18 animais retirou-se o pulmão direito para a determinação da relação entre os pesos úmido e seco. O índice de edema alveolar e a relação peso úmido/peso seco foram comparados entre os grupos através de ANOVA, com a correção de Bonferroni para comparação entre os grupos dois a dois. Resultados: Os animais do GIR apresentaram maior edema alveolar em relação aos do GI e GC (0,24; 0,18; 0,17; respectivamente, com p < 0,001. Não houve diferenças nas relações peso úmido/peso seco dos três grupos. Houve maior infiltração de células inflamatórias nos pulmões dos ratos submetidos a isquemia-reperfusão. Os autores concluem que a oclusão e desoclusão da aorta infra-renal está associada à lesão pulmonar. Essa lesão não foi induzida pela elevação da press

  19. [Inflammatory aneurysms of the abdominal aorta].

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    Tovar Martín, E; Acea Nebril, B

    1993-01-01

    Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.

  20. Ischemic colitis complicating reconstruction of the abdominal aorta

    DEFF Research Database (Denmark)

    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...

  1. Estenose carotídea acima de 70% em pacientes no pré-operatório de cirurgia da aorta abdominal: freqüência e fatores de risco Frequency and risk factors for carotid stenosis above 70% in patients undergoing abdominal aortic surgery

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    André Ventura Ferreira

    2006-03-01

    Full Text Available OBJETIVO: Analisar a freqüência e os fatores de risco associados à estenose carotídea acima de 70% em pacientes que serão submetidos a cirurgias de aorta abdominal. MATERIAL E MÉTODO: Foram analisados 94 pacientes que realizaram ultra-som Doppler de carótidas no pré-operatório de cirurgias de aorta abdominal entre janeiro de 2000 e janeiro de 2003, pela disciplina de Cirurgia Vascular da Santa Casa de São Paulo. RESULTADOS: Sessenta e sete pacientes (71% eram homens. Dentre os 94 pacientes, 42 (44,6% tinham doença oclusiva aorto-ilíaca, e 52 (53,4%, aneurismas da aorta abdominal (AAA. A análise dos dados mostrou uma prevalência de estenose de carótidas acima de 70% em 8,33% dos pacientes com AAA e em 13,51% dos pacientes com doença oclusiva aorto-ilíaca, diferença esta sem significância estatística (P = 0,5. Nos pacientes que apresentavam antecedente de isquemia cerebral - acidente vascular cerebral (AVC ou ataque isquêmico transitório (AIT -, houve uma prevalência estatisticamente maior de estenose carotídea entre 70 e 99%. Outros fatores de risco para aterosclerose, como sexo masculino, diabetes, hipertensão arterial e tabagismo, não foram preditivos da presença de estenose carotídea acima de 70%. CONCLUSÃO: A freqüência de estenose da carótida acima de 70% em pacientes no pré-operatório de cirurgia de aorta foi de 9,57%, e a presença de antecedente de AVC ou AIT na história foi preditiva de estenose acima de 70% neste grupo de pacientes.OBJECTIVE: To analyze the frequency and risk factors of carotid stenosis above 70% in patients undergoing abdominal aortic reconstruction. MATERIAL AND METHOD: Ninety-four patients who underwent Doppler ultrasound preoperative screening for abdominal aortic surgery between January 2000 and January 2003 were analyzed by the Vascular Surgery Unit of the Santa Casa of São Paulo (Faculty of Medical Sciences. RESULTS: Sixty-seven (71% patients were male. Of the 94 patients, 42

  2. Branches of the abdominal aorta in Aotus azarae infulatus

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    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.

  3. Angiograms of the Abdominal Aorta in a Patient of Middle Aortic Syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhou Yafeng; Yang Xiangjun; Song Jianping; Jiang Tingbo; Li Xun; Hui Jie; Liu Zhihua; Jiang Wenping

    2007-01-01

    A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.

  4. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

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    Bayard Gontijo Filho

    1995-09-01

    Full Text Available O presente relato apresenta a experiência obtida em um período de 4 anos (jan/91 - jan/95 com a técnica "open distal" descrita por Cooley, em 1990³, para tratamento cirúrgico de doenças da aorta torácica descendente e aorta tóraco-abdominal. Nesse período foram realizadas 35 operações (25 para aorta descendente e 10 para aorta tóraco-abdominal. Os aneurismas de origem degenerativa e as dissecções aórticas ocorreram em freqüência semelhante (48,5% e 40%, respectivamente; em 8 pacientes havia rotura da aorta, parcialmente tamponada pelo pulmão (5 casos, órgãos abdominais (2 casos e esófago (1 caso. O acesso cirúrgico foi obtido por toracotomia póstero-lateral esquerda ou tóraco-freno-laparotomia. Heparina foi usada na dose de 1,5 mg/kg e todo sangue do campo cirúrgico foi coletado a um reservatório e reinfundido pela veia femoral. Houve 4 (11.4% óbitos hospitalares e 2 (5,8% pacientes portadores de aneurisma tóraco-abdominal desenvolveram paraplegia. A morbi-mortalidade do grupo foi diretamente relacionada à condição clínica per-operatória e à extensão do segmento aórtico acometido. Na nossa opinião, a técnica "open distal" é um método alternativo simples e eficaz no tratamento cirúrgico das doenças da aorta descendente e tóraco-abdominal. Em casos de ressecções extensas com períodos longos de oclusão aórtica, métodos para proteção medular deverão ser avaliadosSince Jan/91 we have been using the "open distal" technique (ODT described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta. Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively. In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases, abdominal organs (2 cases and esophagus (1

  5. Análise da correlação entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal Analysis of correlation between pseudoexfoliation syndrome and aneurysm of the abdominal aorta

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    Paulo de Tarso Ponte Pierre Filho

    2004-06-01

    Full Text Available OBJETIVO: Examinar a correlação sugerida entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal. MÉTODOS: Sessenta e cinco pacientes recentemente operados por aneurisma de aorta abdominal e 51 controles com aterosclerose periférica, sem aneurisma, submeteram-se ao exame oftalmológico sob dilatação pupilar para investigar a presença de síndrome de pseudo-exfoliação. RESULTADOS: Não houve diferenças estatisticamente significantes entre a média de idade, distribuição por sexo e raça entre os 2 grupos (p > 0,05. Dois dos 65 pacientes com aneurisma de aorta e um dos 51 controles apresentaram síndrome de pseudo-exfoliação (p = 1,00. CONCLUSÃO: A prevalência de síndrome de pseudo-exfoliação em pacientes operados por aneurisma de aorta abdominal e em pacientes com aterosclerose periférica foi similar. Este achado não confirma a associação proposta entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal.PURPOSE: To investigate the suggested association between pseudoexfoliation syndrome and aneurysm of the abdominal aorta. METHODS: 65 patients recently operated for abdominal aortic aneurysm and 51 controls with peripheral atherosclerosis, without aneurysm, underwent an ophthalmologic examination under pupillary dilatation to detect the presence of pseudoexfoliation syndrome. RESULTS: There were no significant differences regarding mean age and distribution by gender and race between the groups (p > 0.05. Two of 65 patients with aortic aneurysm and one of 51 controls presented pseudoexfoliation syndrome (p = 1.00. CONCLUSION: The prevalence of pseudoexfoliation syndrome in patients operated for abdominal aortic aneurysm and in patients with peripheral atherosclerosis were similar. This finding does not support the proposed association between pseudoexfoliation syndrome and abdominal aortic aneurysm.

  6. Tratamento endovascular do aneurisma da aorta abdominal infrarrenal em pacientes com anatomia favorável para o procedimento: experiência inicial em um serviço universitário Endovascular treatment of infrarenal abdominal aortic aneurysm in patients with favorable anatomy for the repair: initial experience in a university hospital

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    José Manoel da Silva Silvestre

    2011-03-01

    Full Text Available CONTEXTO: Desde sua introdução, em 1991, o reparo endovascular do aneurisma da aorta abdominal infrarrenal tem se tornado uma alternativa atraente para o tratamento dessa doença. Avaliar nossos resultados iniciais quanto à segurança e eficácia dessa técnica nos levou à realização deste estudo. OBJETIVOS: Analisar a mortalidade perioperatória, a sobrevida tardia, as reoperações, as taxas de perviedade e o comportamento do saco aneurismático em pacientes com anatomia favorável para a realização do procedimento. MÉTODOS: Trata-se de um estudo longitudinal, observacional e retrospectivo realizado entre outubro de 2004 e janeiro de 2009 com 41 pacientes que foram submetidos à correção endovascular do aneurisma de aorta abdominal infrarrenal por apresentarem anatomia favorável para o procedimento. Foram analisados os achados dos exames diagnósticos, o tratamento e o seguimento em todos os pacientes. RESULTADOS: Foram implantadas, com sucesso, 31 (75,6% próteses bifurcadas e 10 (24,5% monoilíacas, de 5 diferentes marcas. O diâmetro médio dos aneurismas fusiformes era de 62 mm. A mortalidade perioperatória foi de 4,8% e a sobrevida tardia, 90,2%. Durante o acompanhamento médio de 30 meses, 2 (4,8% pacientes necessitaram de reintervenção, um por migração da endoprótese e outro por vazamento tipo II. Dois (4,8% pacientes apresentaram oclusão de ramo da prótese. Oito (19,5% vazamentos foram diagnosticados e não houve nenhuma rotura dos aneurismas. CONCLUSÃO: Apesar do pequeno número de pacientes, os resultados observados parecem justificar a realização do procedimento endovascular nos pacientes com anatomia favorável.BACKGROUND: Since its introduction in 1991, endovascular repair of infrarenal aortic aneurysms has become an attractive option to treat this disease. The evaluation of our initial results about safety and efficacy of this technique has led us to carry out this study. OBJECTIVES: To analyze

  7. Observer variation in vascular CT measurements of the abdominal aorta

    Energy Technology Data Exchange (ETDEWEB)

    England, Andrew [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Manchester M23 9LT (United Kingdom); Department of Medical Imaging and Radiotherapy, University of Liverpool, Johnson Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB (United Kingdom)], E-mail: a.england@liverpool.ac.uk; Butterfield, John S.; Ashleigh, Raymond J. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Manchester M23 9LT (United Kingdom)

    2008-11-15

    Aim: To assess the inter-observer variation between a radiographer and radiologist when performing CT measurement of the abdominal aorta before endovascular aortic aneurysm repair (EVAR). Methods: A total of 30 consecutive patients who were considered anatomically suitable for EVAR had aortic measurements performed independently by a vascular radioogist and then by a radiographer training vascular and CT imaging. All measurements were performed on a computer workstation using electronic callipers, each patient had 12 anatomical sites evaluated (eight diameters, four vessel lengths). Statistical analysis was performed by the computer package SPSS for Windows 11.01. Results: Of the 30 patients, mean difference in measurements between observers was 2.3 mm {+-} 1.2 mm and 6.0 mm {+-} 6.4 mm for diameter and vessel length measurements, respectively. Two hundred and seven (86%) diameter measurements were {<=}2 mm of each other and 233 (97%) were within {<=}5 mm. Eighty-two (57%) length measurements were within {<=}5 mm, and 100 (83%) within 10 mm or less. Widest variation existed for measurements of common iliac diameter and aortic neck length, where coefficients of variance were 38.2 (95% CI 35.7-41.0) and 40.0 (95% CI 36.2-44.6), respectively. Conclusion: A good level of agreement exists between a trained radiographer and radiologist when comparing vascular CT measurements of the aorta. It is technically feasible for a radiographer to perform these measurements, and improvements in variability may be achieved from a more standardised technique and automated vessel analysis software. Further research is required to establish the overall variability between different observer types when undertaking vascular CT measurements.

  8. Descrição morfológica dos ramos colaterais viscerais da aorta abdominal do macaco-de-cheiro Morphological description of the collateral visceral branches from abdominal aorta of squirrel monkey

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    Maria Rogéria Menezes da Silva

    2011-01-01

    Full Text Available O Saimiri sciureus é um primata não humano existente na região amazônica e não consta na lista de animais em perigo de extinção, de acordo com o IBAMA. Neste trabalho, sistematizou-se os ramos colaterais viscerais da aorta abdominal de seis animais sendo três machos e três fêmeas, os quais tiveram o sistema circulatório preenchido com látex Neoprene, adicionado de contraste radiográfico. O resultado observado foi que a aorta abdominal emitiu ventralmente, como ramo colateral visceral, a artéria celíaca, que se trifurcou nas artérias gástrica esquerda, hepática e lienal. Os ramos da artéria celíaca promovem a irrigação do estômago, duodeno, fígado, pâncreas e baço. A seguir, a aorta abdominal emitiu a artéria mesentérica cranial, de calibre maior que a artéria celíaca e justaposta caudalmente. A artéria mesentérica cranial emitiu ramos que vascularizaram a parte final do duodeno, pâncreas, jejuno, íleo, ceco, cólon maior e cólon menor. A aorta abdominal emitiu lateralmente as artérias renais direita e esquerda. A artéria adrenal esquerda surgiu como um ramo colateral direto da artéria celíaca e a artéria adrenal direita surgiu da artéria renal direita. A artéria mesentérica caudal foi emitida da superfície ventral da aorta abdominal, logo abaixo das artérias renais. Em L6, a aorta abdominal se bifurcou, dando origem às artérias ilíacas externas direita e esquerda e estas deram origem à artéria ilíaca interna e femoral direita e esquerda. As artérias testiculares ou ováricas tiveram origem na artéria ilíaca interna. A continuidade da aorta abdominal deu origem à artéria sacral mediana e a continuidade desta é chamada de artéria caudal mediana. O estudo da espécie em questão é de suma importância para gerar conhecimentos a respeito dos primatas não humanos existentes em nosso país. Dessa forma, pode-se dizer que o Saimiri sciureus é um importante modelo biológico para o

  9. Traumatic dissection and rupture of the abdominal aorta as a complication of the Heimlich maneuver.

    Science.gov (United States)

    Desai, Shaun C; Chute, Dennis J; Desai, Bharati C; Koloski, Eugene R

    2008-11-01

    Although the Heimlich maneuver is considered the best intervention for relieving acute upper airway obstruction, several complications have been reported in the literature. These complications can occur as a result of an increase in abdominal pressure leading to a variety of well-documented visceral injuries, including the great vessels. Acute abdominal aortic thrombosis after the Heimlich maneuver is a rare but recognized event; however, to date no case of traumatic dissection and rupture of the abdominal aorta has been described. We report the first known case, to our knowledge, of a traumatic dissection and rupture of the abdominal aorta after a forcefully applied Heimlich maneuver.

  10. Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

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    Eduardo Rafael Novero

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos imediatos e em médio prazo do tratamento endovascular em pacientes portadores de aneurisma da aorta abdominal em um centro de referência para doenças cardiovasculares. MATERIAIS E MÉTODOS: Estudo retrospectivo de uma série de pacientes submetidos a tratamento endovascular de aneurisma da aorta abdominal, no período de janeiro de 2009 a julho de 2010. Foram avaliados as características demográficas, o sucesso técnico, o sucesso terapêutico, a morbimortalidade, as complicações e a taxa de reintervenções perioperatórias imediatos, e após um ano de acompanhamento. RESULTADOS: Foram analisados 102 pacientes consecutivos com idade média de 72 ± 9 anos, sendo 79% deles do sexo masculino. Houve sucesso técnico em 97,1% e êxito terapêutico em 81% dos casos. A mortalidade perioperatória foi de 0,9% e a anual, de 7,8%. Foram necessárias reintervenções em 18,8% dos pacientes durante o seguimento. CONCLUSÃO: Em nosso estudo, os resultados obtidos justificam a realização desse procedimento nos pacientes com anatomia adequada.

  11. Evaluation of the normal thoracic and abdominal aorta diameters by computerized tomography; Avaliacao dos diametros normais da aorta toracica e abdominal pela tomografia computadorizada

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    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)

  12. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children

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    Jose Luiz de Oliveira Schiavon

    Full Text Available Abstract Objective: To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods: Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results: We found anterior abdominal aorta displacement in 26 (39.39% of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%, nephroblastoma in 3 (11.54%, and Burkitt lymphoma in 1 (3.85%. The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion: When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%.

  13. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children*

    Science.gov (United States)

    Schiavon, Jose Luiz de Oliveira; Caran, Eliana Maria Monteiro; Odone Filho, Vicente; Lederman, Henrique Manoel

    2016-01-01

    Objective To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results We found anterior abdominal aorta displacement in 26 (39.39%) of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1 (3.85%). The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%. PMID:28100931

  14. Overexpression of Vascular Endothelial Growth Factor in Restenotic Abdominal Aorta of Rabbits

    Institute of Scientific and Technical Information of China (English)

    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

  15. Tuberculous aneurysm of the abdominal aorta: endovascular repair using stent grafts in two cases

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    Liu, Wei Chiang; Kwak, Byung Kook; Kim, Kyo Nam [Sung Ae General Hospital, Seoul (Korea, Republic of); And Others

    2000-12-01

    Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess. (author)

  16. Fatores envolvidos na migração das endopróteses em pacientes submetidos ao tratamento endovascular do aneurisma da aorta abdominal Factors involved in the migration of endoprosthesis in patients undergoing endovascular aneurysm repair

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    Marcelo José de Almeida

    2010-06-01

    Full Text Available A migração da endoprótese é complicação do tratamento endovascular definida como deslocamento da ancoragem inicial. Para avaliação da migração, verifica-se a posição da endoprótese em relação a determinada região anatômica. Considerando o aneurisma da aorta abdominal infrarrenal, a área proximal de referência consiste na origem da artéria renal mais baixa e, na região distal, situa-se nas artérias ilíacas internas. Os pacientes deverão ser monitorizados por longos períodos, a fim de serem identificadas migrações, visto que estas ocorrem normalmente após 2 anos de implante. Para evitar migrações, forças mecânicas que propiciam fixação, determinadas por características dos dispositivos e incorporação da endoprótese, devem predominar sobre forças gravitacionais e hemodinâmicas que tendem a arrastar a prótese no sentido caudal. Angulação, extensão e diâmetro do colo, além da medida transversa do saco aneurismático, são importantes aspectos morfológicos do aneurisma relacionados à migração. Com relação à técnica, não se recomenda implante de endopróteses com sobredimensionamento excessivo (> 30%, por provocar dilatação do colo do aneurisma, além de dobras e vazamentos proximais que também contribuem para a migração. Por outro lado, endopróteses com mecanismos adicionais de fixação (ganchos, farpas e fixação suprarrenal parecem apresentar menos migrações. O processo de incorporação das endopróteses ocorre parcialmente e parece não ser suficiente para impedir migrações tardias. Nesse sentido, estudos experimentais com endopróteses de maior porosidade e uso de substâncias que permitam maior fibroplasia e aderência da prótese à artéria vêm sendo realizados e parecem ser promissores. Esses aspectos serão discutidos nesta revisão.Migration of the endoprosthesis is defined as the misplacement of its initial fixation. To assess the migration, the position of the

  17. Abdominal aorta coarctation: The first three case reports in our literature

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    Gajin Predrag

    2010-01-01

    Full Text Available Introduction. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0% of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called 'middle aortic syndrome' or 'midaortic dysplastic syndrome'. This represents serious pathological condition and indicates multidisciplinary therapy approach. Outline of Cases. From 1996 to 2007, at the Vascular Surgery Clinic of the Institute for Cardiovascular Diseases 'Dedinje', Belgrade, three patients were treated due to abdominal aorta coarctation, two females aged 55 and 50 and a 4-year-old child. The patients were treated surgically (by-pass with a prosthetic graft and patch angioplasty and endovascular-percutaneous transluminal angioplasty (PTA with and without a stent. The follow-up period was 3-70 months. In the 50-year-old patient, angiography showed severe narrowing of the suprarenal segment of the abdominal aorta. Thoraco-abdominal bypass with a 16 mm dacronic tubular graft was performed. In the 4-year-old patient angiography also showed a suprarenal aorta narrowing. In the first act patch angioplasty was performed and after PTA of the visceral arteries was done on several occasions. In the 55-year-old patient, after diagnostic angiography, infrarenal aorta coarctation was registered. PTA was performed with stent placement. All patients were asymptomatic on control check-ups. Conclusion. Abdominal coarctation is a pathological disease which is seldom found in vascular surgery. Angiography is of major importance for setting the diagnosis and for the control of the results of surgical and nonsurgical treatment. The combination of surgical and endovascular treatment in our patients showed very good results in the studied period.

  18. Reação histopatológica da parede da aorta abdominal ao stent não recoberto Histopathological reaction of the abdominal aorta wall to non-covered stents

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    Rubio Bombonato

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a reação histopatológica da parede aorta abdominal, em suínos, no nível das artérias renais, na presença de stent metálico não recoberto. MÉTODO: Foi estudada histopatologicamente a aorta abdominal de 10 suínos, com peso médio de 86,6 quilos e idade média de 6 meses, submetidos a implante de stent metálico posicionado na aorta, no nível das artérias renais, após 100 dias do implante. Os stents foram liberados por auto-expansão com laparotomia. Os cortes histológicos foram realizados nos seguintes locais: 1 transição entre a aorta normal e aorta contendo stent; 2 aorta contendo o stent; 3 porção contendo os óstios das artérias renais, 4 linfonodos periaórticos e, 5 parênquima renal. As lâminas foram coradas pela técnica da hematoxilina e eosina. RESULTADOS: Os achados macroscópicos revelaram: linfonodomegalia periaórtica; espessamento da parede aórtica; artérias lombares e renais pérvias; estrutura anatômica renal normal. Análises microscópicas, próximas aos stents, evidenciaram espessamento da parede vascular, secundário à fibrose intimal e camada média comprometida com fibrose intersticial. Medidas micrométricas da parede aórtica com o stent, comparada à aorta sem o stent, apresentaram aumento da espessura da parede (75,9% por hiperplasia da camada íntima secundária à proliferação de fibroblastos; depósitos de colágeno com infiltrado inflamatório e granulomas do tipo corpo estranho. CONCLUSÃO: O stent de aço inoxidável descoberto, implantado na aorta de suínos, produziu importante reação inflamatória, com fibrose nas camadas média e íntima, evidenciada pelas análises histopatológicas e a sua presença não comprometeu o estado pérvio da aorta e dos ramos lombares e renais.OBJECTIVE: To evaluate the histopathological reaction of the abdominal aorta wall in pigs' renal arteries to the presence of non-covered stainless steel stents. METHODS: The abdominal aorta of

  19. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal

    OpenAIRE

    2012-01-01

    CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma ...

  20. The relationship between wall shear stress distributions and intimal thickening in the human abdominal aorta

    Directory of Open Access Journals (Sweden)

    Butany Jagdish

    2003-11-01

    Full Text Available Abstract Purpose The goal of this work was to determine wall shear stress (WSS patterns in the human abdominal aorta and to compare these patterns to measurements of intimal thickness (IT from autopsy samples. Methods The WSS was experimentally measured using the laser photochromic dye tracer technique in an anatomically faithful in vitro model based on CT scans of the abdominal aorta in a healthy 35-year-old subject. IT was quantified as a function of circumferential and axial position using light microscopy in ten human autopsy specimens. Results The histomorphometric analysis suggests that IT increases with age and that the distribution of intimal thickening changes with age. The lowest WSS in the flow model was found on the posterior wall inferior to the inferior mesenteric artery, and coincided with the region of most prominent IT in the autopsy samples. Local geometrical features in the flow model, such as the expansion at the inferior mesenteric artery (common in younger individuals, strongly influenced WSS patterns. The WSS was found to correlate negatively with IT (r2 = 0.3099; P = 0.0047. Conclusion Low WSS in the abdominal aorta is co-localized with IT and may be related to atherogenesis. Also, rates of IT in the abdominal aorta are possibly influenced by age-related geometrical changes.

  1. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal Postoperative incisional hernias after open abdominal aortic aneurysm repair

    OpenAIRE

    2012-01-01

    CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma ...

  2. A mycotic aneurysm of the abdominal aorta in a child

    NARCIS (Netherlands)

    W. Suijker (W.); J.H.L.J. Bergmeijer (Jan Hein); J.J. Hamming (J.); J.C. Molenaar

    1991-01-01

    textabstractA 6-year-old boy with a previous history of intracardiac correction of a partial atrioventricular canal defect presented with infective endocarditis. Despite antibiotic therapy and reoperation, he developed a mycotic abdominal aneurysm. In situ aortoiliac reconstruction with a prosthesis

  3. Mega aorta syndrome: a case of thoracic and abdominal aortic aneurysm.

    Science.gov (United States)

    Wu, William C; Mitchell, Christopher A; Linklater, Derek

    2010-07-01

    An 83-year-old woman presented to the emergency department (ED) via emergency medical services with the chief complaint of "strokelike symptoms." Physical examination revealed altered mental status, tachycardia, hypotension, and a large nonpulsatile periumbilical mass. Bedside ultrasound revealed a 9-cm abdominal aortic aneurysm with absent central flow. Computed tomography scan demonstrated diffuse thoracic and abdominal aortic dilation with rupture into the mediastinum along with left hemothorax. Repeat beside ultrasound demonstrated abdominal aortic aneurysm rupture not seen on the computed tomography scan. Despite aggressive resuscitation, the patient developed bradycardia, which devolved into pulseless electric activity cardiac arrest. She was unable to be resuscitated. The patient's diffuse aneurysmal dilation places her into the small category of patients with a disease entity known as mega aorta syndrome (MAS). Mega aorta syndrome is defined as aneurysmal dilation of the aorta to greater than 6 cm in diameter. Although not in our case, most cases of MAS are symptomatic before catastrophic presentation. The disease progression for these patients is slow and occurs over years. When this disease is recognized early, a surgery known as the elephant trunk procedure can be performed. This operation replaces the entire aorta in multiple stages. This gives the emergency physician a critical role in the diagnosis and outcome of these patients because they may come through the ED for an unrelated complaint early in the disease process. This case report illustrates an advanced case of MAS.

  4. Anestesia para intervenção cirúrgica endovascular na aorta abdominal Anestesia para intervención quirúrgica endovascular en la aorta abdominal Anesthesia for endovascular surgery of the abdominal aorta

    Directory of Open Access Journals (Sweden)

    Michelle Nacur Lorentz

    2008-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O procedimento endovascular para correção de aneurisma de aorta é menos invasivo que o convencional, além de apresentar outras vantagens, como ausência de incisão abdominal, ausência de pinçamento da aorta e menor tempo de recuperação pós-operatória. Por se tratar de procedimento cirúrgico relativamente novo e apresentar uma série de alterações que devem ser conhecidas pelo anestesiologista foi realizado este trabalho com o objetivo de revisar os aspectos mais relevantes do procedimento endovascular e possibilitar manuseio anestésico mais adequado no perioperatório. CONTEÚDO: Apresentação sucinta da técnica cirúrgica para reparo de aneurismas via endovascular, as possíveis vantagens e desvantagens do procedimento, bem como as complicações potenciais. Além disso, foram abordados os cuidados perioperatórios que o procedimento exige e as técnicas anestésicas que podem ser utilizadas. CONCLUSÕES: O conhecimento das alterações provenientes do procedimento endovascular possibilita conduta anestésica mais adequada e melhora dos resultados perioperatórios nesses pacientes.JUSTIFICATIVA Y OBJETIVOS: El procedimiento endovascular para la corrección del aneurisma de aorta es menos invasivo que el convencional, además de presentar otras ventajas como la ausencia de incisión abdominal, ausencia de pinzamiento de la aorta y un menor tiempo de recuperación postoperatoria. Por tratarse de un procedimiento quirúrgico relativamente nuevo y por presentar una serie de alteraciones que deben ser conocidas por el anestesiólogo, se realizó este trabajo con el objetivo de revisar los aspectos más relevantes del procedimiento endovascular y posibilitar el manejo anestésico más adecuado en el perioperatorio. CONTENIDO: Sencilla presentación de la técnica quirúrgica para la cura de aneurismas vía endovascular, las posibles ventajas y desventajas del procedimiento, como también las complicaciones

  5. Thrombosis of abdominal aorta during cisplatin-based chemotherapy of testicular seminoma - a case report

    Directory of Open Access Journals (Sweden)

    Gehrckens Ralf

    2009-12-01

    Full Text Available Abstract Background Vascular complications occurring during cisplatin-based chemotherapy of germ cell tumours are inadequately recognized to date. Case Presentation A 49 year old man with advanced seminoma underwent two courses of chemotherapy according to the PEB regimen. Upon restaging, two thrombotic deposits were noted in the descending part of the thoracic aorta and in the infrarenal abdominal aorta, respectively. Although thrombotic plaques caused aortic occlusion of about 30%, no clinical signs of malperfusion of limbs were registered. The patient was placed on anticoagulant therapy. Six months after completion of chemotherapy, thrombotic deposits had completely resolved. In the absence of other predisposing factors, it must be assumed that cisplatin-based chemotherapy represented a strong stimulus for arterial thrombosis in the aorta. Conclusions This is the first case of endo-aortic thrombosis during chemotherapy for testicular germ cell cancer. Providers of chemotherapy must be aware of arterial thrombosis even in young patients with testicular cancer.

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

    Science.gov (United States)

    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.

  7. Mycotic Abdominal Aortic Aneurysm Secondary to Septic Embolism of a Thoracic Aorta Graft Infection.

    Science.gov (United States)

    Blanco Amil, Carla Lorena; Vidal Rey, Jorge; López Arquillo, Irene; Pérez Rodríguez, María Teresa; Encisa de Sá, José Manuel

    2016-05-01

    Mycotic aneurysms account for 1% of abdominal aortic aneurysms. There are very few cases published that describe the formation of mycotic aneurysms after septic embolism due to graft infection. We present the first case to our knowledge to be described in the literature of a mycotic aneurysm caused by septic embolism derived from a thoracic aorta graft infection, treated with conventional surgery leading to a successful outcome and evolution.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Thymoquinone protects end organs from abdominal aorta ischemia/reperfusion injury in a rat model

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    Mehmet Salih Aydin

    2015-02-01

    Full Text Available Introduction: Previous studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models. Objective: We aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. Methods: Thirty rats were divided into three groups as sham (n=10, control (n=10 and thymoquinone (TQ treatment group (n=10. Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS, and oxidative stress index (OSI in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy. Results: Total oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI. Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons. Conclusion: Thymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

  10. Clinical analysis of abdominal aorta block in operation of gynecologic tumor

    Institute of Scientific and Technical Information of China (English)

    MU Yu-lan; TANG Chun-sheng; WEN Ze-qing; YIN Fu-bo; LIU Ming

    2006-01-01

    Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005, we collected patients (n= 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n= 12), treatment blocking group (TG, n= 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n=17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing.During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0.01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3.0 h vs 5.7 h and 3.8 h vs 5.7 h, P<0.01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

  11. Endotension: rupture of abdominal aortic aneurysm Endotensão: ruptura de aneurisma de aorta abdominal

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    Alexandre Campos Moraes Amato

    2012-06-01

    Full Text Available Aortic endovascular exclusion technique called 'chimney' consists of placing stents through abdominal aortic visceral branches and a prosthesis that excludes the thoraco-abdominal aneurysm. Stents and an aortic endoprosthesis are placed in the renal arteries. This method is primarily used when open surgery is too risky. The mechanism that provides aneurysm sac increase without the visible presence of endoleaks has not been fully elucidated. The expansion of the aneurysm sac, due to endotension, is difficult to diagnose, even with the use of advanced imaging tests. Its diagnosis is made by exclusion. We present a case of a late complication in a high-risk patient after a 'chimney' endovascular procedure. Following the surgery, the patient presented a ruptured aneurysm sac without a visible endoleak. A second intervention was not feasible due to the high risk of occluding all of the branches, and complicated by previous 'chimney'. Endotension is a possible cause of aneurysm rupture and death.A técnica de exclusão endovascular conhecida como 'chaminé' consiste na colocação de stent em ramos viscerais e de endoprótese excluindo o aneurisma toracoabdominal. São colocados stents revestidos nas artérias renais e uma endoprótese aórtica, que o método utilizado quando a cirurgia aberta tem risco muito alto. O mecanismo que causa a expansão aneurismática sem a presença detectável de vazamento pelos métodos de imagem não está completamente esclarecido. A expansão do saco aneurismático por endotensão é de difícil diagnóstico, mesmo com o uso de técnicas de imagem avançadas, como tomografia computadorizada e eco-Doppler, sendo o diagnóstico por exclusão. Apresenta-se um caso de complicação tardia após o tratamento endovascular pela técnica da 'chaminé'. Após a cirurgia, o paciente apresentou ruptura sem endoleak visível. Outro procedimento endovascular foi impossibilitado pela técnica da 'chaminé', que dificulta novos

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Non-visualized aorta in abdominal aortic aneurysm screening: Screening outcomes and the influence of subject and programme characteristics.

    Science.gov (United States)

    Bennett, Damien; Stewart, Diane; Kearns, Deirdre; Mairs, Adrian; Ellis, Peter

    2017-01-01

    Objectives To compare abdominal aortic aneurysm screening outcomes of men with non-visualized aorta at original scan with subsequent scans and to determine predictors of non-visualized aorta. Methods In the Northern Ireland Abdominal Aortic Aneurysm screening programme, outcomes (discharge, annual surveillance, three-monthly surveillance, or vascular referral) and patient and programme characteristics (age, deprivation quintile, family history, technician experience, and screening location) for men with non-visualized aorta were investigated at original scan, and first and second rescans. Results Non-visualized aorta proportions were 2.9, 11.4, and 4.7% at original, first, and second rescan, respectively. There were no differences in screening outcomes between scanning stages (98.4, 97.6, and 97.4% abdominal aortic aneurysm in men with non-visualized aorta on first or subsequent rescans is no more than for those with visualized aorta on original scanning. Men from deprived areas are much more likely to have non-visualized aorta at original scan.

  14. Rotura de aneurisma de aorta abdominal: su importancia como diagnostico diferencial en abdomen agudo

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2008-01-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  15. ROTURA DE ANEURISMA DE AORTA ABDOMINAL: SU IMPORTANCIA COMO DIAGNOSTICO DIFERENCIAL EN ABDOMEN AGUDO

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2012-02-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  16. PET/CT imaging of abdominal aorta with intramural hematomas, penetrating ulcer, and saccular pseudoaneurysm.

    Science.gov (United States)

    Nguyen, Vien X; Nguyen, Ba D

    2014-05-01

    Acute aortic syndromes, encompassing intramural hematoma, penetrating ulcer, and pseudoaneurysm, are best demonstrated by angiographic CT and magnetic resonance imaging. These imaging modalities provide an accurate evaluation and allow timely therapies of these frequently symptomatic lesions, thus reducing their morbidity and mortality. The inflammatory pathogenesis of these acute aortic syndromes may exhibit positive PET findings predictive of prognosis and outcomes of these vascular events. The authors present a case of PET/CT imaging showing asymptomatic intramural hematomas with penetrating ulcer and saccular pseudoaneurysm of the proximal abdominal aorta.

  17. Oclusión de la aorta abdominal infrarrenal. Reconstrucción endovascular con stent

    Directory of Open Access Journals (Sweden)

    Carlos Fernández-Pereira

    2008-01-01

    Full Text Available Introducción La oclusión total de la aorta abdominal es de presentación poco frecuente y afecta más a menudo a mujeres de edad mediana con antecedentes de tabaquismo y dislipidemia. El punto de partida de la terapéutica endovascular en la aorta fue la angioplastia en las arterias ilíacas y fue progresando desde el balón hasta la colocación de stents.ObjetivoComunicar nuestros resultados inmediatos y el seguimiento a mediano plazo de pacientes con oclusión de la aorta abdominal tratadas con stents por vía endovascular.Material y métodosDesde octubre de 1998 a mayo de 2005 en nuestro servicio se trataron 5 pacientes de sexo femenino por oclusión total de la aorta abdominal, con síntomas de claudicación grave de ambos miembros inferiores. Los procedimientos se realizaron con anestesia local y sedación. Por vía femoral, se intenta recanalizar con las cuerdas de Whooley o hidrófila Glidewire. Posteriormente se realiza un angiograma abdominal e intercambio por cuerda Amplatz con la cual se avanza el balón para realizar las dilataciones antes de implantar el stent. Las pacientes con lesiones ilíacas también se trataron con stent. El índice tobillo-brazo era de 0,71. El promedio de hospitalización fue de 2 días. Al alta se indicaron clopidogrel y aspirina como medicación antiplaquetaria, excepto la primera paciente (ticlopidina y aspirina. El seguimiento fue clínico y por ecografía Doppler color a la semana, al mes, a los 6 meses y a los 12 meses.ResultadosLas pacientes eran de sexo femenino, con antecedentes de tabaquismo y dislipidemia. Todos los procedimientos fueron técnicamente exitosos, con mejoría del índice tobillo-brazo a 0,98. Una paciente presentó un hematoma inguinal en el sitio de punción, con buena evolución posterior. En el seguimiento alejado clínico y por ultrasonido se observó una permeabilidad de la aorta del 100%, con estenosis en una paciente tratada a nivel de la arteria ilíaca en el segmento no

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Aneurismas da aorta Aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Januário M Souza

    1992-09-01

    Full Text Available Entre janeiro de 1979 e janeiro de 1992, foram realizadas 212 operações para correção de aneurismas e de dissecções da aorta. Neste trabalho serão analisados 104 procedimentos cirúrgicos (em 97 pacientes para correção de aneurismas. A idade dos pacientes variou de 14 a 79 anos (média 59,5 anos e o sexo predominante foi o masculino, com 75 pacientes. Os aneurismas localizavam-se na aorta ascendente em 46 pacientes, na croça em 8, na aorta descendente em 8, na aorta toráco-abdominal em 8, na aorta abdominal em 21, na aorta descendente e abdominal em 2, na aorta ascendente e tóraco-abdominal em 2, na aorta ascendente e descendente em 1, na aorta ascendente, croça e descendente em 1. Doenças cardiovasculares associadas estavam presentes em 39 pacientes, sendo valvopatia aórtica em 18 (excluídos os pacientes com ectasiaânulo-aórtíca, insuficiência coronária em 17, coarctação da aorta em 2, persistência do canal arterial em 1 e valvopatia mitral e aórtica em 1. A mortalidade imediata (hospitalar e/ou 30 dias foi de 14,4%, sendo de 27,7% (5/18 para pacientes com mais de 70 anos e de 11,3% (9/79 para pacientes com idade inferior a 70 anos. Os aneurismas localizados na aorta ascendente e croça foram operados como o auxílio de circulação extracorpórea. Parada circulatória e hipotermia profunda foram utilizadas em todos os pacientes com aneurisma da croça. O estudo tomográfico e angiográfico deve ser de toda a aorta, pela possibilidade de aneurismas de localizações múltiplas.Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1

  20. Thrombosis of abdominal aorta in congenital afibrinogenemia: case report and review of literature.

    Science.gov (United States)

    Sartori, M T; Teresa, S M; Milan, M; Marta, M; de Bon, E; Emiliano, D B; Fadin, M; Mariangela, F; Pesavento, R; Raffaele, P; Zanon, E; Ezio, Z

    2015-01-01

    Thrombotic events in congenital hypo-afibrinogenemia have been rarely reported, either in association or not with replacement therapy or thrombotic risk factors. We describe clinical findings and management of thrombosis of abdominal aorta with peripheral embolism in a patient with congenital afibrinogenemia. A review of arterial thrombosis in inherited hypo-afibrinogenemia was also performed. The patient with a severe bleeding history requiring prophylaxis with fibrinogen concentrates (FC) was admitted for ischaemia of the 4th right toe. An angio-CT of abdominal aorta showed a thrombosis from the origin of renal arteries to the carrefour with a distal floating part. No thrombotic risk factors were found; a previous traumatic lesion of aortic wall might have triggered the thrombus formation, whereas the role of FC prophylaxis remains uncertain. The patient was successfully treated with FC, enoxaparin followed by fondaparinux, and low-dose aspirin without bleeding or thrombosis recurrence. After 2 years, aortic thrombus was almost completely recovered. Sixteen hypo/afibrinogenemia patients with arterial thrombosis were found in Literature, showing that thrombosis often occurs at a young age, involves large vessels, its recurrence is not unusual, and therapeutic strategy is not defined yet. Our therapeutic approach was effective and also safe, but further studies are needed to improve the knowledge of pathogenesis and the anti-thrombotic management in this peculiar setting.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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.

  3. 基于高斯混合模型的腹主动脉图像分割%Image Segmentation of Abdominal Aorta Based on Gaussian Mixture Model

    Institute of Scientific and Technical Information of China (English)

    刘海华; 郭杰龙

    2015-01-01

    为了有效地分割腹主动脉图像,提出了基于适度空间约束的高斯混合模型分割算法。该算法将三维空间邻域信息融入高斯混合模型中,利用最大期望算法( EM)获取腹部血管灰度图像的估计参数,从而分割出血管图像。实验结果表明:所提出的方法不仅能准确地分割腹主动脉的血管分支图像,而且对于图像噪声的抑制有较好的效果。%To segment the abdominal aorta from CT images effectively, a improved segmentation algorithm based on Gaussian mixture model with space constraints is proposed.This algorithm integrates 3D neighborhood information into Gaussian mixture model, then estimates the parameters of Gaussian mixture model by using EM algorithm to segment the aorta from gray image of abdominal aorta.The experiments demonstrate that the proposed not only achieves the better segmentation of aortic branches, but also inhibits noise in images by considering the spatial neighborhood information.

  4. Correção endovascular de aneurisma de aorta abdominal e artéria ilíaca comum esquerda em paciente com hemofilia C grave Endovascular repair of abdominal aortic aneurysm and left common iliac artery in a patient with severe hemophilia C

    Directory of Open Access Journals (Sweden)

    Sergio Quilici Belczak

    2012-03-01

    Full Text Available A deficiência do fator XI, também conhecida como hemofilia C, é uma doença hematológica hereditária rara, que se manifesta clinicamente com hemorragia persistente após cirurgias, traumas, menorragias e extrações dentárias. Neste artigo, relatou-se a correção endovascular de um paciente com aneurisma de aorta e de artéria ilíaca comum esquerda em um paciente portador de deficiência major do fator XI (atividade do fator XI inferior a 20%. O procedimento foi realizado com sucesso, com o manuseio do distúrbio da coagulação por meio da infusão de plasma fresco no pré-operatório imediato e no pós-operatório, e controle laboratorial da coagulação do paciente.Factor XI deficiency, also known as hemophilia C, is a rare hereditary blood disease that manifests with persistent bleeding after surgery, trauma, menorrhagia, and dental extractions. This article reports an endovascular repair of a patient diagnosed with an aortic and left common iliac aneurysm, with severe factor XI deficiency (factor XI activity below 20%. The procedure was successfully performed with management of the coagulation disorder by preoperative and postoperative infusion of plasma and laboratory control of the coagulation.

  5. Analysis of axial prestretch in the abdominal aorta with reference to post mortem interval and degree of atherosclerosis.

    Science.gov (United States)

    Horny, Lukas; Adamek, Tomas; Kulvajtova, Marketa

    2014-05-01

    It is a well-known fact that the length of an artery in situ and the length of an excised artery differs. Retraction of blood vessels is usually observed. This prestretch plays an important role in arterial physiology. We have recently determined that the decrease of axial prestretch in the human abdominal aorta is so closely correlated with age that it is suitable for forensic applications (estimation of the age at time of death for cadavers of unknown identity). Since post mortem autolysis may affect the reliability of an estimate based on axial prestretch, the present study aims to detail analysis of the effect of post mortem time. The abdominal aorta is a prominent site of atherosclerotic changes (ATH), which may potentially affect longitudinal prestretch. Thus ATH was also involved in the analysis. Axial prestretch in the human abdominal aorta, post mortem interval (PMI), and the degree of ATH were documented in 365 regular autopsies. The data was first age adjusted to remove any supposed correlation with age. After the age adjustment of the sample, the correlation analysis showed no significant PMI effects on the prestretch in non-putrefied bodies. Analysis of the prestretch variance with respect to ATH suggested that ATH is not a suitable factor to explain the prestretch variability remaining after the age adjustment. It was concluded that, although atherosclerotic plaques may certainly change the biomechanics of arteries, they do not significantly affect the longitudinal prestretch in the human abdominal aorta.

  6. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal Postoperative incisional hernias after open abdominal aortic aneurysm repair

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    Fábio Hüsemann Menezes

    2012-09-01

    Full Text Available CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma de aorta abdominal, entre junho de 1989 e junho de 2010, e que estão em acompanhamento regular no Ambulatório de Moléstias Vasculares. RESULTADOS: O seguimento médio dos pacientes foi de 63 meses (1 a 238. A idade média foi de 67 anos (45 a 91 e o tamanho médio dos aneurismas foi de 6,54 cm. Foram realizadas 130 laparotomias medianas xifo-púbicas e 13 acessos extraperitoniais pelo flanco esquerdo. Nestes pacientes, a incidência de hérnia incisional foi de 18,5 e 7,7%, respectivamente, para incisões na linha média ou no flanco (p=0,315. Um paciente apresentou abaulamento da musculatura oblíqua por denervação. Foi realizada uma laparotomia transversa, que não apresentou hérnia no pós-operatório tardio. CONCLUSÕES: A incidência de hérnia incisional na cirurgia aberta para correção de aneurisma de aorta abdominal é alta, ocorre com maior frequência em incisões da linha média e tem relação direta com a técnica empregada para o fechamento da aponeurose, exigindo do cirurgião atenção especial para este tempo cirúrgico para evitar a causa mais comum de reoperação em tal grupo de pacientes.BACKGROUND: The incidence of incisional hernia in the post operatory of patients submitted to open abdominal aortic aneurysm repair is high, ranging from 10 to 37%, and is more than three times higher than the incidence of hernias in patients operated for aorto-iliac occlusion. OBJECTIVE: To evaluate the incidence of

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

    Science.gov (United States)

    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.

  8. 3D segmentation of abdominal aorta from CT-scan and MR images.

    Science.gov (United States)

    Duquette, Anthony Adam; Jodoin, Pierre-Marc; Bouchot, Olivier; Lalande, Alain

    2012-06-01

    We designed a generic method for segmenting the aneurismal sac of an abdominal aortic aneurysm (AAA) both from multi-slice MR and CT-scan examinations. It is a semi-automatic method requiring little human intervention and based on graph cut theory to segment the lumen interface and the aortic wall of AAAs. Our segmentation method works independently on MRI and CT-scan volumes and has been tested on a 44 patient dataset and 10 synthetic images. Segmentation and maximum diameter estimation were compared to manual tracing from 4 experts. An inter-observer study was performed in order to measure the variability range of a human observer. Based on three metrics (the maximum aortic diameter, the volume overlap and the Hausdorff distance) the variability of the results obtained by our method is shown to be similar to that of a human operator, both for the lumen interface and the aortic wall. As will be shown, the average distance obtained with our method is less than one standard deviation away from each expert, both for healthy subjects and for patients with AAA. Our semi-automatic method provides reliable contours of the abdominal aorta from CT-scan or MRI, allowing rapid and reproducible evaluations of AAA.

  9. Optical pathology study of human abdominal aorta tissues using confocal micro resonance Raman spectroscopy

    Science.gov (United States)

    Liu, Cheng-hui; Boydston-White, Susie; Wang, Wubao; Sordillo, Laura A.; Shi, Lingyan; Weisberg, Arel; Tomaselli, Vincent P.; Sordillo, Peter P.; Alfano, Robert R.

    2016-03-01

    Resonance Raman (RR) spectroscopic technique has a high potential for label-free and in-situ detection of biomedical lesions in vivo. This study evaluates the ability of RR spectroscopy method as an optical histopathology tool to detect the atherosclerotic plaque states of abdominal aorta in vitro. This part demonstrates the RR spectral molecular fingerprint features from different sites of the atherosclerotic abdominal aortic wall tissues. Total 57 sites of five pieces aortic samples in intimal and adventitial wall from an autopsy specimen were examined using confocal micro Raman system of WITec 300R with excitation wavelength of 532nm. The preliminary RR spectral biomarkers of molecular fingerprints indicated that typical calcified atherosclerotic plaque (RR peak at 964cm-1) tissue; fibrolipid plaque (RR peaks at 1007, 1161, 1517 and 2888cm-1) tissue, lipid pool with the fatty precipitation cholesterol) with collagen type I (RR peaks at 864, 1452, 1658, 2888 and 2948cm-1) in the soft tissue were observed and investigated.

  10. Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta

    Directory of Open Access Journals (Sweden)

    Marek Tagowski

    2014-01-01

    Full Text Available The paper intends to present a review of imaging characteristics of secondary aortoenteric fistula (AEF. Mechanical injury, infection, and adherence of a bowel segment to the aorta or aortic graft are major etiologic factors of AEF after open aortic repair. The pathogenesis of AEF formation after endovascular abdominal aortic repair is related to mechanical failure of the stent-graft, to stent graft infection, and to persistent pressurization of the aneurysmal sac. The major clinical manifestations of AEF comprise haematemesis, melaena, abdominal pain, sepsis, and fever. CT is the initial diagnostic modality of choice in a stable patient. However, the majority of reported CT appearances are not specific. In case of equivocal CT scans and clinical suspicion of AEF, scintigraphy, 67Ga citrate scans or 18F-FDG PET/CT is useful. Diagnostic accuracy of endoscopy in evaluation of AEF is low; nevertheless it allows to evaluate other than AEF etiologies of gastrointestinal bleeding. Without adequate therapy, AEF is lethal. Conventional surgical treatment is associated with high morbidity and mortality. The endovascular repair may be an option in hemodynamically unstable and high-risk surgical patients. We also illustrate an example of a secondary AEF with highly specific albeit rare radiologic picture from our institution.

  11. Proposta para padronização do relatório de tomografia computadorizada nos aneurismas da aorta abdominal A proposal for standardizing computed tomography reports on abdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Fabiola Goda Torlai

    2006-08-01

    Full Text Available OBJETIVO: Propor um modelo de padronização de relatório para aneurisma da aorta abdominal na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram realizadas, no período de abril a outubro de 2004, entrevistas com integrantes da Disciplina de Cirurgia Vascular da nossa instituição, para elaboração de um modelo de padronização de relatório de tomografia computadorizada para o estudo do aneurisma da aorta abdominal. A partir deste modelo foi elaborado um questionário, enviado a nove outros cirurgiões, todos com experiência em cirurgia da aorta abdominal. O índice de resposta aos questionários foi de 55,5% (5/9. RESULTADOS: Os parâmetros de interesse citados mais freqüentemente para a avaliação dos aneurismas de aorta abdominal foram: diâmetro máximo do colo proximal, extensão do colo proximal até a artéria renal mais baixa, forma do colo proximal, diâmetro máximo do aneurisma e diâmetro das artérias ilíacas comuns. Estes dados permitiram elaborar uma proposta de modelo para padronização de relatório na tomografia computadorizada. CONCLUSÃO: Um modelo para a análise tomográfica padronizada do aneurisma de aorta abdominal permite atender às necessidades dos cirurgiões vasculares para acompanhar a evolução e planejar o tratamento destes pacientes.OBJECTIVE: To propose a model to standardize computed tomography reports on abdominal aortic aneurysms. MATERIALS AND METHODS: Interviews were carried out with members of 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

  12. The effects of aneurysm repair using an aortic prosthesis on the electrical parameters of the muscular layer of the abdominal aorta.

    Science.gov (United States)

    Hauzer, W; Czerski, A; Zawadzki, W; Gnus, J; Ratajczak, K; Nowak, M; Janeczek, M; Witkiewicz, W; Niespielak, P

    2014-12-01

    The study was carried out on 10 swine of 20-30 kg body weight. Five animals were assigned to each of 2 groups. An aneurysm of the abdominal aorta was created experimentally in animals from the first and second study group. After 4 weeks, animals from the second group were subject to aneurysm repair using an aortic prosthesis. During the experiment, we measured the myoelectric activity of the muscular layer of the abdominal aorta and aneurysmal lesion with the ultrasonographic technique. Measurements of the aorta and aneurysmal lesion and histopathological analyses were carried out post-mortem. We found a statistically significant decrease in the myoelectric activity of the aorta on the aorta-straight prosthesis interface and a significant decrease in the thickness of the muscular layer of the aorta on the aorta-prosthesis interface. No similar changes were found for experimentally induced aneurysms of the abdominal aorta. A straight prosthesis graft may not be the perfect option in the treatment of abdominal aortic aneurysm, as it contributes to the remodelling of the tissue on the prosthesis-aorta interface. This may result in the relapse of an aneurysm and post-operative complications.

  13. Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm

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    J.J. Hosni

    2007-03-01

    Full Text Available Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 ± 5 years with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 ± 5 years participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and ³H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with ³H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 ± 0.017 vs 0.039 ± 0.019 min-1; P < 0.05, but the FCR of14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.

  14. MDCT of the abdominal aorta: basics, technical improvements, and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, C.; Fraioli, F.; Danti, M.; Napoli, A.; Votta, V.; Lanciotti, K.; Bertoletti, L.; Passariello, R. [Dept. of Radiological Sciences, Univ. of Rome ' ' La Sapienza' ' (Italy)

    2003-11-01

    The recent introduction into clinical practice of multidetector-row spiral CT (MDCT) [1] with simultaneous acquisition of multiple channels has had a substantial effect on CT angiography allowing the acquisition of large volumes at high resolution, with excellent visualization of small branches also, including distal collaterals of the celiac trunk and superior and inferior mesenteric arteries (Fig. 1 a, b). Other advantages of multidetector-row over single-slice spiral CT include better separation of different vascular phases of enhancement, more efficient use of contrast material administered intravenously, and comparable, if not better, image quality. For example, the entire abdomen can now be (a) routinely imaged in its entirety with thin sections in a single short breath-hold, (b) repeatedly scanned during early arterial, late arterial, and venous phases, and (c) examined with high-quality multiplanar reconstructions, which are easily generated immediately. In this article we focus on and review the major aspects, advantages, and clinical applications of MDCT in the evaluation of the abdominal aorta. (orig.)

  15. Hemodynamic flow modeling through an abdominal aorta aneurysm using data mining tools.

    Science.gov (United States)

    Filipovic, Nenad; Ivanovic, Milos; Krstajic, Damjan; Kojic, Milos

    2011-03-01

    Geometrical changes of blood vessels, called aneurysm, occur often in humans with possible catastrophic outcome. Then, the blood flow is enormously affected, as well as the blood hemodynamic interaction forces acting on the arterial wall. These forces are the cause of the wall rupture. A mechanical quantity characteristic for the blood-wall interaction is the wall shear stress, which also has direct physiological effects on the endothelial cell behavior. Therefore, it is very important to have an insight into the blood flow and shear stress distribution when an aneurysm is developed in order to help correlating the mechanical conditions with the pathogenesis of pathological changes on the blood vessels. This insight can further help in improving the prevention of cardiovascular diseases evolution. Computational fluid dynamics (CFD) has been used in general as a tool to generate results for the mechanical conditions within blood vessels with and without aneurysms. However, aneurysms are very patient specific and reliable results from CFD analyses can be obtained by a cumbersome and time-consuming process of the computational model generation followed by huge computations. In order to make the CFD analyses efficient and suitable for future everyday clinical practice, we have here employed data mining (DM) techniques. The focus was to combine the CFD and DM methods for the estimation of the wall shear stresses in an abdominal aorta aneurysm (AAA) underprescribed geometrical changes. Additionally, computing on the grid infrastructure was performed to improve efficiency, since thousands of CFD runs were needed for creating machine learning data. We used several DM techniques and found that our DM models provide good prediction of the shear stress at the AAA in comparison with full CFD model results on real patient data.

  16. Anestesia para aneurismectomia de aorta abdominal infra-renal: experiência com 104 casos consecutivos no HCFMRP-USP

    OpenAIRE

    Breno José Santiago Bezerra de Lima

    2006-01-01

    Introdução. A morbi-mortalidade durante e após anestesia para aneurismectomia de aorta abdominal é alta, pois esta doença acomete pacientes após a sétima década de vida e que possuem várias doenças concomitantes. Objetivos. Analisar e discutir as condutas anestésicas utilizadas nos períodos pré e intra-operatório no Serviço de Anestesiologia do HCFMRP-USP. Casuística e Método. Foram analisados os prontuários de 104 pacientes submetidos à aneurismectomia de aorta no tocante às condutas utiliza...

  17. Reduction of contrast medium volume in abdominal aorta CTA: Multiphasic injection technique versus a test bolus volume

    Energy Technology Data Exchange (ETDEWEB)

    Nijhof, Wouter H., E-mail: w.h.nijhof@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Vos, Charlotte S. van der, E-mail: c.s.vandervos@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Anninga, Bauke, E-mail: b.anninga@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Jager, Gerrit J., E-mail: g.jager@JBZ.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands); Rutten, Matthieu J.C.M., E-mail: mj.rutten@online.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands)

    2013-09-15

    Objective: The purpose of this study is to reduce the administered contrast medium volume in abdominal CTA by using a test bolus injection, with the preservation of adequate quantitative and qualitative vessel enhancement. Study design: For this technical efficacy study 30 patients, who were referred for a CTA examination of the abdominal aorta, were included. Randomly 15 patients were assigned to undergo a multiphasic injection protocol and received 89 mL of contrast medium (Optiray 350) (protocol I). Fifteen patients were assigned to the test bolus injection protocol (protocol II), which implies injection of a 10 mL test bolus of Optiray 350 prior to performing CTA with a 40 mL of contrast medium. Quantitative assessment of vascular enhancement was performed by measuring the amount of Hounsfield Units in the aorta at 30 positions from the celiac trunk to the iliac arteries in both groups. Qualitative assessment was performed by three radiologists who scored the images at a 5-point scale. Results: Quantitative assessment showed that there was no significant difference in vascular enhancement for patients between the two protocols, with mean attenuation values of 280.9 ± 50.84 HU and 258.60 ± 39.28 HU, respectively. The image quality of protocol I was rated 4.31 (range: 3.67/5.00) and of protocol II 4.11 (range: 2.67/5.00). These differences were not statistically significant. Conclusion: This study showed that by using a test bolus injection and the administration of 50 mL of contrast medium overall, CTA of the abdominal aorta can reliably be performed, with regard to quantitative and qualitative adequate vessel enhancement.

  18. Quantitative X-ray CT analysis of calcification of the abdominal aorta and its relationship to obesity

    Energy Technology Data Exchange (ETDEWEB)

    Shinagawa, Toshio; Hiraiwa, Yoshio; Mizuno, Seio; Kusunoki, Norio; Nitta, Yu; Matsubara, Takao; Iwainaka, Yoichi; Konishi, Hideo (Toyama Red Cross Hospital (Japan))

    1992-04-01

    Quantitative analysis of abdominal aorta calcification by X-ray CT is useful method for non-invasive diagnosis of atherosclerosis. We recently examined the relationship between the X-ray CT measurement of abdominal aorta calcification and the degree of obesity. For this purpose, the body mass index (BMI) and the subcutaneous fat thickness (determined by X-ray CT at the umbilical level) were analyzed in relation to the abdominal aorta calcification index (ACI) in 845 patients (453 males and 392 females aged 40-79 years). Patients with BMI under 20 were classified as 'lean', those with BMI between 20-26 as 'normal' and those with BMI over 26 as 'obese'. 1. Among males, the ACI was highest in lean individuals and lowest in obese individuals. The difference in ACI between lean and obese males was significant in the middle aged group (40-65 years). Among females, no relationship was observed between the degree of obesity and ACI. 2. Among males, ACI was higher in individuals with low subcutaneous fat thickness and lower in individuals with greater subcutaneous fat thickness. The difference was significant in the middle aged group. Among females, no relationship was observed between the two parameters. 3. When the visceral fat to subcutaneous fat ratio (V/S) in 85 males and females aged 60-69 years was analyzed in relation to ACI, ACI tended to decrease as the V/S increased, in both males and females. 4. Relationships between BMI and subcutaneous fat thickness, between BMI and lipids and between lipids and ACI were also analyzed. (author).

  19. Aneurisma de la aorta abdominal: Tratamiento endovascular con una endoprótesis fenestrada Abdominal aortic aneurysm: Endovascular treatment with fenestrated endoprothesis

    Directory of Open Access Journals (Sweden)

    Román Rostagno

    2008-12-01

    Full Text Available El tratamiento endovascular de los aneurismas de aorta abdominal es una alternativa a la cirugía abierta para pacientes de alto riesgo. Consiste en la exclusión del saco aneurismático mediante la interposición de una endoprótesis colocada por vía femoral. El tratamiento endovascular no puede ser utilizado en todos los pacientes. Una limitación frecuente la constituye el nacimiento de una arteria visceral desde el saco aneurismático. Para contrarrestar esta limitación recientemente se han desarrollado endoprótesis fenestradas que presentan orificios que se corresponden con el nacimiento de las arterias involucradas en el aneurisma evitando su oclusión, permitiendo de esta manera el tratamiento endovascular. En esta comunicación se presenta un caso de tratamiento endovascular de un aneurisma de aorta abdominal mediante la colocación de una endoprótesis fenestrada en un paciente cuya arteria renal izquierda nacía directamente del saco aneurismático.Endovascular treatment of the abdominal aortic aneurysm is consider an alternative to open surgery for high risk patients. Its goal is to exclude the aneurysm from the circulation by using an endoprothesis introduced from a femoral approach. Patients must be strictly selected to avoid possible complications. The most frequent limitation is related to anatomic contraindications such as visceral arteries involved in the aneurysm. Fenestrated endograft have been recently developed to allow endovascular treatment when anatomic features contraindicate classic endovascular procedures. Fenestrated endograft have holes that match with the origin of the visceral arteries maintaining its potency. In this paper we report the endovascular treatment of an abdominal aortic aneurysm by using a fenestrated endoprothesis in a patient whose left renal artery is originated from the aneurysm.

  20. [Isolated orchidodynia as the initial symptom of aneurysm of the abdominal aorta

    NARCIS (Netherlands)

    Vugt, R. van; Valk, L.K.; Leeuwen, H.J. van; Tjan, D.H.; Waal, C. van der; Zanten, A.R. van

    2007-01-01

    A 67-year-old man presented with isolated pain of the right testicle. He was admitted and treated for epididymitis. His symptoms did not improve and lower abdominal pain developed. After hypotension and severe anaemia (Hb 2.1 mmol/l) had developed, abdominal echography was carried out, revealing a r

  1. In vitro contractility of normal and aneurysmal abdominal aorta muscle coat sections in human and animal material.

    Science.gov (United States)

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

    2012-01-01

    The objective of the study was to demonstrate spontaneous contractile activity of the smooth muscle coat of the aorta in human and animal material. Spontaneous contractility of smooth muscle tissue, or tonus, is essential for the proper function of many internal organs as observed in the many types of muscle cells which make up the internal structures. The spontaneous contractile activity of the muscle tissue in blood vessels is particularly marked in resistance vessels, regulating circulation within organs or tissues. It can also be observed in large blood vessels such as arteries and veins. The contractile activity of muscular tissue isolated from arteries is the result of a number of factors, including endogenous paracrine substances, neurotransmitters released at postganglionic endings (mostly within the sympathetic system), cells capable of spontaneously generation of functional potentials (pacemaking cells) and the vascular endothelium. Pacemaking cells present in the aortic wall are an important factor in the development of the spontaneous contractility of the muscular coat of the aorta. They are capable of generating functional potentials, resulting in the constant tonus of the smooth muscular coat (comprising the aortic wall) due to tonic contraction. In vitro studies were carried out on abdominal aortic sections collected from 30 New Zealand rabbits with a body mass of 3-4 kilograms each and also on aneurysmal abdominal aortic sections collected during elective aneurysm repair procedures in humans (10 abdominal aortic sections). The 1.5 cm-long sections were mounted in chambers of an automated water bath. The sections were oriented in a transverse and longitudal fashion in order to compare contractility. The incubation medium consisted of Krebs-Henseleit buffer. Spontaneous contractile activity was observed during the study, characterized by rhythmic contractions of the muscular layer of the aorta. The contractile tension within the sections was 0.15 m

  2. Effects and mechanism of different adrenergic receptor antagonists on left ventricular hypertrophy subsequent to coarctation of abdominal aorta in rats

    Institute of Scientific and Technical Information of China (English)

    HU Qin; LI Long-gui; ZHANG Yun

    2004-01-01

    To study the changes of a collagen-binding protein (Colligin) and myosin heavy chain isoform (α/β-MHC) gene and protein in left ventricular hypertrophy subsequent to coarctation of abdominal aorta in rats and the ef-fects of three kinds of adrenergic receptor blockers: Carvedilol (CAR), Metoprolol (MET) and Terazosin (TER) on these changes, and to elucidate the effects and new mechanism of CAR on left ventricular hypearophy regression. Methods: A model of hypertrophy induced by coarctation of abdominal aorta(CAA) was used in this study. Thirty two male istar rats were divided randomly into four groups 4 weeks after CAA operation: CAA, CAR, MET and TER.emodynamics, ventric-ular remodeling parameters, expressions of Colligin and α/β-MHC mRNA, protein expressions of Collagen Ⅰ /Ⅲ and Colligin were investigated in the four groups and sham operation group. Results: Left ventricle hypertrophy was observed clearly 16 weeks after operation. The ratio of α/β-MHC mRNA decreased, while expressions of Collagen Ⅰ/Ⅲ proteins and Colligin mRNA/protein increased( P < 0.05). CAR could ameliorate left ventricle hypertrophy prior to MET and TER. CAR could also change the expressions of α/β-MHC, Collagen Ⅰ/Ⅲ and Colligin in both gene and protein levels ( P < 0.05), while MET and TER have no effect on them ( P > 0.05). Conclusion: The effects of CAR on extracellular matrix proteins and MHC isoform shift regression of left ventricle may be due to antiproliferative or antioxidative mechanism, which was indepen-dent of beta-adrenergic receptor antagonist.

  3. 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.

    Science.gov (United States)

    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.

  4. Ruptura de aneurismas de aorta abdominal. Herramienta informática para su predicción // Rupture of abdominal aortic aneurysm. Software for its prediction

    Directory of Open Access Journals (Sweden)

    Guillermo Villalta‐Alonso

    2011-01-01

    Full Text Available La ruptura de los aneurismas de aorta abdominal representa un evento clínico muy importantedebido a su alta tasa de mortalidad. Los indicadores empleados actualmente para decidir eltratamiento a pacientes con aneurismas son el diámetro máximo transversal y la tasa de crecimiento,los que pueden ser considerados insuficientes, pues no tienen una base teórica físicamentefundamentada. En el presente artículo se definen los fundamentos para el diseño de una herramientainformática para PC que permita predecir, con suficiente precisión para ser clínicamente relevante, elriesgo de ruptura de aneurismas de aorta abdominal sobre bases personalizadas del paciente. Laherramienta consta de 3 módulos, que están diseñados para procesar toda la información delpaciente e integrarla mediante un modelo que incorpora la interrelación de los factores biomecánicosde diferentes naturalezas (biológicos, estructurales y geométrico y escalas (temporal y dimensional,con el objetivo de calcular un indicador numérico y personalizado del riesgo de ruptura. Estaherramienta debe constituir un elemento auxiliar del facultativo médico en la toma de decisionesrespecto del tratamiento adecuado a pacientes con aneurisma.Palabras claves: AAA, riesgo de ruptura, modelo multiescala, predicción, herramienta informática.___________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event due to its highmortality rate. Currently the criteria to decide on the treatment of AAA patients are the peaktransverse diameter and the growth rate which can be considered insufficient because they have nota reasonable physical base. The foundations for the design of PC software to predict, with sufficientaccuracy to be clinically relevant, the risk of AAA rupture on patient-specific basis are defined in thispaper. The software consists of 3 modules which are designed for processing all

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

    Science.gov (United States)

    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.

  6. Avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores Post-operative evaluation of endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Fabiana Barroso Thomaz

    2008-08-01

    Full Text Available OBJETIVO: Este estudo tem como objetivo a avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. MATERIAIS E MÉTODOS: Foram analisadas, retrospectivamente, angiotomografias de 166 pacientes (137 homens e 29 mulheres com idade média de 73 anos portadores de aneurisma da aorta abdominal submetidos a terapêutica endovascular, no período de junho de 2005 a agosto de 2006. Os exames foram feitos em tomógrafo multidetector de 64 canais e os parâmetros adotados foram: colimação, 0,625 mm; pitch, 0,6-1; mAs, 300-400; kV, 120. Em todos os casos foi utilizado meio de contraste iodado não-iônico (350 mg/ml administrado por meio de bomba infusora, com fluxo de 4 ml/s a 5 ml/s e com volume variável de 70 ml a 100 ml. Os exames foram avaliados quanto à presença de complicações. RESULTADOS: Dos 166 exames realizados, 93 pacientes não apresentaram complicações e 73 apresentaram os seguintes achados: endoleak (n=37, trombose circunferencial da endoprótese (n=29, angulação (n=17, coleção no sítio de punção (n=10, migração da prótese (n=7, dissecção dos vasos de acesso (n=7 e oclusão (n=6. CONCLUSÃO: O endoleak foi a complicação mais prevalente em nosso estudo, sendo o tipo II o mais comum.OBJECTIVE: The present study was aimed at evaluating endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography. MATERIALS AND METHODS: Multidetector computed tomography angiography studies of 166 patients were retrospectively analyzed. The sample included 137 men and 29 women with mean age of 73 years who had undergone endovascular treatment for abdominal aortic aneurysm in the period between June 2005 and August 2006. Images were acquired in a 64-channel multidetector tomograph adopting the following parameters: 0.625 mm collimation, pitch 0.6-1, 300-400 mAs, and 120 kV. A nonionic iodinated contrast agent (350 mg/ml was injected

  7. Avaliação do posicionamento da aorta em pacientes com escoliose idiopática do adolescente

    Directory of Open Access Journals (Sweden)

    Guilherme Augusto Foizer

    2013-01-01

    Full Text Available OBJETIVO: Avaliar o posicionamento da aorta em pacientes com escoliose. MÉTODOS: Foram realizados exames de imagem em pacientes ambulatoriais com escoliose idiopática do adolescente e em um grupo formado por pacientes hígidos, sendo analisados seis parâmetros: comprimento do corpo vertebral, largura, distância aorta-corpo, diâmetro da aorta, distância aorta-canal e ângulo corpo-aorta. RESULTADOS: As curvas variaram entre T3 e L2 com ângulos de Cobb de 46° e 114°. Pela classificação de Lenke os tipos 1AN e 1BN ocorreram em 20% dos casos, além de 1CN, 3BN, 3C+ com 13,3 % e 1B+, 3C- com 6,7 %. As vértebras próximas ao ápice da curva no grupo escoliose apresentam valores superiores às do grupo controle (em T8 com média de 86,93° no grupo escoliose e média 49,07 no grupo controle (p < 0,0001. CONCLUSÃO: Quanto mais próximo do ápice da deformidade, maior a póstero-lateralização da aorta.

  8. Aneurismas complejos de la aorta abdominal: cirugía abierta frente a exclusión endovascular avanzada. Estudio comparativo.

    OpenAIRE

    2015-01-01

    Justificación del estudio e hipótesis de trabajo: la enfermedad aneurismática de la aorta se estima que afecta al 2%-7% de los varones mayores de 60 años. Dichas estimaciones, extrapoladas a la población de España, se corresponderían con 140.000-350.000 personas portadoras de una aneurisma de aorta abdominal. En siete de cada cien personas acaece la rotura del aneurisma, siendo actualmente la décima causa de muerte en varones mayores de 55 años. En aquellos pacientes de alto riesgo para la ci...

  9. [Ruptured aneurysms of the abdominal aorta. A study of their incidence and mortality].

    Science.gov (United States)

    Acea Nebril, B; Tovar Martín, E; Díaz Pardeiro, P; Fernández Pintos, J; Caamaño Martínez, S

    1993-01-01

    Between 1986 and 1992, 133 patients with abdominal aneurysms presented to our Department of Vascular Surgery. Of these, 97 (73%) were elective cases and 36 (27%) had ruptured. In all these patients resections were undertaken. Postoperative complications occurred in 28 patients (28%) for elective resection and in 17 patients (47%) for ruptured aneurysms (p < 0.05), with mortality rates of 46 and 94%, respectively (p < 0.005). The postoperative mortality for elective resection was 13% and for rupture 44% (p < 0.001).

  10. Patient-Specific Simulation Models of the Abdominal Aorta With and Without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand

    This research study presents computational simulation models for analysis of parameters which are in evidence of development and clinical management of abdominal aortic aneurysms (AAA). The research covers three main areas: interpretation of material parameters, implementation of the constitutive....... The collagen fibers are grouped in four directions of orientation. The purpose of the first study was to investigate whether significant risk factors related to AAA development can be identified from a specific pattern in the material parameters of the 4FF model. Smoking is a leading self-inflicted risk factor...... to be isotropic, which may allow simpler phenomenological models to capture these effects. There is a pressing need, however, for more detailed histological information coupled with more complete experimental data for the systemic arteries. The second study was aimed at developing computational simulation models...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Detección de aneurisma de la aorta abdominal en una población derivada para ecocardiografía transtorácica

    Directory of Open Access Journals (Sweden)

    Clotilde S. Berensztein

    2006-01-01

    Full Text Available Se evaluó: 1 la factibilidad de realizar una ecografía limitada a la aorta abdominal en pacientes a quienes se indica un ecocardiograma transtorácico, 2 las variables clínicas y ecocardiográficas que se correlacionan con el diámetro de la aorta abdominal, 3 la prevalencia de aneurisma de la aorta abdominal (AAA y 4 los factores de riesgo clínicos para AAA. Se evaluaron prospectivamente 280 pacientes consecutivos (media de edad: 68, rango 18 a 93 años, 118 de sexo masculino [42%]. Se verificó que: 1 el examen ecográfico de la aorta abdominal es factible en la mayoría de los pacientes (95,36% [IC 95% 92,88-97,84%], 2 el diámetro de la aorta abdominal se correlaciona con el sexo masculino, la edad, los antecedentes personales de enfermedad vascular periférica y los antecedentes de familiares de primer grado con AAA; también se correlaciona con el diámetro de la raíz aórtica (RA y con el grosor parietal relativo (GPR, 3 existe una prevalencia alta de AAA en la población estudiada (4,49% [IC 95% 1,99-7,00%], particularmente en los varones = 65 años (12,33% [IC 95% 4,60-20,05%] y 4 el sexo masculino, la hipertensión arterial, la dislipemia, el tabaquismo, la diabetes, los antecedentes personales de cardiopatía isquémica o de vasculopatía periférica y los antecedentes de familiares de primer grado con AAA son factores de riesgo para AAA. En conclusión, estaría justificada la realización de una ecografía abdominal como extensión de la ecocardiografía transtorácica en varones = 65 años, en particular si coexisten otros factores de riesgo para AAA.

  13. Assessment of the abdominal aorta and its visceral branches by contrast-enhanced dynamic volumetric hepatic parallel magnetic resonance imaging: feasibility, reliability and accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Werder, Robert; Weishaupt, Dominik; Marincek, Borut [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Nanz, Daniel [University Hospital Zurich, Department of Medical Radiology, Zurich (Switzerland); Lutz, Amelie M.; Willmann, Juergen K. [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Stanford University, MIPS, Department of Radiology, Palo Alto, CA (United States); McCormack, Lucas [University Hospital Zurich, Department of Visceral and Transplantation Surgery, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland)

    2007-02-15

    The purpose of this study was to evaluate a new three-dimensional gradient-echo (GRE) MR sequence performed with a parallel acquisition technique to shorten breath-hold times (parallel GRE MRI) in the detection of arterial variants and stenosis of the abdominal aorta and its visceral branches. A total of 102 patients underwent dynamic parallel GRE MRI, timed to the arterial phase by a test bolus (mean breath-hold time, 17 s). For both quantitative and qualitative analysis, the abdominal aorta and its visceral branches were divided into 13 arterial segments. In a subanalysis of 55/102 patients, the accuracy of parallel GRE MRI compared to MDCT in the detection arterial variants and stenosis was calculated for two independent readers. Mean SNRs and CNRs were 47.2 and 35.6, respectively. Image quality was rated good or excellent in 1,234/1,326 segments (93%). Hepatic and renal arterial variants were identified with an accuracy of 93 and 95%, respectively (reader 1) and 98 and 100%, respectively (reader 2). Both readers detected arterial stenosis with an accuracy of 98%. Interobserver agreement was good to excellent for the detection of hepatic ({kappa}=0.69) and renal ({kappa}=0.92) variants and for the diagnosis of stenosis ({kappa}=0.96). Dynamic three-dimensional parallel GRE MRI is feasible and allows a reliable and accurate diagnosis of arterial variants and stenosis of the abdominal aorta and its visceral branches in a short breath-hold-time. (orig.)

  14. Influence of Selective Biochemical and Morphological Agents on Natural History of Aneurysm of Abdominal Aorta Development.

    Science.gov (United States)

    Wołoszko, Tomasz; Skórski, Maciej; Kwasiborski, Przemysław; Kmin, Ewelina; Gałązka, Zbigniew; Pogorzelski, Ryszard

    2016-02-09

    BACKGROUND The development of abdominal aortic aneurysm (AAA) is probably influenced by many factors. The role of some of these factors, such as intraluminal thrombus (ILT) or cystatin C serum levels, remains controversial. Proving their influence could have therapeutic implications for some patients with AAA. Associations between the rate of increase in diameter of an aneurysm and ILT, as well as other factors, including biochemical factors (C-Reactive Protein - CRP, cystatin C), age, sex, and comorbidities, could predict disease progression in individual patients. MATERIAL AND METHODS Seventy patients with small AAA were included into the study. The patients were followed using ultrasound and CT imaging. We evaluated aneurysm dimensions and aneurysm wall thickness, as well as ILT and its dimensions, aneurysm wall morphology, CRP, and cystatin C. RESULTS We observed significant growth of AAA and thinning of aneurysmal wall. Aneurysms over 4 cm grew significantly faster in the second year of observation. ILT grew together with AAA size. Age, sex, smoking, dyslipidemias, or controlled arterial hypertension had no influence on aneurysm progression rate. Changes in serum of CRP concentration did not reach statistical significance, but cystatin C levels did. CONCLUSIONS Presence and size of ILT, wall thickness, and cystatin C levels may be considered in prediction of AAA progression. ILT might exert a protective influence on the risk of aneurysm rupture. However, larger aneurysms containing larger thrombi grow faster and their walls undergo more rapid degradation, which in turn increases the risk of rupture. This matter requires further studies.

  15. Standardized Volume Rendering for Magnetic Resonance Angiography Measurements in the Abdominal Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Persson, A.; Brismar, T.B.; Lundstroem, C.; Dahlstroem, N.; Othberg, F.; Smedby, Oe. [Linkoeping Univ. Hospital (Sweden). Center for Medical Image Science and Visualization (CMIV)

    2006-03-15

    Purpose: To compare three methods for standardizing volume rendering technique (VRT) protocols by studying aortic diameter measurements in magnetic resonance angiography (MRA) datasets. Material and Methods: Datasets from 20 patients previously examined with gadolinium-enhanced MRA and with digital subtraction angiography (DSA) for abdominal aortic aneurysm were retrospectively evaluated by three independent readers. The MRA datasets were viewed using VRT with three different standardized transfer functions: the percentile method (Pc-VRT), the maximum-likelihood method (ML-VRT), and the partial range histogram method (PRH-VRT). The aortic diameters obtained with these three methods were compared with freely chosen VRT parameters (F-VRT) and with maximum intensity projection (MIP) concerning inter-reader variability and agreement with the reference method DSA. Results: F-VRT parameters and PRH-VRT gave significantly higher diameter values than DSA, whereas Pc-VRT gave significantly lower values than DSA. The highest interobserver variability was found for F-VRT parameters and MIP, and the lowest for Pc-VRT and PRH-VRT. All standardized VRT methods were significantly superior to both MIP and F-VRT in this respect. The agreement with DSA was best for PRH-VRT, which was the only method with a mean error below 1 mm and which also had the narrowest limits of agreement (95% of cases between 2.1 mm below and 3.1 mm above DSA). Conclusion: All the standardized VRT methods compare favorably with MIP and VRT with freely selected parameters as regards interobserver variability. The partial range histogram method, although systematically overestimating vessel diameters, gives results closest to those of DSA.

  16. Simulation of blood flow within the abdominal aorta. Computational fluid dynamics in abdominal aortic aneurysms before and after interventions; Simulation des Blutflusses in der abdominellen Aorta. Die numerische Simulation des Blutflusses in abdominellen Aortenaneurysmen vor und nach Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Frauenfelder, T.; Alkadhi, H.; Marincek, B.; Schertler, T. [Universitaetsspital Zuerich, Institut fuer Diagnostische Radiologie, Zuerich (Switzerland); Boutsianis, E. [ETH Zuerich, Labor fuer Computerwissenschaften und Engineering, Zuerich (Switzerland)

    2007-11-15

    The goal of numeric analysis of aortic blood flow is to evaluate the mechanisms leading to an aortic aneurysm with regard to the risk of a rupture and to describe the effect of interventional therapy. Numeric analysis is based on virtual models of vascular structures and the physical characteristics of the vessel wall, of blood as fluidum, and the blood flow. Using this information, numeric analysis solves the appropriate equations. The results can be displayed quantitatively and qualitatively. The results of numeric flow simulation show that in abdominal aortic aneurysms the wall pressure, which is of vital importance for the risk of rupture, depends on several factors, one being the location of the intraluminal thrombus. In models of aneurysms after stent grafting, numeric analysis can be used to evaluate factors leading to stent migration. Although numeric analysis of aortic blood flow still has several limitations, recent studies have shown that this method has the potential for improved estimation of the rupture risk of aortic aneurysms in the near future. (orig.) [German] Das Ziel der numerischen Simulation des Blutflusses in der Aorta ist, die Mechanik der Entstehung von Aortenaneurysmen im Hinblick auf das Rupturrisiko zu untersuchen und die Wirkungen interventioneller Massnahmen zu beschreiben. Die Grundlage der numerischen Simulation sind virtuelle Modelle von Gefaessen und die physikalischen Eigenschaften der Gefaessbestandteile, des Blutes und der Stroemung. Basierend auf diesen Angaben werden mit Hilfe numerischer Methoden die stroemungsmechanischen Probleme des Blutflusses naeherungsweise geloest. Die Ergebnisse koennen dann quantitativ und qualitativ dargestellt werden. Die Ergebnisse der numerischen Flusssimulation zeigen, dass in abdominellen Aortenaneurysmen die Hoehe des Wanddrucks, der von entscheidender Bedeutung fuer das Rupturrisiko ist, von verschiedenen Faktoren, wie z. B. der Lage des Wandthrombus, abhaengt. In Modellen mit Stentgrafts

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

    Directory of Open Access Journals (Sweden)

    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.

  18. [Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].

    Science.gov (United States)

    Konstantinov, B A; Bazylev, V V; Belov, Iu V; Kizyma, A G

    2008-01-01

    Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated. The multifactorial relative risk affecting hospital lethality is defined. The study includes 131 patients with generalized atherosclerosis, which have underwent myocardial revascularization at the first stage (the main group) and at the second stage have been operated on abdominal aorta and peripheral arteries. 1128 patients without peripheral arterial atherosclerosis have made the control group. They underwent only coronary shunting. All patients were treated from December of 1994 till June of 2006. Relying on the results of the study cumulative relative risk for unfavorable outcomes after revascularization is 1.8 times higher in patients from the main group than in patients from the control group, and the risk for primary complications is 2.03 times higher. Concomitant atherosclerotic arterial involvement among cardiosurgical patients is associated with high risk for stroke in postoperative period. In case of chronic renal failure risk factors are cumulated. In the main group lethality made 5% , which was higher as compared with the control group. Correlation of such risk factors as heart failure and renal failure (creatinine level more than 1.8 mg/dl) with lethality has been revealed among patients from the main group. Lethality risk raises in 5.30 times in the presence of heart failure in medical history, and raises in 13.15 times in case of initially elevated creatinine level. Age of patient didn't have any influence on lethality in early postoperative period.

  19. Detection of atherosclerotic plaque progression in the abdominal aorta of rabbits with 3T magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    MA Xiao-hai; ZHAO Lei; ZHAO Quan-ming; FENG Ting-ting; SHANG Jian-feng; ZHANG Zhao-qi

    2012-01-01

    Background With features of high tissue contrast,MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques.In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results.Method Twenty male New Zealand white rabbits were randomly allocated into an experimental group (n=16) and a control group (n=4).Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding.Multiple sequences MRI examination (ToF,T1WI,T2WI,and CE T1WI) were performed at the 2nd,3rd,and 4th months after aortic denudation.Vessel wall thickness,total vessel area,lumen area,and vessel wall area were recorded.Plaque components were analyzed using histological results as a standard reference.Results Seventeen rabbits (14 in the experimental group and 3 in the control group) received all three MR examinations.Gradually,from 2 months to 4 months,vessel wall thickness and area in the experimental group increased significantly compared with the control group (P <0.01).In the lumen area progressive stenosis was not found,even a slight dilation had developed in the experimental group.Lipid,fibretic and calcified plaques can be differentiated by MR image.According to histological results,MRI had good performance in detection of lipid plaque.Conclusion MRI can be used to monitor progression of atherosclerosis and differentiate plaque components.

  20. Origem anômala da artéria pulmonar direita em aorta ascendente (hemitruncus Anomalous origin of right pulmonary artery from ascending aorta (hemitruncus

    Directory of Open Access Journals (Sweden)

    Ivan Romero Rivera

    1998-05-01

    Full Text Available A origem da artéria pulmonar direita em aorta ascendente é uma anomalia congênita rara, com poucos casos descritos na literatura. Descrevemos dois casos desta malformação, um associado à interrupção de arco aórtico tipo B. Em ambos, o diagnóstico foi realizado mediante ecocardiografia bidimensional, com confirmação angiográfica em um. A origem da artéria pulmonar direita era próxima à valva aórtica, anomalia patogeneticamente diferente da origem perto da artéria inominada.The origin of the right pulmonary artery from the ascending aorta is a rare congenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B. In both cases, the diagnosis was made by two-dimensional echocardiography, with angiographic confirmation in one of them. The origin of the right pulmonary artery was close to the aortic valve, anomaly pathogenetically distinct from the type that arises close to the innominate artery.

  1. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    OpenAIRE

    2013-01-01

    Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  2. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    Directory of Open Access Journals (Sweden)

    Isabel Flor de Lima

    2013-10-01

    Full Text Available Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  3. Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisados Procedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards

    Directory of Open Access Journals (Sweden)

    Gosen Gabriel Konig

    2007-03-01

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a definição da mortalidade relacionada ao procedimento após tratamento endovascular do aneurisma de aorta abdominal (EVAR como definido pelo Committee for Standardized Reporting Practices in Vascular Surgery. MÉTODO: Dados de pacientes com aneurisma de aorta abdominal foram analisados do banco de dados EUROSTAR. Os pacientes foram submetidos ao EVAR entre junho de 1996 a fevereiro de 2004 e foram estudados retrospectivamente. A probabilidade explicita da causa de morte foi registrada. O intervalo entre a operação, alta hospitalar ou intervenção secundária até a morte foi registrado. RESULTADOS: De um total de 5612 pacientes, 589 (10,5% faleceram após o EVAR em acompanhamento total e qualquer causa de morte foi inclusa. Cento e quarenta e um pacientes (12,5% morreram devido a causa relacionada ao aneurisma, sendo que 28 (4,8% foram rupturas, 25 (4,2% infecções do implante e 88 (14,9% foram pacientes que morreram num prazo de 30 dias após o procedimento inicial (definição atualmente utilizada, também conhecido como resultado clínico a curto prazo. Além disso, 25 pacientes faleceram após 30 dias, mas continuavam ainda hospitalizados (ou transferidos a home-care para reavaliação posterior, ou necessitaram intervenção secundária. Levando em conta a duração da admissão ao hospital e a mortalidade imediata após o procedimento relacionada a intervenções secundárias, 49 mortes tardias também podem ser relacionadas ao EVAR. CONCLUSÃO: Morte tardia compõe uma proporção considerável da mortalidade relacionada ao EVAR dentro do tempo de análise revisado.OBJECTIVE: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR as defined by the Committee for Standardized Reporting Practices in Vascular Surgery. METHODS: Data on patients with an AAA were taken from the EUROSTAR database. The patients underwent EVAR

  4. Use of ascending-abdominal aorta bypass grafts in the complex coarctation of the aorta%应用升主动脉-腹主动脉搭桥术治疗复杂主动脉缩窄

    Institute of Scientific and Technical Information of China (English)

    马全林

    2013-01-01

    Objective:To study a handy、safe and effective surgical treatment of complex coarctation of the aorta .Method:2 patients with complex coarctation of the aorta underwent ascending -abdominal aorta bypass grafts during general anesthesia and normal tempera-ture.Results:the blood pressure of pectoral limb evidently depress and the blood pressure of pelvic limb satisfactorily raise without neu -roloyic complication .Conclusion:the method is simple and effective ,there is low complication and cost .%目的:探讨手术治疗复杂主动脉缩窄的简便、安全、有效的方法。方法:在全麻和常温下经胸腹正中联合切口行升主动脉-腹主动脉搭桥术。结果:手术治疗3例患者,上肢血压下降明显,下肢血压升高满意,无神经系统和其他严重并发症。结论:该手术显露和操作简单,适应证广,疗效确切,并发症少。

  5. Study on Anatomical Features of CT Images of Abdominal Aorta in Adults%成人腹主动脉CT影像解剖学研究

    Institute of Scientific and Technical Information of China (English)

    杨飞; 王大伟; 朱晓龙; 陈静; 崔书君; 刘怀军

    2015-01-01

    Objective To analyze the anatomical features of the abdominal aorta in adults through MSCT (Multi-Slice Spiral Computerized Tomography).Methods Imaging records of 213 patients (118 cases of male patients; 95 cases of female cases; 109 elder patients; 104 young patients) who had undergone abdominal enhanced MSCT or CTA (Computerized Tomography Angiography) in the hospital were collected to measure the anteroposterior and transverse diameter of abdominal aorta in the cross-sectional images. Results Altogether 213 abdominal aortas were revealed, among which the anteroposterior and transverse diameter of abdominal aorta in male patients were larger than those in female cases; those in older patients were greater than young patients; the anteroposterior diameter of abdominal aortas was greater than the transverse diameter with statistically significant differences (P<0.05).Conclusion MSCT demonstrated excellent abilities in display of anatomical features of abdominal aortic dissections, which could provide clinical guidance and significant blood supply anatomical information in vivo in a non-invasive way for surgical abdominal operations, liver or kidney transplantation and interventional treatment.%目的:采用多层螺旋CT(MSCT)分析成人腹主动脉的影像学解剖特点。方法收集因各种原因在我院行腹部MSCT增强扫描或腹部CT血管造影检查的213例患者,其中男性118例,女性95例,老年人(≥60岁)109例,非老年人(<60岁)104例,在横断面图像上测量腹主动脉管腔的前后径、左右径。结果共检出213支腹主动脉。男性腹主动脉左右径、前后径均大于女性;老年组腹主动脉左右径、前后径均大于非老年组;腹主动脉前后径大于左右径;上述差异均有统计学意义(P<0.05)。结论 MSCT能够很好地显示腹主动脉血管的解剖情况,可无创性地为外科腹部手术、肝肾移植及介入治疗提供有价值的活体血供解

  6. Evaluación del riesgo de ruptura de aneurismas de aorta abdominal personalizados mediante factores biomecánicos/Patient-specific abdominal aortic aneurysms rupture risk assessment by means of biomechanical factors

    Directory of Open Access Journals (Sweden)

    Ariel Zúñiga‐Reyes

    2014-05-01

    Full Text Available El Aneurisma de Aorta Abdominal es la dilatación localizada, irreversible y progresiva que experimenta la pared aortica. Esta patología ha sido reconocida como un importante problema de salud, puesto que su ruptura está asociada mayormente a consecuencias fatales. La falta de criterios fiables, respecto a los actualmente utilizados, para la evaluación del riesgo de ruptura, constituye un inconveniente en la gestión clínica de la enfermedad. El presente trabajo tiene como objetivo evaluar el riesgo de ruptura de Aneurismas de Aorta Abdominal, mediante indicadores numéricos, como es previsto por el enfoque biomecánico. Fueron utilizadas técnicas de modelación por elementos finitos para determinar el comportamiento del flujo sanguíneo y el estado tensional de la pared arterial. Los resultados mostraron que ninguno de los aneurismas analizados presenta riesgo de ruptura elevado y que la evaluación del riesgo de ruptura mediante índices numéricos, es un camino viable para prever la ruptura de un aneurisma específico.Palabras claves: aneurisma de aorta abdominal, factores biomecánicos, interacción fluido-sólido, riesgo de ruptura.______________________________________________________________________________AbstractAbdominal Aortic Aneurysm is a localized, progressive and permanent dilation of the infra-renal aorta.AAA has increasingly been recognized as an important health problem in the last decades. The AAA rupture is mostly associated with fatal consequences. The lack of more reliable criteria for rupture riskassessing, results in a problem in the clinical management of the disease. This paper aims to assess the rupture risk of abdominal aortic aneurysms by means of numerical indexes, as envisaged by the biomechanical approach. Finite Volume Techniques were used to determine the blood flow behavior within aneurysmatic sac and the structural state of the arterial wall. The results showed that none of the assessed aneurysms is at

  7. Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    ... 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, ...

  8. The AORTA Architecture: Integrating Organizational Reasoning in <em>Jason>

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we propose the AORTA architecture for making agents organization-aware. It is designed...... such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss how the agents can coordinate their organizational tasks...

  9. [Curriculum vitae aortae].

    Science.gov (United States)

    Solberg, S

    1998-12-10

    The Greek word aorta means lifter. The vessel was so termed because Aristotle, who first described it, assumed that the heart was lifted by/hanging in aorta. Leonardo da Vinci described the detailed anatomy of aorta. During the 17th century our present understanding of the aorta and the circulation of blood took form due to the descriptions given by William Harvey. The first known operation for abdominal aortic aneurysm was performed in London in 1817 by Sir Astley Cooper who ligated the infrarenal aorta above the aneurysm. Puncture with needles and application of electricity were later tried in order to induce thromboses in the aneurysm. In 1948 Albert Einstein was operated with wrapping of his abdominal aneurysm with cellophane. In 1955 he suffered rupture and died after having refused operation. In 1951 the first successful operation for abdominal aortic aneurysm was performed in Paris by Charles Dubost. With slight modifications, the same operative technique is used today.

  10. The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches

    Energy Technology Data Exchange (ETDEWEB)

    Iozzelli, Andrea [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: andrea.iozzelli@poste.it; D' Orta, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: ammos@tiscali.it; Aliprandi, Alberto [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: a.aliprandi@grupposandonato.it; Secchi, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: francisecchi@virgilio.it; Di Leo, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: gianni.dileo77@virgilio.it; Sardanelli, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: f.sardanelli@grupposandonato.it

    2009-12-15

    To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 {+-} 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta (n = 25); aortic aneurysm (n = 2); patent aorto-iliac surgical prosthesis (n = 2); patent vascular iliac stent (n = 2); aneurysm of iliac artery (n = 1); patent aortic endovascular prosthesis (n = 1); patent aorto-femural bypass (n = 1) and aorto-iliac surgical prosthesis endoleak (n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 {+-} 4.1, median 27) was significantly higher (p = 0.003) than that of Gd-MRA (23.9 {+-} 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 {+-} 1.1 vs. 1.0 {+-} 1.4; p < 0.001) and atheromasic plaques (2.5 {+-} 1.1 vs. 1.2 {+-} 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase.

  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].

    Science.gov (United States)

    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. Effects of simvastatin in abdominal sepsis in rats Efeitos da sinvastatina na sepse abdominal em ratos

    Directory of Open Access Journals (Sweden)

    José Luiz de Souza Neto

    2006-01-01

    Full Text Available PURPOSE: Statins are widely recognized as hypolipemic drugs, but some studies have observed anti-inflammatory and immunomodulatory effects, known as pleiotropic. The aims of this work was to study possible anti-inflammatory effects of simvastatin in abdominal sepsis. Serum pro-inflammatory cytokines and leukocytes count were determined in an experimental model of abdominal sepsis, using cecal ligation and puncture (CLP in rats. METHODS: Twenty eigth Wistar rats weighing 285±12g were randomly divided in: CLP/Sinvastatin rats (n=7, treated with 10 mg/Kg of oral simvastatin 18 and 2 hs berofe CLP; CLP/Saline group rats (n=7, treated with oral saline; group Sham/Simvastatin (n=7, treated with simvastatin, and group Sham/Saline (n=7, treated with saline. Serum TNF-alpha, IL-1beta and IL-6 by ELISA and total leukocytes, neutrophils, lymphocytes, and eosinophils were determined 24 hs after CLP. ANOVA and Tukey test were used considering significant pOBJETIVO: As estatinas são agentes reconhecidamente hipolipemiantes. Vários estudos têm revelado que eles têm ações pleiotrópicas, como antiinflamatória e imunomoduladora. Tentando-se entender o papel antiinflamatório da sinvastatina na sepse, foram analisados os níveis de citocinas pró-inflamatórias e contagem de leucócitos em modelo de sepse abdominal por ligadura e punção do ceco (LPC em ratos. MÉTODOS: Foram utilizados 28 ratos Wistar pesando 285±12g, assim divididos: grupo sepse (n=14, submetidos a LPC e grupo sham (n=14, submetidos a laparotomia e manipulação suave do ceco. No grupo LPC/sinvastatina (n=7 os ratos receberam 10mg/kg de sinvastatina via oral 18 e 2 horas antes da LPC e no grupo LPC/salina (n=7 os ratos receberam injeção oral de solução salina 0,9 %. Os animais dos grupos sham/sinvastatina (n=7 e sham/salina (n=7 receberam o mesmo tratamento. Dosagem de TNF-alfa, IL-1beta e IL-6 por ELISA e contagem de leucócitos totais, neutrófilos, linfócitos e eosin

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Trauma abdominal em grávidas Abdominal trauma in pregnant women

    Directory of Open Access Journals (Sweden)

    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

  15. Avaliação da incidência e de fatores de risco para a colite isquêmica após reparo de aneurisma de aorta abdominal Avaliation of Incidence and risk factors for ischemic colitis following abdominal aortic aneurism repair

    Directory of Open Access Journals (Sweden)

    Gilmara Pandolfo

    2007-09-01

    Full Text Available Este estudo teve como objetivo principal determinar a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal, bem como identificar fatores de risco para o desenvolvimento da mesma. Foram estudados 11 pacientes submetidos a reparo cirúrgico eletivo de aneurisma de aorta abdominal no Serviço de Cirurgia Cardiovascular do HSL-PUCRS. A incidência de colite isquêmica foi determinada através de retossigmoidoscopia flexível, com biópsia, realizada em todos os pacientes no 7º pós-operatório. A incidência da doença foi comparada com variáveis clínicas como: sexo; idade; presença de comorbidades associadas; choque trans-operatório; fluxo na artéria mesentérica inferior (AMI; complicações pós-operatórias; e o desfecho final. Em nossa amostra, a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal foi 36%, sendo destes 25% da forma gangrenosa. A ocorrência de isquemia do cólon foi mais freqüente em associação com o diagnóstico de doença pulmonar obstrutiva crônica, e em pacientes que apresentavam fluxo na artéria mesentérica inferior no pré-operatório (pIschemic colitis is a relatively uncommon complication following abdominal aortic aneurism repair. However, patients with this disease have higher rates of mortality when compared to ischemic colitis alone. The objective of our study is to investigate the incidence and risk factors associated with the occurrence of ischemic colitis following abdominal aortic aneurism repair. We studied eleven patients treated by surgery for aortic aneurism at Hospital São Lucas da PUCRS (HSL-PUCRS. The patients were evaluated for other clinical conditions and were submitted to flexible reto-sigmoidoscopy at the seventh day after surgery. Incidence of ischemic colitis was 36% and it was associated with chronic obstructive pulmonar disease and the presence of blood flow through the inferior mesenteric artery before surgery. Among the

  16. Estresse Isolado ou Associado ao Etanol Libera Prostanóides em Aorta de Ratos via ?2-Adrenoceptores

    Directory of Open Access Journals (Sweden)

    Rafaela de Fátima Ferreira Baptista

    2014-04-01

    Full Text Available Fundamento: Estresse e etanol são ambos, independentemente, importantes fatores de risco cardiovascular. Objetivo: avaliar o risco cardiovascular do consumo de etanol e exposição ao estresse, isolados e em associação, em ratos machos adultos. Métodos: Os ratos foram separados em quatro grupos: controle, etanol (20% na água de beber durante seis semanas, estresse (imobilização 1h dia/5 dias por semana/ 6 semanas e estresse/etanol. As curvas de concentração-resposta à noradrenalina - na ausência e na presença de ioimbina, L-NAME ou indometacina - ou fenilefrina foram determinadas em aortas torácicas com e sem endotélio. EC50 e resposta máxima (n = 8-12 foram comparadas através de ANOVA de dois fatores (two-way / método de Bonferroni. Resultados: Estresse ou estresse em associação com o consumo de etanol aumentaram as respostas máximas de noradrenalina em aortas intactas. Essa hiper-reatividade foi eliminada pela remoção do endotélio, ou pela presença da indometacina ou ioimbina, mas não foi alterada pela presença de L-NAME. Enquanto isso, o consumo de etanol não alterou a reatividade à noradrenalina. As respostas da fenilefrina em aortas com e sem endotélio também permaneceram inalteradas independentemente do protocolo. Conclusão: O estresse crônico aumentou as respostas aórticas dos ratos à noradrenalina. Esse efeito é dependente do endotélio vascular e envolve a liberação de prostanóides vasoconstritores através da estimulação de α-2 adrenoceptores endoteliais. Além disso, o consumo crônico de etanol pareceu não influenciar as respostas de noradrenalina em aorta de rato, nem modificar o aumento de tais respostas observadas em consequência da exposição ao estresse.

  17. Fatores de morbimortalidade na cirurgia eletiva do aneurisma da aorta abdominal infra-renal: experiência de 134 casos Morbidity and mortality factors in the elective surgery of infrarenal abdominal aortic aneurysm: a case study with 134 patients

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2008-09-01

    Full Text Available CONTEXTO: O tratamento cirúrgico convencional do aneurisma da aorta abdominal (AAA infra-renal pode resultar em complicações graves. A fim de otimizar os resultados na evolução do tratamento, é importante que sejam identificados os pacientes predispostos a determinadas complicações e instituídas condutas preventivas. OBJETIVOS: Avaliar a taxa de mortalidade operatória precoce, analisar as complicações pós-operatórias e identificar os fatores de risco relacionados com a morbimortalidade. MÉTODO: Foram analisados 134 pacientes com AAA infra-renal submetidos a correção cirúrgica eletiva no período de fevereiro de 2001 a dezembro de 2005. RESULTADOS: A taxa de mortalidade foi de 5,2%, sendo secundária principalmente a infarto agudo de miocárdio (IAM e isquemia mesentérica. As complicações cardíacas foram as mais freqüentes, seguidas das pulmonares e renais. A presença de diabetes melito (DM, insuficiência cardíaca congestiva (ICC, insuficiência coronariana (ICO e cintilografia miocárdica positiva para isquemia estiveram associadas às complicações cardíacas. A idade avançada, a doença pulmonar obstrutiva crônica (DPOC e a capacidade vital forçada reduzida aumentaram os riscos de atelectasia e pneumonia. História de nefropatia, tempo de pinçamento aórtico prolongado e níveis de uréia elevados aumentaram os riscos de insuficiência respiratória aguda (IRA. A isquemia dos membros inferiores esteve associada ao tabagismo e à idade avançada, e a maior taxa de mortalidade, à presença de coronariopatia, tempos prolongados de pinçamento aórtico e de cirurgia. CONCLUSÃO: A taxa de morbimortalidade esteve compatível com a literatura nacional e internacional, sendo secundária às complicações cardíacas, respiratórias e renais. Os fatores de risco identificados no pré e transoperatório estiveram relacionados com essas complicações.BACKGROUND: Conventional surgical treatment of infrarenal abdominal

  18. A proposal for standardizing computed tomography reports on abdominal aortic aneurysms; Proposta para padronizacao do relatorio de tomografia computadorizada nos aneurismas da aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    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)

  19. Long-term renin-angiotensin blocking therapy in hypertensive patients with normal aorta may attenuate the formation of abdominal aortic aneurysms.

    Science.gov (United States)

    Silverberg, Daniel; Younis, Anan; Savion, Naphtali; Harari, Gil; Yakubovitch, Dmitry; Sheick Yousif, Basheer; Halak, Moshe; Grossman, Ehud; Schneiderman, Jacob

    2014-08-01

    Renin-angiotensin system (RAS) has been implicated in the pathogenesis of abdominal aortic aneurysm (AAA). Angiotensin II type 1 receptor blocker (ARB), when given with angiotensin II prevents AAA formation in mice, but found ineffective in attenuating the progression of preexisting AAA. This study was designed to evaluate the effect of chronic RAS blockers on abdominal aortic diameter in hypertensive patients without known aortic aneurysm. Consecutive hypertensive outpatients (n = 122) were stratified according to antihypertensive therapy they received for 12 months or more, consisting of ARB (n = 45), angiotensin converting enzyme inhibitor (ACE-I; n = 45), or nonARB/nonACE-I (control therapy; n = 32). Abdominal ultrasonography was performed to measure maximal subrenal aortic diameter. Eighty-four patients were reexamined by ultrasonography 8 months later. The correlation between the different antihypertensive therapies and aortic diameter was examined. Aortic diameters were significantly smaller in ARB than in control patients in the baseline and follow-up measurements (P = .004; P = .0004, respectively). Risk factor adjusted covariance analysis showed significant differences between ARB or ACE-I treated groups and controls (P = .006 or P = .046, respectively). Ultrasound that was performed 8 months later showed smaller increases in mean aortic diameters of the ARB and ACE-I groups than in controls. Both ARB and ACE-I therapy attenuated expansion of nonaneurysmal abdominal aorta in humans. These results indicate that RAS blockade given before advancement of aortic medial remodeling may slow down the development of AAA.

  20. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  1. New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio

    Science.gov (United States)

    Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

    2013-09-01

    In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

  2. 胸主动脉供血与腹主动脉供血肺隔离症的对比分析%Comparative analysis of imaging features of pulmonary sequestration supplied by thoracic aorta and supplied by abdominal aor-ta

    Institute of Scientific and Technical Information of China (English)

    田丽; 郝娟娟; 张静玉; 李玉山; 张泽坤

    2014-01-01

    Objective:To compare and analyze the imaging features of pulmonary sequestration (PS)supplied by tho-racic aorta and supplied by abdominal aorta.Methods:A retrospective analysis was performed in 23 patients with PS con-firmed by pathology after operation and the CT images were comparatively analyzed according to the source of blood sup-ply.Results:Of the 23 patients with PS,16 cases were supplied by thoracic aorta and 7 of them had two supplying arteries, 7 cases were supplied by abdominal aorta.The lesions appeared as mass with soft tissue density in 21 cases.One case sup-plied by thoracic aorta showed cystic heterogeneous density.In one case supplied by thoracic aorta,focal thick vessel was shown.The average diameter and length of the supplying arteries from thoracic aorta were (4.8±2.2)mm and (37±12) mm respectively,while these from abdominal aorta were (3.3±0.5)mm and (104±42)mm respectively.The length of sup-plying arteries and volume of sequestrated lung tissues supplied by thoracic aorta were smaller than those supplied by ab-dominal aorta (P<0.001).Conclusion:PS supplied by thoracic and abdominal aorta share similar imaging features.The length of supplying arteries and the volume of sequestrated lung tissues supplied by thoracic aorta are different from those supplied by abdominal aorta.%目的:对比分析胸主动脉供血与腹主动脉供血肺隔离症的影像学征象。方法:回顾性分析经术后病理证实的23例肺隔离症病例,对比分析胸主动脉供血及腹主动脉供血肺隔离症的CT 图像。结果:23例肺隔离症中,16例由胸主动脉供血,其中7例有2支供血动脉;7例由腹主动脉供血。21例表现为实性软组织密度,1例胸主动脉供血者表现为囊实性不均匀密度,1例胸主动脉供血者表现为局部粗大血管。胸主动脉供血动脉直径(4.8±2.2)mm,长度(37±12)mm,腹主动脉供血动脉直径(3.3±0.5)mm,长度(104±42)mm。胸

  3. Cide-A Gene Expression in Patients with Obesity Qualified for Endovascular Treatment of Abdominal Aorta Aneurysm

    Directory of Open Access Journals (Sweden)

    Feldo Marcin

    2015-02-01

    Full Text Available CIDE-A gene and the genes of LRP group play a key role in the regulation of the body weight and lipid metabolism in mammals. CIDE-A is defined as a potential human obesity gene and the LRP1 gene is associated with the development of abdominal aortic aneurysm (AAA.

  4. TRATAMIENTO PERCUTÁNEO CON PRÓTESIS ENDOVASCULAR DE COARTACIÓN DE AORTA ABDOMINAL EN UN ADULTO / Percutaneous treatment with endovascular prosthesis of abdominal aortic coarctation in an adult

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    Luis Felipe Vega Fleites

    2010-12-01

    Full Text Available Resumen: La coartación de la aorta abdominal es una afección vascular no hereditaria poco frecuente, que afecta a hombres y mujeres por igual. Recientemente ha sido nombrada como “Síndrome aórtico medio”, y los hallazgos clínicos son similares a los de la CoAo típica. Para el diagnóstico, se debe recurrir a la resonancia magnética o a la arteriografía, y las opciones terapéuticas incluyen la dilatación percutánea con catéter-globo, el tratamiento quirúrgico y, por último, como opción más novedosa, la implantación de prótesis endovasculares. En este artículo presentamos el caso de una mujer de 45 años de edad, exfumadora, con antecedentes de artritis reumatoidea e hipertensión arterial que presentaba claudicación de miembros inferiores durante la marcha. Existía una disminución bilateral marcada de los pulsos femorales y el Doppler, y mostró un componente amortiguado en ambas arterias femorales y poplíteas. La AngioTAC encontró una estenosis significativa del tercio distal de la aorta abdominal infrarrenal, con hipoplasia marcada de la ilíaca derecha. La aortografía corroboró el diagnóstico (gradiente de 80 mmHg. A través de dos introductores arteriales por las arterias femorales se avanzaron dos catéteres-globo MATCH-35 de 5.0x80 mm que se inflaron simultáneamente y posteriormente, se implantó un stent MEDTRONIC “Bridge Assurant” de 10 x 30 mm en el segmento estenótico, sin complicaciones. El gradiente residual fue de 10 mmHg. La paciente evolucionó favorablemente y fue egresada a las 24 horas del procedimiento. / Abstract: Coarctation of the abdominal aorta is an uncommon, non-inherited vascular condition that affects men and women alike. It has been recently named as "middle aortic syndrome", and the clinical findings are similar to those of typical aortic coarctation. For diagnosis, one must make use of magnetic resonance imaging or arteriography, and therapeutic options include percutaneous

  5. 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

    Directory of Open Access Journals (Sweden)

    Francisco das Chagas de Azevedo

    2005-02-01

    angioresonance provided measurements with no significant differences in the statistic view when compared to the intraoperative measures. CONCLUSIONS: Ultrasonography is a reliable method for the diagnosis and follow-up of the aorta abdominal aneurysms, but insufficient for endovascular surgery planning. The conventional computed tomography can provoke distortion in the length measurements of the aorta dilatation. Helical computed tomography and nuclear magnetic angioresonance provided precise measurements of all the studied parameters, being of great utility for surgical planning.OBJETIVO: Estudar os métodos mais freqüentemente empregados na avaliação dos aneurismas de aorta abdominal - ultrassonografia, tomografia computadorizada convencional, tomografia computadorizada helicoidal e angio-ressonância nuclear magnética - comparando as medidas fornecidas por estes exames radiológicos no pré-operatório com medidas realizadas durante a operação. MÉTODO: Foram incluídos no estudo pacientes portadores de aneurisma da aorta abdominal com indicação de tratamento cirúrgico eletivo por via transperitoneal. O diagnóstico inicial da dilatação aórtica foi feito com ultra-sonografia e, uma vez indicado o tratamento cirúrgico, era então solicitado um outro exame radiológico complementar, já que não é nossa rotina operar esses pacientes com base apenas na ultra-sonografia. Sessenta pacientes foram divididos em 3 grupos de acordo com o exame complementar realizado (tomografia computadorizada convencional, tomografia computadorizada helicoidal ou angio-ressonância nuclear magnética. As ultra-sonografias dos 20 primeiros pacientes foram incluídas em um 4° grupo. Analisamos neste estudo as medidas do colo proximal da aorta, o diâmetro transverso máximo e o comprimento do aneurisma, além do diâmetro transverso das artérias ilíacas comuns conseguidos a partir dos exames radiológicos. As mesmas medidas eram realizadas por ocasião da operação com o auxílio de

  6. [Risk factors for long-term result of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm].

    Science.gov (United States)

    Ye, W; Di, X; Liu, Q; Li, Y J; Zheng, Y H; Zeng, R; Song, X J; Liu, Z L; Liu, C W

    2016-12-06

    Objective: To summarize results of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm(AIPA), and to analysis clinical predictors of long term major adverse clinical events(MACE). Methods: Retrospectively collected endovascular treatment for AIPA cases in Peking Union Medical College Hospital within 2000 to 2015. Twenty-nine cases with AIPA treated by endovascular therapy were enrolled in this study. Twenty five cases were male, range from 23 to 67 years old, mean age was (39.3±11.4) years old.Demographic characters, locations of aneurysms, type to auto-immune disease, immuno medical therapy, operation strategy and long term follow-up data were reported. Statistical analysis was made to verify clinical predictors of long-term MACE. Results: Among the 29 cases, 22 cases with bechet's disease, 4 cases with Takayasu's arteritis, 2 cases with systemic lupus erythematosus, 1 cases with polyarteritis nodosa. Eight cases had ruptured or pending ruptured pesudo-aneurysms, the rest 21 cases had dull pain or no overt symptome. Twenty-four cases had infra-renal artery aneurysms, two were para-and supra-renal artery, two were supra-celiac artery, and the rest one had multiple aneurysms involved thoracic and abdominal aorta.All the cases received regular immune medical therapy except the three emergency cases. All the operations were under general anaesthesia. Nineteen cases underwent classical Endovascular aortic aneurysm repair (EVAR), 5 cases underwent fenestration EVAR, the rest 5 cases underwent hybrid procedure. All the 29 operations were successful, without conversion to open surgery. Major peri-operation complication included 3 incision infection, 3 pulmonary infection. No death occurred. All the cases received regular follow-up from 1 to 120 months. There were five recurrence of pseudo-aneurysm, 1 case suffered from iliac limb occlusion. 5 cases received re-intervention procedure. No occlusion of revascularizal visceral artery was

  7. Exovascular application of epigallocatechin-3-O-gallate-releasing electrospun poly(L-lactide glycolic acid) fiber sheets to reduce intimal hyperplasia in injured abdominal aorta.

    Science.gov (United States)

    Lee, Mi Hee; Kwon, Byeong-ju; Koo, Min-Ah; Jang, Eui Hwa; Seon, Gyeung Mi; Park, Jong-Chul

    2015-09-21

    Intimal hyperplasia is an excessive ingrowth of tissue resulting in chronic structural lesions commonly found at sites of atherosclerotic lesions, arterial angioplasty, vascular graft anastomoses, and other vascular abnormalities. Epigallocatechin-3-O-gallate (EGCG) was shown to elicit antioxidant, anti-proliferative, and anti-thrombogenic effects. In this study, we used an electrospinning technique to synthesize EGCG-eluting biodegradable poly(L-lactide glycolic acid) (PLGA) fiber sheets for local delivery of EGCG and investigated the effect of their exovascular application on intimal hyperplasia following balloon-induced abdominal aorta injury in a rabbit experimental model. The morphology of the composite sheets was characterized using scanning electron microscopy and Fourier transform-infrared spectroscopy. EGCG was loaded and dispersed into the PLGA-based electrospun fibers. The EGCG-loaded PLGA sheets exhibited sustained EGCG release following the initial 24 h of burst release in phosphate-buffered saline. In vivo studies demonstrated significant inhibition of intimal hyperplasia following the application of the EGCG-eluting electrospun PLGA fiber sheets, compared with vehicle PLGA controls. In conclusion, our results show that exovascular application of EGCG-eluting PLGA electrospun fiber sheets may provide a useful system for the effective local delivery of drugs for the prevention of intimal hyperplasia.

  8. Abdominal aortic aneurysm

    Science.gov (United States)

    ... 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 ...

  9. Endovascular abdominal aortic aneurysm repair: surveillance of endoleak using maximum transverse diameter of aorta on non-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Nagayama, Hiroki; Sueyoshi, Eijun; Sakamoto, Ichiro; Uetani, Masataka [Dept. of Radiology, Nagasaki Univ. School of Medicine, Nagasaki (Japan)], E-mail: sueyo@nagasaki-u.ac.jp

    2012-07-15

    Background. Repeat volumetric analysis of abdominal aortic aneurysm (AAA) after endovascular AAA repair (EVAR) is time-consuming and requires advanced processing, dedicated equipment, and skilled operators. Purpose. To clarify the validity of measuring the maximal short-axis diameter (Dmax) of AAA in follow-up non-enhanced axial CT as a means of detecting substantial endoleaks after EVAR. Material and Methods. CT images were retrospectively reviewed in 47 patients (7 women, 40 men; mean age, 76.2 years) who had no endoleak on initial contrast-enhanced CT after EVAR. Regular follow-up CT studies were performed every 6 months. At each CT study, the Dmax on the CT axial image was measured and compared with that on the last CT (115 data-sets). Contrast-enhanced CT was regarded as the standard of reference to decide the presence or absence of endoleaks. The appearance of endoleak was defined as the end point of this study. Results. Endoleaks were detected in 17 patients during the follow-up period. Mean Dmax changes for 6 months were significant between positive and negative endoleak cases (1.8 {+-} 1.9 vs. -1.1 {+-} 3.0 mm, P < 0.0001). When the Dmax change {<=} 0 mm for 6 months was used as the threshold for negative endoleak, the sensitivity, specificity, positive predictive value, and negative predictive value were 74.5, 82.4, 96.1, and 35.9%, respectively. When Dmax change {<=}-1 mm was used as the threshold, the sensitivity, specificity, PPV, and NPV were 38.8, 100, 100, and 22.1%, respectively. Conclusion. Contrast-enhanced CT is not required for the evaluation of endoleaks when the Dmax decreases by at least 1 mm over 6 months after EVAR.

  10. Prevalência e fatores associados à obesidade abdominal em pacientes em hemodiálise em Goiânia - GO

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    Ana Tereza Vaz de Souza Freitas

    2013-12-01

    Full Text Available INTRODUÇÃO: A presença de excesso de peso, especialmente obesidade visceral, contribui para o maior risco de complicações metabólicas e cardiovasculares em pacientes com doença renal crônica. OBJETIVO: Determinar a prevalência e os fatores associados à obesidade abdominal em pacientes em hemodiálise (HD. MÉTODOS: Estudo transversal com 344 pacientes maiores de 18 anos. A obesidade abdominal foi definida pela circunferência da cintura > 94 cm nos homens e > 80 cm nas mulheres. As variáveis independentes envolveram aspectos socioeconômicos, demográficos, hábitos de vida, tempo em HD, consumo alimentar e índice de massa corporal (IMC. A análise dos fatores associados foi realizada por regressão de Poisson múltipla, permanecendo no modelo final as variáveis com p 25 kg/m². Nos homens, a classe econômica D/E também permaneceu associada à obesidade abdominal, p < 0,05. CONCLUSÃO: Observou-se alta prevalência de obesidade abdominal em pacientes em hemodiálise. Idade superior a 40 anos, classes econômicas mais baixas, ingestão proteica inferior ao recomendado e excesso de peso foram associados à obesidade abdominal.

  11. When the diameter of the abdominal aorta should be considered as abnormal? A new ultrasonographic index using the wrist circumference as a body build reference

    Energy Technology Data Exchange (ETDEWEB)

    Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Santagostino, Ilaria, E-mail: isantagostino@hotmail.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20100 Milano (Italy); Di Leo, Giovanni, E-mail: gianni.dileo77@gmail.com [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Piazza, Raffaella; Gozzi, Gino, E-mail: radiologia.como@hsacomo.org [Diagnostica per Immagini, Ospedale Sant’Anna, Via Ravona 1, 22020 San Fermo della Battaglia, Como (Italy); Trimarchi, Santi, E-mail: satrimarchi@gmail.com [Chirurgia Vascolare II, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Sardanelli, Francesco, E-mail: francesco.sardanelli@unimi.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy)

    2013-10-01

    Purpose: To use US to evaluate the normal values of aortic diameter (AD), stratifying the population by age, gender and body build, as measured using wrist circumference (WC). Materials and methods: Between April 2010 and February 2012, consecutive patients ≥ 30 years of age, without history of abdominal aortic aneurysm (AAA) were prospectively enrolled. They underwent an abdominal ultrasonography for reasons other than aorta evaluation. AD was measured at the infrarenal (AD{sub 1}), intermediate (AD{sub 2}), and iliac bifurcation (AD{sub 3}) levels: a diameter ≥ 3 cm was considered as an aneurysm. The maximal aortic diameter (AD{sub max}) was measured for AAA patients. WC was measured; AD/WC ratio was calculated and presented in percentage: the range of normal values was obtained excluding AAA cases and calculated as mean ± 1.96 × standard deviation. Pearson correlation coefficient was used. Results: We recruited 1200 patients, 15 (1.25%; age range = 64–86 years) had AAA. AD ranges of the other patients were: AD{sub 1} = 0.74–1.84 cm, AD{sub 2} = 0.78–1.85 cm, and AD{sub 3} = 0.68–1.76 cm for females; AD{sub 1} = 0.86–2.02 cm, AD{sub 2} = 0.91–2.08 cm, and AD{sub 3} = 0.84–1.95 cm for males. AD{sub 2}/WC ratio of non-AAA patients range was 4–15%, with only one outlier at 18%, while AD{sub max}/WC ratio of AAA patients range was 15–35% (p < 0.001). ADs were significantly correlated with WC (r = 0.253, p < 0.001 for AD{sub 1}, r = 0.318, p < 0.001 for AD{sub 2} and r = 0.280, p < 0.001 for AD{sub 3}). Conclusion: The definition of normal AD should consider body build. An AD{sub 2}/WC ratio of 15% may be regarded as a threshold to differentiate AAA- from non-AAA patients. Patients with AD{sub 2}/WC values comprised between 12% and 15% may be at risk for AAA.

  12. Estudo comparativo entre tratamento endovascular e cirurgia convencional na correção eletiva de aneurisma de aorta abdominal: revisão bibliográfica Endovascular elective treatment of the abdominal aortic aneurysm versus conventional open repair: a comparative study

    Directory of Open Access Journals (Sweden)

    Ana Carolina P. Simão

    2009-12-01

    Full Text Available O tratamento eletivo do aneurisma de aorta abdominal é recomendado pela alta morbiletalidade decorrente da eventual ruptura. O objetivo deste trabalho foi comparar o reparo endovascular eletivo com a cirurgia aberta e avaliar as mortalidades hospitalar e perioperatória, em 1 ano, por todas as causas e relacionadas ao aneurisma, a permanência hospitalar, as complicações, as taxas de sobrevida, conversão e reintervenção, a durabilidade do enxerto, o custo-benefício e a relação desses dados com o treinamento da equipe médica responsável pelo tratamento. Realizou-se uma revisão da literatura sobre reparo endovascular versus cirurgia convencional. Foram observados vantagem na sobrevivência perioperatória e menor estresse pós-cirúrgico; no entanto, os benefícios iniciais são perdidos por complicações e reintervenções tardias. Trabalhos baseados nas primeiras gerações de endopróteses superestimam as taxas de mortalidade em curto prazo, complicações e reintervenções. A durabilidade do enxerto, a real vantagem na sobrevida e o custo-benefício são incertos, e outros estudos são necessários para o seguimento em longo prazo.The elective treatment of the abdominal aortic aneurysm is recommended due to the high morbidity and mortality of a possible rupture. The objective of this study was to compare the elective endovascular aneurysm repair with open repair and to analyze the in-hospital and perioperative mortality rate during 1 year related to all causes and to the aneurysm, as well as the postoperative length of hospital stay, complications, survival rates, conversion and reintervention, graft durability, cost-benefit ratio, and relation with the medical team’s experience. A review of the scientific literature about endovascular versus open repair was carried out. We found a higher rate of perioperative survival and less postoperative stress; nevertheless, the initial benefits were lost due to late complications and

  13. A natação forçada induz subsensibilidade à fenilefrina em aorta torácica de rato Forced-swim induces subsensitivity to phenylephrine in the rat thoracic aorta

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    Maria José C. Sampaio Moura

    2003-12-01

    Full Text Available O estresse pode alterar a função vascular. O objetivo deste trabalho foi estudar a sensibilidade à fenilefrina (FE em aorta torácica de ratos submetidos à natação forçada. Ratos Wistar (200-250 g foram submetidos a três sessões de natação aplicadas em dias consecutivos (15, 30 e 30 min respectivamente. Imediatamente após a última sessão, os animais foram sacrificados e, da aorta torácica foram obtidos anéis (3-5 mm com e sem endotélio. Os anéis foram mantidos em solução de Krebs-Henseleit (37 ºC; 95% O2-5% CO2. A integridade do endotélio foi avaliada pelo relaxamento em resposta à acetilcolina (10 µM, após indução de contração por FE (0,1 µM. Curvas concentração-efeito à FE foram obtidas (n=5/grupo. Não houve diferença na resposta máxima à FE entre os tratamentos controle e estresse, em anéis com e sem endotélio (p>0,05. A natação forçada induziu subsensibilidade à FE em anéis com endotélio de aorta torácica isolada de ratos submetidos à natação (pD2= 6,89 ± 0,07, pStress may change vascular function. The aim of this report was to study the sensitivity to phenylephrine (PHE in the thoracic aorta from rats submitted to forced-swim. Male Wistar rats (200-250 g were submitted to three swimming sessions, one session/day (15, 30 and 30 min, respectively. Immediately after the last swimming session, the animals were sacrificed and thoracic aorta was isolated. Aortic rings (3-5 mm, with and without endothelium, were carefully obtained and were main-tained in Krebs-Henseleit solution (95% O2- 5% CO2, 37 ºC. Endothelial integrity was assessed by relaxation to acetylcholine (10 µM in pre-contracted rings (PHE 0.1 µM. Concentration-effect curves to PHE were obtained (n = 5/group. There was no difference between control and stress groups in the maximum response to PHE of aortic rings with and without endothelium (p>0.05. Forced-swim induced subsensitivity to PHE in aortic rings with endothelium isolated

  14. Efeitos a curto prazo de "stents" não recobertos e recobertos com politetrafluoroetileno em aorta de suínos: um modelo experimental Short-term effects of polytetrafluoroethylene covered and uncovered metallic "stents" in pig aorta: an experimental model

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Grüdtner

    2004-04-01

    Full Text Available OBJETIVO: Descrever um estudo experimental avaliando através da morfometria digital o espessamento intimal na parede arterial após o implante de "stents" metálicos auto-expansíveis recobertos ou não com politetrafluoroetileno (PTFE na aorta de suínos. MÉTODOS: Em três grupos de suínos jovens uma bainha introdutora de 12 F foi inserida na aorta abdominal distal. Os animais do grupo I (n=5 foram considerados controle. Os animais do grupo II (n=10 receberam o implante de um stent metálico auto-expansível não recoberto. No grupo III (n=10 um stent auto-expansível recoberto com PTFE foi inserido. Após quatro semanas os animais foram sacrificados e os espécimes arteriais foram retirados, sendo o espessamento intimal quantificado pela análise morfométrica. RESULTADOS: Na comparação entre os grupos I, II e III quanto às áreas da íntima, média e índice intimal, não foi observada variação estatisticamente significativa. Diferenças foram observadas entre os grupos em relação às áreas luminais proximais (p=0,0036 e distais (p=0,044. Através dos testes de comparação múltipla para Kruskal-Wallis foi identificada uma diferença entre os grupos I e II. Entretanto, quando essas variáveis foram controladas pelo fator peso (relação área luminal/peso, a diferença não foi mais observada. CONCLUSÕES: Nesse estudo a curto prazo, o revestimento de PTFE não esteve associado a adicional espessamento intimal além daquele promovido pelo dispositivo metálico em artérias de grande calibre e condições de alto fluxo.PURPOSE: To report an experimental study evaluating, through digital morphometry, the intimal thickening of the arterial wall after the implant of auto-expandable stainless steel stents covered or not with polytetrafluoroethylene (PTFE in the pig aorta. METHODS: In three groups of pigs a 12 F sheath was inserted in distal abdominal aorta. Group I animals (n=5 served as control. Group II animals (n=10 received an auto

  15. Tratamento endovascular em paciente portador de coarctação da aorta: relato de caso Endovascular treatment in a patient with aortic coarctation: case report

    Directory of Open Access Journals (Sweden)

    Eugênio Carlos Almeida Tinoco

    2007-03-01

    Full Text Available Coarctação da aorta constitui um estreitamento de origem congênita na porção inicial da aorta torácica. Tem incidência de 6 a 8% em nascidos vivos. A apresentação clínica é variada. O tratamento de escolha é o cirúrgico. Relatamos um caso de paciente do sexo feminino de 31 anos, com queixa de dor constrictiva na região cervical, dispnéia e claudicação intermitente em membros inferiores, sendo diagnosticada coarctação da aorta associada a estenose aórtica grave, que foi tratada com combinação das técnicas implantação de stent endovascular e angioplastia por balão.Aortic coarctation is a congenital stenosis in the initial portion of the thoracic aorta. Its incidence ranges between 6-8% of liveborns. Clinical presentations are diversified. The treatment of choice is surgery. We report the case of a 31-year-old female patient with constrictive pain in the cervical region, dyspnea, and intermittent claudication of the lower limbs. She was diagnosed with aortic coarctation associated with severe aortic stenosis, which was treated using a combination of endovascular stent implantation and balloon angioplasty.

  16. Influencia de la geometría de aneurismas de aorta abdominal en la dinámica del flujo sanguíneo y en su riesgo de ruptura

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    G. Vilalta

    2009-05-01

    Full Text Available La ruptura de aneurisma de aorta abdominal (AAA representa un evento clínico muy importante, con una tasa de mortalidad relativamente elevada. En un esfuerzo por aumentar la comprensión sobre este complejo fenómeno, en el presente trabajo se estudia la influencia de la geometría de los aneurismas de aorta abdominal en el riesgo de ruptura. Para esto se ha utilizado un modelo geométrico realista, obtenido por la transformación de imágenes 2D de tomografía computarizada (CT, sometido a un flujo pulsátil fisiológicamente realista, con el objetivo de evaluar e identificar las regiones donde ocurren las principales perturbaciones en los patrones de flujo, cómo ésta modifica los campos de velocidades y de tensiones hemodinámicas en el interior del saco aneurismático, así como la influencia de los diferentes factores biomécanicos relacionados con la geometría que caracterizan el aneurisma. Se presenta una explicación de las modificaciones de las estructuras vorticales y de la distribución de tensiones durante el ciclo cardíaco. Igualmente se determina un indicador numérico (Parámetro de Severidad que integra los 3 factores biomecánicos geométricos y que permite evaluar el riesgo de ruptura del aneurisma para un estado de desarrollo determinado. Los resultados confirman que la asimetría de los aneurismas de aorta abdominal es uno de los principales factores que influyen en su ruptura.The rupture of abdominal aortic aneurysm (AAA represents an important clinical event, with a relatively high mortality rate. In an effort to increase understanding about this complex phenomenon, this paper studies the influence of abdominal aortic aneurysms geometry on the risk of rupture. Patient specific AAA model, created by 2D reconstruction of computed tomography image, was used to identify regions of disturbed patterns flow and how it modifies the velocity field and hemodynamic stress on the inside of the aneurysmatic sac as well as the

  17. Desarrollo de un modelo predictivo de mortalidad a largo plazo y complicaciones relacionadas con la endoprótesis, en la reparacion endovascular de aneurismas de aorta abdominal infrarrenal

    OpenAIRE

    Gómez Palonés, Francisco Julián

    2015-01-01

    Desde el inicio de la reparación endovascular de aneurismas de aorta abdominal infra renal, la progresión de dicho tratamiento ha superado en numero al realizado anualmente mediante cirugía abierta convencional, en la mayoría de servicios de Cirugía Vascular. A ello ha contribuido principalmente la menor mortalidad operatoria los 30 días y al atractivo que supone para pacientes un procedimiento menos agresivo y para los profesionales, el ofrecer una alternativa en casos en los que la cirugía...

  18. Pressão intra-abdominal em cães

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    Ronald Paiva M. Gonçalves

    2011-09-01

    Full Text Available Sob consenso recente em pacientes humanos, os valores basais da pressão intra-abdominal (PIA e seus prováveis limiares em casos mórbidos, foram estipulados com intuito de favorecer a homogeneidade de estudos científicos, além de fornecer diretrizes para conduta diagnóstica e terapêutica destes pacientes. Valores basais e alterações na pressão intra-abdominal em animais não são ainda suficientemente conhecidos e cientificamente determinados. Médicos veterinários necessitam conhecer melhor os estados mórbidos que cursam com Hipertensão Intra-Abdominal (HIA ou Síndrome de Compartimento Abdominal (SCA. O presente estudo objetivou testar em cães a técnica já descrita sob consenso na medicina como modelo de mensuração da pressão intra-abdominal, assim como determinar os valores normais para a espécie. Foram utilizados 15 cães hígidos, machos e fêmeas, homogêneos e todos sem raça definida. A mensuração da pressão intra-abdominal foi realizada por meio da técnica indireta de sondagem vesical e utilização de coluna de água com régua graduada em cm de H2O, sendo seu valor final convertido para a unidade de mm de Hg. Foi observado valor mínimo subatmosférico (abaixo de zero mm de Hg até o valor máximo de 3,75 mmHg. Houve importante variação entre os valores encontrados individualmente em determinados cães, colocando sob discussão questões como massa corporal, freqüência/volume total de solução fisiológica a ser infundida e agitação destes pacientes no momento do exame. Os valores limítrofes encontrados são considerados fisiológicos, indicando confiabilidade da técnica e possibilidade do seu emprego clínico. A ausência de sedação e utilização de sonda uretral não inviabilizou a realização da mensuração, porém podendo culminar numa sub ou superestimativa dos valores encontrados.

  19. Cardiovascular effects of simultaneous occlusion of the inferior vena cava and aorta in patients treated with hypoxic abdominal perfusion for chemotherapy

    NARCIS (Netherlands)

    J. Hofland (Johannes); R. Tenbrinck (Robert); M.G.A. van IJken (Marc); C.H.J. van Eijck (Casper); A.M.M. Eggermont (Alexander); W. Erdmann (Wilhelm)

    2002-01-01

    textabstractBACKGROUND: Animal studies suggest less cardiovascular disturbance if the aorta and vena cava are occluded simultaneously. We set out to establish the effects of simultaneous clamping in humans, because oncologists suggested that perfusion for chemotherapy could be done

  20. Surgery for adult coarctation with the ascending-abdominal aorta bypass procedure%升主动脉-腹主动脉转流术治疗成人主动脉缩窄

    Institute of Scientific and Technical Information of China (English)

    刘巍; 孙立忠; 王晓龙; 程卫平; 朱俊明; 刘永民; 陈雷; 乔志钰; 里程楠

    2011-01-01

    Objective To explore the surgical effects and follow-up results in treating adult aortic coarctation patients using ascending aorta-abdominal aorta vascular prosthesis bypass and summarize the clinical experiences. Methods From May 2008 to July 2009, ascending aorta-abdominal aorta vascular prosthesis bypass surgery was performed in nine patients with adult aortic coarctation, among which, four were male, and five were female, with the average age of 42.6 years old. All patients had upper extremity hypertension, the systolic blood pressure difference between their upper extremities and lower extremities was 55 - 100 mm Hg, mean (70.2 ± 15. 6) mm Hg. Among which, seven cases showed descending aorta aneurysmal dilatation at coarctation segment distal end, with the wall thinning; two cases showed long segment stenosis; three cases showed aortic wall near coarctation segment was calcified. All cases belonged to complex aortic coarctation. All patients underwent radial artery and dorsalis pedis artery puncture manometry, the surgical effects were evaluated according to mean pressure difference changes between radial artery and dorsalis pedis artery before and after operations. Results All patients were cured and dispertension has been significantly improved, before operation, the mean pressure difference between radial artery and dorsalis pedis artery was 36 - 63 mm Hg, mean [(48.2 ± 5.6 ) mm Hg]; 24 hours after operation, the mean pressure difference between radial artery and dorsalis pedis artery was 0 - 13 mm Hg, mean [(6.2 ± 1.6) mm Hg], significantly reduced ( P <per extremity hypertension disappeared, no need for oral antihypertensive drugs, the mean pressure differences between upper extremities and lower extremities after operations were all less than 20 mm Hg, thoracoabodominal aorta main vessels multi-slice CT examination three months after operation showed that bypass vascular prosthesis was unobetructed, two cases showed that autologous artery at aortic

  1. A distensibilidade da aorta prediz o acidente vascular cerebral em pacientes hipertensos

    OpenAIRE

    Telmo Pereira; João Maldonado; Liliana Pereira; Jorge Conde

    2013-01-01

    FUNDAMENTO: A doença cardiovascular continua a ser principal causa de morte nos países desenvolvidos e não é inteiramente prevista por fatores de risco clássicos. O aumento da rigidez arterial constitui um importante determinante de morbidade e mortalidade cardiovascular. OBJETIVO: Avaliar se a velocidade da onda de pulso prediz a ocorrência de acidente vascular cerebral (AVC) em pacientes hipertensos. MÉTODOS: Estudo de coorte, observacional, prospetivo, multicêntrico, incluindo 1.133 pacien...

  2. 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

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    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

  3. The culture and detection of nanobacteria in abdominal aorta atherosclerotic plaque%腹主动脉粥样硬化斑块中纳米细菌的培养与鉴定

    Institute of Scientific and Technical Information of China (English)

    耿文茂; 张倩; 吴亚光; 秦成坤; 苏忠学

    2012-01-01

    目的 观察腹主动脉粥样硬化斑块中是否存在纳米细菌,并对其进行鉴定.方法 12例腹主动脉粥样硬化斑块及12例正常动脉血管组织研磨,取上清液培养.8周后收集培养瓶底白色粉末,用纳米细菌单克隆抗体间接免疫荧光法对其进行检测,并利用电镜进一步观察.结果 12例动脉粥样硬化斑块中10例纳米细菌检测阳性,2例阴性,12例正常动脉血管组织中1例纳米细菌检测阳性,11例阴性,差异有统计学意义(P<0.05).纳米细菌单克隆抗体间接免疫荧光检测时可发出绿色荧光,电镜下测量纳米细菌直径约为100 ~ 300 nm.结论 腹主动脉粥样硬化斑块中存在纳米细菌,它可能导致粥样硬化斑块不稳定.%Objective To investigate whether the nanobacteria exists in abdominal aorta atherosclerotic plaque or not and detect it.Methods 12 case of abdominal aorta atherosclerotic plaques and 12 case of normal artery were grinded,the supematant fluid was cultured for eight weeks.Subsequently,the white extract from the culture flask was detected by nanobacteria monoclonal antibody immunofluorescence and electron microscope.Results Nanobacteria was positive in 10 case of atherosclerotic plaques but only in 1 case of normal artery,the difference was statistically significant (P < 0.05).Green fluorescence could be present during indirect immunofluorescence detection.The size of nanobacreria was measured ranging from 100nm to 300nm by electron microscope analysis.Conclusion Nanobacteria was detected in abdominal aorta atherosclerotic plaques and might led to atherosclerotic plaques instability.

  4. Avaliação da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia

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    Taveira Marcos Roberto

    2001-01-01

    Full Text Available Objetivo: verificar se existe correlação significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realização de transfusões intra-uterinas pela via intravascular (66,7%. Nos fetos que foram submetidos à transfusão intra-uterina pela via intraperitoneal, ou naqueles casos em que não houve necessidade de tratamento intra-uterino (33,3%, a determinação da concentração de hemoglobina do cordão foi realizada pela punção do cordão umbilical, no momento da interrupção da gestação. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associação entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlação significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL, com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL, com um valor de p=0,01. Conclusões: houve associação significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.

  5. Effect of Xuebijing injection on cardiac muscle in the rats undergoing abdominal aorta clamping with sepsis%血必净对腹主动脉阻断合并脓毒症大鼠心肌的影响

    Institute of Scientific and Technical Information of China (English)

    夏文芳; 周青山; 徐洁

    2014-01-01

    Objective It is to observe the protecting effect of Xuebijing injection (XBJ) on cardiac muscle in the rats un-dergoing abdominal aorta clamping complicating with sepsis .Methods 32 Wistar rats were randomly divided into control group (S group), abdominal aorta clamping complicating with sepsis group (I/R+LPS group), Xuebijing injection group (XBJ group ) .The rats in XBJ group were pretreated with XBJ 30 min before abdominal aorta separated , 8 mL/kg by caudal vein in-jection, in 2 h after abdominal aorta ischemia reperfusion injury , they were given LPS20 mg/kg by intraperitoneal injection . All the animals were killed in 8 h after abdominal aorta blocking , and their cardiac tissue was gotten to do HE staining to ob-serve pathological damage , the expression of TNF -αandβ2 adrenoreceptor ( AR) in the tissue was detected by immunohisto-chemistry technique .Results①Cardiac tissue pathology results showed that: no obvious pathological change was found in S group;In I/R+LPS group myocardial cells were swelling with wider intermuscular space , little blood vessel was obviously hy-peremia with agglutination of many red blood cells which were also leaked much in the space , myocardial fibers were degenera-tion and necrosis , many inflammatory cells gathered in the space , even the structure was indistinct in cardiac tissue;In XBJ group , myocardial tissue was disorder in which the cells were slight swelling , and less leak of red blood cells and infiltration of inflammatory cells in the space was found .②Immunohistochemistry detection results showed that the expression of TNF -ɑin cardiac cells:S groupXBJ group>I/R+LPS group, the difference between S group and I/R+LPS group was significant but not in XBJ group compared with the other two groups .Conclusion XBJ pretreatment has some protecting effect on early myocardial injury in the rats undergoing abdominal aorta clamping complicating with sepsis , it can decrease the expression of TNF-αwith no obvious effect

  6. [Acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult - 2014 AS SMC Guidelines on the classification and diagnosis of aortic diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít

    2015-01-01

    In addition to organovascular arterial ischemic diseases (cardiovascular, vasculovascular, neurovascular, extre-mitovascular, renovascular, genitovascular, bronchopulmovascular, mesenteriovascular, osteoarthromusculovascular, dermovascular, oculovascular, otovascular, stomatovascular etc.), aortic diseases contribute to the wide spectrum of arterial diseases: aortic aneurysms (AA), acute aortic syndromes (AAS) including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerosis, vasculitis as well as genetic diseases (e.g. Turner syndrome, Marfan syndrome, Ehlers-Danlos syndrome) and congenital abnormalities including the coarctation of the aorta (CoA). Similarly to other arterial diseases, aortic diseases may be diagnosed after a long period of subclinical development or they may have an acute presentation. Acute aortic syndrome is often the first sign of the disease, which needs rapid diagnosis and decisionmaking to reduce the extremely poor prognosis. Key clinical-etiology-anatomy-patophysiology (CEAP) diagnostic aspects of aortic diseases are discussed in this document (project Vessels).

  7. Prevalência de obesidade abdominal em hipertensos cadastrados em uma Unidade de Saúde da Família Prevalence of abdominal obesity in hypertensive patients registered in a Family Health Unit

    Directory of Open Access Journals (Sweden)

    Edmarlon Girotto

    2010-06-01

    Full Text Available FUNDAMENTO: A obesidade abdominal é importante fator de risco cardiovascular e, juntamente com as dislipidemias, a intolerância a glicose e a hipertensão arterial, compõe a síndrome metabólica. OBJETIVO: Verificar a prevalência de obesidade abdominal e fatores associados em hipertensos. MÉTODOS: Estudo transversal com hipertensos de 20 a 79 anos cadastrados em uma Unidade Saúde da Família do município de Londrina, Paraná. A obesidade abdominal foi identificada por meio da relação cintura-quadril (RCQ e da circunferência abdominal (CA, conforme pontos de corte recomendados pela Organização Mundial de Saúde (RCQ > 1,0 e CA > 102 cm para homens, e RCQ > 0,85 e CA > 88 cm para mulheres. RESULTADOS: Entre os 378 entrevistados, a prevalência de obesidade abdominal identificada pela RCQ foi de 65,3% nos adultos e 68,1% nos idosos, sendo de 87,9% no sexo feminino e de 30,2% no masculino (p BACKGROUND: Abdominal obesity is an important cardiovascular risk factor and, along with dyslipidemia, impaired glucose tolerance and hypertension, it makes up the metabolic syndrome. OBJECTIVE: To investigate the prevalence of abdominal obesity and associated factors in hypertensive patients. METHODS: Cross-sectional study with hypertensive patients aged 20 to 79 registered in a Family Health Unit in the city of Londrina, Paraná. Abdominal obesity was found through waist-hip ratio (WHR and waist circumference (WC according to the cutoff points recommended by the World Health Organization (WHR > 1.0 and > WC 102 cm for men and WHR > WC 0.85 and > 88 cm for women. RESULTS: Among 378 respondents, the prevalence of abdominal obesity determined by WHR was 65.3% in adults and 68.1% in the elderly, and 87.9% in females and 30.2% in males (p <0.001. In women, WHR was associated with reports of high cholesterol, failure to perform regular physical activity, lack of paid work and low education. There was no association of WHR with any variables in males

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

    Science.gov (United States)

    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.

  9. Prevalência e fatores associados à obesidade abdominal em adolescentes Prevalencia y factores asociados a la obesidad abdominal en adolescentes Prevalence of abdominal obesity and associated factors in adolescents

    Directory of Open Access Journals (Sweden)

    Marcelo Romanzini

    2011-12-01

    Full Text Available OBJETIVO: Verificar a prevalência de obesidade abdominal e sua associação com fatores demográficos, econômicos e estilo de vida em adolescentes. MÉTODOS: Estudo transversal conduzido em 644 adolescentes (397 do sexo feminino e 247 do masculino, de 15 a 19 anos. Foram coletadas informações demográficas (sexo e idade, econômicas (nível econômico e comportamentais (atividade física, alimentação, tabagismo e etilismo. A obesidade abdominal (desfecho foi determinada com base em pontos de corte para a circunferência de cintura, específicos ao sexo e à idade. A análise multivariada foi realizada por meio de regressão logística, estimando-se Odds Ratios (OR brutas e ajustadas, com intervalo de confiança de 95%. RESULTADOS: A prevalência de obesidade abdominal foi de 7,5%. Adolescentes do sexo masculino (OR 2,34; IC95% 1,27-4,32, de nível econômico intermediário (OR 2,89; IC95% 1,35-6,19 e alto (OR 2,98; IC95% 1,31-6,77 e que consumiam bebida alcoólica de forma abusiva (OR 2,12; IC95% 1,10-4,09 apresentaram maior chance de possuírem obesidade abdominal. CONCLUSÕES: A prevalência de obesidade abdominal foi baixa em comparação aos estudos internacionais. Ademais, encontrou-se que o sexo, o nível econômico e o consumo abusivo de álcool se associaram à obesidade abdominal.OBJETIVO: Verificar la prevalencia de obesidad abdominal y su asociación con factores demográficos, económicos y estilo de vida en adolescentes. MÉTODOS: Estudio transversal conducido en 644 adolescentes (397 del sexo masculino y 247 del femenino de 15 a 18 años. Se recogieron informaciones demográficas (sexo, edad, económicas (nivel económico y comportamentales (actividad física, alimentación, tabaquismo, alcoholismo. La obesidad abdominal (desfecho fue determinada con base en puntos de corte para la circunferencia de la cintura, específicos al sexo y la edad. El análisis multivariado se realizó mediante regresión logística, estimando

  10. Treatment of infrarenal abdominal aortic dissection concomitant with an aneurysm

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; ZHU Ting; FU Wei-guo; WANG Yu-qi; XI Xun; GUO Da-qiao; CHEN Bin; JIANG Jun-hao; YANG Ju; SHI Zhen-yu

    2007-01-01

    @@ Aortic dissection occurs when layers of the aortic walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta (70%), followed by the descending aorta (22%), the aortic arch (7%) and the abdominal aorta (1/%).1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection (IAAD) concomitant with an abdominal aortic aneurysm (AAA) is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.

  11. Multiple tuberculous aneurysms of the aorta.

    Science.gov (United States)

    Pierret, Charles; Tourtier, Jean-Pierre; Grand, Bertrand; Boddaert, Guillaume; Laurian, Claude; de Kerangal, Xavier

    2011-06-01

    Tuberculous aneurysms of the aorta are quite rare, but are exceptional when found in multiple locations. We report the case of multiple tuberculous aortic aneurysms of the thoracic and abdominal aorta in a 19-year-old female discovered when she consulted for thrombocytopenic purpura. The treatment for both locations included prolonged antituberculous therapy and surgical resection with cryopreserved aortic allograft patch for the reconstruction.

  12. Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus Aneurisma roto da aorta descendente em paciente com lúpus eritematoso sistêmico

    Directory of Open Access Journals (Sweden)

    Daniel Oliveira De Conti

    2011-03-01

    Full Text Available It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative period.Paciente de 25 anos, do sexo feminino, portadora de lúpus eritematoso sistêmico, fazendo uso de corticoesteroide havia 19 anos, deu entrada em unidade de emergência com aneurisma roto de aorta torácica descendente. Foi submetida a tratamento endovascular com 2 stents, recebeu alta hospitalar no 13º dia de pós-operatório, em boas condições de saúde. Três meses depois, retornou em choque hemorrágico secundário a hemorragia digestiva alta. Feito o diagnóstico de fístula aorto-esofágica, foi submetida à cirurgia aberta de emergência, indo a óbito durante o período pós-operatório.

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Anestesia para cesariana em gestante com hipoplasia de aorta distal: relato de caso Anestesia para cesárea en embarazada con hipoplasia de aorta distal: relato de caso Anesthesia for cesarean section on a pregnant woman with hypoplasia of the distal aorta: case report

    Directory of Open Access Journals (Sweden)

    Leonardo de Andrade Reis

    2008-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Anomalias vasculares maternas, potencialmente graves para o feto, podem colocar em risco a perfusão uterina, suscitando cuidados ainda maiores por parte da equipe anestésica. O objetivo deste relato foi mostrar a conduta anestésica para operação cesariana em uma gestante com hipoplasia de aorta distal, logo abaixo da emergência das artérias renais, com estenose da artéria renal e ausência de artérias ilíacas. RELATO DO CASO: Paciente de 30 anos, 54 kg, na segunda gestação com uma cesariana anterior sem intercorrências. Durante a realização de ecografia gestacional na 12ª semana observou-se interrupção da aorta logo abaixo da saída das artérias renais. A paciente foi encaminhada para a realização de cineangiocoronariografia que mostrou hipoplasia da aorta distal abaixo das artérias renais, com ausência das artérias ilíacas. Durante a investigação clínica a paciente mostrou-se assintomática, com exceção de hipertensão arterial e claudicação aos grandes esforços. A paciente foi submetida à anestesia peridural contínua, com titulação da dose anestésica necessária à realização da cesariana. Inicialmente foram injetados 50 mg de bupivacaína a 0,5% sem vasoconstritor e 10 µg de sufentanil. Quinze minutos após, a anestesia foi complementada com mais 25 mg de bupivacaína a 0,5%, o que foi suficiente para atingir adequado nível de bloqueio. A cesariana transcorreu sem intercorrências e a criança nasceu em boas condições clínicas. CONCLUSÕES: O uso de anestesia peridural contínua com doses fracionadas demonstrou ser uma técnica anestésica segura para a realização desse procedimento por reduzir os riscos de hipotensão arterial materna inerente ao bloqueio espinal e também por minimizar a transferência placentária de fármacos, que ocorrem quando do emprego da anestesia geral. A titulação de fármacos através do cateter peridural possibilitou atingir nível anest

  15. Plaque of atherosclerosis in aorta: review on atherogenesis, formation of plaque, clinical significance, methods of imaging and treatment; Placa de aterosclerose em aorta: revisao sobre aterogenese, formacao de placa, significado clinco, metodos de imagens e tratamento

    Energy Technology Data Exchange (ETDEWEB)

    Furtado, Rogerio Gomes; Nunes, Colandy G. de Oliveira; Rassi Junior, Luis; Melato, Luciano Henrique; Turco, Fabio de Paula; Borges, Moises Marcos, E-mail: rogerinhofurtado@gmail.com [Centro de Diagnostico por Imagem (CDI), Goiania, GO (Brazil); Sara, Leonardo [Instituto do Coracao (InCor/FM/USP), Sao Paulo, SP (Brazil)

    2009-04-15

    There is a certain consensus in the literature that the earliest stage of atherogenesis is characterized by the accumulation of spongy cells in the region of the intimal artery. Risk factors such as arterial hypertension, smoking, diabetes mellitus, hypercholesterolemia, male gender and advanced age predispose a person to the formation of plaques in the coronaries and aorta. A greater number of acute coronary events as well as strokes have been observed in people with these risk factors. Strokes are the third cause of death in the USA, with about 40% of the cases being of cryptogenic origin. Since 1989 the atheroma plaques which develop in the thoracic aorta have been considered to be responsible for cerebral and peripheral strokes which were previously considered cryptogenic because imaging techniques such as electrocardiogram transesophageal, computerized tomogram, nuclear magnetic angio-resonance have visualized and characterized the lesions with plaques of arteriosclerosis in the thoracic aorta. The authors of this article made a systematic review in the PUBMED about arteriosclerosis in the aorta and its diagnostic methods. This review includes the physiopathology of the formation of atheroma to the aorta and its consequences, diagnostic methods such as echo transesophageal, computerized tomogram and angio resonance, as well as the advantages and disadvantages of each method of identification of the lesions. An analysis of the clinical significance of the size, form and location of the atheroma plaques in the thoracic aorta were made based on clinical studies, as well as their treatment with anticoagulants, antiplatelet and drugs to reduce cholesterol. (author)

  16. The role of imaging in the transluminal treatment of abdominal aortic aneurysm; Trattamento transluminare degli aneurismi dell'aorta addominale

    Energy Technology Data Exchange (ETDEWEB)

    Meregaglia, D.R.; Piglionica, M.R.; Ferrari, S.; Strada, M.; Deleo, G.; Biasi, G.M. [Ospedale E. Bassini. Azienda Ospedaliera S. Gerardo. Divisione e Cattedra di Chirurgia Vascolare, Monza (Italy); Pavlidis, P. [Red Cross Hospital. Divisione di Chirurgia Vascolare, Athens (Greece)

    1999-03-01

    The authors emphasized the importance of diagnostic imaging: a) in the selection of patients to be treated with the transluminal approach; b) during stent-graft positioning; c) in the follow-up of treated patients. Diagnostic imaging plays a basic role in the endovascular treatment of abdominal aortic aneurysm (AAA), much more than that required for traditional surgical treatment. In particular, pretreatment planning is critical and requires sophisticated imaging, including Spiral CT with 3D reconstruction and angiographic evaluation using catheters with calibrated markers. [Italian] Gli autori intendono evidenziare il ruolo svolto dalla diagnostica per immagini nella selezione dei pazienti candidati all'intevento endovascolare nell'asserire il corretto posizionamento dell'endoprotesi e nei controlli. La diagnostica per immagini ha un ruolo fondamentale nel trattamento endovascolare degli aneurismi aortici, ruolo nettamente amplificati rispetto a quanto richiesto dal trattamento chirurgico tradizionale. In particolare critico e' il lo studio preoperatorio che necessita di metodiche diagnostiche sofisticate come la TC spirale con ricostruzione volumetrica e l'angiografia digitale con catetere centimetrato.

  17. Diagnóstico pouco frequente de dor abdominal em unidade de emergência infantil Unusual diagnosis of abdominal pain in pediatric emergency unit

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    Suelen Bianca S. Martins

    2010-06-01

    Full Text Available OBJETIVO: Relatar um caso de doença péptica na infância em escolar, com queixa inicial de dor abdominal aguda e palidez. DESCRIÇÃO DO CASO: Escolar de nove anos procurou pronto-socorro infantil com queixa de dor abdominal súbita e palidez. Não apresentava outros sintomas ou sinais ao exame físico além de mucosas descoradas e hemograma com nível baixo de hemoglobina. Durante a observação intra-hospitalar, apresentou episódio de melena. Foi realizada endoscopia digestiva alta, sendo observadas gastrite erosiva de antro e úlcera duodenal, com Helicobacter pylori positivo. O paciente foi tratado com esquema tríplice (inibidor de bomba de prótons e dois antimicrobianos por uma semana e, posteriormente, acompanhado ambulatorialmente. COMENTÁRIOS: O caso em questão descreve uma doença rara em unidade de emergência pediátrica. O paciente referia dor abdominal e observou-se palidez confirmada por baixo nível de hemoglobina, que se manteve nos exames subsequentes durante a observação no pronto-socorro infantil, dificultando o diagnóstico de sangramento ativo. Porém, a presença de melena na evolução facilitou e propiciou a condução do caso para se chegar à hipótese de sangramento digestivo alto. Realizada endoscopia digestiva alta, que confirmou o diagnóstico de gastrite erosiva de antro e úlcera duodenal H. pylori positiva, sendo, então, necessário tratamento específico, inclusive para erradicação da bactéria.OBJECTIVE: To report a case of peptic disease in a school child whose first symptoms were acute abdominal pain and paleness. CASE DESCRIPTION: A nine-year-old school child presented to a pediatric emergency unit with acute abdominal pain and sudden pallor. There were no other symptoms or signs on physical examination, except for discolored mucous and a low hemoglobin level. During hospital observation he presented one episode of melena. The esophagogastroduodenoscopy showed erosive antrum gastritis and

  18. Mesenteric thrombosis in patient victim of blunt abdominal trauma Trombose mesentérica em vítima de trauma abdominal fechado

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    Iwan Augusto Collaço

    2008-06-01

    Full Text Available INTRODUCTION: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when associated to low perfusion and hemorrhagic shock. Usually presents a challenging diagnosis and high mortality rates, despite appropriate treatment. OBJECTIVE: To relate a case of a car accident and blunt abdominal trauma with terminal ileum and right colon necrosis. CASE REPORT: After initial procedures, complementary exams showed ribs and humerus fractures. Computerized tomography evidenced aerial distension in small bowel, gastric stasis and hidro-pneumothorax. Hypotension was observed during clinical observation followed by cardiopulmonary arrest, responding to reanimation. At surgery, it was found extensive necrosis of right colon and terminal ileum, and an ileum-transversostomy was performed with primary anastomosis. During the staying in intensive care unit, oliguria, miosis, convulsion and pulseless electric activity happened with death in three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to blunt abdominal trauma and must be considered in a bad abdominal evolution.INTRODUÇÃO: Trombose mesentérica, relacionada à trauma é entidade incomum com pobre prognóstico quando seguida de estados de baixo fluxo e choque hipovolêmico. Geralmente se apresenta com quadro de difícil diagnóstico, mortalidade elevada a despeito de tratamento adequado. OBJETIVO: Apresentar um caso de vítima de atropelamento que evoluiu com necrose de cólon direito e íleo terminal. RELATO DO CASO: Após admissão hospitalar e atendimento inicial, os exames complementares mostraram fratura de costela e úmero. Tomografia computadorizada evidenciou distensão aérea em intestino delgado associada à estase gástrica e hidropneumotórax. O paciente evoluiu com hipotensão durante o período de observação clínica, com parada cardiorespiratória, respondendo à reanimação. Levado

  19. Correção cirúrgica de aneurismas da aorta torácica por técnica de exclusão Surgical correction of aneurysms of the thoracic aorta using the aneurysmal exclusion technique

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    Bayard Gontijo Filho

    1988-04-01

    Full Text Available São apresentados 14 pacientes portadores de aneurisma da aorta torácica (4 do arco aórtico e 10 da aorta descendente, com importantes complicações pré-operatórias, que foram submetidos a correção cirúrgica através de técnica de exclusão da área aneurismática. Esta exclusão foi realizada através de um desvio extra-anatômico entre a aorta ascendente e a aorta abdominal, associado a ligadura da aorta, acima e abaixo do aneurisma. Em 5 pacientes, esta ligadura foi realizada com uso de suturas mecânicas (stapler. Houve 6 (42,8% óbitos no período pós-operatório, quase todos relacionados a grave condição clínica pré-operatória, em pacientes portadores de discussão aórtica aguda (tipo B. Dos 8 pacientes sobreviventes, 7 encontram-se em controle clínico por período de 6 meses a 4 anos, com boa evolução. Todos demonstraram redução progressiva do aneurisma, após a cirurgia, tendo, em alguns casos, ocorrido desaparecimento completo do mesmo.The authors report their experience with 14 patients who underwent correction of aneurysms of the aortic arch and descending thoracic aorta, utilizing a technique based on aortic exclusion. The approach was accomplished with an ascending abdominal aortic by-pass, and the aneurysm was isolated with a ligature of the aorta above and below it. In 5 patients, this ligature was done with staplers. Six patients died in the immediate post-operative period, mainly from preoperative clinical condition related to acute aortic dissection of the descending thoracic aorta. Severn patients have been followed from 6 months to 4 years and all of them showed a progressive reduction of the aneurysmal sac.

  20. MSCT对不同体重注射不同对比剂量在主动脉CTA中的探讨%Research on Thoracico-Abdominal Aorta CTA with Different Dosage of Contrast Medium by Weight

    Institute of Scientific and Technical Information of China (English)

    付传明; 徐霖; 陈伦刚; 周选民; 龚晓虹; 陈文; 吴德红

    2011-01-01

    Objective: To evaluate the thoracico-abdominal aorta imaging effect on 64-slice MSCT with different dosage of contrast medium (CM) according to different weights. Methods: 60 suspecting aortic-diseases patients informed consented were divided into three groups averagely: In group A, 20 patients with the weight over 75 kg were injected 75 mL contrast medium and 25 mL physiological saline; in group B, 20 patients with the weight between 60-70 kg were injected 60 mL contrast medium and 40 mL physiological saline; in group C, 20 patients with weight under 60 kg were injected 50 mL contrast medium and 50 mL physiological saline. All groups were injected at the same injection rate. Before CT scanning, Patients' weight, height, blood pressure and heart rate were measured then received real-time monitoring and triggering sean to measure diameter of the intersecting surface of the blood vessel, the CT values of aorta ascending, thoracic aorta (T7), lumbar arteries (L2) aorta descending and the crotch of the artery. Two professional radiology diagramming doctors evaluated the recombined images of the aorta and branched blood vessels, and statistically analyzed the intensified extent of the blood vessels, diameter of the intersecting surface of the blood vessels, weight, height blood pressure and heart rate. Results: Of three groups, the average CT values of aorta ascending, thoracic aorta (T7), lumbar arteries (L2) aorta descending and the crotch of the artery are 317.08 Hu, 320.27 Hu, 317.61 Hu respectively. The diameters of the blood vessels are 26.45 mm, 23.91 mm, 21.57 mm, the average weights are 79.98 kg, 68.60 kg, 49.50 kg, the average heights are 180.81cm, 171.70cm, 152.50cm, the systolic blood pressure are 126/78mmHg,130/78 mmHg, 124/80 mmHg, the heart rates are 74.8, 76.5, 74.5 beat/min, the delayed scan time 7.3 s, 6.7 s, 6.1 s.The intensified CT values as well as clarity of the recombined blood vessels and display of crotch of the artery are of no statistical

  1. 叶酸摄入量差异对大鼠同型半胱氨酸及腹主动脉的影响%Effects of different folic acid intakes on the homocysteine and abdominal aorta of rats

    Institute of Scientific and Technical Information of China (English)

    闫文强; 周迎; 施铃灵; 石磊; 张泽旭; 郭毛毛; 姚洪; 韩红柳; 王飞通

    2016-01-01

    Objective To observe the effects of different folic acid intake on homocysteine ( Hcy) and abdominal a-orta of rats.Methods A total of 30 adult male SD rats were randomly divided into 3 groups: a folic acid deficiency group, a normal folic acid group and an excessive folic acid group .The concentrations of Hcy and folic acid were meas-ured on Weeks 1, 4 and 7.The HE slice of the abdominal aorta were made and observed under a microscope for the changes of endothelial cells , internal membrance , medial membrance and outer membrance .Results On Week 7, re-markably increased levels of folic acid were measured in the normal folic acid group and the excessive folic acid group , compared with the folic acid deficiency group (P<0.05).The normal folic acid group and the excessive folic acid group produced markedly lower amounts of serum Hcy than the folic acid deficiency group (P<0.05).According to microscop-ic examination , the folic acid deficiency group showed close arrangement of endothelial cells , intact internal membrane and normal medial and outer membrances , which were similar with the normal folic acid group and the excessive folic acid group.Conclusion A short-term lack of folic acid can not lead to an obvious increase in serum Hcy .A long-term lack of folic acid can result in the rising of serum Hcy level .%目的:通过给予大鼠不同量值的叶酸,观察叶酸对大鼠同型半胱氨酸( Hcy)及腹主动脉的影响。方法选取30只成年雄性SD大鼠,按照随机数字表法分为无叶酸组、叶酸正常组及灌胃叶酸组。分别于第1周、第4周及第7周采取血清,测定血清叶酸及Hcy浓度。制作腹主动脉HE切片,于显微镜下观察内皮、内膜、中膜及外膜的变化。结果与无叶酸组相比,叶酸正常组和灌胃叶酸组第7周的血清叶酸浓度显著升高,差异有统计学意义(P<0.05);叶酸正常组和灌胃叶酸组的血清Hcy浓度显著降低,

  2. Influencia de la geometría de aneurismas de aorta abdominal en la dinámica del flujo sanguíneo y en su riesgo de ruptura // Influence of abdominal aortic aneurysms geometry in the blood flow dynamics and in its rupture risk.

    Directory of Open Access Journals (Sweden)

    G. Vilalta

    2009-05-01

    Full Text Available La ruptura de aneurisma de aorta abdominal (AAA representa un evento clínico muy importante,con una tasa de mortalidad relativamente elevada. En un esfuerzo por aumentar la comprensiónsobre este complejo fenómeno, en el presente trabajo se estudia la influencia de la geometría delos aneurismas de aorta abdominal en el riesgo de ruptura. Para esto se ha utilizado un modelogeométrico realista, obtenido por la transformación de imágenes 2D de tomografía computarizada(CT, sometido a un flujo pulsátil fisiológicamente realista, con el objetivo de evaluar e identificarlas regiones donde ocurren las principales perturbaciones en los patrones de flujo, cómo éstamodifica los campos de velocidades y de tensiones hemodinámicas en el interior del sacoaneurismático, así como la influencia de los diferentes factores biomécanicos relacionados con lageometría que caracterizan el aneurisma. Se presenta una explicación de las modificaciones de lasestructuras vorticales y de la distribución de tensiones durante el ciclo cardíaco. Igualmente sedetermina un indicador numérico (Parámetro de Severidad que integra los 3 factoresbiomecánicos geométricos y que permite evaluar el riesgo de ruptura del aneurisma para un estadode desarrollo determinado. Los resultados confirman que la asimetría de los aneurismas de aortaabdominal es uno de los principales factores que influyen en su ruptura.Palabras claves: AAA, asimetría, riesgo de ruptura, factores biomecánicos.__________________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event, with arelatively high mortality rate. In an effort to increase understanding about this complexphenomenon, this paper studies the influence of abdominal aortic aneurysms geometry on the riskof rupture. Patient specific AAA model, created by 2D reconstruction of computed tomographyimage, was used to identify regions of

  3. 正常胰腺及腹主动脉MSCT强化峰值和达峰时间与个体因素的相关性研究%Correlation of Peak Value and Peak Time of Normal Pancreas and Abdominal Aorta on Enhanced MSCT with the Individual Factors

    Institute of Scientific and Technical Information of China (English)

    郭静; 黄小华; 董国礼; 张喜荣; 张小明; 敬宗林

    2012-01-01

    目的:探讨正常胰腺及腹主动脉的强化峰值(PV)和达峰时间(PT)与年龄、性别及体质指数(BMI)的相关性,优化不同个体胰腺多期MSCT扫描时间窗的选择.方法:符合标准的62例患者分别进行MSCT胰腺灌注成像,并按年龄、性别及BMI分组,测量胰腺及腹主动脉的PV及PT值并按组别进行统计学分析.结果:①年龄组:44岁(包括44岁)以下组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(111.10±3.17)HU、(38.33±1.39)s、(343.22±17.65)HU、(31.08±1.41)s; 45-59岁组,其参数值分别为(110.53±2.60)HU、(37.15±1.42)s、(357.88±12.29)HU、(30.62±1.43)s; 60岁(包括60岁)以上组,其参数值分别为(116.67±4.27)HU、(36.92±1.95)s、(355.96±22.94)HU、(30.75±1.59)s.②性别组:男性组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(111.31±2.05)HU、(37.89±1.05)s、(341.28±9.19)HU、(30.83±0.96)s;女性组,其参数值分别为(113.92±4.10)HU、(36.53±1.52)s、(384.90±25.68)HU、(30.80±1.91)s.③BMI组:BMI值为22以下(包括22)组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(113.49±2.57)HU、(38.29±1.20)s、(371.89±12.88)HU、(31.31±1.17)s; BMI值为22以上组,其参数值分别为(109.94±2.56)HU、(36.63±1.28)s、(325.82±12.67)HU、(30.19± 1.27)s.统计结果显示,腹主动脉PV值与BMI值有统计学意义(P<0.05),且呈负相关,其余各参数与年龄、性别及BMI值均无相关性.结论:除腹主动脉PV值随BMI值的增加逐渐降低外,其它参数受个体因素的影响小或不受影响.%Purpose: To explore the correlation between the peak value (PV) and peak time (PT) of normal pancreas and abdominal aorta, and age, gender and the body mass index (BMI), and to optimize the choice of multi-phase CT scanning time window. Methods: Sixty-two patients, who had been undertaken multi-slices spiral CT perfusion imaging, were randomly chosen according to the inclusive criteria of normal pancreas and

  4. Correção cirúrgica da coarctação da aorta em adultos sob assistência circulatória extracorpórea esquerda Surgical repair of coarctation of aorta in adults under left heart bypass

    Directory of Open Access Journals (Sweden)

    Eduardo Carvalho Ferreira

    2012-03-01

    Full Text Available OBJETIVO: Descrever a experiência do serviço com a correção da coarctação da aorta em adultos utilizando assistência circulatória esquerda. MÉTODOS: De novembro de 2007 a outubro de 2009, oito pacientes adultos com coarctação da aorta foram submetidos a correção cirúrgica com interposição de enxerto tubular através de toracotomia póstero-lateral esquerda e uso de assistência circulatória com uso de circuito átrio esquerdo e artéria femoral. Cinco pacientes eram do sexo feminino e tinham idade média de 31,5 ± 13,1 anos. Todos tinham hipertensão arterial sistêmica (HAS e apresentavam doenças cardiovasculares associadas. RESULTADOS: Não houve óbitos ou complicações neurológicas. O tempo médio cirúrgico foi de 308 minutos, o tempo médio de assistência circulatória de 73 minutos e o de pinçamento aórtico médio de 65 minutos. O sangramento médio no pós-operatório foi de 696 ml. Seis pacientes evoluíram com HAS grave no pós-operatório, sendo necessário uso de vasodilatadores endovenosos. As altas hospitalares ocorreram em média no 9º dia pós-operatório. Houve redução significativa do gradiente médio da pressão arterial sistêmica. O seguimento ambulatorial com ecocardiograma até dois meses de pós-operatório demonstrou gradiente aorta/enxerto médio de 20,3 mmHg. CONCLUSÃO: O uso da assistência circulatória esquerda pode ser uma opção na correção cirúrgica da coarctação da aorta em adultos, principalmente em pacientes com alterações parede da aorta, não sendo observada isquemia medular nos casos estudados.OBJECTIVE: To describe our experience with repair of coarctation of the aorta in adults using left heart bypass. METHODS: From November 2007 to October 2009, eight adult patients with coarctation of the aorta underwent surgical repair under circulatory support using a left atrium to femoral artery bypass circuit, with graft interposition tube through left posterolateral thoracotomy

  5. Hematoma da aorta ascendente Intramural hematoma of the ascending aorta

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    Noedir Antônio G. Stolf

    2006-12-01

    Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM, quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco, com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento.It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement of the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM, the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical

  6. Tratamento de aneurismas da parte torácica da aorta pela introdução de "stents" sob visão endoscópica

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    José Honório PALMA

    1998-01-01

    Full Text Available Tratamento de paciente com dois aneurismas saculares da aorta descendente, utilizando dois "stents" distintos, manufaturados sob medida tanto em comprimento quanto em diâmetro. Inseridos sob visão endoscópica com aparelho da marca "Olimpus" esterilizado com óxido de etileno, através de abertura na croça da aorta. O procedimento foi realizado por esternotomia mediana, com circulação extracorpórea, em hipotermia profunda e parada circulatória total. A manipulação endoscópica da aorta descendente, sem sangue, permitiu a identificação dos dois aneurismas, assim como a visão dos ramos principais da aorta e a inserção com expansão , na posição exata, dos dois "stents". A evolução pós- operatória foi satisfatória, sendo que este procedimento, inédito, abre uma nova perspectiva no tratamento dos aneurismas torácicos, toracoabdominais e abdominais.This is a case report of a patient with two saccular aneurysms in the thoracic descending aorta. Treatment consisted of the positioning, through an opening in the aortic arch under deep hipothermia and total circulatory arrest, of two auto expandable stents, guided an Olympus endoscope. The bloodless field made possible the identification of the main thoracic and abdominal aortic branches facilitating the positioning and expansion of both stents. Immediate postoperative recovery was excellent. This is a previously unreported way of placing stents and could open a new perspective in the treatment of thoraco, abdominal and thoracic abdominal aortic aneurysms.

  7. Submucosa de intestino delgado no reparo de defeito em parede abdominal de ratos Small intestinal submucosa to repair anterior abdominal wall defect in rats

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    Fernando Hintz Greca

    2004-10-01

    Full Text Available OBJETIVO: Comparar a biocompatibilidade da tela de polipropileno e do enxerto de submucosa intestinal de suínos, quando usados para o reparo de defeito criado na parede anterior de abdomen de ratos, que envolveu toda a sua espessura e extensão. MÉTODO: Vinte ratos Wistar foram divididos em dois grupos de 10 animais. Um defeito quadrangular, com 3,5cm de lado foi criado cirurgicamente na parede abdominal anterior dos 20 ratos. No primeiro grupo(grupo 1 este defeito foi reparado com submucosa de intestino delgado (SID, e no segundo grupo(grupo 2 com tela de polipropileno. Após 30 dias, os animais foram sacrificados. Além da avaliação macroscópica dos enxertos, realizou-se um estudo tensiométrico e microscópico. RESULTADOS: Os animais de ambos os grupos apresentaram aderências entre o implante e as estruturas intra-abdominais, todavia no grupo com a tela de polipropileno observou-se maior número de aderências entre a tela e as alças intestinais. A força máxima de ruptura foi significantemente maior no grupo de animais com a tela de polipropileno, todavia se corrigida pela espessura do enxerto, a tensão máxima foi maior no enxerto de submucosa porcina que na tela de polipropileno. A mesotelisação foi significativamente mais intensa no grupo da submucosa, assim como a deposição de colágeno. As reações granulomatosas de corpo estranho e inflamação crônica também foram mais intensas no grupo 1. CONCLUSÃO: A SID monstrou ser uma alternativa ao enxerto sintético no reparo de grandes defeitos da parede abdominal em ratos, com melhor mesotelisação e deposição de colágeno, sem aumento no número de complicações. A submucosa apresentou maior resistência por mm², apesar de ter se mostrado menos resistente quando considerada a força maneira absoluta.PURPOSE: The aim of the present study was compare the biocompatibility of a polypropylene mesh and a patch of porcine small intestinal submucosa (SIS when used to repair a

  8. Ultra-sonografia abdominal e pélvica em cães da raça golden retriever sadios, portadores e afetados pela distrofia muscular progressiva Abdominal and pelvic ultrasonography in healthy golden retriever dogs, carriers and affected by gradual muscular dystrophy

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    Angélica Paula Grando

    2009-02-01

    Full Text Available A distrofia muscular de Duchenne (DMD é um tipo de distrofia muscular em humanos caracterizada por uma doença genética ligada ao cromossomo X. O cão golden retriever portador da distrofia muscular (GRMD tem sido intensamente estudado e considerado o modelo mais representativo para a doença observada em humanos. Assim, como forma de verificar anormalidades em órgãos internos nesses animais, foi realizado o exame ultra-sonográfico de 24 cães golden retriever saudáveis, portadores e afetados pela distrofia muscular. O exame ultra-sonográfico do GRMD diagnosticou aumento hepático de moderado a severo, incluindo os vasos hepáticos e seus ramos e aumento de ecogenicidade da vesícula biliar e vesícula urinária. Entretanto, não foram observadas imagens claras de alterações no baço e nos vasos ramos da aorta. A partir disso, acreditamos que o exame ultra-sonográfico constitui-se em um procedimento útil no acesso de órgãos abdominais em cães afetados pela distrofia muscular.Duchenne muscular dystrophy (DMD is one type of human’s muscular dystrophy characterized by a genetic disorder linked to the X chromosome. The Golden Retriever muscular dystrophic (GRMD has been extensively studied and considered the best resembling model to the human disease. Therefore, for identifying internal organs abnormality in GRMD, abdominal and pelvic ultrasonography was performed in 24 golden retriever dogs, either healthy or muscular dystrophic in different levels of disease. The GRMD ultrasonographic exams diagnosed moderate to severe liver enlargement, including hepatic vessels and their branches and increase of echogenicity in gallbladder and urinary bladder. However was not-clearly recognized pathologic images from spleen and aortic vessels were accessed. Therefore, we believe, the ultrasonographic exam was an useful procedure to the assessment of abdominal organs in dogs affected by muscular dystrophy.

  9. Bulky abdominal masses in pediatrics: iconographic essay; Massas abdominais volumosas em pediatria: ensaio iconografico

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Fabiano; Faria, Andreia V.; Kluge, Patricia D.; Volpato, Ricardo G.; Santos, Sergio L.M. dos; Caserta, Nelson M.G. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas]. E-mail: fabiano97@bol.com.br

    2005-04-15

    The ultrasound, computerized tomography and magnetic resonance findings of 19 patients with abdominal bulky masses diagnosed as hydronephrosis, Wilms' tumor, neuroblastoma, adrenal carcinoma, sarcoma, hemangioendothelioma, hepatoblastoma, mesenchymal hamartoma, hepatocellular carcinoma, choledochal cyst, splenic cyst, lymphoma, enteric cyst, teratoma, hydrometrocolpos and lipoma are presented. Imaging findings (including ultrasound, computerized tomography and magnetic resonance imaging) are important tools for the evaluation of abdominal masses in pediatric patients and can contribute to the diagnosis and evaluation of the extension of these diseases. (author)

  10. Consumo de bebida alcoólica e adiposidade abdominal em doadores de sangue Consumo de bebida alcohólica y adiposidad abdominal en donadores de sangre Alcohol consumption and abdominal fat in blood donors

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    Márcia Gonçalves Ferreira

    2008-12-01

    Full Text Available OBJETIVO: Analisar a associação entre o consumo de bebidas alcoólicas e adiposidade abdominal. MÉTODOS: Estudo transversal com uma amostra de homens doadores de sangue (N=1.235, de 20 a 59 anos, em Cuiabá (MT, realizado de agosto/1999 a janeiro/2000. Os indicadores de adiposidade abdominal foram circunferência da cintura e relação cintura/quadril, ajustados pela adiposidade total. As medidas aferidas foram: peso, estatura, circunferências da cintura e do quadril. O consumo de álcool foi avaliado utilizando-se um questionário sobre tipo, freqüência e quantidade da bebida consumida. A associação entre o consumo de álcool e adiposidade abdominal foi analisada por regressão linear múltipla, com os modelos ajustados para idade, atividade física, tabagismo e adiposidade total. RESULTADOS: Após ajuste, a circunferência da cintura e a relação cintura quadril mantiveram-se associadas positivamente ao consumo de cerveja (p=0,02 e ao total de álcool consumido (p=0,01 e 0,03, respectivamente. O consumo de aguardente mostrou associação somente com a circunferência da cintura (p=0,04. CONCLUSÕES: O consumo de álcool, particularmente de cerveja, associou-se com a localização abdominal de gordura.OBJETIVO: Analizar la asociación entre el consumo de bebidas alcohólica y adiposidad abdominal. MÉTODOS: Se efectuó estudio transversal con una muestra de hombres donadores de sangre (N= 1.235, de 20 a 59 años, en Cuiabá (Centro-Oeste de Brasil, realizado de agosto/1999 a enero/2000. Los indicadores de adiposidad abdominal fueron circunferencia de la cintura y relación cintura/cuadril, ajustadas por la adiposidad total. Las medidas verificables fueron: peso, estatura, circunferencias de la cintura y del cuadril. El consumo de alcohol fue evaluado utilizándose un cuestionario sobre tipo, frecuencia y cantidad de la bebida consumida. La asociación entre el consumo de alcohol y adiposidad abdominal fue analizada por regresi

  11. Reconstrução da aorta com conduto de pericárdio bovino corrugado

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    Claudio A. Salles

    1998-04-01

    Full Text Available No período de outubro de 1989 a maio de 1997, 40 pacientes portadores de dissecção aórtica, aneurisma da aorta, coarctação da aorta ou doença oclusiva aorto-ilíaca foram submetidos a reconstrução da aorta utilizando-se conduto de pericárdio bovino corrugado processado em glutaraldeído. A reconstrução total da aorta ascendente com substituição da valva aórtica e reimplante das artérias coronárias foi realizada em 9 pacientes, a simples substituição da aorta ascendente em 6, aorta torácica descendente em 2, arco aórtico em 1, aorta toracoabdominal em 1 e a aorta abdominal foi reconstruída em 21, incluindo pacientes submetidos a reconstrução aorto-ilíaca ou aorto-femoral. A mortalidade hospitalar foi de 8 (20% pacientes e as causas de óbito foram baixo débito cardíaco, recidiva da dissecção aórtica, falência de múltiplos órgãos e sangramento. O seguimento total foi de 128,4 pacientes-anos, com um seguimento médio de 4 anos por paciente. Complicações tardias relacionadas ao conduto vascular foram observadas em 4 pacientes, incluindo obstrução de um dos ramos do tubo bifurcado utilizado para reconstrução aorto-femoral e infecção em 3, resultando em degeneração secundária do conduto e formação de pseudo-aneurisma. Os 4 pacientes foram submetidos a reoperações, correspondendo a uma incidência de 3,1% ± 1,6% por paciente/ano. Ocorreram 5 óbitos tardios e as causas foram morte súbita, doença coronariana, pneumonia, septicemia e complicações metabólicas resultantes de diabetes e insuficiência renal crônica, correspondendo a uma incidência de 3,9% ± 1,7% por paciente/ano. A sobrevida atuarial em 9 anos foi 61,5% ± 9,2%, incluindo a mortalidade cirúrgica e a sobrevida atuarial livre de degeneração tissular estrutural primária do conduto biológico foi de 100%. O corrugamento do pericárdio, resultante da incorporação do princípio crimping utilizado nas próteses vasculares sint

  12. Effect of <em>trans> fatty acid intake on abdominal and liver fat deposition and blood lipids

    DEFF Research Database (Denmark)

    Bendsen, Nathalie Tommerup; Chabanova, E.; Thomsen, Henrik S.

    2011-01-01

    abdominal and liver fat deposition.Objective:We examined the effect of a high intake of TFA as part of an isocaloric diet on whole-body, abdominal and hepatic fat deposition, and blood lipids in postmenopausal women.Methods:In a 16-week double-blind parallel intervention study, 52 healthy overweight...... postmenopausal women were randomized to receive either partially hydrogenated soybean oil providing 15.7 g day(-1) of TFA or a control oil with mainly oleic and palmitic acid. Before and after the intervention, body composition was assessed by dual-energy X-ray absorptiometry, abdominal fat by magnetic resonance...... (MR) imaging, and liver fat by (1)H MR spectroscopy.Results:Compared with the control fat, TFA intake decreased plasma high-density lipoprotein (HDL)-cholesterol by 10%, increased low-density lipoprotein (LDL)-cholesterol by 18% and resulted in an increased LDL/HDL-cholesterol ratio (baseline adjusted...

  13. Histerectomia vaginal versus histerectomia abdominal em mulheres sem prolapso genital, em maternidade-escola do Recife: ensaio clínico randomizado

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    Costa Aurélio Antônio Ribeiro

    2003-01-01

    Full Text Available OBJETIVO: comparar os resultados intra e pós-operatórios em pacientes sem prolapso genital ou doenças anexiais, submetidas a histerectomia vaginal ou abdominal. MÉTODOS: realizou-se estudo do tipo ensaio clínico aberto, randomizado, em pacientes sem prolapso genital que se submeteram a histerectomia total, indicada por doenças benignas, no IMIP, em Recife, Pernambuco. Incluíram-se 35 pacientes, alocadas aleatoriamente em dois grupos, sendo 19 submetidas a histerectomia vaginal e 16 a histerectomia abdominal. Foram estudadas as seguintes variáveis: volume de perda sangüínea, necessidade de hemotransfusão, tempo operatório, dor pós-operatória (intensidade e uso de analgésicos, tempo de permanência hospitalar, complicações operatórias, tempo de retorno às atividades e grau de satisfação das pacientes. Para análise estatística, utilizaram-se os testes chi2 de associação, exato de Fisher e Mann-Whitney para comparação dos grupos, considerando-se significativo erro alfa menor que 5%. RESULTADOS: o volume de sangue perdido durante as histerectomias por via abdominal (mediana de 902 mL foi significativamente maior em relação à perda durante as histerectomias vaginais (mediana de 520 mL, e nenhuma paciente neste último grupo requereu hemotransfusão, contra 19% no primeiro grupo. A duração da cirurgia foi semelhante, com mediana de 120 minutos nos dois grupos. A intensidade da dor, verificada pelos escores da escala analógica visual, foi significativamente menor entre as pacientes submetidas a histerectomia vaginal, que também apresentaram menor freqüência de utilização de analgésicos. Não houve diferença na freqüência de complicações intra ou pós-operatórias entre os dois grupos, encontrando-se apenas um caso de infecção em cada grupo e um caso de trombose venosa profunda no grupo das histerectomias vaginais. O tempo de retorno às atividades das pacientes submetidas à histerectomia vaginal foi

  14. Acceptability of virtual unenhanced CT of the aorta as a replacement for the conventional unenhanced phase

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    Shaida, N., E-mail: nadeem.shaida@addenbrookes.nhs.uk [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Bowden, D.J.; Barrett, T.; Godfrey, E.M.; Taylor, A.; Winterbottom, A.P.; See, T.C. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Lomas, D.J. [Department of Radiology, University of Cambridge, Addenbrooke' s Hospital, Cambridge (United Kingdom); Shaw, A.S. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom)

    2012-05-15

    Aim: To evaluate whether virtual unenhanced (VU) computed tomography (CT) images generated of the aorta were of sufficient quality to replace the conventional unenhanced (CU) images. Materials and methods: Forty-nine patients undergoing examination of the thoracic or abdominal aorta were examined using a dual-energy protocol. VU images were generated from the arterial phase images and compared to the CU images. Objective analysis was performed by drawing paired regions of interest (ROIs) within the thoracic and abdominal aorta and measuring the radiodensity in Hounsfield units attenuation within the ROIs. Subjective analysis was performed by two experienced readers evaluating the VU images in terms of noise, quality, calcium loss, and overall acceptability. Results: The attenuation was significantly higher in the VU images compared to the CU images within the thoracic aorta (p < 0.01) but not within the abdominal aorta (p = 0.15). Overall the VU images of the abdominal aorta were deemed acceptable as replacements for the CU images in 93% of cases. For the thoracic aorta, the VU images were deemed acceptable in only 12% of cases, primarily due to pulsation artefact. Conclusion: VU images of the abdominal aorta are acceptable as replacements for the CU images in the vast majority of cases; however, they are not suitable as replacements for the CU images of the thoracic aorta.

  15. Associação entre aneurismas de aorta abdominal infrarrenal e doença renal policística autossômica dominante: relato de caso Association between infrarenal abdominal aortic aneurysm and autosomal dominant polycystic kidney disease: a case report

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    Milton Alves das Neves Junior

    2009-06-01

    Full Text Available A doença renal policística dominante é uma das doenças renais hereditárias mais comuns, podendo apresentar manifestações extrarrenais vasculares de importância clínica, como aneurismas intracranianos, aneurismas aórticos e dissecções arteriais. Relatamos o caso de um paciente masculino, com 66 anos de idade, renal crônico não-dialítico por doença renal policística dominante, com aneurisma de aorta abdominal infrarrenal assintomático, diagnosticado por ultrassonografia de rotina e operado eletivamente com sucesso. A doença renal policística dominante é uma síndrome genética, associada aos genes PDK1 e PDK2 no cromossomo 16. A expressão desses genes na parede dos vasos leva ao seu enfraquecimento, favorecendo a formação de aneurismas. A produção de metaloproteinases pelos túbulos renais também estaria relacionada às doenças vasculares desses pacientes. Tais doenças se apresentam como importantes fatores de mortalidade precoce e morbidade dos portadores de doença renal policística dominante e, como usualmente são assintomáticas, justifica-se o uso de propedêutica armada e tratamento precoce.Autosomal dominant polycystic kidney disease (ADPKD is one of the most common hereditary renal diseases, which may present important clinical extrarenal vascular manifestations, such as intracranial and aortic aneurysms and artery dissections. We report the case of a 66-year-old male chronic renal out-of-dialysis patient, with dominant polycystic kidney disease, presenting an asymptomatic infrarenal abdominal aortic aneurysm diagnosed by routine ultrasonography, submitted to successful elective surgery. ADPKD is a genetic syndrome, associated with PDK1 and PDK2 genes on chromosome 16. The expression of these genes in the vessel walls leads to vessel wall weakening, favoring aneurysm formation. In addition, metalloproteinase production by kidney tubules could be related to vascular diseases in ADPKD patients. These are

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  17. Evaluación del impacto de las técnicas de control del daño en el tratamiento de los pacientes con aneurisma roto de la aorta abdominal. Hospital Universitario San Vicente de Paúl, Medellín, Colombia, enero de 2000 a octubre de 2007

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    John Fernando García V.

    2008-11-01

    Full Text Available La mortalidad quirúrgica atribuible al aneurisma de la aorta abdominal (AAA roto oscila entre 40 y 70% según los diversos informes de la literatura; la principal causa de ello es la falla orgánica múltiple (FOM, la que a su vez corresponde, en un porcentaje importante de casos, al complejo de hipertensión abdominal/síndrome del compartimento abdominal (HTA/SCA. A principios de la década de los años 90 aparecieron algunos artículos informando que los pacientes tratados con laparostomía, con o sin empaquetamiento, cursaban sin HTA/SCA, y presentaban tasas de supervivencia mejores que las de aquellos a quienes se les cerraba primariamente el abdomen, luego de la corrección de un AAA roto. Decidimos tratar a la mayoría de los pacientes con laparostomía y empaquetamiento abdominal, con el fin de disminuir la mortalidad previa global del servicio, la cual había sido del 81,8% en 44 pacientes (corregida de 79,3%. Se exceptúan 6 pacientes a quienes se les hizo cierre primario de la pared abdominal al momento de corregir su AAA roto. Se obtuvo una tasa global de mortalidad a 30 días del 55,9% y corregida del 45,5%. Con lo anterior se puede concluir que a los pacientes con AAA roto, dada su gravedad, se les deben ofrecer técnicas similares a las utilizadas en el control del daño en el trauma, como la laparostomía y el empaquetamiento abdominal con el fin de que tengan la mejor oportunidad de sobrevivir.

  18. Animal model of chronic abdominal hernia in rabbit Modelo animal de hérnia abdominal crônica em coelhos

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    Walter da Silva

    2009-08-01

    Full Text Available PURPOSE: To create a feasible animal model of hernia that should be reliable to test the different types of mesh and/or surgical technique. METHODS: Thirty six male New Zealand albino rabbits were submitted to surgical procedure to provoke a standard hole in the abdominal wall. A metallic frame measuring 3 cm length and 1 cm width was allocated longitudinally on the umbilicus scar and the comprehensive three squared centimeters area was resected. A continuous 4.0 polyamide was performed to closure the subcutaneous and skin. RESULTS: During three weeks a score of signals/symptoms was performed to evaluate the wound and clinical conditions. No death or severe complications occurred. In the 3rd week the hernia ring and visceral adhesions were evaluated. Soft omental adherences were present in the hernial sac in all animals. The area of hernia ring ranged from 32.1±5.5 to 35.6±3.1 squared centimeter and the maximum was 39 cm² and the minimum was 30 cm². The model results in protrusion which was similar to a human incisional hernia with hernia sac, visceral adhesions and fibrous healing ring. CONCLUSION: The model was more reliable to test further techniques or mesh on hernia repair.OBJETIVO: Criação de um modelo animal de hérnia que seja confiável para testar as diferentes técnicas e tipos de telas. MÉTODOS: Trinta e seis coelhos foram submetidos a procedimento operatório que provocou uma falha na parede abdominal. Uma moldura metálica com 3 cm de comprimento e 1 cm de largura foi colocada longitudinalmente sobre a cicatriz umbilical e ressecada uma área de 3cm². Uma sutura contínua de poliamida 4.0 fechou a tela subcutânea e pele. RESULTADOS: durante três semanas o escore de sinais e sintomas foi coletado para avaliar as condições clínicas e da ferida operatória. Não ocorreram óbitos ou complicações graves. Na terceira semana o anel herniário e aderências peritoneais foram avaliadas. Aderências frouxas estavam presentes

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

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    Diego G. D Christofaro

    2011-06-01

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

  20. Experimental models of longitudinal abdominal incisional hernia in rats Modelos experimentais de hérnias incisionais abdominais longitudinais, em ratos

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    Danilo N. S. Paulo

    1997-12-01

    Full Text Available Abdominal incisional hernias in rats has been produced after resection of a segment of abdominal muscle. In a attempt to create a model of incisional hernia in rats, without resection of abdominal muscle, the following surgical procedures were performed: (a Rats anesthetized with ether were submitted to a 4 cm long median incision, supra and infraumbilical, followed by dissection of the subcutaneous tissue 1.5 cm laterally to the median line in each side; after, one incision was performed in the linea alba and peritoneum, with the same extension of the skin incision; the skin incision was sutured. (b Rats were submited to a suprapubic transversal incision and a scissors introduced through this incision and used to dissect the subcutaneous tissue at least 1.5 cm for each side of median line; after, the linea alba and peritoneoum were incised and the transversal skin incision sutured. (c For control, rats were submitted to a resection of a 2.5 x 4 cm of the abdominal muscles, creating a large defect in the abdominal wall. All the animal, submitted to the three different procedures, developed similar well constituted hernias. We concluded that abdominal incisonal hernias are easily induced in rats after an incision of the abdominal wall, without partial resection of abdominal muscle, since the subcutaneous have been dissected at least 1.5 cm laterally to the median line.Hérnias incisionais abdominais no rato têm sido produzidas pela ressecção de fragmento dos músculos de parede abdominal. Na tentativa de criar um modelo de hérnia incisional abdominal no rato, sem ressecção de fragmentos de músculo de parede abdominal, os seguintes procedimentos cirúrgicos foram realizados: (a Ratos anestesiados com vapores de éter foram submetidos à uma incisão longitudinal mediana supra e infra umbilical, de 4 cm de comprimento, seguida do descolamento do tecido celular subcutaneo em uma extensão de 1,5 cm lateralmente à linha mediana; de cada lado

  1. Imaging anatomical study of abdominal aorta terminal blocking in vitro assisting in standard cardiopulmonary resuscitation%体外腹主动脉末端阻断辅助标准心肺复苏的影像解剖研究

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    钟涛; 张旻海; 菅洪健; 武钢

    2015-01-01

    Objective To supply imaging anatomical basis for abdominal aorta blocking assisting in standard cardiopulmonary resuscitation to improve coronary perfusion pressure. Methods CT images of 75 patients, 41 males and 34 females, were collected. The bellybutton was used as the landmark, and indexes as follows were measured:①The vertebral level of the bellybutton midpoint; ②The relationship between abdominal aorta termination and bellybutton midpoint;③The relationship among the vertical tracks of abdominal artery, lumbar vertebrae,and inferior vena cava. Results The markers for the end of abdominal artery,lumbar vertebrae and navel roughly overlapped at the human median line:①The navel midpoint was located between 40.31 mm above and 32.82 mm below the inferior border of L4;②The end of the abdominal artery was located between 35 mm above and 35 mm below the bellybutton midpoint; ③The end of abdominal artery was located slightly to the left of the lumbar spine, and inferior vena cava was located to right of the lumbar spine at the transverse section of the body at the level of the end of the abdominal artery. Conclusions According to the imaging study, navel can be adopted as the landmark for blocking in vitro the end of the abdominal aorta, assisting in the standard cardiopulmonary resuscitation. It could improve the hemodynamic indexes, ensure blood supply of the critical organs such as brain and heart, and improve coronary perfusion pressure with high success rate.%目的:为体外腹主动脉末端阻断辅助标准心肺复苏(CPR)提供影像解剖学基础。方法75名患者的CT影像解剖图中,以脐为标志点,主要观测:①脐中点水平面对应椎体的位置;②腹主动脉末端与脐中点的关系;③腹主动脉下段、下腔静脉下段与腰椎的相对位置关系。结果腹主动脉末端、腰椎与脐标志点基本重叠于人体正中线位置:①脐中点位于腰4椎体下缘以上40.31mm,以下32.82 mm

  2. Infecção de prótese vascular em cirurgia da aorta torácica: revisão da experiência e relato de caso tratado por técnica não convencional Vascular prosthesis infection in thoracic aorta surgery: review of the experience and a case report illustrating treatment with an unconventional technique

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    Ronaldo Ducceschi Fontes

    2004-03-01

    Full Text Available Relatamos o caso de uma paciente de 37 anos de idade, que há cinco anos havia sido submetida à operação de Bental-de Bono em nosso serviço e retornou com dor de forte intensidade no toráx, sendo diagnosticada dissecção aguda de aorta do tipo III e tratada clinicamente. Um ano após esse episódio houve expansão dessa dissecção e a paciente foi submetida à cirurgia com interposição de prótese de dacron em aorta descendente. No pós-operatório imediato houve broncopneumonia esquerda e a paciente recebeu alta em boas condições e afebril. Após um mês da alta, retornou com febre e toxemia. Com diagnóstico de empiema pleural, foi submetida à toracotomia exploradora que não confirmou esse diagnóstico, havendo apenas intenso espessamento pleural. Quatro meses após a toracotomia exploradora, foram isolados Klebsiella pneumoniae e Enterobacter sp na hemocultura. A ressonância magnética revelou imagens compatíveis com infecção peri-prótese. Com esse quadro clínico e laboratorial foi indicada a remoção do enxerto e derivação axilo-bifemoral. A operação foi realizada com sucesso, a paciente recebeu alta em boas condições e continua fazendo controle ambulatorial e, atualmente, encontra-se com 57 meses de evolução sem complicações. São discutidos os métodos empregados para o diagnóstico e tratamento da infecção de prótese na cirurgia da aorta torácica.We report the case of a 37-year-old-female patient who had undergone a Bentall procedure at our service and returned with intense chest pain and acute aortic dissection type III, which was diagnosed and clinically treated. One year after this episode, this dissection expanded, and the patient underwent surgery with interposition of a Dacron graft in the descending aorta. In the immediate postoperative period, the patient experienced left bronchopneumonia and was discharged afebrile and in good condition. One month after discharge, she returned with fever and

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

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    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida

  4. Efeitos do Tenoxicam sobre a cicatrização da parede abdominal: estudo experimental em ratos

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    Watanabe André Luís Conde

    2005-01-01

    Full Text Available OBJETIVO: Analisar os efeitos do tenoxicam, um antiinflamatório não hormonal, na cicatrização da parede abdominal de ratos. MÉTODOS: Foram utilizados 40 ratos adultos, submetidos à laparotomia mediana e distribuídos, aleatoriamente, em um grupo controle (C, constituído de 20 animais que receberam solução de NaCl a 0,9 %; e um grupo tratado (T, constituído de 20 animais que receberam o tenoxicam. Os animais de cada grupo foram divididos, conforme a data de sacrifício, em subgrupos de 10 animais, denominados C7, C14, T7 e T14. As inscrições 7 e 14 determinaram o sacrifício dos animais no sétimo e décimo quarto dia pós-operatório, respectivamente. As soluções de tenoxicam (1mg/ml e de NaCl a 0,9% foram administradas no pós-operatório imediato e nos quatro dias seguintes, por via intramuscular, na dose volume de 0,6 ml/kg/dia. No dia do sacrifício, realizou-se a ressecção de dois fragmentos da parede abdominal (1cm x 3cm, que foram utilizados para determinação da concentração de hidroxiprolina e avaliação da força de ruptura. RESULTADOS: Não foram observadas complicações da ferida operatória, incluindo infecção ou deiscência, nos quatro subgrupos de animais. Na análise comparativa dos quatro subgrupos de animais, não foi evidenciada diferença estatisticamente significante no estudo da força de ruptura (p=0,262 e na concentração de hidroxiprolina (p=0,392. CONCLUSÃO: A administração de tenoxicam, por via intramuscular, não interfere na cicatrização da parede abdominal de ratos.

  5. Nonwoven polypropylene prosthesis in large abdominal wall defects in rats Tela de polipropileno sem tecelagem na correção de grandes defeitos da parede abdominal em ratos

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    Patrick dos Santos Barros dos Reis

    2012-10-01

    Full Text Available PURPOSE: To evaluate, in large abdominal wall defects surgically shaped in rats, if a synthetic polypropylene nonwoven prosthesis could be used as a therapeutic option to conventional polypropylene mesh. METHODS: Twenty four (24 Wistar rats were enrolled into three groups. Group 1 (Simulation group with an abdominal wall defect of 3 X 3 left untreated and Groups 2 and 3, respectively treated with a conventional polypropylene mesh and a polypropylene nonwoven (NWV prosthesis to cover the breach. At the 45th postoperatively day, adhesion (area and strength and vascularization of Groups 2 and 3 were evaluated. The histological preparations with Hematoxylin-Eosin, Tricromium of Masson, Pricrosirius red and polarization with birefringence, and also the structural analysis of the prostheses carried on by Thermogravimetry and Differential Scanning Calorimetry were also assessed. RESULTS: There were no significant differences between the Groups 2 and 3. CONCLUSION: In rats, the polypropylene nonwoven prosthesis showed to be safe and has to be considered as an alternative to conventional mesh manufactured by weaving in the treatment of great defects of the abdominal wall.OBJETIVO: Avaliar, em grandes defeitos da parede abdominal produzidos cirurgicamente em ratos, se uma prótese sintética de polipropileno sem tecelagem poderia ser utilizada como alternativa terapêutica às telas convencionais de polipropileno. MÉTODOS: Vinte e quatro ratos foram distribuídos em três grupos numericamente iguais. Grupo 1 (Simulação, no qual um defeito de 3 x 3 cm foi constituído na parede abdominal sem tratamento. Uma tela convencional de polipropileno e uma tela de polipropileno sem tecelagem foram colocadas para cobrir o defeito, nos grupos 2 e 3 , respectivamente. No 45º dia de pós-operatório foram avaliadas a área e a força das aderências, além da vascularização. Também foram analisados os preparados histológicos com Hematoxilina-eosina, Tricr

  6. Malformações detectadas pelo ultrassom abdominal em crianças com cardiopatia congênita

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    Rosana Cardoso Manique Rosa

    Full Text Available FUNDAMENTO: Malformações extracardíacas podem estar presentes em pacientes com cardiopatia congênita (CC, trazendo maior risco de comorbidade e mortalidade. OBJETIVO: Verificar a frequência e os tipos de anormalidades abdominais detectadas em crianças com e sem CC através do ultrassom abdominal (USA, comparar os pacientes quanto a seus achados dismórficos/citogenéticos e realizar uma estimativa do custo-benefício da triagem pelo USA. MÉTODOS: Foi realizado um estudo transversal com controle. Os casos consistiram de pacientes com CC admitidos pela primeira vez em uma unidade de terapia intensiva pediátrica; os controles consistiram de crianças sem CC submetidas ao USA no hospital logo após cada caso. Todos os pacientes com CC foram submetidos ao USA, ao cariótipo de alta resolução e à hibridização in situ fluorescente (FISH para microdeleção 22q11.2. RESULTADOS: USA identificou anormalidades clinicamente significativas em 12,2% dos casos e em 5,2% dos controles (p = 0,009, com um poder de significância de 76,6%. A maioria das malformações com significado clínico foi de anomalias renais (10,4% nos casos e 4,9% nos controles, p = 0,034. No Brasil, o custo de um exame de USA pelo Sistema Único de Saúde é de 21 dólares. Uma vez que anormalidades clinicamente significativas foram observadas em um a cada 8,2 pacientes com CC, o custo para identificar uma criança afetada foi de 176 dólares. CONCLUSÃO: Pacientes com CC apresentam uma frequência significativa de anomalias detectadas pelo USA, um método diagnóstico barato e não invasivo, com boa sensibilidade. O custo da triagem para esses defeitos é consideravelmente menor que o custo para tratar as complicações do diagnóstico tardio de malformações abdominais, como a doença renal.

  7. Experimental study on enhanced ultrasonography of normal abdominal aorta using self-made perfluorocarbon ultrasound contrast agent in rabbits%自制氟碳声学造影剂对正常兔腹主动脉造影的实验研究

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    马娜; 任卫东; 杨欣

    2006-01-01

    目的观察自制氟碳声学造影剂对正常兔腹主动脉造影效果及不同造影剂注入方式造影的时间-强度曲线变化.方法经兔耳缘静脉注入0.5 mL/kg自制造影剂,常规成像观察实时造影过程,触发成像模式定量分析团注和推注法(0.1 mL/s)造影的时间-强度曲线变化.结果造影后腹主动脉灰阶及多普勒信号显著增强.团注法同推注方式比较,峰值强度显著增高,但曲线下降斜率快,平均通过时间短(P<0.001);而推注方式可显著延长造影剂平均通过时间(P<0.001).结论自制氟碳声学造影剂显著增强血流显像,根据不同检查目的选择合适的造影剂注入方式,对提高造影效果有重要价值.%[Objective ] To observe the effect of enhanced ultrasonography on normal rabbit abdominal aorta using self-made perfluorocarbon ultrasound contrast agent and the time-intensity curve changes by different injection methods. [Methods] Self-made contrast agent was injected via rabbit ear vein at a dose of 0.5 mL/kg, real-time abdominal aorta enhancement was observed by conventional imaging, and changes of time-intensity curves were quantitatively analyzed using triggered imaging by bolus injection and infusion (0.1 mL/s). [Results] Gray-scale and Doppler signal of abdominal aorta were significantly enhanced by contrast agent. Peak intensity and descending slope were much increased by bolus compared with by infusion, but mean transit time was reduced (P <0.001); while mean transit time was longer using infusion (P <0.001). [Conclusion] Self-made perfluorocarbon ultrasound contrast agent can significantly enhance blood flow display,it is importance to choice ideal injection method according to checking aim to improve the effect of enhanced ultrasonography.

  8. Effects of "Kanli Granule" on Skeletal Muscle Apoptosis in Rats with Chronic Heart Failure Induced by Constriction of Abdominal Aorta%坎离颗粒对腹主动脉缩窄致慢性心衰大鼠骨骼肌细胞凋亡的影响

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    姚成增; 蒋梅先; 阮小芬; 腾名子

    2013-01-01

    目的:观察中药坎离颗粒对腹主动脉缩窄致慢性心衰大鼠骨骼肌细胞凋亡的影响.方法:以腹主动脉缩窄致慢性心衰大鼠为研究对象,对其细胞凋亡基因Bax、Bcl-2的蛋白表达进行观察,采用TUNEL检测凋亡细胞;并分别以中药坎离颗粒生药高(13.5 g/kg、)、中(6.75g/kg)、低(3.375g/kg)剂量及培哚普利(0.36 mg/kg)每日1次灌胃,3周1疗程,每疗程后停药1周,共干预8个疗程.结果:慢性心衰大鼠存在骨骼肌细胞凋亡增多的现象;培哚普利、坎离颗粒预防给药能改善上述病理变化,并观察到坎离颗粒改善心衰时骨骼肌细胞凋亡呈现明显的剂量依赖关系.结论:坎离颗粒在改善腹主动脉缩窄致慢性心衰大鼠心功能的同时还能改善其细胞凋亡,对骨骼肌功能的改善可能起有益作用.%To investigate the effects of "Kanli Granule" on the skeletal muscle apoptosis in rats with chronic heart failure (CHF) induced by constriction of abdominal aorta. Methods; The CHF rat model was established by ligating the abdominal aorta. The CHF rats were fed intragastrically with "Kanli Granule" (13. 5,6. 75, 3. 375 g/kg) and perindopril once a day for 32 weeks. The protein expressions of Bax and Bcl-2 genes were observed, and the apoptosis was detected by TUNEL. Results; The skeletal muscle apoptosis of the CHF rats was increased. Preventive therapy with "Kanli Granule" or perindopril could improve the skeletal muscle apoptosis of the CHF rats, and " Kanli Granule" had a clear dose-dependent relationship in improving the skeletal muscle apoptosis of CHF rats. Conclusion: "Kanli Granule" can improve the skeletal muscle apoptosis in rats with CHF induced by constriction of abdominal aorta.

  9. Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model Influência da laparoscopia e laparotomia na gasometria, leucócitos e citocinas em modelo de sepse abdominal em ratos

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    Irami Araújo Filho

    2006-04-01

    Full Text Available PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only, laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA. Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (pOBJETIVO: A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. MÉTODOS: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia, laparotomia, pneumoperitôneo com CO2, ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFalfa, IL-1beta e IL-6 foram dosadas no líquido intraperitoneal (por ELISA. Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos

  10. The intestinal tract as the major source of interleukin 6 production during abdominal aortic clamping and hind limb ischaemia-reperfusion injury O trato intestinal como a principal fonte na producao de interleucina 6 durante clampeamento da aorta abdominal e lesão de isquemia/rererfusão de membros inferiores

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    Márcio Benedito Palma Pimenta

    2007-01-01

    Full Text Available PURPOSE: The aim of this study was to investigate whether the hind limbs or intestinal tract is the most important initiator of the inflammatory response secondary aortic clamping and hind limb ischemia/reperfusion injury. METHODS: Blood samples of Wistar rats obtained from posterior cava vein, portal vein, and heart cavity during either laparotomy (control group, n=8 or laparotomy + 2 h of aortic clamping and bilateral hind limb ischemia (ischemia group, n=8, or 2 h after ischemia and 2 h of reperfusion (ischemia-reperfusion group, n=8 were assayed for interleukin 6 (IL-6 and C-reactive protein (CRP. RESULTS: Serum IL-6 at the heart (223.6±197.9 [10-832] pg/mL was higher (pOBJETIVO: Investigar qual o principal mediador da resposta inflamatória na lesao de isquemia/reperfusão após clampeamento da aorta abdominal e isquemia dos membros inferiores: o intestine ou as extremidades inferiores. MÉTODOS: amostra de sangue de ratos Wistar coletados da cava posterior, porta e cavidade cardíaca during tanto laparotomia (grupo controle n=8 ou laparotomia + 2 horas de clampeamento aórtico e isquemia bilateral de membros posteriores (grupo isquemia n=8, ou 2 h de isquemia seguido por 2 horas de reperfusão (grupo isquemia/reperfusão n=8, onde foram dosados interleucina 6 e proteína C-reativa. RESULTADOS: Il-6 no coração (223.6±197.9 [10-832] pg/mL foi maior (p<0.001 tanto na veia porta (133.08±108.52 [4-372] pg/mL quanto na veia cava posterior (127.58±109.15 [8-388] pg/mL. PCR não foi significativamente diferente entre os grupos. CONCLUSÃO: o trato intestinal foi responsável pela resposta inflamatória secundária a lesão de isquemia/reperfusão.

  11. Onze anos de experiência com emprego do anel intraluminal para tratamento das doenças da aorta

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    BERNARDES Rodrigo de Castro

    1999-01-01

    Full Text Available O tratamento cirúrgico das doenças da aorta é geralmente acompanhado de altas taxas de morbimortalidade. O paciente que tem média de idade avançada geralmente é apresentado ao cirurgião em estado grave, com má condição nutricional, muitas vezes com alterações em vários órgãos e sistemas causados pela própria doença aguda. A correção convencional exige técnicas coadjuvantes complexas e agressivas como a circulação extracorpórea prolongada, hipotermia profunda, parada circulatória total além de prolongados tempos de pinçamento de aorta. Na tentativa de reduzir a agressão cirúrgica no paciente já intensamente debilitado pela própria doença, desenvolvemos, em 1988, um anel intraluminal (1, 2 que tem medidas projetadas e experimentadas para facilitar a sua manipulação e anastomose, proporcionando uma diminuição acentuada no tempo de operação, tempo de CEC, tempo de pinçamento de aorta, excluindo muitas vezes a circulação extracorpórea e a hipotermia, obtendo uma anastomose fácil, rápida, segura e hemostática. Entre março de 1988 e janeiro de 1999, 432 pacientes foram submetidos a tratamento cirúrgico de dissecções ou aneurismas da aorta em nosso Serviço. Em 328 pacientes empregamos o anel intraluminal como técnica de anastomose. Usamos 489 anéis. Cento e vinte e cinco pacientes eram portadores de dissecção aguda de aorta do tipo A, 29 eram portadores de dissecção aguda de aorta do tipo B, 81 de aneurisma de aorta ascendente, 8 de aneurisma de arco aórtico, 28 pacientes eram portadores de aneurisma de aorta torácica descendente, 17 eram portadores de aneurisma toracoabdominal e 40 pacientes de aneurisma de aorta abdominal infra-renal. A mortalidade global foi de 13,41%. O seguimento ambulatorial destes pacientes variou de 11 anos a 25 dias. A curva actuarial de sobrevivência em 11 anos mostra 67,3%. Em nenhum caso observamos as complicações descritas na literatura, como embolia, formação de

  12. Effect of potassium iodate and potassium iodide on the SR-B1 protein expression of abdominal aorta in rats%碘酸钾和碘化钾对大鼠腹主动脉SR-B1蛋白表达的影响

    Institute of Scientific and Technical Information of China (English)

    曹晓晓; 徐菁; 谷云有; 王海燕; 李秀维; 王建强; 刘列钧

    2013-01-01

    目的 观察不同剂量的碘酸钾和碘化钾对大鼠腹主动脉SR-B1蛋白表达的影响.方法 根据喂养碘剂和剂量不同将Wistar大鼠随机分为适碘组(KI、KIO3),10倍高碘组(10KI、10KIO3)、50倍高碘组(50KI、50KIO3),100倍高碘组(100KI、100KIO3).喂养半年后,利用免疫蛋白印迹分析(Western-blot)检测大鼠腹主动脉中SR-B1蛋白表达水平.结果 大鼠腹主动脉重量无组间统计学差异(P>0.05);大鼠动脉SR-B1蛋白水平在适碘组之间无差异(P>0.05),而在高剂量的碘酸钾组中,SR-B1蛋白水平均低于等剂量的碘化钾组(P<0.05);SR-B1的蛋白表达水平随着碘酸钾喂养剂量的增加而下降,但在不同剂量碘化钾组中无明显变化趋势.结论 与碘化钾相比,高剂量的碘酸钾抑制了大鼠动脉SR-B1蛋白表达水平.%Objective To observe the effect of potassium iodate and potassium iodide on the SR - Bl protein expression of abdominal aorta in rats. Methods The SPF wistar rats were randomly divided into 8 groups, normal iodide groups ( KI, KIO3), 10 fold iodide groups (10KI, 10KIO3), 50 fold iodide groups (50KI, 50KIO3) and 100 fold iodide groups (100KI , 100KIO3). After 6 months treatment, the SR - Bl protein levels in abdominal aorta were determined by western - blot analysis. Results The weights of rat abdominal aorta showed no statistically significant change among 8 groups ( P >0. 05); The SR - Bl protein expression displayed no remarkable difference between the group of KI and KIO3( P >0.05). But the protein level of SR - Bl in high dose groups of potassium iodate (10KIO3, 50KIO3, and 100KIO3) were higher than those in isodose groups of potassium iodide (10KI, 50KI and 100KI) ( P <0. 05); The SR - Bl protein level decreased with the increase of potassium iodate feeding dosage, but there was no apparent trend among the groups of potassium iodide. Conclusion Compared with potassium iodide, high dose potassium iodate can depress the SR - Bl protein

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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

  14. Coarctation of the Aorta

    Science.gov (United States)

    ... of the aorta (aneurysm) Aortic rupture or tear (dissection) Premature coronary artery disease — narrowing of the blood ... have a higher risk of aortic rupture, aortic dissection or other complications during pregnancy and delivery. Doctors ...

  15. Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros

    Directory of Open Access Journals (Sweden)

    Lerario Daniel D G

    2002-01-01

    Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

  16. Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros

    Directory of Open Access Journals (Sweden)

    Daniel D G Lerario

    2002-02-01

    Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

  17. [Inflammatory abdominal aortic aneurysm].

    Science.gov (United States)

    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.

  18. Angiostrongilose abdominal: profilaxia pela destruição das larvas infectantes em alimentos tratados com sal, vinagre ou hipoclorito de sódio

    Directory of Open Access Journals (Sweden)

    Graziela Maria Zaniní

    1995-12-01

    Full Text Available A infecção acidental humana pelo Angiostrongylus costaricensis ocorre com elevada prevalência em certas áreas do Brasil meridional, eventualmente se manifestando como doença abdominal severa. Profilaxia é importante, pois não hã tratamento medicamentoso. Um dos modos de transmissão é a ingestão de frutas e vegetais contaminados com a mucosidade de moluscos infectados, os hospedeiros intermediários deste parasita. Larvas de terceiro estágio obtidas do ciclo mantido em laboratório foram incubadas a 5°C por 12 horas, em vinagre, solução saturada de cloreto de sódio e hipocloríto de sódio a 1,5%. A viabilidade das lamas tratadas foi testada através da inoculação em camundongos albinos. Os percentuais de larvas que estabeleceram infecção foram: 0% com hipocloríto de sódio, 1,8% com salmora e 2,4% com vinagre. Em conclusão, todas as substâncias - de baixo custo e disponíveis nas áreas endêmicas - reduziram à população de lamas viáveis e podem ser úteis na descontaminação de alimentos para profilaxia da angiostrongilose abdominal.

  19. Fístula aortobroncopulmonar em pós-operatório tardio de coarctação da aorta Fístula aortobroncopulmonar en postoperatorio tardío de coartación de aorta Aortobronchopulmonary fistula in the postoperative period of aortic coarctation

    Directory of Open Access Journals (Sweden)

    Antônio Fernando Coelho Júnior

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Em pacientes com hemoptise e história de cirurgia aórtica, a possibilidade de fístula aortobroncopulmonar deve sempre ser considerada. O objetivo deste estudo foi relatar um caso raro de hemoptise por fístula aortobroncopulmonar em pós-operatório tardio de cirurgia aórtica. RELATO DE CASO: Mulher, 34 anos, correção cirúrgica de coarctação de aorta na infância, apresentando hemoptise maciça. Ecocardiograma evidenciou pseudoaneurisma. Foi realizada a cirurgia e implantado tubo de dacron no segmento aórtico envolvido com sucesso. CONCLUSÕES: Fístula aortobroncopulmonar deve ser lembrada em pacientes com cirurgia aórtica prévia, principalmente pela elevada morbimortalidade se não diagnosticada e tratada precocemente.JUSTIFICATIVA: En pacientes con hemoptisis e historia de cirugía aórtica, la posibilidad de fístula aortobroncopulmonar siempre debe tenerse en cuenta. OBJETIVOS: Relatar un caso raro de hemoptisis por fístula aortobroncopulmonar en postoperatorio tardío de cirugía aórtica. INFORME DE CASO: Mujer, 34 años, corrección quirúrgica de coartación de la aorta en la infancia, presentando hemoptisis masiva. Ecocardiograma mostró evidencias de seudoaneurisma. Se realizó la cirugía, implantándose con éxito un tubo de dacron en el segmento aórtico involucrado. CONCLUSIONES: La fístula aortobroncopulmonar debe ser considerada en pacientes con cirugía aórtica previa, principalmente por la elevada morbimortalidad cuando no es diagnosticada y tratada precozmente.BACKGROUND AND OBJECTIVES: In patients with hemoptysis and a history of aortic surgery, the possibility of aortobronchopulmonary fistula must always be considered. The objective of this study was to report a rare case of hemoptysis due to aortobronchopulmonary fistula in the late postoperative period of aortic surgery. CASE REPORT: Female patient, 34 years, surgical correction of aortic coarctation, presenting massive hemoptysis

  20. Dor abdominal aguda como manifestação de violência física em lactente: alerta aos pediatras Dolor abdominal agudo como manifestación de violencia física en lactante: alerta a los pediatras Acute abdominal pain as a manifestation of physical violence in an infant: alert to pediatricians

    Directory of Open Access Journals (Sweden)

    Patricia Gomes de Souza

    2012-12-01

    Full Text Available OBJETIVO: Alertar os pediatras e residentes de Pediatria quanto à possibilidade da ocorrência de violência contra a criança por meio do relato de um caso clínico. DESCRIÇÃO DO CASO: Paciente de 18 meses deu entrada à emergência com dor abdominal e vômitos há 48 horas. O exame abdominal revelou dois orifícios e massa pequena endurecida. O raio X de abdome mostrou imagem compatível com três objetos metálicos. Duas agulhas e um prego sem cabeça foram removidos da cavidade abdominal por meio de laparotomia. COMENTÁRIOS: O diagnóstico foi realizado no segundo atendimento médico, provavelmente por não ter sido aventada a possibilidade de lesão intencional no primeiro. A violência física é um diagnóstico diferencial a ser pensado nos quadros de dor abdominal em crianças. Ressalta-se a importância de aprimorar a formação do residente de Pediatria e dos pediatras em geral para a abordagem da violência contra a criança, de forma que estejam mais preparados para o acionamento da linha de cuidado em situações de violência.OBJETIVO: Alertar a los pediatras y médicos internos en Pediatría respecto a la posibilidad de ocurrencia de violencia contra el niño por medio del relato de un caso clínico. DESCRIPCIÓN DEL CASO: Paciente con 18 meses llevado a la emergencia por dolor abdominal y vómitos hace 48 horas. El examen abdominal reveló dos agujeros y masa pequeña endurecida. Rayo-X abdominal mostró imagen compatible con tres objetos metálicos. Dos agujas y un clavo sin cabeza fueron removidos de la cavidad abdominal mediante laparotomía. COMENTARIOS: El diagnóstico se realizó en la segunda atención médica, probablemente por no haber sido aventada la posibilidad de lesión intencional en la primera atención. La violencia física es un diagnóstico diferencial que se debe tener en cuenta en los cuadros de dolor abdominal en niños. Se subraya la importancia de perfeccionar la formación del médico interno en

  1. Proteção medular em cirurgia da aorta descendente com uso de "bio-pump" e exsangüinação controlada Spinal protection during descending aortic surgery

    Directory of Open Access Journals (Sweden)

    Henrique Murad

    1994-06-01

    Full Text Available Os autores utilizam como método de proteção medular em cirurgia de aorta descendente, circulação extracorpórea átrio esquerdo-femoral esquerda, com baixa dose de heparina (1 mg/kg, bomba centrífuga (bio-pump e exsangüinação controlada. Operaram 4 doentes com esta metodologia sem que houvesse mortalidade, paraplegia ou sangramento excessivo.The authors have used for spinal cord protection during descending aortic surgery, partial extracorporeal circulation from left atrium to left femoral artery, low dose of heparin (1 mg/kg, centrifugal pump (bio-pump and controlled exsanguination. They have operated upon with this methodology 4 patients without mortality, paraplegia or excessive bleeding.

  2. Fatores associados à obesidade global e à obesidade abdominal em mulheres na pós-menopausa Factors associated with body and abdominal obesity in post-menopausal women

    Directory of Open Access Journals (Sweden)

    Ana Paula França

    2008-03-01

    Full Text Available OBJETIVOS: avaliar a prevalência de obesidade global e obesidade abdominal, em mulheres pós-menopausa, segundo o grau de instrução, nível de atividade física, uso de terapia hormonal na menopausa (THM e paridade. MÉTODOS: foram entrevistadas 157 mulheres na pós-menopausa, atendidas em dois ambulatórios públicos da cidade de São Paulo, São Paulo, Brasil. A obesidade foi determinada segundo o índice de massa corporal (IMC > 30,0 e segundo o percentual de gordura corporal (%GC > 37%. A obesidade abdominal foi determinada pela relação cintura-quadril (RCQ > 0,85. RESULTADOS: a prevalência de obesidade global foi 34,4% (segundo o IMC e de 40,1% (segundo o %GC. A prevalência de obesidade abdominal foi de 73,8%. Grande parte das entrevistadas referiu até sete anos de instrução formal (47,8%, foi considerada sedentária ou insuficientemente ativa (52,3% e nunca tinha utilizado THM oral ou tinha utilizado por menos de 12 meses (72,0%. Foi constatada maior prevalência de obesidade global no grupo de mulheres sedentárias ou insuficientemente ativas e no grupo de não usuárias de THM (pOBJECTIVES: to evaluate the body and abdominal obesity in post-menopausal women, according to educational level, level of physical activity, use of hormone therapy (HT, and parity. METHODS: 157 post-menopausal women, attending two public out-patients clinics in the city of São Paulo, State of São Paulo, Brazil, were interviewed. The prevalence of body obesity was calculated using the body mass index (BMI >30.0 and the body fat percentage (%BF > 37%. Abdominal obesity was calculated using the waist hip ratio (WHR >0.85. RESULTS: the prevalence of body obesity was 34.4% (using the BMI and 40.1% (using %BF. The prevalence of abdominal obesity was 73.8%. Most of the women had up to seven years of formal schooling (47.8%, were considered sedentary or insufficiently active (52.3%, and had never used oral HT or had been using it for less than 12 months (72

  3. The Inhibitory Effect of Astilbin on the Arteriosclerosis of Murine Thoracic Aorta Transplant

    Institute of Scientific and Technical Information of China (English)

    Jinping ZHAO; Ping LI; Yunfeng ZHANG; Xianguo WANG; Qilin AO; Sihai GAO

    2009-01-01

    The inhibitory effect of astilbin on transplant arteriosclerosis in murine model of thoracic aorta transplantation was examined.Model of rat thoracic aorta transplantation was established.Ninety rats were divided into three groups.In isograft group,the thoracic aorta of Brown Norway (BN) rat was anastomosed with the abdominal aorta of another BN rat.In allograft group,the thoracic aorta of BN rat was anastomosed with the abdominal aorta of Lewis rat.In astilbin group,the rats receiving allo-transplantation were given astiibin 5 mg/kg per day for a time of 28 days.The donor thoracic aorta and the recipient abdominal aorta were anastomosed by means of a polyethylene cannula (inner diameter:1.5 mm,length:3 mm length).The grafts were histologically examined for structural changes.The areas of arterial lumen and endatrium were calculated.Our results showed that,in the allograft group,28 days after aliografting,conspicuous proliferation of smooth muscles and infiltration with a great number of inflammatory cells were found in the tunica intima and tunica media.Astilbin significantly inhibited the proliferation of smooth muscles and ameliorated the infiltration of inflammatory cells thereyby prevent against the development of transplant arteriosclerosis.It is concluded that asltilbin can effectively prevent the development of arteriosclerosis in allotrausplant by inhibiting the proliferation of smooth muscles and inhibit the proliferation of smooth muscles in tunica of intima and media and reducing infiltration of the inflammatory cells.

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.).

  5. Inibição da formação de abscesso abdominal em rato: mortalidade por sepse Inhibition of abdominal abscess formation in rat: Mortality by sepsis

    Directory of Open Access Journals (Sweden)

    Fernando Henrique Oliveira Carmo Rodrigues

    2005-03-01

    Full Text Available RACIONAL: Atribui-se aos abscessos intra-abdominais e às aderências peritoniais a função de isolar os processos sépticos e proteger o organismo da bacteremia. Por outro lado, esses fenômenos também dificultam o afluxo de fatores imunitários e antibióticos para a região infectada. OBJETIVO: Avaliar o efeito da prevenção de abscessos na sobrevida após peritonite bacteriana. MÉTODOS: Foram estudados 30 ratos Wistar machos que receberam solução de fezes a 50% intra-abdominal e que foram distribuídos em três grupos (n = 10. Grupo 1: controle (solução de fezes; grupo 2: solução de fezes mais solução salina a 0,9%; grupo 3: solução de fezes mais carboximetilcelulose a 1%, para inibir a formação de aderências. Os três grupos foram divididos em dois subgrupos (n = 5: subgrupo A: nova laparotomia, após 4 dias, para inspeção da cavidade abdominal; e subgrupo B: acompanhamento durante 30 dias para avaliação da mortalidade e da causa de morte. A análise estatística utilizou o teste exato de Fisher. RESULTADOS: O acréscimo de solução salina a 0,9% não aumentou a mortalidade do grupo. Entretanto, no grupo em que se acrescentou a solução de carboximetilcelulose, houve menor formação de abscessos, que também foram mais tênues e a mortalidade aumentou em relação ao grupo controle. CONCLUSÃO: A inibição na formação de aderências peritoniais e de abscessos acompanha-se de maior mortalidade decorrente do processo séptico intra-abdominal generalizado.

  6. 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

    Directory of Open Access Journals (Sweden)

    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

  7. Tratamento endovascular de aneurismas da aorta em pacientes com doença de Behçet: relato de dois casos Endovascular treatment of aortic aneurysms in patients with Behcet's disease: report of two cases

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    Sergio Quilici Belczak

    2010-06-01

    Full Text Available A doença de Behçet, uma vasculite sistêmica de causa desconhecida, pode ser causa de doença aneurismática da aorta em alguns portadores dessa patologia. Nós apresentamos nossa experiência com dois casos de aneurismas aórticos em pacientes com doença de Behçet submetidos à terapêutica endovascular, descrevendo seus respectivos seguimentos. A terapêutica atual, a patofisiologia e os critérios diagnósticos vigentes foram revisados. Concluímos que a técnica endovascular é uma excelente opção terapêutica para certos pacientes com doença de Behçet e que esta deve ser acompanhada de tratamento imunossupressivo adequado.Behcet's disease, a systemic vasculitis of unknown etiology, may be the cause of aortic aneurysmal diseases in some patients. We report our experience with two Behcet's disease patients who presented with aortic aneurysms and were submitted to endovascular therapy, and describe their respective follow-ups. Current pathophysiology, diagnosis, and treatment approaches were reviewed. Our experience suggests that the endovascular approach, combined with adequate immunosuppressive treatment, is an excellent therapeutic option for some patients with Behcet's disease suffering from aneurysms.

  8. Hérnias abdominais e inguinais em pacientes cirróticos: qual é a melhor conduta? Abdominal and inguinal hernia in cirrhotic patients: what's the best approach?

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    Felipe Duarte Silva

    2012-03-01

    Full Text Available INTRODUÇÃO: Tradicionalmente os procedimentos abdominais eletivos em pacientes cirróticos têm sido amplamente desencorajados graças à elevada morbi-mortalidade consequente às complicações da cirrose, descritas por diversos autores. Outros serviços, em contrapartida, obtiveram resultados distintos, advogando a favor de cirurgia eletiva. MÉTODOS: Uma revisão de artigos utilizando-se a palavras "abdominal wall hernia" e "cirrhotic patients" foi realizada na base de dados PubMed. Dos resultados obtidos, 28 artigos foram considerados para elaboração desta revisão. RESULTADOS: Pôde-se observar que a incidência de hérnias em parede abdominal é relativamente elevada em pacientes cirróticos, sendo que muitas delas têm evolução desfavorável e requerem tratamento cirúrgico específico. Com o advento do sistema de alocação de órgãos baseados no escore de MELD, muitos centros estão repensando suas condutas em situações como esta, dado que muitos dos pacientes em questão encontram-se em lista de espera para transplante hepático. Dessa forma a cirurgia eletiva tem conquistado maior papel no manejo desta condição com intuito de diminuir morbi-mortalidade nesses pacientes. Além disso, a qualidade de vida mostrou-se um importante fator a ser considerado, estando muito prejudicada nesta condição. CONCLUSÃO: Poucos estudos com grandes amostragens foram conduzidos até o momento e não há consenso sobre qual conduta é a mais indicada levando em consideração taxas de morbi-mortalidade.BACKGROUND: Traditionally, elective abdominal procedures in cirrhotic patients have been largely discouraged due to high morbidity and mortality consequent to complications of cirrhosis, described by several authors. Other services, however, obtained different results, advocating in favor of elective surgery. METHODS: A literature review using as key-words "abdominal wall hernia" and "cirrhotic patients" was performed using PubMed database

  9. Animal model of the abdominal compartment syndrome as a single insult and as a second insult in rats Modelo experimental de síndrome de compartimento abdominal como insulto único e como um segundo insulto, em ratos

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    João Baptista de Rezende-Neto

    2003-01-01

    êmica com solução de cloreto de sódio a 0,9% (NaCl 33,2 ml/kg mais 75% da sangria e laparotomia. Duas horas após o início do choque hemorrágico os animais são anestesiados, intubados por via orotraqueal, colocados em ventilação mecânica, monitorizados invasivamente (pressão arterial média e submetidos à síndrome de compartimento abdominal. Nesta fase é administrada solução NaCl 0,9% a 45 ml/kg/h. A associação dos insultos, síndrome de compartimento abdominal e choque hemorrágico, proporciona modelo clinicamente relevante.

  10. 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

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    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

  11. Segmental and age differences in the elastin network, collagen, and smooth muscle phenotype in the tunica media of the porcine aorta.

    Science.gov (United States)

    Tonar, Zbyněk; Kubíková, Tereza; Prior, Claudia; Demjén, Erna; Liška, Václav; Králíčková, Milena; Witter, Kirsti

    2015-09-01

    The porcine aorta is often used in studies on morphology, pathology, transplantation surgery, vascular and endovascular surgery, and biomechanics of the large arteries. Using quantitative histology and stereology, we estimated the area fraction of elastin, collagen, alpha-smooth muscle actin, vimentin, and desmin within the tunica media in 123 tissue samples collected from five segments (thoracic ascending aorta; aortic arch; thoracic descending aorta; suprarenal abdominal aorta; and infrarenal abdominal aorta) of porcine aortae from growing domestic pigs (n=25), ranging in age from 0 to 230 days. The descending thoracic aorta had the greatest elastin fraction, which decreased proximally toward the aortic arch as well as distally toward the abdominal aorta. Abdominal aortic segments had the highest fraction of actin, desmin, and vimentin positivity and all of these vascular smooth muscle markers were lower in the thoracic aortic segments. No quantitative differences were found when comparing the suprarenal abdominal segments with the infrarenal abdominal segments. The area fraction of actin within the media was comparable in all age groups and it was proportional to the postnatal growth. Thicker aortic segments had more elastin and collagen with fewer contractile cells. The collagen fraction decreased from ascending aorta and aortic arch toward the descending aorta. By revealing the variability of the quantitative composition of the porcine aorta, the results are suitable for planning experiments with the porcine aorta as a model, i.e. power test analyses and estimating the number of samples necessary to achieving a desirable level of precision. The complete primary morphometric data, in the form of continuous variables, are made publicly available for biomechanical modeling of site-dependent distensibility and compliance of the porcine aorta.

  12. Role of Dryk1A-ASF-CaMKⅡδ signaling pathway in EGCG preventing myocardial hypertrophy in rats with coarctation of abdominal aorta%Dyrk1A-ASF-CaMKⅡδ信号通路在EGCG预防腹主动脉缩窄大鼠心肌肥厚中的作用

    Institute of Scientific and Technical Information of China (English)

    陆晓晨; 姚健; 盛红专; 顾青青; 朱健华

    2012-01-01

    Objective To investigate the role and underlying mechanism of epigallocatechin gallate( EGCG) in preventing myocardial hypertrophy in rats with abdominal aortic constrictioa Methods Thirty SD rats were equally randomized into three groups of A (coarctation of suprarenal abdominal aorta) ,B(coarctation of suprarenal abdominal aorta and fed with EGCG 100 mg · kg-1· d-1) and C(sham operated). The ratio of left ventricular weight to body weight(LVW/BW) was calculated for judging the degree of myocardial hypertrophy. The protein expressions of dual-specificity tyrosine phosphorylated and regulated kinase lA(DyrklA) and alternative splicing factor(ASF) were detected by Western blot, and the mRNA expression of calmodulin-dependent protein kinase Ⅱδ (CaMK Ⅱδ) was measured by RT-PCR. Results Compared with group C,the ratio of LVW/BW, protein expression of DyrklA and mRNA expressions of CaMKⅡδ A and B were significantly increased, while the protein expression of ASF and mRNA expression of CaMK US C were decreased in group A(P<0. 05) , which were all obviously reversed in group B(P<0. 05). Conclusion EGCG can prevent myocardial hypertrophy in rats with abdominal aortic constriction via inhibiting Dryk1A-ASF-CaMKⅡδ signaling pathways.%目的 探讨表没食子儿茶素没食子酸酯(EGCG)对腹主动脉缩窄大鼠心肌肥厚的影响及可能机制.方法 30只SD大鼠随机均分为腹主动脉缩窄组(A组)、腹主动脉缩窄+EGCG组(B组)和假手术组(C组).4周后,计算左室重量/体重(LVW/BW)比值以判断大鼠心肌肥厚程度,Western blot法检测双特异性酪氨酸磷酸化调控激酶1A(Dyrk1A)和可变剪接因子(ASF)蛋白表达,RT-PCR法检测钙调素依赖蛋白激酶Ⅱδ(CaMKⅡδ)mRNA表达.结果 与C组相比,A组大鼠LVW/BW升高,心肌中Dyrk1A蛋白及CaMKⅡδA、B亚型mRNA表达增加,ASF蛋白及CaMKⅡδC亚型mRNA表达下降(P<0.05);而B组能明显逆转A组上述指标的变化(P<0.05).结论 EGCG

  13. Síntese da parede abdominal: avaliação de dois tipos de sutura contínua em ratos

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    Loureiro Vanessa Medeiros

    2003-01-01

    Full Text Available OBJETIVO: Comparar a sutura simples contínua e a sutura contínua em oito vertical no fechamento da parede abdominal de ratos. MÉTODOS: Quarenta e oito ratos machos Wistar, foram submetidos a laparotomia padronizada e fechamento da parede abdominal com sutura simples contínua (n=24 e sutura contínua em oito-vertical (n=24, com fio de polipropileno. No 7° e 14° pós-operatório foram submetidos a eutanásia 12 animais de cada grupo e deles retirados a camada músculo-aponevrótica da parede abdominal envolvendo a cicatriz operatória e preparados para exames histológico e imunohistoquímico. Os segmentos levados ao exame histológico foram corados por Hematoxilina-eosina sendo feita observação qualitativa do processo cicatricial e Picrosirius red F3BA, para avaliação quantitativa do colágeno. Também foram estudadas as porcentagens de macrófagos na linha de sutura por imunohistoquímica. Para a quantificação de macrófagos e fibras colágenas foi utilizado avaliação histológica por digitalização de imagem, baseados nos princípios de espectrofotometria. Os dados encontrados foram analisados estatisticamente pelos testes qui-quadrado, exato de Fisher e Mann-Whitney (p< 0,05. RESULTADOS: A análise qualitativa, nos parâmetros necrose, fibrose, neovascularização, presença de abscesso, reação de corpo estranho e coaptação das bordas de sutura, não mostrou dados significantes nos dois grupos aos 7 ou 14 dias. A porcentagem de fibras colágenas foi significantemente maior, apenas no 7° dia, na sutura contínua em oito-vertical. A porcentagem de macrófagos mostrou-se significantemente maior na sutura simples contínua no 7º. dia. CONCLUSÃO : No 7° dia de pós-operatório a parede abdominal suturada em oito vertical apresenta significantemente, maior quantidade de fibras colágenas e menor quantidade de macrófagos do que a suturada por técnica contínua. Aos 14 dias de observação as suturas mostraram

  14. Nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury%严重骨盆外伤合并血管损伤应用腹主动脉球囊阻断技术的护理配合

    Institute of Scientific and Technical Information of China (English)

    钱维明; 杜丽丽; 项海燕

    2011-01-01

    This paper summarizes the experience of nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury in traffic accidents. Measures of nursing assistance included preoperative preparation,maintaining vascular access,monitoring urine volume,bilateral dorsalis pedis arterial pulses and the change of blood pressure during the operation. Postoperative nursing focused on effective compression on femoral artery after withdrawal of catheter,observation of urine volume,and local hematoma and skin temperature of lower extremities. The four patients got through the perioperative period safely and were discharged with recovery.%总结了4例因车祸致严重骨盆外伤合并血管损伤的急诊患者应用腹主动脉球囊阻断技术的护理配合经验.护理配合重点包括:完善术前准备,术中确保动静脉通路畅通,准确观察尿量,密切观察双侧足背动脉的搏动,监测血压的变化,穿刺侧肢体拔管后予有效压迫,观察尿量、局部血肿及肢体皮温.4例患者均安全度过围手术期,痊愈出院.

  15. Influence of small volume resuscitation with different fluids on cardiac function and hemodynamics of abdominal aorta in septic shock rats%超声多普勒评估小容量复苏时感染性休克大鼠心功能及腹主动脉血流的变化

    Institute of Scientific and Technical Information of China (English)

    罗晨芳; 刘德昭; 陈景晖; 庞红宇; 黑子清

    2012-01-01

    Objective To investigate Influence of different fluids small -volume resuscitation on cardiac function and hemodynamics of abdominal aorta in septic shock rats. Methods 30 SD rats weighting 180 ~ 250 g were divided randomly into 5 groups ( n = 6 ) : Group N ( LPS negative control group) , Group E(LPS + 4 mL/kg physiologic saline) , Group HSS(LPS + 4 mL/kg Hypertonic saline solution) , Group HES ( LPS + 4 ml/kg Hydroxyethyl Starch) , Group HSH ( LPS + 4 mL/kg Hypertonic Sodium Chloride Hydroxyethyl Starch). Resuscitation were administrated 30 min after LPS injected. Doppler ultrasound examination of heart and abdominal aorta were measured at five time points: pre - injection of LPS, 30min post - injection of LPS, l0min post resuscitation, 30min post resuscitation , 60min post resuscitation. Then rats were executed and hearts were taken out. Heart pathological examination was observed under light microscope. Results ①On the early stage of sepsis, septic septic shock rats'heart systolic function increased first and then decreased obviously (P <0. 01) , LVDd decreased significantly, heart rate increased and blood pressure dereased. while these indexes were obviously recovered in resuscitation group, especially Group HSH; ② septic shock rats'abdominal aorta blood flow rate( BFR) became slower in systolic and diastolic phase, resistent index( RI) increased significantly(P < 0. 01) . While BFR rised and RI descended in resuscitation group, especially Group HSH; ③ There were no significant pathological change between these five group. Conclusion Septic shock rats cardiac function depressed, blood volume decreased, the abdominal aorta BFR descended, RI increased. Small - volume resuscitation could improve cardiac function, increased blood volume and BFR, lowered RI. The use of HSH succeed to ameliorate the deleterious hemodynamic responses associated with endotoxemia in rat.%目的 探讨不同液体早期小容量复苏对大鼠感染性休克引起的心功能和

  16. Coartação de aorta em crianças até um ano: análise de 20 anos de experiência Coarctation of the aorta in infants under one year of age: an analysis of 20 years of experience

    Directory of Open Access Journals (Sweden)

    Gabriel Lorier

    2005-07-01

    Full Text Available OBJETIVO: Revisão da experiência com diversas técnicas de correção empregadas, nos últimos 20 anos, em crianças menores de um ano de idade. MÉTODOS: No período de 1978 a 1998, foram operados 148 pacientes (pc consecutivos com coartação de aorta (CoAo com até um ano de idade, com ou sem defeitos intracardíacos associados. A idade apresentou mediana de 50 dias, 92 pc do sexo feminino (62,1%. O peso foi de 4.367±1.897 gramas. O seguimento foi em média de 1.152±1.462 dias. A população foi dividida em 3 grupos: Grupo I, CoAo isolada: 74 pc (50%; Grupo II, CoAo e comunicação interventricular (CIV: 41 pacientes (27,7% e Grupo III, CoAo com malformações complexas: 33 pc (22,3%. RESULTADOS: Mortalidade total foi 43 pc (29%: com menos de 30 dias, foi 53%, p=0,009, OR=4,5, entre 31 e 90 dias, foi 14,7%, p=0,69, e acima de 91 dias, 15%, p=0,004. A probabilidade de sobrevida atuarial de toda a população foi de 67% aos 5 e 10 anos. Trinta e seis pacientes (24,3% recoartaram, dos quais 18 pacientes (50% tinham menos de 30 dias, OR=6,35. A incidência de recoartação foi com a técnica de Waldhausen em 4 pacientes (10% e com a término-terminal clássica em 19 pacientes (26% p=0.03, e a istmoplastia em 6 pacientes (37,5%. A probabilidade de sobrevida atuarial livre de recoartação aos 5 e 10 anos foi de 69% com a técnica de Waldhausen e 63% com a técnica término-terminal clássica. CONCLUSÃO: Pacientes com menos de 30 dias apresentaram risco aumentado de mortalidade e recoartação. A técnica de Waldhausen em pacientes com mais de 30 dias mostrou-se efetiva. A técnica término-terminal clássica mostrou não ser uma boa opção em todas as faixas etárias, sendo imperativo executar variantes técnicas como término-terminal estendida.OBJECTIVE: A review of experience with techniques of correction used, in the last 20 years, in children younger than one year old. METHODS: In the period from 1978 to 1998, 148 patients (pt with

  17. Angiostrongilose abdominal: profilaxia pela destruição das larvas infectantes em alimentos tratados com sal, vinagre ou hipoclorito de sódio

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    Graziela Maria Zaniní

    1995-12-01

    Full Text Available A infecção acidental humana pelo Angiostrongylus costaricensis ocorre com elevada prevalência em certas áreas do Brasil meridional, eventualmente se manifestando como doença abdominal severa. Profilaxia é importante, pois não hã tratamento medicamentoso. Um dos modos de transmissão é a ingestão de frutas e vegetais contaminados com a mucosidade de moluscos infectados, os hospedeiros intermediários deste parasita. Larvas de terceiro estágio obtidas do ciclo mantido em laboratório foram incubadas a 5°C por 12 horas, em vinagre, solução saturada de cloreto de sódio e hipocloríto de sódio a 1,5%. A viabilidade das lamas tratadas foi testada através da inoculação em camundongos albinos. Os percentuais de larvas que estabeleceram infecção foram: 0% com hipocloríto de sódio, 1,8% com salmora e 2,4% com vinagre. Em conclusão, todas as substâncias - de baixo custo e disponíveis nas áreas endêmicas - reduziram à população de lamas viáveis e podem ser úteis na descontaminação de alimentos para profilaxia da angiostrongilose abdominal.There is a high prevalence of accidental human infection with Angiostrongylus costaricensis in some areas in southern Brazil and sometimes it presents as severe intestinal disease. Prophylaxis is important since there is no medical treatment for the disease. The ingestion of fruits and vegetables contaminated with the mucous secretion of infected molluscs (the intermediate hosts is one of the proposed modes of transmission. Third stage lamae were incubated at 5°C for 12 hours, in solutions of saturated sodium chloride, vinegar and sodium hypochlorite 1.5%. The larvae had their viability tested through inoculation into albino mice. The percentage of larvae that established infection were 0% in the group treated with sodium hypochloride, 1.8% with NaCl and 2.4% with vinegar. In conclusion, all substances tested reduced the population of viable larvae and may be useful in food

  18. Coarctation of the aorta

    Science.gov (United States)

    ... Saunders; 2015:chap 62. Read More Abdominal aortic aneurysm Aortic dissection Endocarditis Heart failure - overview High blood pressure Magnetic resonance angiography Pediatric heart surgery Stable angina Stroke Turner syndrome Patient ...

  19. FREQUÊNCIA DA DIÁSTASE ABDOMINAL EM PUÉRPERAS E FATORES DE RISCO ASSOCIADOS

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    Danielle Cristina Barbosa de Luna

    2012-12-01

    Full Text Available Introdução: Na gestação ocorrem expressivas transformações fisiológicas no organismo materno. Alterações hormonais associados ao crescimento uterino podem provocar o estiramento da musculatura abdominal, aumentando a linha da cintura e o alongamento do músculo reto abdominal, causando a formação da diástase dos músculos retos abdominais. Objetivos: Avaliar a frequência e as medidas da diástase abdominal no puerpério imediato e identificar fatores de risco associados. Metodologia: Uma análise de freqüência através de corte transversal foi realizada entre julho de 2010 a junho de 2011, envolvendo 89 puérperas do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP. Os dados foram coletados através de um questionário, onde utilizou-se os fatores associados à diástase abdominal: idade materna, peso e IMC materno, realização de atividade física, tipo de parto, diabetes, hipertensão e peso do neonato, além da mensuração da diástase abdominal. Resultados: Mulheres submetidas ao parto cesáreo apresentaram maiores valores de diástase abdominal quando comparadas aquelas que fizeram parto normal (p. Conclusões: Características maternas como o peso, bem como seu IMC e a presença de hipertensão, além do peso do neonato e o parto cesáreo são fatores que podem estar associados à frequência e a valores maiores da diástase abdominal. Palavras-chave: Diástase. Reto do abdome. Período Pós-Parto.

  20. Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies Adesivo de fibrina e a síntese da cúpula vaginal após histerectomia abdominal em coelhos fêmeas

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    Ari Gonçalves Lima

    2009-02-01

    Full Text Available PURPOSE: To investigate the effectiveness of fibrin glue in comparison with polyglycolic acid suture to promote the closure of rabbit's vaginal vault, after abdominal hysterectomy. METHODS: Twenty female, adults, New Zealand rabbits, were submitted to abdominal hysterectomy and randomly distributed to polyglycolic acid suture (G-PA / n=10 or fibrin glue closure of vaginal vault (G-FG / n=10. Radiograph study allowed identifying vault vaginal suture disrupter or fistulas to urinary bladder or rectum. Videovaginoscopy study allowed identifying the presence of cellulites, abscess formation, tissue granulation or granuloma. Vaginal cuff burst test allowed to identify by the escape of air bubbles and rupture pression record. Histological sections stained with Picrosirius red allowed the measure of fibrous tissue healing. RESULTS: The videovaginoscopy identified a significant difference (Fisher Test pOBJETIVO: Investigar a eficácia da cola de fibrina e da sutura usando fio de ácido poliglicólico para promover o fechamento da cúpula vaginal de coelhas, após histerectomia abdominal. MÉTODOS: Vinte coelhos fêmeas, New Zealand, adultas foram submetidas à histerectomia abdominal e distribuídas para sutura da cúpula vaginal com fio de ácido poliglicólico (G-PA / n=10 ou cola de fibrina (G-FG / n=10. Estudo radiológico foi realizado para identificar deiscências ou fístulas vesicais ou retais. Videovaginoscopia foi realizada para identificar a presença de secreções, abscessos, tecido de granulação ou granuloma tipo corpo estranho. Teste in vitro de pressão de rompimento sob selo d'água foi realizado para identificar a perviedade da sutura. O tecido de cicatrização foi estudado pela coloração com picrosirius red para mensuração do tecido fibrótico. RESULTADOS: A videovaginoscopia mostrou uma diferença significante (Teste de Fisher p<0,3142 no tecido de granulação do grupo G-PA (40% em comparação com o grupo G-FG (20%. A an

  1. Tenascin C protects aorta from acute dissection in mice

    Science.gov (United States)

    Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

    2014-02-01

    Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGFβ signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

  2. Malformações detectadas pelo ultrassom abdominal em crianças com cardiopatia congênita Malformations detected by abdominal ultrasound in children with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Rosana Cardoso Manique Rosa

    2012-01-01

    Full Text Available FUNDAMENTO: Malformações extracardíacas podem estar presentes em pacientes com cardiopatia congênita (CC, trazendo maior risco de comorbidade e mortalidade. OBJETIVO: Verificar a frequência e os tipos de anormalidades abdominais detectadas em crianças com e sem CC através do ultrassom abdominal (USA, comparar os pacientes quanto a seus achados dismórficos/citogenéticos e realizar uma estimativa do custo-benefício da triagem pelo USA. MÉTODOS: Foi realizado um estudo transversal com controle. Os casos consistiram de pacientes com CC admitidos pela primeira vez em uma unidade de terapia intensiva pediátrica; os controles consistiram de crianças sem CC submetidas ao USA no hospital logo após cada caso. Todos os pacientes com CC foram submetidos ao USA, ao cariótipo de alta resolução e à hibridização in situ fluorescente (FISH para microdeleção 22q11.2. RESULTADOS: USA identificou anormalidades clinicamente significativas em 12,2% dos casos e em 5,2% dos controles (p = 0,009, com um poder de significância de 76,6%. A maioria das malformações com significado clínico foi de anomalias renais (10,4% nos casos e 4,9% nos controles, p = 0,034. No Brasil, o custo de um exame de USA pelo Sistema Único de Saúde é de 21 dólares. Uma vez que anormalidades clinicamente significativas foram observadas em um a cada 8,2 pacientes com CC, o custo para identificar uma criança afetada foi de 176 dólares. CONCLUSÃO: Pacientes com CC apresentam uma frequência significativa de anomalias detectadas pelo USA, um método diagnóstico barato e não invasivo, com boa sensibilidade. O custo da triagem para esses defeitos é consideravelmente menor que o custo para tratar as complicações do diagnóstico tardio de malformações abdominais, como a doença renal.BACKGROUND: Extracardiac malformations may be present in patients with congenital heart disease (CHD, bringing greater risk of comorbidity and mortality. OBJECTIVE: Verify frequency

  3. Malformações detectadas pelo ultrassom abdominal em crianças com cardiopatia congênita Malformations detected by abdominal ultrasound in children with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Rosana Cardoso Manique Rosa

    2012-12-01

    Full Text Available FUNDAMENTO: Malformações extracardíacas podem estar presentes em pacientes com cardiopatia congênita (CC, trazendo maior risco de comorbidade e mortalidade. OBJETIVO: Verificar a frequência e os tipos de anormalidades abdominais detectadas em crianças com e sem CC através do ultrassom abdominal (USA, comparar os pacientes quanto a seus achados dismórficos/citogenéticos e realizar uma estimativa do custo-benefício da triagem pelo USA. MÉTODOS: Foi realizado um estudo transversal com controle. Os casos consistiram de pacientes com CC admitidos pela primeira vez em uma unidade de terapia intensiva pediátrica; os controles consistiram de crianças sem CC submetidas ao USA no hospital logo após cada caso. Todos os pacientes com CC foram submetidos ao USA, ao cariótipo de alta resolução e à hibridização in situ fluorescente (FISH para microdeleção 22q11.2. RESULTADOS: USA identificou anormalidades clinicamente significativas em 12,2% dos casos e em 5,2% dos controles (p = 0,009, com um poder de significância de 76,6%. A maioria das malformações com significado clínico foi de anomalias renais (10,4% nos casos e 4,9% nos controles, p = 0,034. No Brasil, o custo de um exame de USA pelo Sistema Único de Saúde é de 21 dólares. Uma vez que anormalidades clinicamente significativas foram observadas em um a cada 8,2 pacientes com CC, o custo para identificar uma criança afetada foi de 176 dólares. CONCLUSÃO: Pacientes com CC apresentam uma frequência significativa de anomalias detectadas pelo USA, um método diagnóstico barato e não invasivo, com boa sensibilidade. O custo da triagem para esses defeitos é consideravelmente menor que o custo para tratar as complicações do diagnóstico tardio de malformações abdominais, como a doença renal.BACKGROUND: Extracardiac malformations may be present in patients with congenital heart disease (CHD, bringing greater risk of comorbidity and mortality. OBJECTIVE: Verify frequency

  4. FECHAMENTO DA PAREDE ABDOMINAL COM AFASTAMENTO PARCIAL DAS BORDAS DA APONEUROSE UTILIZANDO SOBREPOSIÇÃO COM TELAS DE VICRYL OU MARLEX EM RATOS

    Directory of Open Access Journals (Sweden)

    Mazzini Décio Luiz

    1999-01-01

    Full Text Available O presente experimento tem por finalidade estudar o efeito da aplicação de telas absorvíveis e inabsorvíveis, como reforço no fechamento de incisões medianas abdominais em ratos, na situação de aproximação parcial das bordas das aponeuroses. Para isto, foram estudados 45 ratos machos da raça Wistar, divididos em três grupos, nos quais se procedeu da seguinte maneira: Grupo "controle" - incisão mediana abdominal atingindo a cavidade peritoneal, seguida por fechamento apenas da pele; Grupo "vicryl" - incisão mediana abdominal atingindo a cavidade peritoneal, seguida por reforço com tela de vicryl, sobreposta em forma de ponte sobre a aponeurose, mantendo os lábios da aponeurose distantes entre si por 1,0 cm; Grupo "marlex" - procedimento idêntico ao grupo "vicryl", substituindo-se a tela de vicryl por marlex. Após um ano, os animais foram sacrificados e submetidos à avaliação macroscópica quanto à presença de hérnias e aderências às telas; aferição da resistência tênsil da cicatriz cirúrgica através da tração por dinamômetro e estudo histológico dos seguintes fenômenos da cicatrização: reação inflamatória crônica, inflamação granulomatosa tipo corpo estranho, tecido de granulação, hiperplasia fibroblástica e fibrose. Apenas os animais do grupo "controle" desenvolveram hérnias ao final do experimento. Não houve formação de aderências intestinais significativas em nenhum dos grupos estudados. A resistência tênsil foi significativamente maior nos animais em que se aplicaram telas para reforço. A reação inflamatória crônica e a inflamação granulomatosa tipo corpo estranho foram muito mais intensas no grupo em que se utilizou marlex, que nos demais grupos. Quanto ao tecido de granulação e hiperplasia fibroblástica, estavam ausentes em todos os grupos. A fibrose foi mais intensa nos grupos em que as telas foram empregadas. Conclui-se que a utilização de telas nesta situação evita o

  5. Abdominal aortic aneurysms : clinical insights and outcome after endovascular repair

    NARCIS (Netherlands)

    Zandvoort, H.J.A.

    2013-01-01

    Abdominal aortic aneurysm (AAA) is a focal dilatation of the abdominal aorta. The pathophysiology of AAA is a complex multifactorial process and much is still unknown. Histologic and biochemical analysis of AAA wall characteristics can contribute to a better insight in AAA pathophysiology. To make t

  6. Acute abdominal aortic thrombosis following the Heimlich maneuver.

    Science.gov (United States)

    Ayerdi, Juan; Gupta, Sushil K; Sampson, Lawrence N; Deshmukh, Narayan

    2002-04-01

    Complications from the Heimlich maneuver are relatively infrequent. Two fatal cases of abdominal aortic thrombosis have been reported following this technique. We report on the first patient that suffered an acute thrombosis of the abdominal aorta and survived. Prompt recognition of this complication provides the only hope of survival from this rare and catastrophic complication.

  7. Fatores de risco pré, intra e pós-operatórios para mortalidade hospitalar em pacientes submetidos à cirurgia de aorta Risk factors for pre, intra, and postoperative hospital mortality in patients undergoing aortic surgery

    Directory of Open Access Journals (Sweden)

    Mário Issa

    2013-03-01

    Full Text Available OBJETIVOS: O objetivo primário deste estudo é identificar preditores de óbito hospitalar em pacientes submetidos à cirurgia de aorta. O objetivo secundário é identificar fatores associados ao desfecho clínico composto hospitalar (óbito, sangramento, disfunção ventricular ou complicações neurológicas. MÉTODOS: Delineamento transversal com componente longitudinal; por meio de revisão de prontuários, foram incluídos 257 pacientes. Os critérios de inclusão foram: dissecção crônica de aorta tipo A de Stanford e aneurisma de aorta ascendente. Foram excluídos casos de dissecção aguda de aorta, qualquer tipo, e aneurisma de aorta não envolvendo segmento ascendente. As variáveis avaliadas foram demografia, fatores pré, intra e pós-operatórios. RESULTADOS: Variáveis com risco aumentado de óbito hospitalar (RC; IC95%; P valor: etnia negra (6,8; 1,54 30,2; 0,04, doença cerebrovascular (10,5; 1,12-98,7; 0,04, hemopericárdio (35,1; 3,73-330,2; 0,002, operação de Cabrol (9,9; 1,47-66,36; 0,019, cirurgia de revascularização miocárdica simultânea (4,4; 1,31-15,06; 0,017, revisão de hemostasia (5,72; 1,29-25,29; 0,021 e circulação extracorpórea (CEC [min] (1,016; 1,007-1,026; 0,001. Dor torácica associou-se com risco reduzido de óbito hospitalar (0,27; 0,08-0,94; 0,04. Variáveis com risco aumentado do desfecho clínico composto hospitalar foram: uso de antifibrinolítico (3,2; 1,65-6,27; 0,0006, complicação renal (7,4; 1,52-36,0; 0,013, complicação pulmonar (3,7; 1,5-8,8; 0,004, EuroScore (1,23; 1,08-1,41; 0,003 e tempo de CEC [min] (1,01; 1,00-1,02; 0,027. CONCLUSÃO: Etnia negra, doença cerebrovascular, hemopericárcio, operação de Cabrol, revascularização miocárdica simultânea, revisão de hemostasia e tempo de CEC associaram-se com risco aumentado de óbito hospitalar. Dor torácica associou-se com risco reduzido de óbito hospitalar. Uso de antifibrinolítico, complicação renal, complica

  8. Facts about Coarctation of the Aorta

    Science.gov (United States)

    ... Websites Information For... Media Policy Makers Facts about Coarctation of the Aorta Recommend on Facebook Tweet Share ... the body, is narrower than usual. What is Coarctation of the Aorta? Coarctation of the aorta is ...

  9. Neurofibromatosis type 1-associated hypertension secondary to coarctation of the thoracic aorta

    Science.gov (United States)

    Mavani, Gaurang; Kesar, Vivek; Devita, Maria V.; Rosenstock, Jordan L.; Michelis, Michael F.; Schwimmer, Joshua A.

    2014-01-01

    Neurofibromatosis type 1 (NF-1), also known as von Recklinghausen's disease, is an autosomal dominant genetic disorder. NF-I vasculopathy has been used to describe various vascular malformations associated with NF-1. Secondary hypertension related to NF-1 vasculopathy has been reported because of renal artery stenosis, coarctation of the abdominal aorta and other vascular lesions; however, coarctation of the thoracic aorta has seldom been reported. We report the first case, to our knowledge, of isolated coarctation of thoracic aorta in a pregnant female with NF-1. Healthcare providers caring for patients with NF-1 should be aware of associated vascular complications. PMID:25852916

  10. 腹主动脉阻断术后合并脓毒症大鼠肾脏损伤TNF-α的变化%Changes of TNF-αin rats underwent kidney injury complicated with metastasizing septicemia infection after abdominal aorta clamping

    Institute of Scientific and Technical Information of China (English)

    朱睿瑶; 尹述洲; 张迪; 夏文芳; 邹捍东; 周青山

    2014-01-01

    目的:观察大鼠腹主动脉阻断缺血再灌注术后合并脓毒症时肾脏组织病理学改变及肾脏组织中肿瘤坏死因子-α( TNF-α)的变化。方法 SPF级 Wistar大鼠32只随机分为4组:假手术组(A组),腹主动脉阻断组(B 组),脓毒症组(C 组)及腹主动脉阻断合并脓毒症组( D组)。所有动物于再灌注后8 h处死。4%多聚甲醛灌注固定后取肾脏,采用 HE染色光镜下对各组肾脏进行组织形态学对比观察,免疫组化法检测肾脏组织中 TNF -α的表达。结果 HE染色显示 A组无明显病理改变,B 组可见轻度损伤,C 组较 B 组病理改变严重,D组最为严重。TNF -α表达平均总面积 A、B、C、D 组依次递增,与 A 组比较,B、C、D 组均显著增加(P均<0.05),但 B组与 C组无显著性差异(P>0.05);TNF-α表达平均积分光密度 A、B、D、C组依次递增,各组间有显著性差异(P均<0.05)。结论腹主动脉阻断术后合并脓毒症时急性肾损伤最为严重,TNF-α作为一种至关重要的前炎性因子发挥了重要作用;免疫紊乱和肾脏再灌注无复流,对肾脏 TNF -α表达造成了复杂的影响。%Objective It is to observe the pathmorphological changes of kidney tissues and the expression of TNF -α in kidney tissues of rats with ischemic reperfusion injury complicated with sepsis after abdominal aorta champing( AAC). Meth-ods Thirty-two Wistar rats of SPF were randomly divided into four groups:control group( group A),abdominal aorta cham-ping group( group B),sepsis group( group C),and abdominal aorta champing complicated with sepsis group( group D). All animals were killed 8 hours after the reperfusion. The pathomorphological changes in Kidney tissues were observed with HE method,and the TNF-α expression was detection by immunohistochemistty methods. Results There was no obviously patho-logical changes in group A,and was slight pathological changes

  11. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues.

    Science.gov (United States)

    Victorio, Jamaira A; Fontes, Milene T; Rossoni, Luciana V; Davel, Ana P

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  12. Coarctation of the aorta and renal artery stenosis in tuberous sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, P.M.; Robinson, M.B.; Stapleton, F.B.; Roy, S. III; Koh, G.; Tonkin, I.L.D.

    1984-07-01

    Among neurocutaneous disorders, coarctation of the abdominal aorta and renal artery stenosis have traditionally been associated with neurofibromatosis. We report a 5-year-old girl who was discovered to have bilateral renal artery stenosis, coarctation of the abdominal aorta, renal cysts and typical skin lesions of tuberous clerosis during the evaluation of asymptomatic hypertension. Renal vascular hypertension has not been reported previously in tuberous sclerosis. We conclude that the tuberous sclerosis complex should be expanded to include vascular malformations and the hypertension should not be assumed to be secondary to renal hamartomata or cysts in patients with tuberous sclerosis.

  13. Circunferência abdominal como preditor de evolução em 30 dias na síndrome coronariana aguda

    Directory of Open Access Journals (Sweden)

    Priscilla Azambuja Lopes de Souza

    2011-05-01

    Full Text Available FUNDAMENTO: A circunferência abdominal (CA é a medida que mais se correlaciona com os fatores de risco e morte por doença cardiovascular. Entretanto, o impacto da obesidade no prognóstico de pacientes com doenças cardiovasculares permanece controverso e requer maiores esclarecimentos. OBJETIVO: Avaliar a CA como preditor de evolução em 30 dias em pacientes que internaram com síndrome coronariana aguda (SCA, em hospital de referência no tratamento de doenças cardiovasculares. MÉTODOS: Coorte contemporânea com 267 pacientes que internaram por SCA e que foram seguidos por 30 dias após a alta levando em consideração os eventos cardiovasculares maiores - MACE - (óbito, reinfarto, reinternação para procedimentos de revascularização. Nas primeiras 24 horas da admissão, os pacientes responderam a um questionário e posteriormente tiveram a CA mensurada. A análise estatística foi realizada com SPSS 17.0, utilizando o teste do Qui-quadrado para variáveis categóricas e o teste t de Student para as variáveis numéricas, com o nível de significância de p < 0,05. As variáveis que apresentaram valores de p < 0,10, na análise bivariada, foram incluídas em um modelo de regressão logística para avaliar o papel da CA como preditor independente de MACE. RESULTADOS: Após análise multivariável, apenas o gênero feminino (RC = 8,86; 95% IC:4,55-17,10; p < 0,00, hipertensão arterial sistêmica (RC = 2,06; 95% IC:1,10-3,87; p = 0,02 e história familiar de cardiopatia isquêmica (RC = 2,10; 95% IC:1,17-3,74; p = 0,01 permaneceram associados com os MACE. CONCLUSÃO: Em nosso estudo, a CA alterada não se associou à maior incidência de MACE em 30 dias de seguimento.

  14. Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros Weight excess and abdominal fat in the metabolic syndrome among Japanese-Brazilians

    Directory of Open Access Journals (Sweden)

    Daniel D G Lerario

    2002-02-01

    Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

  15. [TIC4]endomorphins, analogues of endomorphins, have significantly enhanced vasorelaxant effects in rat aorta rings.

    Science.gov (United States)

    Zhao, Qian-Yu; Chen, Qiang; Feng, Yun; Lin, Xin; Wang, Rui

    2005-05-01

    [Tic(4)]EM1 and [Tic(4)]EM2, new endomorphins (EMs) analogues, caused relaxation of rat aorta rings precontracted with phenylphrine in a concentration-dependent manner and were 240- to 370-fold more potent than EMs. This effect was inhibited by endothelium removal or by incubation with NO synthase inhibitor L-NNA or opioid receptor antagonist naloxone. The results demonstrate that [Tic(4)]EMs have NO- and endothelium-dependent vasorelaxant effects which are mediated by the opioid receptor.

  16. Teratologias alar e abdominal observadas em Sympetrum fonscolombii (Sélys, 1840) (Odonata: Libellulidae) dos Açores

    OpenAIRE

    Vieira, Virgílio

    2012-01-01

    Copyright © 2012 Sociedad Entomológica Aragonesa. Descreve-se um caso de teratologia alar num macho e um caso de deformação abdominal numa fêmea de Sympetrum fonscolombii. Estas teratologias resultam provavelmente de problemas observados durante a emergência. Também, constituem a primeira referência de malformações para esta espécie nos Açores. ABSTRACT: Wing teratology is reported in the male of Sympetrum fonscolombii. Also, the description is included of a teratological female present...

  17. Pseudo-aneurisma em tubo valvulado de pericárdio bovino corrugado após reconstrução da aorta ascendente: relato de caso False aneurysm of crimped bovine pericardial conduit after reconstruction of the ascending aorta: case report

    Directory of Open Access Journals (Sweden)

    Noedir A. G. STOLF

    1999-10-01

    Full Text Available Os autores descrevem o caso de paciente que, 9 anos após a correção cirúrgica de um aneurisma de aorta ascendente com tubo valvulado de pericárdio bovino corrugado, evoluiu com a formação de um pseudo-aneurisma de aorta localizado, posteriormente, sobre a linha de sutura do tubo de pericárdio bovino. Foi realizada substituição do tubo de pericárdio bovino por tubo de Dacron valvulado (com prótese mecânica e reimplante dos óstios coronários utilizando-se a técnica de hemi-Cabrol. O tempo de seguimento pós-operatório do paciente é de 12 meses, permanecendo assintomático.The authors describe the case of a patient who had an aneurysm of the ascending aorta repaired with biologic valved crimped bovine pericardial conduit. Nine years after the surgery he presented a false aneurysm of the ascending aorta, located posteriorly on the suture line of the pericardial tube. The patient was reoperated and the pericardial tube was replaced by a valved Dacron composite graft using the hemi- Cabrol technique for the reimplantation of the coronary ostia. At 12 months follow-up the patient remains free of symptoms.

  18. Tratamento cirúrgico da dissecção da aorta Surgical treatment of the aortic dissection

    Directory of Open Access Journals (Sweden)

    Marcos Fassheber Berlinck

    1990-04-01

    Full Text Available Entre janeiro de 1979 e dezembro de 1989, foram realizadas 85 operações para o tratamento da dissecção da aorta, sendo 50 na fase aguda e 35 na fase crónica. A mortalidade imediata (hospitalar foi de 21,1% (18 pacientes, tendo como causa principal a síndrome de baixo débito cardíaco. Foi maior nos pacientes operados na fase aguda. Dentre quatro pacientes reoperados por recidiva ou dissecção em outro local, dois faleceram. Com relação à morbidade, uma paciente, reoperada por aneurisma tóraco-abdominal, apresentou paraplegia no período de pós-operatório. O seguimento tardio mostrou boa evolução dos 63 sobreviventes.Between January 1979 and December 1989, eighty five operations were performed to treat aortic dissection, including fifty in the acute phase, and thirty five in a chronic phase. The Hospital mortality was 21.1% (eighteen patients and low cardiac output was the major cause of death. The mortality was higher in the group of patients operated upon in the acute phase. Four patients were operated upon for redissection or dissection in other localization of the aorta, and all of them died. One patient developed paraplegy in the postoperative period. The late follow-up showed good evolution in the survivors group.

  19. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    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. PCR para o diagnóstico da angiostrongilíase abdominal em tecido humano e resultados em camundongos tratados com enoxaparina

    OpenAIRE

    Rubens Rodriguez

    2013-01-01

    A angiostrongilíase abdominal (AA) é uma doença causada pelo nematódeo Angiostrongylus costaricensis, tendo como hospedeiros definitivos roedores silvestres e hospedeiros intermediários moluscos terrestres. No homem, hospedeiro acidental, pode causar infartos intestinais e pseudotumorações, que podem complicar com peritonite e sepse. O diagnóstico definitivo é realizado pelo estudo histopatológico de peças cirúrgicas, ao serem identificadas estruturas parasitárias como vermes, ovos ou larvas....

  1. Atherosclerotic Human Aorta

    Directory of Open Access Journals (Sweden)

    Igor A. Sobenin

    2011-01-01

    Full Text Available We have evaluated the binding of sialylated and desialylated lipoproteins to collagen isolated from the proteoglycan and musculoelastic layers of intima and media of uninvolved human aorta and atherosclerotic lesions. Comparing various collagen preparations from the uninvolved intima-media, the binding of sialylated apoB-containing lipoproteins was best to collagen from the intimal PG-rich layer. Binding of sialylated apoB-containing lipoproteins to collagen from this layer of fatty streak and fibroatheroma was 1.4- and 3.1-fold lower, respectively, in comparison with normal intima. Desialylated VLDL versus sialylated one exhibited a greater binding (1.4- to 3.0-fold to all the collagen preparations examined. Desialylated IDL and LDL showed a higher binding than sialylated ones when collagen from the intimal layers of fibroatheroma was used. Binding of desialylated HDL to collagen from the intimal PG-rich layer of normal tissue, initial lesion, and fatty streak was 1.2- to 2.0-fold higher compared with sialylated HDL.

  2. Prevalência e fatores associados à obesidade abdominal em indivíduos na faixa etária de 25 a 59 anos do Estado de Pernambuco, Brasil Prevalencia y factores asociados a la obesidad abdominal en individuos en una franja de edad de 25 a 59 años del estado de Pernambuco, Brasil Prevalence of abdominal obesity and associated factors among individuals 25 to 59 years of age in Pernambuco State, Brazil

    Directory of Open Access Journals (Sweden)

    Claudia Porto Sabino Pinho

    2013-02-01

    Full Text Available Com o objetivo de estimar a prevalência de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 indivíduos na faixa etária de 25-59 anos. A obesidade abdominal foi determinada pela circunferência da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variáveis socioeconômicas, demográficas, reprodutivas e comportamentais. A prevalência de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7 no sexo masculino e 69,9% (IC95%: 66,8-72,8 no feminino (p Con el objetivo de estimar la prevalencia de obesidad abdominal y evaluar los factores asociados en adultos del estado de Pernambuco, Brasil, se realizó, en 2006, un estudio transversal, de base poblacional, involucrando a 1.580 individuos en una franja de edad de 25-59 años. La obesidad abdominal fue determinada por la circunferencia de la cintura ≥ 80cm para mujeres y ≥ 94cm para hombres. El modelo conceptual consideró variables socioeconómicas, demográficas, reproductivas y de comportamiento. La prevalencia de obesidad abdominal fue de un 27,1% (IC95%: 23,8-30,7 en el sexo masculino y un 69,9% (IC95%: 66,8-72,8 en el femenino (p In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC ≥ 80cm in women and ≥ 94cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7 in males and 69.9% (95%CI: 66.8-72.8 in females (p < 0.001. Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women

  3. Aneurisma de aorta abdominal y fistula aorto-cava

    Directory of Open Access Journals (Sweden)

    Juan Jose Gonzalez Soler

    2012-03-01

    Full Text Available Paciente de 67 años de edad que acude al servicio de urgencias por dolor dorsolumbar intenso de 4 horas de evolu-ción. Se trata de un paciente con hipoacusia neurosensorial severa que dificulta la anamnesis. Se desconocen factores de riesgo cardiovascular por no constar seguimiento médico habitual.

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

    Science.gov (United States)

    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.

  5. THE COURSE OF DISSECTING ANEURYSM OF THE AORTA

    Directory of Open Access Journals (Sweden)

    N. A. Kosheleva

    2016-01-01

    Full Text Available Research objective. To define features of a course of dissecting aortic aneurysm now.Materials and methods. 11 clinical records of the patients with the established diagnosis of dissecting aortic aneurysm who have come to Regional clinical hospital of Saratov for 2015 are analysed.Results. Along with traditional risk factors, such as the male, existence of arterial hypertension are revealed also additional risk factors, in particular, regular heavy lifting. Gender features in localization of dissecting aortic aneurysm are defined: at men more often of dissecting aortic aneurysm of an aorta is localized in the abdominal aorta, at women in the thoracic region.Conclusions. Additional risk factor of stratification of dissecting aortic aneurysm in the thoracic region at women is the systematic raising of weights.

  6. Técnica de sutura en plicatura abdominal que prescinde de un ayudante Plicatura em abdominoplastia que elimina um auxiliar Plication in abdominoplasty that excuses aid

    Directory of Open Access Journals (Sweden)

    F.A.M. Cido Carvalho

    2009-12-01

    Full Text Available La plicatura en la abdominoplastia es una de las técnicas indicada para corregir la flacidez de la región muscular del abdomen. Requiere un tiempo quirúrgico importante y de la ayuda de un cirujano auxiliar. Presentamos una variante de sutura en X, con nylon 2.0, que evita la necesidad de un ayudante quirúrgico.A plicatura nas abdominoplastias é uma dessas técnicas e tem sido indicado para corrigir a flacidez da região musculofascial. Demanda tempo cirúrgico substancial e de um cirurgião auxiliar. É demonstrada uma variação de sutura em X, com nylon 2.0, que dispensa o cirurgião auxiliarPlication in abdominoplasty is an indicated technique to correct muscular flaccidity of the musculofascial system in abdominal region. It demands surgical time and helping from an aid surgeon. We present a technical variation in X plication suture, with nylon 2.0 that does not require an auxiliary surgeon.

  7. Abdominal pain

    Science.gov (United States)

    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 ...

  8. Abdominal actinomycosis.

    Science.gov (United States)

    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.

  9. Analgesia preemptiva com S(+cetamina e bupivacaína peridural em histerectomia abdominal Analgesia preemptiva con S(+cetamina y bupivacaína peridural en histerectomía abdominal Preemptive analgesia with epidural bupivacaine and S(+ketamine in abdominal hysterectomy

    Directory of Open Access Journals (Sweden)

    Ferdinand Edson de Castro

    2005-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O presente estudo investiga a capacidade de o antagonista do receptor NMDA, S(+cetamina, associado à injeção peridural de anestésico local (bupivacaína, previamente administrado à incisão promover analgesia preemptiva em pacientes submetidas a histerectomia total abdominal. MÉTODO: Foram avaliadas 30 pacientes, distribuídas aleatoriamente em dois grupos de igual tamanho e estudadas prospectivamente de forma encoberta. Injeção peridural e inserção de cateter foram realizadas entre os interespaços de L1-L2. No grupo I (G1, n = 15, as pacientes receberam, por via peridural, 17 mL de bupivacaína a 0,25%, sem vasoconstritor, associados a 30 mg de S(+cetamina (3 mL, trinta minutos antes da incisão cirúrgica; após 30 minutos da incisão, receberam 20 mL de solução fisiológica a 0,9%. No grupo 2 (G2, n = 15, receberam 20 mL de solução fisiológica, por via peridural, 30 minutos antes da incisão, sendo feita administração de 17 mL de bupivacaína a 0,25% associados a 30 mg de S(+cetamina (3 mL, trinta minutos depois da incisão. Após a injeção peridural, realizou-se anestesia geral com propofol, pancurônio, O2 e isoflurano. Para analgesia pós-operatória foi usada solução peridural em bolus de fentanil associada à bupivacaína, em intervalo mínimo de quatro horas e suplementação com dipirona, se necessária. Avaliou-se a intensidade da dor através de escala numérica e verbal (ao despertar, 6, 12, 18 e 24 horas após o término da operação, o tempo necessário para solicitar pela primeira vez o analgésico e o consumo total de analgésicos. RESULTADOS: Não houve diferença significativa entre os grupos em relação ao tempo para solicitar analgésicos pela primeira vez, ao consumo de analgésicos e aos escores de dor pelas escalas numérica e verbal. CONCLUSÕES: Não foi possível demonstrar efeito preemptivo com a utilização peridural de S(+cetamina e bupivacaína nas doses

  10. Efeitos hemodinâmicos da oclusão da aorta durante anestesia inalatória com isoflurano e sevoflurano: estudo experimental em cães Efectos hemodinámicos de la oclusión de la aorta durante anestesia por inhalación con isoflurano y sevoflurano: estudio experimental en perros Hemodynamic effects of aortic occlusion during inhalational anesthesia with isoflurane and sevoflurane: experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Artur Udelsmann

    2006-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A supressão do fluxo aórtico e sua posterior liberação em intervenções cirúrgicas da aorta ocasionam importantes distúrbios hemodinâmicos. O objetivo deste estudo foi avaliar essas alterações em cães anestesiados com isoflurano ou sevoflurano. MÉTODO: Foram estudados 41 cães, divididos em dois grupos segundo o anestésico empregado na manutenção com 1 CAM: GI (n = 21 isoflurano; GS (n = 20 sevoflurano. Foi realizada a oclusão aórtica por insuflação de balão intra-arterial infradiafragmático por 30 minutos. Os parâmetros hemodinâmicos foram observados nos momentos M1 (controle, M2 e M3, 15 e 30 minutos após a oclusão aórtica, M4 e M5, 15 e 30 minutos após a desinsuflação do balão. RESULTADOS: Durante a oclusão da aorta, observou-se aumento da pressão arterial média (PAM, da pressão venosa central (PVC, da pressão de artéria pulmonar (PAP, da pressão de capilar pulmonar (PCP e da resistência vascular sistêmica (RVS sem aumento da resistência vascular pulmonar (RVP e do débito cardíaco (DC. O DC manteve-se mais estável com o isoflurano comparado com o sevoflurano, com o qual apresentou diminuição após a oclusão. A freqüência cardíaca teve diminuição inicial seguida de aumento durante a oclusão sendo em GS mais expressiva do que em GI, porém sem diferença significativa entre os grupos. O volume sistólico não teve grandes alterações; o trabalho sistólico dos ventrículos esquerdo e direito aumentou após a oclusão de forma semelhante nos dois grupos. Com a liberação do fluxo PAM, PVC, PAP, PCP e RVS diminuíram, a RVP aumentou nos dois grupos; o trabalho ventricular diminuiu abruptamente. CONCLUSÕES: O estudo demonstrou ser o isoflurano mais bem indicado nessas intervenções cirúrgicas por causar menores alterações hemodinâmicas.JUSTIFICATIVA Y OBJETIVOS: La supresión del flujo aórtico y su posterior liberación en intervenciones quirúrgicas de la

  11. Coarctation of the Aorta (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Coarctation of the Aorta KidsHealth > For Teens > Coarctation of ... of Yourself en español Estrechamiento aórtico What Is Coarctation of the Aorta? The aorta (pronounced: ay-OR- ...

  12. Medical image of the week: atherosclerotic aneurysm of aortic arch and descecnding thoracic aorta

    Directory of Open Access Journals (Sweden)

    Parasram M

    2016-02-01

    Full Text Available No abstract available. Article truncated after 150 words. A 94-year-old Spanish-speaking woman presented to the hospital with intermittent episodes of dyspnea and abdominal pain for one week. Her past medical history was notable for 30 pack-year smoking history and hypertension, which was reportedly controlled with medical therapy. Physical exam showed trace peripheral edema bilaterally, intact peripheral pulses, and a mild abdominal bruit. Work up at the emergency department revealed a non-ST elevation myocardial infarction with troponin T of 0.34 ng/mL but no ST-wave abnormality on electrocardiography. Chest x-ray displayed an incidental thoracic aneurysm (Figure 1. Chest computed tomography with contrast demonstrated a continuous aneurysm of the aortic arch and descending thoracic aorta with diameters measuring 6.8 cm and 6 cm, respectively (Figure 2A and 2B. Eccentric thrombi are noted in the aortic arch and the descending aorta. Interestingly, the distal descending thoracic aorta curves as it transitions to the abdominal aorta, which is evidence of a tortuous descending ...

  13. Avaliação da aderência peritoneal com utilização de pericárdio bovino no reparo de grandes defeitos da musculatura da parede abdominal em ratos Wistar de ratos Wistar

    Directory of Open Access Journals (Sweden)

    Mauro Razuk Filho

    2014-10-01

    Full Text Available Introdução: A reconstrução dos grandes defeitos congênitos da parede abdominal tem sido um problema. No entanto, o uso de materiais biológicos, como o Pericárdio Bovino (PB tem se mostrado uma boa alternativa. Sua aplicação para reparos na musculatura abdominal continua sendo objeto de estudos e pouco disseminada na prática cirúrgica humana; Objetivos: Propor um modelo experimental de um defeito congênito da parede abdominal em ratos Wistar que será corrigido com PB; Metodologia: Ratos foram submetidos à laparotomiaxifoumbilical em que foram suturadas pequenas placas de pericárdio bovino ou foi realizada somente a sutura, de acordo com o grupo, diretamente no peritônio dos animais, sem lesá-los. O grupo 1 foi constituído por 5 animais que foram submetidos à sutura de placa de pericárdio bovino, o grupo 2 foi constituído por 5 animais que foram submetidos à sutura do peritônio (grupo controle. Três semanas após as cirurgias, os peritônios foram retirados e submetidos a a realização da análise histológica; Resultados: Foi identificado a presença de fibrose, infiltrado mononuclear e neoformação vascular em ambos os grupos; Conclusões: A microscopia revelou semelhanças entre os grupos controle de estudo, o que sugere que o uso do pericárdio bovino para o reparo de grandes defeitos da parede abdominal é seguro;

  14. Efeito histológico causado na parede posterior da cavidade abdominal pela lavagem com solução salina 0,9% aquecida a diferentes temperaturas: estudo experimental em ratos

    Directory of Open Access Journals (Sweden)

    Silva Alcino Lázaro da

    2001-01-01

    Full Text Available A lavagem da cavidade abdominal com solução salina 0,9% aquecida é uma prática comum em cirurgia geral, mas, geralmente, não há um controle adequado da sua temperatura, sendo por vezes introduzida na cavidade abdominal a temperaturas elevadas, possivelmente causando lesões no nível celular. O objetivo do trabalho é estudar a célula da parede posterior da cavidade abdominal de ratos após o tratamento desta com solução salina 0,9% aquecida a graus diversos. Foram utilizados 28 ratos divididos em três grupos com 9 animais cada e um rato controle. O grupo A foi tratado com solução salina 0,9% a 37ºC, o grupo B a 45ºC e o grupo C a 60ºC. O rato controle não recebeu tratamento com solução salina 09,%. Em todos os grupos a solução salina 0,9% permaneceu na cavidade durante 1 minuto. Exame histopatológico revelou que no rato controle e nos grupos A e B as fibras musculares e as estriações celulares estavam intactas. No grupo C, no entanto, observaram-se princípios de degeneração celular. Como conclusão ressalta-se a importância de um controle efetivo da temperatura da solução salina 0,9% a ser introduzida na cavidade abdominal de ratos para prevenir um trauma térmico no nível celular.

  15. Caracterização dos traumas abdominais em pacientes atendidos no Hospital Universitário Regional de Maringá, 2006 = Abdominal trauma at the University Hospital of Maringá, 2006

    Directory of Open Access Journals (Sweden)

    Orlando Ribeiro Prado Filho

    2008-07-01

    Full Text Available De todas as mortes por causas externas por trauma, metade poderia ser evitada, e um terço delas é dito potencialmente evitável. Objetiva-se determinar as características comuns referentes ao paciente com traumatismo abdominal. Realizou-se um estudo de 57 casos de pacientes com traumatismo abdominal atendidos no Hospital UniversitárioRegional de Maringá, no período de janeiro a dezembro de 2006. Constatou-se que a maioria das vítimas é do sexo masculino; a faixa etária mais acometida é a terceira década de vida; o trauma abdominal aberto mostrou-se discretamente mais frequente, sendo o ferimento por arma branca mais comum; a maioria das contusões abdominais se deveu aacidentes de trânsito; a realização de intervenção cirúrgica supera o tratamento conservador nos traumas abdominais abertos; nos traumas contusos, o baço e os rins foram os órgãos mais acometidos, enquanto nos ferimentos abertos a víscera mais acometida foi o intestinodelgado; a evolução para óbito predominou nos traumas abdominais abertos. Em virtude da prevalência, gravidade e importância do tema, sugere-se que mais estudos sejam realizados para que, assim, seja possível estabelecer condutas cada vez mais apropriadas à realidade doSistema Único de Saúde.Of all the deaths due to external cause trauma, half could be avoided, and a third are potentially preventable. The objective of this study was to determine the common characteristics related to patients with abdominal trauma. A study was conducted of 57 cases of abdominal trauma at the University Hospital of Maringá, during the period from January to December 2006. The majority of victims are male; the most affected age group is in its third decade oflife; open abdominal trauma proved to be slightly more prevalent, and wounds from cold steel weapons were the most common; most abdominal injuries were due to traffic accidents; the conduct of surgical intervention overcomes conservative treatment in

  16. Abdominal Sepsis.

    Science.gov (United States)

    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.

  17. Therapeutic Prospect of Adipose-Derived Stromal Cells for the Treatment of Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    Parvizi, Mojtaba; Harmsen, Martin C.

    2015-01-01

    Aneurysm refers to the dilation of the vessel wall for more than 50%. Abdominal aortic aneurysm (AAA) refers to the dilation and weakening of all three layers of the abdominal aorta, which mostly occur infrarenally. The population aged above 50 years is at risk of AAA development, while a familiar h

  18. Familial Abdominal Aortic Aneurysm : Clinical Features and Genetics

    NARCIS (Netherlands)

    K.M. van de Luijtgaarden (Koen)

    2016-01-01

    markdownabstractAbstract Cardiovascular disease is the most important cause of death in the world and encompasses occlusive as well as aneurysmal disease. The most common aneurysm in humans is the abdominal aortic aneurysm (AAA). The question is why the aorta dilates in aneurysmal disease and occ

  19. Effects of bromopride on abdominal wall healing with induced peritoneal sepsis after segmental colectomy and colonic anastomosis in rats Efeitos da bromoprida na cicatrização da parede abdominal com sepse peritoneal induzida e submetidos à ressecção segmentar e anastomose do cólon esquerdo em ratos

    Directory of Open Access Journals (Sweden)

    Marcos Vinícius Melo de Oliveira

    2011-12-01

    Full Text Available PURPOSE: Evaluate the effects of bromopride on abdominal wall healing of rats with induced peritoneal sepsis after segmental colectomy and colonic anastomosis. METHODS: Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of bromopride (bromopride group - B or saline solution (control group - C. Each group was divided into subgroups of 10 animals each to be killed on the third (GB3 and GC3 or seventh postoperative day (GB7 and GC7. It was analyzed the following characteristics: breaking strength of the abdominal wall's wound; surgical and histopathological features of the abdominal wall; and clinical features of the rats. RESULTS: There was no difference between the groups in relation to the weight of the rats and the breaking strength of the abdominal wall's wound. The GB7 group presented less edema and less quantity of fibrin during histopathological evaluation compared to the GC7 group. CONCLUSION: Bromopride did not have harmful effects on the healing of abdominal wall in rats.OBJETIVO: Avaliar o efeito da bromoprida, na cicatrização da ferida operatória da parede abdominal de ratos com sepse peritoneal experimentalmente induzida e submetidos a ressecção segmentar e anastomose de cólon esquerdo. MÉTODOS: 40 ratos distribuídos em dois grupos contendo 20 animais, para administração de bromoprida (grupo bromoprida- B ou solução de NaCl 0,9% (grupo controle - C. Cada grupo foi dividido em subgrupos contendo 10 animais, para eutanásia no terceiro (GB3 e GC3 ou sétimo dia (GB7 e GE7 de pós-operatório. Os ratos foram submetidos à secção do cólon esquerdo e anastomose término-terminal. No dia da eutanásia foram avaliadas as características cirúrgicas da cavidade abdominal e clínicas dos ratos. Foram coletados segmentos da parede para a avaliação histopatológica e de resistência tênsil da ferida operatória. RESULTADOS: N

  20. Verificação da viabilidade do transplante autógeno de testículo no omento e na parede abdominal em ratos Verification of the feasibility of autogenous testis implant in omentum and abdominal wall in mice

    Directory of Open Access Journals (Sweden)

    Sergio Ibañez Nunes

    2013-02-01

    Full Text Available OBJETIVO: verificar a viabilidade do transplante autógeno de testículos na parede abdominal e omento, em ratos, sem anastomose vascular, analisando a estrutura histológica das células testiculares após o implante. MÉTODOS: foram utilizados 60 ratos Wistar, machos, de 10-12 semanas de idade, distribuídos em três grupos: grupo controle: 20 ratos sem orquiectomia, com operação simulada; grupo 2: 20 ratos com orquiectomia bilateral sendo um testículo implantado no omento maior; grupo 3: 20 ratos com orquiectomia bilateral, sendo um testículo implantado na parede abdominal. Após dois meses eles foram mortos e os testículos avaliados pelo exame anatomopatológico. RESULTADO: o peso dos implantes teve perda de 0,62g no grupo 2, de 0,73g no grupo 3 e no grupo controle houve aumento de 0,1g. Ao estudo anatomopatológico, no grupo controle a estrutura testicular foi preservada; no grupo 2 encontrou-se 80% de inflamação e necrose, não foram visualizadas células de Sertoli ou de Leydig, em dois animais encontraram-se túbulos seminíferos; no grupo 3 encontrou-se 75% de inflamação e 60% de necrose, somente em um conseguiu-se visualizar células de Sertoli e em três células de Leydig. CONCLUSÃO: não é viável o transplante autógeno de testículo sem anastomose vascular em ratos no omento maior e na parede abdominal.OBJECTIVE: To verify the feasibility of autologous transplantation of testes to the abdominal wall and omentum of rats without vascular anastomosis, analyzing the histological structure of the testicular cells after implantation. METHODS: We used 60 male Wistar rats, 10-12 weeks of age, which were divided into three groups: control group: 20 rats without orchiectomy with sham operation; group 2: 20 rats undergoing bilateral orchiectomy, with one of the testicles being implanted into the greater omentum; and group 3: 20 rats submitted to bilateral orchiectomy, with one testicle implanted in the abdominal wall. After two

  1. 缬沙坦涂层支架置入兔腹主动脉对血管内膜胶原沉积及AT2受体表达的影响%Influence of valsartan-eluting stent implantation into rabbit abdominal aorta on collagen deposition and AT2 receptor expression

    Institute of Scientific and Technical Information of China (English)

    李贵华; 王雷; 贾三庆; 赵林; 姚道阔; 丁荣晶; 任文林

    2008-01-01

    BACKGROUND:Clinical trials have shown that oral administration of valsartan can decrease in-stent restenosis after stent implantation.But whether valsartan used locally also has the sanle effect and the possible mechanism should be validated.OBJECTIVE:To observe the effect of valsartan-eluting stents on collagen deposition in neointima and AT2 receptor expression after implanting valsartan-eluting stents into rabbit abdominal orta.DESIGN:Randomized and controlled animal experiment.SETTING:Beijing Friendship Hospital.MATERIALS:The experiment was performed at the Laboratory of Beijing Friendship Hospital between October 2004 and March 2006.Fifteen New Zealand white rabbits,irrespective of gender,weighing 2.75-3.25 kg were selected(Animal Laboratory of Beijing Friendship Hospital).The rabbits were adaptively fed for one week.All the operations of rabbits during the experiment were accorded with animal ethical standards.Valsartan powder was presented as a gift by Novartis.China;Reagent of MASSON was provided by Department of Pathology of Beijing Friendship Hospital;1%picrosirius solution was provided by the Department of Pathology of China-Japan Friendship Hospital:Mice-anti-rabbit monoclonal AT2 antibody was product of Santa Cruz Biotechnology (USA);Envision reagent was purphased from Dako;primers were synthesized by SBS Genetech(SBS).METHODS:①The animals were randomized into bare-metal stent group,carrier-eluting stent group and valsartan-eluting stent group with 5 animals in each group.All rabbits were implanted with corresponding types of above-mentioned stents into abdominal aortas down below renal artery.②Quantitative angiography before,immediately after and 3 months after stent implantation were performed to compare vascular diameters of the aortas.③Three months Iater,the rabbits were executed after anaesthesia.The vessels with stents were processed with HE staining.Indices of the vascular neointimal formation,I.e. iBrier and external elastic membrane

  2. Circunferência abdominal como preditor de evolução em 30 dias na síndrome coronariana aguda Circunferencia abdominal como predictor de evolución en 30 días en el Síndrome Coronario Agudo Abdominal circumference as a predictor of 30-day outcome in acute coronary syndrome

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    Priscilla Azambuja Lopes de Souza

    2011-05-01

    Full Text Available FUNDAMENTO: A circunferência abdominal (CA é a medida que mais se correlaciona com os fatores de risco e morte por doença cardiovascular. Entretanto, o impacto da obesidade no prognóstico de pacientes com doenças cardiovasculares permanece controverso e requer maiores esclarecimentos. OBJETIVO: Avaliar a CA como preditor de evolução em 30 dias em pacientes que internaram com síndrome coronariana aguda (SCA, em hospital de referência no tratamento de doenças cardiovasculares. MÉTODOS: Coorte contemporânea com 267 pacientes que internaram por SCA e que foram seguidos por 30 dias após a alta levando em consideração os eventos cardiovasculares maiores - MACE - (óbito, reinfarto, reinternação para procedimentos de revascularização. Nas primeiras 24 horas da admissão, os pacientes responderam a um questionário e posteriormente tiveram a CA mensurada. A análise estatística foi realizada com SPSS 17.0, utilizando o teste do Qui-quadrado para variáveis categóricas e o teste t de Student para as variáveis numéricas, com o nível de significância de p FUNDAMENTO: La circunferencia abdominal (CA es la medición que se correlaciona con los factores de riesgo y la muerte por enfermedad cardiovascular. Sin embargo, el impacto de la obesidad en el pronóstico de los pacientes con enfermedades cardiovasculares sigue siendo controvertido y requiere una mayor clarificación. OBJETIVO: Evaluar la CA como un predictor de evolución en 30 días en pacientes que fueron hospitalizados con síndrome coronario agudo (SCA, en un hospital de referencia para el tratamiento de las enfermedades cardiovasculares. MÉTODOS: Cohorte contemporánea con 267 pacientes que fueron hospitalizados por SCA y que fueron seguidos durante 30 días después del alta, teniendo en cuenta los eventos cardiovasculares mayores - MACE - (muerte, reinfarto, rehospitalización por procedimientos de revascularización. En las primeras 24 horas del ingreso, los pacientes

  3. O uso do peritônio de paca conservado em solução supersaturada de açúcar a 300% ou glicerina a 98% implantados na parede abdominal de ratos

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    L.M. Leal

    2014-10-01

    Full Text Available Na busca de material biológico alternativo para a realização de implantes, objetivou-se com o presente estudo avaliar comparativamente a implantação do peritônio de paca, uma nova opção de biomaterial, conservado em solução supersaturada de açúcar a 300% e conservado em glicerina a 98% na parede abdominal de ratos Wistar. Foram utilizados 60 ratos, machos, da linhagem Wistar, pesando entre 150 e 200 gramas, organizados nos seguintes grupos experimentais: grupo controle (GI, grupo peritônio conservado em solução supersaturada de açúcar a 300% (GII e grupo peritônio conservado em glicerina a 98% (GIII, cada um com 20 animais. Os grupos GII e GIII receberam o enxerto de peritônio da paca conservado em solução de açúcar 300% e glicerina 98%, respectivamente, e o grupo GI não recebeu a membrana. Cinco ratos de cada grupo foram submetidos à eutanásia em quatro momentos distintos: sete, 15, 30 e 60 dias de pós-operatório para avaliações macroscópicas e microscópicas da interface implante-tecido nativo. Apesar de reações adversas observadas em 57,5% dos animais do grupo GII e GIII, em 95% dos animais desses grupos houve boa cicatrização da membrana. Na análise histológica, verificou-se a presença de grande infiltrado inflamatório nos períodos iniciais (sete e 15 dias e grande presença de tecido conjuntivo nos momentos finais (30 e 60 dias. Concluiu-se que o peritônio da paca como membrana biológica conservado nos meios estudados pode ser utilizado com segurança na parede abdominal de ratos; ainda, que sua conservação em solução supersaturada de açúcar a 300% permitiu melhor maleabilidade no ato cirúrgico.

  4. Micromanaging Abdominal Aortic Aneurysms

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    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.

  5. Application of two multi-dimensional analytical methods to histological study of the aorta in dietary atherosclerosis of the rabbit.

    Science.gov (United States)

    Richard, J L; Martin, C; Desecure, J P; Jacotot, B

    1980-01-01

    Multivariate analysis (principal component analysis, discriminant analysis) have been applied to the histological data of arterial lesions in experimental atherosclerosis of the rabbit. We carried out a comparative study of: 1. the lesion observed at three levels of the aortas; origin of the aorta, thoracic aorta and abdominal aorta, and 2. the lesions according to the type of fat ingested during the experimental period. Five edible fats were studied: butter, olive oil, arachid oil, rapeseed oil rich in erucic acid, and rapeseed oil poor in erucic acid (Primor). This study re-affirms the possible importance of the above mentioned methods in evaluation by histology of lesions induced in the arteries by the different hyperlipidic regimens. Indeed these methods are complementary and enable the introduction of statistical methods in the quantitative evaluation of morphological lesions.

  6. Mice aorta loop grafting: A new model which separate vascular rejection and neointimal formation in chronic rejection

    Institute of Scientific and Technical Information of China (English)

    陈勇; 窦科峰; 何勇; 孙凯

    2003-01-01

    Objective: To study the cause and mechanism of transplantation vasculopathy which characterized by accelerated graft arteriosclerosis (AGA), we established a mouse aorta graft model. Methods: A segment of thoracic aortas of B10.A (2R) mice were transplanted to C57BL/10 mice abdominal aorta by end to side anastomoses. The different time point collected grafts were analyzed by morphological, histochemical and electro microscopic methods. Results: Rejection was manifested as a concentric progressive destruction of the smooth muscle cells. In contrast, the endothelial inflammation and subsequent neointimal proliferation characteristic of AGA was localized to the regions of turbulent flow, i.e. the junction of the graft with the recipient aorta. Conclusion: This model separates the processes of rejection and neointimal formation which usually manifested together in the lesion of AGA, elucidate that different mechanisms control vascular rejection and neointimal formation in chronic rejection.

  7. Endovascular treatment of penetrating ulcers of the paraceliac aorta using fenestrated endografts.

    Science.gov (United States)

    Gargiulo, Mauro; Gallitto, Enrico; Freyrie, Antonio; Stella, Andrea

    2014-04-01

    Penetrating atherosclerotic ulcers (PAUs) are usually focal aortic lesions found in patients with significant comorbidities. They are ideal targets for an endovascular approach if localized in the descending thoracic or infrarenal aorta, but when an origin in the visceral vessels is involved, a standard endovascular approach might not be feasible or effective. We report 2 cases of endovascular treatment of PAUs involving the paraceliac abdominal aorta, using a custom-made tube fenestrated endograft with 4 fenestrations for the abdominal visceral vessels (i.e., celiac-trunk, superior mesenteric artery, and renal arteries). There were no intra- or perioperative complications. At 1 year of follow-up, patients were asymptomatic and computed tomography angiography revealed total lesion exclusion and patency of the visceral vessels. The use of a fenestrated endograft is a safe and effective option to treat paraceliac PAUs.

  8. [Abdominal multi-organ transplantation in dogs].

    Science.gov (United States)

    Kumagae, T

    1988-07-01

    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  9. Tratamento endovascular de pseudoaneurisma de aorta torácica com fístula aorto-brônquica em pós-operatório tardio de cirurgia de correção de coarctação de aorta Endovascular treatment of thoracic aortic pseudoaneurysm with aortobronchial fistula in the late postoperative period of surgical correction of the aortic coarctation

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    Ana Augusta Gayoso Neves

    2011-03-01

    Full Text Available Fístula aorto-brônquica é uma conexão entre a aorta e o brônquio, e mesmo quando imediatamente reconhecida e tratada possui alto risco de letalidade. Pode se desenvolver após cirurgias de aorta, e é geralmente uma consequência de pseudoaneurisma. A hemoptise, massiva ou intermitente, é o principal sintoma apresentado. O tratamento convencional da fístula aorto-brônquica é a cirurgia aberta de aorta torácica, com reconstrução traqueobrônquica. Recentemente, o reparo endovascular tem sido proposto como uma alternativa. Os autores apresentam um relato de tratamento endovascular, realizado com êxito, de pseudoaneurisma de aorta torácica com fístula aorto-brônquica 22 anos após cirurgia para correção de coarctação aórtica.Aortobronchial fistula is an abnormal passage between the aorta and the bronchus, and even when recognized and treated promptly, it carries a high risk of fatality. It can develop after aortic operations, and it is usually the result of a pseudoaneurysm. Massive or intermittent hemoptysis is the main symptom. Conventional treatment of aortobronchial fistula is open surgery of the thoracic aorta with tracheobronchial reconstruction. Recently, endovascular repair has been proposed as an alternative. The authors report a case of successful endovascular treatment of thoracic aortic pseudoaneurysm with aortobronchial fistula, 22 years after surgical correction of the aortic coarctation.

  10. Tensile strength study of the abdominal wall following laparotomy synthesis using three types of surgical wires in Wistar rats Estudo da resistência tênsil da parede abdominal após síntese de laparotomia usando três tipos de fios cirúrgicos em ratos Wistar

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    Lucas Félix Rossi

    2008-02-01

    Full Text Available PURPOSE: To study the tensile strength of the abdominal wall following laparotomy synthesis utilizing three types of surgical wires. METHODS: Thirty Wistar rats were randomized into three groups of ten rats each. Each group underwent a 3cm-laparotomy which was closed with 3-0 polyglactin 910, polyglecrapone and catgut wires. After 63 days, euthanasia was performed and part of the abdominal wall was removed with which a strip was produced measuring 2.0 cm in length by 6.0 cm in width comprising the abdominal muscles with the implanted mesh. The sample was fixed in a mechanical test machine in which constant force was applied contrary to the tissue strips. Maximum force was considered, expressed in Newton, until full rupture of the tissue occurred. The non-parametrical Kruskal - Wallis test was used for the statistical analysis, admitting pOBJETIVO: Estudar a resistência tênsil da parede abdominal após síntese de laparotomia utilizando três tipos de fios cirúrgicos. MÉTODOS: Trinta ratos da linhagem Wistar randomizados em três grupos de dez exemplares cada um. Em cada grupo fez-se uma laparotomia de dois centímetros que foi fechada com fios 3-0 de poliglactina 910, poliglecaprone e categute. Após 63 dias, foi feita a eutanásia e retirou-se uma área da parede abdominal com a qual fez-se uma tira medindo 2,0 cm de comprimento por 6,0 cm de largura englobando os músculos abdominais com a tela implantada. A amostra foi fixada em máquina de ensaios mecânicos na qual se aplicou força constante contrária às tiras de tecido. Foi considerada a força máxima expressa em Newton até ocorrer a ruptura total da amostra. Para a análise estatística, utilizou-se teste não paramétrico de Kruskal - Wallis admitindo-se p<0,05. RESULTADOS: A média de resistência do grupo categute foi ligeiramente menor (33.50 N ao da poliglactina (34.23 N, sendo essa diferença não estatisticamente significativa (p=0,733. O grupo poliglecaprone foi o que

  11. Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda Factors associated with variation in intracranial pressure in a model of intra-abdominal hypertension with acute lung injury

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    Fernando Godinho Zampieri

    2011-06-01

    Full Text Available OBJETIVO: Avaliar o efeito de alterações hemodinâmicas, respiratórias e metabólicas sobre a pressão intracraniana em um modelo de lesão pulmonar aguda e síndrome compartimental abdominal. MÉTODOS: Oito porcos Agroceres foram submetidos, após a instrumentação, a cinco cenários clínicos: 1 estado basal com baixa pressão intra-abdominal e pulmão sadio; 2 pneumoperitôneo, com pressão intra-abdominal de 20 mm Hg; 3 lesão pulmonar aguda induzida por lavagem pulmonar e desativação de surfactante; 4 pneumoperitôneo com pressão intra-abdominal de 20 mm Hg na vigência de lesão pulmonar aguda e com PEEP baixo; e 5 PEEP ajustado a 27 cm H2O na vigência de pneumoperitôneo e lesão pulmonar aguda. Variáveis respiratórias e hemodinâmicas foram coletadas. Análise multivariada foi realizada buscando as variáveis associadas com elevação da pressão intracraniana nos cinco cenários estudados. RESULTADOS: Após a análise multivariada, nas situações não associadas com lesão pulmonar aguda apenas a pressão de platô das vias aéreas se correlacionou positivamente com a pressão intracraniana. Nos modelos associados com lesão pulmonar aguda, a pressão de platô de vias aéreas, a pressão arterial de CO2, o CO2 no final da expiração e a pressão venosa central se correlacionaram positivamente com incrementos da pressão intracraniana. CONCLUSÃO: Em um modelo de disfunção orgânica múltipla com situações clínicas associadas com aumento da pressão torácica e abdominal, o incremento da pressão intracraniana desencadeado pela elevação da pressão abdominal parece ser decorrente da piora da complacência do sistema respiratório e da redução do gradiente para drenagem venosa cerebral ocasionado pela elevação da pressão venosa central.OBJECTIVE: To evaluate the effects of hemodynamic, respiratory and metabolic changes on intracranial pressure in a model of acute lung injury and abdominal compartment syndrome

  12. Avaliação da atividade mioelétrica do trato gastrointestinal em cães: avaliação de um sistema de fixação de eletrodos na parede abdominal Gastrointestinal myoelectric activity in dogs: evaluation of a fixation system of electrodes on the abdominal wall

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    Álvaro Antônio Bandeira Ferraz

    2002-01-01

    Full Text Available OBJETIVO: A implantação de eletrodos intra-abdominais para captura de sinais de onda elétrica constitui instrumento de estudo da atividade mioelétrica do tubo gastrointestinal. O deslocamento destes eletrodos do local de implantação ocorre com certa freqüência em animais de experimentação não anestesiados, devido aos movimentos da musculatura diafragmática, abdominal, do peristaltismo gastrintestinal e sobretudo aos hábitos inerentes à espécie de animal estudada, particularmente presentes em caninos. No referido estudo foi proposto um procedimento que proporciona estabilidade ao referido sistema utilizando-se recursos simples e de custos irrelevantes. MÉTODOS: Os autores apresentam através de diagramas e fotos um sistema de ancoração dos eletrodos elétricos na pele dos animais com botões. RESULTADOS: Foram realizados 5 experimentos, fixando-se em cada animal 3 eletrodos bipolares. Os animais foram mantidos em repouso até a completa recuperação do íleo paralítico. Não foi identificado nos animais estudados nenhuma migração dos eletrodos. CONCLUSÃO: O procedimento proposto é eficiente, simples, de fácil confecção e permite o monitoramento da atividade mioelétrica, em cães não anestesiados, por períodos de tempo prolongado.OBJECTIVE: The use of intra-abdominal electrodes in the study of gastrointestinal electrical wave is an important instrument of the gastrointestinal mioelectric activity. However, the dislocations of the electrodes in non-anaesthetized animals due to diaphragmatic muscle movements, gastrointestinal movements and mainly due to the animals habits, especially in dogs. The study has the objective to demonstrate a procedure that stabilize the system using simple resources an irrelevant cost. METHODS: The authors demonstrate under diagrams and picture a fixed system to fix the electrical electrodes through the animal skin using bottoms. RESULTS: The system was used in 5 animals. Each animal had 3

  13. Is subdiaphragmatic aortic cross-clamping a suitable model for spinal cord ischemia/reperfusion injury study in rats? O pinçamento sub-diagragmático da aorta é um modelo adequado para o estudo da lesão medular de isquemia/reperfusão em ratos?

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    Sonia Elizabeth Lopez Carrillo

    2006-08-01

    Full Text Available PURPOSE: To evaluate the efficacy of subdiaphragmatic aortic cross-clamping in an experimental model of ischemia/reperfusion injury of the spinal cord in albino rats. METHODS: Thirty-six male Wistar rats were randomized in two groups (n=18: G-1 (Sham and G-2 (Ischemia/Reperfusion, I/R. G-2 rats were submitted to 30 min subdiafragmatic aortic cross-clamping. G-1 rats served as controls and were submitted to surgical trauma (laparotomy without ischemia. Samples (spinal cord and arterial blood were collected at the end of ischemic period and 10 (T-10 and 20 (T-20 min later in G-2 rats. Sham rats (G-1 samples were collected at the same time-points. Blood and tissue metabolites concentrations of pyruvate, lactate, glucose and medullary adenosine triphosphate (ATP were assayed. RESULTS: Blood and tissue concentrations of pyruvate and glucose as well as lactate and medullary ATP were not different when comparing G1 to G2. Lactacemia was significantly elevated in G-2 compared with G-1 rats during reperfusion (T-10. CONCLUSION: Subdiaphragmatic aortic cord cross-clamping is not a suitable rat model for spinal cord ischemia/reperfusion injury study as it does not ensure changes in in vivo tissue metabolites concentrations similar to those found in tissues subjected to ischemia/reperfusion.OBJETIVO: Avaliar a eficácia do pinçamento da aorta subdiafragmática no modelo experimental de isquemia/reperfusão da medula espinhal em ratos. MÉTODOS: Trinta e seis ratos Wistar, machos, foram aleatoriamente distribuídos em 2 grupos (n=18 e submetidos ao pinçamento subdiafragmático da aorta, durante 30 minutos (Grupo-2 -Isquemia/Reperfusão. Os ratos do Grupo-1 (G-1 - Sham foram utilizados como controles e submetidos a laparotomia sem pinçamento arterial. As amostras (medula e sangue arterial foram coletadas ao término do período de isquemia (T-0 e 10 (T-10 e 20 (T-20 minutos mais tarde e nos mesmos intervalos, no grupo G-1. As concentrações teciduais e

  14. Self-expandable nitinol stent placement in homocysteinemic porcine aorta

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    Luís Henrique Gil França

    2008-01-01

    Full Text Available PURPOSE: To compare aortic intimal thickening of normal and hyperhomocysteinemic pigs (induced with a methionine-rich diet following placement of a self-expanding nitinol stent. METHODS: Eighteen Macau pigs were used. They were older than eight weeks in age and had an average weight of 30 kg. Pigs were randomly divided into two groups. The first, Group C (control, was fed a regular diet, and the second group, Group M, was fed a methionine-rich diet for 30 days to induce hyperhomocysteinemia. The self-expandable nitinol stents were 25mm in length and 8 mm in diameter after expansion. Blood samples were collected to measure total cholesterol, triglycerides, HDL and homocysteine concentrations. All animals were subjected to angiography. Thirty days after the procedure, the animals were sacrificed, and the abdominal aorta was removed for histological and digital morphometry analysis. RESULTS: Under microscopic evaluation, the intima was significantly thicker in Group C than in Group M. When groups were compared by digital morphometric analysis, intimal thickening of the vessel wall was higher in Group C than in Group M. There was no significant change in total cholesterol, triglycerides or HDL concentrations in either group. In group C the levels of plasma homocysteine ranged from 14,40 to 16,73µmol/l; in Group M, plasma homocysteine levels ranged from 17.47 to 59.80 µmol/l after 30 days of a methionine-rich diet. CONCLUSION: Compared to normal pigs, less intimal hyperplasia was observed in the abdominal aortas of hyperhomocysteinemic pigs thirty days after the insertion of a self-expandable nitinol stent.

  15. Obesidade abdominal e risco cardiovascular: desempenho de indicadores antropométricos em mulheres Obesidad abdominal y riesgo cardiovascular: desempeño de indicadores antropométricos en mujeres Abdominal obesity and cardiovascular risk: performance of anthropometric indexes in women

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    Rogério Tosta de Almeida

    2009-05-01

    Full Text Available FUNDAMENTO: Os indicadores antropométricos de obesidade abdominal (OABD estimam a quantidade de tecido adiposo visceral, que, por sua vez, está associado a maior risco de desenvolvimento de doença cardiovascular. Nas últimas décadas, houve um aumento de OABD na população feminina brasileira, constituindo grande problema de saúde pública. OBJETIVO: Avaliar o desempenho de diferentes pontos de corte do índice de conicidade (índice C, da razão cintura-quadril (RCQ, da circunferência de cintura (CC e da razão cintura-estatura (RCEst para discriminar risco coronariano elevado (RCE em mulheres. MÉTODOS: Estudo transversal realizado em Feira de Santana, Bahia, com 270 funcionárias de uma universidade pública com idade entre 30 e 69 anos. A análise da sensibilidade e especificidade, feita por meio das curvas ROC, permitiu identificar e comparar os melhores pontos de corte para discriminar RCE, calculado com base no escore de risco de Framingham. RESULTADOS: Os pontos de corte encontrados foram: CC = 86 cm, RCQ = 0,87, índice C = 1,25 e RCEst = 0,55, sendo, respectivamente, as áreas sob a curva ROC de 0,70 (IC95% = 0,63-0,77, 0,74 (IC95% = 0,67-0,81, 0,76 (IC95% = 0,70-0,83 e 0,74 (IC95% = 0,67-0,81. Os indicadores antropométricos de OABD analisados apresentaram desempenhos satisfatórios e semelhantes para discriminar RCE. Entretanto, o índice C foi o indicador que apresentou o melhor poder discriminatório. CONCLUSÃO: Espera-se que esses resultados contribuam para melhor quantificar a OABD na população feminina brasileira, fornecendo informações para que os profissionais de saúde atuem na prevenção dessa condição clínica multifatorial, evitando o aparecimento das doenças cardiovasculares.FUNDAMENTO: Los indicadores antropométricos de obesidad abdominal (OABD estiman la cantidad de tejido adiposo visceral, que a su vez está asociado a un mayor riesgo de desarrollo de enfermedad cardiovascular. En las últimas d

  16. A comparative study of the performance of catgut and polyglecaprone 25 sutures in rat abdominal walls, contaminated or not Estudo comparativo entre o fio de categute e o poliglecaprone 25 em paredes abdominais, contaminadas ou não, de ratos

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    Maria de Lourdes Pessole Biondo-Simões

    1997-09-01

    Full Text Available Forty Wistar-Tecpar rats were used to determine the performance of polyglecaprone 25 sutures in the abdominal wall, contaminated or not. The animals were anesthetized and polyglecaprone 25 was implanted into the ventral abdominal wall on the left side and compared to the use of plain catgut implanted on the right. The subcutaneous tissue of 20 animals was contaminated with a standardized Staphylococcus aureus solution and the remaining 20 animals were not contaminated. The animals were checked on the third and seventh day after implant and the tissue reaction caused by polyglecaprone 25 in the presence or absence of contamination was found to be significantly less intense.Comparou-se as suturas realizadas com poliglecaprone e categute na parede abdominal, contaminada ou não, de ratos. Foram utilizados 40 ratos Wistar Tecpar divididos em dois grupos de 20 designados A e B. Implantavam-se os fios na parede abdominal ventral, com o poliglecaprone à esquerda e o categute à direita. No grupo B inoculava-se na tela subcutânea 1,0ml de solução padronizada de Staphylococcus aureus no trajeto de cada um dos fios. Praticava-se a eutanásia, em 10 animais de cada grupo, no terceiro e no sétimo dia. A parede abdominal ventral, repartida em duas metades, direita e esquerda, era fixada em formalina e encaminhada para estudo histopatológico. O fio de poliglecaprone 25, na presença ou ausência de contaminação da parede abdominal de ratos, apresentou reação tecidual significantemente menos intensa do que o fio de categute, em ratos.

  17. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

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    Juvenal da Rocha Torres Neto

    2007-09-01

    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  18. Ligation of the abdominal esophagus decreases scorpion toxin-induced gastric secretion in rats Ligadura do esôfago abdominal diminui a secreção gástrica induzida por toxina de escorpião em ratos

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    Claudia S. Vidal

    2004-06-01

    Full Text Available PURPOSE: Scorpion toxin purified from Tityus serrulatus venom (Tx induces an increase in volume, acidity and pepsin secretion in the gastric juice of rats. Ligation of oesophagus has been shown to reduce the acid gastric secretion in rats. The aim of this paper was to determine the influence of the esophageal ligation on gastric secretion induced by Tx in rats METHODS: Forty-four male albino rats were given water ad libitum, but no food for 20 to 24 hours, anesthetized with urethane and the trachea and jugular vein cannulated. Cervical or abdominal esophageal ligation or sham-operations were performed before and after the injection of 0.25 mg/kg of scorpion toxin (fraction T1 into the jugular vein. One hour later, the volume, acidity, pH and peptic activity of gastric juice were determined. RESULTS: The scorpion toxin induced an increase in gastric juice volume, acidity and pepsin output and a decrease in pH when injected into the vein of intact animals or in sham-operated animals. Cervical esophagus ligation did not interfere with the effects of toxin, however, ligation of the abdominal esophageal decreased the toxin effect on the rat stomach. CONCLUSION: Ligation of the abdominal esophagus decreases the gastric secretion induced by scorpion toxin.OBJETIVO: A toxina de escorpião purificada do veneno do escorpião Tityus serrulatus (Tx induz um aumento no volume, acidez e secreção de pepsina no suco gástrico de ratos. A ligadura do esôfago diminui a secreção ácida do estômago em ratos. O objetivo deste trabalho foi determinar a influência da ligadura do esôfago sobre a secreção gástrica induzida pela Tx em ratos. MÉTODOS: 44 ratos machos, brancos foram administrados água ad libitum, mas não alimentados por 20 a 24 horas, anestesiados com uretana e canulados a traquéia e a veia jugular. Foram realizadas as ligaduras do esôfago cervical ou abdominal ou operações simuladas antes e após a administração na veia jugular de 0

  19. Artérias mesentéricas cranial e caudal em mocós Kerodon rupestris (Wied, 1820

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    Paula V.S. Queiroz

    2011-07-01

    Full Text Available No estudo sobre a origem e ramificações das artérias mesentéricas cranial (AMCr e caudal (AMCa do mocó, foram utilizados 20 animais (18 machos e 2 fêmeas de diferentes idades, que, após morte natural, foram dissecados rebatendo-se as paredes torácica e abdominal, pelo antímero esquerdo, expondo-se a aorta que foi então canulada em seu trajeto pré-diafragmático, procedendo-se a injeção de neoprene látex corado, no sentido caudal. A seguir, foram fixados em solução aquosa de formol a 10%, durante 48 horas, e posteriormente dissecados. Os resultados mostraram que em 18 animais (90%, a AMCr originou-se da aorta abdominal isoladamente, logo após a artéria celíaca, emitindo as artérias cólica média (CoM, pancreaticoduodenal caudal (PDC, duodenojejunal (DJ, jejunal (J e ileocecocólica (ICeCo. Em um mocó (5%, as AMCr e AC se originaram da aorta abdominal em um tronco comum. Neste caso, a AMCr originou às artérias CoM, PDC, ICeCo e J. Em uma observação (5%, as artérias AMCr e AMCa surgiram em tronco comum. Neste animal, as artérias PDC, DJ, ICeCo, CoM e J foram originadas da AMCr, enquanto as aterias cólica esquerda (CoE e retal cranial (ARCr derivaram da AMCa. Dois animais (10% apresentaram como colaterais da AMCr as artérias CoM, PDC, DJ, J e o tronco ICeCo, que originou às artérias CoD e ileocecal (ICe. No que diz respeito a AMCa, nos 20 casos (100% originou as artérias CoE e RCr.

  20. Dor abdominal crônica, dispepsia não ulcerosa e infecção pelo Helicobacter pylori em crianças e adolescentes

    OpenAIRE

    Silva, Renato Guilherme Silveira Corrêa [UNESP

    2014-01-01

    Aims: To investigate if the use of refined clinical characteristics of chronic abdominal pain can identify patients for further investigation of Helicobacter pylori (H. pylori) infection. An observational study on children and adolescents with chronic non-ulcer dyspepsia was performed to investigate the potential association between specific gastrointestinal symptoms and H. pylori infection. The hypothesis was that the use of demographics and clinical data with defined criteria for chronic ab...

  1. Mechanical characterization of human aortas from pressurization testing and a paradigm shift for circumferential residual stress.

    Science.gov (United States)

    Labrosse, Michel R; Gerson, Eleanor R; Veinot, John P; Beller, Carsten J

    2013-01-01

    Material properties needed for accurate stress analysis of the human aorta are still incompletely known, especially as many reports have ignored the presence of residual stresses in the aortic wall. To contribute new material regarding these issues, we carried out measurements and pressurization testing on ascending, thoracic and abdominal aortic samples from 24 human subjects aged 38-77 years, and evaluated the opening angle describing the circumferential residual stress level present in the aorta. We determined material constants for the aorta by gender, anatomic location and age group, according to a simple phenomenological constitutive model. The unpressurized aortic radius positively correlated with age, and the circumferential and longitudinal stretch ratios under systemic pressure negatively correlated with age, confirming the known enlargement and stiffening of the aorta with aging. The opening angle was measured to range from a minimum of 89° to above 360° for extreme cases. For given aortic dimensions and material properties, analysis of the in vivo circumferential and longitudinal mural stress distributions indicated a profound influence of the opening angle. For instance, in the thoracic aorta of males aged 38-66, opening angles in the range of 0° to 80° (resp. 60°) may equalize the gradient of in vivo circumferential (resp. longitudinal) stress between the inner and outer layers of the aorta, as commonly expected; however, opening angles above 160° (resp. 120°) may cause the gradient of circumferential (resp. longitudinal) stress to reverse and increase compared to the case without residual stress, putting the maximum stresses toward the adventitia instead of the intima. Even though the analysis of the aortic wall excluded possible longitudinal residual stresses as well as material inhomogeneities, such as constitutive differences between the intimal, medial and adventitial layers, the experimental data reported herein are important to aortic

  2. Tratamento do aneurisma da aorta toracoabdominal com endoprótese ramificada para as artérias viscerais Branched endovascular stent graft for thoracoabdominal aortic aneurysm repair

    Directory of Open Access Journals (Sweden)

    André Simi

    2007-03-01

    Full Text Available Apresentamos um caso de aneurisma da aorta toracoabdominal (AATA tratado, exclusivamente, pela técnica endovascular, utilizando uma endoprótese ramificada e customizada. Paciente do sexo feminino, 68 anos de idade, tabagista, hipertensa, portadora de extenso AATA e múltiplas comorbidades que restringiam a indicação de cirurgia convencional. O aneurisma iniciava-se na aorta torácica descendente, estendendo-se até a aorta abdominal infra-renal, envolvendo as emergências das artérias viscerais, tronco celíaco, artérias mesentérica superior e renais. O AATA foi tratado pela técnica endovascular com implante de uma endoprótese ramificada. Essa endoprótese ramificada foi customizada com base nas características anatômicas da aorta e no posicionamento dos ramos viscerais, obtidos em angiotomografia, objetivando excluir o aneurisma, mantendo a perfusão das artérias viscerais. O procedimento foi realizado em centro cirúrgico, sob anestesia combinada, regional e geral, antecedido de drenagem liquórica e sob orientação fluoroscópica. O acesso para o implante do corpo principal da endoprótese ramificada e o controle radiológico foram realizados através das artérias femorais, previamente dissecadas. Através das ramificações da endoprótese, foram implantadas extensões secundárias, com stents revestidos, para as respectivas artérias viscerais, cujo acesso foi realizado via artéria axilar esquerda. O tempo total do procedimento foi de 14 horas, com 4 horas e 30 minutos de fluoroscopia, e foram utilizados 120 mL de contraste iodado. No pós-operatório, a paciente apresentou instabilidade hemodinâmica. Ecocardiograma transesofágico mostrou dissecção retrógrada da aorta torácica, tipo A, seguida de trombose espontânea da falsa luz. A tomografia de controle mostrou exclusão do AATA e perviedade das pontes para os ramos viscerais, sem vazamentos. A alta ocorreu no 13º dia de pós-operatório. O tratamento endovascular do

  3. Human Aorta Is a Passive Pump

    Science.gov (United States)

    Pahlevan, Niema; Gharib, Morteza

    2012-11-01

    Impedance pump is a simple valveless pumping mechanism that operates based on the principles of wave propagation and reflection. It has been shown in a zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. Our aim in this study was to examine if the human aorta is a passive pump working like an impedance pump. A hydraulic model with different compliant models of artificial aorta was used for series of in-vitro experiments. The hydraulic model includes a piston pump that generates the waves. Our result indicates that wave propagation and reflection can create pumping mechanism in a compliant aorta. Similar to an impedance pump, the net flow and the flow direction depends on the frequency of the waves, compliance of the aorta, and the piston stroke.

  4. Breathing exercises in upper abdominal surgery: a systematic review and meta-analysis Exercícios respiratórios em cirurgia abdominal alta: revisão sistemática e metanálise

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    Samantha T. Grams

    2012-10-01

    Full Text Available BACKGROUND: There is currently no consensus on the indication and benefits of breathing exercises for the prevention of postoperative pulmonary complications PPCs and for the recovery of pulmonary mechanics. OBJECTIVE: To undertake a systematic review of randomized and quasi-randomized studies that assessed the effects of breathing exercises on the recovery of pulmonary function and prevention of PCCs after upper abdominal surgery UAS. METHOD: Search Strategy: We searched the Physiotherapy Evidence Database PEDro, Scientific Electronic Library Online SciELO, MEDLINE, and Cochrane Central Register of Controlled Trials. Selection Criteria: We included randomized controlled trials and quasi-randomized controlled trials on pre- and postoperative UAS patients, in which the primary intervention was breathing exercises without the use of incentive inspirometers. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data on maximal respiratory pressures MIP and MEP, spirometry, diaphragm mobility, and postoperative complications were extracted and analyzed. Data were pooled in fixed-effect meta-analysis whenever possible. RESULTS: Six studies were used for analysis. Two meta-analyses including 66 participants each showed that, on the first day post-operative, the breathing exercises were likely to have induced MEP and MIP improvement treatment effects of 11.44 mmH2O (95%CI 0.88 to 22 and 11.78 mmH2O (95%CI 2.47 to 21.09, respectively. CONCLUSION: Breathing exercises are likely to have a beneficial effect on respiratory muscle strength in patients submitted to UAS, however the lack of good quality studies hinders a clear conclusion on the subject.

  5. Abdominal aortic thrombosis in association with an attempted Heimlich maneuver.

    Science.gov (United States)

    Roehm, E F; Twiest, M W; Williams, R C

    1983-03-04

    We report herein a case of an incorrectly applied Heimlich maneuver--to the best of our knowledge, the first reported fatal complication associated with a Heimlich maneuver, acute thrombosis of an abdominal aortic aneurysm, and the distal aorta. While the Heimlich maneuver is effective for the relief of foreign body-induced upper airway obstruction, increased efforts should be directed toward instructing the public in correctly recognizing and optimally treating airway obstruction.

  6. Trauma abdominal fechado: análise dos pacientes vítimas de trauma esplênico em um Hospital Universitário de Curitiba Blunt abdominal trauma: analysis of the patients victims of splenic trauma in a University Hospital of Curitiba

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    Luiz Carlos von Bahten

    2006-12-01

    Full Text Available OBJETIVO: determinar as características comuns referentes ao mecanismo de trauma e às lesões anatômicas e fisiológicas dos pacientes vítimas de trauma esplênico. MÉTODO: revisão dos prontuários de dezembro de 1999 a janeiro de 2003, sendo selecionados 524 vítimas de doença tóraco-abdominal e posteriormente internados. Desses prontuários, foram excluídos aqueles que não apresentavam mecanismo de trauma contuso e os menores de 16 anos. Resultando em uma amostra com N = 200. As variáveis de interesse no estudo foram: etiologia do trauma, órgão lesado, grau e segmento da lesão, pressão arterial sistólica e freqüência cardíaca na admissão hospitalar e fraturas de costela. RESULTADOS: a lesão esplênica isolada teve a maior incidência 39%, já a lesão associada hepato-esplênica representou 14%. Dos 116 pacientes com diagnóstico de lesão esplênica, a classificada anatomicamente em Grau IV foi a mais comum (44 pacientes. A maioria das lesões teve como mecanismo de trauma veículo auto-motor (VAM 56 pacientes, entre os quais a lesão Grau III teve maior prevalência 33,93%. Observou-se que 20% dos pacientes com lesão Grau III, IV ou V não havia descrito dor abdominal em seus prontuários, já nas lesões Grau I ou II 30,13% não se descreveu dor. Freqüência cardíaca média (FC média e a Pressão arterial sistólica (PA sistólica mostraram-se equivalentes entre as diferentes lesões. A maior incidência de lesão esplênica está relacionada com ausência de fratura dos arcos costais. Quando diagnosticada fratura há predomínio do grupo com arcos costais esquerdos, nos quais as lesões Grau III, IV ou V predominam com 62,50%. CONCLUSÕES: os acidentes por veículo automotor foram a causa mais comum de trauma esplênico, sendo que a lesão Grau III foi a mais comum dentre as vítimas de VAM. Em 80% dos pacientes com lesão Grau III, IV ou V havia sido descrito dor abdominal, revelando-se um parâmetro significativo

  7. [Abdominal aortic aneurysm treated by endovascular surgery: a case report].

    Science.gov (United States)

    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.

  8. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm

    OpenAIRE

    Jiaze Li; Smriti Murali Krishna; Jonathan Golledge

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of funct...

  9. [Management of seat-belt aorta in severe polytrauma: a review].

    Science.gov (United States)

    Hornez, E; Bourgouin, S; Baudoin, Y; Prunet, B; Monchal, T; Schlienger, G; Meyrat, L; Thouard, H

    2011-07-01

    Blunt trauma of the abdominal aorta is rare. Secondary to high-energy trauma, it is observed mainly in association with complex lesions. Evaluation of injury to the aorta must be a priority due to the risk of life-threatening massive hemorrhage. The clinical presentation can be quite obvious but also variable and often misleading. If in doubt, a systematic injected whole body scan is essential to diagnose aortic lesions. Hemorrhage or ischemia dictates emergency laparotomy. Opening the retroperitoneum increases the risk of infection if there is an associated gastrointestinal tract injury and may contraindicate use of arterial prostheses. Endovascular treatment can be proposed for less symptomatic lesions, including intimal dissection. Stents can be inserted via a femoral approach. In the event of juxtarenal dissection, there is a risk of renal artery thrombosis. Endovascular treatment is currently not recommended. This treatment can be delayed for a few days if necessary. Morbidity is low and long-term results are good.

  10. Severe diffuse hypoplasia of the aorta associated with multiple vascular abnormalities.

    Science.gov (United States)

    Grebeldinger, Slobodan P; Balj, Svetlana S; Adic, Oto

    2011-06-01

    Hypoplasia of the thoracic and abdominal aorta is an extremely rare vascular pathology. The most common clinical manifestation is severe uncontrolled hypertension in adolescents and young adults. Medical treatment alone can decrease blood pressure, but often very high doses of antihypertensive drugs are needed. When hypertension is refractory to the antihypertensive medications, surgical revascularization is considered as the treatment of choice. We report the case of a severe and diffuse hypoplasia of the aorta, beginning with the aortic isthmus, to the aortic bifurcation, associated with an aberrant celiac trunk and superior mesenteric artery, and with other multiple vascular abnormalities. Unlikely, the only manifestation of this extensive vascular malformation was medicamentously controllable hypertension. To our knowledge, this severe vascular anomaly, with such a minimal clinical manifestation, has not been previously described in the English literature.

  11. Double renal artery in cat/ Artéria renal dupla em gato

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    Marcelo Abidu-Figueiredo

    Full Text Available Knowledge of the renal vessels variations has importance in a systematization program of radiological and surgical anatomy, both in humans and animals, applied for research and surgical training. Renal arteries have been considered by dissective or angiographic study means. Particular attention has been paid to the study of these vessels, outlining the variations noticed among various animal species. The renal arteries sites of origin of the abdominal aorta vary according to the renal topography of the different animals. As a rule, the right artery arises more cranially than the left one, according with the most cranial position of the right kidney. Thus, the goal of this article is to describe a case of a left double renal artery originating from the ventral portion of the aorta, in a three old male cat cadaver, formalin-preserved at 10% and with latex colored vascular injection. It was observed that the left kidney was supplied by two arteries of different topography and arrangements, showing duplicity of the renal artery.O conhecimento das variações nos vasos renais possui importância em um programa de sistematização da anatomia radiológica e cirúrgica, tanto para o homem quanto para animais destinados a pesquisa, ensino e treinamento cirúrgico. As artérias renais têm sido estudas tanto radiograficamente quanto através de dissecção. Atenção particular é dada ao estudo desses vasos enfatizando as variações entre as diferentes espécies animais. O local de origem das artérias renais a partir da aorta abdominal varia de acordo com a topografia renal nos diferentes animais. A artéria renal direita se origina mais cranialmente que a esquerda de acordo com a posição mais cranial do rim direito. O objetivo deste artigo é descrever um caso de dupla artéria renal esquerda originando-se da superfície ventral da artéria aorta abdominal em um cadáver de gato macho com três anos de idade. O mesmo foi fixado e preservado com

  12. Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review.

    Science.gov (United States)

    Georgiadis, George S; Antoniou, George A; Georgakarakos, Efstratios I; Nikolopoulos, Evagelos S; Papanas, Nikolaos; Trellopoulos, George; Iatrou, Christos; Papadopoulou, Maria Z; Lazarides, Miltos K

    2013-10-01

    Little is known regarding the outcomes of endovascular and surgical treatment of penetrating ulcers in the abdominal aorta. The potential benefit of conservative management of asymptomatic disease is also debatable. A systematic review of the literature was undertaken to investigate these issues.

  13. Validation and application of intravascular ultrasound in endovascular treatment of abdominal aortic aneurysm

    NARCIS (Netherlands)

    J.A. van Essen (Anthonie)

    2000-01-01

    textabstractAn abdominal aortic aneurysm (AAA) is a localized and permanent dilatation of the aorta that presents a clear danger for the patient because of the risk of rupture. The chance of rupture increases with the size of the aneurysm. Mortality after rupture is high: 60-70% of patients with a r

  14. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    Science.gov (United States)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  15. Influência da adiposidade global e da adiposidade abdominal nos níveis de proteína C-reativa em mulheres idosas Influence of overall and abdominal adiposity on C-reactive protein levels in elderly women

    Directory of Open Access Journals (Sweden)

    Jeffer Eidi Sasaki

    2007-10-01

    Full Text Available OBJETIVO: Examinar como a adiposidade global e a adiposidade abdominal, expressas pela circunferência da cintura (CC, pelo índice de massa corporal (IMC e pelo somatório de dobras cutâneas (sigmaDC, influenciam os níveis de proteína C-reativa (PCR em mulheres idosas. MÉTODOS: A amostra foi composta por 387 mulheres idosas, com idade superior a 60 anos (média, 68,9; desvio padrão, 5,9 anos. Foram avaliados o IMC, a CC, o sigmaDC, e os níveis de PCR. Foi utilizada a análise estatística ANOVA one-way para verificar as diferenças nas variáveis entre as categorias investigadas. Para avaliar a influência das medidas de adiposidade nos níveis de PCR foi utilizada a regressão logística. O nível de significância adotado foi de p OBJECTIVE: To investigate how overall and abdominal adiposity, measured by waist circumference (WC, body mass index (BMI, and sum of skinfolds (sigmaSK, affect plasma C-reactive protein levels (CRP in elderly women. METHODS: Study sample consisted of 387 women older than 60 years (mean age 68.9; standard deviation 5.9 years. BMI, WC, sigmaSK, and CRP levels were all measured. One-way ANOVA was performed to detect differences in study variables among the CRP levels investigated. Logistic regression analysis was used to determine the influence of body fat measurements on CRP levels. The significance level was set at p < 0.05. RESULTS: The analysis of variance showed that mean WC was lower in women with normal CRP levels, as compared to those with high CRP levels. Logistic regression analysis examined the influence of BMI, WC, and sigmaSK quartiles on CRP levels, yielding the following results: only WC was predictive of elevated CRP levels, its highest quartile (cut-off point of 94.0 cm showing levels nearly two times higher than its lowest quartile (odds ratio = 2.23; 95% confidence interval = 1.92-4.18; p = 0.012. CONCLUSION: The results of this study indicate that abdominal adiposity is a strong predictor of

  16. Biomechanical evaluation of microbial cellulose (Zoogloea sp. and expanded polytetrafluoroethylene membranes as implants in repair of produced abdominal wall defects in rats Avaliação biomecânica de membranas de celulose microbiana (Zoogloea sp. e de politetrafluoretileno expandido como implantes no reparo de defeitos produzidos na parede abdominal em ratos

    Directory of Open Access Journals (Sweden)

    Suyiene Cordeiro Falcão

    2008-04-01

    Full Text Available PURPOSE: To evaluate the Load of Rupture of implants of membranes of microbial cellulose (Zoogloea sp. and extended polytetrafuoroethylene in sharp defects of abdominal wall of rats. METHODS: Sixty Wistar male rats, with a mean weight of 437,7g ± 40,9, anesthetized by a mixture of ketamine (5mg/100g and xylazine (2mg/100g, were submitted to a rectangular (2x3cm excision of the abdominal wall, including fascia, muscle and peritoneum, and treated with membranes of microbial cellulose (MC (MC Group- 30 animals or extended polytetrafluoroethylene (ePTFE (ePTFE Group- 30 animals. Each group was subdivided in 14th POD, 28th POD and 60th POD Subgroups. Under anesthesia, animals were submitted to euthanasia at 14th POD, 28th POD and 60th POD for evaluation of Load of Rupture. RESULTS: Load of Rupture levels were significantly elevated (pOBJETIVO: Avaliar a Carga de Ruptura de implantes de membranas de celulose microbiana (Zoogloea sp. e de politetrafluoretileno expandido em defeitos agudos produzidos na parede abdominal de ratos. MÉTODOS: Sessenta ratos machos Wistar, com média de peso de 437,7g ± 40,9, anestesiados com uma mistura de cetamina (5mg/100g e xilazina (2mg/100g, foram submetidos à excisão retangular (2x3cm na parede ventral do abdômen, incluindo fáscia, músculo e peritônio. Subseqüentemente, foram tratados com implante de membranas de celulose microbiana (CM (Grupo CM - 30 animais ou de politetrafluoretileno expandido (PTFEe (Grupo PTFEe - 30 animais. Cada grupo foi ainda subdividido nos Subgrupos 14º DPO, 28º DPO e 60º DPO. Os animais foram submetidos à eutanásia com doses letais de tiopental no 14º DPO, 28º DPO e 60º DPO, para avaliação da Carga de Ruptura na área do implante. RESULTADOS: Os níveis da Carga de Ruptura foram significativamente elevados (p<0,05 entre os Subgrupos 14º DPO, 28º DPO e 60º DPO de cada grupo estudado. Quando comparados entre Grupos, os valores da Carga de Ruptura foram

  17. Análise da relação entre a estatura e o perímetro abdominal em indivíduos portadores de percentuais normais de gordura Relationship between the stature and abdominal circumference in individuals with normal fat percentages

    Directory of Open Access Journals (Sweden)

    Walter Celso de Lima

    2010-03-01

    Full Text Available RACIONAL: No indivíduo portador de obesidade há evidentes alterações morfofuncionais, que caracterizam a síndrome. São empregados vários parâmetros e índices perimétricos na análise de suas medidas antropométricas, que possuem relação com as alterações endocrinometabólicas. Muitos destes índices são aplicados de forma generalizada à população de uma maneira geral. OBJETIVO: Verificar a existência de uma razão cintura-estatura comum em indivíduos masculinos, de 18 a 25 anos de idade, portadores de percentuais de gordura normais, para fornecer modalidade de medida da cintura (perímetro abdominal personalizada e não generalizada. MÉTODOS: Foram selecionados de forma não probabilística intencional 380 sujeitos do sexo masculino, da faixa etária entre 18 e 45 anos, estratos de estatura de 160 a 169 cm, 170 a 179 cm e de 180 a 189 cm, do banco de dados do Ambulatório da Clínica Escola da empresa IBRATE - Instituto Brasileiro de Therapias e Ensino, sede de Curitiba/PR, com dados inclusos entre os anos de 2004 a 2008. Desta população foram triados 174 indivíduos, da faixa etária entre 18 e 25 anos, possuidores de percentuais de gordura dentro da faixa de normalidade, ou seja, entre 4% e 16% de gordura. Foi determinado coeficiente de correlação de Pearson (r entre o percentual de gordura e o perímetro abdominal; foi determinada a média e o desvio-padrão de todas as variáveis dispostas, e o intervalo de confiança para 95% para média do perímetro abdominal e as razões cintura-estatura da população foram transcritos em percentuais, e determinadas as médias do perímetro abdominal. RESULTADOS: A análise da amostra de 174 indivíduos resultou estarem na faixa etária de 21,2 + 2,1 anos; com estatura de 174,3 + 6,2 cm; com percentual de gordura de 10,8 %; com medida do perímetro abdominal de 75,5 + 5,7 cm e com a razão cintura/estatura apresentando o valor de 0,43 + 0,033. CONCLUSÃO: Existe relação comum

  18. Hybrid Endovascular Aorta Repair with Simultaneous Supra-aortic Branch or Iliac Branch Revascularization

    Institute of Scientific and Technical Information of China (English)

    Yue-hong Zheng; Nim Choi; Hong-ru Deng; CU Kouk; Kun Yu; Furtado Rui

    2009-01-01

    Objective To describe a hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta.Methods From June 2007 to May 2008,5 consecutive patients who presented with aortic aneurysm or dissection were treated with a new hybrid aorta repair technique.Complete surgical rerouting of supra-aortic vessels was simultaneously created by endovascular repair of aortic arch aneurysm with stent graft.Hybrid left carotid-subclavian bypass with stent graft deployment covering the ostium of the left subclavian artery was performed in a Debakey type Ⅲ aortic dissection case.The supra-aortic branch was revascularized in 2 cases from ascending aorta to bilateral common carotid arteries using a 16-8 mm bifurcated graft,then total aortic arch and descending artery was occluded with stent-graft.The left carotid artery to the left subclavian artery bypass was created in 1 case,followed by stent-graft deployment.Two cases of infrarenal abdominal aortic aneurysm underwent left external iliac artery to left internal iliac artery bypass by a retroperineal route,then hybrid procedure was performed with bifurcated stent-graft.All stent grafts were deployed via a retrograde femoral artery approach in 5 patients.Results Technical success with complete aneurysmal exclusion was achieved in all patients.There was no incidence of endoleak.During a follow-up period of 2 to 10 months,documented perioperative neurologic events did not occur in all patients.One patient suffered from adult respiratory distress syndrome.After received tracheostomy,he recovered later.There was one death resulting from a postoperative myocardial infarction.Conclusion Hybrid arch repair provides an alternative therapy to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

  19. Abdominal radiation - discharge

    Science.gov (United States)

    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 ...

  20. Abdominal and Pelvic CT

    Medline Plus

    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, ...

  1. Obesidade abdominal e risco cardiovascular: desempenho de indicadores antropométricos em mulheres Obesidad abdominal y riesgo cardiovascular: desempeño de indicadores antropométricos en mujeres Abdominal obesity and cardiovascular risk: performance of anthropometric indexes in women

    OpenAIRE

    2009-01-01

    FUNDAMENTO: Os indicadores antropométricos de obesidade abdominal (OABD) estimam a quantidade de tecido adiposo visceral, que, por sua vez, está associado a maior risco de desenvolvimento de doença cardiovascular. Nas últimas décadas, houve um aumento de OABD na população feminina brasileira, constituindo grande problema de saúde pública. OBJETIVO: Avaliar o desempenho de diferentes pontos de corte do índice de conicidade (índice C), da razão cintura-quadril (RCQ), da circunferência de cintur...

  2. Post trauma abdominal cocoon.

    Science.gov (United States)

    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.

  3. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  4. Pseudoprominent aorta: Radiographic findings and CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-05-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.

  5. Mycotic aneurysm rupture of the descending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, H.; Buitrago-Tellez, C.H.; Nesbitt, E.; Hauenstein, K.H. [Department of Radiology, Albert-Ludwigs-Universitaet, Freiburg (Germany)

    1998-03-01

    A 69-year-old diabetic male with salmonella bacteremia developed hypovolemic shock and swelling of the neck. A CT examination revealed massive mediastinal hemorrhage extending into the neck soft tissues caused by false aneurysm rupture of the descending thoracic aorta. Aortography showed continuous extravasation from a large leak at the medial side of the descending thoracic aorta. Although surgical intervention was immediately performed, the patient died 3 weeks later from multiple-organ failure. In this report, CT and angiographic findings of mycotic aneurysm rupture are presented and a review is given. (orig.) With 2 figs., 11 refs.

  6. Tratamento das lesões de aorta nos traumatismos torácicos fechados Management of aortic lesions in blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Boulanger Mioto Neto

    2005-09-01

    Full Text Available OBJETIVO: Rever a casuística, etiologia, lesões associadas, tipos de tratamento e evolução das lesões da aorta por trauma torácico fechado. MÉTODOS: Estudo retrospectivo em prontuário dos pacientes atendidos no Pronto-Socorro do Hospital das Clínicas da Universidade de São Paulo e tratados pelo Grupo de Cirurgia Vascular de janeiro de 2001 a junho de 2004. Foram analisados 10 pacientes, todos do sexo masculino, sendo sete com técnica endovascular e três com técnica operatória aberta. RESULTADOS: Quanto à localização, foram observadas oito lesões da aorta descendente junto ao istmo, uma lesão da aorta descendente na transição tóraco-abdominal e uma dissecção traumática da aorta. O intervalo de tempo para o tratamento cirúrgico foi, em média, de 10,62 ± 3,45 horas para os que receberam tratamento endoluminal e 28 ± 32,39 para os operados de forma convencional. Já o período de internação total variou de 9 a 180 dias (média de 23,33 ± 6,66 dias para os tratados com endoprótese e 42,55 ± 52,7 para os operados de forma convencional. Foram utilizadas uma endoprótese Excluder®, uma Apolo® e cinco Talent®. Dos pacientes operados, dois utilizaram bomba átrio femoral. Ocorreram dois óbitos, um entre os operados de forma convencional e um entre os operados com endopróteses. CONCLUSÕES: As lesões da aorta em casos de trauma torácico fechado são pouco freqüentes e geralmente associadas a um grande número de lesões associadas. O diagnóstico precoce e preciso é fundamental para a evolução do paciente. A correção com endopróteses nos pacientes estáveis do ponto de vista hemodinâmico apresenta-se como solução eficaz.OBJECTIVE: To review the population, etiology, associated injuries, types of treatment, and evolution of aortic injuries due to blunt chest trauma. METHODS: Retrospective study of medical charts of patients admitted to the Emergency Department at Hospital das Clínicas of Universidade de S

  7. Relação entre obesidade e síndrome metabólica em adolescentes de 10 a 14 anos com obesidade abdominal = The relationship between obesity and metabolic syndrome in adolescents between ages 10 and 14, with abdominal obesity

    Directory of Open Access Journals (Sweden)

    Cristina Gomes de Oliveira Teixeira

    2009-04-01

    Full Text Available Os objetivos do presente estudo foram analisar a relação entre a obesidade e a síndrome metabólica (SM; identificar a prevalência da SM; classificar o estado nutricional e comparar as variáveis: triglicérides, HDL-c, pressão arterial e glicose em adolescentes comobesidade abdominal. A amostra foi constituída por 393 adolescentes de ambos os sexos entre dez e 14 anos de idade. Foram feitas medidas de circunferência do abdômen, aferição da pressão arterial e exames laboratoriais de glicose, colesterol HDL-c e triglicérides. Osresultados apresentaram que, na condição nutricional, o sexo masculino apresentou obesidade de 27,1%, sobrepeso de 4,3 e 68,6% de peso normal. Quanto ao sexo feminino, 29,5% estão com peso normal, 1,6%, com sobrepeso e 68,9%, com obesidade. A obesidade no sexo feminino foi estatisticamente maior do que no masculino. A prevalência de SM foi de 37%, e os meninos tiveram a prevalência maior da síndrome metabólica. Não foi encontrada diferença estatística entre os sexos nas variáveis: triglicérides, HDL-c e pressão arterial. Concluímos que a obesidade foi fator determinante para a SM em adolescentes do sexo feminino, a prevalência da SM e a de obesidade foram altas e nos parâmetros bioquímicos não foi encontrada nenhuma diferença estatística entre os sexos.The objectives of this study were: to analyze the relationship between obesity and metabolic syndrome (MS; identify the prevalence of MS; classify the nutritional condition; and compare the variables:triglycerides, HDL-c, arterial pressure and glucose in adolescents with abdominal obesity. The sample consisted of 393 adolescents of both genders between ages 10 and 14. Measurements were taken of abdominal circumference, arterial pressure, and laboratory exams of glucose, cholesterol HDL-c and triglycerides. The results showed that, in the nutritional condition, the male gender presented an obesity rate of 27.1, 4.3% overweight, and a rate of

  8. Platelet affinity for burro aorta collagen

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, M.D.

    1977-10-01

    Despite ingenious concepts, there are no unequivocal clues as to what, when, and how some undefined biochemical factor(s) or constituent(s) that localizes in the arterial wall can precipitate a thromboatheromatous lesion or arterial disease. The present study focused on the extraction, partial purification, and characterization of a collagen-active platelet stimulator from the aortas of aged burros. The aggregator moiety in the aorta extracts invariably had a higher affinity for platelets in citrated platelet-rich plasma of human beings than for platelets of homologous burros. The platelet-aggregating factor(s) in the aorta extract was retained by incubation with ..cap alpha..-chymotrypsin. Platelet-aggregating activity was rapidly abolished after incubation with collagenase, as determined by platelet-aggregometry tests. Evidence based on light microscope and polysaccharide histochemical reactions indicates a probability that the intracellular amorphous matrix (PAS-positive) and filamentous components (PTAH-positive) expelled from smooth muscle cells disrupted during homogenization of the aorta may be a principal source of a precursor collagen species which is a potent inducer of platelet aggregation.

  9. Thoracic aorta stent grafting through transapical access.

    NARCIS (Netherlands)

    Saouti, N.; Vos, J.A.; Heuvel, D. van de; Morshuis, W.J.; Heijmen, R.H.

    2015-01-01

    BACKGROUND: To describe the transapical approach for thoracic endovascular aortic repair (TEVAR). METHODS: Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The tec

  10. The preventive effect of fish oil on abdominal aortic aneurysm development.

    Science.gov (United States)

    Kugo, Hirona; Zaima, Nobuhiro; Mouri, Youhei; Tanaka, Hiroki; Yanagimoto, Kenichi; Urano, Tetsumei; Unno, Naoki; Moriyama, Tatsuya

    2016-06-01

    Abdominal aortic aneurysm (AAA) is a vascular disease involving gradual dilation of the abdominal aorta and high rupture-related mortality rates. AAA is histologically characterized by oxidative stress, chronic inflammation, and extracellular matrix degradation in the vascular wall. We previously demonstrated that aortic hypoperfusion could cause the vascular inflammation and AAA formation. However, the preventive method for hypoperfusion-induced AAA remains unknown. In this study, we evaluated the effect of fish oil on AAA development using a hypoperfusion-induced AAA animal model. Dilation of the abdominal aorta in the fish oil administration group was smaller than in the control group. Collagen destruction and oxidative stress were suppressed in the fish oil administration group than in the control group. These results suggested that fish oil could prevent the development of AAA induced by hypoperfusion.

  11. [Ascending aorta-supraceliac++ aorta bypass. Correction of a case of atypical coarctation in the adult].

    Science.gov (United States)

    Vaquero, F; Zorita, A; Samos, R F; Vázquez, J G; Ortega, J M; Morán, C F

    1993-01-01

    A case of atypic coarctation at the aortic arch in an adult patient is described. Coarctation was surgically treated by a retrosternal bypass from the ascendant aorta to the supra-celiac aorta. After a short prelude the clinical case is summarized. Furthermore, the etiopathogenic features of the disease, the different diagnostic methods and the multiple surgical procedures are discussed. Finally, we briefly review the literature.

  12. Avaliação da força muscular respiratória e amplitudes torácicas e abdominais após a RFR em indivíduos obesos Evaluación de la fuerza muscular respiratorio y amplitud toracica y abdominal espués de la RFR en individuos obsesos Evaluation of respiratory muscle strength and thoracic and abdominal amplitudes after a functional reeducation of breathing program for obese individuals

    Directory of Open Access Journals (Sweden)

    Dirceu Costa

    2003-03-01

    Full Text Available Este estudo teve como objetivo avaliar os elementos da mecânica respiratória, de indivíduos obesos no que se refere á força muscular respiratória, através das medidas de Pressão Respiratória Máxima (PImáx e PEmáx e, da mobilidade tóraco abdominal, através da Amplitude Tóraco-Abdominal nos níveis: axilar (AAx, xifoidiano (AXf e abdominal (AAb. Avaliaram-se 29 indivíduos obesos com média de idade de 43 ± 13 anos, divididos em dois grupos: Grupo Experimental (E e Grupo Controle (C, através das medidas da PImáx e da PEmáx e Amplitude Tóraco-abdominal. O Grupo E foi submetido a 18 sessões de Reeducação Funcional Respiratória (RFR que constituiu-se de orientação respiratória, exercícios de coordenação da respiração associados aos movimentos de tronco e membros, alongamento geral da musculatura e relaxamento muscular, 2 vezes por semana, durante 9 semanas. Constatou-se, através do Teste-t de Student (pEsto estudio tiene como objetivo avaluar los elementos de la mecánica respiratoria de individuos obesos en lo que respecta a la fuerza muscular respiratoria, a través de las medidas de Presión respiratoria Máxima (PImax e PEmax y de la movilidad toraco-abdominal, a través de la Amplitud tóraco-abdominal en los niveles: axilar (AAx, Xifoidiano (AXf y Abdominal (AAb. Se evaluaron 29 individuos obesos con promedio de edad de 43 ± 13 años, divididos en 2 grupos: Grupo Experimental (E e Grupo Control (c, a través de las medidas de la PImax y de la PEmax y Amplitud Tóraco-abdominal. El Grupo E fue sometido a 18 sesiones de Re-educación Funcional Respiratoria (RFR que consistió de orientación respiratoria, ejercicios de coordinación de la respiración asociados a los movimientos del tronco e miembros, alargamiento general de la musculatura y relajación muscular, 2 veces por semana, durante 9 semanas. Se constató a través del Test t Student (pThe purpose of this study was to assess the elements of respiratory

  13. Aorta Structural Alterations in Term Neonates: The Role of Birth and Maternal Characteristics

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2013-01-01

    Full Text Available Aim. To evaluate the influence of selected maternal and neonatal characteristics on aorta walls in term, appropriately grown-for-gestational age newborns. Methods. Age, parity, previous abortions, weight, height, body mass index before and after delivery, smoking, and history of hypertension, of diabetes, of cardiovascular diseases, and of dyslipidemia were all assessed in seventy mothers. They delivered 34 males and 36 females healthy term newborns who underwent ultrasound evaluation of the anteroposterior infrarenal abdominal aorta diameter (APAO, biochemical profile (glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, fibrinogen, and D-dimers homeostasis model assessment [HOMAIR]index, and biometric parameters. Results. APAO was related to newborn length (r=+0.36; P=0.001, head circumference (r=+0.37; P=0.001, gestational age (r=+0.40, P=0.0005, HOMA index (r=+0.24; P=0.04, and D-dimers (r=+0.33, P=0.004. Smoke influenced APAO values (odds ratio: 1.80; confidence interval 95%: 1.05–3.30, as well as diabetes during pregnancy (r=+0.42, P=0.0002. Maternal height influenced neonatal APAO (r=+0.47, P=0.00003. Multiple regression analysis outlined neonatal D-dimers as still significantly related to neonatal APAO values. Conclusions. Many maternal and neonatal characteristics could influence aorta structures. Neonatal D-dimers are independently related to APAO.

  14. Abdominal epilepsy in chronic recurrent abdominal pain

    Directory of Open Access Journals (Sweden)

    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

  15. Intra-abdominal pressure: an integrative review.

    Science.gov (United States)

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  16. Implantação de biomembrana de colágeno tratada em solução alcalina ou conservada em glicerina a 98% na parede abdominal de equinos

    Directory of Open Access Journals (Sweden)

    Valcinir Aloisio Scalla Vulcani

    Full Text Available Objetivou-se, neste trabalho, obter biomembranas de colágeno tratadas em solução alcalina por 72 horas (GE, a partir de centros tendinosos diafragmáticos de equinos e comparar sua biocompatibilidade com membranas conservadas em solução de glicerina a 98% (GG e membranas não tratadas (GC. As membranas foram implantadas na fáscia interna do músculo reto do abdome de equinos e retiradas, juntamente com os tecidos adjacentes, aos sete, 63 e 126 dias pós-operatórios para a preparação de lâminas histológicas. O estudo histomorfométrico das lâminas revelou processo inflamatório mais intenso para os implantes GG e CC e cicatrização mais rápida para os implantes GE. Concluiu-se que as biomembranas colagênicas tratadas em solução alcalina são mais biocompatíveis do que biomembranas conservadas em glicerina 98%.

  17. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  18. Abdominal Decompression in Children

    Directory of Open Access Journals (Sweden)

    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.

  19. Abdominal Compartment Syndrome

    OpenAIRE

    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

    Directory of Open Access Journals (Sweden)

    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

    Directory of Open Access Journals (Sweden)

    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. [Abdominal ischemia and lesions of the pancreas].

    Science.gov (United States)

    Myshanych, T V; Moskal', O M; Arkhiĭ, E Ĭ; Sozoniuk, O V

    2014-01-01

    The analysis of the results of 50 patients with diseases of coronary heart disease (25 pers.) And chronic pancreatitis (25 people) are submitted. Along with the standard test from these patients underwent Doppler-ultrasonography of abdominal aorta and its visceral branches. Conclusions: A characteristic feature of Doppler indices in AIC is to reduce Vps and Ved, and PI BbA, increase Vps, Ved, IR and PI after exercise in chBA, chC and BbA. At patients with CP with IHD feature is the increase in Ved and IR in the chC, and Ved and PI in BbA under act of loading Bleed a feature at CP with IHD must be taken into account for optimization of treatment of IHD at CP.

  3. Hybrid Treatment of Acute Abdominal Aortic Thrombosis Presenting with Paraplegia.

    Science.gov (United States)

    Azzarone, Matteo; De Troia, Alessandro; Iazzolino, Luigi; Nabulsi, Bilal; Tecchio, Tiziano

    2016-05-01

    Acute thrombotic or embolic occlusion of the abdominal aorta is a rare vascular emergency associated with high morbidity and mortality rates. Classically, the clinical presentation is a severe peripheral ischemia with bilateral leg pain as the predominant feature. Aortic occlusion presenting as an isolated acute onset of paraplegia due to spinal cord ischemia is very rare and requires improved awareness to prevent adverse outcomes associated with delayed diagnosis. We report the case of a 54-year-old man who presented with sudden paraplegia due to the thrombotic occlusion of the infrarenal aorta involving the first segment of the common iliac arteries on both sides; emergent transperitoneal aorto iliac thrombectomy combined with the endovascular iliac kissing-stent technique were performed achieving perioperative complete regression of the symptoms.

  4. Involvement of the aorta in brucellosis: the forgotten, life-threatening complication. A systematic review.

    Science.gov (United States)

    Cascio, Antonio; De Caridi, Giovanni; Lentini, Salvatore; Benedetto, Filippo; Stilo, Francesco; Passari, Gabriele; Iaria, Chiara; Spinelli, Francesco; Pappas, Georgios

    2012-10-01

    Human brucellosis is a disease of protean manifestations, and has been implicated in complications and focal disease in many human organ systems. However, little is collectively known about the background, the course, the clinical characteristics, the diagnostic issues raised, and the short- and long-term therapeutic approaches in patients with aortic involvement as a complication of brucellosis. With the aim to glean from the literature useful information to better understand and manage this complication, a computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patients with involvement of the aorta due to a Brucella infection. The epidemiologic and clinical characteristics of 44 cases of brucellar aortic involvement found through the systematic review of the literature were analyzed together with those of two new cases that we treated in the recent past. This complication involved the ascending thoracic aorta in 18 cases (in 16 of them as a consequence of brucellar endocarditis), and the descending thoracic aorta or the abdominal aorta in the remaining 30 cases. In the latter it was associated with spondylodiscitis of the lumbar spine in 13 cases. History of or symptoms indicative of brucellosis were not universally present. Brucellar aortic involvement represents a possibly underdiagnosed and underreported complication with major morbidity and mortality potential. Experience with novel invasive therapeutic approaches remains limited. Early suspicion through detailed history and diagnosis, aided by advances in aortic imaging, would allow for better planning of therapeutic interventions.

  5. Controle de danos no trauma abdominal e lesões associadas: experiência de cinco anos em um serviço de emergência Damage control in abdominal trauma and associated lesions: five years experience in emergency room

    Directory of Open Access Journals (Sweden)

    Carla Martinez Menini Stalhschmidt

    2006-08-01

    Full Text Available OBJETIVO: Baseado no conceito de cirurgia para controle de danos (damage control, o presente estudo tem por objetivo analisar, epidemiologicamente, os pacientes submetidos a esta modalidade cirúrgica no Hospital Universitário Cajuru (HUC, em Curitiba, PR. MÉTODO: No período de Janeiro de 2001 à Março de 2005, foram revisados os prontuários de pacientes atendidos no HUC, vítimas de traumatismos diversos, sendo encontrados 39 pacientes submetidos à cirurgia para controle de danos abdominal. RESULTADOS: Dos 39 prontuários de pacientes analisados, 35 foram do sexo masculino (87,74% e quatro do sexo feminino (10,26%. A idade dos pacientes variou de 4 a 73 anos, sendo sua média de 30,35 anos. Trauma penetrante ocorreu em 24 pacientes (61,54%, sendo que 18 destes (46,15% sofreram ferimentos por armas de fogo e seis (15,38%, ferimentos por arma branca. O trauma fechado ocorreu em 15 pacientes, perfazendo um total de 38,46%. O ISS (Injury Severity Score médio dos pacientes foi de 44,03. A quantidade média de hemoderivados utilizados foi de 7,2 unidades papa de hemácias e 4,95 unidades de plasma fresco. O pH médio no intraoperatório foi de 7,1 e o BE (base excess de -14,4. O intervalo de tempo médio entre o início e o término da primeira cirurgia foi de 174,18 minutos (2,9 horas, levando-se em conta outros procedimentos de emergência também efetuados como craniectomias e/ou fixação de pelve e ossos longos. Foram constatados complicações imediatas em 28 pacientes, perfazendo um total de 53,85%. A média de sobrevida foi de 20,51% (n=8 e o tempo médio de permanência na Unidade de Terapia Intensiva (UTI após a primeira cirurgia foi de 41,75 horas (n=24. A maioria dos óbitos (n=17 ocorreu nas primeiras 24 horas de internação. CONCLUSÕES: O Damage Control é de fato uma medida que aumenta a taxa de sobrevida dos pacientes gravemente traumatizados, desde que esses mesmos pacientes tenham uma estabilização dentro das primeiras

  6. Fourier transform infrared spectroscopy to quantify collagen and elastin in an in vitro model of extracellular matrix degradation in aorta.

    Science.gov (United States)

    Cheheltani, Rabee; McGoverin, Cushla M; Rao, Jayashree; Vorp, David A; Kiani, Mohammad F; Pleshko, Nancy

    2014-06-21

    Extracellular matrix (ECM) is a key component and regulator of many biological tissues including aorta. Several aortic pathologies are associated with significant changes in the composition of the matrix, especially in the content, quality and type of aortic structural proteins, collagen and elastin. The purpose of this study was to develop an infrared spectroscopic methodology that is comparable to biochemical assays to quantify collagen and elastin in aorta. Enzymatically degraded porcine aorta samples were used as a model of ECM degradation in abdominal aortic aneurysm (AAA). After enzymatic treatment, Fourier transform infrared (FTIR) spectra of the aortic tissue were acquired by an infrared fiber optic probe (IFOP) and FTIR imaging spectroscopy (FT-IRIS). Collagen and elastin content were quantified biochemically and partial least squares (PLS) models were developed to predict collagen and elastin content in aorta based on FTIR spectra. PLS models developed from FT-IRIS spectra were able to predict elastin and collagen content of the samples with strong correlations (RMSE of validation = 8.4% and 11.1% of the range respectively), and IFOP spectra were successfully used to predict elastin content (RMSE = 11.3% of the range). The PLS regression coefficients from the FT-IRIS models were used to map collagen and elastin in tissue sections of degraded porcine aortic tissue as well as a human AAA biopsy tissue, creating a similar map of each component compared to histology. These results support further application of FTIR spectroscopic techniques for evaluation of AAA tissues.

  7. Análise macroscópica infra-vermelha da difusão do óxido nitroso via inalatória para a cavidade abdominal, em ratos submetidos a pneumoperitônio Análisis macroscópica infrarroja de la difusión del óxido nitroso vía inhalatoria para la cavidad abdominal, en ratones sometidos a pneumoperitoneo Macroscopic infrared analysis of inhaled nitrous oxide diffusion to abdominal cavity in rats submitted to pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Daniel Colman

    2004-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O óxido nitroso (N2O, por ser uma estrutura tri-atômica assimétrica, assume características de alta emissão e absorção de energia no espectro infra-vermelho, com um pico característico de absorção em 4,5 µm, o que o torna visível ao infra-vermelho curto, quando contrastado com uma fonte emissora de calor (anteparo quente. Diversos autores têm descrito a difusão do N2O para cavidades fechadas por métodos como cromatografia gasosa e analisador de gases, que não permitem um estudo macroscópico detalhado do gás. O presente estudo teve como objetivo a filmagem macroscópica no espectro infra-vermelho da difusão de N2O, utilizado em anestesia inalatória, para a cavidade peritoneal de ratos submetidos a pneumoperitônio de 20 mmHg com ar ambiente. MÉTODO: Dividiu-se os animais em três grupos, de acordo com o anestésico utilizado: I - controle venoso: tiopental intra-peritoneal; II - controle inalatório: isoflurano a 1,2% em O2 100%; III - óxido nitroso: N2O 66% em oxigênio e isoflurano a 0,6%. Os termogramas provenientes da descompressão abdominal foram obtidos, por meio de um radiômetro AGEMA 550 filmados a 7 quadros por segundo. RESULTADOS: O N2O demonstrou-se visível ao infra-vermelho. No momento da descompressão abdominal, não houve nos grupos I e II termogramas com rastros de gases visíveis ao infra-vermelho. Houve, porém, rastros de gases visíveis ao infra-vermelho no grupo III. CONCLUSÕES: Conclui-se que o óxido nitroso inalatório a 66% difundiu-se para a cavidade peritoneal de ratos submetidos a pneumoperitônio de 20 mmHg com ar ambiente, sem aumento de pressão intra-abdominal.JUSTIFICATIVA Y OBJETIVOS: El óxido nitroso (N2O, por ser una estructura tri-atómica asimétrica, toma características de alta emisión y absorción de energía en el espectro infrarrojo, con un pico característico de absorción en 4,5 µm, lo que lo hace visible al infrarrojo corto, cuando contrastado

  8. Recurrent Abdominal Pain

    Science.gov (United States)

    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…

  9. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    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.

  10. Distribution, size, and shape of abdominal aortic calcified deposits and their relationship to mortality in postmenopausal women

    DEFF Research Database (Denmark)

    Ganz, Melanie; de Bruijne, Marleen; Dam, Erik B.

    2012-01-01

    -of-the-art AC24 marker introduced by Kauppila. Methods. For 308 postmenopausal women, we quantified the number of AAC and the percentage of the abdominal aorta that the lesions occupied in terms of their area, simulated plaque area, thickness, wall coverage, and length. We analysed inter...

  11. Randomized clinical trial of mast cell inhibition in patients with a medium-sized abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Sillesen, H; Eldrup, N; Hultgren, R

    2015-01-01

    BACKGROUND: Abdominal aortic aneurysm (AAA) is thought to develop as a result of inflammatory processes in the aortic wall. In particular, mast cells are believed to play a central role. The AORTA trial was undertaken to investigate whether the mast cell inhibitor, pemirolast, could retard...

  12. Increased apoptosis and decreased density of medial smooth muscle cells in human abdominal aortic aneurysms

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian张健; Jan Schmidt; Eduard Ryschich; Hardy Schumacher; Jens R Allenberg

    2003-01-01

    Objective To determine the increase of apoptosis and the decrease of smooth muscle cells (SMCs) density in human abdominal aortic aneurysms (AAA). Methods In situ terminal transferase-mediated dUTP nick end labeling (TUNEL) was employed to detect apoptosis of SMCs in patients with AAA (n=25) and normal abdominal aortae (n=10). Positive cells were identified by specific cell marker in combination with immunohistochemistry. Meanwhile SMC counting was performed by anti-α-actin immunohistostaining to compare the SMC density. Results TUNEL staining revealed that there was significantly increased apoptosis in AAAs (average 8.6%) compared with normal abdominal aortae (average 0.95%, P<0.01). Double staining showed that most of these cells were SMCs. Counting of α-actin positive SMCs revealed that medial SMC density of AAAs (37.5±7.6 SMCs /HPF) was reduced by 79.1% in comparison with that of normal abdominal aortae (179.2±16.1 SMCs /HPF, P<0.01). Conclusions Significantly increased SMCs of AAA bear apoptotic markers initiating cell death. Elevated apoptosis may result in a decreased density of SMCs in AAA, which may profoundly influence the development of AAA.

  13. The clinical application of multi-slice spiral CT angiography in abdominal aortic disease

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical application of multi-slice spiral CT angiography(MSCTA) in the assessment of abdominal aortic disease. Methods: Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent (Omnipaque 300 I g/L) 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique,Tll level abdominal aorta was set as the target vessel and the threshold was 180-200 Hu, slice width was 3 mm and with a pitch of 4-6.Original data were transferred to working-station to perform functional reconstruction. Results: Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms (Debakay type Ⅲ ) and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rupture site of abdominal aorta intima and mural thrombus. Conclusion: MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.

  14. Gastrointestinal causes of abdominal pain.

    Science.gov (United States)

    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.

  15. Functional Abdominal Pain in Children

    Science.gov (United States)

    ... 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. ...

  16. Tratamento cirúrgico dos aneurismas toracoabdominais da aorta Surgical treatment of thoracoabdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Januário M Souza

    1991-04-01

    Full Text Available Foram operados, em nosso Serviço, 161 aneurismas da aorta, sendo 99 por dissecção e 62 por outras causas. Em cinco pacientes, os aneurismas eram de localização toracoabdominal, sendo três por degeneração aterosclerótica e dois por dissecção; três pacientes eram do sexo feminino e a idade variou de 31 a 71 anos. Dois pacientes submeteram-se a aneurismectomia previamente (um da aorta ascendente e outro da porção proximal da aorta torácica. Revascularização miocárdica foi feita em um paciente, 40 dias antes da aneurismectomia. A indicação em todos os pacientes foi dor, causada por compressão do aneurisma, sendo que, em dois, havia insuficiência respiratória associada. Todos os pacientes foram operados através de incisão toracoabdominal e abertura do diafragma. A aorta foi substituída por tubo de Dacron, desde sua porção proximal até sua bifurcação, e as artérias viscerais foram implantadas no tubo. Quatro pacientes foram operados com pinçamento da aorta; um paciente necessitou emprego de circulação extracorpórea e parada circulatória, por impossibilidade de pinçamento da aorta junto à artéria subclávia. Todos os pacientes sobreviveram ao ato cirúrgico, ocorrendo dois óbitos no pós-operatório, um subitamente no 12º dia e outro por coma neurológico secundário a parada cardíaca causada por hipoxia.Five patients have been operated on of thoracoabdominal aortic aneurysms. The mean age was 53 years (range 31-71 and three were women. All the patients were symptomatic, three of them had arteriosclerotic aneurysms, and the other two had dissecting aneurysms. Three patients had been operated on previously. The exposure of aneurysm was made through a thoracoabdominal incision, in four patients clamps were placed above and below the aneurysm and it was incised longitudinally. Bypass between left atrium and left femoral artery with hypothermia and circulatory arrest was used in the other patients, since the

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. [Early detection of abdominal aortic aneurysm in risk population].

    Science.gov (United States)

    Enríquez-Vega, María Elizabeth; Solorio-Rosete, Hugo Francisco; Cossío-Zazueta, Alfonso; Bizueto-Rosas, Héctor; Cruz-Castillo, Juan Ernesto; Iturburu-Enríquez, Alessandra

    2015-01-01

    Introducción: aneurisma es el incremento del diámetro de una arteria > 50 %; los más frecuentes son los aneurismas de la aorta abdominal (AAA). La ecografía abdominal es el estudio de escrutinio para su diagnóstico. La detección oportuna del AAA en población de riesgo disminuye la morbimortalidad. El objetivo fue estimar la frecuencia de AAA en pacientes mayores de 65 años.Métodos: Se realizó un estudio transversal entre junio y octubre del 2012 en pacientes de ambos sexos mayores de 65 años que cubrieron los criterios de selección. Se les practicó ultrasonidoDoppler dúplex y se midió el diámetro anteroposterior de la aorta abdominal infrarrenal, se definió como AAA a una aorta abdominal con un diámetro mayor a 3 cm. Se empleó estadística descriptiva y regresión logística para factores de riesgo.Resultados: se incluyeron 144 pacientes, edad media (72.7 ± 6.7), el 95.1 % sexo masculino. El 13 % continuaban fumando. En 127 el diámetro de la aorta fue normal. Se detectaron 10 pacientes con AAA, todos del sexo masculino, el diámetro de los aneurismas identificados variaron de 3.2 a 7.11 cm, el diámetro promedio de 3 - 4 cm (n = 5). Solo el tabaquismo activo fue un factor predictivo significativo para AAA.Conclusión: Se demostró frecuencia significativa de AAA no detectada en masculinos mayores de 65 años, el tabaquismo fue el factor de riesgo más importante.

  19. Tratamento híbrido com endoprótese não recoberta nas dissecções agudas da aorta tipo A New surgical strategy for acute type A aortic dissection: hybrid procedure

    Directory of Open Access Journals (Sweden)

    Ricardo Ribeiro Dias

    2007-12-01

    Full Text Available O tratamento da dissecção aguda da aorta tipo A de Stanford, com a utilização de um novo dispositivo (stent de aorta não recoberto em associação à interposição de tubo supracoronariano para a substituição da aorta ascendente e hemiarco permitem que o arco aórtico e porção da aorta descendente sejam tratados, sem acrescentar complexidade ao procedimento operatório, nem prolongar o tempo de isquemia cerebral ou sistêmica.The new surgical strategy to treat patients with acute type A aortic dissection, the hybrid procedure with an uncovered aortic stent, allows surgeons to treat the aortic arch and the proximal descending aorta, besides the ascending segment, without extension of cerebral or systemic ischemia.

  20. [Takayasu's disease disclosed by isolated involvement of the ascending aorta].

    Science.gov (United States)

    Marcaggi, X; Courant, N; Soubrier, M; Kemeny, J L; Camilleri, L; Lusson, J R; Cassagnes, J

    1992-03-01

    The authors report the histological discovery of a case of Takayasu syndrome affecting the ascending aorta. This involvement appearing to concern only the aorta, with no symptomatic complaints nor any laboratory abnormalities indicative of an inflammatory syndrome, corticosteroids were not prescribed. Management consisted of biennial monitoring by transthoracic and transesophageal ultrasonography of the aorta and the supra-aortic main vessels together with monitoring of laboratory parameters.

  1. Abdominal wall endometriosis.

    Science.gov (United States)

    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.

  2. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    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...

  3. [Pathobiological determinants of atherosclerosis in youths: data from a macromorphometric and histomorphometric investigation of the aorta and coronary arteries].

    Science.gov (United States)

    Lesauskaite, Vaiva; Stalioraityte, Elena; Tanganelli, Piero; Epistolato, Maria Carmela

    2004-01-01

    We present a review of data from epidemiological and morphological studies carried out in Kaunas of atherosclerosis in youths. Since 1985, Kaunas has been a Collaborating Center involved with the World Health Organization and International Society and Federation of Cardiology studying the pathobiological determinants of atherosclerosis in youth. During the pilot study (1985-1987), we estimated the prevalence and extent of atherosclerotic lesions in the aorta and coronary arteries correlated to various risk factors in Kaunas residents aged 5 to 44 years. Within the framework of this international study, we compared histomorphometric characteristics of arteries collected from trauma victims aged 5 to 34 years in Budapest (Hungary), Heidelberg (Germany), Kaunas (Lithuania), Yaounde (Cameroon), and Mexico City (Mexico). These data revealed that males from countries with a high mortality from ischemic heart disease (Hungary, Lithuania, Germany) tended to have thicker intima in the thoracic and abdominal aorta and left anterior descending coronary artery than did males from countries with low mortality from ischemic heart disease (Mexico, Cameroon). We detected an increased mean intimal thickness of the abdominal aorta in male smokers aged 25-34 years. Males with hypertension aged 15-24 and 25-34 years had a thicker intima in the aorta and left anterior descending coronary artery than normotensive males. The morphological and epidemiological studies of atherosclerosis in youths carried out in Kaunas demonstrated that aortic and coronary atherosclerotic lesions appeared as early as childhood and advanced until the lesions become clinically apparent in adulthood. Histomorphometric findings support the postulate that increased intimal thickness can be considered a structural determinant of atherogenesis. These data draw attention to the means for the primary prevention of atherosclerosis in youth.

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

    LENUS (Irish Health Repository)

    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.

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

    LENUS (Irish Health Repository)

    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.

  6. AORTA: Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. This extended abstract introduces AORTA, a component that can be integrated into agents’ reasoning mechanism......, allowing them to reason about (and act upon) regulations specified by an organizational model using simple reasoning rules. The added value is that the organizational model is independent of that of the agents, and that the approach is not tied to a specific organizational model....

  7. Hemoptise e hemotórax como apresentação de ruptura de aorta torácica

    OpenAIRE

    Lima,Márcio Silva Miguel; Vieira, Marcelo Luiz Campos

    2009-01-01

    Dissecção da aorta torácica é doença de grande mortalidade em sua fase inicial, mas pode, em alguns casos, se cronificar. Relatamos caso de paciente com dissecção crônica de aorta tipo B (Stanford), admitido na Emergência com confusão mental, dispnéia e relato de hemoptise importante. O eletrocardiograma mostrava alterações inespecíficas e a radiografia de tórax revelou opacificação do hemitórax esquerdo. O ecocardiograma transtorácico não evidenciou dissecção aórtica, mas demonstrou imagem c...

  8. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Abdominal and Pelvic CT

    Medline Plus

    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 ...

  10. [The abdominal catastrophe].

    Science.gov (United States)

    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.

  11. Abdominal ultrasound (image)

    Science.gov (United States)

    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 ...

  12. Abdominal x-ray

    Science.gov (United States)

    ... 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 ...

  13. Linear abdominal trauma.

    Science.gov (United States)

    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.

  14. Ascending Aorta to Hepatic and Mesenteric Artery Bypassing, in Patients with Chronic Mesenteric Ischemia and Extensive Aortic Disease-A Case Report and Review of the Literature.

    Science.gov (United States)

    Barr, James; Kokotsakis, John; Tsipas, Pantelis; Papapavlou, Prodromos; Velissarios, Konstantinos; Kratimenos, Theodoros; Athanasiou, Thanos

    2017-02-01

    Chronic mesenteric ischemia (CMI) is a rare disorder caused by severe stenosis of the mesenteric arterial supply that results in postprandial pain and weight loss. Treatment options are surgical or endovascular. Surgical bypass can be performed in an antegrade fashion from the supraceliac abdominal aorta (AA) or the distal descending thoracic aorta or in a retrograde fashion from the infrarenal aorta or the common iliac artery. However, in some patients with disease of the descending thoracic aorta or the AA, another site for the proximal anastomosis needs to be found. In this article, we report the case of a 69-year-old man with a thoracoabdominal aortic aneurysm and CMI in whom we performed bypass grafts to the hepatic and superior mesenteric arteries using the ascending aorta as the site for the proximal anastomoses via a median sternolaparotomy. In addition, we performed a literature review of all similar cases and provide an analysis of this technique and an assessment of the success rates.

  15. CT diagnosis of inflammatory abdominal aneurysms. Computertomographische Diagnostik des inflammatorischen Bauchaortenaneurysmas

    Energy Technology Data Exchange (ETDEWEB)

    Koch, J.A. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Gruetzner, G. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Jungblut, R.M. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Kniemeyer, H.W. (Abt. fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf Univ. (Germany)); Moedder, U. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany))

    1994-07-01

    Amongst 1599 patients undergoing surgery for abdominal aortic aneurysm, there were 89 patients (5,6%) who showed typical features of inflammatory aneurysms of the abdominal aorta (IAAA). 37 of the 89 patients had been examined preoperatively by CT. In 73% of the cases (27/37) a correct diagnosis had been made. Localisation, width and extent of the IAAA was correctly diagnosed in all patients. Involvement of the renal arteries by the inflammatory process, the extent of thrombus and of mural calcification were accurately shown. The inflammatory tissues were typically ventral and lateral to the aorta. Frequently, there were adhesions to neighbouring structures. Aortic rupture, aortic dissection and retroperitoneal lymphoma may produce similar CT appearances; nevertheless, CT remains at present the method of choice for the diagnosis of IAAA because of its high sensitivity. (orig.)

  16. Posterior ''Nutcracker'' phenomenon in a patient with abdominal aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Puig, Stefan [Department of Radiology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Stuehlinger, Hermann Georg; Domanovits, Hans [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Staudenherz, Anton [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Zebenholzer, Karin [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Neurology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Rebhandl, Winfried [Department of Surgery, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Prokop, Mathias [Department of Radiology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)

    2002-07-01

    We report on a posterior ''nutcracker'' phenomenon due to an abdominal aortic aneurysm in a patient with a retro-aortic left renal vein. A 71-year-old man with a known abdominal aortic aneurysm presented in the emergency room with mild hematuria and flank pain. Computed tomography angiography revealed an aortic aneurysm, which compressed the left renal vein between the aorta and the vertebral column. Compression of the left renal vein, due to the aorta with consecutive congestion and hematuria as well as flank pain, was previously described as nutcracker phenomenon. In case of a retro-aortic left renal vein, increase of the aortic diameter can lead to compression of the renal vein and furthermore to the classical signs and symptoms of the ''nutcracker'' phenomenon, even though the aneurysm is not ruptured or there are no aorto-caval or aorto-left renal vein fistulas. (orig.)

  17. Primary stenting in the treatment of focal atherosclerotic abdominal aortic stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, W.; Falkowski, A.; Garncarek, J.; Karasek, M.; England, S.; Zawierucha, D

    2006-08-15

    Aim: To evaluate the results of primary stent placement in focal atherosclerotic aortic stenoses using balloon expandable stents. Materials and methods: Twenty-six primary balloon expandable stent placements in the abdominal aorta were performed and reviewed. All the aortic stenoses were atherosclerotic. Patients were followed up by ankle/brachial pressure indices (ABPI) and Doppler ultrasound (US) at 24 h after procedure and at 12 and 24 months. Follow-up angiograms were performed at 12 months. Results: Twenty-six stents in 26 patients were placed in the infrarenal aorta. All procedures were technically successful and immediate clinical success was obtained. The mean ABPI significantly improved from 0.52 {+-} 0.10 to 0.94 {+-} 0.09 within 24 h after procedure, and remained at 0.90 {+-} 0.12 between 12 and 24 months follow-up (mean 18 months). There was full haemodynamic success at hospital discharge and at 12 and 24 months after the procedure. Clinical success at 12 and 24 months (mean 18 months) was defined as an improvement in the Fontaine classification by at least one class compared with the pre-procedure class and was shown to be 100%. Conclusion: In summary, we report that primary stenting is a safe and effective alternative to surgery in cases of symptomatic stenosis of the infrarenal abdominal aorta. The excellent intermediate term results suggested that we would recommend primary stenting as the treatment of choice for focal atherosclerotic stenoses of the infrarenal aorta in selected patients.

  18. Tratamento cirúrgico das dissecções de aorta tipo A utilizando parada cardiocirculatória total com hipotermia profunda

    OpenAIRE

    Albuquerque,Luciano Cabral; Goldani, Marco Antônio; GOLDANI,Juremir João; PIANTÁ Ricardo Medeiros; Rubens Lorentz ARAÚJO; Petracco,João Batista

    1993-01-01

    No período de julho de 1986 a julho de 1993, 22 pacientes portadores de dissecção de aorta tipo A foram tratados cirurgicamente utilizando-se parada cardiocirculatória (PCC) total sob hipotermia profunda (18ºC), dos quais 15 apresentavam dissecção aguda e 7 dissecção crônica. Em 14 casos (64%) a aorta ascendente foi reconstruída utilizando-se enxerto reto de Dacron, com troca valvar aórtica em 5 pacientes e ressuspensão valvar aórtica em 2; a reconstrução do arco aórtico foi empregada em 8 ca...

  19. Vínculos entre la obesidad abdominal y la dislipidemia

    OpenAIRE

    Pedro Enrique Miguel Soca

    2011-01-01

    Tomando como punto de partida la discusión de un artículo publicado por la propia revista <em>Finlay em>en su número anterior, la presente carta se refiere a algunas alteraciones que relacionan la obesidad abdominal con la dislipidemia.

     

    Linking Abdominal Obesity and Dyslipidemia

    Considering as a start point the discussion of an article published by this same ...

  20. Dynamic Morphology of the Aorta. Pre- and postoperative imaging

    NARCIS (Netherlands)

    van Prehn, J.

    2009-01-01

    With endovascular treatment of the aorta a folded covered stentgraft is introduced in the aorta via the femoral arteries. Adequate pre-operative planning is necessary to allow for proper stentgraft sizing. Stentgrafts should be adequately oversized to ensure good apposition to the aortic wall and pr

  1. Stent migration during transcatheter management of coarctation of aorta.

    Science.gov (United States)

    Kannan, Bhava R J; Srinivasan, Muthusamy

    2012-02-15

    A 13-year-old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20-mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome.

  2. Coil embolization of an anastomotic leak after ascending aorta replacement

    DEFF Research Database (Denmark)

    Nørgaard, Anders; Andersen, Lars Ib; Haahr, P.E.

    2008-01-01

    Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly...... accepted--embolization with endovascular coils--successfully resulting in occlusion of the leakage....

  3. Comparative study of abdominal and thoracic aortic aneurysms: their pathogenesis and a gingival fibroblasts-based ex vivo treatment.

    Science.gov (United States)

    Cherifi, Hafida; Gogly, Bruno; Loison-Robert, Ludwig-Stanislas; Couty, Ludovic; Ferré, François Côme; Nassif, Ali; Lafont, Antoine; Fournier, Benjamin Pj

    2015-01-01

    Aortic aneurysms (AAs) consist of slow proteolysis and loss of both collagen and elastin matrix in the aorta wall, leading to wall dilation, weakening and rupture in well-advanced lesions. This can occur in both abdominal aorta (Abdominal Aortic Aneurysm: AAA) and thoracic aorta (Thoracic Aortic Aneurysm: TAA). To date, no non-surgical therapy has been proposed to slow or stop AA progression. Previously published preclinical studies from our team using an aneurysm rabbit model showed a promising concept for treatment of AAs with gingival fibroblast (GFs) which are readily available cells. In this study, we investigated the possible tissue repair of human AAAs and TAAs using ex vivo models co-cultured with GFs. Histological analysis showed that TAA and AAA are two distinct pathologies. Both lesions presented destruction of the aorta wall, highly evidenced in AAA samples. The results have confirmed the presence of the bacterial Porphyromonas gingivalis (Pg) protein in all AAA samples, but not in TAA samples, indicating the possible role of an infectious factor in the developing and progression of AAA lesions compared to TAA. The co-culture of GFs with AA lesions shows increased expression of TIMP-1, the inhibitor of the aneurysm severity marker MMP-9. Our study indicates that GFs might ameliorate aorta wall reestablishment in both AA types by their regenerative and immunomodulatory capacities. It also demonstrates the possible infectious cause of AAA compared with TAA that may explain their different behavior.

  4. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

    DEFF Research Database (Denmark)

    Michel, Jean-Baptiste; Martin-Ventura, José-Luis; Egido, Jesus

    2011-01-01

    and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall...... into diagnostic and therapeutic applications....

  5. Aortoscopia no tratamento das dissecções agudas da aorta Aortoscopy in the treatment of acute dissecting aneurysms of the aorta

    Directory of Open Access Journals (Sweden)

    Gladyston SOUTO

    1999-07-01

    Full Text Available No período de janeiro a dezembro de 1998 , foram operados 10 pacientes portadores de dissecção aguda da aorta (DA Ao 4 do tipo A e 6 do tipo B. O sexo masculino predominou e a idade dos pacientes variou de 34 a 78 anos. Em todos foram realizadas aortoscopias usando hipotermia profunda com parada circulatória total. Usou-se um gastroscópio, obtendo visão do lume da Ao, sendo que todos os pacientes tinham menos que 15 dias da doença. No tipo A, havia re-entrada abaixo da subclávia esquerda em 2 pacientes e, nos outros 2, na bifurcação das ilíacas. No tipo B, havia re-entrada ao nível das renais em 2 pacientes e, ao nível da bifurcação da Ao e das ilíacas, em 4. Em 2 pacientes do tipo A, a aortoscopia orientou na colocação de uma "Tromba de Elefante" como complemento. Nos outros 2, orientou na inversão do sentido da linha arterial. No tipo B, orientou na perfeita colocação da "Tromba de Elefante" e, em 4 pacientes, utilizamos a aortoscopia como complemento diagnóstico. O tempo utilizado na aortoscopia não alterou a morbimortalidade. Podemos concluir que a aortoscopia é um método de diagnóstico rápido, com boa definição das alterações anatômicas da Ao, permitindo um tratamento efetivo. Nos casos agudos instáveis podemos dispensar alguns exames pré-operatórios para não retardarmos a operação. O diagnóstico da re-entrada nos seguimentos inferiores da Ao ajuda a evitar a dissecção retrógrada. Acreditamos que a aortoscopia poderá, no futuro, ser de grande ajuda no diagnóstico e tratamento das DA Ao, bem como de outras lesões da Ao.From January to December 1998, ten patients with dissecting aneurysms of the Aorta (ADA Ao were operated on, 4 type A and 6 type B. Males predominated and ages ranged from 34 to 78 years. In all of them aortoscopy was performed with deep hypothermia and circulatory arrest. A gastroscope was used with visualization of the aortic lumen and all patients had less than 15 days of disease

  6. O processo aterosclerótico em artérias de coelhos submetidos a dieta suplementada com gema de ovo: modelo experimental de baixo custo Atherosclerotic lesion formation in rabbits fed on egg yolk-supplemented diet: an inexpensive experimental model

    Directory of Open Access Journals (Sweden)

    Rodrigo Gibin Jaldin

    2006-12-01

    Full Text Available OBJETIVO: Verificar a aterogenicidade do modelo de hipercolesterolemia por suplementação alimentar com gema de ovo em coelhos e seu uso como modelo de aterosclerose experimental de baixo custo. MATERIAL E MÉTODO: Foram utilizados 14 coelhos divididos em dois grupos de sete animais: grupo controle (G1, que recebeu ração comercial ad libitum, e grupo tratado (G2, que foi alimentado com dieta suplementada com gema de ovo. Ambos os grupos foram alimentados por 90 dias. Foram realizadas dosagens do perfil lipídico dos animais nos momentos 0, 30, 60 e 90 dias. Ao término do período experimental, os animais foram submetidos a eutanásia e retirada da aorta e de seus ramos diretos para realização de estudo anatomopatológico. RESULTADOS Apenas no grupo G2 houve aumento significativo nos níveis de colesterol total e frações. Ao exame macroscópico, foram observadas estrias gordurosas no arco aórtico e aorta abdominal e, à microscopia, acúmulos lipídicos discretos na íntima da aorta abdominal, renal, carótida, transição toracoabdominal e femoral. Portanto, a dieta com gema de ovo provocou aterosclerose leve no animal de experimentação e alterações equivalentes àquelas provocadas pelo colesterol purificado comercial quando fornecido em baixa dosagem. Assim sendo, a gema de ovo pode ser utilizada como fonte de colesterol alimentar de baixo custo em modelos de aterosclerose experimental.OBJECTIVE: To observe whether an inexpensive dietary-induced hypercholesterolemia model in rabbits using a chow diet supplemented with egg yolks can be used to develop atherosclerotic lesions in animals. MATERIAL AND METHOD: Fourteen rabbits were divided into two groups of seven animals: control group (G1, in which the rabbits were fed standard chow diet; and experimental group (G2, in which the rabbits were fed standard chow supplemented with egg yolks. Both groups were fed for 90 days. The lipid profile of all animals was measured at 0, 30, 60 and

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    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.

  9. Paradoxical Hypertension after Successful Cheatham Platinum Stent Implantation in an Adolescent with Coarctation of the Aorta

    Science.gov (United States)

    Tan, Yin Ling; Chih, Wan-Ling; Wang, Jou-Kou; Chen, Chun-An

    2016-01-01

    Stent implantation using a Cheatham Platinum (CP) stent for coarctation of the aorta (CoA) is a promising treatment alternative to traditional surgical repair. However, there are no earlier reports in the literature focusing on use of this stent in a Taiwanese patient. Herein we report a 16-year-old boy with CoA presenting with heart murmur and exercise intolerance who underwent successful CP stent placement. However, severe hypertension with arterial blood pressure increasing to 207/104 mmHg occurred four hours after stent implantation. There was no abdominal pain, nausea or vomiting. The patient’s hypertension was controlled by intravenous nitroglycerin infusion, followed by an oral antihypertensitve agent for the following 7 days. Experience from this case highlighted the usefulness of CP stent implantation for native CoA, and the importance of early recognition and management of paradoxical hypertension after CoA stenting. PMID:27899866

  10. "Stent" auto-expansível nas dissecções da aorta tipo B

    Directory of Open Access Journals (Sweden)

    PEREIRA Wagner Michael

    1999-01-01

    Full Text Available O tratamento clínico das dissecções agudas da aorta do tipo B tem mortalidade em torno de 25% menor que a mortalidade cirúrgica. O tratamento cirúrgico das dissecções crônicas também produz uma morbidade e mortalidade elevadas. A utilização de "stents"auto-expansíveis endovasculares pode ser uma nova alternativa no tratamento destas lesões. De abril a dezembro de 1998 foram implantados 15 "stents" endovasculares, 10 em dissecções agudas e 5 em crônicas. A idade dos pacientes variou entre 48 e 75 anos (média=60,53±9,73 anos com 66,6% do sexo masculino. Os pacientes foram submetidos à esternotomia mediana, circulação extracorpórea (CEC com hipotermia profunda (18° - 20°C, parada circulatória total (PCT e perfusão cerebral retrógrada (PCR. A aorta transversa foi incisada e implantado o "stent" na aorta descendente sob auxílio de aortoscopia. Foram analisados os tempos de CEC, pinçamento aórtico, PCT, PCR, reaquecimento, ventilação mecânica, internação, sangramento trans e pós-operatório, reposição sangüínea, gasometria, curva de eventos e sobrevida. A mortalidade hospitalar (30 dias foi de 6,6%; 2 pacientes foram reoperados com 3 e 6 meses após a operação com dissecção da aorta ascendente e aneurisma roto distal ao "stent". Quatorze vêm sendo acompanhados com 1 a 8m de evolução, sendo que 85,7% estão livres de eventos e curva de sobrevida de 93,1%(240 dias. Concluímos que o implante de "stent"intraluminais auto-expansíveis apresentou mortalidade menor na fase aguda da doença (6,6% comparada à nossa experiência anterior com o tratamento clínico (30%. Apesar da amostra ser pequena, o procedimento parece ser promissor e necessita mais acompanhamento.

  11. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    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

  12. Abdominal paracentesis and thoracocentesis.

    Science.gov (United States)

    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.

  13. [Abdominal actinomycosis with IUD].

    Science.gov (United States)

    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.

  14. Abdominal obesity in Japanese-Brazilians: which measure is best for predicting all-cause and cardiovascular mortality? Obesidade abdominal em nipo-brasileiros: que medida antropométrica tem maior capacidade de predizer a mortalidade geral e por doenças cardiovasculares?

    Directory of Open Access Journals (Sweden)

    Marselle Rodrigues Bevilacqua

    2011-10-01

    Full Text Available This study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in Japanese-Brazilians. The study followed 1,581 subjects for 14 years. Socio-demographic, lifestyle, metabolic, and anthropometric data were collected. The dependent variable was vital status (alive or dead at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. The mortality rate was estimated, and Poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. The mortality rate was 10.68/thousand person-years. Male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. The results indicate that prevalence of abdominal obesity was high among Japanese-Brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality in this group.O objetivo foi verificar qual medida antropométrica de obesidade abdominal melhor prediz mortalidade geral e por doenças cardiovasculares entre nipo-brasileiros. Foram seguidos, por 14 anos, 1.581 sujeitos. Coletaram-se dados sociodemográficos, de estilo de vida, metab��licos e antropométricos. Considerou-se vivo ou óbito ao final do estudo como variável dependente e a presença de obesidade abdominal por diferentes medidas na linha de base como variável independente. Estimou-se o coeficiente de mortalidade e se usou o modelo de Poisson para obtenção das razões entre eles e a obesidade abdominal, ajustados simultaneamente às demais variáveis. O coeficiente de mortalidade foi de 10,68/mil pessoas-ano. O gênero masculino, a idade > 60 anos e ter hipertensão arterial foram fatores de risco independentes para mortalidade. Os resultados indicaram que entre nipo-brasileiros a prevalência de obesidade abdominal foi

  15. Comparative study of the healing process of the aponeurosis of the anterior abdominal wall of rats after wound closure using 3-0 nylon suture and N-butil-2-cyanoacrylate tissue adhesive Estudo comparativo da cicatrização da aponeurose da parede abdominal anterior com a utilização do fio de poliamida monofilamentar 3-0 e o adesivo N-Butil-2-Cianoacrilato em ratos

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Marques Batista

    2008-08-01

    Full Text Available PURPOSE: To investigate the healing process of the aponeurosis of the anterior abdominal wall of rats, comparing two different materials for wound closure: 3-0 nylon suture and tissue adhesive N-butyl-2-cyanoacrylate. METHODS: Forty-four Wistar rats were randomly divided into four groups according to the type of material used (suture or adhesive and the number of days until reoperation (seven or 14 days. After a 4 cm incision in the aponeurosis, 22 rats underwent wound closure using 3-0 nylon suture and the other 22, the tissue adhesive. After seven days, 11 rats from each group were weighed again, submitted to reoperation and then euthanized. The same procedure was carried out after 14 days with the remaining rats. The surgical wound was macroscopically examined, the tensile strength was measured and the tissue edges were histologically examined. The statistical analysis was performed using analysis of variance and Cox's proportional hazards model. Significance level was set at p OBJETIVO: Investigar o processo de cicatrização da aponeurose da parede abdominal anterior em ratos, comparando dois diferentes materiais de sutura: fio de poliamida monofilamentar 3-0 e adesivo N-butil-2-cianoacrilato. MÉTODOS: Quarenta e quatro ratos Wistar, foram divididos aleatoriamente em quatro grupos, de acordo com o material de síntese (fio e adesivo cirúrgico e o tempo de reoperação (7 e 14 dias. Após uma incisão de 4 cm na aponeurose, 22 animais foram submetidos à síntese com o fio de poliamida e os outros 22 animais com o adesivo proposto. Após o procedimento, aguardou-se um período de 7 e 14 dias, quando os animais, 11 de cada grupo, foram novamente pesados e submetidos à eutanásia, sendo realizada a avaliação macroscópica da ferida operatória, mensuração da força de ruptura da parede abdominal e estudo histológico das bordas da incisão. A análise estatística foi realizada através de um modelo de análise de variância e de riscos

  16. Adult thoracic and abdominal aortic

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    Randa O. Kaddah

    2016-06-01

    Conclusion: Aortic COA could be found in any segment of the aorta. Proper identification of the anatomical details and pressure gradient studies are important factors affecting the plan of management.

  17. COARCTATION OF AORTA AND TAKAYASU ARTERITIS FOR LSCS: ANAESTHESIA MANAGEMENT

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    Rashmi

    2015-10-01

    Full Text Available Coarctation of aorta is a congenital disorder with 5-10% incidence. It occurs in about 1 in 10,000 births .It may remain asymptomatic till adulthood. During pregnancy, early gestational hypertension is the presenting sign. Difference in blood pressure in upper and lower limb is a characteristic finding of coarctation of aorta. Association of bicuspid aortic valve and ventricular septal defect is seen in 50% patients of coarctation. Major cardiovascular complications are infrequent but continue to be a source of concern for patients with coarctation who become pregnant. Coarctation of aorta commonly located at the junction of the arch of aorta and proximal descending aorta at the level of ductal structure, may be diagnosed for the first time during pregnancy. Dilatation and dissection of the aorta can lead to increased maternal mortality; significant stenosis is a contraindication to pregnancy. However, successful pregnancies have been reported in women with uncorrected coarctation if preconception risk stratification is done. Here is a case of LSCS with coarctation of aorta and Takayasu arteritis done successfully under epidural anaesthesia.

  18. Associação de aptidão cardiorrespiratória e circunferência abdominal com hipertensão em mulheres idosas brasileiras Asociación de aptitud cardiorrespiratoria y circunferencia abdominal con hipertensión en mujeres adultas mayores brasileñas Association of fitness and waist circumference with hypertension in Brazilian elderly women

    Directory of Open Access Journals (Sweden)

    Maressa Priscila Krause

    2009-07-01

    Full Text Available FUNDAMENTO: O efeito protetor da aptidão cardiorrespiratória tem sido reconhecido nos adultos. Entretanto, essa relação ainda não se mostra esclarecida nos idosos. OBJETIVO: Analisar a associação entre hipertensão e aptidão cardiorrespiratória (ACR em 1.064 mulheres idosas Brasileiras. MÉTODO: A obesidade central foi estimada pela circunferência abdominal (CA e a ACR pelo teste de caminhada de 6 minutos. Os testes de ANOVA one-way, Qui-quadrado e regressão logística foram usados para a análise estatística. RESULTADOS: A prevalência de hipertensão foi de 53,9%. O grupo obesidade central apresentou maior risco para hipertensão quando comparado ao grupo não-obesidade central, mesmo pertencendo ao mesmo nível de ACR. Além disso, ambos os grupos mostraram um aumento progressivo do risco para hipertensão do maior para o menor grupo de ACR, indicando uma relação inversa entre ACR e obesidade central. O grupo não-obesidade central obteve o menor odds ratio (OR de 1,49 (95%IC 0,97-2,28 e 1,54 (95%IC 0,94-2,51; enquanto que no grupo obesidade central, o OR foi 2,08 (95%IC 1,47-2,93, 2,79 (95%IC 1,79-4,33 e 3,09 (95%IC 1,86-5,12. CONCLUSÃO: Os resultados encontrados indicaram que a CC é um forte preditor de hipertensão, e que o efeito protetor da ACR pode ser estendido às mulheres idosas, mesmo àquelas com obesidade central.FUNDAMENTO: El efecto protector de la aptitud cardiorrespiratoria ha sido reconocido en los adultos. Sin embargo, esa relación todavía no está aclarada en las personas adultas mayores. OBJETIVO: Analizar la asociación entre hipertensión y aptitud cardiorrespiratoria (ACR en 1.064 mujeres adultas mayores brasileñas. MÉTODOS: La obesidad central se estimó por la circunferencia abdominal (CA y la ACR por el test de marcha de 6 minutos. Se emplearon las pruebas de ANOVA one-way, Chi-cuadrado y regresión logística para el análisis estadístico. RESULTADOS: La prevalencia de hipertensión fue de un 53

  19. Through-Plane Movement at Multiple Aortic Levels on Dynamic Computed Tomography Angiography Is Limited in Patients With an Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    de Jonge, Jeroen C; Zandvoort, Herman J A; Vonken, Evert-Jan P A; Moll, Frans L; van Herwaarden, JA

    2015-01-01

    PURPOSE: To analyze the movement of the aorta in the craniocaudal direction (through-plane movement) during the cardiac cycle at several levels to determine any potential impact on endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS: For this study, 30 patients (median ag

  20. Vasorelaxant responses to endomorphin1[psi] and endomorphin2[psi], analogues of endomorphins, in rat aorta rings.

    Science.gov (United States)

    Feng, Yun; Zhao, Qian-Yu; Chen, Qiang; Wang, Rui

    2005-11-01

    Endomorphin-1 (Tyr-Pro-Trp-Phe-NH2, EM1) and endomorphin-2 (Tyr-Pro-Phe-Phe-NH2, EM2), the endogenous selective mu-opioid receptor agonists, can inhibit phenylephrine (PE) induced contraction which is related to the release of nitric oxide from vascular endothelium in aorta rings of rats and rabbits. The reduced (CH2NH) amide bond is a useful peptide bond surrogate in the design of opioid mimetics because it could enhance conformational flexibility and metabolic stability. The present work was designed to investigate the vascular activities of interrelated endomorphin analogues: endomorphin-1[psi] (Tyr[psi(CH2NH)]Pro-Trp-Phe-NH2, EM1[psi]) and endomorphin-2[psi] (Tyr[psi(CH2NH)]Pro-Phe-Phe-NH2, EM2[psi]). The effect of EM1[psi] (1, 2, 3, 4, 5 microM) and EM2[psi] (0.001, 0.01, 0.1, 1, 5 microM) were evaluated on rat thoracic aortic rings pre-contracted with PE (0.1 microM). EM1[psi] and EM2[psi] both caused a concentration-dependent relaxation. The IC50 of EM1[psi] and EM2[psi] was 3.332 microM and 1.226 microM, respectively. The vasorelaxant effect of EMs[psi] is 216.9 and 237.1 fold more potent than EMs. Moreover, the vasorelaxant effect of EMs[psi] was blocked by naloxone (NaCl, 1 microM) and was reduced by N(omega)-nitro-L-arginine (L-NNA, 1 microM) and removal of endothelium. The present study demonstrated that EMs[psi] had more potent vasorelaxant effects and their activities were naloxone-sensitive and endothelium-dependent and partially NO-dependent, similar to the mechanism of parent EMs.

  1. [Endovascular repair for coarctation of the aorta in an adult].

    Science.gov (United States)

    Hayashi, Jun; Abe, Kazuo; Hata, Masaki; Nagano, Naoko; Hamasaki, Azumi; Suzuki, Kenji

    2013-09-01

    A 27-year-old woman with Turner's syndrome who underwent successful endovascular treatment for coarctation of the aorta is presented. She was admitted to our hospital complaining of upper extremity hypertension. Computed tomography revealed discrete stenosis of the proximal descending aorta and developed collateral circulation. After endovascular repair with a balloon expandable stent, her transcoarctation gradient fell from 44 mmHg preoperatively to less than 10 mmHg. She was discharged with no complications on the 7th postoperative day. Coarctation of the aorta in an adult patient could be safely and effectively managed by endovascular treatment.

  2. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    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.

  3. Screening for Abdominal Aortic Aneurysm

    Science.gov (United States)

    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 ...

  4. Abdominal aortic aneurysm repair - open

    Science.gov (United States)

    ... 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 ...

  5. Duplicidade da artéria renal em cão Renal artery duplicity in dog

    Directory of Open Access Journals (Sweden)

    Fabrício Singaretti de Oliveira

    2007-12-01

    Full Text Available Alterações vasculares renais são observadas com baixa freqüência em medicina veterinária e podem ter implicações diretas no funcionamento normal destes órgãos devido à alteração do fluxo sangüíneo. Assim, o objetivo deste relato é descrever um caso de duplicidade da artéria renal em uma cadela de cinco anos, sem raça definida e com 18kg. O animal veio a óbito após hemoparasitose crônica e foi submetido à injeção de látex pela aorta torácica, na altura do sexto espaço intercostal esquerdo. O animal foi dissecado após fixação com solução de formol a 10%, no laboratório de Anatomia Animal da Faculdade de Medicina Veterinária da UNICASTELO, Campus Fernandópolis, SP, visando-se à evidenciação dos ramos da aorta abdominal. Observou-se que o rim direito era irrigado por duas artérias, de calibres diferentes, caracterizando uma duplicidade dessa artéria renal. A artéria secundária apresentava diâmetro 28,1% menor que a principal do mesmo antímero e 34,3% menor que a principal do outro antímero. Ambas as artérias adentravam o rim pela região do hilo renal e apresentavam trajetos praticamente paralelos. O rim esquerdo apresentava irrigação pela artéria renal correspondente, sem qualquer alteração anatômica em número. Esta duplicidade da artéria renal deve ser considerada em cães, principalmente quando alterações renais estiverem presentes ou quando intervenções cirúrgicas abdominais forem conduzidas próxima aos rins, visando-se, dessa forma, a evitar que erros sejam cometidos por desconhecimento anatômico de estruturas importantes.Renal vessels abnormalities are noticed with low frequency in veterinary medicine ad may have direct implications on the regular functioning of these organs due blood flow change. Thus, the aim of this report is describe a case of duplicity of the renal artery in a five year crossbred female weighting 18kg. The animal went to death due chronic hemoparasitosis and had

  6. Magnetic resonance imaging of congenital abnormalities of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Requejo, I.; Fernandez, R. [Department of Radiology, Hospital Juan Canalejo, La Coruma (Spain); Raposo, I. [Department of Pediatric Cardiology, Hospital Juan Canalejo, La Coruna (Spain)

    1998-05-01

    This article outlines the ability of MR imaging in the detection and presurgical evaluation of congenital abnormalities of the thoracic aorta (CATA). Congenital abnormalities of the thoracic aorta may be found incidentally on chest radiographs in patients without symptoms, or it can be associated with clinical findings which are very variable depending on the association with congenital cardiac malformations or vascular ring. When CATA is suspected as the cause of anomalies in the mediastinum in asymptomatic patients, confirmation of the abnormality should be by MR imaging allowing precise evaluation of the thoracic aorta and origin of the principal arteries. When CATA is considered because clinical findings indicate coarctation of the aorta, vascular ring or associated cardiac disorder, evaluation with ultrasound can be complemented by MR, which in most cases will replace the diagnostic catheterization. (orig.) With 12 figs., 24 refs.

  7. Endovascular management of recurrent adult coarctation of the aorta.

    Science.gov (United States)

    Kpodonu, Jacques; Ramaiah, Venkatesh G; Rodriguez-Lopez, Julio A; Diethrich, Edward B

    2010-11-01

    Traditional open surgical repair has proven to be an effective treatment for the management of primary and recurrent coarctation of the thoracic aorta. Potential complications at short-term and long-term follow-up have included recurrent coarctation, hypertension, premature coronary artery disease, cerebrovascular disease, and anastomotic pseudoaneurysm. Endovascular repair of recurrent coarctation of the thoracic aorta offers a less invasive treatment approach in potential high-risk surgical patients.

  8. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2013-01-01

    Full Text Available Introduction. The term “penetrating atherosclerotic ulcer” (PAU of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to our hospital. Transthoracic echocardiography showed no pathological changes of the ascending aorta. However, multislice computed tomography (CT showed an aortic ulcer with varying degree of the subadventitial hemorrhage in the region of the thoracic aorta at the level of Th 8-9. Due to imminent rupture of the penetrating aortic ulcer, the patient was promptly prepared for surgery. A 15 cm long subadventitial hematoma was found intraoperatively in the right posterolateral aspect of the descending aorta, 5 cm above the diaphragm and 7 cm below the origin of the left subclavial artery. The affected segment of the aorta was resected, followed by an inlay aortic reconstruction with a Dacron tube graft of 24 mm. Control CT revealed satisfactory reconstruction of the descending aorta. Conclusion. PAU is a rare, but potentially fatal disease. Open surgery in patients with PAU is an effective treatment strategy, although endovascular treatment options are emerging.

  9. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    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...

  10. Relação entre obesidade e síndrome metabólica em adolescentes de 10 a 14 anos com obesidade abdominal - DOI: 10.4025/actascihealthsci.v31i2.6194 The relationship between obesity and metabolic syndrome in adolescents between ages 10 and 14, with abdominal obesity - DOI: 10.4025/actascihealthsci.v31i2.6194

    Directory of Open Access Journals (Sweden)

    Francisco Martins Silva

    2009-09-01

    Full Text Available Os objetivos do presente estudo foram analisar a relação entre a obesidade e a síndrome metabólica (SM; identificar a prevalência da SM; classificar o estado nutricional e comparar as variáveis: triglicérides, HDL-c, pressão arterial e glicose em adolescentes com obesidade abdominal. A amostra foi constituída por 393 adolescentes de ambos os sexos entre dez e 14 anos de idade. Foram feitas medidas de circunferência do abdômen, aferição da pressão arterial e exames laboratoriais de glicose, colesterol HDL-c e triglicérides. Os resultados apresentaram que, na condição nutricional, o sexo masculino apresentou obesidade de 27,1%, sobrepeso de 4,3 e 68,6% de peso normal. Quanto ao sexo feminino, 29,5% estão com peso normal, 1,6%, com sobrepeso e 68,9%, com obesidade. A obesidade no sexo feminino foi estatisticamente maior do que no masculino. A prevalência de SM foi de 37%, e os meninos tiveram a prevalência maior da síndrome metabólica. Não foi encontrada diferença estatística entre os sexos nas variáveis: triglicérides, HDL-c e pressão arterial. Concluímos que a obesidade foi fator determinante para a SM em adolescentes do sexo feminino, a prevalência da SM e a de obesidade foram altas e nos parâmetros bioquímicos não foi encontrada nenhuma diferença estatística entre os sexos.The objectives of this study were: to analyze the relationship between obesity and metabolic syndrome (MS; identify the prevalence of MS; classify the nutritional condition; and compare the variables: triglycerides, HDL-c, arterial pressure and glucose in adolescents with abdominal obesity. The sample consisted of 393 adolescents of both genders between ages 10 and 14. Measurements were taken of abdominal circumference, arterial pressure, and laboratory exams of glucose, cholesterol HDL-c and triglycerides. The results showed that, in the nutritional condition, the male gender presented an obesity rate of 27.1, 4.3% overweight, and a rate of

  11. Ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    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.

  12. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Optimal control applied to a thoraco-abdominal CPR model.

    Science.gov (United States)

    Jung, Eunok; Lenhart, Suzanne; Protopopescu, Vladimir; Babbs, Charles

    2008-06-01

    The techniques of optimal control are applied to a validated blood circulation model of cardiopulmonary resuscitation (CPR), consisting of a system of seven difference equations. In this system, the non-homogeneous forcing terms are chest and abdominal pressures acting as the 'controls'. We seek to maximize the blood flow, as measured by the pressure difference between the thoracic aorta and the right atrium. By applying optimal control methods, we characterize the optimal waveforms for external chest and abdominal compression during cardiac arrest and CPR in terms of the solutions of the circulation model and of the corresponding adjoint system. Numerical results are given for various scenarios. The optimal waveforms confirm the previously discovered positive effects of active decompression and interposed abdominal compression. These waveforms can be implemented with manual (Lifestick-like) and mechanical (vest-like) devices to achieve levels of blood flow substantially higher than those provided by standard CPR, a technique which, despite its long history, is far from optimal.

  14. A subpopulation of large granular von Willebrand Ag negative and CD105 positive endothelial cells, isolated from abdominal aortic aneurysms, overexpress ICAM-1 and Fas antigen.

    Science.gov (United States)

    Páez, Araceli; Archundia, Abel; Méndez Cruz, René; Rodríguez, Emma; López Marure, Rebeca; Masso, Felipe; Aceves, José Luis; Flores, Leopoldo; Montaño, Luis F

    2002-01-01

    The aim of this work was to determine whether there is a pre-established basal condition of the endothelial cells isolated from aortic abdominal aneurysm that might augment immune effector mechanisms and thus provide us an insight into the possible causes of aneurysm rupture. Endothelial cells isolated from saccular aortic aneurysm fragments were analyzed by cytofluorometry for the expression of different immune response-related molecules. Our results showed that there is a subpopulation of granule-rich, CD105 positive and von Willebrand antigen negative endothelial cells that have an enhanced basal expression of ICAM-1, and Fas antigen, but, interestingly, no apoptotic bodies were detected. Control endothelial cells derived from healthy areas of the same abdominal aortas did not show such enhanced expression. We conclude that in the endothelium that lines abdominal aorta aneurysms there is, at least, one endothelial cell subpopulation with an apparent inhibition of programmed cell death and in a proinflammatory activation status.

  15. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway.

    Directory of Open Access Journals (Sweden)

    Ya-Wei Yan

    Full Text Available Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA. Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway.

  16. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway.

    Science.gov (United States)

    Yan, Ya-Wei; Fan, Jun; Bai, Shu-Ling; Hou, Wei-Jian; Li, Xiang; Tong, Hao

    2016-01-01

    Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA). Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs) were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway.

  17. Morphological Evidence of Telocytes in Mice Aorta

    Directory of Open Access Journals (Sweden)

    Hong-Qi Zhang

    2015-01-01

    Full Text Available Background: Telocytes (TCs are a novel type of interstitial cells, which have been recently described in a large variety of cavitary and noncavitary organs. TCs have small cell bodies, and remarkably thin, long, and moniliform prolongations called telopodes (Tps. Until now, TCs have been found in various loose connective tissues surrounding the arterioles, venules, and capillaries, but as a histological cellular component, whether TCs exist in large arteries remains unexplored. Methods: TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice. Results: TCs in aortic arch had small cell bodies (length: 6.06-13.02 μm; width: 1.05-4.25 μm with characteristics of specific long (7.74-39.05 μm, thin, and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia: TCs in the innermost layer of tunica adventitia, located at the juncture between media and adventitia, with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers of tunica adventitia, were embedded among transverse and longitudinal oriented collagen fibers, forming a highly complex three-dimensional meshwork. Moreover, desmosomes were observed, serving as pathways connecting neighboring Tps. In addition, vesicles shed from the surface of TCs into the extracellular matrix, participating in some biological processes. Conclusions: TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries, such as fibroblasts. And further biologically functional correlations need to be elucidated.

  18. Morphological Evidence of Telocytes in Mice Aorta

    Institute of Scientific and Technical Information of China (English)

    Hong-Qi Zhang; Shan-Shan Lu; Ting Xu; Yan-Ling Feng; Hua Li; Jun-Bo Ge

    2015-01-01

    Background:Telocytes (TCs) are a novel type of interstitial cells,which have been recently described in a large variety of cavitary and noncavitary organs.TCs have small cell bodies,and remarkably thin,long,and moniliform prolongations called telopodes (Tps).Until now,TCs have been found in various loose connective tissues surrounding the arterioles,venules,and capillaries,but as a histological cellular component,whether TCs exist in large arteries remains unexplored.Methods:TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice.Results:TCs in aortic arch had small cell bodies (length:6.06-13.02 μm; width:1.05-4.25 μm) with characteristics of specific long (7.74-39.05 μm),thin,and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia:TCs in the innermost layer of tunica adventitia,located at the juncture between media and adventitia,with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers oftunica adventitia,were embedded among transverse and longitudinal oriented collagen fibers,forming a highly complex three-dimensional meshwork.Moreover,desmosomes were observed,serving as pathways connecting neighboring Tps.In addition,vesicles shed from the surface of TCs into the extracellular matrix,participating in some biological processes.Conclusions:TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries,such as fibroblasts.And further biologically functional correlations need to be elucidated.

  19. Intramural aortic hematomas; Intramurale Haematome der Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Raab, B.W.; Vosshenrich, R.; Fischer, U.; Funke, M.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik

    2001-08-01

    Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can be differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membran are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. (orig.) [German] Das intramurale Haematom (IMH) ist eine Einblutung in die Aortenwand. Grundsaetzlich kann zwischen traumatischer Genese und einer atraumatischen spontanen Form unterschieden werden. Praedisponierend sind arterielle Hypertension und mesoektodermale Dysplasiesyndrome. Die Diagnose ergibt sich aus der Klinik und den Befunden in den bildgebenden Verfahren. Zu den klinischen Symptomen zaehlen akut oder subakut auftretende Schmerzen, assoziiert mit einer Kollapsneigung. Typische Befunde in der transoesophagealen Echokardiographie, der Computer- oder der Magnetresonanztomographie sind eine halbmondfoermige oder konzentrische Wandverdickung der Aorta ohne Nachweis von Blutfluss oder einer Dissektionsmembran mit Dichtewerten bzw. Signalintensitaeten in Abhaengigkeit vom Alter der Einblutung. Differenzialdiagnostisch ist eine Abgrenzung

  20. Influência do pré-condicionamento isquêmico na proteção miocárdica em revascularização do miocárdio com pinçamento intermitente da aorta Ischemic preconditioning in myocardial revascularization with intermittent aortic cross - clamping

    Directory of Open Access Journals (Sweden)

    Paulo M. PÊGO-FERNANDES

    2001-03-01

    Full Text Available Objetivo: Este estudo testa a hipótese de que curtos períodos de isquemia podem aumentar a proteção obtida pelo pinçamento intermitente da aorta. Métodos: No grupo controle (18, a operação foi realizada com hipotermia sistêmica a 32 ºC com pinçamento intermitente da aorta e uso de circulação extracorpórea (CEC. No segundo grupo, denominado de pré-condicionamento (17, foram acrescidos dois pinçamentos de 3 minutos da aorta com intervalo de 2 minutos de reperfusão entre eles, previamente ao pinçamento intermitente da forma convencional. CK-MB, troponina I, adenosina e lactato foram obtidos do seio ocoronário no início da circulação extracorpórea (1, ao final da segunda anastomose (2 e ao final da CEC (3. Resultados: Os níveis de CK-MB e troponina I apresentaram uma leve tendência a aumentar ao final da CEC no grupo controle, enquanto os de adenosina e lactato não apresentaram diferença. Conclusão: Concluímos que o pré-condicionamento isquêmico não promoveu melhora significante na proteção miocárdica.Background: This study tests the hypothesis that initial brief periods of ischemia could improve the protection obtained by intermittent aortic cross-clamping. Methods: In the control group (18, the procedure was performed under intermittent aortic cross-clamping at 32ºC. Patients in the preconditioned group (17 received a stimulus of two 3-min periods of cross-clamping followed by 2 min of reperfusion prior to standard operation. CKMB, troponin I, adenosine and lactate were obtained from the great cardiac vein at the onset of cardiopulmonary bypass (CPB (1, at the end of the first anastomosis (2 and at the end of CPB (3. Results: CKMB and troponin I presented a slight trend to be higher at the end of CPB in the control group, while there was no difference between adenosine and lactate levels. Conclusion: Ischemic preconditioning showed no significant improvement in myocardial protection.

  1. Finite Element Implementation of a Structurally-Motivated Constitutive Relation for the Human Abdominal Aortic Wall with and without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand; Henneberg, Kaj-Åge; Lönn, L

    2011-01-01

    The structural integrity of the abdominal aorta is maintained by elastin, collagen, and vascular smooth muscle cells. Changes with age in the structure can lead to develop-ment of aneurysms. This paper presents initial work to capture these changes in a finite element model (FEM) of a structural......-ly-motivated anisotropic constitutive relation for the “four fiber family” arterial model. First a 2D implementation is used for benchmarking the FEM implementation to fitted biaxial stress-strain data obtained experimentally from four different groups of persons; 19-29 years, 30-60 years, 61-79 years and abdominal aortic...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. Ultra-sonografia abdominal e pélvica em cães da raça golden retriever sadios, portadores e afetados pela distrofia muscular progressiva

    OpenAIRE

    GRANDO, Angélica Paula; MARIANA, Arani Nanci Bonfim; Miglino,Maria Angélica; Sterman, Franklin de Almeida; Zatz, Mayana; Kanayama,Luciane Maria; FEITOSA, Matheus Levi Tjara; Martins,Daniele dos Santos; Morini, Adriana Caroprezo; Santos,Juliana Passos Alves dos; FADEL, Leandro; Alves, Flávio Ribeiro; Ambrósio, Carlos Eduardo

    2009-01-01

    A distrofia muscular de Duchenne (DMD) é um tipo de distrofia muscular em humanos caracterizada por uma doença genética ligada ao cromossomo X. O cão golden retriever portador da distrofia muscular (GRMD) tem sido intensamente estudado e considerado o modelo mais representativo para a doença observada em humanos. Assim, como forma de verificar anormalidades em órgãos internos nesses animais, foi realizado o exame ultra-sonográfico de 24 cães golden retriever saudáveis, portadores e afetados p...

  4. Right thoracotomy approach for repair of recurrent or complex coarctation of the aorta using an extra-anatomic ascending aorta to descending aorta bypass graft off-pump.

    Science.gov (United States)

    Tabry, Imad F; Zachariah, Zachariah P

    2013-01-01

    A previously described but rarely used surgical technique for the repair of complex or recurrent coarctation of the aorta through a right thoracotomy approach is presented in detail. It has the advantages of being simple and avoiding left chest re-entry, median sternotomy and cardiopulmonary bypass altogether.

  5. Prevalência e fatores de risco na associação entre doença arterial coronariana e aneurisma de aorta Prevalence and risk factors for combined coronary artery disease and aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Carlos Romério Costa Ferro

    2007-01-01

    Full Text Available OBJETIVO: Avaliar a prevalência da doença arterial coronariana (DAC em portadores de aneurisma de aorta (AA, bem como as diferenças relacionadas às diferentes topografias. Descrever os principais fatores de risco para DAC relacionados a esta associação e suas eventuais diferenças de acordo com as diferentes topografias. MÉTODOS: Estudo prospectivo, aberto, não randomizado que avaliou 95 pacientes (62 homens, 33 mulheres, idade 63 ± 11,8 anos com AA. Todos os pacientes, assintomáticos para DAC, possuíam tomografia computadorizada de aorta e angiografia coronariana. De acordo com a topografia do AA, eles foram divididos em três grupos: 1 pacientes com AA torácica (AAT; 2 com AA toracoabdominal (ATA e 3 com AA abdominal (AAA. Foi criado um banco de dados com as informações clínicas e de exames complementares. A análise estatística realizada com o teste t de Student ou análise de variância (ANOVA para as variáveis contínuas e qui-quadrado para as categóricas, sendo considerado p significante quando 70% e 19 (31,6% > 50%. Quinze pacientes (25% eram uniarteriais, 11 (18% biarteriais e 34 (57% triarteriais. CONCLUSÃO: Em portadores de AA a prevalência de DAC assintomática é elevada, principalmente naqueles com AAA. Os resultados deste estudo sugerem a necessidade de uma estratificação diagnóstica para DAC nos portadores de AA, principalmente nos com AAA.OBJECTIVE: To evaluate CAD prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. To describe the primary risk factors for CAD related to this association and their occasional differences according to AA topographies. METHODS: This was an open, prospective, nonrandomized study that evaluated 95 patients (66 men and 33 women, mean age 63 ± 11.8. All patients, asymptomatic for CAD, had undergone aortic CT and coronary angiography. According to the AA topography, they were classified into three groups: 1 patients with thoracic

  6. Avaliação do gradiente pressórico aorto-radial em pacientes submetidos à intervenção cirúrgica com circulação extracorpórea Evaluación del gradiente presórico aorto-radial en pacientes sometidos a la intervención quirúrgica con circulación extracorpórea Evaluation of the aorta-to-radial artery pressure gradient in patients undergoing surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Maria José Carvalho Carmona

    2007-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Diversos estudos têm demonstrado diferença significativa entre a pressão aórtica e a pressão radial em pacientes submetidos à circulação extracorpórea (CEC. Os objetivos deste estudo foram avaliar o comportamento da diferença entre pressão arterial radial e a pressão aórtica durante revascularização do miocárdio (RM com CEC e sua correlação com resistência vascular sistêmica. MÉTODO: Após aprovação pelo Comitê de Ética Hospitalar, 16 pacientes submetidos à RM com CEC hipotérmica foram estudados. Pressões sistólica, diastólica e média foram obtidas na raiz da aorta e na artéria radial, através de cateteres específicos. Débito cardíaco foi obtido com o uso de cateter de artéria pulmonar ou diretamente da máquina de CEC e resistência vascular sistêmica indexada (RVSi foi calculada nos momentos pré-CEC, início da CEC, após a última RM, no fim da CEC e pós-CEC. A análise estatística foi realizada por meio de Análise de Variância para medidas repetidas e correlação de ordem de Spearman e o nível de significância foi fixado em 0,05. RESULTADOS: Após o início da CEC, a pressão arterial radial foi sistematicamente menor que a pressão aórtica em 3 a 5 mmHg. Foi observada correlação significativa entre o gradiente médio de pressão aorto-radial e a RVSi somente após a última RM, correspondendo ao aquecimento do paciente (Rho = 0,67, p = 0,009. CONCLUSÕES: A medida de pressão na arterial radial subestimou sistematicamente a pressão arterial na raiz da aorta após a CEC e a RVSi não forneceu estimativa acurada da magnitude do gradiente de pressão aorto-radial.JUSTIFICATIVA Y OBJETIVOS: Diversos estudios han demostrado diferencia significativa entre la presión aórtica y la presión radial en pacientes sometidos a la circulación extracorpórea (CEC. Los objetivos de este estudio fueron evaluar el comportamiento de la diferencia entre presión arterial radial y la

  7. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    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.

  8. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    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....

  9. Lower Abdominal Pain.

    Science.gov (United States)

    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.

  10. Dolor abdominal recurrente .

    Directory of Open Access Journals (Sweden)

    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.

  11. Abdominal perfusion computed tomography.

    Science.gov (United States)

    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.

  12. Modification of an endovascular stent graft for abdominal aortic aneurysm

    Science.gov (United States)

    Moloye, Olajompo Busola

    Endovascular surgery is currently used to treat abdominal aortic aneurysms (AAA). A stent graft is deployed to exclude blood flow from the aneurysm sac. It is an effective procedure used in preventing aneurysm rupture, with reduced patient morbidity and mortality compared to open surgical repair. Migration and leakage around the device ("endoleak") due to poor sealing of the stent graft to the aorta have raised concerns about the long-term durability of endovascular repair. A preliminary study of cell migration and proliferation is presented as a prelude to a more extensive in vivo testing. A method to enhance the biological seal between the stent graft and the aorta is proposed to eliminate this problem. This can be achieved by impregnating the stent graft with 50/50 poly (DL-lactide co glycolic acid) (PLGA) and growth factors such as basic fibroblast growth factor (bFGF) or connective tissue growth factor (CTGF), at the proximal and distal ends. It is hypothesized that as PLGA degrades it will release the growth factors that will promote proliferation and migration of aortic smooth muscle cells to the coated site, leading to a natural seal between the aorta and the stent graft. In addition, growth factor release should promote smooth muscle cell (SMC) contraction that will help keep the stent graft in place at the proximal and distal ends. It is shown that a statistically significant effect of increased cell proliferation and migration is observed for CTGF release. Less of an effect is noted for bFGF or just the PLGA. The effect is estimated to be large enough to be clinically significant in a future animal study. The long term goal of this study is to reduce migration encounter after graft deployment and to reduce secondary interventions of EVAR especially for older patients who are unfit for open surgical treatment.

  13. Increased RhoA translocation in aorta of diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Jiping TANG; Ikuyo KUSAKA; Amber R MASSEY; Shadon ROLLINS; John H ZHANG

    2006-01-01

    Aim: To analyze RhoA expression and activation in the aorta of diabetic rats. Methods: Male SD rats (n=70) were divided into 2 groups: the diabetic group and the control group. Diabetes was induced by intravenous injection of streptozotocin (55 mg/kg). The Rats were studied 3 weeks after the induction of diabetes. Western blotting was used to measure the expression and activation of Rho. Results: Heart rate was measured 24 h/d; it decreased by 58±13 beats/min in the diabetic rats. Isometric tension showed that the contraction of diabetic aorta was significantly reduced compared with that of control aorta when stimulated by KCl and serotonin. The relaxation of the diabetic aorta was reduced when stimulated by acetylcholine. An enhanced RhoA translocation in the aortic tissues of diabetic rats was determined by a 90% increase in membrane-bound RhoA, indicating that the activation of RhoA is markedly increased in the diabetic aorta. Conclusion: Our data suggest that upregulated RhoA could be involved in the vascular dysfunction of diabetic rats.

  14. Abdominal pregnancy- a case report.

    Science.gov (United States)

    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. EXPERIENCE ON SURGICAL MANAGEMENT OF RUPTURE OF ABDOMINAL AORTIC ANEURYSM

    Institute of Scientific and Technical Information of China (English)

    管珩; 郑月宏; 李拥军; 刘昌伟; 刘暴; 叶炜

    2003-01-01

    Objective. To describe our surgical experience on rupture of abdominal aortic aneurysm .Methods. Two cases of ruptured aortic aneurysms with severe complication were analyzed. Aorta re-construction procedures were performed using bifurcated e-PTFE grafts during emergency operation. Diag-nosis, preoperative resuscitation, emergency surgical intervention, and postoperative complications of thesepatients were summarized and discussed.Results. Rupture of aortic aneurysm in both patients presented as a huge retroperitoneum haematomaby computed tomography scan. They were successfully saved by prompt body fluid compensation, emer-gency procedure, intraoperative resuscitation, and postoperative intensive care.Conclusions. Correct diagnosis, prompt surgical management, immediate intraoperative proximal aortaclamping during procedure, and effective management of postoperative complications were the key pointsto successful treatment of ruptured aortic aneurysm.

  16. Jejunal perforation caused by abdominal angiostrongyliasis Perfuração jejunal causada por angiostrongilíase abdominal

    Directory of Open Access Journals (Sweden)

    Jaques WAISBERG

    1999-09-01

    Full Text Available The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.Os autores descrevem caso de angiostrongilíase abdominal em doente adulto que se manifestou como abdômen agudo devido à perfuração de alça jejunal, evento raro, uma vez que esta afecção geralmente envolve o íleo terminal, apêndice, ceco ou cólon ascendente. A doença é causada pelo nematódeo Angiostrongylus costaricensis cujos hospedeiros definitivos são roedores silvestres e os hospedeiros intermediários são caracóis e caramujos. A infecção em humanos é acidental e ocorre pela ingestão de secreção mucóide destes invertebrados presentes em vegetais ou por contato direto com o muco. A angiostrongilíase abdominal é clinicamente caracterizada pela presença de febre prolongada, anorexia, dor no quadrante inferior direito do abdômen e eosinofilia periférica. Embora a doença seja de

  17. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    Science.gov (United States)

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta.

  18. Tratamento cirúrgico da coarctação de aorta pela aortoplastia trapezoidal Surgical treatment of coarctation of the aorta using trapezoidal aortoplasty

    Directory of Open Access Journals (Sweden)

    Jarbas Jakson Dinkhuysen

    2004-01-01

    Full Text Available OBJETIVO: A aortoplastia trapezoidal é uma variante técnica da anastomose término-terminal que, amparada em elementos da geometria, objetiva aumentar o diâmetro da aorta ao nível da sutura reduzida e, consequentemente, a manutenção de gradientes pressóricos residuais ou recorrentes indesejáveis a curto e a longo prazo. MÉTODOS: Após a ressecção da área coarctada e tecido ductal, são confeccionados em cada coto aórtico 3 trapezóides que, ao serem confrontados, criam linha de sutura com aspecto sinusoidal (zigue-zague. Foram operados por esta técnica 33 pacientes, a maioria homens, com idades variando de 3 meses a 36 anos (m 9,5 ± 9,7. RESULTADOS: Não ocorreu mortalidade imediata ou tardia e o tempo de evolução a longo prazo foi de 1,1 a 7,6 anos (m 3,6 ± 3,4. A maioria dos pacientes ficou assintomática com níveis normais de pressão arterial, possibilitando a descontinuação da terapêutica antihipertensiva (pOBJECTIVE: Trapezoidal aortoplasty is a technical variant of end-to-end anastomosis, which, based on elements of geometry, aims at increasing the diameter of the aorta at the level of the suture, therefore reducing the occurrence of residual or recurrent pressure gradients in the short and long run. METHODS: After resecting the coarcted area and ductal tissue, 3 trapezoids are confected in each aortic stump, which, when confronted, create a suture line with a sinusoidal aspect (zigzag. Thirty-three patients underwent surgery with this technique, 22 (66.7% males, with ages ranging from 3 months to 36 years (mean of 9.84 ± 9.69. RESULTS: No immediate or late deaths occurred. Follow-up ranged from 1.1 to 7.6 years (mean of 3.6 ± 3.4. Most patients became asymptomatic with normal blood pressure levels, enabling the discontinuation of antihypertensive therapy (P<0.0001. A significant reduction in the pressure gradients was observed on Doppler echocardiography and during cardiac catheterization (P<0.001. The analysis of

  19. Parasternal approach for redo in ascending aorta pseudoaneurysm Abordagem paraesternal para refazer um pseudo-aneurisma aórtico

    Directory of Open Access Journals (Sweden)

    Guillermo Nuncio Vaccarino

    2008-06-01

    Full Text Available Aortic ascending pseudoaneurysm is a rare complication following aortic root surgery. The surgical solution of the complication is rather demanding and complex, especially when reaching the mediastinum. The latter translates into an elevated morbidity and mortality. We present a case performed through a minimal anterior right thoracotomy, which allowed us to dissect between the pseudoaneurysm and the internal site of the sternum as a first step prior to a second esternotomy. By using this approach, we minimized bleeding risks and the possibility of aortic rupture. This technique could have the potential to be generally applicable in this complication after further evaluation.Pseudo-aneurisma na parte ascendente da aorta é uma complicação rara após cirurgia da raiz da aorta. A solução cirúrgica é bastante exigente e complexa, especialmente quando chega ao mediastino. Esta parte última se traduz em elevada morbidade e mortalidade. Apresentamos um caso realizado por meio de uma toracotomia direita anterior mínima, que nos permitiu dissecar entre o pseudo-aneurisma e o sítio interno do esterno como um passo inicial, antes de uma segunda esternotomia. Ao usar essa abordagem, minimizamos os riscos de hemorragia e a possibilidade de um rompimento da aorta. Essa técnica tem o potencial para ser aplicável amplamente nessa complicação, após avaliação ulterior.

  20. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. Improving the efficiency of abdominal aortic aneurysm wall stress computations.

    Science.gov (United States)

    Zelaya, Jaime E; Goenezen, Sevan; Dargon, Phong T; Azarbal, Amir-Farzin; Rugonyi, Sandra

    2014-01-01

    An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses.

  2. Cardiovascular syphilis complicated by Lower thoracic and upper abdominal aneurysm – A rare case report

    Directory of Open Access Journals (Sweden)

    K Gayathri

    2016-01-01

    Full Text Available A 50-year-old male presented with left lower abdominal pain, visible pulsation below xiphoid process, and tenderness in the left iliac fossa for the past 10 days. Chest X-ray revealed blunting of left cardiophrenic angle. Echocardiogram revealed descending thoracic aortic pseudoaneurysm. Contrast-enhanced computed tomography of the chest and abdomen revealed dissecting aneurysm of lower thoracic and upper abdominal aorta. Thoracoabdominal aortogram revealed erosion of D12 vertebra and infected aneurysm of adjacent thoracoabdominal aorta. Serum venereal disease research laboratory assay was positive in 1:4 dilution Treponema pallidum hemagglutination assay was positive. The patient was treated with Injection procaine penicillin for 20 days undercover of steroids. Cerebrospinal fluid analysis was normal. Aortic aneurysm repair with reconstruction was done. Histopathology was in favor of syphilitic etiology. This case is being presented as descending thoracic and upper abdominal aortic aneurysm due to syphilis complicated by dissection and erosion of vertebral body is rare and has not been reported nowadays to the best of our knowledge.

  3. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    Science.gov (United States)

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress.

  4. Tratamento cirúrgico das dissecções de aorta tipo A utilizando parada cardiocirculatória total com hipotermia profunda Surgical treatment of type A aortic dissections utilizing total cardiocirculatory arrest with deep hypothermia

    OpenAIRE

    Luciano Cabral Albuquerque; Marco Antônio Goldani; Juremir João Goldani; Ricardo Medeiros Piantá; Rubens Lorentz Araújo; João Batista Petracco

    1993-01-01

    No período de julho de 1986 a julho de 1993, 22 pacientes portadores de dissecção de aorta tipo A foram tratados cirurgicamente utilizando-se parada cardiocirculatória (PCC) total sob hipotermia profunda (18ºC), dos quais 15 apresentavam dissecção aguda e 7 dissecção crônica. Em 14 casos (64%) a aorta ascendente foi reconstruída utilizando-se enxerto reto de Dacron, com troca valvar aórtica em 5 pacientes e ressuspensão valvar aórtica em 2; a reconstrução do arco aórtico foi empregada em 8 ca...

  5. Demonstration of coarctation of the aorta by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Amparo, E.; Higgins, C.B.; Shafton, E.P.

    1984-12-01

    The physical findings in coarctation of the aorta are sufficiently characteristic to allow a reasonably accurate clinical diagnosis. The preoperative evaluation has been accomplished by catheterization, aortography, intravenous digital subtraction angiography, computed tomography (CT), and two-dimensional (2D) echocardiography. The authors report a case of coarctation of the aorta clinically suspected in a 29-year-old man. Magnetic resonance imaging (MRI) was the initial preoperative imaging technique. In retrospect, it provided sufficient information for preoperative evaluation so that other imaging techniques would not have been required.

  6. Dissemination of bacteria labeled with technetium-99m after laparotomy and abdominal insufflation with different CO2 pressures on rats; Disseminacao de bacterias marcadas com tecnecio-99m apos laparotomia e insuflacao com diferentes pressoes de CO2 em ratos

    Energy Technology Data Exchange (ETDEWEB)

    Pitombo, Marcos Bettini; Faria, Clarice Abreu dos Santos Albuquerque de; Steinbruck, Klaus [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Escola de Medicina]. E-mail: mpitombo@urbi.com.br; Bernardo, Luciana Camargo; Bernardo Filho, Mario[Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes (IBRAG). Lab. de Radiofarmacia Experimental

    2008-01-15

    Purpose: To asses the dissemination of bacteria labeled with technetium-99m (99mTc) from peritoneal cavity after different surgical procedures. Methods: Bacteria of the Escherichia coli species labeled with 99mTc were used in a concentration of 108 units of colony-makers for ml (UFC/ml) and 1 ml was inoculated through intra-peritoneal via. Forty-eight rats were divided into four groups: control, laparotomy, pneumoperitoneum with 10 mmHg and pneumoperitoneum with 20 mmHg of CO2. Procedures were performed 20 min after injection of the inoculum and lasted 30 min. Animals were sacrificed after six hours (Group 1) and 24 hours (Group 2). Samples of blood, liver and spleen were collected for radioactivity counting. Results: After six hours, indirect detection of the bacteria in different organs was uniform in all groups. After 24 hours, a larger detection of technetium was observed in the livers of animals of the group insufflated with 20 mmHg of CO2, when compared with those of control group (p<0.01). The other groups did not present statistically significant variations. Conclusions: The use of a higher intra-abdominal pressure was associated with a higher bacterial dissemination to the liver. The application of lower intra-abdominal pressures may be associated with a lower dissemination of the infectious status during laparoscopic approach of peritonitis status. (author)

  7. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    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...

  8. Abdominal Complications after Severe Burns

    Science.gov (United States)

    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

  9. Effect of Low-Pressurized Perfusion with Different Concentration of Elastase on the Aneurysm Formation Rate in the Abdominal Aortic Aneurysm Model in Rabbits.

    Science.gov (United States)

    Nie, Maoxiao; Yan, Yunfeng; Li, Xinhe; Feng, Tingting; Zhao, Xin; Zhang, Mingduo; Zhao, Quanming

    2016-01-01

    Establishing an animal model of abdominal aortic aneurysm (AAA) is the key to study the pathogenesis and the pathophysiological features of AAAs. We investigated the effects of low-pressurized perfusion with different concentrations of elastase on aneurysm formation rate in the AAA model. Fifty male New Zealand white rabbits were randomly divided into A, B, C, D, and E groups. 10 μL of normal saline was perfused into the abdominal aorta in group A and 1 U/mL, 10 U/mL, 100 U/mL, or 200 U/mL of elastase was, respectively, perfused for the other four groups. All the animals were perfused for 7 min. Doppler ultrasound examinations of the abdominal aorta were performed before surgery and on day 14 after surgery. The rabbits were sacrificed and the perfused segment of the abdominal aorta was observed visually and after staining. The aneurysm formation rate of group A, group B, group C, group D, and group E was, respectively, 0%, 0%, 33.3%, 102.5-146.8%, and 241.5-255.2%. The survival rate of five groups was 90%, 90%, 90%, 90%, and 40%, respectively. So, we concluded that low-pressurized perfusion with 100 U/mL of elastase can effectively establish AAAs in rabbits with a high aneurysm formation rate.

  10. 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.

    Science.gov (United States)

    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.

  11. Endovascular covered stent treatment for descending aorta pseudoaneurysm following coarctation of the aorta repair in an infant.

    Science.gov (United States)

    Takawira, Farirai F; Sinyangwe, Greenwood; Mooloo, Rene

    2010-12-01

    The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.

  12. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    Science.gov (United States)

    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.

  13. Isolated Anomalous Origin of Left Pulmonary Artery From the Descending Aorta: An Embryologic Ambiguity.

    Science.gov (United States)

    Gnanappa, Ganesh Kumar; Laohachai, Karina; Orr, Yishay; Ayer, Julian

    2016-11-01

    Anomalous origin of a branch pulmonary artery from the aorta is a rare malformation, accounting for 0.12% of all congenital heart defects. Anomalous origin of the left pulmonary artery from the aorta (ALPA) constitutes a small proportion of these cases. ALPA has been reported to arise from the ascending aorta with various embryologic postulates. We report a case of isolated ALPA arising from the descending aorta in association with a patent ductus arteriosus, to emphasize its embryologic ambiguity.

  14. Abdominal aortic surgery and renal anomalies

    Directory of Open Access Journals (Sweden)

    Ilić Nikola

    2011-01-01

    Full Text Available Introduction. Kidney anomalies present a challenge even for the most experienced vascular surgeon in the reconstruction of the aortoilliac segment. The most significant anomalies described in the surgery of the aortoilliac segment are a horse-shoe and ectopic kidney. Objective. The aim of this retrospective study was to analyze experience on 40 patients with renal anomalies, who underwent surgery of the aortoilliac segment and to determine attitudes on conventional surgical treatment. Methods. In the period from 1992 to 2009, at the Clinic for Vascular Surgery of the Clinical Centre of Belgrade we operated on 40 patients with renal anomalies and aortic disease (aneurysmatic and obstructive. The retrospective analysis involved standard epidemiological data of each patient (gender, age, risk factors for atherosclerosis, type of anomaly, type of aortic disease, presurgical parameter values of renal function, type of surgical approach (laparatomy or retroperitoneal approach, classification of the renal isthmus, reimplantation of renal arteries and perioperative morbidity and mortality. Results. Twenty patients were males In 30 (70% patients we diagnosed a horse-shoe kidney and in 10 (30% ectopic kidney. In the cases of ruptured aneurysm of the abdominal aorta the diagnosis was made by ultrasound findings. Pre-surgically, renal anomalies were confirmed in all patients, except in those with a ruptured aneurysm who underwent urgent surgery. In all patients we applied medial laparatomy, except in those with a thoracoabdominal aneurysm type IV, when the retroperitonal approach was necessary. On average the patients were under follow-up for 6.2 years (from 6 months to 17 years. Conclusion. Under our conditions, the so-called double clamp technique with the preservation of the kidney gave best results in the patients with renal anomalies and aortic disease.

  15. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Directory of Open Access Journals (Sweden)

    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.

  16. Segmentation of the thoracic aorta in noncontrast cardiac CT images.

    Science.gov (United States)

    Avila-Montes, Olga C; Kurkure, Uday; Nakazato, Ryo; Berman, Daniel S; Dey, Damini; Kakadiaris, Ioannis A

    2013-09-01

    Studies have shown that aortic calcification is associated with cardiovascular disease. In this study, a method for localization, centerline extraction, and segmentation of the thoracic aorta in noncontrast cardiac-computed tomography (CT) images, toward the detection of aortic calcification, is presented. The localization of the right coronary artery ostium slice is formulated as a regression problem whose input variables are obtained from simple intensity features computed from a pyramid representation of the slice. The localization, centerline extraction, and segmentation of the aorta are formulated as optimal path detection problems. Dynamic programming is applied in the Hough space for localizing key center points in the aorta which guide the centerline tracing using a fast marching-based minimal path extraction framework. The input volume is then resampled into a stack of 2-D cross-sectional planes orthogonal to the obtained centerline. Dynamic programming is again applied for the segmentation of the aorta in each slice of the resampled volume. The obtained segmentation is finally mapped back to its original volume space. The performance of the proposed method was assessed on cardiac noncontrast CT scans and promising results were obtained.

  17. Mineralization of human aortas with coarctation: quantitative electron probe microanalysis

    Energy Technology Data Exchange (ETDEWEB)

    Krefting, E.R.; Roehrig, T.; Broecker, W.; Anyanwu, E.; Schlake, W.; Dittrich, H.; Hoehling, H.J.

    1982-01-01

    Aortas with coarctation (isthmus stenosis) are obviously an ideal model to investigate pressure dependent changes of the aorta, as one can compare the proximal region (high pressure) with the distal region (low pressure). 7 aortas of patients aged from 2 months to 54 years were investigated. The concentrations of Na, Mg, P, S, C1, K, and Ca were determined by electronprobe microanalysis. Ca and P are constituent parts of the developing mineral and are mainly discussed. The Ca/P ratio (by weight) is about 0.3 in the unmineralized and about 2 in the mineralized tissue. Mineralization is demonstrated by a parallel increase of Ca, P, and the Ca/P ratio. Enrichments of Ca and P are found above all in a subintimal band. Usually they occur proximally and distally, but are much more pronounced proximally. Even in the aorta of a 2 month old infant enrichments were found proximally, but not distally. Thus mineral deposits occur very early in regions of hypertension. The differences between the proximal and distal region may demonstrate the influence of blood pressure on vascular mineralization. The mineralization starts in small compartments, which increase in size and number in the process of mineralization. Mineralized regions could often be localized by cathodoluminescence. But to demonstrate and localize the initial mineral deposits and to quantify element contents, electronprobe microanalysis became indispensable.

  18. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Ramachandra Barik

    2014-01-01

    Full Text Available Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA.

  19. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta.

    Science.gov (United States)

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A

    2000-06-08

    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels.

  20. Wall Shear Stress in Aorta with Coarctation and Post-Stenotic Dilatation - Scale Resolved Simulation of Pulsatile Blood Flow

    Science.gov (United States)

    Gardhagen, Roland; Karlsson, Matts

    2012-11-01

    Large eddy simulations of pulsating blood flow in an idealized model of a human aorta with a coarctation and a post-stenotic dilatation were conducted before and after treatment of the stenosis using Ansys Fluent. The aim was to study wall shear stress (WSS), which influences the function of endothelial cells, and turbulence, which may play a role in thrombus formation. Phase average values of WSS before the treatment revealed high shear in the stenosis at peak systole, as expected, but also at the end of the dilatation. In the dilatation backflow causes a negative peak. Diastolic WSS is characterized by low amplitude oscillations, which promotes atherogenesis. Also noticeable is the asymmetric pattern between the inner and outer sides of the vessel caused by the arch upstream of the stenosis. Thus, large spatial, temporal, and probably asymmetric WSS gradients in the already diseased region suggest increased risk for further endothelial dysfunction. This reflects a complex, partly turbulent, flow pattern that may disturb the blood flow in the abdominal aorta. After treatment of the stenosis, but not the dilatation, fluctuations of velocity and WSS were still found, thus harmful flow conditions still exist.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  2. [Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].

    Science.gov (United States)

    Nikul'nikov, P I; Liksunov, O V; Ratushniuk, A V; Lugovs'koĭ, E V; Kolesnikova, I M; Lytvynova, L M; Kostiuchenko, O P; Chernyshenko, T M; Hornyts'ka, O V; Platonova, T M

    2012-09-01

    Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.

  3. Complicações pós-operatórias em pacientes submetidos à abdominoplastia isolada e combinada à outras cirurgias do abdome Postoperative complications in patients submitted to isolated abdominoplasty alone or associated to other abdominal surgeries

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Porchat

    2004-12-01

    Full Text Available OBJETIVO: A realização de abdominoplastias associadas a outras cirurgias da parede ou da cavidade abdominal, embora atrativa, é motivo de controvérsias. O objetivo deste trabalho é avaliar o grau de morbidade e mortalidade destas associações. MÉTODO: Foram estudados retrospectivamente 75 pacientes com indicação de abdominoplastia dos quais 39 submeteram-se a abdominoplastia isoladamente (grupo 1 e 36 à associação de abdominoplastia a outras cirurgias do abdome (grupo 2, como correção de hérnias, histerectomias e colecistectomias. Foram analisados os diversos fatores capazes de interferir na evolução do paciente, como doenças pré-existentes, assim como as complicações pós-operatórias. RESULTADOS: As complicações observadas foram: seroma (grupo 1: 2.6% , grupo 2: 25%,, epidermólise (grupo 1: 12.82% , grupo 2: 5.55%, deiscência de sutura (grupo 1: 5.12% , grupo 2: 5.55%, infecção da ferida operatória (grupo 1: 0%,