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Sample records for aortoiliac occlusive disease

  1. Aortoiliac occlusive disease masquerading as cerebrovascular accident

    Directory of Open Access Journals (Sweden)

    Nandeesh B

    2007-01-01

    Full Text Available Acute aortoiliac occlusion is an unusual but potentially catastrophic condition causing acute limb ischemia and associated with early and high rates of mortality and morbidity. It is caused by either embolic occlusion of the infra renal aorta at the bifurcation or beyond or thrombosis of the abdominal aorta and its large terminal branches. Neurological symptoms are rare manifestation of acute aortoiliac occlusion and when neurological symptoms predominate, patients are mistakenly considered to have cerebrovascular event. We present a 60-year-old man with atherosclerotic thrombotic occlusion of the left common iliac artery causing acute painful monoplegia. We mistook the acute monoplegia due to acute limb ischemia for cerebrovascular accident. Pathologic examination revealed a firm thrombus occluding the origin of left common iliac artery and extending along the length of the vessel. Acute aortic iliac occlusion can masquerade as a cerebrovascular stroke and a thorough clinical evaluation and imaging studies allow early diagnosis and instituting life-saving treatment timely.

  2. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease

    NARCIS (Netherlands)

    Groot Jebbink, Erik; Mathai, Varghese; Boersen, Johannes Thomas; Sun, Chao; Slump, Cornelis H.; Goverde, Peter C.J.M.; Versluis, Michel; Reijnen, Michel M.P.J.

    Background Endovascular treatment of aortoiliac occlusive disease entails the use of multiple stents to reconstruct the aortic bifurcation. Different configurations have been applied and geometric variations exist, as quantified in previous work. Other studies concluded that specific stent geometry

  3. Oxidative Stress in Human Aorta of Patients with Advanced Aortoiliac Occlusive Disease.

    Science.gov (United States)

    Lucas, Márcio Luís; Carraro, Cristina Campos; Belló-Klein, Adriane; Kalil, Antonio Nocchi; Aerts, Newton

    2016-01-01

    Oxidative stress seems to be a role in the atherosclerosis process, but research in human beings is scarce. To evaluate the role of oxidative stress on human aortas of patients submitted to surgical treatment for advanced aortoiliac occlusive disease. Twenty-six patients were divided into three groups: control group (n=10) formed by cadaveric organ donors; severe aortoiliac stenosis group (patients with severe aortoiliac stenosis; n=9); and total aortoiliac occlusion group (patients with chronic total aortoiliac occlusion; n=7). We evaluated the reactive oxygen species concentration, nicotinamide adenine dinucleotide phosphate-oxidase, superoxide dismutase and catalase activities as well as nitrite levels in samples of aortas harvested during aortofemoral bypass for treatment of advanced aortoiliac occlusive disease. We observed a higher level of reactive oxygen species in total aortoiliac occlusion group (48.3±9.56 pmol/mg protein) when compared to severe aortoiliac stenosis (33.5±7.4 pmol/mg protein) and control (4.91±0.8 pmol/mg protein) groups (Pcontrol group (3.81±1.7 versus 1.05±0.31 µmol/min.mg protein; Pcontrol cases (Pbe due to a compensative phenomenon to reactive oxygen species production mediated by nicotinamide adenine dinucleotide phosphate oxidase. This preliminary study offers us a more comprehensive knowledge about the role of oxidative stress in advanced aortoiliac occlusive disease in human beings.

  4. Oxidative Stress in Human Aorta of Patients with Advanced Aortoiliac Occlusive Disease

    Directory of Open Access Journals (Sweden)

    Márcio Luís Lucas

    Full Text Available Abstract Introduction: Oxidative stress seems to be a role in the atherosclerosis process, but research in human beings is scarce. Objective: To evaluate the role of oxidative stress on human aortas of patients submitted to surgical treatment for advanced aortoiliac occlusive disease. Methods: Twenty-six patients were divided into three groups: control group (n=10 formed by cadaveric organ donors; severe aortoiliac stenosis group (patients with severe aortoiliac stenosis; n=9; and total aortoiliac occlusion group (patients with chronic total aortoiliac occlusion; n=7. We evaluated the reactive oxygen species concentration, nicotinamide adenine dinucleotide phosphate-oxidase, superoxide dismutase and catalase activities as well as nitrite levels in samples of aortas harvested during aortofemoral bypass for treatment of advanced aortoiliac occlusive disease. Results: We observed a higher level of reactive oxygen species in total aortoiliac occlusion group (48.3±9.56 pmol/mg protein when compared to severe aortoiliac stenosis (33.5±7.4 pmol/mg protein and control (4.91±0.8 pmol/mg protein groups (P<0.05. Nicotinamide adenine dinucleotide phosphate oxidase activity was also higher in total aortoiliac occlusion group when compared to the control group (3.81±1.7 versus 1.05±0.31 µmol/min.mg protein; P<0.05. Furthermore, superoxide dismutase and catalase activities were significantly higher in the severe aortoiliac stenosis and total aortoiliac occlusion groups when compared to the control cases (P<0.05. Nitrite concentration was smaller in the severe aortoiliac stenosis group in comparing to the other groups. Conclusion: Our results indicated an increase of reactive oxygen species levels and nicotinamide adenine dinucleotide phosphate-oxidase activity in human aortic samples of patients with advanced aortoiliac occlusive disease. The increase of antioxidant enzymes activities may be due to a compensative phenomenon to reactive oxygen species

  5. Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease

    DEFF Research Database (Denmark)

    Bredahl, Kim; Jensen, Leif Panduro; Schroeder, Torben V

    2015-01-01

    OBJECTIVE: Open surgery has given way to endovascular grafting in patients with aortoiliac occlusive disease. The growing use of endovascular grafts means that fewer patients with aortoiliac occlusive disease have open surgery. The declining open surgery caseload challenges the surgeon's operative...... skills, particularly because open surgery is increasingly used in those patients who are unsuitable for endovascular repair and hence technically more demanding. We assessed the early outcome after aortic bifurcated bypass procedures during two decades of growing endovascular activity and identified...

  6. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease.

    Science.gov (United States)

    Groot Jebbink, Erik; Mathai, Varghese; Boersen, Johannes T; Sun, Chao; Slump, Cornelis H; Goverde, Peter C J M; Versluis, Michel; Reijnen, Michel M P J

    2017-07-01

    Endovascular treatment of aortoiliac occlusive disease entails the use of multiple stents to reconstruct the aortic bifurcation. Different configurations have been applied and geometric variations exist, as quantified in previous work. Other studies concluded that specific stent geometry seems to affect patency. These variations may affect local flow patterns, resulting in different wall shear stress (WSS) and oscillating shear index (OSI). The aim of this study was to compare the effect of different stent configurations on flow perturbations (recirculation and fluid stasis), WSS, and OSI in an in vitro setup. Three different stent configurations were deployed in transparent silicone models: bare-metal kissing (BMK) stents, covered kissing (CK) stents, and the covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration. Transparent covered stents were created with polyurethane to enable visualization. Models were placed in a circulation setup under physiologic flow conditions. Time-resolved laser particle image velocimetry techniques were used to quantify the flow, and WSS and OSI were calculated. The BMK configuration did not show flow disturbances at the inflow section, and WSS values were similar to the control. An area of persistent low flow was observed throughout the cardiac cycle in the area between the anatomic bifurcation and neobifurcation. The CK model showed recirculation zones near the inflow area of the stents with a resulting low average WSS value and high OSI. The proximal inflow of the CERAB configuration did not show flow disturbances, and WSS values were comparable to control. Near the inflow of the limbs, a minor zone of recirculation was observed without changes in WSS values. Flow, WSS, and OSI on the lateral wall of the proximal iliac artery were undisturbed in all models. The studied aortoiliac stent configurations have distinct locations where flow disturbances occur, and these are related to the radial mismatch

  7. Internal thoracic artery collateral to the external iliac artery in chronic aortoiliac occlusive disease

    International Nuclear Information System (INIS)

    Kim, Jinna; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2003-01-01

    To evaluate the incidence and angiographic findings of the collateral pathway involving the internal thoracic artery in patients with chronic aortoiliac occlusive disease. Between March 2000 and Februrary 2001, 124 patients at our hospital underwent angiographic evaluation of chronic aortoiliac occlusive disease, and in 15 of these complete obstruction or severe stenosis of the aortoiliac artery was identified. The aortograms and collateral arteriograms obtained, including internal thoracic arteriograms, as well as the medical records of the patients involved, were evaluated. In nine patients there was complete occlusion of the infrarenal aorta, or diffuse stenosis of 75% or more in the descending thoracic aorta, and in the other six, a patent aorta but complete occlusion or stenosis of 75% or more of the common iliac artery was demonstrated. Collateral perfusion via hypertrophied internal thoracic arteries and rich anastomoses between the superior and inferior epigastric arteries, reconstituting the external iliac artery, were noted in all fifteen patients, regardless of symptom duration, which ranged from six months to twelve years. In patients with chronic aortoiliac occlusive disease, the internal thoracic artery, along with visceral collaterals and those from the contralateral side, is one of the major parietal collateral pathways

  8. aorto-iliac occlusive disease in the different population groups

    African Journals Online (AJOL)

    T E Madiba, M Mars, J V Robbs. Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease ...

  9. Aorto-iliac occlusive disease in the different population groups ...

    African Journals Online (AJOL)

    Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease presenting to the vascUlar ...

  10. Successful total robotic-assisted aortobifemoral bypass for treatment of complicated aortoiliac occlusive disease.

    Science.gov (United States)

    Lin, Judith C; Kaul, Sanjeev A; Rogers, Craig G

    2011-05-01

    Laparoscopic aortobifemoral bypass (AFB) for aortoiliac occlusive disease (AIOD) is a durable, minimally invasive procedure with comparable long-term outcomes to conventional open AFB. However, laparoscopic AFB requires advance training in laparoscopy with prolong learning curve to accomplish infrarenal aortic dissection and vascular reconstruction to minimize aortic clamp time and leg ischemia time. We describe another minimally invasive technique of total robotic-assisted AFB for extensive, complicated AIOD in 3 patients who are not endovascular candidate or have failed endoluminal approach previously.

  11. Anterior Rectal Resection in a Patient with Aortoiliac Occlusive Disease and Coexisting Collateral Pathways: Management and Pitfalls

    Science.gov (United States)

    Gassend, Jean-Loup; Martinet, Olivier; Andrejevic-Blant, Snezana; Hoogewoud, Henri-Marcel

    2016-01-01

    Chronic aortoiliac occlusive disease most often affects the common iliac arteries and distal aorta but can progress all the way to the renal arteries, occluding the inferior mesenteric artery. A compensatory collateral network typically develops to preserve lower body perfusion. Inadvertent compression or ligation of such collaterals during surgery can have catastrophic consequences. In this article, we present the case of a 63-year-old patient with aortoiliac occlusive disease, requiring surgery for an adenocarcinoma of the rectosigmoid junction. A CT angiography was performed in order to map out the collateral pathways that had developed and Doppler ultrasound was used to mark their positions. The surgical procedure was adapted to his specific anatomy. A successful anterior resection was performed, and the patient made an uneventful recovery. In cases of aortoiliac obliteration, the existence of collaterals must be kept in mind and investigated with a multidisciplinary approach before any surgery is considered. PMID:27800205

  12. Anterior Rectal Resection in a Patient with Aortoiliac Occlusive Disease and Coexisting Collateral Pathways: Management and Pitfalls

    Directory of Open Access Journals (Sweden)

    Floryn Cherbanyk

    2016-01-01

    Full Text Available Chronic aortoiliac occlusive disease most often affects the common iliac arteries and distal aorta but can progress all the way to the renal arteries, occluding the inferior mesenteric artery. A compensatory collateral network typically develops to preserve lower body perfusion. Inadvertent compression or ligation of such collaterals during surgery can have catastrophic consequences. In this article, we present the case of a 63-year-old patient with aortoiliac occlusive disease, requiring surgery for an adenocarcinoma of the rectosigmoid junction. A CT angiography was performed in order to map out the collateral pathways that had developed and Doppler ultrasound was used to mark their positions. The surgical procedure was adapted to his specific anatomy. A successful anterior resection was performed, and the patient made an uneventful recovery. In cases of aortoiliac obliteration, the existence of collaterals must be kept in mind and investigated with a multidisciplinary approach before any surgery is considered.

  13. Computed Tomography Fractional Flow Reserve Can Identify Culprit Lesions in Aortoiliac Occlusive Disease Using Minimally Invasive Techniques.

    Science.gov (United States)

    Ward, Erin P; Shiavazzi, Daniele; Sood, Divya; Marsden, Allison; Lane, John; Owens, Erik; Barleben, Andrew

    2017-01-01

    Currently, the gold standard diagnostic examination for significant aortoiliac lesions is angiography. Fractional flow reserve (FFR) has a growing body of literature in coronary artery disease as a minimally invasive diagnostic procedure. Improvements in numerical hemodynamics have allowed for an accurate and minimally invasive approach to estimating FFR, utilizing cross-sectional imaging. We aim to demonstrate a similar approach to aortoiliac occlusive disease (AIOD). A retrospective review evaluated 7 patients with claudication and cross-sectional imaging showing AIOD. FFR was subsequently measured during conventional angiogram with pull-back pressures in a retrograde fashion. To estimate computed tomography (CT) FFR, CT angiography (CTA) image data were analyzed using the SimVascular software suite to create a computational fluid dynamics model of the aortoiliac system. Inlet flow conditions were derived based on cardiac output, while 3-element Windkessel outlet boundary conditions were optimized to match the expected systolic and diastolic pressures, with outlet resistance distributed based on Murray's law. The data were evaluated with a Student's t-test and receiver operating characteristic curve. All patients had evidence of AIOD on CT and FFR was successfully measured during angiography. The modeled data were found to have high sensitivity and specificity between the measured and CT FFR (P = 0.986, area under the curve = 1). The average difference between the measured and calculated FFRs was 0.136, with a range from 0.03 to 0.30. CT FFR successfully identified aortoiliac lesions with significant pressure drops that were identified with angiographically measured FFR. CT FFR has the potential to provide a minimally invasive approach to identify flow-limiting stenosis for AIOD. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Endovascular Treatment Strategies in Aortoiliac Occlusion

    International Nuclear Information System (INIS)

    Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri; Gumus, Burcak

    2009-01-01

    The aim of this study was to report our experience in endovascular treatment of total aortoiliac occlusion. Five patients who underwent endovascular recanalization procedures including manual aspiration thrombectomy, balloon angioplasty, and stent placement for total aortoiliac occlusion in a 4-year period were reviewed retrospectively. The mean age of patients was 51 years (range, 43 to 58 years). All patients had abdominal aorta and bilateral common iliac artery occlusion with or without external iliac artery occlusion. All patients either had a contraindication to surgery or refused it. Initial technical success was obtained in four of five (80%) patients. Endovascular techniques were successful in four patients who had good distal runoff and short-segment aortoiliac occlusion, but failed in a patient who had the worst distal runoff and long-segment aortoiliac occlusion. We observed two major complications, one of which was bilateral rupture of the common iliac arteries treated with covered stent placement. Another patient had extension of intra-aortic thrombus into the iliac stent after primary stenting. This was successfully treated with manual aspiration thrombectomy. Aortic and iliac stents remained patent during the follow-up period (median, 18 months; range, 3 to 26 months) in four patients. Primary patency rates at 6, 12, and 24 months were all 80%. In conclusion, endovascular treatment can be an alternative for aortoiliac occlusion in selected patients. Short- to midterm follow-up so far is satisfactory. Removal of intra-aortic thrombus with manual aspiration thrombectomy before balloon angioplasty and/or stenting is possible and a good alternative to thrombolysis.

  15. Surgical treatment of chronic aortoiliac occlusion

    Directory of Open Access Journals (Sweden)

    Márcio Luís Lucas

    2015-03-01

    Full Text Available BACKGROUND: Chronic aortoiliac occlusion (CAIO is a significant cause of lower limb ischemia and is often found in young patients who smoke. OBJECTIVE: To review recent results achieved treating CAIO patients with open surgery. METHODS: From November 2011 to April 2014, 21 patients with CAIO were treated at the Santa Casa de Misericórdia, Porto Alegre, Brazil. Demographic data, comorbidities, clinical presentation and surgical results were analyzed. RESULTS: Eleven women and ten men were treated with direct aortic bypass (DAB; n=18 or with extra-anatomic bypass (EAD; n=3. Mean age was 53.7 ± 7.3 years (range: 43-79 years and all patients smoked. Thirteen patients (62% had critical ischemia. Six of the patients treated with DAB (33.4% also required additional revascularization (3 renal and 3 femoropopliteal procedures. Perioperative mortality was zero. Four patients (22.2% suffered transitory renal dysfunction, but only one patient (5.6% required hemodialysis. Median follow-up time was 17 months (range: 2-29 months and there was just one late death, from ischemic heart disease, 7 months after the surgery on the abdominal aorta. CONCLUSIONS: Aortic reconstruction is a safe method for treating patients with CAIO, with low perioperative morbidity and mortality rates.

  16. Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning

    NARCIS (Netherlands)

    Coffi, S. B.; Ubbink, D. Th; Dijkgraaf, M. G. W.; Reekers, J. A.; Legemate, D. A.

    2008-01-01

    OBJECTIVES: Cost-effectiveness analysis of three diagnostic imaging strategies for the assessment of aortoiliac and femoropopliteal arteries in patients with peripheral arterial occlusive disease. The strategies were: angiography as the reference strategy, duplex scanning (DS) plus supplementary

  17. Endovascular Stent Grafting for Aortic Arch Aneurysm in Aortoiliac Occlusive Disease following Aortic Arch Debranching and Aortobifemoral Reconstruction

    Directory of Open Access Journals (Sweden)

    Didem Melis Oztas

    2017-01-01

    Full Text Available Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient. In these situations stent grafting may even be more complicated. In this report, we present the treatment of a 92-year-old patient with aortic arch aneurysm and proximal descending aortic aneurysm. For successful thoracic endovascular stent grafting, the patient needed an alternative route other than the native femoral and iliac arteries for the deployment of the stent graft. In addition, debranching of left carotid and subclavian arteries from the aortic arch was also required for successful exclusion of the thoracic aneurysm.

  18. Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note

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    Abdel Aziz A. Jaffan

    2013-01-01

    Full Text Available Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

  19. Aortoiliac interventions

    International Nuclear Information System (INIS)

    Chatziioannou, A.

    2012-01-01

    Full text: Atheromatosis is a systemic disease that involves various vascular beds. The most known risk factors are smoking, diabetes mellitus, dyslipedemia, hypertension, advanced age, black gender and male sex. Occlusive aortoiliac disease is due to atheromatosis in the vast majority of cases and is a common distribution of that pathology. Historically aortoiliac occlusions were treated with surgery. Nowadays, the endovascular minimally invasive techniques have revolutionized the treatment of such lesions. The success rate is extremely high with a technical success of 96%. Long term (5 years) patency of the diseased vessel can be as high as 71%. These results combined to the advent of new materials and techniques have set the new standards for treating aortoiliac occlusive disease. The first TASC recommendations (TASC I) were recently revised (TASC II) and the new guidelines (TASC III) will be shortly published. On the other hand endovascular techniques are not always successful. Technical failure (inability to cross the lesion) is estimated to be approximately 5% in single short iliac occlusions and can rise up to 15- 20% in complex long or multiple occlusive lesions. Possible, although not very frequent, complications are dissection, rupture and distal embolization. In the case of total occlusions we can use different materials and techniques. For example in an acute or subacute total occlusion chemical (urokinase or rtPA), mechanical or aspiration thrombolysis can be implemented. These minimally invasive techniques are of the outmost importance if we consider that the majority of the patients are old with a high rate of cardiac and other co-morbidities and therefore cannot go into surgery. That is the reason why the risk of morbidity and mortality following open surgical intervention remains high (5 - 20%). In chronic lesions we can use rentry catheters, glidewires, laser or thrombolysis/thrombectomy (if the clot is not very 'old'). Nevertheless, it should

  20. Screening for aortoiliac lesions by visual interpretation of the common femoral Doppler waveform

    DEFF Research Database (Denmark)

    Eiberg, J P; Jensen, F; Grønvall Rasmussen, J B

    2001-01-01

    to study the accuracy of simple visual interpretation of the common femoral artery Doppler waveform for screening the aorto-iliac segment for significant occlusive disease.......to study the accuracy of simple visual interpretation of the common femoral artery Doppler waveform for screening the aorto-iliac segment for significant occlusive disease....

  1. Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning

    Energy Technology Data Exchange (ETDEWEB)

    Coffi, S.B. [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Ubbink, D.Th. [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands)], E-mail: D.Ubbink@amc.nl; Dijkgraaf, M.G.W. [Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Reekers, J.A. [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Legemate, D.A. [Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)

    2008-04-15

    Objectives: Cost-effectiveness analysis of three diagnostic imaging strategies for the assessment of aortoiliac and femoropopliteal arteries in patients with peripheral arterial occlusive disease. The strategies were: angiography as the reference strategy, duplex scanning (DS) plus supplementary angiography (S1) and DS plus confirmative angiography (S2). Design, materials and methods: A decision model was built with sensitivity and specificity data from literature, supplemented with prospective hospital cost data in Euro ( Euro ). The probability of correctly identifying the status of a lesion was taken as the primary outcome. We compared strategies by assessing the extra costs per additional correctly identified case. Results: Assuming no false positive or false negative results, angiography is the most effective strategy if the prevalence of significant obstructive lesions in the aortoiliac and femoropopliteal tract exceeds 70%, or if the sensitivity of duplex scanning is lower than 83%. In case of lower prevalence, strategy S1 becomes equally or even more effective than angiography. At a prevalence of 75%, performing angiography costs Euro 8443 per extra correctly identified case compared with strategy S1. Conclusions: In most situations angiography is more effective than diagnostic strategy S1. However, if society is unwilling to pay more than Euro 8443 for knowing a patient's disease status, diagnostic strategy S1 is a cost-effective alternative to angiography, especially at lower prevalence values.

  2. Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning

    International Nuclear Information System (INIS)

    Coffi, S.B.; Ubbink, D.Th.; Dijkgraaf, M.G.W.; Reekers, J.A.; Legemate, D.A.

    2008-01-01

    Objectives: Cost-effectiveness analysis of three diagnostic imaging strategies for the assessment of aortoiliac and femoropopliteal arteries in patients with peripheral arterial occlusive disease. The strategies were: angiography as the reference strategy, duplex scanning (DS) plus supplementary angiography (S1) and DS plus confirmative angiography (S2). Design, materials and methods: A decision model was built with sensitivity and specificity data from literature, supplemented with prospective hospital cost data in Euro ( Euro ). The probability of correctly identifying the status of a lesion was taken as the primary outcome. We compared strategies by assessing the extra costs per additional correctly identified case. Results: Assuming no false positive or false negative results, angiography is the most effective strategy if the prevalence of significant obstructive lesions in the aortoiliac and femoropopliteal tract exceeds 70%, or if the sensitivity of duplex scanning is lower than 83%. In case of lower prevalence, strategy S1 becomes equally or even more effective than angiography. At a prevalence of 75%, performing angiography costs Euro 8443 per extra correctly identified case compared with strategy S1. Conclusions: In most situations angiography is more effective than diagnostic strategy S1. However, if society is unwilling to pay more than Euro 8443 for knowing a patient's disease status, diagnostic strategy S1 is a cost-effective alternative to angiography, especially at lower prevalence values

  3. Outcome of 'Kissing Stents' for Aortoiliac Atherosclerotic Disease, Including the Effect on the Non-diseased Contralateral Iliac Limb

    International Nuclear Information System (INIS)

    Mohamed, Faheez; Sarkar, B.; Timmons, G.; Mudawi, A.; Ashour, H.; Uberoi, R.

    2002-01-01

    Purpose: To assess outcomes following 'kissing stents' for aortoiliac atherosclerotic disease,particularly in the non-diseased/non-symptomatic limb. Methods: Twenty-four patients underwent kissing stenting over 36 months. There were 36 symptomatic and 12 non-symptomatic/non-diseased limbs. Patients were prospectively followed with 3-monthly clinical assessment as well as duplex ultrasound. Results: At 23.5 months follow-up (range 3-36 months), 75% of patients had improvement in symptoms, 20% no change and 5% had deterioration. Sixty-one percent of limbs maintained an increase in ankle-brachial pressure index of >0.1. There were 15 reinterventions in nine patients, including three in non-symptomatic/non-diseased limbs. Primary patency at 6, 12 and 24 months was 94%, 81% and 58%, respectively. Primary assisted and secondary patency rates were 96%, 84% and 84% respectively for diseased limbs, and 92% and 100% for non-symptomatic/non-diseased limbs. Although reinterventions were required, there were no long-term occlusions in the non-diseased/non-symptomatic limb. Conclusion: Kissing stents offer an invaluable alternative to surgery. There were no long-term occlusions following kissing stents in a previously non-symptomatic/non-diseased limb

  4. LONG-TERM SUCCESS OF AORTOILIAC OPERATION FOR ARTERIOSCLEROTIC OBSTRUCTIVE DISEASE

    NARCIS (Netherlands)

    VANDENAKKER, PJ; VANSCHILFGAARDE, R; BRAND, R; VANBOCKEL, JH; TERPSTRA, JL

    The current retrospective study was performed on 747 patients with aortoiliac obstructive disease who under-went reconstructive operation. Unlike many other centers, the University Hospital Leiden has, throughout the years, maintained the strategy of avoiding the implantation of a prosthesis in

  5. Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience

    International Nuclear Information System (INIS)

    Ierardi, Anna Maria; Duka, Ejona; Radaelli, Alessandro; Rivolta, Nicola; Piffaretti, Gabriele; Carrafiello, Gianpaolo

    2016-01-01

    AimTo evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.Materials and MethodsBetween September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.ResultsImage co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02–63.75 Gycm2). The mean total procedure time was 32.2 min (range 27–38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20–40 mL).ConclusionsIF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration

  6. Aortitis and aortic occlusion in Crohn disease.

    Science.gov (United States)

    Delay, Charline; Schwein, Adeline; Lejay, Anne; Gaertner, Sébastien; Aleil, Boris; Thaveau, Fabien; Georg, Yannick; Chakfe, Nabil

    2015-02-01

    Patients with Crohn disease (CD) or ulcerative colitis are known to be at increased risk of arterial thromboembolic complications. We report the case of a 33-year-old woman suffering from CD for 19 years who presented lower limb claudication. Computed tomography scan revealed an aortoiliac occlusion extending from the level of the inferior mesenteric artery to both iliac bifurcations. Endovascular recanalization was attempted as a first option but failed. We then performed an aortobi-femoral bypass through a left retroperitoneal approach that allowed a total relief of the symptoms. Histologic study of the aorta demonstrated a nonspecific aortitis with lymphohistiocytic cell infiltration in the media and adventitia tunica. There was no signs of associated vasculitis. At the light of a literature review, we discussed our surgical strategy and the inflammation of the aortic wall as local factor of thrombosis that has never been previously described. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... Lower Your Stroke Risk? Ecstasy May Help Some PTSD Sufferers, but Safety Issues Remain First Death Reported ... of these factors contributes not only to the development of occlusive peripheral arterial disease but also to ...

  8. Epidemiology of aortic disease - aneurysm, dissection, occlusion

    International Nuclear Information System (INIS)

    Steckmeier, B.

    2001-01-01

    The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of 7 cm were below 5%, 39% and 65%, respecitvely. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection - including 5% of Marfan patients -, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aortoiliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I patients in most cases are female and more

  9. Supervised exercise, stent revascularization, or medical therapy for claudication due to aortoiliac peripheral artery disease: the CLEVER study.

    Science.gov (United States)

    Murphy, Timothy P; Cutlip, Donald E; Regensteiner, Judith G; Mohler, Emile R; Cohen, David J; Reynolds, Matthew R; Massaro, Joseph M; Lewis, Beth A; Cerezo, Joselyn; Oldenburg, Niki C; Thum, Claudia C; Jaff, Michael R; Comerota, Anthony J; Steffes, Michael W; Abrahamsen, Ingrid H; Goldberg, Suzanne; Hirsch, Alan T

    2015-03-17

    Treatment for claudication that is due to aortoiliac peripheral artery disease (PAD) often relies on stent revascularization (ST). However, supervised exercise (SE) is known to provide comparable short-term (6-month) improvements in functional status and quality of life. Longer-term outcomes are not known. The goal of this study was to report the longer-term (18-month) efficacy of SE compared with ST and optimal medical care (OMC). Of 111 patients with aortoiliac PAD randomly assigned to receive OMC, OMC plus SE, or OMC plus ST, 79 completed the 18-month clinical and treadmill follow-up assessment. SE consisted of 6 months of SE and an additional year of telephone-based exercise counseling. Primary clinical outcomes included objective treadmill-based walking performance and subjective quality of life. Peak walking time improved from baseline to 18 months for both SE (5.0 ± 5.4 min) and ST (3.2 ± 4.7 min) significantly more than for OMC (0.2 ± 2.1 min; p OMC, but not for ST compared with OMC. Many disease-specific quality-of-life scales demonstrated durable improvements that were greater for ST compared with SE or OMC. Both SE and ST had better 18-month outcomes than OMC. SE and ST provided comparable durable improvement in functional status and in quality of life up to 18 months. The durability of claudication exercise interventions merits its consideration as a primary PAD claudication treatment. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. The Use of the Profunda Femoral Artery as the Sole Target Vessel to Bypass Aortoiliac Disease in Patients with Critical Limb Ischemia and Concomitant Unreconstructable Infrainguinal Disease.

    Science.gov (United States)

    Kontopodis, Nikolaos; Lioudaki, Stella; Chronis, Christos; Kalogerakos, Paris; Lazopoulos, George; Papaioannou, Alexandra; Ioannou, Christos V

    2018-04-01

    Critical limb ischemia (CLI) often results from multilevel occlusive disease. There are occasions where a patent profunda femoral artery (PFA) is the only target artery that can be used as outflow during reconstruction to bypass aortoiliac disease (AOID), with no further option for infrainguinal revascularization. We aim to report results of the use of PFA as the sole target vessel for the treatment of these patients. This is a retrospective, single-center study including CLI patients treated during 36 months. All procedures were included regardless of inflow site. The outcomes examined were hemodynamic improvement, clinical status change, amputation-free and overall survival, and patency of the prosthesis. Univariate analysis was performed to identify possible predictors of adverse outcomes. Twenty-three patients and 27 limbs were included (2 female, mean age 70.6). Sixteen limbs presented rest pain and 11 tissue loss. Inflow was obtained from the axillary (n = 9), contralateral femoral (n = 8), abdominal aorta (n = 2), thoracic aorta (n = 1), ipsilateral external iliac (n = 2), and contralateral external iliac artery (n = 1). Immediately postoperatively ankle-brachial index significantly increased from 0.15 (0-0.5) to 0.50 (0.25-0.9), (P-value limbs presented clinical improvement (3 minimally, 18 moderately, and 3 markedly improved) and 3 presented no change. During a mean follow-up of 15.8 (2-36) months, we recorded 4 deaths and 4 major amputations. Mean predicted overall survival and amputation-free survival were 29.8 (95% confidence interval [CI] 24.5-35.1) and 26.5 months (95% CI 21.1-31.8), respectively. Predicted primary patency was 76% at 3 years. Univariate analysis revealed significant associations only between bypass patency and limp loss (P-value = 0.021). In the presence of CLI due to AOID and unreconstructable infrainguinal disease, the use of PFA as the sole target vessel during bypass is associated with significant rates of clinical

  11. Pulmonary veno-occlusive disease.

    Science.gov (United States)

    Montani, David; Lau, Edmund M; Dorfmüller, Peter; Girerd, Barbara; Jaïs, Xavier; Savale, Laurent; Perros, Frederic; Nossent, Esther; Garcia, Gilles; Parent, Florence; Fadel, Elie; Soubrier, Florent; Sitbon, Olivier; Simonneau, Gérald; Humbert, Marc

    2016-05-01

    Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension (PH) characterised by preferential remodelling of the pulmonary venules. In the current PH classification, PVOD and pulmonary capillary haemangiomatosis (PCH) are considered to be a common entity and represent varied expressions of the same disease. The recent discovery of biallelic mutations in the EIF2AK4 gene as the cause of heritable PVOD/PCH represents a major milestone in our understanding of the molecular pathogenesis of PVOD. Although PVOD and pulmonary arterial hypertension (PAH) share a similar clinical presentation, with features of severe precapillary PH, it is important to differentiate these two conditions as PVOD carries a worse prognosis and life-threatening pulmonary oedema may occur following the initiation of PAH therapy. An accurate diagnosis of PVOD based on noninvasive investigations is possible utilising oxygen parameters, low diffusing capacity for carbon monoxide and characteristic signs on high-resolution computed tomography of the chest. No evidence-based medical therapy exists for PVOD at present and lung transplantation remains the preferred definitive therapy for eligible patients. Copyright ©ERS 2016.

  12. Aortic aneurysm disease vs. aortic occlusive disease - differences in outcome and intensive care resource utilisation after elective surgery

    DEFF Research Database (Denmark)

    Bisgaard, Jannie; Gilsaa, Torben; Rønholm, Ebbe

    2013-01-01

    CONTEXT: Abdominal aortic surgery is a high-risk procedure, with aortic aneurysm and aortic occlusive diseases being the main indications. These groups are often regarded as having equal perioperative risk profiles. Previous reports suggest that the haemodynamic and inflammatory response to aortic...... clamping is more pronounced in patients with aortic aneurysm disease, which may affect outcome. OBJECTIVES: The aim of this observational cohort study was to evaluate outcome after open elective abdominal aortic surgery, hypothesising a higher 30-day mortality, a higher incidence of postoperative organ...... January 2007 to 1 March 2010. PATIENTS: One thousand two hundred and ninety-three patients scheduled for primary open elective, aortoiliac bypass or aortofemoral bypass procedures or abdominal aortic aneurysm repair. MAIN OUTCOME MEASURES: Mechanical ventilation, acute dialysis, use of vasopressors...

  13. Arterial occlusive disease after radiotherapy

    International Nuclear Information System (INIS)

    Piedbois, P.; Mazeron, J.J.; Le Bourgeois, J.P.; Becquemin, J.P.; Blanc, I.; Lange, F.; Melliere, D.

    1990-01-01

    Fourteen cases of arterial occlusion or severe narrowing following radiotherapy are studied in order to assess the possible etiological role of such therapy in arterial lesion. Surgical results are also discussed in terms of long-term efficacy. The average time of occurrence after radiotherapy was 8 years post-radiotherapy. This series includes 7 supra-aortic trunk stenoses and 7 abdominal aorta trunk stenoses. The doses received in the volumes iradiated ranged from 47 to 70 Gy with standard fractionation. Association of atherosclerotic risk factors was present in 12 patients, but stenoses were usually confined to irradiated areas, and at imes occurred in uncommon sites. Surgical management included 11 by-passes, 2 endarterectomies and one percutaneous transluminal angioplasty. All patients experienced immediate and satisfactory functional improvements. Three patients were re-operated on because of the re-occlusion of the by-pass and graft infection. On the whole, stenoses in previously irradiated areas showed no particular difficulties for surgical treatment. It was concluded that radiotherapy seems to be a definite risk factor for arterial occlusion or narrowing, especially in association in association with atherosclerotic risk factors. (author). 45 refs.; 3 figs.; 2 tabs

  14. A balloon protection sheath to prevent peripheral embolization during aortoiliac endovascular procedures

    NARCIS (Netherlands)

    Reekers, J. A.

    1998-01-01

    Peripheral embolization is a known complication occurring during aortoiliac recanalization. In particular, acute, fresh thrombotic occlusions, with a history shorter than 6 months, have a high risk for peripheral embolization. We describe a balloon occlusion sheath used to manage embolic material

  15. Central Retinal Vein Occlusion Revealing Coelic Disease

    Directory of Open Access Journals (Sweden)

    Hana ZOUBEIDI

    2016-11-01

    Full Text Available Introduction: Thrombosis has been widely reported in coeliac disease (CD but central retinal vein occlusion (CRVO is rarely described. Case presentation: A 27-year-old woman presented with acute visual loss and was diagnosed with CRVO. Her protein S and protein C levels were low and CD was diagnosed on the basis of endoscopic, immunological and histological results. A gluten-free diet resulted in favourable evolution. Conclusion: CD should be considered in young patients with thrombosis, especially if in an unusual location. Treatment is based on a gluten-free diet.

  16. Tibioperoneal Occlusive Disease: A Review of below the Knee Endovascular Therapy in Patients with Critical Limb Ischemia.

    Science.gov (United States)

    Muir, Kathryn B; Cook, Patrick R; Sirkin, Maxwell R; Aidinian, Gilbert

    2017-01-01

    Tibioperoneal occlusive disease is one of the most difficult disease processes to successfully treat. Previous studies have attempted to address the outcomes of tibial interventions in this patient population; however, the majority of these study cohorts are composed of patients who have undergone concomitant aortoiliac or femoral procedures. Our objective was to present the outcomes of patients treated with endovascular intervention for isolated below-the-knee atherosclerotic disease causing critical limb ischemia (CLI). We performed a retrospective review of all patients who underwent isolated endovascular treatment of the below-knee popliteal, tibial, and/or peroneal arteries for CLI (Rutherford class 4-6). Primary outcomes include wound healing, reintervention rates, and amputation-free survival out to 5 years, as well as 1-year primary patency rates. 116 patients were identified as having undergone a tibial endovascular intervention. Ninety-two had concomitant aortoiliac or femoropopliteal interventions; after excluding those patients, we identified 24 limbs that were treated for isolated below-knee popliteal, tibial, and/or peroneal occlusive disease using an endovascular modality. 62.5% of limbs had successful wound healing, whereas 37.5% eventually required a major amputation. Mean time to amputation was 514.6 days (standard error: 57.3). Of those patients with successful limb salvage (n = 15), 66.7% required only the index procedure to heal; the remaining 33.3% required a repeat endovascular intervention, an arterial bypass, or a combination to successfully heal. The mean time to reintervention was 780.1 days (standard error: 179.5). The 1-year primary patency rate was 52.6% (n = 19). Patients with CLI secondary to isolated below-the-knee atherosclerotic occlusive disease are a difficult population to successfully treat; despite this, these patients benefit from an initial attempt at endovascular limb salvage. In our experience, this approach

  17. Occlusion and periodontal disease--where is the link?

    Science.gov (United States)

    Fu, Jia Hui; Yap, Adrian U J

    2007-12-01

    The effect of occlusion on the periodontium has been the subject of much debate. Interest on this subject has decreased over the years but has been renewed with the popularity of implant dentistry. This paper reviews the literature and explores the relationship between trauma from occlusion with periodontal disease and peri-implant bone loss. With regards to periodontal disease, there are two schools of thought on the effect that trauma from occlusion has on the periodontium. One believes that trauma from occlusion is a co-destructive factor in the initiation and progression of periodontal disease. The other believes that it is not. Up till now, there are no conclusive explanations on the association between trauma from occlusion and periodontal disease. For dental implants, current literature suggests that there is an association between occlusal overloading and peri-implant bone loss even in the absence of inflammation. However, there is a need for more randomized clinical trials to validate this relationship.

  18. Blood flow velocity prediction in aorto-iliac stent grafts using computational fluid dynamics and Taguchi method.

    Science.gov (United States)

    Chong, Albert Y; Doyle, Barry J; Jansen, Shirley; Ponosh, Stefan; Cisonni, Julien; Sun, Zhonghua

    2017-05-01

    Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) is a new technique to treat extensive aortoiliac occlusive disease with covered expandable stent grafts to rebuild the aortoiliac bifurcation. Post stenting Doppler ultrasound (DUS) measurement of maximum peak systolic velocity (PSV max ) in the stented segment is widely used to determine patency and for follow up surveillance due to the portability, affordability and ease of use. Anecdotally, changes in hemodynamics created by CERAB can lead to falsely high PSV max requiring CT angiography (CTA) for further assessment. Therefore, the importance of DUS would be enhanced with a proposed PSV max prediction tool to ascertain whether PSV max falls within the acceptable range of prediction. We have developed a prediction tool based on idealized models of aortoiliac bifurcations with various infra-renal PSV (PSV in ), iliac to aortic area ratios (R) and aortoiliac bifurcation angles (α). Taguchi method with orthogonal arrays (OA) was utilized to minimize the number of Computational Fluid Dynamics (CFD) simulations performed under physiologically realistic conditions. Analysis of Variance (ANOVA) and Multiple Linear Regression (MLR) analyses were performed to assess Goodness of fit and to predict PSV max. PSV in and R were found to contribute 94.06% and 3.36% respectively to PSV max . The Goodness of fit based on adjusted R 2 improved from 99.1% to 99.9% based on linear and exponential functions. The PSV max predictor based on the exponential model was evaluated with sixteen patient specific cases with a mean prediction error of 9.9% and standard deviation of 6.4%. Eleven out of sixteen cases (69%) in our current retrospective studies would have avoided CTA if the proposed predictor was used to screen out DUS measured PSV max with prediction error greater than 15%. The predictor therefore has the potential to be used as a clinical tool to detect PSV max more accurately post aortoiliac stenting and might

  19. Veno-occlusive disease of the colon - CT findings

    International Nuclear Information System (INIS)

    Rademaker, J.

    1998-01-01

    Venous occlusion is a rare cause of ischemic bowel disease and is usually brought about by thrombosis that may occur as a complication of systemic disorders like systemic lupus erythematosus, Behcet disease or Churg-Strauss syndrome. This report describes a patient with veno-occlusive disease of the colon caused by lymphocytic phlebitis. Typical CT findings included homogeneous bowel wall thickening and vascular engorgement. (orig.) (orig.)

  20. Hepatic veno-occlusive disease associated with comfrey ingestion.

    Science.gov (United States)

    Yeong, M L; Swinburn, B; Kennedy, M; Nicholson, G

    1990-01-01

    A 23 year old man presented with hepatic veno-occlusive disease and severe portal hypertension and subsequently died from liver failure. Light microscopy and hepatic angiography showed occlusion of sublobular veins and small venous radicles of the liver, associated with widespread haemorrhagic necrosis of hepatocytes. The patient had been on a predominantly vegetarian diet and, prior to his illness, took comfrey leaves which are known to contain hepatotoxic pyrrolizidine alkaloids. Comfrey is widely used as a herbal remedy, but so far has only been implicated in two other documented cases of human hepatic veno-occlusive disease. A possible causal association of comfrey and this patient's veno-occlusive disease is suggested by the temporal relationship of the ingestion of comfrey to his presentation, the histological changes in the liver and the exclusion of other known causes of the disease.

  1. Endovascular Treatment of an Aortoiliac Tuberculous Pseudoaneurysm

    International Nuclear Information System (INIS)

    Villegas, Miguel O.; Mereles, Alberto Pérez; Tamashiro, Gustavo A.; Dini, Andrés E.; Mollón, Ana P.; De Cándido, Laura V.; Zelaya, Denis A.; Soledispa-Suarez, Carlos I.; Denato, Sergio; Tamashiro, Alberto; Diaz, Jose A.

    2013-01-01

    We report a rare case of a tuberculous mycotic aortoiliac pseudoaneurysm treated with an endovascular procedure and follow-up of 36 months. The patient was a white 72-year-old man with pulmonary tuberculosis and a former smoker with hypertension, chronic renal failure, and dyslipidemia. A computed tomographic scan of the abdomen and pelvis revealed a left paravertebral cavity with fluid content and involvement of vertebrae L2–L4. After a surgical repair attempt, the patient was treated with the implant of a bifurcated endoprosthesis. Because it is unlikely that any center has extensive experience in the management of this rare manifestation of the disease, we reviewed the literature for similar cases.

  2. Endovascular Treatment of an Aortoiliac Tuberculous Pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Villegas, Miguel O.; Mereles, Alberto Perez; Tamashiro, Gustavo A.; Dini, Andres E.; Mollon, Ana P.; De Candido, Laura V.; Zelaya, Denis A.; Soledispa-Suarez, Carlos I.; Denato, Sergio; Tamashiro, Alberto; Diaz, Jose A., E-mail: joseantoniodiaz@hotmail.com [Hospital Nacional Prof. Alejandro Posadas, Department of Cardiology, Section of Hemodinamia (Argentina)

    2013-04-15

    We report a rare case of a tuberculous mycotic aortoiliac pseudoaneurysm treated with an endovascular procedure and follow-up of 36 months. The patient was a white 72-year-old man with pulmonary tuberculosis and a former smoker with hypertension, chronic renal failure, and dyslipidemia. A computed tomographic scan of the abdomen and pelvis revealed a left paravertebral cavity with fluid content and involvement of vertebrae L2-L4. After a surgical repair attempt, the patient was treated with the implant of a bifurcated endoprosthesis. Because it is unlikely that any center has extensive experience in the management of this rare manifestation of the disease, we reviewed the literature for similar cases.

  3. [Peripheral arterial occlusive disease. Symptoms, basic diagnosis and staged therapy].

    Science.gov (United States)

    Welter, H F; Kettmann, R; Grothe, A

    2002-06-13

    Intermittent claudication or rest pain are typical symptoms of peripheral arterial occlusive disease (PAOD) affecting the lower limbs. The pain is localized one level below that of the occlusion. Initial investigations should determine skin temperature and color, pulse status, stenotic sounds and Doppler occlusive pressures. If intermittent claudication is present, angiography of the pelvis and legs then follows. Treatment is stage-dependent: while in stages I and IIa conservative treatment such as cessation of smoking, administration of acetylsalicylic acid and walking training suffices, stages IIb and higher require invasive measures extending from PTA to amputation of gangrenous parts of the limb.

  4. Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction

    International Nuclear Information System (INIS)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Recaldini, Chiara; Lumia, Domenico; Cuffari, Salvatore; Caronno, Roberto; Castelli, Patrizio; Fugazzola, Carlo

    2007-01-01

    Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery and can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach

  5. Pulmonary veno-occlusive disease in a female gardener.

    Science.gov (United States)

    Rodríguez Rodríguez, Paula; Pedraza Serrano, Fernando; Morán Caicedo, Liliana Patricia; Rodríguez de Guzmán, Maria Carmen; Cebollero Presmanes, María; de Miguel Díez, Javier

    2014-01-01

    Pulmonary veno-occlusive disease (PVOD) is a subgroup of pulmonary arterial hypertension with a poor prognosis. The diagnosis is usually delayed and treatment options other than lung transplantation are unfortunately limited. We report the case of 51-year-old female gardener diagnosed with PVOD by open lung biopsy before her death. Although there are many reported cases of hepatic veno-occlusive disease due to toxic agents present in nature, such as pyrrolizidine alkaloid exposure, to date this has not been linked to PVOD. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  6. Epidemiology of aortic disease - aneurysm, dissection, occlusion; Epidemiologie der Aortenerkrankung: Aneurysma, Dissektion, Verschluss

    Energy Technology Data Exchange (ETDEWEB)

    Steckmeier, B. [Klinikum der Universitaet Muenchen-Innenstadt, Muenchen (Germany). Chirurgische Klinik und Poliklinik, Gefaesschirurgie

    2001-08-01

    The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of <5 cm, between 5.1 and 6.9 cm, and of >7 cm were below 5%, 39% and 65%, respecitvely. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection - including 5% of Marfan patients -, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aortoiliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I

  7. Contralateral symptoms after unilateral intervention for peripheral occlusive disease

    NARCIS (Netherlands)

    de Vries, S.O.; Donaldson, M.C.; Hunink, M.G.

    Objective: The objectives of this study were (1) to determine the incidence of contralateral symptoms in patients with a unilateral intervention for peripheral arterial occlusive disease and (2) to identify characteristics that predict these symptoms. Subjects and Setting: We included patients who

  8. Digital subtraction angiography in pediatric cerebrovascular occlusive disease

    International Nuclear Information System (INIS)

    Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.

    1984-01-01

    While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease

  9. Thrombolysoangioplasty in chronic, long segmental occlusive arterial disease

    International Nuclear Information System (INIS)

    Chung, Tae Woong; Kim, Jae Kyu; Koh, Byung Kwan; Kim, Jin Yup; Seo, Jeoung Jin; Kang, Hyeoung Keun

    1993-01-01

    From July 1988 to September 1992, we experienced 15 cases of thrombolysoangioplasty (TLA) at Chonnam University Hospital. Among 15 cases, 5 had claudication (Clinical stage II according to Modified Fontaine Classification), pain at rest (III),and gangrene (IV). Duration of symptoms was 1-7 months except patients of clinical stage IV unable to guess occlusion age. The occlusion length was 5-10 cm in 8 cases, 10-20 cm in 4 cases, and above 30 cm in 2 cases. In all cases, thrombolytic therapy was performed with intraarterial urokinase infusion. The total amount of urokinase ranged from 300,000 IU to 2,000,000 IU and infusion time ranged from 2 to 50 hours except three cases infused bolus dose only. Complete successful TLA was defined as technical (less than 50% of residual stenosis) and clinical success. Partial success was defined as technical success but clinical failure. Follow-up angiography could be performed in 8 cases. Overall initial success rate was 86.6% (13/15). Among them, complete success was in 11 cases and partial success was in 2 cases. Recurrence of disease was not noted on all cases(n=8). Severe complications, such as hemorrhage, did not occurred. TLA was considered to be effective and safe way to recanalized chronic long artery occlusion in lower extremity

  10. Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review

    International Nuclear Information System (INIS)

    Met, Rosemarie; Lienden, Krijn P. Van; Koelemay, Mark J. W.; Bipat, Shandra; Legemate, Dink A.; Reekers, Jim A.

    2008-01-01

    The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency

  11. Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview

    Science.gov (United States)

    2007-01-01

    Antiphospholipid syndrome (APS) is primarily considered to be an autoimmune pathological condition that is also referred to as "Hughes syndrome". It is characterized by arterial and/or venous thrombosis and pregnancy pathologies in the presence of anticardiolipin antibodies and/or lupus anticoagulant. APS can occur either as a primary disease or secondary to a connective tissue disorder, most frequently systemic lupus erythematosus (SLE). Damage to the nervous system is one of the most prominent clinical constellations of sequelae in APS and includes (i) arterial/venous thrombotic events, (ii) psychiatric features and (iii) other non-thrombotic neurological syndromes. In this overview we compare the most important vascular ischemic (occlusive) disturbances (VIOD) with neuro-psychiatric symptomatics, together with complete, updated classifications and hypotheses for the etio-pathogenesis of APS with underlying clinical and laboratory criteria for optimal diagnosis and disease management. PMID:18159581

  12. EVAR of aortoiliac aneurysms with branched stent-grafts.

    Science.gov (United States)

    Dias, N V; Resch, T A; Sonesson, B; Ivancev, K; Malina, M

    2008-06-01

    Branched iliac stent-grafts (bSG) have recently been developed in order to preserve internal iliac artery (IIA) flow in patients with aneurysmal or short common iliac arteries. The aim of this study is to evaluate a single-center experience with bSG for the IIA. Twenty-two male patients (70 (IQR 65-79) years old) underwent EVAR with 23 bSG (1 bilateral repair) between September 2002 and August 2007. Median AAA diameter was 52 (37-60) mm while common iliac diameter on the side of the bSG was 34 (27-41) mm. Two in-house modified Zenith SG and subsequently 21 commercially available bSG (18 Zenith Iliac Side and 3 Helical Branches) were used. Follow-up (FU) included CT at one month and yearly thereafter. Data was prospectively entered in a database. Primary technical success was 91% (21 bSG). Median FU duration was 20 (8-31) months. One patient (5 %) died after discharge from acute myocardial infarction on day 13. Another patient died 30 months after EVAR of an unrelated cause. The overall bSG patency was 74% due to 6 branch occlusions (2 intraoperative and 4 late). All patients with patent bSG were asymptomatic. Three occlusions were asymptomatic findings on CT, while the other three developed claudication (two patients with contralateral IIA occlusion and one with simultaneous occlusion of the external iliac). One patient (5%) developed an asymptomatic type III endoleak at 1 month and was successfully treated with a bridging SG. Overall, four patients (18%) required reinterventions (1 bilateral stenting of the external iliac arteries, 1 external and 1 internal SG extensions and 1 femoro-femoral cross-over bypass). Nine out of 16 patients (56%) with CT-FU>/=1 year had shrinking aneurysms. There were no postoperative aneurysm expansions. EVAR of aortoiliac aneurysms with IIA bSG is a good alternative to occlusion of the IIA in patients with challenging distal anatomy.

  13. Revascularization experience and results in ischaemic cerebrovascular disease: Moyamoya disease and carotid occlusion.

    Science.gov (United States)

    Arikan, Fuat; Rubiera, Marta; Serena, Joaquín; Rodríguez-Hernández, Ana; Gándara, Darío; Lorenzo-Bosquet, Carles; Tomasello, Alejandro; Chocrón, Ivette; Quintana-Corvalan, Maximiliano; Sahuquillo, Juan

    2018-03-14

    Cerebral revascularization techniques are an indispensable tool in the current armamentarium of vascular neurosurgeons. We present revascularization surgery experience and results in both moyamoya disease and occlusive cerebral ischaemia. Patients with ischaemic occlusive disease and moyamoya disease who underwent microsurgical revascularization between October 2014 and September 2017 were analysed. In the study period, 23 patients with occlusive ischaemic disease underwent microsurgical revascularization. Three patients presented with serious postoperative complications (2 intraparenchymal haemorrhages in the immediate postoperative period and one thrombosis of the femoral artery). All patients, except one, achieved normalization of the cerebral hemodynamic reserve (CHR) in the SPECT study. Twenty patients had a good neurological result, with no ischaemic recurrence of the revascularized territory. Among patients with moyamoya, 20 had moyamoya disease and 5 had moyamoya syndrome with unilateral involvement. Five patients were treated at paediatric age. Haemorrhagic onset occurred in 2 patients. The CHR study showed hemodynamic compromise in all patients. Cerebral SPECT at one year showed resolution of the hemodynamic failure in all patients. There have been 4 postoperative complications (acute subdural hematoma, two subdural collections and one dehiscence of the surgical wound). No patient presented with neurological worsening at 6 and 12months of follow-up. Cerebral revascularization through end-to-side anastomosis between the superficial temporal artery and a cortical branch of the middle cerebral artery is an indisputable technique in the treatment of moyamoya disease and possibly in a subgroup of patients with symptomatic occlusive ischaemic cerebrovascular disease. Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Hepatic veno-occlusive disease due to pyrrolizidine (Senecio) poisoning in Arizona.

    Science.gov (United States)

    Stillman, A S; Huxtable, R; Consroe, P; Kohnen, P; Smith, S

    1977-08-01

    An infant with documented hepatic veno-occlusive disease due to ingestion of pyrrolizidine alkaloids is presented. The alkaloids were ingested in the form of an herbal tea commonly used as a folk remedy among the Mexican-American population. Among these people, this herb is known as gordolobo yerba. The patient presented with acute hepatocellular disease and portal hypertension which progressed over 2 months to extensive hepatic fibrosis. Other potential causes of hepatic venous occlusion were absent.

  15. Fatal veno-occlusive disease of the liver associated with herbal tea consumption and radiation

    International Nuclear Information System (INIS)

    Feigen, M.

    1984-01-01

    A case is presented of fatal veno-occlusive disease of the liver in a patient undergoing treatment by whole abdomen irradiation for carcinoma of the ovary. She had also been exposed to herbal tea and chemotherapy, each of which may cause veno-occlusive disease in its own right. Interaction of these agents is postulated and should be considered before submitting patients to combination treatment

  16. Revascularization Techniques for Acute Basilar Artery Occlusion : Technical Considerations and Outcome in the Setting of Severe Posterior Circulation Steno-Occlusive Disease.

    Science.gov (United States)

    Siebert, Eberhard; Bohner, Georg; Zweynert, Sarah; Maus, Volker; Mpotsaris, Anastasios; Liebig, Thomas; Kabbasch, Christoph

    2018-04-12

    To describe the clinical and radiological characteristics, frequency, technical aspects and outcome of endovascular treatment of acute basilar artery occlusion (ABO) in the setting of vertebrobasilar steno-occlusive disease. Retrospective analysis of databases of two universitary stroke centers including all consecutive patients from January 2013 until May 2017 undergoing thrombectomy for a) acute stroke due to basilar artery occlusion and either significant basilar artery stenosis or vertebral artery stenosis/occlusion as well as b) presumed embolic basilar artery occlusions. Demographics, stroke characteristics, time metrics, recanalization results and outcome were recorded. Interventional strategies were evaluated concerning the thrombectomy technique, additional angioplasty, type of approach with respect to lesion pattern (ipsilateral to steno-occlusive VA lesion: dirty road or contralateral: clean road) and sequence of actions. Out of 157 patients treated for ABO 38 (24.2%) had associated significant vertebrobasilar steno-occlusive lesions. An underlying significant basilar artery stenosis was present in 23.7% and additionally significant steno-occlusive vertebral lesions were present in 81.5%. Thrombectomy was performed with primary aspiration in 15.8% and with stent-retrievers in 84.2%. Successful revascularization (TICI 2b-3) was achieved in 86.8%. In 52.6% additional stent angioplasty was performed, in 7.9% balloon angioplasty only. The clean road approach was used in 22.5% of cases, the dirty road in 77.4%. Final modified Rankin scale (mRS) was 0-2 in 6 patients (15.8%) and 3-5 in 32 (84.2%). The in-hospital mortality was 36.8%. There were no statistically significant differences in outcome compared to presumed cases of embolisms. Endovascular treatment of ABO with underlying significant vertebrobasilar steno-occlusive lesions is effective and reasonably safe. Specific procedural strategies apply depending on individual patient pathology and anatomy

  17. S3 guidelines for diagnostics and treatment of peripheral arterial occlusive disease

    International Nuclear Information System (INIS)

    Huppert, P.; Tacke, J.; Lawall, H.

    2010-01-01

    This report summarizes the most important aspects of the new German S3 guidelines for the diagnostics and treatment of peripheral arterial occlusive disease (PAOD) from March 2009. The guidelines include definitions and epidemiology of peripheral arterial occlusive disease, diagnostic methods including clinical and technical procedures as well as imaging methods, treatment by non-invasive, interventional and surgical methods and patient care during follow-up. In key messages recommendations are given which are graded corresponding to the scientific evidence concluded from the literature. (orig.) [de

  18. Angioplasty and stenting to treat occlusive vascular disease.

    Science.gov (United States)

    Caplan, Louis R; Meyers, Philip M; Schumacher, H Christian

    2006-01-01

    The advent of effective percutaneous treatment of occlusive vascular lesions by angioplasty and stenting is one of the most important contributions to medical care early in the 21st century. Evaluation of angioplasty and stenting procedures is still in a very early phase. New types of stents and other technologies and devices are being continuously developed and there is a definite learning curve. The experience, training, and number of procedures clearly relate to outcomes, and many different specialists are still learning and so far have not had optimal experience. This review provides an overview of studies that have examined the efficacy of stenting in conjunction with balloon angioplasty for carotid atherosclerosis compared with endarterectomy. Also discussed are angioplasty/stenting of other neck arteries and intracranial arteries and the key issues surrounding percutaneous intervention, including patient selection criteria, clinical assessment of lesions most suitable for treatment, the use of distal protective devices and drug-eluting stents, and recommendations for physician selection.

  19. Measurement of free radicals using electron paramagnetic resonance spectroscopy during open aorto-iliac arterial reconstruction.

    Science.gov (United States)

    Majewski, Wacław; Krzyminiewski, Ryszard; Stanisić, Michał; Iskra, Maria; Krasiński, Zbigniew; Nowak, Marek; Dobosz, Bernadeta

    2014-11-27

    Aortic cross-clamping during abdominal aortic aneurysm (AAA) open repair leads to development of ischemia-reperfusion injury. Electron paramagnetic resonance spectroscopy (EPR) spin-trapping is a valuable method of direct measurement of free radicals. The objective of the study was to evaluate the results of EPR as a direct method of free radical measurement and degree of inflammatory response in open operative treatment of patients with AAA and aorto-iliac occlusive disease (AIOD). The study was performed on a group of 32 patients with AAA and 25 patients with AIOD scheduled for open repair. Peripheral venous blood for EPR spectroscopy and for SOD, GPx, ox-LDL, Il-6, TNF-alfa, CRP, and HO-1 were harvested. Selected parameters were established accordingly to specified EPR and immunohistochemical methods and analyzed between groups by Mann-Whitney U test and Wilcoxon matched-pairs signed-ranks test with Bonferroni correction. Free radicals level was correlated with the time of the aortic cross-clamping after the reperfusion of he first and second leg in AAA (r=0.7; r=0.47). ox-LDL in AAA decreased 5 min after reperfusion of the first leg (32.99 U/L, range: 14.09-77.12) and 5 min after reperfusion of the second leg (26.75 U/L, range: 11.56-82.12) and 24 h after the operation (25.85 U/L, range: 14.29-49.70). HO-1 concentration increased to above the level before intervention 24 h after surgery. The activities of GPx and SOD decreased 5 min after the first-leg reperfusion in AAA. Twenty-four hours after surgery, inflammatory markers increased in AAA to CRP was 14.76 ml/l (0.23-38.55), IL-6 was 141.22 pg/ml (84.3-591.03), TNF-alfa was 6.82 pg/ml (1.76-80.01) and AIOD: CRP was 18.44 mg/l (2.56-33.14), IL-6: 184.1 pg/ml (128.46-448.03), TNF-alfa was 7.74 pg/ml (1.74-74.74). EPR spin-trapping demonstrates temporarily elevated level of free radicals in early phase of reperfusion, leading to decrease antioxidants in AAA. Elevated free radical levels decreased 24 h after

  20. Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

    Energy Technology Data Exchange (ETDEWEB)

    Massmann, Alexander, E-mail: Alexander.Massmann@uks.eu; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)

    2012-10-15

    Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

  1. Doppler spectrum of superficial femoral artery in patients with occlusive arterial disease of lower extremity: Comparison with angiography

    International Nuclear Information System (INIS)

    Jae, Hwan Jun; Koh, Young Hwan; Kim, Kyoung Won; Kim, Hyun Boem; Jung, Jin Wook; Park, Jae Hyung

    2000-01-01

    To compare Doppler waveform of superficial femoral artery (SFA) with the angiographic findings according to the location and severity of occlusive arterial disease of lower extremity. We examined 32 lower extremities in 20 patients (M:F=18:2, Age: 37-86, Mean age:62) with the occlusive arterial disease of lower extremity using Doppler sonography and angiography. We classified them into 6 groups according to the location and severity of arterial stenosis or occlusion on angiography; stenosis 50% proximal to SFA (n=5), total occlusion proximal to (n=5), stenosis>50% or occlusion in the distal SFA or popliteal artery (n=8), stenosis>50% or occlusion below trifurcation (n=4), stenosis>50% or occlusion i the proximal to SFA (n=6). The Doppler waveforms SFA were retrospectively analyzed tot he 6 groups classified by the angiographic findings. Normal triphasic pattern (3/4) of SFA was preserved in case with stenosis 50% or occlusion in the distal SFA or popliteal artery. Triphasic (2/4) or biphasic pattern with absent diastolic flow (2/4) was detected in stenosis>50% or occlusion in the lover than trifurcation. The waveform was variable in the cases with stenosis>50% or occlusion in the proximal and distal lesion. The Doppler waveform of SFA in the occlusive arterial disease of the lower extremity was variable. However, it tends to show pulsus tardus et parvus pattern in the total occlusion proximal to SFA and high resistive pattern with absent early diastolic reversal in stenosis>50% or occlusion in the distal SFA or popliteal artery.

  2. Level selection in leg amputation for arterial occlusive disease

    DEFF Research Database (Denmark)

    Holstein, P

    1982-01-01

    measurements of the skin perfusion pressure (SPP). Out of 62 BK amputations with an SPP above 30 mmHg wound healing failed in only 2 cases (3 per cent). Out of 13 BK amputations with an SPP between 20 and 30 mmHg 7 cases (54 per cent) failed and out of 9 BK amputations with an SPP below 20 mmHg no less than 8......In 102 leg amputations for arterial occlusion including 84 below-knee (BK), 16 above-knee (AD) and 2 through-knee (TK) amputations, the amputation level was determined by means of clinical criteria. The healing results and the selection of levels were then compared with sealed preoperative...... cases (89 per cent) failed to heal. The difference in failure rate is significant (P less than 0.0001). Out of the 15 failed BK amputations at low pressures (below 30 mmHg) only one case had local signs of ischaemia, which might have warned the surgeons. On the other hand, in 13 out of the 18 cases...

  3. Level selection in leg amputation for arterial occlusive disease

    DEFF Research Database (Denmark)

    Holstein, P

    1982-01-01

    cases (89 per cent) failed to heal. The difference in failure rate is significant (P less than 0.0001). Out of the 15 failed BK amputations at low pressures (below 30 mmHg) only one case had local signs of ischaemia, which might have warned the surgeons. On the other hand, in 13 out of the 18 cases......In 102 leg amputations for arterial occlusion including 84 below-knee (BK), 16 above-knee (AD) and 2 through-knee (TK) amputations, the amputation level was determined by means of clinical criteria. The healing results and the selection of levels were then compared with sealed preoperative...... measurements of the skin perfusion pressure (SPP). Out of 62 BK amputations with an SPP above 30 mmHg wound healing failed in only 2 cases (3 per cent). Out of 13 BK amputations with an SPP between 20 and 30 mmHg 7 cases (54 per cent) failed and out of 9 BK amputations with an SPP below 20 mmHg no less than 8...

  4. Cost-identification analysis of revascularization procedures on patients with peripheral arterial occlusive disease

    NARCIS (Netherlands)

    Jansen, R.M.G.; de Vries, S.O.; Cullen, K.A.; Donaldson, M.C.; Hunink, M.G.M.

    1998-01-01

    Objective: To determine average total in-hospital costs of various revascularization procedures for peripheral arterial occlusive disease; to examine the effect of procedure-related complications and patient characteristics on these costs; and to examine whether costs have changed over time.

  5. Outcomes after treatment of acute aortic occlusion.

    Science.gov (United States)

    de Varona Frolov, Serguei R; Acosta Silva, Marcela P; Volo Pérez, Guido; Fiuza Pérez, Maria D

    2015-11-01

    Acute aortic occlusion (AAO) is a rare disease with high morbidity and mortality. The aim of this study was to describe the results of surgical treatment of acute aortic occlusion and risk factors for mortality. Retrospective review of the clinical history of 29 patients diagnosed and operated on for AAO during 28 years. The following variables were analysed: age, sex, tabaco use, diabetes, chronic renal insufficiency, chronic heart failure, atrial fibrillation, arterial hypertension, symptoms, diagnosis and treatment, 30-day mortality and long-term survival. A univariant analysis was performed of variables related to mortality. Twenty-nine patients were included (18 male) with a mean age of 66,2 years. The aetiology was: embolism (EM) in 11 cases and Thrombosis (TR) in 18 cases. The surgical procedures performed included bilateral transfemoral thrombectomy (14 cases), aorto-bifemoral by-pass (8 cases), axilo uni/bifemoral by-pass (5 cases) and aortoiliac and renal tromboendarterectomy (2 cases). Morbidity included: renal failure (14 cases), mesenteric ischemia (4 cases), cardiac complications (7 cases), respiratory complications (5 cases) and loss of extremity (2 cases). The in-hospital mortality was 21% (EM 0%, TR 21%). The estimated survival at 1.3 and 5 years was 60, 50 and 44% respectively. Age (p=0.032), arterial hypertension (p=0.039) and aetiology of the AAO (p=0.039) were related to mortality. Acute aortic occlusion is a medical emergency with high mortality rates. Acute renal failure is the most common postoperative complication. Copyright © 2012 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Pulmonary veno-occlusive disease Report of case and revision of the literature

    International Nuclear Information System (INIS)

    Jimenez Q, Andres; Palacios, Diana; Camacho D, Fidel

    2008-01-01

    The real incidence of veno-occlusive pulmonary disease (VOPD) is unknown because it is largely under diagnosed or is not classified as primary pulmonary hypertension, being in fact a variant of the primary disease, primarily affecting post-capillary pulmonary vasculature. It is also known as isolated pulmonary venous sclerosis, obstructive disease of the pulmonary veins or primary pulmonary hypertension of the venous type. VOPD is the result of multiple aggressors associated to a great variety of risk factors. The diagnosis of the disease requires clinical, radiological and pathological features. Vasodilators, immunosuppressants, anticoagulation and oxygen have been proposed as treatments with a poor prognosis, and with reported survival limited by the scarce reporting of cases. We report a case of veno-occlusive pulmonary disease which was diagnosed in this institution.

  7. Femoral artery pressure measurement to predict the outcome of arterial surgery in patients with multilevel disease

    DEFF Research Database (Denmark)

    Faris, I; Tønnesen, K H; Agerskov, K

    1982-01-01

    Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac and ...

  8. Peripheral arterial occlusive disease: role of MR angiography.

    Science.gov (United States)

    Gozzi, M; Amorico, M G; Colopi, S; Favali, M; Gallo, E; Torricelli, P; Polverini, I; Gargiulo, M

    2006-03-01

    Magnetic resonance angiography (MRA) has recently become instrumental in the diagnosis of arterial disease in various body districts and is gaining an increasingly important role in the study of peripheral vascularisation. The aim of our study was to evaluate the reliability of MRA using digital subtraction angiography (DSA) as the reference standard. Between November 2003 and August 2004, 30 patients with known peripheral arterial disease were studied by MRA and DSA. MRA was performed with a Philips Intera 1.5 T, with acquisitions from the coeliac trunk to the feet. For acquisitions of the feet and ankles we used unenhanced time-of-flight (TOF) sequences with a head coil. The angiographic sequence was acquired in three volumes of 40-45 cm after administration of paramagnetic contrast material. In the patients with peripheral arterial disease, the technique provided a precise evaluation of the stenosis (mild, moderate, severe) or obstruction of the peripheral district as well as the detection of other diseases, such as stenosis of the renal arteries or aneurysms. Total-body three-dimensional (3D) MRA allows a fast, safe, and accurate assessment of the arterial system in patients with arteriosclerosis and can be considered an alternative to DSA in the management of patients with steno-obstructive disease of the peripheral arteries.

  9. HIV-occlusive vascular disease | Van Marle | South African Journal ...

    African Journals Online (AJOL)

    The usual risk factors for atherosclerosis were present, but the incidence was less than reported in the classic atherosclerosis population. More than 90% of the patients presented with advanced stage vascular disease (Fontaine III/IV), which explains the high rate (31.9%) of primary amputation. Eightyseven patients ...

  10. Usefulness of time-resolved projection MRA on evaluation of hemodynamics in cerebral occlusive diseases

    International Nuclear Information System (INIS)

    Oka, Yoshihisa; Kusunoki, Katsusuke; Nochide, Ichiro; Igase, Keiji; Harada, Hironobu; Sadamoto, Kazuhiko; Nagasawa, Kiyoshi

    2001-01-01

    The usefulness for evaluation of cerebral hemodynamics using time-resolved projection MRA was studied in normal volunteers and patients of cerebrovascular diseases. Six normal volunteers and ten patients with cerebrovascular occlusive diseases including 6 of IC occlusion and 4 of post EC/IC bypass surgery underwent time-resolved projection MRA on a 1.5 T clinical MRI system. Projection angiograms are acquired with 2D-fast SPGR sequence with a time resolution of approximately one image per second, 40 images being acquired consecutively before and after bolus injection Gd-DTPA. And all images were calculated by complex subtraction from the background mask in a work station. In normal volunteers, the quality of images of time-resolved projection MRA was satisfactory. The arteries from internal carotid artery through M2 segment of middle cerebral artery and all major venous systems were well portrayed. In 4 cases of IC occlusion who were assessed the collateral flow through the anterior communicating artery and posterior communicating artery, there were delayed to demonstrate the ipsilateral MCA. However, in 2 cases of IC occlusion that were assessed the collateral flow through leptomeningeal anastomosis, ipsilateral MCA and collateral circulation were not demonstrated. In all patients of post EC/IC bypass surgery, the patency of EC/IC bypass could be evaluated as properly with time-resolved projection MRA as 3D-TOF MRA. Although the temporal and spatial resolutions are insufficient, time-resolved projection MRA was power-full non-invasive method to evaluate the cerebral hemodynamics vis the basal communicating arteries in IC occlusion and identify the patency of EC/IC bypass. (author)

  11. Dynamics of von Willebrand factor reactivity in sickle cell disease during vaso-occlusive crisis and steady state

    NARCIS (Netherlands)

    Sins, J. W. R.; Schimmel, M.; Luken, B. M.; Nur, E.; Zeerleder, S. S.; van Tuijn, C. F. J.; Brandjes, D. P. M.; Kopatz, W. F.; Urbanus, R. T.; Meijers, J. C. M.; Biemond, B. J.; Fijnvandraat, K.

    2017-01-01

    Background: Endothelial activation plays a central role in the pathophysiology of vaso-occlusion in sickle cell disease (SCD), facilitating adhesive interactions with circulating blood cells. Upon activation, various adhesive molecules are expressed, including von Willebrand factor (VWF). Increased

  12. Percutaneous transluminal angioplasty and stent placement for iliofemoral arterial atherosclerotic occlusive disease

    International Nuclear Information System (INIS)

    Zheng Yanbo; Jiang Wenjin; Liu Sheng; Song Xuepeng; Sheng Qirui

    2006-01-01

    Objectives: To assess the safety and efficacy of percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of iliofemoral arterial atherosclerotic occlusive diseases. Methods From April 1999 to August 2004, 13 cases of iliofemoral arterial occlusions were recanalized with contact thrombolytic therapy combined with guide wire mechanical recanalization method, followed by angioplasty and stent placement. A total of 25 self-expanding Wallstents were deployed. All patients were followed up by means of duplex ultrasound, angiography, or both. Results: All 13 cases were successfully recanalized, with technical successful rate of 100%. Available follow-up for all patients from 8 months-5 years (mean 26.2 months) included one patient undergoing again with successful contact thrombolysis because of early thrombosis; another patient with recurrent symptoms at 19 month after operation undertaking surgical bypass because of later reocclusion; all of the rest stents showing patency by the end of the study. Conclusions: Contact thrombolysis combined with guide wire mechanical recanalization for iliofemoral arterial occlusion is safe and effective, whereas PTA and stent placement would have the nearly same efficacy for the disease with mild injury and low restenosis. (authors)

  13. Cerebral blood flow reduction in Alzheimer's disease: impact of capillary occlusions on mice and humans

    Science.gov (United States)

    Berg, Maxime; Merlo, Adlan; Peyrounette, Myriam; Doyeux, Vincent; Smith, Amy; Cruz-Hernandez, Jean; Bracko, Oliver; Haft-Javaherian, Mohammad; Nishimura, Nozomi; Schaffer, Chris B.; Davit, Yohan; Quintard, Michel; Lorthois, Sylvie

    2017-11-01

    Alzheimer's disease may be the most common form of dementia, yet a satisfactory diagnosis procedure has still to be found. Recent studies suggest that a significant decrease of cerebral blood flow, probably caused by white blood cells stalling small vessels, may be among the earliest biological markers. To assess this hypothesis we derive a blood flow model, validate it against in vitro controlled experiments and in vivo measurements made on mice. We then investigate the influence of capillary occlusions on regional perfusion (sum of all arteriole flowrates feeding the network) of large mice and humans anatomical networks. Consistent with experiments, we observe no threshold effect, so that even a small percentage of occlusions (2-4%) leads to significant blood flow decrease (5-12%). We show that both species share the same linear dependance, suggesting possible translation from mice to human. ERC BrainMicroFlow GA61510, CALMIP HPC (Grant 2017-1541).

  14. Mitomycin-Induced Pulmonary Veno-Occlusive Disease: Evidence From Human Disease and Animal Models.

    Science.gov (United States)

    Perros, Frédéric; Günther, Sven; Ranchoux, Benoit; Godinas, Laurent; Antigny, Fabrice; Chaumais, Marie-Camille; Dorfmüller, Peter; Hautefort, Aurélie; Raymond, Nicolas; Savale, Laurent; Jaïs, Xavier; Girerd, Barbara; Cottin, Vincent; Sitbon, Olivier; Simonneau, Gerald; Humbert, Marc; Montani, David

    2015-09-01

    Pulmonary veno-occlusive disease (PVOD) is an uncommon form of pulmonary hypertension characterized by the obstruction of small pulmonary veins and a dismal prognosis. PVOD may be sporadic or heritable because of biallelic mutations of the EIF2AK4 gene coding for GCN2. Isolated case reports suggest that chemotherapy may be a risk factor for PVOD. We reported on the clinical, functional, and hemodynamic characteristics and outcomes of 7 cases of PVOD induced by mitomycin-C (MMC) therapy from the French Pulmonary Hypertension Registry. All patients displayed squamous anal cancer and were treated with MMC alone or MMC plus 5-fluoruracil. The estimated annual incidence of PVOD in the French population that have anal cancer is 3.9 of 1000 patients, which is much higher than the incidence of PVOD in the general population (0.5/million per year). In rats, intraperitoneal administration of MMC induced PVOD, as demonstrated by pulmonary hypertension at right-heart catheterization at days 21 to 35 and major remodeling of small pulmonary veins associated with foci of intense microvascular endothelial-cell proliferation of the capillary bed. In rats, MMC administration was associated with dose-dependent depletion of pulmonary GCN2 content and decreased smad1/5/8 signaling. Amifostine prevented the development of MMC-induced PVOD in rats. MMC therapy is a potent inducer of PVOD in humans and rats. Amifostine prevents MMC-induced PVOD in rats and should be tested as a preventive therapy for MMC-induced PVOD in humans. MMC-induced PVOD in rats represents a unique model to test novel therapies in this devastating orphan disease. © 2015 American Heart Association, Inc.

  15. Percutaneous Management of Occlusive Arterial Disease Associated with Vasculitis: A Single Center Experience

    International Nuclear Information System (INIS)

    Both, M.; Jahnke, T.; Reinhold-Keller, E.; Reuter, M.; Grimm, J.; Biederer, J.; Brossmann, J.; Gross, W.L.; Heller, M.; Mueller-Huelsbeck, S.

    2003-01-01

    The purpose of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty for occlusive arterial disease associated with vasculitis. Eleven patients(10 women, 1 man; ages 35-82 years) with the diagnosis of vasculitis of the large vessels underwent interventional treatment during intraarterial angiography. The causes included giant cell arteritis(n = 8) and Takayasu arteritis (n = 3).Thirty-three occlusive lesions (including brachiocephalic and renalarteries, and arteries of upper and lower extremities) were treated with balloon angioplasty and/or stent placement. Follow-up included clinical examination, angiography, and color duplex ultrasound.Technical success was 100% (25/25) for stenoses and 50% (4/8) for occlusive lesions, representing all lesions combined from different anatomic locations. Dissection (n = 3) and arterial rupture with retroperitoneal hematoma (n = 1) was found in three patients. During follow-up (mean 12 months), restenoses(n = 8) and re-restenoses (n = 1)occurred in 8 vascular areas. Three of these lesions were treated with repeated PTA (n = 4). The cumulative primary clinical success rate was 67.6%, cumulative secondary success rate 74.4%, and cumulative tertiary success rate 75.9%. Interventional therapy in systemic vasculitis provides promising results in technical success rates and followup. Angioplasty may result in arterial injury, but the rate of complications is low

  16. Delayed Diagnosis in an Elderly Patient With Atypical Presentation of Peripheral Artery Occlusion Disease

    Directory of Open Access Journals (Sweden)

    Yu-Ya Tseng

    2011-03-01

    Full Text Available Peripheral artery occlusion disease (PAOD is a clinical disorder with occlusion in the arteries of the limbs. PAOD is common but frequently overlooked because of subtle physical findings and a lack of classic symptoms, especially in the elderly. A 67-year-old female arrived at the emergency department with unconsciousness and progressive left lower leg cyanotic change. Her history revealed that she had felt severe left calf pain with foot numbness 3 weeks earlier. She visited a neurology clinic then, and only an analgesic was prescribed. At the emergency department, her left lower leg had cyanotic change with dry gangrene over the toes and a pulseless left dorsalis pedis artery was found. Septic shock with respiratory failure occurred, and intubation with fluid resuscitation was performed. However, emergent surgery was not arranged because of her unstable physical condition. After several days of antibiotics use, the sepsis persisted. Peripheral vessel ultrasonography revealed total artery occlusion in the left popliteal artery, and, consequently, above-the-knee amputation was performed. She then recovered smoothly and was discharged. We therefore report a case of PAOD that, through a delayed finding by clinicians, led to life-threatening infection and limb amputation.

  17. Classification of peripheral occlusive arterial diseases based on symptoms, signs and distal blood pressure measurements

    DEFF Research Database (Denmark)

    Tønnesen, K H; Noer, Ivan; Paaske, William

    1980-01-01

    mmHg, half had arterial lesions proximal to the groin. None had diabetes. Fourteen per cent non-diabetic patients had chronic ulcerations on the foot with arterial lesions similar to those in patients with rest pain. Eleven per cent diabetic patients with chronic ulcerations had less pronounced...... occlusive arterial disease which was located distally on the legs. A classification in three groups is suggested: (1) ischemia only during exercise; (2) ischemia at rest with or without ulcerations: and (3) diabetics with chronic ulcerations....

  18. Vibration sense and sympathetic vasoconstrictor activity in patients with occlusive arterial disease

    DEFF Research Database (Denmark)

    Bjerre-Jepsen, K; Henriksen, O; Parm, Martin Lehnsbo

    1983-01-01

    The function of sympathetic vasoconstrictor fibres was studied in 18 patients with occlusive arterial disease of the legs and somatic neuropathy, as evidenced as an increased vibration perception threshold. Nine patients suffered from long-term diabetes mellitus. Sympathetic vasoconstrictor...... of vibration sense, abnormal vasoconstrictor function was found. In three of these patients, the abnormal response most likely could be ascribed to impaired function of the vascular smooth muscle cells. Neither in diabetics nor in non-diabetics could an abnormal vibration sense be taken as evidence for loss...... of sympathetic vasoconstrictor function. It is suggested that this is studied by a simple postural test as used in the present study....

  19. Basilar artery occlusive disease in stroke survivors in a multiethnic population.

    Science.gov (United States)

    Ciríaco, Jovana Gobbi Marchesi; Leite, Claudia da Costa; dMartin, Maria a Graça Morais; Barros, Cristiano Venturim; Puglia, Paulo; Caldas, José Guilherme Pereira; Scaff, Milberto; Conforto, Adriana Bastos

    2010-04-01

    To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC). Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or occlusion was shown by magnetic resonance or digital subtraction angiography in all patients. Demographical, clinical and radiological characteristics were described. Modified Rankin Scale (MRS) scores at 30 days and 6 months after the ischemic event were evaluated. Association between demographical, clinical, radiological features and outcome were analyzed with Chi-square and Fisher's exact tests. MRS scores at 30 days and 6 months were compared with the Wilcoxon test. Sixty percent of the patients were men, and 33% were Afro-Brazilian. Mean age was 55.8+/-12.9 years. Most (90%) had multiple vascular risk factors. Stroke was preceded by TIA in 48% of the patients, and 80% had a history of arterial hypertension. The most common neurological symptom was vertigo/dizziness (60%) and the sign, hemiparesis (60%). Most of the infarcts were located in the pons (85%) and the BA middle third was the most frequently affected segment (33%). BA occlusion occurred in 58% of the patients. More severe vascular occlusive lesions were present in Whites (p=0.002) and in patients with involvement of the middle third of the BA (p=0.021). Large-artery atherosclerosis was the most common stroke etiology (88%) and was more frequent in older patients (p<0.001). Most patients were treated with anticoagulation. MRS scores improved significantly at 6 months (p<0.001); at this time, 78% of the patients had MRS scores between 0 and 2. We observed different results compared with other series: greater proportion of Afro-descendents, higher frequency of atherosclerosis and BA occlusion. Rates of preceding TIAs and good outcome at 6 months were similar to previously published data. These results represent

  20. Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

    Science.gov (United States)

    Patel, Shivam; Usmani, Abdullah Y.; Muralidhar, K.

    2017-06-01

    Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q-function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m-2 and is lowered to the range ±0.2 N m-2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-03-01

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

  2. Impact of a rehabilitation program on muscular strength and endurance in peripheral arterial occlusive disease patients.

    Science.gov (United States)

    Cousin, A; Popielarz, S; Wieczorek, V; Tiffreau, V; Mounier-Vehier, C; Thevenon, A

    2011-10-01

    Rehabilitation care and physical exercise are known to constitute an effective treatment for chronic peripheral arterial occlusive disease (PAOD) at the intermittent claudication (IC) stage. Improvements in functional capacities and quality of life have been reported in the literature. We decided to assess the effects of hospital-based exercise training on muscle strength and endurance for the ankle plantar and dorsal flexors in this pathology. This prospective study included 31 subjects with chronic peripheral arterial occlusive disease (PAOD) and IC who followed a 4-week rehabilitation program featuring walking sessions, selective muscle strengthening, general physical exercise and therapeutic patient education. An isokinetic assessment of ankle plantar and dorsal flexors strength was conducted on the first and last days of the program. We also studied the concentric contractions at the angular velocity of 30°/s and 120°/s for muscle strength and at 180°/s for muscle fatigue. We also measured the walking distance for each patient. Walking distance improved by 246%. At baseline, the isokinetic assessment revealed severe muscle weakness (mainly of the plantar flexors). The only isokinetic parameter that improved during the rehabilitation program was the peak torque for plantar flexors at 120°/s. All patients presented with severe weakness and fatigability of the ankle plantar and dorsal flexors. Our program dramatically improved walking distance but not muscle strength and endurance. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  3. Assessment of Occlusal Function in a Patient with an Angle Class I Spaced Dental Arch with Periodontal Disease Using a Brux Checker

    Directory of Open Access Journals (Sweden)

    Ayako Taira

    2018-01-01

    Full Text Available Comprehensive and appropriate occlusion reconstruction therapy is necessary for orthodontic treatment of adult patients with malocclusion with periodontal disease associated with occlusal trauma. We report the case of a patient with extensive moderate chronic periodontitis associated with occlusal trauma. The patient was diagnosed with extensive moderate chronic periodontitis associated with occlusal trauma and underwent thorough treatment for periodontal disease, oral management, and 20 months of orthodontic therapy. Moreover, reconstructed occlusion was performed to evaluate occlusal trauma for visualization using Brux Checker (BC analysis before and after active orthodontic treatment. The patient acquired stable anterior guidance and a functional occlusal relationship. BC findings revealed weakening of the functional contact between the lateral occlusal force of the dentition and the front teeth and alveolar bone regeneration. The laminar dura became clearer, and the periodontal tissue improved. Our results suggest that assessment of occlusion function using BC analysis and periodontal examination was effective in enabling occlusal treatment goal clarification through orthodontic treatment in case of periodontal disease associated with occlusal trauma.

  4. Computed tomography findings of hepatic veno-occlusive disease caused by Sedum aizoon with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Shao, H.; Chen, H. Z., E-mail: chenhz@enzemed.com; Zhu, J. S. [Department of Infectious Diseases, Taizhou Hospital Affiliated to Wenzhou Medical College, Linhai (China); Ruan, B. [State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (China); Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou (China); Zhang, Z. Q. [Department of Infectious Disease, Xianju Hospital of Traditional Chinese Medicine, Xianju (China); Lin, X.; Gan, M. F. [Department of Infectious Diseases, Taizhou Hospital Affiliated to Wenzhou Medical College, Linhai (China)

    2015-11-23

    This study investigated the value of computed tomography (CT) in the diagnosis and treatment of hepatic veno-occlusive disease (HVOD) caused by Sedum aizoon (SA). The clinical manifestations, treatment results, imaging findings, and histological findings of the liver were analyzed in 39 patients with HVOD caused by SA. Hepatomegaly, liver dysfunction, abdominal effusion, and geographic density changes on liver CT scans were found in all 39 patients. The pathological findings of histological liver examination included swelling and point-like necrosis of liver cells, significant expansion and congestion of the sinuses, endothelial swelling, and wall thickening with incomplete lumen occlusion of small liver vessels. CT geographic density changes were confirmed by histological examination of the liver in 18 patients. Sixteen patients with small amounts of ascites that started within 4 weeks of treatment recovered completely or significantly improved after symptomatic and supportive treatment. However, only 43.75% of the patients with larger amounts of ascites improved following symptomatic and supportive treatment. In conclusion, liver CT examination is a valuable, safe, and noninvasive tool for the diagnosis of HVOD caused by SA. In selected cases, liver CT examination may replace liver biopsy and histological analysis.

  5. Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

    Directory of Open Access Journals (Sweden)

    Annie M Bérard

    Full Text Available BACKGROUND: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups. METHODS AND RESULTS: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old presenting either a peripheral arterial occlusive disease (N = 64 or a thromboangiitis obliterans (N = 49, and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin and zinc. Premature peripheral arterial occlusive disease was characterized by the presence of a family history of peripheral arterial and carotid artery diseases (OR 2.3 and 5.8 respectively, 95% CI, high lipoprotein (a levels above 300 mg/L (OR 2.3, 95% CI, the presence of the factor V Leiden (OR 5.1, 95% CI and the glycoprotein Ia(807T,837T,873A allele (OR 2.3, 95% CI. In thromboangiitis obliterans group, more patients were regular consumers of cannabis (OR 3.5, 95% CI and higher levels in plasma copper has been shown (OR 6.5, 95% CI. CONCLUSIONS: According to our results from a non exhaustive list of study parameters, we might hypothesize for 1 a genetic basis for premature peripheral arterial occlusive disease development and 2 the prevalence of environmental factors in the development of thromboangiitis obliterans (tobacco and cannabis. Moreover, for the first time, we demonstrated that the 807T/837T/873A allele of platelet glycoprotein Ia may confer an additional risk for development of peripheral

  6. Large deep infarcts found in proximal middle cerebral artery steno-occlusive disease: MRI and angiographic findings

    International Nuclear Information System (INIS)

    Yi, Bum Ha; Kim, Eui Jong; Choi, Woo Suk; Jang, Dae Il; Chung, Kyung Cheon; Oh, Joo Hyung; Yoon, Yup; Hong, Hoon Pyo

    1998-01-01

    To determine the nature of large deep-seated infarcts without cortical infarct in patients with steno-occlusive disease of the proximal middle cerebral artery (MCA) using magnetic resonance images (MRI) and angiography. By means of MRI and MR angiography (MRA), we examined 24 patients with large deep cerebral infarctions (>3cm in size) involving the basal ganglia, corona radiata and/or centrum semiovale, as well as steno-occlusive lesion of the proximal MCA. According to location, infarctions were classified into five groups, as follows:Group 1:basal ganlgia and corona radiata; 2:basal ganglia, corona radiata and centrum semiovale;3:corona radiata and centrum semiovale;4:corona radiata;5:basal ganglia only. We evaluated the topography of the lesions and correlated the results with the findings of angiography (all 24 MRA;the 13:conventional angiography). Involvement of the head of the caudate nucleus and the internal capsule were also evaluated. Fifteen of 24 cases (63%) were assigned to group 1 (4 proximal MCA(M1) occlusion and 11 stenosis), and five of 24 (21%) with M1 occlusions to group 2. Group 3 comprised only one case with M1 occlusion. Two cases with both occlusion and stenosis were included in group 4, and only one case-with M1 stenosis-in group 5. Infarctions at the caudate nucleus were seen in five cases, and at the internal capsule in two. On conventional angiography (13 cases) cortical branches of the MCA were delineated through the leptomeningeal collaterals of anterior or posterior cerebral arteries. Most large deep cerebral infarctions found in proximal MCA diseases are thought to extend cephalad to the corona radiata. When large deep-seated infarctions with proximal MCA occlusion is observed more frequently than stenosis.=20

  7. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...... (SPPH) as measured with a photocell. Thirty-two patients (35 feet with ulcerations) had diabetes mellitus. The treatment was conservative. In 42 feet the ulcers healed after an average period of 5.8 months; in 24 feet major amputation became necessary after an average of 4.3 months. The frequency...... of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two...

  8. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...... of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two...... and peripheral neuropathy were frequent in the diabetic group. The data show that the systolic digital blood pressure is a particularly valuable prognostic parameter....

  9. Pulmonary veno-occlusive disease: advances in clinical management and treatments.

    Science.gov (United States)

    Huertas, Alice; Girerd, Barbara; Dorfmuller, Peter; O'Callaghan, Dermot; Humbert, Marc; Montani, David

    2011-04-01

    Pulmonary veno-occlusive disease (PVOD) is a rare disorder that can be misdiagnosed as idiopathic pulmonary arterial hypertension (PAH) and accounts for 5-10% of cases initially considered as idiopathic PAH. PVOD and idiopathic PAH share a similar clinical presentation, genetic background and hemodynamic profile. A definite diagnosis of PVOD necessitates a surgical biopsy, but since it represents a high-risk procedure in these patients, it is contraindicated. Therefore, a noninvasive diagnostic approach using chest high-resolution computed tomography, arterial blood gas analysis, pulmonary function tests and bronchoalveolar lavage is helpful to detect PVOD. PVOD is characterized by a poor prognosis and the possibility of developing severe pulmonary edema with specific PAH therapy. Lung transplantation remains the treatment of choice.

  10. Percutaneous transluminal angioplasty of chronic arterial occlusive disease below the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Woong; Kim, Jae Kyu; Park, Soo Min; Kim, Yun Hyeon; Kang, Heoung Keun [Chonnam Univ. Medical School, Kwangju (Korea, Republic of)

    1996-01-01

    The purpose of this study was to determine the safety and efficacy of the percutaneous transluminal angioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged 57-75 years(mean, 62 years). Indications were disabling claudication (SVS/ISCVS grade 1, category 3) in five cases, rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade3, category 5) in eight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheter in tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combined thrombolytic therapy with Urokinase was performed in 14 patients. Involved infrapopliteal vessels were four distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibial arteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than 30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearance of claudication or rest pain, and healing of ulcereation. Technical success was achieved in 30 of 36 arteries(83%). Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46 months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and 63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vessel thrombosis, and one occluding intimal flap. PTA was an effective method for treatment of chronic arterial occlusive disease below the knee joint and considered as the procedure of first choice. Severe claudicant(grade1) should be included in the indication of the tibioperoneal PTA.

  11. Pharmacotherapeutical strategies in the prevention of acute, vaso-occlusive pain in sickle cell disease: a systematic review

    NARCIS (Netherlands)

    Sins, Joep W. R.; Mager, David J.; Davis, Shyrin C. A. T.; Biemond, Bart J.; Fijnvandraat, Karin

    2017-01-01

    Sickle-cell disease (SCD) is characterized by frequent and painful vaso-occlusive crises (VOCs). Various treatments have been evaluated over the years. However, a clear overview is lacking. The objective of this study was to systematically review all pharmacotherapeutical strategies in the

  12. Dynamics of von Willebrand factor reactivity in sickle cell disease during vaso-occlusive crisis and steady state

    NARCIS (Netherlands)

    Sins, J. W.R.; Schimmel, Marein; Luken, Brenda M.; Nur, Erfan; Zeerleder, S.; van Tuijn, Charlotte F. J.; Brandjes, Dees P. M.; Kopatz, W. F.; Urbanus, R. T.; Meijers, Joost C. M.; Biemond, B. J.; Fijnvandraat, K.

    2017-01-01

    Essentials The role of von Willebrand Factor (VWF) in the pathophysiology of sickle cell disease is unclear. We assessed markers of VWF during admission for vaso-occlusive crisis (VOC) and steady state. VWF reactivity was higher during VOC and was associated with inflammation and neutrophil

  13. Altered low frequency oscillations of cortical vessels in patients with cerebrovascular occlusive disease – a NIRS study

    DEFF Research Database (Denmark)

    Phillip, Dorte; Iversen, Helle K; Schytz, Henrik W

    2013-01-01

    patients with both symptomatic carotid occlusive disease and cerebral hypoperfusion in comparison to healthy controls. Each hemisphere was examined with two NIRS channels using a 3 cm source detector distance. Arterial blood pressure (ABP) was measured via a finger plethysmograph. Using transfer function...

  14. Comparative diagnosis of venous occlusive diseases of lower extremity through multi-slice CT angiography and DSA

    International Nuclear Information System (INIS)

    Wu Gang; Gu Jianping; Wang Shuzhi; Yin Xinxao; Lu Lingquan

    2008-01-01

    Objective: To assess the clinical application value of multi-slice CT angiography(MSCTA) in the diagnosis of venous occlusive diseases of lower extremity. Methods: Thirty-two suspected patients with venous occlusive diseases of lower extremity underwent 16-slice MSCTA and DSA simultaneously. The MSCTA technique and its diagnostic value were analyzed with clinical data. Results: Thirty-two cases of suspected lower extremity venous occlusive diseases were diagnosed by MSCTA, including 19 cases of iliac vein compression syndrome (left iliac vein in 16 cases, right iliac vein 3 cases). Nine cases of deep vein thrombosis (2 on left side, 5 on right and another 2 bilaterally). The left external iliac vein was compressed by a cyst in left inguinal region in one case and another case showed simple varicosis of superficial veins of the left lower limb. The results were similar demonstrated by DSA and MSCTA in above thirty cases. The right femoral and popliteal venous dilatations were diagnosed by MSCTA in one case and no abnormality in the other. The two cases were found to be valvular functional defect of deep veins of lower limb by DSA. Conclusion: MSCTA possesses rather high application value in the diagnosis of venous occlusive diseases of lower extremity. (authors)

  15. Occlusal fissures of the equine cheek tooth: prevalence, location and association with disease in 91 horses referred for dental investigation.

    Science.gov (United States)

    Ramzan, P H L; Palmer, L

    2010-03-01

    Fissures of the occlusal surface of the equine cheek tooth are poorly understood and their association with dental disease is unknown. To describe the prevalence and location of occlusal fissures in the cheek teeth (CT) of a group of horses referred for dental investigation/treatment, and determine association with intercurrent dental disease. Digital video recordings of oral endoscopic examinations for all horses referred to the Rossdales Equine Hospital for dental investigation from November 2006 to June 2009 were reviewed. Location of occlusal fissures in relation to both Triadan tooth position and pulpar secondary dentine was recorded; direction of fissure and concurrent involvement of enamel was also documented. The CT location considered at the time of examination to be the primary site/s of disease was correlated with presence of fissures on these teeth. 91 cases meeting the inclusion criteria were identified. Occlusal fissures were documented in 58.2% (53/91) cases, with a total of 227 CT being affected. Fissures were most prevalent mid-arcade. The majority (92.1%) of fissures in maxillary CT were associated with the caudal palatal pulp horn. Fissures in mandibular CT were predominantly associated with the buccal pulp horns (95.7%). There was no significant difference in the median number of CT with fissures in relation to gender. There was no correlation between age (r(2)= 0.01) of horse and number of CT with fissures. A significantly greater number of CT with multiple occlusal fissures was found in mandibular compared to maxillary arcades. No correlation was found between presence of fissures and location of individual CT considered to be primarily responsible for presentation. Occlusal fissures in this group of animals were common and not correlated to primary site of dental disease. In horses subjected to dental investigation, occlusal fissures of the cheek teeth should not be considered an indicator of tooth compromise. Location and direction of

  16. Resting and hypercapnic rCBF in patients with unilateral occlusive disease of the internal carotid artery

    International Nuclear Information System (INIS)

    Keyeux, A.; Laterre, C.; Beckers, C.

    1988-01-01

    Regional cerebral blood flow was measured by the 133 Xe inhalation technique in 15 patients with severe unilateral internal carotid artery stenosis (75%) or occlusion, and in the absence of evidence of any sign of occlusive disease in other main afferent cerebral arteries. A comparison with normal subjects showed that lowered resting flow in both hemispheres was a common finding in all patients. Interhemispheric asymmetry was present only in patients with occlusion and the precentral, posterior temporal, and occipital regions were the most seriously affected. The CO 2 reactivity was substantially reduced in both hemispheres of all stenotic and occluded patients, but occluded patients showed an increased reduction of CO 2 reactivity only in the ipsilateral hemisphere. In addition to an hypothetical age effect, the atherosclerotic involvement of the cerebral vascular system leads to a reduction of flow and loss of CO 2 reactivity in both hemispheres. In this context, the collateral supply capacity is not overloaded in case of a unilateral severe stenosis but fails in case of a unilateral occlusion of the internal carotid artery. A suitable estimate of the blood flow reduction as a result of occlusion is made by the hemispheric and regional laterality indices applied in resting and hypercapnia conditions. These indices could be used as indicators for endarterectomy or bypass surgery as well as a sensitive means for appreciating cerebral blood flow response to treatment

  17. Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

    International Nuclear Information System (INIS)

    Amarteifio, E.; Wormsbecher, S.; Krix, M.; Demirel, S.; Braun, S.; Delorme, S.; Böckler, D.; Kauczor, H.-U.; Weber, M.-A.

    2012-01-01

    Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time–CEUS–intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t max ), slope to maximum (m), vascular response after occlusion (AUC post ), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p max was delayed (31.2 ± 13.6 vs. 16.7 ± 8.5 s, p post as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

  18. Cytotoxic cells and granulysin in pulmonary arterial hypertension and pulmonary veno-occlusive disease.

    Science.gov (United States)

    Perros, Frédéric; Cohen-Kaminsky, Sylvia; Gambaryan, Natalia; Girerd, Barbara; Raymond, Nicolas; Klingelschmitt, Isabelle; Huertas, Alice; Mercier, Olaf; Fadel, Elie; Simonneau, Gerald; Humbert, Marc; Dorfmüller, Peter; Montani, David

    2013-01-15

    Pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease (PVOD) both display occlusive remodeling of the pulmonary vasculature responsible for increased pulmonary vascular resistances. Cytotoxic T (CTL), natural killer (NK), and natural killer T (NKT) cells play a critical role in vascular remodeling in different physiological and pathological conditions. Granulysin (GNLY) represents a powerful effector protein for all these subpopulations. To analyze the cytolytic compartment of inflammatory cells in patients with PAH and PVOD. The overall functional status of the cytolytic compartment was studied through epigenetic analysis of the GNLY gene in explanted lungs and in peripheral blood mononuclear cells. Flow cytometry technology allowed analysis of specific circulating cytolytic cells and GNLY contents. A GNLY-specific ELISA allowed measurement of GNLY serum concentrations. A decrease in GNLY demethylation in the gDNA extracted from peripheral blood mononuclear cells and explanted lungs was found specifically in PVOD but not in PAH. This was associated with a decrease in populations and subpopulations of CTL and NKT and an increase of NK populations. Despite the reduced granulysin-containing cells in patients with PVOD, GNLY serum levels were higher, suggesting these cells were wasting their content. Furthermore, the increase of GNLY concentration in the serum of PVOD was significantly higher than in patients with PAH. PVOD is characterized by alterations of circulating cytotoxic cell subpopulations and by epigenetic dysregulation within the GNLY gene. Our findings may be helpful in the quest to develop needed diagnostic tools, including flow cytometry analyses, to screen for suspected PVOD in patients with pulmonary hypertension.

  19. Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

    International Nuclear Information System (INIS)

    Saito, Yuko

    1982-01-01

    CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the teritorry of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appeares inside of the teritorry of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area. (J.P.N.)

  20. Prevalence of Dental Occlusal Patterns and Their Association with Obstractive Upper Airway Diseases in Primary School Children, Isfahan, Iran

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    SM Sonbolestan

    2005-11-01

    Full Text Available Background: Teeth, apart from their physiologic function, play an important role in general appearance of indivduals. Therefore any disorder in their growth and evolution, will cause psychologic, social and even economic problems for the person. This observational cross- sectional study aimed to investigate relationship between dental occlusal patterns and obstructive nasal-upper airway- diseases. Methods: This study was perfromed in schools of No.4 Education at district of Isfahan in educational year 1381-82 between 607 students (277 male, 330 female aged 9-12 years old. Results of accurate ENT and dentistry physical examination were registered and analyzed using SPSS software and Chi-square and Mantel - Hanzel test. Results: With increasing age, The frequency of abnormal occlusal patterns increases (from 45.5% to 68.2% in males and 25.8% to 48.5% in females, p=0.015. The increasing in degree of palatal tonsilar hypertrophy was related to higher frequency of abnormal occlusal patterns (36.7% in +1 tonsilar hypertrophy, and 70% in +4 tonsilar hypertrophy, p=0.02. Also, history of frequent common colds, and history of previous nasal fractures were related with abnormal patterns [58.9% (p=0.032, and 83.4% (p= 0.043%, respectively].Five other parameters including sinusitis, hypertrophy of nasal turbinates, rhinitis, nasal polyposis and nasal septal deviation were not associated with abnormal occlusal patterns (p>0.1. Conclusion: Some of obstructive upper airwacy diseases are related with abnormal dental occlusal patterns. These parameters can be simply diagnosed, treated or prevented. Key words: dental occlusion, malocclusion, obstructive nasal disorders, nasal turbinates, adenoid, rhinitis, tonsillectomy, open mouth breathing

  1. Surgical treatment of chronic occlusive in peripheral arteries (Review of 100 cases

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    H. AHRARI

    1977-01-01

    Full Text Available The purpose of this article is to diseuse the philosophy of our approch to the severely ischemic extremity and ourcurrent methods of treatment. 1 - The natural history of artheriosclerotic arterial obstruction should always be borne in mind. There is no doubt that many people have some degree of arterial stenosis or obstrcction and never suffer symptoms, either because of the reduced demand due to senility or because they are prepared to tolerate minor inconveniences which do not significantly interfere with their lives or livelihood. It should also be remembered that a proportion of patients with claudication improve spontaneously ever a time scale extending to many months or years. Taylor and Cale (1962, in a long term follow up of patients with untreated intermittent claudication, found spontaneous relief of symptoms in 39 per cent of the cases, no change in 45% and 16% worsening. Because of this it is impossible to lay down precise rules concerning the treatment of patients with intermittent claudication. It would be wrong to advise major arterial surgery in an elderly patient with extensive main' vessel disease and relatively mild claudication, and equally wrong to deny surgical treatment to an active younger patient with a we 11 localized arterial lesion. It is superfuous to add that anyhow, the surgery must not make the patient worse. 2- In a survey of a decade of experience, the arterioplastie treatment of occlusive disease seems to fall int three groups based on the anatomic distribution of the lesion. (Ref, 13. A - These in whom the obstructive disease is limited to the aortoiliac segments of the arterial tree supplying the leg. B - Those with both aort-iliao and femoral arterial disease. C - These with only femoropopliteal or proximal part of the popliteal arteries. Results in both the aorto-iliac and femoral arterial disease operations were in general satisfactory. The good early results of aorto-iliac operations showed only a

  2. Percutaneous intervention for infrainguinal occlusive disease in women: equivalent outcomes despite increased severity of disease compared with men.

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    DeRubertis, Brian G; Vouyouka, Angela; Rhee, Soo J; Califano, Joseph; Karwowski, John; Angle, Niren; Faries, Peter L; Kent, K Craig

    2008-07-01

    Experience with open surgical bypass suggests similar overall outcomes in women compared with men, but significantly increased risk of wound complications. Percutaneous treatment of lower extremity occlusive disease is therefore an attractive alternative in women, although it is not clear whether there is a difference in outcomes between women and men treated with this technique. We sought to determine the results and predictors of failure in women treated by percutaneous intervention. Percutaneous infrainguinal revascularization was performed on 309 women between 2001 and 2006. Procedures, complications, demographics, comorbidities, and follow-up data were entered into a prospective database for review. Patency was assessed primarily by duplex ultrasonography. Outcomes were expressed by Kaplan-Meier curves and compared by log-rank analysis. A total of 447 percutaneous interventions performed in 309 women were analyzed and compared with 553 interventions in men. Mean age in women was 73.2 years; comorbidities included hypertension (HTN) (86%), diabetes melitus (DM) (58%), chronic renal insufficiency (CRI) (15%), hemodialysis (7%), hypercholesterolemia (52%), coronary artery disease (CAD) (42%), and tobacco use (47%). Indications in women included claudication (38.0%), rest pain (18.8%), and tissue loss (43.2%). Overall primary & secondary patency and limb-salvage rates for women were 38% +/- 4%, 66% +/- 3%, and 80% +/- 4% at 24 months. In this patient sample, women were significantly more likely than men to present with limb-threatening ischemia (61.6% vs 47.3%, P diabetes, and advanced TASC severity lesions were at increased risk of failure overall, there were no differences between women and men with these characteristics. Percutaneous infrainguinal revascularization is a very effective modality in women with lower extremity occlusive disease. Although women in this sample were more likely to present with limb-threat than men, patency and limb-salvage rates were

  3. Biomarkers of inflammation may be of use for identification of more severe peripheral arterial occlusive disease

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    Luciana Garofolo

    2014-09-01

    Full Text Available Background:Atherosclerosis is a multifactorial disease with an inflammatory pathophysiological basis. Cytokines released during the atherosclerotic process induce production of C-reactive protein (CRP in the liver, which is an important marker of inflammation.Objective:We tested whether inflammatory biomarkers were associated with deterioration of peripheral arterial occlusive disease (PAOD in a population at high cardiovascular risk.Methods:1,330 subjects ≥30 years of age underwent clinical and laboratory examinations as part of a population-based study of the prevalence of diabetes. PAOD was defined as an ankle-brachial index (ABI ≤0.90. After application of exclusion criteria, the sample comprised 1,038 subjects. Traditional risk factors, CRP and interleukin 6 (IL-6 were also compared across three ABI categories (≤0.70; 0.71-0.90; ≥0.90. Mean values for these variables were compared by presence/absence of DAOP (Student's t test and by ABI categories (ANOVA. Poisson regression and logistic regression models were used to test for associations between risk factors and DAOP and between risk factors and the ABI categories. Pearson's linear correlation coefficients were calculated for the relationship between CRP and IL-6 levels.Results:Mean age was 56.8±12.9 years, 54% of the sample were women and the prevalence of DAOP was 21.0% (95%CI 18.4-24.1. Individuals with ABI ≤0.70 had higher concentrations of CRP-us (2.1 vs. 1.8 and of IL-6 (1.25 vs. 1.17. Concentrations of CRP and IL-6 were only correlated in patients with DAOP, (p=0.004.Conclusions:The finding that CRP and IL-6 levels were only elevated among people with advanced DAOP may suggest that these biomarkers have a role to play as indicators of more severe disease. Prospective studies are needed to test this hypothesis.

  4. Gender-related differences in critical limb ischemia due to peripheral arterial occlusive disease

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    Vanessa Prado dos Santos

    2013-12-01

    Full Text Available BACKGROUND: Mortality from cardiovascular disease has declined among men and increased among North American women. Recent studies have revealed differences between genders in the epidemiology of atherosclerotic disease. OBJECTIVE: To study possible differences between male and female patients with critical limb ischemia (CLI according to risk factors of atherosclerosis and clinical characteristics of lower limbs with peripheral arterial occlusive disease (PAOD. METHODS: The study included 171 male and female patients treated for CLI due to infrainguinal PAOD and compared clinical characteristics (Rutherford category and PAOD territory, risk factors for atherosclerosis (diabetes, age, smoking and hypertension and number of opacified arteries on digital angiograms of the leg. The EPI-INFO software was used for statistical analysis, and the level of significance was set at p<0.05. RESULTS: Mean age was 70 years, and 88 patients were men (52%. For most patients (both genders, Rutherford category was 5 (82 % of men and 70% of women; p=0.16. The group of women had higher mean age (73 vs. 67 years; p=0.0002 and greater prevalence of diabetes (66% vs. 45%; p=0.003 and hypertension (90% vs. 56%; p=0.0000001. Among men, the prevalence of smoking was higher (76% vs. 53%; p=0.0008. The analysis of digital angiograms revealed that opacification of only one artery in the leg was found for 74% of women (vs. 50% of men. CONCLUSION: The prevalence of risk factors for atherosclerosis and the characteristics of PAOD are different between male and female patients with CLI.

  5. CT imaging of hepatic veno-occlusive disease (an analysis 14 cases)

    International Nuclear Information System (INIS)

    Zhang Guohua; Kong Azhao; Fang Junwei; Chen Yuejing; Zheng Weiliang; Dong Danjun; Zhang Shizheng

    2006-01-01

    Objective: To probe imaging characteristics of the hepatic veno-occlusive disease (VOD) based on clinical features and abdomen CT findings. Methods: Fourteen patients including 6 male and 8 female aged from 41 to 73 years were enrolled in this study. They all had previous trauma history and notoginseng was given as herbal remedy. Dynamic enhanced CT and color Dopplor ultrasound examinations were routinely used. Two of them received venous angiography and four cases were pathologically proved as VOD after CT guided needle biopsy. Results: Hepatic swelling and ascites were found on plain CT scan. Diffuse patchy areas without enhancement indicative of poorly hepatic perfusion were found. Hepatic veins were compressed and became thin, and inferior vena cava was flat and narrow without distal dilation or collateral circulation. No obstruction of hepatic veins and inferior vena cava was found on ultrasound and venography. Conclusion: Dynamic enhanced CT is highly valuable for early assessing VOD and imaging features of venous hepatic congestion found on CT was strongly suggestive of VOD if there's previous history of treatment of gynura segetum. (authors)

  6. Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data.

    Science.gov (United States)

    Liou, Li-Syue; Chang, Chih-Ya; Chen, Hsuan-Ju; Tseng, Chun-Hung; Chen, Cheng-Yu; Sung, Fung-Chang

    2017-01-01

    This population-based cohort study investigated the risk of developing peripheral arterial occlusive disease (PAOD) in patients with Bell's palsy. We used longitudinal claims data of health insurance of Taiwan to identify 5,152 patients with Bell's palsy newly diagnosed in 2000-2010 and a control cohort of 20,608 patients without Bell's palsy matched by propensity score. Incidence and hazard ratio (HR) of PAOD were assessed by the end of 2013. The incidence of PAOD was approximately 1.5 times greater in the Bell's palsy group than in the non-Bell's palsy controls (7.75 vs. 4.99 per 1000 person-years). The Cox proportional hazards regression analysis measured adjusted HR was 1.54 (95% confidence interval (CI) = 1.35-1.76) for the Bell's palsy group compared to the non-Bell's palsy group, after adjusting for sex, age, occupation, income and comorbidities. Men were at higher risk of PAOD than women in the Bell's palsy group, but not in the controls. The incidence of PAOD increased with age in both groups, but the Bell's palsy group to control group HR of PAOD decreased as age increased. The systemic steroid treatment reduced 13% of PAOD hazard for Bell's palsy patients, compared to those without the treatment, but not significant. Bell's palsy appears to be associated with an increased risk of developing PAOD. Further pathophysiologic, histopathology and immunologic research is required to explore the underlying biologic mechanism.

  7. Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data.

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    Li-Syue Liou

    Full Text Available This population-based cohort study investigated the risk of developing peripheral arterial occlusive disease (PAOD in patients with Bell's palsy.We used longitudinal claims data of health insurance of Taiwan to identify 5,152 patients with Bell's palsy newly diagnosed in 2000-2010 and a control cohort of 20,608 patients without Bell's palsy matched by propensity score. Incidence and hazard ratio (HR of PAOD were assessed by the end of 2013.The incidence of PAOD was approximately 1.5 times greater in the Bell's palsy group than in the non-Bell's palsy controls (7.75 vs. 4.99 per 1000 person-years. The Cox proportional hazards regression analysis measured adjusted HR was 1.54 (95% confidence interval (CI = 1.35-1.76 for the Bell's palsy group compared to the non-Bell's palsy group, after adjusting for sex, age, occupation, income and comorbidities. Men were at higher risk of PAOD than women in the Bell's palsy group, but not in the controls. The incidence of PAOD increased with age in both groups, but the Bell's palsy group to control group HR of PAOD decreased as age increased. The systemic steroid treatment reduced 13% of PAOD hazard for Bell's palsy patients, compared to those without the treatment, but not significant.Bell's palsy appears to be associated with an increased risk of developing PAOD. Further pathophysiologic, histopathology and immunologic research is required to explore the underlying biologic mechanism.

  8. State of the Art Management of Acute Vaso-occlusive Pain in Sickle Cell Disease.

    Science.gov (United States)

    Puri, Latika; Nottage, Kerri A; Hankins, Jane S; Anghelescu, Doralina L

    2018-02-01

    Acute vaso-occlusive crisis (VOC) is a hallmark of sickle cell disease (SCD). Multiple complex pathophysiological processes can result in pain during a VOC. Despite significant improvements in the understanding and management of SCD, little progress has been made in the management of pain in SCD, although new treatments are being explored. Opioids and non-steroidal anti-inflammatory drugs (NSAIDs) remain the mainstay of treatment of VOC pain, but new classes of drugs are being tested to prevent and treat acute pain. Advancements in the understanding of the pathophysiology of SCD and pain and the pharmacogenomics of opioids have yet to be effectively utilized in the management of VOC. Opioid tolerance and opioid-induced hyperalgesia are significant problems associated with the long-term use of opioids, and better strategies for chronic pain therapy are needed. This report reviews the mechanisms of pain associated with acute VOC, describes the current management of VOC, and describes some of the new therapies under evaluation for the management of acute VOC in SCD.

  9. Management of veno-occlusive disease: the multidisciplinary approach to care.

    Science.gov (United States)

    Wallhult, Elisabeth; Kenyon, Michelle; Liptrott, Sarah; Mank, Arno; Ní Chonghaile, Mairéad; Babic, Aleksandra; Bijkerk, Jacobine; Bompoint, Caroline; Corbacioglu, Selim; de Weijer, Roel; Fink, Claudia; Marktel, Sarah; Soni, Vivek; Sprenger, Sarah; Arjona, Eugenia Trigoso; Mohty, Mohamad

    2017-04-01

    Although it is considered a relatively rare disorder, veno-occlusive disease (VOD) is one of the main causes of overall, non-relapse mortality associated with haematopoietic stem cell transplantation (HSCT). This article, based on the consensus opinion of haemato-oncology nurses, haemato-oncologists and pharmacists from both adult and paediatric services at the VOD International Multi-Disciplinary Advisory Board at the European Society for Blood and Marrow Transplantation (EBMT) meeting, Istanbul, 2015, aims to explore the multidisciplinary approach to care for the management of VOD, with an emphasis on current challenges in this area. The careful monitoring of HSCT patients allows early detection of the symptoms associated with VOD and timely treatment, ultimately improving patient outcomes. As part of a multidisciplinary team, nurses have an essential role to play, from pretransplant assessment to medical management and overall care of the patient. Physicians and pharmacists have a responsibility to facilitate education and training so that nurses can work effectively within that team. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Evaluation of successive Tc-99m brain angiography and vasoactive drugs on occlusive cerebrovascular disease

    International Nuclear Information System (INIS)

    Shimamura, Osamu

    1986-01-01

    Cerebral circulation in the patients with unilateral occlusive cerebrovascular disease (CVD) in chronic stage was evaluated by radionuclide angiography (RNA) using Tc-99m pertechnetate. RNA (each Tc-99m dose = 20 mCi) was repeated in short time interval. Employed parameters were as follows; appearance to peak time (APT), brain transit time (BTT), peak count (PC) and up slope (US). These parameters were calculated from time activity curve (TAC) of ''region of interest'' on each hemisphere and the values obtained in affected side were compared with those of normal side and control hemisphere. Reproducibility of these values were satisfactory in PC and US. The results obtained were as follows: In affected hemisphere, PC and US were significantly reduced, while APT and BTT were not significantly affected. The ratio of PC and US between left and right hemispheres increased in the patients with CVD and the latter was particularly significant to detect the abnormality. Effect of vasoactive drugs such as papaverine, acetazolamide, angiotensin II or methoxamine on these parameters was studied in 24 patients with CVD and 16 patients without CVD. Papaverine and acetazolamide increased significantly PC and US in normal hemisphere of patients without CVD and US in normal hemisphere of patients with CVD, while US in these hemispheres were decreased under high blood pressure induced by angiotensin II and methoxamine. These responses, however, were mild or not detected in the affected hemispheres. (J.P.N.)

  11. Sickle cell disease presenting with extensive peri-macular arteriolar occlusions in a nine-year-old boy.

    Science.gov (United States)

    Al-Abdulla, N A; Haddock, T A; Kerrison, J B; Goldberg, M F

    2001-02-01

    To report a dramatic occlusive event of the macula surrounding the foveal avascular zone, causing severe and permanent loss of vision in a child with sickle cell disease. Case report. A nine-year-old boy with SS hemoglobinopathy and oculocutaneous albinism developed acute unilateral loss of vision. Ophthalmoscopy revealed a pale, milky white, thickened retinal lesion centered on the fovea in the right eye as well as foveal hypoplasia in the left eye. The presence of macular malformation associated with oculocutaneous albinism precluded formation of a cherry-red spot. Fluorescein angiography of the right eye demonstrated extensive occlusions of the arterioles surrounding the foveal avascular zone. The presence of occlusions surrounding the fovea from multiple directions suggested the possibility of central retinal artery occlusion with migration of microemboli downstream. The patient, the youngest case reported, developed an irreversible macular infarction that was not improved by an exchange erythrocyte transfusion. He was placed on a long-term monthly transfusion protocol to protect his unaffected eye.

  12. Occlusal stability.

    Science.gov (United States)

    Wiens, Jonathan P; Priebe, Jennifer W

    2014-01-01

    Occlusion is the foundation for clinical success in fixed, removable, and implant prosthodontic treatment. Understanding those principles is critical when restoring a patient's occlusion. Many philosophies, devices, and theories of occlusion have evolved based on anecdotal clinical observations and applied geometric perceptions. The literature has reported these classic and contemporary occlusal concepts. As evidence-based dentistry emerged, it championed scrutiny of previously held beliefs, resulting in the abandonment of many pragmatic, yet beneficial occlusal procedures. The impetus toward scientific discovery, whereby factual information might be universally applied in dental education and clinical practice, has renewed interest in occlusal studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Does peripheral arterial occlusive disease influence muscle strength and exercise capacity in COPD patients?

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    Natacha Angélica da Fonseca Miranda

    Full Text Available Abstract Background The pathophysiology of chronic obstructive pulmonary disease (COPD is complex and understanding of it has been changing in recent years, with regard to its multisystemic manifestations, especially peripheral dysfunction and its influence on intolerance to exercise. Objectives To evaluate the relationship between peripheral arterial occlusive disease (PAOD and peripheral muscle strength and exercise capacity in COPD patients. Methods We conducted a cross-sectional study of 35 patients with COPD who were evaluated with the Ankle-Brachial Index, handgrip strength test, 1 repetition maximum (1RM of knee extensors and flexors, and distance covered in the incremental shuttle walking test (dISWT. Results COPD patients with coexisting PAOD had lower dominant handgrip strength test results (33.00 vs. 26.66 kgf, p = 0.02 and worse performance in the dISWT (297.32 vs. 219.41 m, p = 0.02 when compared to the COPD patients without PAOD. Strong correlations were found between the result of the handgrip strength test and both the dISWT (r = 0.78; p < 0.001 and the 1RM/knee extension (r = 0.71; p = 0.03; and also between the dISWT and both the 1RM/knee extension (r = 0.72; p = 0.02 and the 1RM/knee flexion (r = 0.92; p < 0.001. The linear regression model showed that the dISWT variable alone explains 15.3% of the Ankle-Brachial Index result (p = 0.01. Conclusion COPD patients with PAOD exhibit reduced muscle strength and lower exercise capacity than COPD patients without PAOD.

  14. Serum Levels of Platelet Released CD40 Ligand Are Increased in Early Onset Occlusive Carotid Artery Disease

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    József Balla

    2006-01-01

    Full Text Available Objective: Soluble CD40 ligand (sCD40L has been suggested as a key mediator between inflammation and atherosclerosis, and the CD40-CD40L interaction has a role in atherosclerotic lesion progression. We evaluated if platelet released serum sCD40L and sCD40 levels differ between patients with early onset occlusive carotid artery disease and age-matched controls.

  15. Veno-occlusive disease nurse management: Development of a dynamic monitoring tool by the GITMO nursing group

    OpenAIRE

    Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; De Cecco, Valentina; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena

    2016-01-01

    Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and t...

  16. Low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease.

    Science.gov (United States)

    van Zuuren, Esther J; Fedorowicz, Zbys

    2015-12-18

    Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be broadly divided into two distinct clinical phenotypes characterized by either haemolysis or vaso-occlusion. Pain is the most prominent symptom of vaso-occlusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Low-molecular-weight heparins might control this hypercoagulable state through their anticoagulant effect. This is an update of a previously published version of this review. To assess the effects of low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell disease. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches. We also searched abstract books of conference proceedings and several online trials registries for ongoing trials.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 28 September 2015. Randomised controlled clinical trials and controlled clinical trials that assessed the effects of low-molecular-weight heparins in the management of vaso-occlusive crises in people with sickle cell disease. Study selection, data extraction, assessment of risk of bias and analyses were carried out independently by the two review authors. Two studies comprising 287 participants were included. One study (with an overall unclear to high risk of bias) involved 253 participants and the quality of the evidence for most outcomes was very low. This study, reported that pain severity at day two and day three was lower in the tinzaparin group than in the placebo group (P quality of evidence rated very low. The most important reasons for downgrading the quality of evidence were serious risk of bias and imprecision (due to low sample size or low occurrence of events). Based on the results

  17. Treatment and prevention of pain due to vaso-occlusive crises in adults with sickle cell disease: an educational void.

    Science.gov (United States)

    Solomon, Lawrence R

    2008-02-01

    Pain due to vaso-occlusive crisis is the major cause of hospital use in sickle cell disease. Although available guidelines provide recommendations for opioid administration in this setting, only 4 (21%) of 19 medical textbooks present treatment regimens that are consistent with them. Moreover, only 7 texts (37%) note that addiction is infrequent in this population, while 11 (92%) of 12 texts provide such reassurance for cancer-related pain (P occlusive crises is completely defined only in 2 textbooks. Thus, most medical texts provide neither adequate information for the treatment or prevention of pain due to vaso-occlusive crisis in sickle cell disease nor reassurance of the unlikelihood of addiction in this population. In contrast, treatment recommendations for less common hematologic disorders are consistent with current standards in 53% to 84% of appropriate texts (P training on pain control in sickle cell disease are needed to parallel studies of environmental and genetic factors contributing to the known clinical heterogeneity of this disorder.

  18. Penumbra Stroke System as an ''add-on'' for the treatment of large vessel occlusive disease following thrombolysis: first results

    International Nuclear Information System (INIS)

    Struffert, Tobias; Engelhorn, Tobias; Richter, Gregor; Doerfler, Arnd; Koehrmann, Martin; Nowe, Tim; Schellinger, Peter D.; Schwab, Stefan

    2009-01-01

    The Penumbra Stroke System (PSS) was cleared for use in patients with ischemic stroke by the FDA in January 2008. We describe our experience of using this new system in acute large vessel occlusive disease following thrombolysis. Fifteen consecutive patients (mean age 60 years) suffering from acute ischemic stroke were treated with the PSS after intravenous or intra-arterial standard treatment with tissue plasminogen activator (n = 14) or ReoPro (n = 1). All patients presented with TIMI 3 before use of the PSS. Carotid stenting (n = 3) and intracranial balloon angioplasty or stenting (n = 2) were performed if indicated. Neurological evaluation was performed using the NIHSS score and the mRS score. Initial median NIHSS score in 12 patients with occlusions in the anterior circulation was 15; three patients with basilar artery occlusion presented with coma. Median symptom to procedure start time was 151 min. In the anterior circulation, 9 of the 12 target vessels were recanalised successfully (TIMI 2 and 3). The rate of patients with independent clinical outcome (mRS ≤ 2) was 42%. One patient died 5 days after unsuccessful treatment, one after 28 days and one after 85 days owing to heart attack. Basilar artery occlusions could be recanalised in all cases to TIMI 3. The clinical result after 90 days was mRS 4 in two cases and mRS 5 in one case. Symptomatic haemorrhage did not occur. The PSS can safely be used for recanalisation in patients with acute ischemic stroke due to large vessel occlusion, who have already received thrombolysis treatment. The recanalisation rate was 80%. Symptomatic haemorrhage did not occur. Randomized trials may demonstrate that endovascular mechanical thrombectomy improves patient outcome. (orig.)

  19. Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

    Energy Technology Data Exchange (ETDEWEB)

    Amarteifio, E., E-mail: erick.amarteifio@med.uni-heidelberg.de [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Wormsbecher, S. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Krix, M. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Bracco Imaging Germany, Konstanz (Germany); Demirel, S. [University Hospital of Heidelberg, Department of Vascular Surgery, Heidelberg (Germany); Braun, S. [Department of Biostatistics, German Cancer Research Center, Heidelberg (Germany); Delorme, S. [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Boeckler, D. [University Hospital of Heidelberg, Department of Vascular Surgery, Heidelberg (Germany); Kauczor, H.-U. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Weber, M.-A. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany)

    2012-11-15

    Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time-CEUS-intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t{sub max}), slope to maximum (m), vascular response after occlusion (AUC{sub post}), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p < 0.014). In PAD, t{sub max} was delayed (31.2 {+-} 13.6 vs. 16.7 {+-} 8.5 s, p < 0.0001) and negatively correlated with ankle-brachial-index (r = -0.65). m was decreased in PAD (4.3 {+-} 4.6 mL/s vs. 13.1 {+-} 8.4 mL/s, p < 0.0001) and had highest diagnostic accuracy (sensitivity/specificity, 75%/93%) for detection of diminished muscular micro-perfusion in PAD (cut-off value, m < 5{approx}mL/s). Discriminant analysis and ROC curves revealed m, and AUC{sub post} as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

  20. Mid-Term Outcomes of Endovascular Treatment for TASC-II D Femoropopliteal Occlusive Disease with Critical Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Torres-Blanco, Álvaro, E-mail: atorres658@yahoo.es; Edo-Fleta, Gemma; Gómez-Palonés, Francisco; Molina-Nácher, Vicente; Ortiz-Monzón, Eduardo [Hospital Universitario Dr. Peset, Department of Angiology, Endovascular and Vascular Surgery (Spain)

    2016-03-15

    PurposeThe purpose of the study was to assess the safety and midterm effectiveness of endovascular treatment in Trans-Atlantic Inter-Society Consensus II (TASC-II) D femoropopliteal occlusions in patients with critical limb ischemia (CLI).MethodsPatients with CLI who underwent endovascular treatment for TASC-D de novo femoropopliteal occlusive disease between September 2008 and December 2013 were selected. Data included anatomic features, pre- and postprocedure ankle-brachial index, duplex ultrasound, and periprocedural complications. Sustained clinical improvement, limb salvage rate, freedom from target lesion revascularization (TLR), and freedom from target extremity revascularization (TER) were assessed by Kaplan–Meier estimation and predictors of restenosis/occlusion with Cox analysis.ResultsThirty-two patients underwent treatment of 35 TASC-D occlusions. Mean age was 76 ± 9. Mean lesion length was 23 ± 5 cm. Twenty-eight limbs (80 %) presented tissue loss. Seventeen limbs underwent treatment by stent, 13 by stent-graft, and 5 by angioplasty. Mean follow-up was 29 ± 20 months. Seven patients required major amputation and six patients died during follow-up. Eighteen endovascular and three surgical TLR procedures were performed due to restenosis or occlusion. Estimated freedom from TLR and TER rates at 2 years were 41 and 76 %, whereas estimated primary and secondary patency rates were 41 and 79 %, respectively.ConclusionsEndovascular treatment for TASC II D lesions is safe and offers satisfying outcomes. This patient subset would benefit from a minimally invasive approach. Follow-up is advisable due to a high rate of restenosis. Further follow-up is necessary to know the long-term efficacy of these procedures.

  1. Occlusion revisited.

    Science.gov (United States)

    Taner, Tulin

    2012-03-01

    The evaluation of occlusion is of utmost importance, when planning for dental and orthodontic treatment. The occlusal characteristics of normal occlusion change according to the dentoalveolar maturation stages. In primary dentition, flush terminal plane relationship of the second primary molars is desired for a normal molar relationship. In the early mixed dentition stage, cusp to cusp molar relationship is the normal occlusal feature, when posterior primary teeth are in place and leeway space is preserved.

  2. Diagnostic accuracy of three-dimensional contrast-enhanced automatic moving-table MR angiography in patients with peripheral arterial occlusive disease in comparison with digital subtraction angiography

    Directory of Open Access Journals (Sweden)

    Hazem Soliman

    2015-03-01

    Conclusion: Our prospective comparison shows that three-dimensional contrast-enhanced automatic moving-table MRA is a noninvasive imaging modality that has a diagnostic accuracy comparable to DSA for the assessment of peripheral arterial occlusive disease.

  3. Endovascular repair of para-anastomotic aortoiliac aneurysms.

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2009-11-01

    The purpose of this study is to evaluate the use of endovascular stent grafts in the treatment of para-anastomotic aneurysms (PAAs) as an alternative to high-risk open surgical repair. We identified all patients with previous open aortic aneurysm repair who underwent infrarenal endovascular aneurysm repair (EVAR) at our institution from June 1998 to April 2007. Patient demographics, previous surgery, and operative complications were recorded. One hundred forty-eight patients underwent EVAR during the study period and 11 patients had previous aortic surgery. Of these 11 redo patients, the mean age was 62 years at initial surgery and 71 years at EVAR. All patients were male. Initial open repair was for rupture in five (45%) patients. The average time between initial and subsequent reintervention was 9 years. All patients were ASA Grade III or IV. Fifty-five percent of the PAAs involved the iliac arteries, 36% the abdominal aorta, and 9% were aortoiliac. Ten patients had endovascular stent-grafts inserted electively, and one patient presented with a contained leak. Aorto-uni-iliac stent-grafts were deployed in seven patients, and bifurcated stent-grafts in four patients. A 100% successful deployment rate was achieved. Perioperative mortality was not seen and one patient needed surgical reintervention to correct an endoleak. Endovascular repair of PAAs is safe and feasible. It is a suitable alternative and has probably now become the treatment of choice in the management of PAAs.

  4. Efficacy of superficial temporal artery-middle cerebral artery bypass in cerebrovascular steno-occlusive diseases: Hemodynamics assessed by perfusion computed tomography.

    Science.gov (United States)

    Kwon, Woo-Keun; Kwon, Taek-Hyun; Park, Dong-Hyuk; Kim, Joo-Han; Ha, Sung-Kon

    2017-01-01

    Our purpose of this study was to assess the cerebral hemodynamic improvement with perfusion computed tomography (CT), before and after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in patients with cerebrovascular steno-occlusive diseases including both moyamoya disease and nonmoyamoya steno-occlusions. Twenty-four STA-MCA bypasses were performed to 22 patients with symptomatic cerebrovascular steno-occlusive diseases, including both moyamoya disease and nonmoyamoya steno-occlusive diseases. Brain perfusion CT images were obtained before and after the bypass surgery. The relative parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) derived from the perfusion CT were collected and analyzed to assess the efficacy of STA-MCA bypass. The CBF increased, and MTT decreased after the bypass surgery in both moyamoya group and nonmoyamoya group. The increase of CBF in nonmoyamoya group and the decrease of MTT delay in moyamoya group, overall group were statistically significant ( P cerebrovascular steno-occlusive diseases, such as moyamoya disease and internal carotid artery/MCA steno-occlusion. And perfusion CT can be used as an effective quantitative modality to assess the cerebral perfusion before and after the STA-MCA bypass surgery.

  5. Foot CT perfusion in patients with peripheral arterial occlusive disease (PAOD): A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, R., E-mail: roberto.iezzi@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Santoro, M., E-mail: dott.santoromarco@gmail.com [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Dattesi, R., E-mail: robertadattesi@gmail.com [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); La Torre, M.F. [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Tinelli, G., E-mail: tinelli@rm.unicatt.it [Department of Vascular Surgery, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Snider, F., E-mail: fsnider@rm.unicatt.it [Department of Vascular Surgery, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Bonomo, L., E-mail: lbonomo@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy)

    2013-09-15

    Purpose: To prospectively assess the technical feasibility and reproducibility of quantitative foot perfusion multidetector-row computed tomography (MDCT) in patients with peripheral occlusive artery disease (PAOD) and to evaluate perfusion parameters changes after endovascular treatment. Materials and methods: Institutional review board approval and informed patient consent were obtained. 10 patients older than 65 years (mean 74.1 years, range 66–95 years) with PAOD and who were referred to our department for single-limb endovascular treatment were enrolled prospectively. All patients underwent foot CT perfusion examinations before and within 72 h after endovascular treatment. A 64-row CT lightspeed VCT scanner (GE Medical Systems) was used with acquisition of eight contiguous 5-mm reconstructed sections (60-s acquisition time; 40 mL Iomeprol 400 mgI/mL, @4 mL/s). Data were analyzed by two blinded readers using commercially available software to calculate perfusion parameters. Inter-observer and intra-observer agreement of perfusion CT analysis was assessed using Bland–Altman analyses and intra-class correlation coefficient (ICC). Changes in perfusion parameters after endovascular treatment were assessed using Wilcoxon's test. Results: Good inter-observer and intra-observer agreement was obtained in all patients. Good agreement was obtained for perfusion parameters for the untreated foot and in repeated studies. By comparing perfusion parameters in the treated foot, a significantly shorter mean transit time (MTT) was obtained. Conclusions: Foot CT perfusion is a feasible and reproducible technique. A significant decrease of MTT between pre- and post-revascularization suggests improved flow in the below-the-knee arteries.

  6. Low, fixed dose defibrotide in management of hepatic veno-occlusive disease post stem cell transplantation.

    Science.gov (United States)

    Bagal, Bhausaheb; Chandrasekharan, Arun; Chougle, Aliya; Khattry, Navin

    2018-03-01

    Hepatic veno-occlusive disease (VOD) is well recognized potentially serious regimen-related toxicity seen after stem cell transplantation. Severe VOD is associated with poor long-term outcomes with very high mortality. Besides supportive care, only defibrotide has been found to be effective in the management of VOD. The recommended dose of defibrotide is 25mg/kg/d but there has been no classical dose finding study done for this drug. A higher dose of defibrotide is associated with increased risk of bleeding and this drug is prohibitively expensive. We report our experience of using fixed low dose of defibrotide in patients with VOD. We retrospectively evaluated 511 patients who underwent stem cell transplant at our center from November 2007 and December 2015. All patients received ursodeoxycholic acid as VOD prophylaxis. Modified Seattle criterion was used for diagnosis and severity grading of VOD. Patients developing VOD were initially treated with furosemide and adequate analgesia. Defibrotide was started within 12 to 24 hours of diagnosis of VOD. All adult patients received defibrotide at a fixed dose of 200mg twice daily while two children were given dose of 100mg and 50mg twice daily. Nine (1.7%) of our patients developed VOD. Daily dose of defibrotide ranged from 5mg/kg/d to 20mg/kg/d till resolution of VOD. All patients had complete resolution of VOD. None of our patients required ventilator support or dialysis. No episodes of bleeding were observed. No dose response relationship was observed between defibrotide dose and time to resolution of VOD. Low fixed dose defibrotide initiated early seems to be effective and safe in treatment of VOD. This is relevant in a resource limited setting and warrants prospective evaluation. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

  7. Haemosiderin-laden sputum macrophages for diagnosis in pulmonary veno-occlusive disease.

    Directory of Open Access Journals (Sweden)

    Heidi Lederer

    Full Text Available Pulmonary veno-occlusive disease (PVOD is a rare condition of pulmonary arterial hypertension (PAH, in which post-capillary veins are affected. Since the therapeutic approach in PVOD differs from other forms of PAH, it is crucial to establish the diagnosis. Due to the fact that affected patients are often hemodynamically unstable, minimal invasive procedures are necessary for the diagnostic work-up. Chronic alveolar haemorrhage has been observed during bronchoalveolar lavage in PVOD cases. This study therefore investigates whether signs of alveolar haemorrhage can also be found in the sputum of these patients.Six patients suffering from PVOD were included in this analysis. As controls, patients with idiopathic PAH (n = 11, chronic thromboembolic PH (n = 9 and with sclerodermia-associated PH (n = 10 were assessed. Sputum from every patient was obtained by a non-invasive manner. The amount of haemosiderin-laden macrophages was determined using the Golde score. There were statistically significant more haemosiderin-laden macrophages in the sputum of patients suffering from PVOD as compared to the other groups (P<0.05. Assuming a cut-off of 200 on the Golde score, all of the 6 PVOD patients surpassed this value compared with only 1 out of the 30 cases with precapillary PH. Thus, sensitivity and specificity with respect to the diagnosis of PVOD was 100% and 97%, respectively.The content of haemosiderin-laden macrophages in the sputum of patients suffering from PVOD is significantly higher as compared to other forms of PH and may be useful in the non-invasive diagnostic work-up of these patients.

  8. Haemosiderin-laden sputum macrophages for diagnosis in pulmonary veno-occlusive disease.

    Science.gov (United States)

    Lederer, Heidi; Muggli, Bettina; Speich, Rudolf; Treder, Ula; Stricker, Hans; Goede, Jeroen; Ulrich, Silvia; Stämpfli, Simon F; Breitenstein, Alexander

    2014-01-01

    Pulmonary veno-occlusive disease (PVOD) is a rare condition of pulmonary arterial hypertension (PAH), in which post-capillary veins are affected. Since the therapeutic approach in PVOD differs from other forms of PAH, it is crucial to establish the diagnosis. Due to the fact that affected patients are often hemodynamically unstable, minimal invasive procedures are necessary for the diagnostic work-up. Chronic alveolar haemorrhage has been observed during bronchoalveolar lavage in PVOD cases. This study therefore investigates whether signs of alveolar haemorrhage can also be found in the sputum of these patients. Six patients suffering from PVOD were included in this analysis. As controls, patients with idiopathic PAH (n = 11), chronic thromboembolic PH (n = 9) and with sclerodermia-associated PH (n = 10) were assessed. Sputum from every patient was obtained by a non-invasive manner. The amount of haemosiderin-laden macrophages was determined using the Golde score. There were statistically significant more haemosiderin-laden macrophages in the sputum of patients suffering from PVOD as compared to the other groups (P<0.05). Assuming a cut-off of 200 on the Golde score, all of the 6 PVOD patients surpassed this value compared with only 1 out of the 30 cases with precapillary PH. Thus, sensitivity and specificity with respect to the diagnosis of PVOD was 100% and 97%, respectively. The content of haemosiderin-laden macrophages in the sputum of patients suffering from PVOD is significantly higher as compared to other forms of PH and may be useful in the non-invasive diagnostic work-up of these patients.

  9. COPART Risk Score Predicts Long-term Mortality in Peripheral Arterial Occlusive Disease.

    Science.gov (United States)

    Hackl, G; Belaj, K; Gary, T; Rief, P; Deutschmann, H; Seinost, G; Brodmann, M; Hafner, F

    2015-07-01

    The COhorte de Patients ARTériopathes (COPART) Risk Score is a risk score assessing the 1 year outcome of patients who received inpatient treatment because of their peripheral arterial occlusive disease (PAOD). The COPART Risk Score consists of six variables each of which is allocated a different number of points (age, history of myocardial infarction, C-reactive protein, ankle-brachial index, estimated glomerular filtration rate, medication with antiplatelet agents, statins and renin-angiotensin system inhibitors). 129 consecutive claudicants were included in a prospective trial with an average follow up of 8.8 (± 0.7) years. All patients were hospitalized for their first endovascular procedure to the pelvic and/or femoropopliteal arteries. The endpoints were all cause mortality and cardiovascular (CV) death. The COPART Risk Score was calculated for the three patient cohorts (low risk: 52 patients [40.3%]; medium risk: 41 patients [31.8%]; high risk: 36 patients [27.9%]). During the follow up period 23.1% (n = 12) of patients in the low risk group, 34.1% (n = 14) of patients in the medium risk group, and 63.9% (n = 23) of patients in the high risk group died. CV death occurred in 11.5% in the low, 22.0% in the medium, and 41.7% in the high risk groups. The three groups differed significantly with regard to all cause and CV mortality (p < .0001 and p = .001). The COPART Risk Score is a suitable instrument to predict long-term all cause and CV mortality in claudicants preceding their first peripheral intervention. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Risk indicators in coronary cardiac disease and occlusive disease of the peripheral arteries

    International Nuclear Information System (INIS)

    Roth, H.

    1982-01-01

    In 160 patients with clinically confirmed coronary heart diseases, angiograms of the coronary vessels, the left ventricle, the abdominal aorta, the pelvic and femoral arteries and the supra-aortic vessels were taken. At the same time the incidence of the risk indicators overweight, hypercholesterinaemia, hypertriglyceridaemia, hyperuricaemia, diabetes mellitus, hypertension and cigarette smoking was established and compared with the angiograms. Hypercholesterinaemia, hypertriglyceridaemia, diabetes mellitus and hypertension are found to be in a clearly positive correlation with the frequency and severity of coronary and peripheral vascular diseases. For hyperuricaemia and overweight a relation to the frequency and severity of peripheral but not coronary vascular stenoses is outlined. Cigarette smoking, again, proves to be a clear risk indicator. (orig./MG) [de

  11. Cerebral hemodynamics in adult ischemic-type patients with moyamoya disease compared with those of atherothrombotic middle cerebral artery occlusion

    International Nuclear Information System (INIS)

    Idei, Masaru; Yamane, Kanji; Nishida, Masahiro; Manabe, Kazufumi; Yokota, Akira

    2005-01-01

    We measured regional cerebral blood flow (rCBF) in adult ischemic-type patients with moyamoya disease and in patients with atherothrombotic middle cerebral artery occlusion (MCAO) to investigate cerebral hemodynamics in adult ischemic-type of moyamoya disease. In this study we measured rCBF and regional cerebro-vascular response (rCVR) using acetazolamide by Xe-non-enhanced CT. Our subjects consisted of 15 adult ischemic-type patients with moyamoya disease and 27 atherothrombotic stroke patients with proximal occlusion of the middle cerebral artery. The region of inter est was conducted in the anterior cerebral artery, middle cerebral artery and posterior cerebral artery territories as well as basal ganglia regions. rGBF was preserved in all regions of patients with moyamoya disease. However, rCVR severely decreased in the anterior circulation territory in patients with moyamoya disease compared with those of MCAO. These results suggest that rCBF in the anterior circulation territory of adult ischemic-type patients with moyamoya disease is preserved by vasodilation of the cerebral arteries, while cerebral hemodynamic reserve capacity is severely reduced. The results indicated that basal moyamoya vessels are dilated. These findings may be one of the reasons why stroke occurs more frequently in adult than child patients with moyamoya disease. (author)

  12. Early treatment with infliximab in bilateral occlusive vasculitis as a presenting manifestation of Behçet' disease.

    Science.gov (United States)

    Bañeros-Rojas, P; Berrozpe-Villabona, C; Peraza-Nieves, J E; Díaz-Valle, D

    2015-06-01

    A 24 year old woman who complained of maculo-papulo rash, genital and bucal aphthous ulcers, abdominal pain, minor dyspnea and visual loss in both eyes. Funduscopy revealed a bilateral occlusive vasculitis including central vessels. Treatment was initiated with a methylprednisolone bolus (1 g/24h) and infliximab 5mg/kg/day (0-2-6 weeks and every 8 weeks). The treatment prescribed induced a fast remission. Visual acuity improved. The patient did not suffer any other relapse after one year of follow-up. An initial treatment with Infliximab should be considered in Behçet disease for serious outbreaks, such as macular occlusive vasculitis with ischemia. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Should incidental asymptomatic angiographic stenoses and occlusions be treated in patients with peripheral arterial disease?

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-09-01

    The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation.

  14. Sinusoidal obstruction syndrome (veno-occlusive disease in a patient receiving bevacizumab for metastatic colorectal cancer: a case report

    Directory of Open Access Journals (Sweden)

    Agarwal Vijay

    2008-07-01

    Full Text Available Abstract Introduction We present the case of a patient with colon cancer who, while receiving bevacizumab, developed sinusoidal obstruction syndrome (veno-occlusive disease (SOSVOD. Certain antitumour agents such as 6-mercaptopurine and 6-thioguanine have also been reported to initiate hepatic SOSVOD in isolated cases. There have been no reports so far correlating bevacizumab with SOSVOD. Case presentation A 77-year-old man was being treated with oxaliplatin and a modified de Gramont regimen of 5-fluorouracil for metastatic colon cancer. Bevacizumab (7.5 mg/kg was added from the seventh cycle onwards. Protracted neutropenia and thrombocytopenia led to discontinuation of oxaliplatin after the ninth cycle. A computed tomography scan showed complete response and bevacizumab was continued for another 3 months, after which time the patient developed right hypochondrial pain, transudative ascites, splenomegaly and abnormal liver function tests. Upper gastrointestinal endoscopy showed oesophageal varices. Liver biopsy showed features considered to be consistent with SOSVOD. Bevacizumab was stopped and a policy of watchful waiting was adopted. He tolerated the acute damage to his liver and subsequently the ascites resolved and liver function tests normalised. Conclusion We need to be aware that bevacizumab can cause sinusoidal obstruction syndrome (veno-occlusive disease and that the occurrence of ascites should not be attributed to progressive disease without appropriate evaluation.

  15. Arterial spin labeling in patients with chic cerebral artery steno-occlusive disease - Correlation with 15O-PET

    International Nuclear Information System (INIS)

    Kamano, Hironori; Yoshiura, Takashi; Hiwatashi, Akio; Abe, Koichiro; Yamashita, Koji; Honda, Hiroshi; Togao, Osamu

    2013-01-01

    Background: Heterogeneity of arterial transit time due to cerebral artery steno-occlusive lesions hampers accurate regional cerebral blood flow measurement by arterial spin labeling (ASL). Purpose: To assess the feasibility of regional cerebral blood flow measurement by ASL with multiple-delay time sampling in patients with steno-occlusive diseases by comparing with positron emission tomography (PET), and to determine whether regional arterial transit time measured by this ASL technique is correlated with regional mean transit time, a PET index of perfusion pressure. Material and Methods: Sixteen patients with steno-occlusive diseases received both ASL and 15 O-PET. The mean regional cerebral blood flow measured by ASL and PET, regional arterial transit time by ASL, and regional mean transit time by PET were obtained by a region-of-interest analysis. Correlation between regional cerebral blood flow by ASL and that by PET, and correlation between regional arterial transit time by ASL and regional mean transit time by PET were tested using Pearson's correlation coefficient for both absolute and relative values. A multivariate regression analysis was performed to test whether regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling the effect of regional cerebral blood flow by ASL. Results: A significant positive correlation was found between regional cerebral blood flow by ASL and that by PET for both absolute (r = 0.520, P < 0.0001) and relative (r = 0.691, P < 0.0001) values. A significant positive correlation was found between regional arterial transit time by ASL and regional mean transit time by PET both for absolute (r = 0.369, P = 0.0002) and relative (r = 0.443, P < 0.0001) values. The regression analysis revealed that regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling regional cerebral blood flow by ASL

  16. Preserve the lower limb in a patient with calcaneal osteomyelitis and severe occlusive peripheral vascular disease by partial calcanectomy

    Directory of Open Access Journals (Sweden)

    Chin-Ta Lin

    2015-01-01

    Full Text Available Heel ulcers in patients with severe peripheral artery occlusive disease represent a challenge to the treating physician. They become more difficult to treat with underlying medical comorbidities. We report a case of 76-year-old man with hypertension, diabetes mellitus, and end-stage renal disease in uremia status presented to our hospital with a 3-month history of a diabetic foot ulcer on his right heel. He was diagnosed with near total artery occlusion below the knee at the local hospital, and vascular reconstruction failed. After admission, surgical debridement was performed with subsequent partial calcanectomy facilitating wound closure without tension. After surgery, the foot was immobilized with a short-leg splint for 2 weeks. Thereafter, ankle immobilization was accomplished using a thermal protective plastic splint and cast shoes with a posterior window for wound care. The wound healed well with no recurrence during the 12-month follow-up period, and the patient may return to an ambulatory status, including a normal gait pattern. In this case, we demonstrate that the partial calcanectomy is practical for the treatment of plantar heel ulcers in a patient with severe comorbidities. With proper surgical planning and postoperative care, partial calcanectomy is a viable alternative to below-the-knee amputation and may better serve the patient who would otherwise be restricted to a sedentary lifestyle.

  17. Cell Therapy Applications for Retinal Vascular Diseases: Diabetic Retinopathy and Retinal Vein Occlusion.

    Science.gov (United States)

    Park, Susanna S

    2016-04-01

    Retinal vascular conditions, such as diabetic retinopathy and retinal vein occlusion, remain leading causes of vision loss. No therapy exists to restore vision loss resulting from retinal ischemia and associated retinal degeneration. Tissue regeneration is possible with cell therapy. The goal would be to restore or replace the damaged retinal vasculature and the retinal neurons that are damaged and/or degenerating from the hypoxic insult. Currently, various adult cell therapies have been explored as potential treatment. They include mesenchymal stem cells, vascular precursor cells (i.e., CD34+ cells, hematopoietic cells or endothelial progenitor cells), and adipose stromal cells. Preclinical studies show that all these cells have a paracrine trophic effect on damaged ischemic tissue, leading to tissue preservation. Endothelial progenitor cells and adipose stromal cells integrate into the damaged retinal vascular wall in preclinical models of diabetic retinopathy and ischemia-reperfusion injury. Mesenchymal stem cells do not integrate as readily but appear to have a primary paracrine trophic effect. Early phase clinical trials have been initiated and ongoing using mesenchymal stem cells or autologous bone marrow CD34+ cells injected intravitreally as potential therapy for diabetic retinopathy or retinal vein occlusion. Adipose stromal cells or pluripotent stem cells differentiated into endothelial colony-forming cells have been explored in preclinical studies and show promise as possible therapies for retinal vascular disorders. The relative safety or efficacy of these various cell therapies for treating retinal vascular disorders have yet to be determined.

  18. Retinal vein occlusion and risk of cerebrovascular disease and myocardial infarction: A meta-analysis of cohort studies.

    Science.gov (United States)

    Zhong, Chongke; You, Shoujiang; Zhong, Xiaoyan; Chen, Guo-Chong; Xu, Tan; Zhang, Yonghong

    2016-04-01

    Retinal vein occlusion (RVO) has been hypothesized to be associated with cerebrovascular disease and myocardial infarction (MI), but the results are inconclusive. We thus systematically evaluated the effect of RVO on the development of cerebrovascular disease and MI by a meta-analysis of cohort studies. PubMed, Embase and Web of Science databases were searched from inception to October 2015. Reference lists of retrieved papers were also reviewed. Cerebrovascular disease and MI were considered as the endpoints. Either fixed- or random-effects models were used to calculate the overall summary risk estimates. Subgroup and sensitivity analysis were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Overall, a total of 9 cohort studies were included. Of these, 8 reported results on cerebrovascular disease and 5 reported on MI. The summary adjusted relative risks (RRs) for patients with RVO compared with the reference group were 1.50 (95% confidence interval [CI]: 1.32-1.69) for cerebrovascular disease and 1.28 (95% CI: 1.17-1.41) for MI. These associations were not significantly modified by geographic area, sample size, length of follow-up, and adjustment for potential confounding factors. Sensitivity analyses according to various inclusion criteria yielded similar results. No evidence of publication bias was observed. This meta-analysis provides further evidence supporting that RVO is associated with increased risk of future cerebrovascular disease and MI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Hyperbaric oxygen, oxygen-ozone therapy, and rheologic parameters of blood in patients with peripheral occlusive arterial disease.

    Science.gov (United States)

    Verrazzo, G; Coppola, L; Luongo, C; Sammartino, A; Giunta, R; Grassia, A; Ragone, R; Tirelli, A

    1995-03-01

    For many years, clinical practice has consolidated the use of both hyperbaric oxygen and oxygen-ozone therapy in the treatment of peripheral occlusive arterial disease (POAD). We investigated the influence of these treatments on hemorrheologic parameters that play an important role in the pathogenesis and the clinical course of arteriosclerosis. Two groups of 15 patients suffering from POAD, assigned at random either to a cycle of HBO therapy or O2-O3 therapy, were evaluated for blood viscosity, erythrocyte filterability, hematocrit value, fibrinogen concentration, and thrombin time. The O2-O3 therapy caused a significant increase of erythrocyte filterability and a significant decrease of blood viscosity. By contrast, HBO therapy did not produce any significant change. The increase of lipid peri-oxidation, proved by raised malonyldialdehyde plasma levels, seems a likely mechanism involved in the hemorrheologic effects of O2-O3 therapy.

  20. Manifestations and management of veno-occlusive disease/sinusoidal obstruction syndrome in the era of contemporary therapies.

    Science.gov (United States)

    Tewari, Priti; Wallis, Whitney; Kebriaei, Partow

    2017-02-01

    The concept of veno-occlusive disease (VOD), along with our understanding of it, has historically been and remains an evolving phenomenon. This review presents a broad view of VOD, also known as sinusoidal obstruction syndrome (SOS), including (1) traditional hematopoietic stem cell transplant-associated VOD/SOS, (2) late-onset VOD/SOS, (3) pulmonary VOD, and (4) VOD/SOS associated with chemotherapy only. Several VOD/SOS management modalities exist that include modes for both prophylaxis and treatment. An extensive review of the literature on monoclonal antibodies, both approved and pending approval by the US Food and Drug Administration, reveals that only a few have been associated with an increased risk for VOD/SOS. In fact, bevacizumab appears to have a protective effect against the development of VOD/SOS. As the landscape of cancer treatment changes, careful attention needs to be focused on how new therapies affect the incidence of VOD/SOS.

  1. Isolated pulmonary veno-occlusive disease and pulmonary arterial thrombosis in systemic sclerosis – a lethal combination

    Directory of Open Access Journals (Sweden)

    Arun Jeevagan

    2010-05-01

    Full Text Available Arun JeevaganGeneral Medicine, Ipswich NHS Hospital, UKBackground: Isolated pulmonary hypertension secondary to systemic sclerosis is not uncommon. Our patient with systemic sclerosis presented with a very aggressive form of pulmonary hypertension due to a lethal combination of pulmonary veno-occlusive disease (PVOD and pulmonary arterial thrombosis. This combined presentation has never before been reported in medical literature.Case report: A 75-year-old woman with a 4-month history of atypical chest pains was admitted with a 3-week history of worsening symptoms of shortness of breath, reduced exercise tolerance, and bilateral pitting edema. On examination she had thickened skin in her hands, telangiectasia on her face, maculopapular rash in her legs, raised jugular venous pressure, and bilateral pitting edema. Her autoimmune profile revealed positive anticentromere antibodies, and her echocardiogram showed right ventricular systolic pressure of 91 mmHg. She also had renal impairment secondary to hypoperfusion. A diagnosis of isolated pulmonary hypertension secondary to limited systemic sclerosis was made. As she was clinically improving on slow diuretic infusion and awaiting transfer to a specialist center for management of pulmonary hypertension, our patient died due to cardiopulmonary arrest. Her postmortem revealed that she died of a combination of PVOD and pulmonary arteriopathy due to thrombosis.Conclusion: This is clearly a unique case both in presentation and difficulty of management. Pulmonary vasodilators used in therapy of pulmonary arteriopathy can be detrimental in patients with PVOD. There is no definitive investigation, curative treatment, or management, that exists for a combination of PVOD and pulmonary arteriopathy due to thrombosis secondary to systemic sclerosis.Keywords: pulmonary veno-occlusive disease, pulmonary arterial hypertension, systemic sclerosis, pulmonary arteriopathy with thrombosis

  2. Assessment of cortical hemodynamics by multichannel near-infrared spectroscopy in steno-occlusive disease of the middle cerebral artery.

    Science.gov (United States)

    Oldag, Andreas; Goertler, Michael; Bertz, Anne-Katrin; Schreiber, Stefanie; Stoppel, Christian; Heinze, Hans-Jochen; Kopitzki, Klaus

    2012-11-01

    In a pilot study we evaluated near-infrared spectroscopy as to its potential benefit in monitoring patients with steno-occlusive disease of a major cerebral artery for alterations in cortical hemodynamics. Cortical maps of time-to-peak (TTP) in 10 patients unilaterally affected by severe stenosis or occlusion of the middle cerebral artery were acquired by multichannel near-infrared spectroscopy after bolus application of indocyanine green. Hemodynamic manifestations were assessed by comparison between affected and unaffected hemisphere and evaluated for common constituents by principal component analysis. In one patient, TTP values were compared with those obtained by dynamic susceptibility contrast imaging. TTP was increased on the affected hemisphere in 9 patients. Mean difference in TTP between hemispheres was 0.44 second (P<0.05) as compared with a mean lateral difference of 0.12 second found in a control group of 10 individuals. In group analysis a significant rise in TTP was found in the distribution of the affected middle cerebral artery, whereas principal component analysis suggests augmentation of hemodynamic effects toward the border zones as a dominant pattern. A linear correlation of 0.61 between TTP values determined by dynamic susceptibility contrast MRI and near-infrared spectroscopy was found to be statistically significant (P<0.001). Multichannel near-infrared spectroscopy might facilitate detection of disease-related hemodynamic changes as yet only accessible by tomographic imaging modalities. Being indicative for hypoperfusion and collateral flow increased values of TTP, as found to a varying extent in the present patient group, might be of clinical relevance.

  3. Risk of Peripheral Arterial Occlusive Disease in Patients With Systemic Lupus Erythematosus: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Chuang, Ya-Wen; Yu, Mei-Ching; Lin, Cheng-Li; Yu, Tung-Min; Shu, Kuo-Hsiung; Kao, Chia-Hung

    2015-11-01

    Systemic lupus erythematosus (SLE) is associated with atherosclerosis, but the relationship between SLE and peripheral arterial occlusive disease (PAOD) remains unclear. We sought to investigate this relationship by comparing cardiovascular complications in patients with and without SLE.Data on patients from 2000 to 2011 were collected from the National Health Insurance Research Database of Taiwan. The SLE cohort was frequency-matched according to age, sex, and history of diabetes mellitus (DM) with patients without SLE (control cohort). We evaluated the risk of cardiovascular complications, including hypertension, DM, stroke, chronic obstructive pulmonary disease, heart failure, coronary artery disease, and hyperlipidemia.The study included 10,144 patients with SLE and 10,144 control patients. The incidence of PAOD was 9.39-fold higher (95% confidence interval [CI] = 7.70-11.15) in the SLE cohort than in the non-SLE cohort. Moreover, SLE was an independent risk factor for PAOD. The adjusted risk of PAOD was highest in patients with SLE who were aged ≤34 years (hazard ratio = 47.6, 95% CI = 26.8-84.4). The risk of PAOD was highest during the first year of follow-up and decreased over time.Patients with SLE exhibit a higher incidence and an independently higher risk of PAOD compared with the general population. The PAOD risk is markedly elevated in patients with SLE who are young and in whom the disease is at an early stage.

  4. Endovascular revascularization of TASC C and D femoropopliteal occlusive disease using carbon dioxide as contrast

    Energy Technology Data Exchange (ETDEWEB)

    Mendes, Cynthia de Almeida; Teivelis, Marcelo Passos; Kuzniec, Sergio; Fukuda, Juliana Maria; Wolosker, Nelson [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2016-07-01

    To analyze the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO{sub 2} as primary contrast in patients with no formal contraindication to iodine, aiming to decrease allergic reactions and potential nephrotoxicity in high-risk patients. We describe the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO{sub 2} as primary contrast in patients with high risk for open revascularization and no formal contraindication to iodine. We analyzed feasibility of the procedures, complications, quality of the angiographic images, clinical and surgical outcomes, and costs of C and D lesions treated using CO{sub 2} as contrast medium. The use of CO{sub 2} in C and D lesions needed iodine complementation in most of the cases (nine cases) but decreased the potential nephrotoxicity of iodine contrast medium by the reduction of its volume in this group of high-risk patients. The extension of the arterial lesions was the factor that most contributed to the need for iodine supplementation due to the difficulty to visualize the refill after a long arterial occlusion. The use of CO{sub 2} as contrast in patients with C and D lesions with no restriction for iodine contrast medium was an alternative that did not dismiss the need of iodine supplementation in most of the cases, but could decrease the potential nephrotoxicity of iodine constrast medium.

  5. Early Introduction of Everolimus Immunosuppressive Regimen in Liver Transplantation with Extra-Anatomic Aortoiliac-Hepatic Arterial Graft Anastomosis

    Directory of Open Access Journals (Sweden)

    Emanuele Felli

    2014-01-01

    Full Text Available Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage.

  6. Impact of chronic kidney disease on left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation.

    Science.gov (United States)

    Kefer, Joelle; Tzikas, Apostolos; Freixa, Xavier; Shakir, Samera; Gafoor, Sameer; Nielsen-Kudsk, Jens Erik; Berti, Sergio; Santoro, Gennaro; Aminian, Adel; Landmesser, Ulf; Nietlispach, Fabian; Ibrahim, Reda; Danna, Paolo Luciano; Benit, Edouard; Budts, Werner; Stammen, Francis; De Potter, Tom; Tichelbäcker, Tobias; Gloekler, Steffen; Kanagaratnam, Prapa; Costa, Marco; Cruz-Gonzalez, Ignacio; Sievert, Horst; Schillinger, Wolfgang; Park, Jai-Wun; Meier, Bernhard; Omran, Heyder

    2016-03-15

    Left atrial appendage occlusion (LAAO) using the Amplatzer cardiac plug (ACP) is a preventive treatment of atrial fibrillation related thromboembolism. To assess the safety and efficacy of LAAO in patients with chronic kidney disease (CKD). Among the ACP multicentre registry, 1014 patients (75±8yrs) with available renal function were included. Patients with CKD (N=375, CHA2DS2-VASc: 4.9±1.5, HASBLED: 3.4±1.3) were at higher risk than patients without CKD (N=639, CHA2DS2-VASc: 4.2±1.6, HASBLED: 2.9±1.2; p<0.001 for both). Procedural (97%) and occlusion (99%) success were similarly high in all stages of CKD. Peri-procedural major adverse events (MAE) were observed in 5.1% of patients, 0.8% of death, with no difference between patients with and those without CKD (6.1 vs 4.5%, p=0.47). In patients with complete follow-up (1319 patients years), the annual stroke+transient ischaemic attack (TIA) rate was 2.3% and the observed bleeding rate was 2.1% (62 and 60% less than expected, similarly among patients with and those without CKD). Kaplan-Meier analysis showed a lower overall survival (84 vs 96% and 84 vs 93% at 1 and 2yrs. respectively; p<0.001) among patients with an eGFR <30ml/min/1.73m(2). LAAO using the ACP has a similar procedural safety among CKD patients compared to patients with normal renal function. LAAO with ACP offers a dramatic reduction of stroke+TIA rate and of bleeding rate persistent in all stages of CKD, as compared to the expected annual risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Risks of peripheral arterial occlusive disease in patients with obstructive sleep apnoea: a population-based case-control study.

    Science.gov (United States)

    Chen, J-C; Koo, M; Hwang, J-H

    2015-10-01

    This study aimed to evaluate the risk of peripheral arterial occlusive disease (PAOD) in patients with obstructive sleep apnoea (OSA) using a nationwide claim database in Taiwan. A population-based case-control study. Data from the Longitudinal Health Insurance Database 2000 of the Taiwan's National Health Insurance Research Database. Eleven thousand eight hundred and seventeen adult patients diagnosed with PAOD between January 1, 2001 and December 31, 2010 and 35 451 controls without PAOD frequency matched by sex, 10-year age interval and year of index date. Obstructive sleep apnoea and a number of comorbidities prior to the index date were assessed and analysed with logistic regression analyses. Univariate logistic regression analysis showed that PAOD was significantly associated with OSA (odds ratio, OR = 1.60, P disease or myocardial infarction, chronic kidney disease, hyperurecaemia and obesity, also showed that PAOD was significantly associated with OSA (adjusted OR = 1.37, P = 0.014). However, the association was attenuated when it was further adjusted for hypertension, hyperlipidaemia and diabetes mellitus (DM). Findings from this nationwide population-based study indicated that PAOD was significantly associated with OSA. Further studies are warranted to determine whether OSA may contribute to the development of PAOD indirectly via increasing the risks of hypertension, hyperlipidaemia and/or DM. © 2015 John Wiley & Sons Ltd.

  8. The role of hematopoietic stem cell transplantation in SP110 associated veno-occlusive disease with immunodeficiency syndrome.

    Science.gov (United States)

    Ganaiem, Hammam; Eisenstein, Eli M; Tenenbaum, Ariel; Somech, Raz; Simanovsky, Natalia; Roscioli, Tony; Weintraub, Michael; Stepensky, Polina

    2013-05-01

    Veno-occlusive disease with immunodeficiency (VODI) is an autosomal recessive disorder of combined immunodeficiency (CID) and hepatic injury. Hematopoietic stem cell transplantation (HSCT) - the only definitive treatment for CID - appeared to have a high rate of complications in a previous report. In this study, we describe a new group of patients with VODI highlighting further clinical and immunologic aspects of this disease and re-evaluating the effectiveness of HSCT for the treatment of this disorder. Review of clinical data, immunologic features, molecular studies, treatment, and final outcome of eight kindred members with VODI. The patients described had clinical and immunologic findings consistent with VODI. The molecular studies revealed a new mutation in the SP110 gene. HSCT was carried out in five patients and was successful in three. The diagnosis of VODI should be considered in all patients regardless of ethnicity with a severe combined immunodeficiency (SCID)-like presentation, especially with a normal mitogen response, or with signs of hepatic injury. VODI is a primary immune deficiency, which can be successfully corrected by bone marrow transplantation if applied early in the course of disease using appropriate conditioning. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  9. Comparative study of multi-slice spiral CT angiography and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity

    International Nuclear Information System (INIS)

    Li Wanjun; Lai Zhenhui; Cui Dong; Lin Xiupeng; Du Muxuan

    2010-01-01

    Objective: To compare the difference between multi-slice spiral CT angiography (MSCTA) and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity. Methods: Patients with arteriosclerosis occlusion were assessed by color doppler ultrasound, multi-slice spiral CT angiography and digital subtraction angiography (DSA). The image information of color doppler ultrasound and MSCTA were compared with that of DSA. Results: Color doppler ultrasound showed the anatomical shape and hemodynamics of the arteries of lower extremity. The sensitivity, specificity, and accuracy for diagnosis arteriosclerotic occlusive disease of lower extremity were 88.04%, 90.69% and 88.77% respectively. MSCTA showed the three dimensional structure of the arteries of lower extremity as well as the collateral arteries and the distal arterials. The sensitivity, specificity and accuracy of MSCTA were 97.69%, 96.90% and 97.66%, respectively. Conclusion: Multi-slice spiral CT angiography is an ideal imaging method for the diagnosis of arteriosclerotic occlusive disease of lower extremity. (authors)

  10. Detection of Sp110 by Flow Cytometry and Application to Screening Patients for Veno-occlusive Disease with Immunodeficiency.

    Science.gov (United States)

    Marquardsen, Florian A; Baldin, Fabian; Wunderer, Florian; Al-Herz, Waleed; Mikhael, Raymond; Lefranc, Gérard; Baz, Zeina; Rezaee, Fariba; Hanna, Rabi; Kfir-Erenfeld, Shlomit; Stepensky, Polina; Meyer, Benedikt; Jauch, Annaise; Bigler, Marc B; Burgener, Anne-Valérie; Higgins, Rebecca; Navarini, Alexander A; Church, Joeseph A; Chou, Janet; Geha, Raif; Notarangelo, Luigi D; Hess, Christoph; Berger, Christoph T; Bloch, Donald B; Recher, Mike

    2017-10-01

    Mutations in Sp110 are the underlying cause of veno-occlusive disease with immunodeficiency (VODI), a combined immunodeficiency that is difficult to treat and often fatal. Because early treatment is critically important for patients with VODI, broadly usable diagnostic tools are needed to detect Sp110 protein deficiency. Several factors make establishing the diagnosis of VODI challenging: (1) Current screening strategies to identify severe combined immunodeficiency are based on measuring T cell receptor excision circles (TREC). This approach will fail to identify VODI patients because the disease is not associated with severe T cell lymphopenia at birth; (2) the SP110 gene contains 17 exons, making it a challenge for Sanger sequencing. The recently developed next-generation sequencing (NGS) platforms that can rapidly determine the sequence of all 17 exons are available in only a few laboratories; (3) there is no standard functional assay to test for the effects of novel mutations in Sp110; and (4) it has been difficult to use flow cytometry to identify patients who lack Sp110 because of the low level of Sp110 protein in peripheral blood lymphocytes. We report here a novel flow cytometric assay that is easily performed in diagnostic laboratories and might thus become a standard assay for the evaluation of patients who may have VODI. In addition, the assay will facilitate investigations directed at understanding the function of Sp110.

  11. Endovascular reconstruction of the occluded aortoiliac segment using "double-barrel" self-expanding stents and selective use of the Outback LTD catheter.

    Science.gov (United States)

    Varcoe, Ramon L; Nammuni, Isuru; Lennox, Andrew F; Walsh, William R

    2011-02-01

    To present the early and midterm results of endovascular stent reconstruction of the occluded aortoiliac segment with selective use of the Outback LTD re-entry catheter. Between April 2004 and February 2010, 8 patients (5 women; mean age 58.4 years, range 47-68) with occlusion of the infrarenal aorta extending to the common or external iliac arteries underwent endovascular reconstruction with double-barrel self-expanding stents. Indications for treatment were severe claudication in 6 and ulceration in 2 patients. The technical success rate was 100%, facilitated by the use of the Outback LTD catheter for accurate wire re-entry in 3 cases. There was no in-hospital mortality. One patient had a major complication (femoral artery dissection, brachial artery thrombosis, and retroperitoneal hematoma) unrelated to the re-entry device. Mean operating time was 137 minutes (range 70-253) and length of stay was 1.5 days (range 1-2). During a mean follow-up of 12.5 months (range 6-29), primary patency was 100% with no secondary interventions. Total endovascular reconstruction of the occluded infrarenal aorta that extends into the iliac arteries is durable at midterm follow-up. Adjunctive use of the Outback LTD re-entry catheter can facilitate technical success.

  12. Impact of Diabetes and Peripheral Arterial Occlusive Disease on the Functional Microcirculation at the Plantar Foot

    Directory of Open Access Journals (Sweden)

    Mohammad Kabbani, MD

    2013-10-01

    Conclusions: Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD.

  13. Extra-Thoracic Supra-aortic Bypass Surgery Is Safe in Thoracic Endovascular Aortic Repair and Arterial Occlusive Disease Treatment.

    Science.gov (United States)

    Gombert, Alexander; van Issum, Lea; Barbati, Mohammad E; Grommes, Jochen; Keszei, Andras; Kotelis, Drosos; Jalaie, Houman; Greiner, Andreas; Jacobs, Michael J; Kalder, Johannes

    2018-04-20

    The safety and feasibility of supra-aortic debranching as part of endovascular aortic surgery or as a treatment option for arterial occlusive disease (AOD) remains controversial. The aim of this study was to assess the clinical outcome of this surgery. This single centre, retrospective study included 107 patients (mean age 69.2 years, 38.4% women) who underwent supra-aortic bypass surgery (carotid-subclavian bypass, carotid-carotid bypass, and carotid-carotid-subclavian bypass) because of thoracic or thoraco-abdominal endovascular aortic repair (57%; 61/107) or as AOD treatment (42.9%; 46/107) between January 2006 and January 2015. Mortality, morbidity with a focus on neurological complications, and patency rate were assessed. Twenty-six of 107 (14.2%) of the debranching patients were treated under emergency conditions because of acute type B dissection or symptomatic aneurysm. Follow up, conducted by imaging interpretation and telephone interviews, continued till March 2017 (mean 42.1, 0-125, months). The in hospital mortality rate was 10.2% (11/107), all of these cases from the debranching group and related to emergency procedures (p supra-aortic bypass surgery involves low complication rates and high mid-term bypass patency rates. It is a safe and feasible treatment option in the form of debranching in combination with endovascular aortic aneurysm repair and in AOD. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

  14. Blood oxygenation level-dependent MRI of the skeletal muscle during ischemia in patients with peripheral arterial occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Potthast, Silke [Unispital Basel, Inst. fuer Radiologie (Switzerland); Schulte, A. [Univ. Hospital Ulm (Germany). Clinic for Radiation Therapy and Radiooncology; Kos, S.; Bilecen, D. [Unispital Basel, Interventional Radiology (Switzerland); Aschwanden, M. [Unispital Basel (Switzerland). Angiologie

    2009-12-15

    Purpose: to compare calf muscle Blood Oxygenation Level-Dependent (BOLD) response during ischemia in patients suffering from peripheral arterial occlusive disease (PAOD) and age-matched non-PAOD subjects. Materials and methods: PAOD patients with symptoms of intermittent calf claudication and an age-matched control group underwent T2*-weighted single-shot multi-echo planar imaging on a whole-body MR scanner at 1.5 T. The muscle BOLD signal in the calf was acquired during 60 sec of baseline and 240 sec of ischemia induced by cuff compression. T2* time courses in four calf muscles were evaluated. Results: significant differences in the mean T2* values were noted after 150 sec of measurement (p < 0.05). Patients with PAOD revealed a significantly reduced BOLD signal decrease compared to an age-matched control group. Conclusion: potential cause for this observation may be changes in the structure and/or the metabolic turnover of the muscle in PAOD patients. (orig.)

  15. Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group.

    Science.gov (United States)

    Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

    2016-01-01

    Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses' areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not.

  16. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients.

    Science.gov (United States)

    Gary, Thomas; Pichler, Martin; Belaj, Klara; Hafner, Franz; Gerger, Armin; Froehlich, Harald; Eller, Philipp; Rief, Peter; Hackl, Gerald; Pilger, Ernst; Brodmann, Marianne

    2013-01-01

    Platelet-to-Lymphocyte Ratio (PLR) is an easily applicable blood test. An elevated PLR has been associated with poor prognosis in patients with different oncologic disorder. As platelets play a key role in atherosclerosis and atherothrombosis, we investigated PLR and its association with critical limb ischemia (CLI) and other vascular endpoints in peripheral arterial occlusive disease (PAOD) patients. We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. PLR was calculated and the cohort was categorized into tertiles according to the PLR. An optimal cut-off value for the continuous PLR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI significantly increased with an increase in PLR. As an optimal cut-off value, a PLR of 150 was identified. Two groups were categorized, one containing 1228 patients (PLR≤150) and a second group with 893 patients (PLR>150). CLI was more frequent in PLR>150 patients (410(45.9%)) compared to PLR≤150 patients (270(22.0%)) (p150 was associated with an OR of 1.9 (95%CI 1.7-2.1) for CLI even after adjustment for other well-established vascular risk factors. An increased PLR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The PLR is a broadly available and cheap marker, which could be used to highlight patients at high risk for vascular endpoints.

  17. ECG-triggered non-contrast-enhanced MR angiography (TRANCE) versus digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease of the lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Sutter, Reto [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Froehlich, Johannes M.; Roos, Justus E.; Sautter, Thomas; Schoch, Erik; Giger, Barbara; Weymarn, Constantin von; Binkert, Christoph A. [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Wyss, Michael [University and ETH Zurich, Institute for Biomedical Engineering, Zurich (Switzerland); Graf, Nicole [University Hospital of Zurich, Clinical Trials Center, Center for Clinical Research, Zurich (Switzerland); Jenelten, Regula [Cantonal Hospital Winterthur, Department of Angiology, Winterthur (Switzerland); Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria)

    2011-09-15

    To prospectively determine the diagnostic value of electrocardiography-triggered non-contrast-enhanced magnetic resonance angiography (TRANCE) of the lower extremities including the feet versus DSA. All 43 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent TRANCE before DSA. Quality of MRA vessel depiction was rated by two independent radiologists on a 3-point scale. Arterial segments were graded for stenoses using a 4-point scale (grade 1: no stenosis; grade 2: moderate stenosis; grade 3: severe stenosis; grade 4: occlusion). Findings were compared with those of DSA. In the 731 vessel segments analysed, intra-arterial DSA revealed 283 stenoses: 33.6% moderate, 16.6% severe and 49.8% occlusions. TRANCE yielded a mean sensitivity, specificity, positive and negative predictive value and diagnostic accuracy to detect severe stenoses or occlusions of 95.6%, 97.4%, 87.2%, 99.2%, 97.1% for the thigh segments and 95.2%, 87.5%, 83.2%, 96.6%, 90.5% for the calf segments. Excellent overall image quality was observed for TRANCE in 91.4% versus 95.7% (DSA) for the thigh and in 60.7% versus 91.0% for the calves, while diagnostic quality of the pedal arteries was rated as insufficient. TRANCE achieves high diagnostic accuracy in the thigh and calf regions, whereas the pedal arteries showed limited quality. (orig.)

  18. Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

    Science.gov (United States)

    Kopp, Reinhard; Weidenhagen, Rolf; Hoffmann, Ralf; Waggershauser, Tobias; Meimarakis, Georgios; Andrassy, Joachim; Clevert, Dirk; Czerner, Stephan; Jauch, Karl-Walter

    2006-07-01

    An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

  19. Success of an outpatient claudication group training program for patients with peripheral arterial occlusive disease (PAOD): the Tübingen model.

    Science.gov (United States)

    Klyscz, T; Jünger, M; Jünger, I; Hahn, M; Rassner, G

    1997-03-01

    Active exercise therapy plays a decisive role in the prognosis for early forms of peripheral arterial occlusive disease (stages I and II). We present a model project for an outpatient claudication group which has proved successful in the active exercise therapy of early forms of arterial occlusive disease (PAOD). In addition to the training principles familiar from intensified, performance-keyed walking programs, a newly developed pedal ergometer was employed which makes controlled endurance training possible for this patient group. The distance patients were able to walk without pain increased significantly in 17 out of the 26 patients taking part in the program. This clinical success was confirmed by an examination of arterial hemodynamics. The transformation of a theoretical concept into a functioning training program and the positive results achieved with it should encourage others to establish similar programs close to the patients' homes.

  20. Quantitative Doppler ultrasound evaluation of occlusive arterial disease in the lower limb

    DEFF Research Database (Denmark)

    Bagi, P; Sillesen, H; Hansen, H J

    1988-01-01

    Forty consecutive patients with lower limb arterial disease were evaluated using a multi-gated pulsed Doppler system. Doppler signals were sampled at 4 sites in each limb, and following spectral analysis, the pulse rise time (PRT) was measured. The value obtained at the location giving the longest...... duration of PRT was used for comparison with ankle/brachial pressure index (A/B index) and angiography. A highly significant correlation was found between PRT and A/B index (r = -0.75, P less than 0.001). Based on receiver operating characteristic curves an overall diagnostic accuracy of 90% in diagnosing...

  1. SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Momose, Toshimitsu; Machida, Kikuo; Honda, Norinari; Nishikawa, Junichi; Sasaki, Yasuhito.

    1994-01-01

    Cerebral blood volume before and after acetazolamide was measured by SPECT to evaluate cerebral vasodilatory capacity in eight patients with cerebrovascular disease and five control subjects. Two SPECT measurements were performed serially, and acetazolamide was administered between them. The ratio of increase in hemispheric blood volume was calculated, and it was compared with the results of cerebral blood flow and cerebral blood volume measurements. A cerebral vasodilatory capacity map, the image after acetazolamide minus the baseline image, was also produced. Acetazolamide increased hemispheric blood volume in all subjects. The ratio of increase was lower in the involved hemispheres of the patients with unilateral carotid disease than in the uninvolved hemispheres of the patients and control subjects. The ratio of concordance with blood flow and blood volume measurements was approximated at 80%. Cerebral vasodilatory capacity mapping revealed three defects compatible with the clinical data. SPECT measurements of cerebral blood volume after acetazolamide can be performed following baseline SPECT with no additional radiotracer, and may be helpful to assess hemodynamic status. (author)

  2. A clinical study on chronic arterial occlusive diseases of the lower extremities by scintiangiography of the foot

    International Nuclear Information System (INIS)

    Oya, Yoshitaro

    1981-01-01

    Scintiangiography of the foot was performed on 210 limbs with peripheral vascular diseases of the lower extremities in comparison with 12 normal limbs. After an intravenous bolus of 10 to 20 mCi of sup(99m)Tc-human serum albumin, the arrival and distribution of activity in foot during reactive hyperemia were observed and photographed on the monitor scope of the gamma camera and recorded on video tape. The activity curve was obtained for several regions of interest and analysed to obtain the arrival time of activity Ta, the maximum counts time Tmax and the perfusion index. Those results were compared with angiography and the pressure index. The gamma camera image provided approximately the state of the peripheral circulation, and the defect or delay of the image was obtained on 93 per cent of the ischemic extremities. The pattern of the activity curves were classified into three types, I: rapid appearance with high activity peak, II: relatively rapid appearance with low activity peak, III: delayed appearance with the absence of the activity peak. In normal subjects and good run-off patients, the typical pattern of the activity curve was mainly observed being to I type, on the other hand, the pattern was generally being to III type in patients with ulcerated or cyanotic foot. The difference between the arrival time of activity of foot and toe under conditions of reactive hyperemia was longer evidently according to degree of arterial occlusion. The perfusion index was well correlated to the pressure index on foot and toe. In conclusion, scintiangiography of the foot is a simple and harmless procedure to evaluate the hemodynamic state of the lower extremities and is applicable for screening the peripheral vascular diseases and postoperative study. (author)

  3. The effects of Crenotherapy and exercise in peripheral arterial occlusive disease. A comparison with simple exercise training.

    Science.gov (United States)

    Quarto, Gennaro; Amato, Bruno; Serra, Raffaele; Benassai, Giacomo; Monti, Maria G; Salzano, Andrea; D'Assante, Roberta; Furino, Ermenegildo

    2017-01-01

    Conservative therapies for patients affected by Peripheral Arterial Occlusive Disease (PAOD) aim first to correct the risk factors and to slow down the disease progression. Among these, exercise has positive effects on blood flow, muscle metabolism and well demonstrated systemic effects. These include reduction of chronic inflammation markers, improvement of walking mechanics and heart function. Controlled physical training increases the ability to perform the daily activities improving life expectancy of these patients. The aim of this study is to evaluate the effects and the effectiveness of physical training performed in thermal water compared to traditional treadmill walking exercise. 98 patients affected by IIb stage PAOD, according to Leriche-Fontaine classification, were enrolled. Patients were randomized into two groups: the first arm carried out an intensive training program under medical supervision (group A); the second one carried out a rehabilitative exercise associated with crenotherapy (group B). The following parameters were detected: Ankle-Brachial pressure index (ABI), actual claudication distance (ACD), maximum walking distance (MWD), flow mediated dilatation (FMD) and the intima-media thickness (IMT). All patients underwent Doppler echocardiography and complete biochemical assay. In both groups, there was a statistically significant improvement of lipidaemia compared to baseline. When compared with each other, the two groups did not show statistically significant differences. There were no significant differences between the two groups regarding echocardiographic findings. Vascular reactivity study showed a statistically significant improvement of FMD after 3 months of exercise in both groups. In crenotherapy group (B) FMD values were significantly higher than the treadmill ones (A). In both groups a statistically significant improvement in ACD was observed CONCLUSIONS: Our experience shows that crenotherapy has similar effects compared to

  4. Multidisciplinary treatment for peripheral arterial occlusive disease and the role of eHealth and mHealth.

    Science.gov (United States)

    Fokkenrood, Hugo Jp; Lauret, Gert-Jan; Scheltinga, Marc Rm; Spreeuwenberg, Cor; de Bie, Rob A; Teijink, Joep Aw

    2012-01-01

    Increasingly unaffordable health care costs are forcing care providers to develop economically viable and efficient health care plans. Currently, only a minority of all newly diagnosed peripheral arterial occlusive disease (PAOD) patients receive efficient and structured conservative treatment for their disease. The aim of this article is to introduce an innovative effective treatment model termed ClaudicatioNet. This concept was launched in The Netherlands as a means to combat treatment shortcomings and stimulate cohesion and collaboration between stakeholders. The overall goal of ClaudicatioNet is to stimulate quality and transparency of PAOD treatment by optimizing multidisciplinary health care chains on a national level. Improved quality is based on stimulating both a theoretical and practical knowledge base, while eHealth and mHealth technologies are used to create clear insights of provided care to enhance quality control management, in addition these technologies can be used to increase patient empowerment, thereby increasing efficacy of PAOD treatment. This online community consists of a web portal with public and personal information supplemented with a mobile application. By connecting to these tools, a social community is created where patients can meet and keep in touch with fellow patients, while useful information for supervising health care professionals is provided. The ClaudicatioNet concept will likely create more efficient and cost-effective PAOD treatment by improving the quality of supervised training programs, extending possibilities and stimulating patient empowerment by using eHealth and mHealth solutions. A free market principle is introduced by introducing transparency to provided care by using objective and subjective outcome parameters. Cost-effectiveness can be achieved using supervised training programs, which may substitute for or postpone expensive invasive vascular interventions.

  5. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation

    OpenAIRE

    Mohty, M; Malard, F; Abecassis, M; Aerts, E; Alaskar, A S; Aljurf, M; Arat, M; Bader, P; Baron, F; Bazarbachi, A; Blaise, D; Ciceri, F; Corbacioglu, S; Dalle, J-H; Dignan, F

    2016-01-01

    Sinusoidal obstruction syndrome, also known as veno-occlusive disease (SOS/VOD), is a potentially life threatening complication that can develop after hematopoietic cell transplantation. Although SOS/VOD progressively resolves within a few weeks in most patients, the most severe forms result in multi-organ dysfunction and are associated with a high mortality rate ( > 80%). Therefore, careful attention must be paid to allow an early detection of SOS/VOD, particularly as drugs have now prove...

  6. MEK1/2 inhibitors reverse acute vascular occlusion in mouse models of sickle cell disease.

    Science.gov (United States)

    Zhao, Yulin; Schwartz, Evan A; Palmer, Gregory M; Zennadi, Rahima

    2016-03-01

    In sickle cell disease (SCD), treatment of recurrent vasoocclusive episodes, leading to pain crises and organ damage, is still a therapeutic challenge. Vasoocclusion is caused primarily by adherence of homozygous for hemoglobin S (SS) red blood cells (SSRBCs) and leukocytes to the endothelium. We tested the therapeutic benefits of MEK1/2 inhibitors in reversing vasoocclusion in nude and humanized SCD mouse models of acute vasoocclusive episodes using intravital microscopy. Administration of 0.2, 0.3, 1, or 2 mg/kg MEK1/2 inhibitor to TNF-α-pretreated nude mice before human SSRBC infusion inhibited SSRBC adhesion in inflamed vessels, prevented the progression of vasoocclusion, and reduced SSRBC organ sequestration. By use of a more clinically relevant protocol, 0.3 or 1 mg/kg MEK1/2 inhibitor given to TNF-α-pretreated nude mice after human SSRBC infusion and onset of vasoocclusion reversed SSRBC adhesion and vasoocclusion and restored blood flow. In SCD mice, 0.025, 0.05, or 0.1 mg/kg MEK1/2 inhibitor also reversed leukocyte and erythrocyte adhesion after the inflammatory trigger of vasoocclusion and improved microcirculatory blood flow. Cell adhesion was reversed by shedding of endothelial E-selectin, P-selectin, and αvβ3 integrin, and leukocyte CD44 and β2 integrin. Thus, MEK1/2 inhibitors, by targeting the adhesive function of SSRBCs and leukocytes, could represent a valuable therapeutic intervention for acute sickle cell vasoocclusive crises. © FASEB.

  7. Targeted True Lumen Re-Entry With the Outback Catheter: Accuracy, Success, and Complications in 100 Peripheral Chronic Total Occlusions and Systematic Review of the Literature.

    Science.gov (United States)

    Kitrou, Panagiotis; Parthipun, Aneeta; Diamantopoulos, Athanasios; Paraskevopoulos, Ioannis; Karunanithy, Narayan; Katsanos, Konstantinos

    2015-08-01

    To report a single-center experience with the Outback re-entry device for targeted distal true lumen re-entry during subintimal recanalization of chronic total occlusions (CTOs) and compare the results with a systematic review of the literature. Between February 2011 and July 2013, 104 Outback devices were employed in 91 patients (mean age 64±9 years; 57 men) for subintimal recanalization of 100 vessels with CTOs after initial failure of spontaneous reentry. Fifty-two cases involved a retrograde approach to aortoiliac occlusions and 48 were re-entry attempts in infrainguinal CTOs. Outcome measures included complications and technical success, defined as successful targeted re-entry at the preplanned site of the distal true lumen. To evaluate device accuracy, the re-entry distance (between the point of true vessel reconstitution and the eventual re-entry point) was measured. Outback success was 93% (93/100); only 7 cases failed owing to heavy calcification (5/52 aortoiliac vs 2/48 infrainguinal, p=0.44). Re-entry was highly accurate, with a re-entry distance of ~1 cm in both subgroups (1.2±0.1 cm in aortoiliac vs 1.3±0.1 cm in infrainguinal, p=0.40). There were no major and 17 minor complications (9/52 aortoiliac vs 8/48 infrainguinal, p=0.93). Results are in line with the systematic review that identified 11 studies (only 1 randomized trial) involving mostly the femoropopliteal segment (119 aortoiliac and 464 infrainguinal segments). The pooled Outback success rate was 90% (95% confidence interval 85% to 94%) and the pooled complication rate was 4.3% (95% confidence interval 1.6% to 8.3%). The Outback device is safe and has a very high rate of achieving targeted true lumen re-entry, which minimizes the sacrifice of healthy vessel in the aortoiliac and infrainguinal arteries. © The Author(s) 2015.

  8. Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, Rolf W. [University Hospital Basel, Department of Radiology, Division of Interventional Radiology, Basel (Switzerland)]|[Kantonsspital Bruderholz, Department of Radiology, Bruderholz (Switzerland); Schulte, Anja-Carina [University of Basel, Biocenter, Basel (Switzerland); Aschwanden, Markus; Thalhammer, Christoph [University Hospital Basel, Department of Angiology, Basel (Switzerland); Kos, Sebastian; Jacob, Augustinus L.; Bilecen, Deniz [University Hospital Basel, Department of Radiology, Division of Interventional Radiology, Basel (Switzerland)

    2009-02-15

    The purpose was to evaluate the effect of percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) on the blood oxygenation level-dependent (BOLD) signal change in the calf musculature of patients with intermittent claudication. Ten patients (mean age, 63.4 {+-} 11.6 years) with symptomatic peripheral arterial occlusive disease (PAOD) caused by SFA stenoses were investigated before and after PTA. Patients underwent BOLD-MRI 1 day before and 6 weeks after PTA. A T2*-weighted single-shot multi-echo echo-planar MR-imaging technique was applied. The BOLD measurements were acquired at mid-calf level during reactive hyperaemia at 1.5 T. This transient hyperperfusion of the muscle tissue was provoked by suprasystolic cuff compression. Key parameters describing the BOLD signal curve included maximum T2*(T2*{sub max}), time-to-peak to reach T2*{sub max} (TTP) and T2* end value (EV) after 600 s of hyperemia. Paired t-tests were applied for statistic comparison. Between baseline and post-PTA, T2*{sub max} increased from 11.1{+-}3.6% to 12.3{+-}3.8% (p=0.51), TTP decreased from 48.5{+-}20.8 s to 35.3{+-}11.6 s (p=0.11) and EV decreased from 6.1{+-}6.4% to 5.0{+-}4.2% (p=0.69). In conclusion, BOLD-MRI reveals changes of the key parameters T2*{sub max}, TTP, and EV after successful PTA of the calf muscles during reactive hyperaemia. (orig.)

  9. Hospitalist management of vaso-occlusive pain crisis in patients with sickle cell disease using a pathway of care.

    Science.gov (United States)

    Allen Liles, Edmund; Kirsch, Jonathan; Gilchrist, Michael; Adem, Mukhtar

    2014-04-01

    Patients with sickle cell disease (SCD) suffer from intermittent vaso-occlusive pain crises (VOCs). These crises lead to frequent hospitalizations, significant morbidity, and increased mortality risk. Care pathways can enhance efficiency and quality of care. Our study sought to evaluate the development and implementation of a care pathway for patients with SCD experiencing VOCs. The University of North Carolina (UNC) Comprehensive Sickle Cell Program provides all levels of care for a large population of patients with sickle cell anemia. All patients admitted to UNC Hospitals with SCD VOCs from January 2009 through June 2011 were evaluated. During this time period, we also assessed sequential prospective cohorts during progressive phases of developing and implementing a quality improvement and pathway of care program for this patient population in our study. The developed pathway entailed geographic localization for VOC patients, a single group of faculty physicians caring for these patients, and early use of patient-controlled analgesia (PCA) to achieve pain control. Physicians from the UNC Hospital Medicine Program were responsible for the initiatives. Cohorts were compared to a baseline historical control. Outcomes of interest included patient length of stay (LOS) in the hospital, 30-day readmission rate, need for transfusion, incidence of acute chest syndrome, use of naloxone, and use of PCA. Compared with an historical baseline cohort, the development and implementation of a VOC care pathway for patients with SCD led to reduction in average hospital LOS by 1.44 days (P management of patients with SCD VOCs using a care pathway that emphasizes early, aggressive PCA-based pain control is associated with reduced hospital LOS. The LOS reduction seen in our study is clinically meaningful. Notably, other measures of patient outcomes and quality of care metrics did not change significantly, and some trended towards improvement.

  10. Predictive value of elevated neutrophil to lymphocyte ratio for long-term cardiovascular mortality in peripheral arterial occlusive disease.

    Science.gov (United States)

    Erturk, Mehmet; Cakmak, Huseyin Altug; Surgit, Ozgur; Celik, Omer; Aksu, Hale Unal; Akgul, Ozgur; Gurdogan, Muhammet; Bulut, Umit; Ozalp, Begum; Akbay, Ertan; Yildirim, Aydin

    2014-11-01

    Peripheral arterial occlusive disease (PAOD), which is common in male gender and elderly population, is related with increased cardiovascular mortality and morbidity. Neutrophil to lymphocyte ratio (NLR) has been found to be an independent predictor of cardiovascular mortality in atherosclerosis. The aim of the present study was to investigate the association between NLR and cardiovascular mortality both in patients with intermittent claudication and critical limb ischemia. In a retrospective study, 593 consecutive patients who had been admitted to the inpatient ward of the vascular department of a large tertiary training and research hospital with diagnosis of symptomatic PAOD between May 2009 and September 2012 were included. Patients were divided into two groups according to their NLR as follows: high NLR (NLR>3.0) and low NLR (NLR ≤ 3.0) groups. During the course of the present study [median follow-up period of 20 months (interquartile range, 12-27)], 75 deaths occurred out of 508 patients (14.8%). Cardiovascular mortality was found to be significantly higher in elevated NLR group (n = 43) as compared to low NLR group (n = 32) (23.6% vs 9.8%, respectively; p 3 and age were found as independent predictors of long-term cardiovascular mortality in Cox regression analysis [hazard ratios (95% confidence interval), 2.04 (1.26-3.30) and 1.04 (1.01-1.07), p = 0.004 and p = 0.004, respectively]. We demonstrated that an increased NLR was related with higher cardiovascular mortality in patients with PAOD, who were admitted with critical limb ischemia or intermittent claudication. NLR, which reflects the patient's inflammatory status, is an inexpensive and readily available biomarker that provides an additional level of risk stratification beyond that provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  11. Dual-energy CTA in patients with symptomatic peripheral arterial occlusive disease. Study of diagnostic accuracy and impeding factors

    Energy Technology Data Exchange (ETDEWEB)

    Klink, Thorsten [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology; Wilhelm, Theresa; Roth, Christine [Univ. Hospital Giessen and Marburg, Marburg (Germany). Dept. of Diagnostic and Interventional Radiology; Heverhagen, Johannes T. [Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology

    2017-05-15

    The purpose of this study was to assess the diagnostic performance of dual-energy CT angiography (DE-CTA) in patients with symptomatic peripheral artery occlusive disease (PAOD) and to identify factors that impede its diagnostic accuracy. Dual-source DE-CTA scans of the lower extremities of 94 patients were retrospectively compared to the diagnostic reference standard, digital subtraction angiography (DSA). Two independent observers assessed PAOD incidence, image quality, artifacts, and diagnostic accuracy of DE-CTA in 1014 arterial segments on axial, combined 80/140 kVp reconstructions and on 3 D maximum intensity projections (MIP) after automated bone and plaque removal. The impact of calcifications, image quality, and image artifacts on the diagnostic accuracy was evaluated using Fisher's exact test. Furthermore, interobserver agreement was analyzed. Two observers achieved sensitivities of 98.0% and 93.9%, respectively, and specificities of 75.0% and 66.7%, respectively, for detecting stenoses of >50% of the lower extremity arteries. Calcifications impeded specificity, e.g. from 81.2% to 46.2% for reader 1 (p<0.001). Specificity increased with higher image quality, e.g. from 70.0% to 76.4% for reader 1 (p<0.001). Artifacts decreased the specificity of reader 2 (p<0.001). The overall interobserver agreement ranged between moderate and substantial for stenosis detection and calcified plaques. Conclusion DE-CTA is accurate in the detection of arterial stenoses of >50% in symptomatic PAOD patients. Calcified atherosclerotic plaques, image quality, and artifacts may impede specificity.

  12. Intraarterial contrast-enhanced MR aortography with and without parallel acquisition technique in patients with peripheral arterial occlusive disease.

    Science.gov (United States)

    Potthast, Silke; Bongartz, Georg M; Huegli, Rolf; Schulte, Anja-Carina; Schwarz, Jochen G; Aschwanden, Markus; Bilecen, Deniz

    2007-03-01

    Repeated intraarterial gadolinium injections are necessary in endovascular MRI-guided interventions; therefore a low-dose protocol with a short acquisition time is preferable. The purpose of this study was to conduct a quantitative comparison of intraarterial MR aortograms obtained with and without high-speed parallel acquisition technique. Intraarterial MR aortography was performed at 1.5 T on nine patients with peripheral arterial occlusive disease and in an aortic phantom with pulsatile flow. A 3D fast low-angle shot MRI sequence was used for standard technique (acquisition time, 20 seconds) and for parallel acquisition technique (acquisition time, 14 seconds). In all patients, a pigtail catheter was left in the suprarenal position after digital subtraction angiography. Contrast-enhanced intraarterial MR aortography was performed after automated injection of 50 mmol/L gadoterate dimeglumine at an injection rate of 4 mL/s. Contrast-to-noise ratio (CNR) and image quality were evaluated in both imaging series at different locations. In an aortic phantom with pulsatile flow, CNR was determined 1, 30, and 60 cm distal to the catheter tip with standard and parallel acquisition techniques. In all patients, intraarterial MR aortography was feasible with both acquisition techniques. No significant difference in CNR or image quality was observed in the patient study. Similar results were calculated for the pulsatile aortic flow phantom at all locations. Intraarterial MR aortography is feasible with parallel acquisition technique without a significant loss of CNR. This technique reduces contrast agent consumption approximately 30% owing to an approximately 30% reduction in acquisition time.

  13. Graz Critical Limb Ischemia Score: A Risk Score for Critical Limb Ischemia in Peripheral Arterial Occlusive Disease.

    Science.gov (United States)

    Gary, Thomas; Belaj, Klara; Hafner, Franz; Eller, Philipp; Rief, Peter; Hackl, Gerald; Brodmann, Marianne

    2015-07-01

    Critical limb ischemia (CLI), a frequently encountered disorder, is associated with a high rate of limb amputation and mortality. To identify patients at high risk for CLI, we developed a simple risk score for peripheral arterial occlusive disease (PAOD).In our cross-sectional study, we first evaluated 1000 consecutive PAOD patients treated at our institution from 2005 to 2007, documenting clinical symptoms, comorbidities, and concomitant medication. We calculated odds ratios (OR) in a binary logistic regression model to find possible risk factors for CLI. We then verified the score in a second step that included the 1124 PAOD patients we treated between 2007 and 2011.In the first patient group, the greatest risk factors for CLI were age ≥75 years (OR 2.0), type 2 diabetes (OR 3.1), prior myocardial infarction (OR 2.5), and therapy with low molecular weight heparins (2.8). We scored 1 point for each of those conditions. One point was given for age between 65 and 75 years (OR 1.6) as well as for therapy with cardiac glycosides (OR 1.9) or loop diuretic therapy (OR 1.5). As statin therapy was protective for CLI with an OR of 0.5, we subtracted 1 point for those patients.In the second group, we could prove that frequency of CLI was significantly higher in patients with a high CLI score. The score correlated well with inflammatory parameters (c-reactive protein and fibrinogen). We were also able to define 3 different risk groups for low (score -1 to 1), intermediate (score 2-4), and high CLI risk (score >4).We developed a simple risk stratification scheme that is based on conditions that can be easily assessed from the medical history, without any laboratory parameters. This score should help to identify PAOD patients at high risk for CLI.

  14. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients.

    Directory of Open Access Journals (Sweden)

    Thomas Gary

    Full Text Available BACKGROUND: Platelet-to-Lymphocyte Ratio (PLR is an easily applicable blood test. An elevated PLR has been associated with poor prognosis in patients with different oncologic disorder. As platelets play a key role in atherosclerosis and atherothrombosis, we investigated PLR and its association with critical limb ischemia (CLI and other vascular endpoints in peripheral arterial occlusive disease (PAOD patients. METHODS AND FINDINGS: We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. PLR was calculated and the cohort was categorized into tertiles according to the PLR. An optimal cut-off value for the continuous PLR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI significantly increased with an increase in PLR. As an optimal cut-off value, a PLR of 150 was identified. Two groups were categorized, one containing 1228 patients (PLR≤150 and a second group with 893 patients (PLR>150. CLI was more frequent in PLR>150 patients (410(45.9% compared to PLR≤150 patients (270(22.0% (p150 was associated with an OR of 1.9 (95%CI 1.7-2.1 for CLI even after adjustment for other well-established vascular risk factors. CONCLUSIONS: An increased PLR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The PLR is a broadly available and cheap marker, which could be used to highlight patients at high risk for vascular endpoints.

  15. Outcomes after open repair for ruptured abdominal aortic aneurysms in patients with friendly versus hostile aortoiliac anatomy

    NARCIS (Netherlands)

    van Beek, S. C.; Reimerink, J. J.; Vahl, A. C.; Wisselink, W.; Reekers, J. A.; Legemate, D. A.; Balm, R.

    2014-01-01

    In patients with a ruptured abdominal aortic aneurysm (RAAA), anatomic suitability for endovascular aneurysm repair (EVAR) depends on aortic neck and iliac artery characteristics. If the aortoiliac anatomy is unsuitable for EVAR ("hostile anatomy"), open repair (OR) is the next option. We

  16. Iodine-123 IMP SPECT before and after bypass surgery in a patient with occlusion of left anterior and middle cerebral arteries with basal abnormal telangiectasis (unilateral Moyamoya disease)

    International Nuclear Information System (INIS)

    Honda, Norinari; Machida, Kikuo; Takishima, Teruo; Kaizu, Hiroyuki; Sugimoto, Eiichi

    1987-01-01

    A case of left anterior and middle cerebral arterial occlusion with angiographic features similar to Moyamoya disease was reported. IMP SPECT of the patient revealed the success of bypass surgery clearly. The patient complained of transient right hemiparesis with aphasia 4 times. The cerebral arteriography disclosed occlusions of left anterior and middle cerebral arteries at their proximal portions. Right internal carotid and its branches were normal. I-123 IMP SPECT study showed hypoperfusion in left temporal lobe, basal ganglia with incomplete reperfusion on the delayed (4 hours after injection) SPECT images. After the superficial temporal-middle cerebral artery anastomosis, I-123 IMP SPECT showed improvement of the brain blood flow. I-123 IMP SPECT was very useful in detecting the ischemic areas and evaluating the revascularizing surgery in this case. (author)

  17. Association between proximal internal carotid artery steno-occlusive disease and diffuse wall thickening in its petrous segment: a magnetic resonance vessel wall imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiaoyi; Li, Dongye [Capital Medical University and Beijing Institute for Brain Disorders, Center for Brain Disorders Research, Beijing (China); Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Zhao, Huilin [Shanghai Jiao Tong University, Department of Radiology, Renji Hospital, School of Medicine, Shanghai (China); Chen, Zhensen; Qiao, Huiyu; He, Le; Li, Rui [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Cui, Yuanyuan [PLA General Hospital, Department of Radiology, Beijing (China); Zhou, Zechen [Philips Research China, Healthcare Department, Beijing (China); Yuan, Chun [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); University of Washington, Department of Radiology, Seattle, WA (United States); Zhao, Xihai [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Beijing Institute for Brain Disorders, Center for Stroke, Beijing (China)

    2017-05-15

    Significant stenosis or occlusion in carotid arteries may lead to diffuse wall thickening (DWT) in the arterial wall of downstream. This study aimed to investigate the correlation between proximal internal carotid artery (ICA) steno-occlusive disease and DWT in ipsilateral petrous ICA. Symptomatic patients with atherosclerotic stenosis (>0%) in proximal ICA were recruited and underwent carotid MR vessel wall imaging. The 3D motion sensitized-driven equilibrium prepared rapid gradient-echo (3D-MERGE) was acquired for characterizing the wall thickness and longitudinal extent of the lesions in petrous ICA and the distance from proximal lesion to the petrous ICA. The stenosis degree in proximal ICA was measured on the time-of-flight (TOF) images. In total, 166 carotid arteries from 125 patients (mean age 61.0 ± 10.5 years, 99 males) were eligible for final analysis and 64 showed DWT in petrous ICAs. The prevalence of severe DWT in petrous ICA was 1.4%, 5.3%, 5.9%, and 80.4% in ipsilateral proximal ICAs with stenosis category of 1%-49%, 50%-69%, 70%-99%, and total occlusion, respectively. Proximal ICA stenosis was significantly correlated with the wall thickness in petrous ICA (r = 0.767, P < 0.001). Logistic regression analysis showed that proximal ICA stenosis was independently associated with DWT in ipsilateral petrous ICA (odds ratio (OR) = 2.459, 95% confidence interval (CI) 1.896-3.189, P < 0.001). Proximal ICA steno-occlusive disease is independently associated with DWT in ipsilateral petrous ICA. (orig.)

  18. Pulmonary vascular remodeling patterns and expression of general control nonderepressible 2 (GCN2) in pulmonary veno-occlusive disease.

    Science.gov (United States)

    Nossent, Esther J; Antigny, Fabrice; Montani, David; Bogaard, Harm Jan; Ghigna, Maria Rosa; Lambert, Mélanie; Thomas de Montpréville, Vincent; Girerd, Barbara; Jaïs, Xavier; Savale, Laurent; Mercier, Olaf; Fadel, Elie; Soubrier, Florent; Sitbon, Olivier; Simonneau, Gérald; Vonk Noordegraaf, Anton; Humbert, Marc; Perros, Frédéric; Dorfmüller, Peter

    2017-10-04

    Heritable pulmonary veno-occlusive disease (PVOD) is linked to mutations in the eukaryotic initiation factor 2 alpha kinase 4 (EIF2AK4) gene, leading to a loss of general control nonderepressible 2 (GCN2). The role of GCN2 expression in pulmonary vascular remodeling remains obscure. We sought to identify specific histologic and biologic features in heritable PVOD. Clinical data and lung histology of 24 PVOD patients (12 EIF2AK4 mutation carriers, 12 non-carriers) were submitted to systematic histologic analysis and semiautomated morphometry. GCN2 expression was quantified by Western blotting in 24 PVOD patients, 44 patients with pulmonary arterial hypertension (PAH; 23 bone morphogenetic protein receptor type II [BMPR2] mutation carriers, 21 non-carriers), and 3 experimental pulmonary hypertension models. PVOD patients showed a significant decrease of pulmonary arterial patency (p < 0.0001) compared with healthy controls. Histology of EIF2AK4 mutation carriers was distinctive from non-carriers regarding (1) arterial remodeling, with significantly more severe intimal fibrosis (p = 0.001), less severe medial hypertrophy (p = 0.001), and (2) stronger muscular hyperplasia of interlobular septal veins (p = 0.002). GCN2 expression was abolished in heritable PVOD (p < 0.0001), but also importantly decreased in sporadic PVOD (p = 0.03) as well as in heritable (p = 0.002) and idiopathic PAH (p = 0.003); moreover, GCN2 was abolished in 2 experimental pulmonary hypertension models and importantly decreased in 1 model (p < 0.0001 for all models). Pulmonary arterial remodeling in PVOD is present to an important extent. A significant decrease of GCN2 expression is a common denominator of all tested groups of PVOD and PAH, including their respective experimental models. Our results underline specific morphologic and biologic similarities between PAH and PVOD and let us consider both conditions rather in one large spectrum of disease than as two distinct and clear-cut entities

  19. Importance of Collateralization in Patients With Large Artery Intracranial Occlusive Disease: Long-Term Longitudinal Assessment of Cerebral Hemodynamic Function

    Directory of Open Access Journals (Sweden)

    Larissa McKetton

    2018-04-01

    Full Text Available Patients with large artery intracranial occlusive disease (LAICOD are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR using blood oxygen level-dependent (BOLD MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients. Here, we report a case of long-term follow-up in a 28-year-old Caucasian female presented to the neurology clinic with a history of TIAs and LAICOD of the right middle cerebral artery (MCA. Initial structural MRI showed a right MCA stenosis and a small right coronal radiate lacunar infarct. Her CVR study showed a large area of impaired CVR with a paradoxical decrease in BOLD signal with hypercapnia involving the right MCA territory indicating intracerebral steal. The patient was managed medically with anticoagulant and antiplatelet therapy and was followed-up for over 9 years with both structural and functional imaging. Cortical thickness (CT measures were longitudinally assessed from a region of interest that was applied to subsequent time points in the cortical region exhibiting steal physiology and in the same region of the contralateral healthy hemisphere. In the long-term follow-up, the patient exhibited improvement in her CVR as demonstrated by the development of collaterals with negligible changes to CT. Management of patients with LAICOD remains challenging since no revascularization strategies have shown efficacy except in patients with moyamoya disease. Management is well

  20. Multidisciplinary treatment for peripheral arterial occlusive disease and the role of eHealth and mHealth

    Directory of Open Access Journals (Sweden)

    Fokkenrood HJP

    2012-10-01

    Full Text Available Hugo JP Fokkenrood,1,2 Gert-Jan Lauret,1,2 Marc RM Scheltinga,4 Cor Spreeuwenberg,3 Rob A de Bie,2 Joep AW Teijink1,21Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; 2CAPHRI Research School, Department of Epidemiology, 3Department of Integrated Care, Maastricht University, Maastricht, The Netherlands; 4Department of Vascular Surgery, Maxima Medical Centre, Veldhoven, The NetherlandsAbstract: Increasingly unaffordable health care costs are forcing care providers to develop economically viable and efficient health care plans. Currently, only a minority of all newly diagnosed peripheral arterial occlusive disease (PAOD patients receive efficient and structured conservative treatment for their disease. The aim of this article is to introduce an innovative effective treatment model termed ClaudicatioNet. This concept was launched in The Netherlands as a means to combat treatment shortcomings and stimulate cohesion and collaboration between stakeholders. The overall goal of ClaudicatioNet is to stimulate quality and transparency of PAOD treatment by optimizing multidisciplinary health care chains on a national level. Improved quality is based on stimulating both a theoretical and practical knowledge base, while eHealth and mHealth technologies are used to create clear insights of provided care to enhance quality control management, in addition these technologies can be used to increase patient empowerment, thereby increasing efficacy of PAOD treatment. This online community consists of a web portal with public and personal information supplemented with a mobile application. By connecting to these tools, a social community is created where patients can meet and keep in touch with fellow patients, while useful information for supervising health care professionals is provided. The ClaudicatioNet concept will likely create more efficient and cost-effective PAOD treatment by improving the quality of supervised training

  1. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... Flow Audio provided by Morton Tavel, MD. Pulse assessment is also useful to assess blood flow. A ... claudication is incapacitating or occurs during rest, when wounds do not heal, or when gangrene develops. Good ...

  2. Addressing challenges of clinical trials in acute pain: The Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study.

    Science.gov (United States)

    Nottage, Kerri A; Hankins, Jane S; Faughnan, Lane G; James, Dustin M; Richardson, Julie; Christensen, Robbin; Kang, Guolian; Smeltzer, Matthew; Cancio, Maria I; Wang, Winfred C; Anghelescu, Doralina L

    2016-08-01

    Neuropathic pain is a known component of vaso-occlusive pain in sickle cell disease; however, drugs targeting neuropathic pain have not been studied in this population. Trials of acute pain are complicated by the need to obtain consent, to randomize participants expeditiously while optimally treating pain. We describe the challenges in designing and implementing the Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study (NCT01954927), a phase II, randomized, double-blind, placebo-controlled trial to determine the effect of gabapentin for vaso-occlusive crisis. In the Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study, we aim to assess the analgesic effect of gabapentin during vaso-occlusive crisis. Difficulties we identified included avoiding delay of notification of study staff of potential participants which we resolved by automated notification. Concern for rapid randomization and drug dispensation was addressed through careful planning with an investigational pharmacy and a single liquid formulation. We considered obtaining consent during well-visits to avoid the time constraints with acute presentations, but the large number of patients and limited duration that consent is valid made this impractical. In all, 79% of caregivers/children approached have agreed to participate. The trial is currently active, and enrollment is at 45.8% of that targeted (76 of 166) and expected to continue for two more years. Maintaining staff availability after-hours remains problematic, with 8% of screened patients missed for lack of available staff. Lessons learned in designing a trial to expedite procedures in the acute pain setting include (1) building study evaluations upon a standard-of-care backbone; (2) implementing a simple study design to facilitate consent and data capture; (3) assuring ample, well-trained study staff; and (4) utilizing technology to automate procedures

  3. Constriction of collateral arteries induced by "head-up tilt" in patients with occlusive arterial disease of the legs

    DEFF Research Database (Denmark)

    Agerskov, K; Henriksen, O; Tønnesen, K H

    1981-01-01

    not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...... absent indicating that the constriction of the collateral arteries is mainly mediated via sympathetic vasoconstrictor fibres....

  4. Bilateral internal carotid artery occlusion

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  5. Systemic vasculitis is associated with a higher risk of lower extremity amputation in patients with severe peripheral arterial occlusive disease: a secondary analysis of a nationwide, population-based health claims database.

    Science.gov (United States)

    Lu, Ming-Chi; Hsu, Honda; Lin, Ching-Hsing; Koo, Malcolm

    2017-11-01

    Previous research has shown that diabetes mellitus increases the risk of lower extremity amputation in patients with peripheral arterial occlusive disease. However, to our knowledge, no studies have investigated whether systemic autoimmune disease, in particular systemic vasculitis is associated with a higher risk of lower extremity amputation in these patients. To investigate the association between systemic autoimmune disease and lower extremity amputation in patients with severe peripheral arterial occlusive disease based on a secondary analysis of a nationwide, population-based health claims database. Using the inpatient datafile of the Taiwan's National Health Insurance Research Database (NHIRD), we identified 432 patients with severe peripheral arterial occlusive disease that required hospitalization between 2000 and 2012. We also identified patients who had undergone lower extremity amputation and their comorbidities using the same datafile. The risk of lower extremity amputation was assessed using multiple logistic regression analysis, adjusting for age, sex, insured amount, the urbanization level of residence, and the presence of comorbidities. Among patients with severe peripheral arterial occlusive disease, those with systemic vasculitis exhibited a significant higher risk of lower extremity amputation (adjusted odds ratio [aOR] = 6.82, p risk of lower extremity amputation. Among patients with severe peripheral arterial occlusive disease, a significantly higher risk of lower extremity amputation was observed in those with systemic vasculitis.

  6. Carbogen inhalation increases oxygen transport to hypoperfused brain tissue in patients with occlusive carotid artery disease: increased oxygen transport to hypoperfused brain

    DEFF Research Database (Denmark)

    Ashkanian, Mahmoud; Gjedde, Albert; Mouridsen, Kim

    2009-01-01

    Hyperoxic therapy for cerebral ischemia reduces cerebral blood flow (CBF) principally from the vasoconstrictive effect of oxygen on cerebral arterioles. Based on a recent study in normal volunteers, we now claim that the vasodilatory effect of carbon dioxide predominates when 5% CO(2) is added...... to inhaled oxygen (the mixture known as carbogen). In the present study, we measured CBF by positron emission tomography (PET) during inhalation of test gases (O(2), carbogen, and atmospheric air) in healthy volunteers (n = 10) and in patients with occlusive carotid artery disease (n = 6). Statistical...

  7. Recalcitrant Venous Leg Ulcers May Heal by Outpatient Treatment of Venous Disease Even in the Presence of Concomitant Arterial Occlusive Disease.

    Science.gov (United States)

    Mosti, G; Cavezzi, A; Massimetti, G; Partsch, H

    2016-09-01

    Peripheral arterial occlusive disease (PAOD) is reported in about 15-20% of patients with venous leg ulcers (VLU). In such cases arterial recanalization is often recommended, and compression therapy is considered a contraindication when the ankle brachial pressure index (ABPI) is venous recalcitrant leg ulcer" [pvRLU]) and with associated PAOD ("mixed arterial and venous recalcitrant leg ulcer" [mavRLU]), by treating only the venous disease. The records of 180 outpatients with recalcitrant ulcers treated between January 2011 and July 2014 were reviewed retrospectively. In total, 109 were affected by pvRLU and 71 by mavRLU, with moderate PAOD defined by an ABPI between 0.5 and 0.8. In addition to the same local wound dressing, the patients received ultrasound guided foam sclerotherapy of the refluxing superficial veins and a modified inelastic compression with a pressure ≤ 40 mmHg. No patient was referred for arterial revascularization. The patients were followed until ulcer healing. Patients with pvRLU and mavRLU showed comparable demographic characteristics. Twenty-five patients were lost to follow up and the outcomes were analyzed in 93 patients with pVLU (85.4%) and in 62 patients with mavRLU (87.4%). The maximum time to complete healing was 48 weeks in the pvRLU group and 52 weeks in the mavRLU group (p = .009), The median healing time was 23 (pvRLU) versus 25.5 weeks (mavRLU) (p = .030). Deep venous incompetence (p ulcer surface area (p ulcer duration (p ulcers by treating venous incompetence by foam sclerotherapy and modified compression is successful, even if underlying moderate PAOD is not actively treated. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease. Comparison with dynamic susceptibility contrast-perfusion MR imaging

    International Nuclear Information System (INIS)

    Ida, Kentaro; Akaki, Shiro; Sei, Tetsuro; Kanazawa, Susumu; Tsunoda, Masatoshi

    2006-01-01

    To determine the efficacy of flow-sensitive alternating inversion recovery using half-Fourier single-shot turbo spin-echo (FAIR-HASTE) in detecting cerebral hypoperfusion in chronic carotid occlusive disease, we subjected 12 patients with various degrees of cervical internal carotid artery stenoses and/or occlusion (Stenosis group) and 24 volunteers (Normal group) to FAIR-HASTE. In addition, 10 out of 12 patients in the Stenosis group underwent dynamic susceptibility contrast-perfusion magnetic resonance imaging (DSC-pMRI) before and after revascularization in the dominantly affected side. The absolute asymmetry indexes (AIs) of both cerebral hemispheres in the Normal and Stenosis groups were compared in FAIR-HASTE. In addition, the AIs were compared with those in the Stenosis group before and after revascularization in both FAIR-HASTE and regional cerebral blood flow (rCBF), calculated with DSC-pMRI. A statistically significant difference was recognized between the AIs in the Normal and Stenosis groups (AI=2.25±1.92, 8.09±4.60, respectively; p<0.0001). Furthermore, in the Stenosis group the AIs on both FAIR-HASTE (8.88±4.93, 2.22±1.79, respectively; p=0.0003) and rCBF (7.13±3.57, 1.25±1.33, respectively; p=0.0003) significantly decreased after revascularization. In the Stenosis group, before revascularization, signal intensity on both FAIR-HASTE and rCBF had a tendency to be lower in the dominantly affected side. FAIR-HASTE imaging was useful in the detection and evaluation of cerebral hypoperfusion in chronic occlusive carotid disease. (author)

  9. Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation.

    Science.gov (United States)

    Kato-Lin, Yi-Chin; Krishnamurti, Lakshmanan; Padman, Rema; Seltman, Howard J

    2014-11-01

    There is limited application and evaluation of health information systems in the management of vaso-occlusive pain crises in sickle cell disease (SCD) patients. This study evaluates the impact of digitization of paper-based individualized pain plans on process efficiency and care quality by examining both objective patient data and subjective clinician insights. Retrospective, before and after, mixed methods evaluation of digitization of paper documents in Children's Hospital of Pittsburgh of UPMC. Subjective perceptions are analyzed using surveys completed by 115 clinicians in emergency department (ED) and inpatient units (IP). Objective effects are evaluated using mixed models with data on 1089 ED visits collected via electronic chart review 28 months before and 22 months after the digitization. Surveys indicate that all clinicians perceived the digitization to improve the efficiency and quality of pain management. Physicians overwhelmingly preferred using the digitized plans, but only 44% of the nurses had the same response. Analysis of patient records indicates that adjusted time from analgesic order to administration was significantly reduced from 35.50 to 26.77 min (pmanagement. This study highlights the important role of health information technology (HIT) on vaso-occlusive pain management for pediatric patients with sickle cell disease and the critical challenges in accommodating human factor considerations in implementing and evaluating HIT effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Intensive vascular training in stage IIb of peripheral arterial occlusive disease. The additive effects of intravenous prostaglandin E1 or intravenous pentoxifylline during training.

    Science.gov (United States)

    Scheffler, P; de la Hamette, D; Gross, J; Mueller, H; Schieffer, H

    1994-08-01

    In a randomized open study, the combination of either prostaglandin E1 (PGE1) or pentoxifylline with controlled vascular training was compared with vascular training alone in patients with peripheral arterial occlusive disease in stage IIb. Forty-four patients were randomly assigned to treatment either of intensive vascular training alone (n = 15) or in combination with either i.v. pentoxifylline (200 mg over 2 hours BID, n = 15) or PGE1 (40 micrograms over 2 hours BID, n = 14). The basic therapy was a well-defined routine for vascular training, which was identical for all groups. The duration of therapy was 4 weeks. In all three test groups, there was a significant increase in the walking distance. There was a 119% increase in symptom-free walking distance in the exercise-only group. In comparison with exercise alone, the additional administration of pentoxifylline produced no greater effect; the increase was 105%. In contrast, administration of PGE1 combined with exercise achieved a remarkable improvement of 604%. Between-group comparison revealed the significant superiority of treatment with PGE1 (P occlusive disease 1 year after PGE1 therapy.

  11. Direct measured systolic pressure gradients across the aorto-iliac segment in multiple-level-obstruction arteriosclerosis

    DEFF Research Database (Denmark)

    Noer, Ivan; Praestholm, J; Tønnesen, K H

    1981-01-01

    Patients with severe ischemia due to multi-level obstructions in the leg arteries both above and below the region were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aorto-iliac obstructions was compared to the angiogra....... Due to large variations, however, the angiographic information was found to be useless in the individual patient. No difference in the pressure drop was found between cases in which rich and poor collateral networks were visualized....

  12. Transradial percutaneous coronary intervention for chronic total occlusion of coronary artery disease using sheathless standard guiding catheters.

    Science.gov (United States)

    Chen, Huang-Chung; Lee, Wei-Chieh; Hsueh, Shu-Kai; Cheng, Cheng-I; Chen, Chien-Jen; Yang, Cheng-Hsu; Fang, Chih-Yuan; Hang, Chi-Ling; Yip, Hon-Kan; Wu, Chiung-Jen; Fang, Hsiu-Yu

    2015-03-01

    Our aim was to evaluate the feasibility and safety of routine transradial approach (TRA) percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions using the sheathless technique with standard guiding catheters. Transradial approach PCI was applied for CTO lesions. A major limitation of TRA CTO PCI is the inability to use large guiding catheters because of the relatively small size of the radial artery. Therefore, the sheathless technique for TRA PCI has been recently developed. However, reports on TRA CTO PCI using the sheathless technique are still lacking. Sixty-eight patients with CTO lesions were enrolled for TRA PCI using the sheathless technique with standard guiding catheters. The baseline characteristics, coronary angiographic characteristics and major procedure or access site related complications were compared between procedure success and procedure failure group to determine the predictors of success in sheathless CTO PCI. In-hospital and 30-day clinical outcomes were also evaluated in this study. Routine assessments of radial artery occlusion via Doppler ultrasound and pulse oximeter were recorded during one-year clinical follow-up. The mean duration of CTO by history was 31.8 ± 42.3 months. The 7 Fr standard guiding catheter was used with the sheathless technique in 91.2%, and bilateral sheathless approach in 42.6% of the study patients. The procedure-related complications included coronary perforation needing covered stent deployment (2.9%), cardiac tamponade (2.9%), collateral perforation needing coil deployment (4.4%), and contrast induced nephropathy (2.9%). Only 2 patients (2.9%) experienced forearm ecchymosis at the radial artery access sites. In-hospital mortality and 30-day all-cause mortality were 2.9%, and 30-day MACEs were 1.5%. The rate of radial artery occlusion during one-year clinical follow-up was only 3.0%. It is feasible and safe to routinely use the sheathless technique with standard guiding catheters for

  13. Ankle Brachial Index <0.9 Underestimates the Prevalence of Peripheral Artery Occlusive Disease Assessed with Whole-Body Magnetic Resonance Angiography in the Elderly

    International Nuclear Information System (INIS)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H.

    2008-01-01

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one ≥50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a ≥ 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  14. Collateral circulation via the circle of Willis in patients with carotid artery steno-occlusive disease: evaluation on 3-T 4D MRA using arterial spin labelling

    International Nuclear Information System (INIS)

    Iryo, Yasuhiko; Hirai, Toshinori; Nakamura, Masanobu; Inoue, Yasuteru; Watanabe, Masaki; Ando, Yukio; Azuma, Minako; Nishimura, Shinichiro; Shigematsu, Yoshinori; Kitajima, Mika; Yamashita, Yasuyuki

    2015-01-01

    Aim: To evaluate whether 3-T four-dimensional (4D) arterial spin-labelling (ASL) -based magnetic resonance angiography (MRA) is useful for assessing the collateral circulation via the circle of Willis in patients with carotid artery steno-occlusive disease. Materials and methods: Institutional review board approval and prior written informed consent from all patients were obtained. The inclusion criteria were fulfilled by 13 patients with carotid artery steno-occlusive disease. All underwent 4D-ASL MRA at 3 T and digital subtraction angiography (DSA). The flow-sensitive alternating inversion recovery (FAIR) preparation scheme with look-locker sampling was used for spin labeling. At 300-ms intervals seven dynamic scans were obtained with a spatial resolution of 0.5×0.5×0.6 mm 3 . The collateral flow via the circle of Willis was read on 4D-ASL MRA and DSA images by two sets of two independent readers each. κ statistics were used to assess interobserver and intermodality agreement. Results: On DSA, collateral flow via the anterior communicating artery (AcomA) was observed in six patients, via the posterior communicating artery (PcomA) in four patients, and via both the AcomA and PcomA in three patients. With respect to the qualitative evaluation of 4D-ASL MRA images, interobserver agreement was excellent for all items (κ=1). 4D-ASL MRA and DSA consensus readings agreed on the type of collateral flow pattern in 10 of the 13 patients (77%). Intermodality agreement was good (κ=0.606; 95% confidence interval (CI): 0.215–0.997). Conclusion: 3 T 4D-ASL MRA may be a useful tool for the evaluation of the collateral circulation in patients with carotid artery steno-occlusive disease. -- Highlights: •3-T 4D-ASL MRA has high spatial and temporal resolution. •There is no need for the use of contrast agents in this technique. •4D-ASL MRA is useful for assessing the collateral flow associated with carotid artery stenosis. •Intermodality agreement between 4D

  15. Macro- and microperfusion during application of a new compression system, designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease.

    Science.gov (United States)

    Jünger, Michael; Haase, Hermann; Schwenke, Linda; Bichel, Jens; Schuren, Jan; Ladwig, Andrea

    2013-01-01

    To investigate macro- and microperfusion during 14 days of treatment with a new 2-layer compression system (3M™ Coban™ 2 Lite), designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease. A single-centre, open-label, prospective pilot study was performed with 15 subjects suffering from peripheral arterial occlusive disease with an ankle brachial pressure index (ABPI) of 0.5-0.8, who volunteered to have their 'study leg' bandaged with the new system. Coincident leg ulcer or chronic venous disease was not mandatory. All subjects received the new compression system, which stayed in place from 1 up to 4 days according to scheduled study visits. The system was reapplied by study personnel at each clinical visit (days 1, 2, 3, 4, 7, 10 and 14). The study participation stopped after 14 days. At each clinical visit safety assessments were performed: measurement of acral pulsation to capture macroperfusion; laser Doppler fluxmetry to capture microperfusion; clinical signs of pressure related skin damage, hypoxia-related pain and sub-bandage pressure measurement. In addition, the leg volume was measured and a comfort questionnaire was completed. An average sub-bandage pressure in standing position of approximately 30 mmHg was measured at the B1 location immediately after bandage application. Laser Doppler fluxmetry demonstrated positive effects on microcirculation regarding vasomotion and respiratory reflux. No change of the cardiac signal appeared. For acrale pulsations a high intraindividual variability was found with no clear interference to the bandage application. No pressure-related skin damage or hypoxia-related pain was detected. After application of the new compression system in subjects with moderate PAOD, laser Doppler fluxmetry indicated significant improvements of the microcirculation. High variability and lack of correlation to clinical symptoms was found for the acral pulsation. The new compression system revealed a high

  16. Effects of carbonated mineral water treatment in Băile Tuşnad on chronic arterial occlusive disease – a case report

    Directory of Open Access Journals (Sweden)

    Gabriela Dogaru

    2017-05-01

    Full Text Available Introduction. Băile Tușnad spa is recognized for its role in the prevention and rehabilitation treatment of cardiovascular diseases, including chronic arterial occlusive disease, due to the presence of natural therapeutic factors: carbonated mineral waters through their peripheral vasodilator effects, natural mofettes, stimulating bioclimate. Aim. The current study aimed to assess the clinical efficiency of natural therapeutic factors in Băile Tuşnad for the continuation of rehabilitation treatment in a patient with chronic arterial occlusive disease, in order to encourage walking, reduce cardiovascular risk and improve quality of life. Material and method. Patient N.M., aged 75, with multiple cardiovascular risk factors. In 2013, he was diagnosed with lower limb peripheral ischemia syndrome stage II B Fontaine, predominantly left claudication at about 100 m, for which balloon angioplasty was performed. He attended rehabilitation treatment for 3 years in Baile Tuşnad, consisting of carbonated mineral water baths for 15 minutes, aerotherapy for 30 minutes daily for the stimulation of walking, massotherapy, kinesiotherapy, performed daily for 16 days, and in 2016, at the Rehabilitation Hospital Cluj-Napoca. He was clinically evaluated before and at the end of treatment by the Visual Analogue Scale, the 10-m walking test, adverse reactions, Doppler ultrasound. Results. At the end of treatment, an increase in the walking distance and speed, a significant improvement in the quality of gait was found; claudication occurred after 250 m, pain in the lower limbs was improved. There were no side reactions. Conclusions. Rehabilitation treatment with natural therapeutic factors influenced the clinical and functional picture, determining a significant improvement in the quality of gait and quality of life.

  17. Analyzing Physiologic occlusion

    Directory of Open Access Journals (Sweden)

    M. Emamie

    1987-08-01

    Full Text Available Generally speaking, when preserving and restoring the gnathostomatic system the dentist controls tooth morphology to insure proper distribution of stress. So, we restore a portion of a tooth or all the teeth in such a manner as to subject the associated parts of the system to the least stress. We evaluate our diagnosis and control it in our treatment. The treatment should be based on the scientific method. We create optimal occlusion or a desirable functional state of the masticatory system.  Many persons with occlusal imperfections will not have symptoms of functional disorders. This is the psychological adaptive capacity of the neuromuscular system, teeth, dental arches, and periodontal tissues.Recent developments in dental material, technology and instruments however, have simplified the taskaf restoring rebuilding and rehabilitating diseased mouths. So, optimum oral health and function should be the prime objective of all treatment procedures. Because the ultimate aim will always be to restore the mouth to health and preserve this status throughout the life of a patient.

  18. Pulmonary veno-occlusive disease: a rare cause of pulmonary hypertension in systemic sclerosis. Case presentation and review of the literature .

    Science.gov (United States)

    Daraban, Ana Maria; Enache, Roxana; Predescu, L; Platon, P; Constantinescu, T; Mihai, Carina; Coman, I M; Ginghina, Carmen; Jurcuţ, Ruxandra

    2015-01-01

    Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary arterial hypertension (PAH). Because of the similar clinical picture of dyspnea on exertion and signs of right heart failure, PVOD is difficult to distinguish from idiopathic PAH. However, the distinction is mandatory because PVOD has a worse prognosis and, more importantly, the administration of PAH specific therapy (vasodilators) can precipitate severe acute pulmonary oedema. We present a challenging case of PAH in a patient with systemic sclerosis in whom a marked decrease in functional capacity after the initiation of bosentan therapy led to the diagnosis of PVOD. Management of PVOD patients is challenging and referral for lung transplantation should be done at the moment of diagnosis.

  19. Ectatic and Occlusive Diseases of the Venous Drainage System of Cerebral Arteriovenous Malformations (AVMs) - with Emphasis on Spectacular Shrinking Neurological Deficits after Embolization.

    Science.gov (United States)

    Goto, K

    2005-10-05

    During reviewing cases with AVM, the author noticed that stenotic and occlusive changes of the draining veins are commonly seen in high flow cerebral AVMs. However, little attention has been paid to these venous diseases until ectatic veins, generated in the upstream of the venous system, cause mass effect to the surrounding structures, or redistribution and shunting toward regional veins became insufficient after they are markedly overloaded or occluded. Cases with such venous abnormality are clinically important because of the possibility of dramatic improvement of neurological deficits after embolization of AVMs. Following presenting treatment results of 177 AVM case, the author is going to present five cases with abnormality in the Galenic venous system and two cases with abnormality in cortical veins associating with high flow cerebral AVMs. Consideration will be made on symptomatology and pathophysiologic mechanism of venous abnormalities associating with high flow cerebral AVMs.

  20. Randomized, multicenter study comparing expanded polytetrafluoroethylene-covered endoprosthesis placement with percutaneous transluminal angioplasty in the treatment of superficial femoral artery occlusive disease.

    Science.gov (United States)

    Saxon, Richard R; Dake, Michael D; Volgelzang, Robert L; Katzen, Barry T; Becker, Gary J

    2008-06-01

    To compare the safety and effectiveness of the Viabahn endoprosthesis with that of percutaneous transluminal angioplasty (PTA) alone in the treatment of symptomatic peripheral arterial disease (PAD) affecting the superficial femoral artery (SFA). From 1998 to 1999, patients with symptomatic SFA PAD were enrolled in a prospective, multicenter randomized study and underwent either PTA alone (n = 100) or PTA followed by stent-graft placement (expanded polytetrafluoroethylene/nitinol self-expanding stent-graft) (n = 97) for stenoses or occlusions of the SFA that were 13 cm long or shorter. At baseline, there were no significant differences between the PTA and stent-graft treatment groups, including chronic limb ischemia status and treated lesion length. The stent-graft group had a significantly higher technical success rate (95% vs 66%, P late major adverse events. In this multicenter study, the patency, technical success, and clinical status results obtained with stent-grafts were superior to those obtained with PTA alone.

  1. First-in-man experience of self-expanding nitinol stents combined with drug-coated balloon in the treatment of femoropopliteal occlusive disease.

    Science.gov (United States)

    Mwipatayi, Bibombe Patrice; Perera, Kalpa; Daneshmand, Ali; Daniel, Rhys; Wong, Jackie; Thomas, Shannon D; Burrows, Sally A

    2018-02-01

    Purpose The present study aimed to determine the safety and efficacy of a drug-coated balloon inflated within a thin-strut self-expanding bare-metal stent in patients with severe and complex femoropopliteal occlusive disease. Methods This prospective study used the Pulsar-self-expanding stent and Passeo-18 Lux drug-coated balloon in patients with severe and complex femoropopliteal occlusive disease. The primary endpoint was the 12-month primary patency, and the secondary endpoints included 24-month primary patency, assisted primary patency, secondary patency, and clinically associated target lesion revascularisation. Results The study included 44 patients (51 limbs). The mean age of the patients was 67.6 ± 10.2 years, with 73% men. Chronic limb severity was classified as Rutherford Category III in 41% of the patients, stage IV in 31%, and stage V in 27%. Lesions were predominantly Trans-Atlantic Inter-Society Consensus (TASC 2007) D (51%) and C (45%), with 32 (63%) chronic total occlusions. Procedural success was obtained in all cases. The mean lesion length was 200 ± 74.55 mm (95% CI = 167.09-208.01) with a mean number of stents per limb used of 1.57 ± 0.70 (95% CI = 1.37-1.76). Distal embolisation occurred in two patients. The primary patency rates at the 12- and 24-month follow-up were 94% (95% CI = 82.9-98.1) and 88% (95% CI = 75.7-94.5), respectively. The assisted primary was 94% (95% CI = 82.9-98.1) and secondary patency was 96% (95% CI = 85.2-99.0) at 24-month follow-up. The cumulative stent fracture rate at the 24-month follow-up was 10%. Freedom from clinically driven target lesion revascularisation was 94% (95% CI = 83-98%) at 12-month follow-up and 88% (95% CI = 76-94%) at 24-month follow-up, with two patients requiring a bypass graft. Conclusion Our novel approach involving the combination of a thin-strut bare-metal stent and a drug-coated balloon may be safe and effective, with sustainable and promising

  2. Network meta-analysis of balloon angioplasty, nondrug metal stent, drug-eluting balloon, and drug-eluting stent for treatment of infrapopliteal artery occlusive disease.

    Science.gov (United States)

    Xiao, Yaowen; Chen, Zhong; Yang, Yaoguo; Kou, Lei

    2016-01-01

    We aimed to conduct a network meta-analysis of mixed treatments for the infrapopliteal artery occlusive disease. We searched randomized controlled trials (RCTs) regarding balloon angioplasty (BA), nondrug metal stent (NDMS), drug-eluting balloon (DEB), or drug-eluting stent (DES) in PubMed, Embase, CENTRAL, Ovid, Sinomed, and other relevant websites. We selected and assessed the trials that met the inclusion criteria and conducted a network meta-analysis using the ADDIS software. We included 11 relevant trials. We analyzed data of 1322 patients with infrapopliteal artery occlusive disease, of which 351 were in the NDMS vs. DES trials, 231 in the NDMS vs. BA trials, 490 in the BA vs. DEB trials, 50 in the DEB vs. DES trials, and 200 in the BA vs. DES trials. The network meta-analysis indicated that with NDMS as the reference, DES had a better result with respect to restenosis (odds ratio [OR], 5.16; 95% credible interval [CI], 1.58-18.41; probability of the best treatment, 84%) and amputation (OR, 2.50; 95% CI, 0.81-7.11; probability of the best treatment, 61%) and DEB had a better result with respect to target lesion revascularization (TLR; OR, 3.74; 95% CI, 0.78-17.05; probability of the best treatment, 57%). Moreover, with BA as the reference, NDMS had a better result with respect to technical success (OR, 0.10; 95% CI, 0.00-1.15; probability of the best treatment, 86%). Our meta-analysis revealed that DES is a better treatment with respect to short-term patency and limb salvage rate, NMDS may provide a better technical success, and DEB and DES are good choices for reducing revascularization.

  3. Use of a clinical pathway to improve the acute management of vaso-occlusive crisis pain in pediatric sickle cell disease.

    Science.gov (United States)

    Ender, Katherine L; Krajewski, Jennifer A; Babineau, John; Tresgallo, Mary; Schechter, William; Saroyan, John M; Kharbanda, Anupam

    2014-04-01

    The most common, debilitating morbidity of sickle cell disease (SCD) is vaso-occlusive crisis (VOC) pain. Although guidelines exist for its management, they are generally not well-followed, and research in other pediatric diseases has shown that clinical pathways improve care. The purpose of our study was to determine whether a clinical pathway improves the acute management of sickle cell vaso-occlusive crisis (VOC) pain in the pediatric emergency department (PED). Pain management practices were prospectively investigated before and after the initiation of a clinical pathway in the PED of an urban, tertiary care center with 50,000 ED visits per year and approximately 200 active sickle cell patients. The pathway included instructions for triage, monitoring, medication administration, and timing of assessments and interventions. Data were eligible from 35 pre-pathway and 33 post-pathway visits. Primary outcome was time interval to administration of first analgesic medication. Statistical analysis was by Student's t-test, using natural-log-transformed data for outcomes with skewed distribution curves. Time interval to first analgesic improved from 74 to 42 minutes (P = 0.012) and to first opioid from 94 to 46 minutes (P = 0.013). The percentage of patients who received ketorolac increased from 57% to 82% (P = 0.03). Decrease in time interval to subsequent pain score assessment was not statistically significant (110 to 72 minutes (P = 0.07)), and change in pain score was not different (P = 0.25). The use of a clinical pathway for sickle cell VOC in the PED can improve important aspects of pain management and merits further investigation and implementation. © 2013 Wiley Periodicals, Inc.

  4. Branch retinal artery occlusion in Susac's syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Evangelista Marrocos de Aragão

    2015-02-01

    Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

  5. Risk factors for incisional hernia repair after aortic reconstructive surgery in a nationwide study

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Helgstrand, Frederik; Vogt, Katja C

    2013-01-01

    Abdominal aortic aneurysm disease has been hypothesized as associated with the development of abdominal wall hernia. We evaluated the risk factors for incisional hernia repair after open elective aortic reconstructive surgery for aortoiliac occlusive disease and abdominal aortic aneurysm....

  6. Fentanyl Buccal Tablet: A New Breakthrough Pain Medication in Early Management of Severe Vaso-Occlusive Crisis in Sickle Cell Disease.

    Science.gov (United States)

    De Franceschi, Lucia; Mura, Paolo; Schweiger, Vittorio; Vencato, Elisa; Quaglia, Francesca Maria; Delmonte, Letizia; Evangelista, Maurizio; Polati, Enrico; Olivieri, Oliviero; Finco, Gabriele

    2016-07-01

    Sickle cell disease (SCD) is a worldwide distributed hereditary red cell disorder. The principal clinical manifestations of SCD are the chronic hemolytic anemia and the acute vaso-occlusive crisis (VOCs), which are mainly characterized by ischemic/reperfusion tissue injury. Pain is the main symptom of VOCs, and its management is still a challenge for hematologists, requiring a multidisciplinary approach. We carried out a crossover study on adult SCD patients, who received two different types of multimodal analgesia during two separate severe VOCs with time interval between VOCs of at least 6 months. The first VOC episode was treated with ketorolac (0.86 mg/kg/day) and tramadol (7.2 mg/kg/day) (TK treatment). In the second VOC episode, fentanyl buccal tablet (FBT; 100 μg) was introduced in a single dose after three hours from the beginning of TK analgesia (TKF treatment). We focused on the first 24 hours of acute pain management. The primary efficacy measure was the time-weighted-sum of pain intensity differences (SPID24). The secondary efficacy measures included the pain intensity difference (PID), the total pain relief (TOTPAR), and the time-wighted sum of anxiety (SAID24). SPID24 was significantly higher in TKF than in TK treatment. All the secondary measures were significantly ameliorated in TKF compared to TK treatment, without major opioid side effects. Patients satisfaction was higher with TKF treatment than with TK one. We propose that VOCs might require breakthrough pain drug strategy as vaso-occlusive phenomena and enhanced vasoconstriction promoting acute ischemic pain component exacerbate the continuous pain of VOCs. FBT might be a powerful and feasible tool in early management of acute pain during VOCs in emergency departments. © 2015 World Institute of Pain.

  7. Acetazolamide-augmented dynamic BOLD (aczBOLD imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience

    Directory of Open Access Journals (Sweden)

    Junjie Wu

    2017-01-01

    Full Text Available The purpose of this study was to measure cerebrovascular reactivity (CVR in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ vasoreactivity (aczBOLD, to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM: 4.13% ± 1.16% vs. 4.90% ± 0.98%, P = 0.002; white matter (WM: 2.83% ± 1.23% vs. 3.50% ± 0.94%, P = 0.005. In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0–4.43 min for the GM and 1.80 min (time range above 95% of the maximum value: 1.40–3.53 min for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (Tmax (P = 0.008 for the WM and normalized cerebral blood flow (P = 0.003 for the GM, and P = 0.001 for the WM. AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

  8. Acetazolamide-augmented dynamic BOLD (aczBOLD) imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience.

    Science.gov (United States)

    Wu, Junjie; Dehkharghani, Seena; Nahab, Fadi; Qiu, Deqiang

    2017-01-01

    The purpose of this study was to measure cerebrovascular reactivity (CVR) in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ) vasoreactivity (aczBOLD), to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC) perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM): 4.13% ± 1.16% vs. 4.90% ± 0.98%, P  = 0.002; white matter (WM): 2.83% ± 1.23% vs. 3.50% ± 0.94%, P  = 0.005). In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~ 8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0-4.43 min) for the GM and 1.80 min (time range above 95% of the maximum value: 1.40-3.53 min) for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (T max ) ( P  = 0.008 for the WM) and normalized cerebral blood flow ( P  = 0.003 for the GM, and P  = 0.001 for the WM). AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

  9. Retinal Vein Occlusion in a Multi-Ethnic Asian Population: The Singapore Epidemiology of Eye Disease Study.

    Science.gov (United States)

    Koh, Victor; Cheung, Carol Y; Li, Xiang; Tian, Dechao; Wang, Jie Jin; Mitchell, Paul; Cheng, Ching-Yu; Wong, Tien Y

    2016-01-01

    To describe the prevalence of retinal vein occlusion (RVO) and its risk factors in a multi-ethnic Asian population. This population-based study of 10,033 participants (75.7% response rate) included Chinese, Indian and Malay persons aged 40 years and older. A comprehensive ophthalmic examination, standardized interviews and laboratory blood tests were performed. Digital fundus photographs were assessed for presence of RVO following the definitions used in the Blue Mountains Eye Study. Regression analysis models were constructed to study the relationship between ocular and systemic factors and RVO. Age-specific prevalence rates of RVO were applied to project the number of people affected in Asia from 2013 to 2040. The overall crude prevalence of RVO was 0.72% (n = 71; 95% confidence interval, CI, 0.54-0.87%). The crude prevalence of RVO was similar in Chinese, Indian and Malay participants (p = 0.865). In multivariable regression models, significant risk factors of RVO included increased age (odds ratio, OR, 1.03, 95% CI 1.01-1.06), hypertension (OR 3.65, 95% CI 1.61-8.31), increased serum creatinine (OR 1.04, 95% CI 1.01-1.06, per 10 mmol/L increase), history of heart attack (OR 2.25, 95% CI 1.11-4.54) and increased total cholesterol (OR 1.31, 95% CI 1.07-1.59, per 1 mmol/L increase). None of the ocular parameters were associated with RVO. RVO is estimated to affect up to 16 and 21 million people in Asia by 2020 and 2040, respectively. RVO was detected in 0.72% of a multi-ethnic Asian population aged 40-80 years in Singapore. The significant systemic risk factors of RVO are consistent with studies in white populations.

  10. Effects of exercise training program on functional capacity and quality of life in patients with peripheral arterial occlusive disease. Evaluation of a pilot project.

    Science.gov (United States)

    Gartenmann, Ch; Kirchberger, I; Herzig, M; Baumgartner, I; Saner, H; Mahler, F; Meyer, K

    2002-02-01

    In patients with peripheral arterial occlusive disease (PAOD) stage II, exercise training seems to be important to reduce symptoms and improve functional capacity. We evaluated the effects of an out-patient treatment program on walking distance (standardized treadmill testing), training exercise capacity, and disease specific quality of life (PAVK-86 questionnaire). Thirty-one patients aged 70 +/- 2 with intermittent claudicatio in stage IIa/IIb according to Fontaine (n = 18/13) underwent a supervised 12 week exercise training and education outpatient program. During course of intervention, patients demonstrated improvements in pain-free training walking distance (p 364 +/- 53 m; p 546 +/- 63 m; p training, mean subscale scores of the PAVK-86 demonstrated distinct impairments concerning pain and functional status. After 12 weeks of intervention, with exception of the subscale complaints, all dimensions of quality of life assessed have improved significantly. The highest effect size was observed for the subscales pain, mood, and functional status. Improvement in the subscale anxiety and pain-free walking distance (treadmill test) correlated significantly (r = 0.46) as well as improvement in the subscale mood and maximum walking distance (r = 0.45). In patients with PAOD stage II considerable effects on functional capacity and important dimensions of quality of life can be achieved by a short exercise and education program.

  11. An Outbreak of Hepatic Veno-Occlusive Disease in Western Afghanistan Associated with Exposure to Wheat Flour Contaminated with Pyrrolizidine Alkaloids

    Directory of Open Access Journals (Sweden)

    Faizullah Kakar

    2010-01-01

    Full Text Available Pyrrolizidine alakloids (PAs are known to cause hepatic veno-occlusive disease (VOD. Outbreaks have occurred in Western Afghanistan since 1974, the latest in February 2008. We conducted an outbreak investigation using a case-control design. Sixty-seven cases of VOD were compared with 199 community controls. Consumption of bread was strongly associated with disease (adjusted odds ratio: 35.8 [95%CI: 7.6–168.2]. Toxic doses of PA were found in plant extracts and in samples of wheat flour taken from the study area. Compared to wheat flour there was 1000 times less PA in milk and whey and in water samples the PA content was zero. Although direct analysis was not possible, contaminated wheat flour used to make bread was the likely source of PA causing the outbreak. Eating a more varied diet including meat and fruit may be protective. Prevention and control measures will rely on community awareness and agricultural interventions to ensure safety of the food supply.

  12. An Outbreak of Hepatic Veno-Occlusive Disease in Western Afghanistan Associated with Exposure to Wheat Flour Contaminated with Pyrrolizidine Alkaloids

    Science.gov (United States)

    Kakar, Faizullah; Akbarian, Zarif; Leslie, Toby; Mustafa, Mir Lais; Watson, John; van Egmond, Hans P.; Omar, Mohammad Fahim; Mofleh, Jawad

    2010-01-01

    Pyrrolizidine alakloids (PAs) are known to cause hepatic veno-occlusive disease (VOD). Outbreaks have occurred in Western Afghanistan since 1974, the latest in February 2008. We conducted an outbreak investigation using a case-control design. Sixty-seven cases of VOD were compared with 199 community controls. Consumption of bread was strongly associated with disease (adjusted odds ratio: 35.8 [95%CI: 7.6–168.2]). Toxic doses of PA were found in plant extracts and in samples of wheat flour taken from the study area. Compared to wheat flour there was 1000 times less PA in milk and whey and in water samples the PA content was zero. Although direct analysis was not possible, contaminated wheat flour used to make bread was the likely source of PA causing the outbreak. Eating a more varied diet including meat and fruit may be protective. Prevention and control measures will rely on community awareness and agricultural interventions to ensure safety of the food supply. PMID:20652038

  13. An Outbreak of Hepatic Veno-Occlusive Disease in Western Afghanistan Associated with Exposure to Wheat Flour Contaminated with Pyrrolizidine Alkaloids

    International Nuclear Information System (INIS)

    Kakar, F.; Akbarian, Z.; Mustafa, M.L.; Omar, M.F.; Mofleh, J.; Toby Leslie, T.; Watson, J.; Egmond, H.P.V.

    2010-01-01

    Pyrrolizidine alkaloids (PAs) are known to cause hepatic veno-occlusive disease (VOD). Outbreaks have occurred in Western Afghanistan since 1974, the latest in February 2008. We conducted an outbreak investigation using a case-control design. Sixty-seven cases of VOD were compared with 199 community controls. Consumption of bread was strongly associated with disease (adjusted odds ratio: 35.8 [95%CI: 7.6 168.2]). Toxic doses of PA were found in plant extracts and in samples of wheat flour taken from the study area. Compared to wheat flour there was 1000 times less PA in milk and whey and in water samples the PA content was zero. Although direct analysis was not possible, contaminated wheat flour used to make bread was the likely source of PA causing the outbreak. Eating a more varied diet including meat and fruit may be protective. Prevention and control measures will rely on community awareness and agricultural interventions to ensure safety of the food supply.

  14. Veno-occlusive liver disease after infradiaphragmatic total lymphoid irradiation. A rare complication; Die Venenverschlusskrankheit der Leber nach infradiaphragmaler total lymphatischer Bestrahlung. Eine seltene Nebenwirkung

    Energy Technology Data Exchange (ETDEWEB)

    Bischof, M.; Zierhut, D.; Gutwein, S.; Wannenmacher, M. [Heidelberg Univ. (DE.) Abt. fuer Klinische Radiologie - Schwerpunkt Strahlentherapie; Hansmann, J. [Heidelberg Univ. (DE.) Abt. fuer Radiologische Diagnostik; Stremmel, W.; Mueller, M. [Heidelberg Univ. (DE). Abt. Innere Medizin 4 (Schwerpunkt Gastroenterologie)

    2001-06-01

    Background: Radiotherapy is potentially curative in early stages of follicle center lymphoma. Frequent side effects are pancytopenia, nausea and abdominal discomfort. A radiation-induced liver injury with serious clinical symptoms and changes in liver function is a rare complication. Case report: Whole abdomen was irradiated in a 49-year-old-patient with a centrocytic-centroblastic lymphoma, stage IA (localization: Left inguinal region). A total dose of 30 Gy was delivered in a weekly fractionation of five times 1.5 Gy. Kidneys were protected by shielding after a dose of 13.5 Gy, liver blocks were positioned after 25 Gy. During the last 2 days of therapy the patient presented with weight gain, ascites, dyspnoea and elevated liver enzymes. Diagnostics revealed hepatosphlenomegaly, ascites and an increased portosystemic pressure gradient. Liver biopsy specimen showed a veno-occlusive disease. Complete relief of symptomatology was achieved within 7 days following placement of a transjugular intrahepatic portosystemic stent-shunt (TIPSS), heparinization and diuretics. Liver enzymes are in the normal range. Conclusion: Veno-occlusive disease of the liver (VOD) is a very rare side effect of primary abdominal irradiation of follicle center lymphoma. This complication should be taken into consideration if a patient presents with upper right quadrant pain, ascites and elevation of liver enzymes especially within 4 months following radiotherapy. Genesis of veno-occlusive disease, diagnostics, therapy and a review of the literature are presented. (orig.) [German] Hintergrund: Die Strahlentherapie spielt bei der kurativen Behandlung der Fruehstadien follikulaerer Keimzentrumslymphome die entscheidende Rolle. Therapiebegleitende Nebenwirkungen sind haeufig Panzytopenie, Nausea und abdominelle Beschwerden. Eine radiogen induzierte Leberschaedigung mit klinisch manifester Symptomatik und schwerer Leberfunktionsstoerung ist dagegen aeusserst selten. Fallbeschreibung: Bei einem 49

  15. Diagnosis and Management of Occlusal Wear: A Case Report

    OpenAIRE

    Thirumurthy, V. R.; Bindhoo, Y. A.; Jacob, Sunil Joseph; Kurien, Anjana; Limson, K. S.; Vidhiyasagar, P.

    2012-01-01

    The rationale for doing full mouth rehabilitation are, when occlusal forces become traumatic hampering the health of periodontal tissues, extensive occlusal diseases, trauma, temporomandibular joint disease and congenital disorders with malformed dentition. Literature exposes that full mouth fixed rehabilitation is one of the taxing procedures in the field of Prosthodontics. A critical aspect for successful occlusal rehabilitation is to determine the aetiology, correct sequence of treatment a...

  16. Occlusion effects, Part I

    DEFF Research Database (Denmark)

    Hansen, Mie Østergaard

    annoyances and the objective measurements were analysed. Persons suffering from tinnitus behaved differently than person without tinnitus. The latter group showed significant relations between the measured occlusion effect, hearing loss and the personal of occlusion. The actual sensation level is also...

  17. Veno-occlusive disease of the liver in the absence of elevation in bilirubin in pediatric patients after hematopoietic stem cell transplantation.

    Science.gov (United States)

    Myers, Kasiani C; Dandoy, Christopher; El-Bietar, Javier; Davies, Stella M; Jodele, Sonata

    2015-02-01

    Veno-occlusive disease (VOD) of the liver is a well-described and significant complication of hematopoietic stem cell transplantation (HSCT), with limited successful therapeutic options in severe cases. Prompt diagnosis and initiation of treatment is crucial to restrict the extent of disease. However, a subset of patients may not meet all current diagnostic criteria at presentation, and waiting for these to be met may delay therapy. We retrospectively reviewed 794 HSCT patients treated at our institution between 2003 and 2013, identifying 17 (2.1%) who developed VOD. Of these, 5 (29%) were noted to have an absence of elevated bilirubin at the time of VOD diagnosis and reversal of portal venous flow on ultrasound. Median total and conjugated bilirubin at VOD diagnosis were 1.0 and 0.2 mg/dL, respectively. All 5 patients were subsequently diagnosed with multiorgan failure associated with VOD, including 1 with encephalopathy. Four were treated with intravenous high-dose methylprednisolone (500 mg/m(2) per dose every 12 hours for 6 doses). One patient received defibrotide therapy in addition to steroids and another supportive care alone. VOD resolved in 4 of 5 patients, with median time to resolution of VOD, defined as recovery of all organ function and normalization of bilirubin and portal venous flow, of 8 days. Two patients died later from progressive primary disease and chronic graft-versus-host disease, respectively. We conclude that a high index of suspicion for VOD should be maintained in patients despite lack of bilirubin elevation in the presence of other diagnostic criteria such as hepatomegaly, abdominal pain, ascites, or weight gain. Early ultrasound evaluation in these patients may lead to more timely diagnosis and therapeutic interventions. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  18. Viewpoint-based ambient occlusion.

    Science.gov (United States)

    González, Francisco; Sbert, Mateu; Feixas, Miquel

    2008-01-01

    A new ambient occlusion technique builds a channel between various viewpoints and an object's polygons, providing the information needed to create an occlusion map with multiple application possibilities.

  19. Effect of Graft Material on Red Blood Cell Loss Following Aortic Surgery

    National Research Council Canada - National Science Library

    Fisher, Jay

    1990-01-01

    ... (Meadox Woven Double Velour) and PTFE (Gore-Tex) grafts. A total of 25 patients (13 Dacron, 12 PTFE) were studied including 21 with abdominal aortic aneurysms, and 4 with aorto-iliac occlusive disease...

  20. Influence of Iliac Stenotic Lesions on Blood Flow Patterns Near a Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Stent Configuration

    NARCIS (Netherlands)

    Jebbink, Erik Groot; Engelhard, Stefan; Lajoinie, Guillaume; de Vries, Jean-Paul P.M.; Versluis, Michel; Reijnen, Michel M.P.J.

    2017-01-01

    Purpose: To investigate the effect of distal stenotic lesions on flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration used in the treatment of aortoiliac occlusive disease. Method: Laser particle image velocimetry measurements were performed using

  1. The AST/ALT (De-Ritis) ratio: A novel marker for critical limb ischemia in peripheral arterial occlusive disease patients.

    Science.gov (United States)

    Rief, Peter; Pichler, Martin; Raggam, Reinhard; Hafner, Franz; Gerger, Armin; Eller, Philipp; Brodmann, Marianne; Gary, Thomas

    2016-06-01

    The aspartat aminotransferase (AST)/alanin aminotransferase (ALT) (De-Ritis) ratio (AAR) is an easily applicable blood test. An elevated AAR on the one hand has been associated with an increase in nonalcoholic fatty liver disease (NAFLD). NAFLD on the other hand is associated with an increase in cardiovascular disease, all-cause mortality, and diabetes. As the AAR is also elevated in case of muscular damage, we investigated AAR and its association with critical limb ischemia (CLI) in peripheral arterial occlusive disease (PAOD) patients.In our cross-sectional study, we included 1782 PAOD patients treated at our institution from 2005 to 2010. Patients with chronic alcohol consumption (>20 g/day) were excluded. AAR was calculated and the cohort was categorized into tertiles according to the AAR. An optimal cut-off value for the continuous AAR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI.In our cohort, occurrence of CLI significantly increased with an elevation in AAR. As an optimal cut-off value, an AAR of 1.67 (sensitivity 34.1%, specificity 81.0%) was identified. Two groups were categorized, 1st group containing 1385 patients (AAR  1.67). CLI was more frequent in AAR > 1.67 patients (166 [41.9%]) compared to AAR  1.67 was associated with an odds ratio (OR) of 2.0 (95% confidence interval [CI] 1.7-2.3) for CLI even after adjustment for other well-established vascular risk factors.An increased AAR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The AAR is a broadly available and cheap marker, which might be useful to highlight patients at high risk for vascular endpoints.

  2. Retinal vein occlusion: current treatment.

    Science.gov (United States)

    Lattanzio, Rosangela; Torres Gimeno, Ana; Battaglia Parodi, Maurizio; Bandello, Francesco

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management. Copyright © 2010 S. Karger AG, Basel.

  3. Influence of controlled vascular training on the pain free walking distance and plasmaviscosity in patients suffering from peripheral arterial occlusive disease.

    Science.gov (United States)

    Häfner, Hans-Martin; Jünger, Irmgard; Geyer, Annette; Jünger, Michael; Strölin, Anke

    2009-01-01

    Does controlled vascular training influence plasmaviscosity and the pain free walking distance in patients with peripheral arterial occlusive disease (paod) Fontaine stage II?37 patients, 24 men and 13 women with a mean age of 64.5 years SD 8.5 took part in ambulant vascular training over a period of 12 months.Before, after 6 months and after 12 months, pain free (pfwd) and maximum walking distance (mwd) was measured using a standardized treadmill program. Also ankle-brachials systolic pressure index (a-bspi), transcutaneous oxygen tension (tcPO2) and plasmaviscosity (pv) were measured.Pfwd increased from 212 SD 143 m to 371 SD 249 m (ptraining, but without statistically significance. A-bspi increased between the first 6 months of training statistically significant. Before training pv was 1.31 mPa s SD 0.10, after training period of 6 months it was 1.27 mPa s SD 0.11 (p=0.06) and 12 months later it was 1.28 SD 0.11 mPa s (p=0.35). The improvement of pfwd and the decrease of pv correlates (r=-0.39, p=0.05).In most patients, arterial vascular training improves pfwd and mwd. Simultaneously to the increase of the walking distances plasmaviscosity decreases and crurobrachial indexes increases. We found a coupling between improvement of pfwd and pv. Pv seems to participate in improvement of leg hemodynamics in patients with paod.

  4. The effects of exercise training on walking function and perception of health status in elderly patients with peripheral arterial occlusive disease.

    Science.gov (United States)

    Tsai, J C; Chan, P; Wang, C H; Jeng, C; Hsieh, M H; Kao, P F; Chen, Y J; Liu, J C

    2002-11-01

    To determine the effects of 12-week exercise programme on ambulatory function, free-living daily physical activity and health-related quality of life in disabled older patients with intermittent claudication. Prospective, randomized controlled trial. University Medical Center and Veterans Affairs Medical Center, Taipei, Taiwan. Thirty-two of 64 patients with Fontaine stage II peripheral arterial occlusive disease (PAOD) were randomized to exercise training and 32 to usual care control. Five patients from the exercise group and six patients from the control group dropped out, leaving 27 and 26 patients, respectively, completing the study in each group. Twelve weeks of treadmill exercise training. Treadmill walking time to onset of claudication pain and to maximal claudication pain, 6-min walk distance, self-reported ambulatory ability and perceived health-related quality of life (QOL). Compliance of exercise programme was 83% of the possible sessions. Exercise training increased treadmill walking time to onset of claudication pain by 88% (P training in elderly PAOD patients were observed. Increase in treadmill walking time to maximal claudication pain in these patients translated into the improvement of perceived physical health, which enabled the patients to become more functionally independent.

  5. Calorie restriction prevents the occlusive coronary vascular disease of autoimmune (NZW x BXSB)F1 mice.

    OpenAIRE

    Mizutani, H; Engelman, R W; Kinjoh, K; Kurata, Y; Ikehara, S; Matsuzawa, Y; Good, R A

    1994-01-01

    Male (NZW x BXSB)F1 (W/BF1) mice develop systemic autoimmunity involving autoantibodies, thrombocytopenia, lupus nephritis, and coronary vascular disease (CVD) with myocardial infarction. To determine whether this murine lupus-associated CVD can be prevented by the reduction of dietary calories, male W/BF1 mice were separated into five experimental groups and fed either ad libitum (designated group A, n = 50), fed 32% fewer calories of an otherwise comparable diet (designated group B6, n = 20...

  6. Treatment strategies for extensive chronic SFA occlusions : indications and results

    NARCIS (Netherlands)

    Lensvelt, M. M. A.; Reijnen, M. M. P. J.; De Vries, B. M. Wallis; Zeebregts, C. J.

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  7. Treatment strategies for extensive chronic SFA occlusions: indications and results.

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Reijnen, M.M.P.J.; Wallis de Vries, B.M.; Zeebregts, C.J.A.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  8. Vertebrobasilar Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Schoen, Jessica

    2011-05-01

    Full Text Available The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality. Here we present a review of the literature and a case of a patient with altered mental status caused by vertebrobasilar artery occlusion. [West J Emerg Med. 2011;12(2:233-239.

  9. Usefulness of the platelet-to-lymphocyte ratio in predicting long-term cardiovascular mortality in patients with peripheral arterial occlusive disease

    Science.gov (United States)

    Erturk, Mehmet; Cakmak, Huseyin Altug; Kalkan, Ali Kemal; Akturk, Ibrahim Faruk; Yalcin, Ahmet Arif; Uygur, Begum; Bulut, Umit; Oz, Kursat

    2017-01-01

    Introduction Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases. Aim To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both. Material and methods In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included. Patients were divided into two groups according to their PLR as follows: high PLR (PLR > 142) and low PLR (PLR ≤ 142) groups. Results During the follow-up period (median: 33.8 months (interquartile range: 21–45)), 131 deaths occurred out of 602 (21.8%) patients. Cardiovascular mortality was found to be significantly higher in the high PLR group compared to the low PLR group (31.6% vs. 17.2 %; p 142 and age were found to be independent predictors of long-term cardiovascular mortality in Cox regression analysis (hazard ratios (95% confidence interval): 1.03 (1.01–1.04) and 1.04 (1.02–1.06), p < 0.001 and p < 0.001, respectively). Conclusions Platelet-to-lymphocyte ratio, which is one of the parameters of routine complete blood count, reflects increased inflammatory status, platelet activation and aggregation. PLR is a cheap and readily available marker that has the ability to improve risk stratification provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD. PMID:28344615

  10. An alternative treatment of occlusal wear: Cast metal occlusal surface

    OpenAIRE

    Sandeep Kumar; Aman Arora; Reena Yadav

    2012-01-01

    Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal sur...

  11. Cerebral blood flow reactivity to hyperventilation in children with spontaneous occlusion of the circle of Willis (moyamoya disease)

    Energy Technology Data Exchange (ETDEWEB)

    Isobe, Masanori; Kuroda, Satoshi; Kamiyama, Hiroyasu; Abe, Hiroshi (Hokkaido Univ., Sapporo (Japan). School of Medicine); Mitumori, Kenji

    1992-04-01

    To elucidate the relationship between cerebral blood flow (CBF) after hyperventilation (HV) and the re-build-up phenomenon on the encephaloelectrogram (EEG) in children with moyamoya disease, comparative study of CBF immediately after HV and CBF after administration of acetazolamide (Diamox) was examined. CBF was measured by means of single photon emission CT (SPECT) using the {sup 133}Xe inhalation method. The subjects were 11 children (21 hemispheres) with moyamoya disease who were divided into two groups as follows: Bypass group; who underwent STA-MCA anastomosis with other synangiosis. Non-bypass group; who underwent only some synangiosis such as EDAS, EMAS and EMS. Regional CBF (rCBF) after HV of the frontal lobes in the non-bypass group had an evident tendency to show low perfusion compared with CBF in other regions. The correlation between low perfusion area after HV, and areas where the increase of rCB is less after administration of acetazolamide became clear. The strongest relation was observed between low perfusion after HV and re-build-up phenomenon on EEG. On the other hand, rCBF after HV of the frontal lobes in the bypass group had, compared with other regions, no tendency to show low perfusion. From this study and our previous reports, it is assumed that there is some hemodynamics insufficiency in the frontal lobes of the non-bypass group. The reason why the reduction of rCBF was less after HV especially in the frontal lobes of the bypass group is still unknown. But, most of anterior branches of STA were used for the anastomosis and the craniotomy of the bypass group was made in a more anterior position than that of the non-bypass group. These surgical procedures are estimated to bring about a much better collateral blood flow to the frontal lobes. (author).

  12. Occlusion effects, Part II

    DEFF Research Database (Denmark)

    Hansen, Mie Østergaard

    The present report studies the mechanism of the occlusion effect by means of literature studies, experiments and model estimates. A mathematical model of the occlusion effect is developed. The model includes the mechanical properties of the earmould and the airborne sound as well as the body...... conducted sound from own voice. These aspects are new in the sense that previous studies disregard the earmould mechanics and includes only one sound source placed in the ear canal....

  13. Exercícios físicos na doença arterial obstrutiva periférica Physical exercise in peripheral occlusive arterial disease

    Directory of Open Access Journals (Sweden)

    Elenir Carlot Locatelli

    2009-09-01

    Full Text Available A maioria dos pacientes portadores de claudicação intermitente, um aspecto clínico da doença arterial periférica, tem importante limitação nas atividades físicas e redução na qualidade de vida. O objetivo deste estudo foi realizar uma revisão da literatura sobre a intervenção através de exercícios em portadores de doença arterial obstrutiva periférica com claudicação intermitente. Trata-se de uma revisão de artigos científicos consultados nos bancos de dados da BIREME, PubMed e SciELO, através das fontes LILACS e MEDLINE e a partir dos descritores em Ciências da Saúde claudicação intermitente, doenças vasculares periféricas, reabilitação, exercício e terapia por exercício. Concluiu-se que, apesar da variabilidade dos regimes de caminhada identificados na literatura, o treino aeróbio, de uma forma geral, proporciona benefícios a pacientes portadores de doença arterial obstrutiva periférica com claudicação intermitente, principalmente na melhora do desempenho de caminhada, o que pode ter impacto significativo na qualidade de vida desses pacientes.Most patients with intermittent claudication, a clinical aspect of peripheral arterial disease, have important limitations on physical activity and a reduced quality of life. The purpose of this study was to review literature on exercise intervention for patients with peripheral occlusive arterial disease and intermittent claudication. BIREME, PubMed (MEDLINE, SciELO and LILACS databases were searched for the terms intermittent claudication, peripheral vascular diseases, rehabilitation, exercise, exercise therapy, all of which were taken from the list of Health Science Descriptors (BIREME. It was concluded that, despite the variability of walking regimens identified in the literature, the aerobic training is of general benefit to patients with peripheral arterial disease and intermittent claudication, mainly improving their walking performance, which can have a

  14. Endovascular Stent Treatment for Symptomatic Benign Iliofemoral Venous Occlusive Disease: Long-Term Results 1987–2009

    International Nuclear Information System (INIS)

    Gutzeit, A.; Zollikofer, Ch. L.; Dettling-Pizzolato, M.; Graf, N.; Largiadèr, J.; Binkert, C. A.

    2011-01-01

    Venous stenting has been shown to effectively treat iliofemoral venous obstruction with good short- and mid-term results. The aim of this study was to investigate long-term clinical outcome and stent patency. Twenty patients were treated with venous stenting for benign disease at our institution between 1987 and 2005. Fifteen of 20 patients (15 female, mean age at time of stent implantation 38 years [range 18–66]) returned for a clinical visit, a plain X-ray of the stent, and a Duplex ultrasound. Four patients were lost to follow-up, and one patient died 277 months after stent placement although a good clinical result was documented 267 months after stent placement. Mean follow-up after stent placement was 167.8 months (13.9 years) (range 71 (6 years) to 267 months [22 years]). No patient needed an additional venous intervention after stent implantation. No significant difference between the circumference of the thigh on the stented side (mean 55.1 cm [range 47.0–70.0]) compared with the contralateral thigh (mean 54.9 cm [range 47.0–70.0]) (p = 0.684) was seen. There was a nonsignificant trend toward higher flow velocities within the stent (mean 30.8 cm/s [range 10.0–48.0]) and the corresponding vein segment on the contralateral side (mean 25.2 cm/s [range 12.0–47.0]) (p = 0.065). Stent integrity was confirmed in 14 of 15 cases. Only one stent showed a fracture, as documented on x-ray, without any impairment of flow. Venous stenting using Wallstents showed excellent long-term clinical outcome and primary patency rate.

  15. Current possibilities in occlusal caries management

    Directory of Open Access Journals (Sweden)

    Hrvoje Jurić

    2013-11-01

    Full Text Available Dental caries is a multifactorial disease that affects most populations throughout the world and it is still the primary cause of oral pain and tooth loss. The occlusal surfaces of posterior teeth are the most vulnerable sites for dental caries due to their anatomy. Therefore, the aim of the following article is to summarize current knowledge on occlusal caries development and the possibilities of its prevention. Although the overall caries rate today has fallen for populations in industrialized countries, the rate of occlusal surface caries has not decreased. This may be explained with fact that topically applied fluorides and their mode of action prevent caries better on smooth than on occlusal surfaces. As we know, tooth decay of first permanent molars causes a great deal of different short and long term difficulties for patients. Therefore, there is a continuous need for implementation of programs for caries prevention in permanent teeth. Nowadays, we like to treat our patients by minimally invasive methods. A very important step in our effective preventive treatment is sealing pits and fissures as a cornerstone of occlusal caries management. Reliable assessment of caries activity is also very important for defining treatment needs and plans. A very important decision, which should be made during occlusal caries management, is the selection of restorative material according to the treatment plan. Conclusion. Current possibilities in occlusal caries prevention and management are very effective. Therefore, dentists today do not have any excuse for avoiding the philosophy of Minimally Invasive Dentistry, especially when we talk about caries management of occlusal surfaces in permanent molars.

  16. Non-Occlusive Mesenteric Ischemia

    International Nuclear Information System (INIS)

    Kraemer, S.C.; Universitaetsklinikum Ulm; Goerich, J.; Oertel, F.; Scheld, H.; Heindel, W.

    2003-01-01

    The so-called non-occlusive disease (NOD) or non-occlusive mesenteric ischemia (NOMI) is a severe and life-threatening pathology. Even under optimal circumstances and standardised diagnostic and therapeutic procedures maximum survival rates do not exceed 50%. The NOD is a pathology of the elder patient and its incidence rises with other comorbidities such as reduced cardiac output, diabetes and renal insufficiency. Induction of the disease with a severe vasoconstriction of the splanchnic vessels may be a simple cardiac decompensation, a frequent trigger however is a previous heart surgery with consecutive cardiac shock. Early diagnosis is difficult to conduct because of unspecific symptoms. Beside abdominal pain in awake patients, ileus or subileus is remaining the single acute symptom which could be also a consequence of a postoperative paralysis. Laboratory parameters such as leucocytosis and elevated lactat levels are often positive, but unspecific and the latter may be a delayed sign of progressive disease. The only sufficient method for diagnosis implicating a possible treatment option seems to be an immediate angiographic examination. Because of the disappointing results of a solitary surgical approach transarterial medication via catheter is indicated. Depending of the course of the disease only a combination of local mesenteric infusion of vasodilatory drugs and surgical resection of already necrotic bowel promises a successful therapeutic approach and better survival rates. (orig.) [de

  17. Efficacy and Safety of a Novel Vascular Closure Device (Glubran 2 Seal) After Diagnostic and Interventional Angiography in Patients with Peripheral Arterial Occlusive Disease

    Energy Technology Data Exchange (ETDEWEB)

    Del Corso, Andrea [University of Pisa, Department of Vascular Surgery (Italy); Bargellini, Irene, E-mail: irenebargellini@hotmail.com; Cicorelli, Antonio; Perrone, Orsola [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Leo, Michele [University of Pisa, Department of Vascular Surgery (Italy); Lunardi, Alessandro [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Alberti, Aldo; Tomei, Francesca [University of Pisa, Department of Vascular Surgery (Italy); Cioni, Roberto [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Ferrari, Mauro [University of Pisa, Department of Vascular Surgery (Italy); Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy)

    2013-04-15

    To prospectively evaluate safety and efficacy of a novel vascular closure device (Glubran 2 Seal) after peripheral angiography in patients with peripheral arterial occlusive disease (PAOD). From December 2010 to June 2011, all consecutive patients with PAOD undergoing peripheral angiography were prospectively enrolled onto the study after percutaneous antegrade or retrograde puncture of the common femoral artery. After angiography, the Glubran 2 Seal device was used to achieve hemostasis. The following data were registered: technical success and manual compression duration, patients' discomfort (scale 0-5), operators' technical difficulty (scale 0-5), and vascular complications. The site of hemostasis was evaluated by clinical inspection and color-coded Duplex ultrasound performed 1 day and 1 month after the procedure. One hundred seventy-eight patients were enrolled (112 male, mean age 70.8 years) with a total of 206 puncture sites, including 104 (50.5 %) antegrade accesses. The device was successful in 198(96.1 %) of 206 procedures, with 8 cases of manual compression lasting longer than 5 min (maximum 20 min). No major vascular complications were observed, resulting in 100 % procedural success. Minor complications occurred in seven procedures (3.4 %), including two cases of pseudoaneurysms, successfully treated by ultrasound-guided glue injection. The mean {+-} standard deviation score for patients' discomfort was 0.9 {+-} 0.7, whereas the mean score for operators' difficulty was 1.2 {+-} 0.9. In patients with PAOD, the Glubran 2 Seal represents a simple, painless, and efficient vascular closure device, able to achieve hemostasis both in antegrade and retrograde accesses.

  18. Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis

    International Nuclear Information System (INIS)

    Ahmed, Ahmed T.; Mohammed, Khaled; Chehab, Monzer; Brinjikji, Waleed; Hassan Murad, M.; Cloft, Harry; Bjarnason, Haraldur

    2016-01-01

    Background and PurposeSubclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.Materials and MethodsWe searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.ResultsA total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8 %, p = 0.007). Long-term primary patency rates (76.9 vs 79.6 %, p = 0.729) and symptom resolution rates (82.2 vs 73.0 %, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.ConclusionStent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.

  19. Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Ahmed T., E-mail: Ahmed.Ahmed1@mayo.edu; Mohammed, Khaled, E-mail: Mohammed.Khaled@mayo.edu [Mayo Clinic, Evidence-Based Practice Research Program (United States); Chehab, Monzer, E-mail: moe.chehab@beumont.edu [Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging (United States); Brinjikji, Waleed, E-mail: Brinjikji.Waleed@mayo.edu [Mayo Clinic, Department of Radiology (United States); Hassan Murad, M., E-mail: Murad.Mohammad@mayo.edu [Mayo Clinic, Evidence-Based Practice Research Program (United States); Cloft, Harry, E-mail: Cloft.Harry@mayo.edu; Bjarnason, Haraldur, E-mail: Bjarnason.Haraldur@mayo.edu [Mayo Clinic, Department of Radiology (United States)

    2016-05-15

    Background and PurposeSubclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.Materials and MethodsWe searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.ResultsA total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8 %, p = 0.007). Long-term primary patency rates (76.9 vs 79.6 %, p = 0.729) and symptom resolution rates (82.2 vs 73.0 %, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.ConclusionStent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.

  20. MAGnesium-oral supplementation to reduce PAin in patients with severe PERipheral arterial occlusive disease: the MAG-PAPER randomised clinical trial protocol.

    Science.gov (United States)

    Venturini, Monica Aida; Zappa, Sergio; Minelli, Cosetta; Bonardelli, Stefano; Lamberti, Laura; Bisighini, Luca; Zangrandi, Marta; Turin, Maddalena; Rizzo, Francesco; Rizzolo, Andrea; Latronico, Nicola

    2015-12-16

    Magnesium exerts analgaesic effects in several animal pain models, as well as in patients affected by acute postoperative pain and neuropathic chronic pain. There is no evidence that magnesium can modulate pain in patients with peripheral arterial occlusive disease (PAOD). We describe the protocol of a single-centre randomised double-blind clinical trial aimed at assessing the efficacy of oral magnesium supplementation in controlling severe pain in patients with advanced PAOD. Adult patients affected by PAOD at stages III and IV of Lèriche-Fontaine classification, who are opioid-naïve, and who have been admitted to our Acute Pain Service for intractable pain, will be eligible. Patients will be randomised to the control group, treated with standard therapy (oxycodone and pregabalin) plus placebo for 2 weeks, or to the experimental group (standard therapy plus magnesium oxide). Patients will be evaluated on days 0, 2, 4, 6, 8, 12 and 14; the following information will being collected: daily oxycodone dose; average and maximum pain (Numerical Rating Scale); pain relief (Pain Relief Scale); characteristics of the pain (Neuropathic Pain Scale); impact of pain on the patient's daily activities (Brief Pain Inventory). The primary outcome will be oxycodone dosage needed to achieve satisfactory analgaesia on day 14. Secondary outcomes will be pain relief on day 2, time needed to achieve satisfactory analgaesia and time needed to achieve a pain reduction of 50%. A sample size calculation was performed for the primary outcome, which estimated a required sample size of 150 patients (75 per group). Ethical approval of the study protocol has been obtained from Comitato Etico Provinciale di Brescia, Brescia, Italy. Trial results will be disseminated through scientific journal manuscripts and scientific conference presentations. NCT02455726. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Quantitative sensory testing is feasible and is well-tolerated in patients with sickle cell disease following a vaso-occlusive episode

    Directory of Open Access Journals (Sweden)

    Bakshi N

    2018-02-01

    Full Text Available Nitya Bakshi,1 Ines Lukombo,1,2 Inna Belfer,3 Lakshmanan Krishnamurti1 1Division of Pediatric Hematology-Oncology, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 2University of Pittsburgh, 3Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA Introduction: Sickle cell disease (SCD is an inherited blood disorder characterized by abnormally shaped sickle cells. The hallmark of this disease is intermittent, painful vaso-occlusive episodes (VOE, but a subset of individuals with SCD experience chronic pain. The mechanism of transition to chronic pain is not well understood in SCD, but there is evidence of altered pain processing in individuals with SCD. The impact of VOE on pain sensitivity is not established. The objective of this study was to determine the feasibility and tolerability of quantitative sensory testing (QST in SCD following a VOE to better understand the contribution of VOE to the development of chronic pain. Methods: As part of a larger pain sensitivity study, pediatric patients with SCD were offered QST following a VOE-related Emergency Room visit or inpatient hospitalization. The feasibility of recruitment and completion of QST was measured, and tolerability of QST was determined using post-QST assessments of pain, and compared with measurements at steady state. Results: Ten participants completed QST following a VOE. The median age was 16.5, and 60% were female. Overall, 10 of 16 (62.5% patients approached for QST following VOE completed QST. This included 8 of 12 patients who had previously completed QST at steady state. There were no statistically significant differences in pain intensity and Gracely Box scores after QST following a VOE, when compared to steady-state QST. Conclusion: QST is feasible and is well-tolerated following a VOE in patients with SCD. Large prospective studies are needed to determine the impact of VOE on experimental pain sensitivity and must

  2. [Complete denture occlusion considered from occlusal contacts during mastication].

    Science.gov (United States)

    Suzuki, Tetsuya

    2004-12-01

    Few reports describe the functional superiority of full balanced occlusion to that of lingualized occlusion. Recently, a bilateral balanced scheme has been much more generally applied than a unilateral balanced scheme in lingualized occlusion as well as in full balanced occlusion. Occlusal contacts on the non-chewing side occur earlier than on the chewing side;in the order of second molar, first molar, and then premolars. The contact on the balancing side contributes to the prevention of denture dislocation and guidance from eccentric positions to the centric occlusal position during mastication. Therefore, bilateral balanced occlusion was shown to be effective for denture stability during mastication with complete dentures. Today's typical edentulous patients have greater mean age than in the past, and thus are seen with severe alveolar bone resorption, thin mucosa and sometimes abnormalities of the maxillomandibular relation. Their occlusal positions are often unstable and changeable after insertion of complete dentures. Because lingualized occlusion allows for easier accommodation and correction, lingualized occlusion is more suitable for such cases than full balanced occlusion, which requires a strict occlusal relationship. In light of the standard Japanese diet, there is some doubt about why lingualized occlusion might be suitable for Japanese edentulous patients in terms of the sense of mastication. A method of evaluating the sense of mastication needs to be established.

  3. How to assess post-occlusive hyperaemia by means of laser Doppler perfusion monitoring: application of a standardised protocol to patients with peripheral arterial obstructive disease

    NARCIS (Netherlands)

    Morales, Fernando; Graaff, Reindert; Smit, Andries J.; Bertuglia, Silvia; Petoukhova, Anna; Steenbergen, Wiendelt; Leger, Philippe; Rakhorst, Gerhard

    2005-01-01

    The standardisation of manoeuvres to perform clinically discriminative microvascular flow reserve tests is still poorly developed, as well as the response analysis. The aim of this study was to establish a reproducible analysis method for the post-occlusive reactive hyperaemia (PORH) test measured

  4. How to assess post-occlusive reactive hyperaemia by means of laser Doppler perfusion monitoring : Application of a standardised protocol to patients with peripheral arterial obstructive disease

    NARCIS (Netherlands)

    Morales, F; Graaff, R; Smit, AJ; Bertuglia, S; Petoukhova, AL; Steenbergen, W; Leger, P; Rakhorst, G

    The standardisation of manoeuvres to perform clinically discriminative microvascular flow reserve tests is still poorly developed, as well as the response analysis. The aim of this study was to establish a reproducible analysis method for the post-occlusive reactive hyperaemia (PORE) test measured

  5. Combined central retinalartery and vein occlusion complicating ...

    African Journals Online (AJOL)

    Orbital Cellulitis is a dreaded ophthalmologic disease. Itmay destroy vision and the eye andmay even become life threatening. Often visual loss is the result of exposure and subsequent destruction of ocular tissue commonly the cornea and the uvea. We report a case of combined central retinal artery and vein occlusion ...

  6. Quantitative assessment of lower limb ischemia of arterial occlusive disease utilizing leg scintigraphy by abdominal aortic infusion of {sup 201}Tl chloride

    Energy Technology Data Exchange (ETDEWEB)

    Hirooka, Noriyuki [Wakayama Medical Univ. (Japan)

    2001-06-01

    We developed leg scintigraphy by abdominal aortic infusion of {sup 201}Tl (111 Mbq, which is equivalent dose in leg scintigraphy by intravenous injection) for diagnosis of ischemic leg. An evaluation of the image by this scintigraphy and a quantitative assessment of ischemic leg by time radioactivity curve (TAC) on calf was preformed among 36 limbs in 18 patients with intermittent claudication. These limbs were divided into 4 groups based on walking distance without calf pain as follows; Group 1 (5 limbs): asymptomatic, Group 2 (13 limbs); over 500 m and less than 1000 m, Group 3 (12 limbs); over 100 m and less than 500 m, Group 4 (6 limbs); less than 100 m. The image of supreme quality for diagnosis of leg ischemia was obtained in all subjects due to a lack of interference from background radioactivity. The relationship between each group and following 3 indicators; peak value, peak time and k value as washout rate obtained from TAC was evaluated. The peak value was 792.6{+-}78.6, 419.4{+-}42.3, 252.6{+-}32.7 and 77.0{+-}21.6 in G1, G2, G3 and G4, respectively (significant difference among each group). The peak time was 11.6{+-}0.6, 14.3{+-}1.2, 16.5{+-}0.85 and 18.6{+-}2.2 in G1, G2, G3 and G4, respectively (G1 vs G2 and G2 vs G3: significant difference, G3 vs G4: not significant). The k value was 1.89{+-}0.32, 1.35{+-}0.33, 0.91{+-}0.12 and 0.56{+-}0.11 in G1, G2, G3 and G4, respectively (significant difference among each group). The peak value is affected by the infused dose of Tl, but the k value is not affected by the dose and is constant indicator in a given leg. These results suggest that lower limb muscle scintigraphy using abdominal aortic infusion of {sup 201}Tl produces a clear image for diagnosis of ischemic leg and k value is one of useful indicators to evaluate the clinical grading of arterial occlusive disease of leg. (author)

  7. Occlusal vertical dimension. Review article

    OpenAIRE

    Alvítez Temoche, Daniel Augusto; Facultad de Odontología de la Universidad Nacional Mayor de San Marcos.

    2016-01-01

    Modication of occlusal vertical dimension is a procedure that is often necessary for complex oral reha-bilitation treatments to get a functional occlusal for patients. is literature review was made on databases: Medline (PubMed), Scopus, Scielo, BSV (Bireme), ISI (Web of science) and Lilacs using the keywords “occlusal vertical dimension”,”altered vertical dimension”, “temporomandibular joint”, and “masticatory muscles”. It can be said that the management of occlusal vertical dimension is a s...

  8. Advanced Oxidation Protein Products and Carbonylated Proteins as Biomarkers of Oxidative Stress in Selected Atherosclerosis-Mediated Diseases

    Directory of Open Access Journals (Sweden)

    Bogna Gryszczyńska

    2017-01-01

    Full Text Available Objectives. The main question of this study was to evaluate the intensity of oxidative protein modification shown as advanced oxidation protein products (AOPP and carbonylated proteins, expressed as protein carbonyl content (C=O in abdominal aortic aneurysms (AAA, aortoiliac occlusive disease (AIOD, and chronic kidney disease (CKD. Design and Methods. The study was carried out in a group of 35 AAA patients and 13 AIOD patients. However, CKD patients were divided into two groups: predialysis (PRE included 50 patients or hemodialysis (HD consisted of 34 patients. AOPP and C=O were measured using colorimetric assay kit, while C-reactive protein concentration was measured by high-sensitivity assay (hsCRP. Results. The concentration of AOPP in both AAA and AIOD groups was higher than in PRE and HD groups according to descending order: AAA~AIOD > HD > PRE. The content of C=O was higher in the PRE group in comparison to AIOD and AAA according to the descending order: PRE~HD > AAA~AIOD. Conclusions. AAA, AIOD, and CKD-related atherosclerosis (PRE and HD contribute to the changes in the formation of AOPP and C=O. They may promote modification of proteins in a different way, probably due to the various factors that influence oxidative stress here.

  9. Factor V Leiden (G1691A), Factor V R2 (A4070G), and Prothrombin (G20210A) Genetic Polymorphisms in Macedonian Patients with Occlusive Artery Disease and Deep Vein Thrombosis

    OpenAIRE

    Spiroski, Igor; Kedev, Sashko; Efinska-Mladenovska, Olivija

    2015-01-01

    AIM: The aim was to analyze association of Factor V Leiden (G1691A), Factor V R2 (A4070G), and Prothrombin (G20210A) Genetic Polymorphism in Macedonian Patients with Occlusive Artery Disease (OAD) and Deep Vein Thrombosis (DVT).METHODS: Investigated groups consists of 82 healthy, 76 patients with OAD, and 67 patients with DVT. Blood samples were collected after written consent, and DNA was isolated from peripheral blood leukocytes. Identification of Factor V Leiden (G1691A), Factor V R2 (A407...

  10. Endovascular repair of postoperative vascular graft related complications after aorto-iliac surgery

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, P E; Larsen, K E

    2014-01-01

    with anastomotic pseudoaneurysms without leak, of which three had proximal anastomotic pseudoaneurysms and one had distal iliac anastomotic pseudoaneurysm. Implanted stent graft were Endurant (Medtronic) bifurcated endoprostheses in three patients and Excluder (Gore) prosthesis in a two cases. Tubular Medtronic....... The mortality and morbidity is higher compared to the initial treatment. We present twelve patients with these complications which were treated by an endovascular approach. METHODS: From January 2008 through January 2013 our radiological records were searched for cases with post surgical vascular complications...... treated with endovascular intervention. These comprised of anastomotic pseudoaneurysm, suture leakage and arterial enteric fistulas. Patients with limb occlusions were not included in this study. RESULTS: Twelve patients with graft related complications treated with endovascular intervention were recorded...

  11. Endovascular repair of postoperative vascular graft related complications after aorto-iliac surgery

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, P E; Larsen, K E

    2014-01-01

    with anastomotic pseudoaneurysms without leak, of which three had proximal anastomotic pseudoaneurysms and one had distal iliac anastomotic pseudoaneurysm. Implanted stent graft were Endurant (Medtronic) bifurcated endoprostheses in three patients and Excluder (Gore) prosthesis in a two cases. Tubular Medtronic...... endoprosthesis was implanted in one case and in two cases aortic cuff was used. Fluency periphery stent grafts were used in four cases. There was a 100% technical success. Intervention related early mortality was 8%. One patient with pseudoaneurysm died 28 months after endovascular treatment because of cardiac......-36 months) in the other 9 patients. There were no complications like endoleaks or limb occlusions. CONCLUSION: Endovascular treatment of vascular graft related postsurgical complications is a valuable therapeutic option followed by lower mortality and morbidity rates compared with re-operation. Short...

  12. Higher Levels of Cystatin C Are Associated with Extracranial Carotid Artery Steno-Occlusive Disease in Patients with Noncardioembolic Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Toshitaka Umemura

    2016-01-01

    Full Text Available Background: Large artery atherosclerosis is a major cause of ischemic stroke worldwide. Differential biomarker profiles associated with extra- and intracranial atherosclerosis are a topic of considerable interest. Cystatin C (CysC, a marker of renal function, is a risk factor for cardiovascular disease. Aim: We sought to determine whether CysC levels were associated with extra- and intracranial large artery stenosis (LAS in patients with acute ischemic stroke. Methods: We retrospectively analyzed data of acute noncardioembolic ischemic stroke patients who were admitted to our stroke center within 5 days from symptom onset. Serum CysC levels were measured using latex agglutination turbidimetric immunoassay. Extra- and intracranial LAS were defined as ≥50% diameter stenosis or occlusion of the relevant internal carotid artery (ICA and/or middle cerebral artery (MCA using carotid echography and volume rendering on magnetic resonance angiography. Multivariate logistic analyses were used to assess the association between CysC levels and LAS after adjustment for potential confounders. Results: Of 205 patients (mean age 70.2 years, 76 (37.1% had LAS. The distribution of LAS was 29 extracranial ICA, 34 intracranial ICA/MCA (8 ICA only, 25 MCA only, 1 ICA+MCA and 13 tandem stenosis (both extracranial ICA and intracranial ICA/MCA. Levels of CysC were higher in patients with extracranial ICA stenosis than in those with intracranial ICA/MCA stenosis (1.23 ± 0.33 vs. 0.97 ± 0.21 mg/l, p 1.04 mg/l was significantly associated with extracranial ICA stenosis (adjusted odds ratio [OR] 5.01, 95% confidence interval [CI] 1.51-16.63, p = 0.009 after adjustment for age, sex, diabetes, chronic kidney disease, current smoking, systolic blood pressure, HDL cholesterol, high-sensitivity C-reactive protein (hs-CRP and premorbid lipid-lowering drugs use. When CysC was considered as a continuous variable, 1 SD increase in CysC was significantly associated with

  13. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  14. An alternative treatment of occlusal wear: cast metal occlusal surface.

    Science.gov (United States)

    Kumar, Sandeep; Arora, Aman; Yadav, Reena

    2012-01-01

    Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures.

  15. An alternative treatment of occlusal wear: Cast metal occlusal surface

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2012-01-01

    Full Text Available Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures.

  16. [Relationship between Occlusal Discomfort Syndrome and Occlusal Threshold].

    Science.gov (United States)

    Munakata, Motohiro; Ono, Yumie; Hayama, Rika; Kataoka, Kanako; Ikuta, Ryuhei; Tamaki, Katsushi

    2016-03-01

    Occlusal dysesthesia has been defined as persistent uncomfortable feelings of intercuspal position continuing for more than 6 months without evidence of physical occlusal discrepancy. The problem often occurs after occlusal intervention by dental care. Although various dental treatments (e. g. occlusal adjustment, orthodontic treatment and prosthetic reconstruction) are attempted to solve occlusal dysesthesia, they rarely reach a satisfactory result, neither for patients nor dentists. In Japan, these symptoms are defined by the term "Occlusal discomfort syndrome" (ODS). The aim of this study was to investigate the characteristics of ODS with the simple occlusal sensory perceptive and discriminative test. Twenty-one female dental patients with ODS (mean age 55.8 ± 19.2 years) and 21 age- and gender-matched dental patients without ODS (mean age 53.1 ± 16.8 years) participated in the study. Upon grinding occlusal registration foils that were stacked to different thicknesses, participants reported the thicknesses at which they recognized the foils (recognition threshold) and felt discomfort (discomfort threshold). Although there was no significant difference in occlusal recognition thresholds between the two patient groups, the discomfort threshold was significantly smaller in the patients with ODS than in those without ODS. Moreover, the recognition threshold showed an age-dependent increase in patients without ODS, whereas it remained comparable between the younger (patient subgroups with ODS. These results suggest that occlusal discomfort threshold rather than recognition threshold is an issue in ODS. The foil grinding procedure is a simple and useful method to evaluate occlusal perceptive and discriminative abilities in patients with ODS.

  17. Occlusion et posture

    OpenAIRE

    Le Breton, Alix

    2017-01-01

    L'objectif majeur de l'orthodontie est d'obtenir une occlusion fonctionnelle. Cette fonction occlusale est capitale dans la croissance du complexe maxillo-facial mais aussi dans la croissance et la statique générale du corps. Le champ d'action de l'orthodontiste s'inscrit donc dans une prise en charge globale. Il doit prendre conscience que son traitement risque d'influer sur la posture et modifier le schéma corporel du patient. Ce travail va dans un premier temps définir le système postural ...

  18. Peripheral Stent Thrombosis Leading to Acute Limb Ischemia and Major Amputation: Incidence and Risk Factors in the Aortoiliac and Femoropopliteal Arteries

    Energy Technology Data Exchange (ETDEWEB)

    Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Al-Lamki, Said A. M. [The Royal Hospital, Department of Radiology (Oman); Parthipun, Aneeta [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Spiliopoulos, Stavros [ATTIKO Athens University Hospital, 2nd Department of Radiology, Interventional Radiology Unit (Greece); Patel, Sanjay Dhanji [King’s Health Partners, Academic Department of Surgery, Cardiovascular Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Paraskevopoulos, Ioannis [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Zayed, Hany [King’s Health Partners, Academic Department of Surgery, Cardiovascular Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Diamantopoulos, Athanasios [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)

    2017-03-15

    PurposeTo report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit.Materials and MethodsMedical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia. Cases were stratified between aortoiliac and femoropopliteal anatomy. Cox regression analysis was employed to adjust for baseline clinical and procedural confounders and identify predictors of stent thrombosis and major limb loss.Results256 patients (n = 277 limbs) were analysed over a 5-year period (2009–2014) including 117 aortoiliac stents (34 CNS; 12.8 ± 5.0 cm and 83 BNS; 7.8 ± 4.0 cm) and 160 femoropopliteal ones (60 CNS; 21.1 ± 11.0 cm and 100 BNS; 17.5 ± 11.9 cm). Median follow-up was 1 year. Overall stent thrombosis rate was 6.1% (17/277) after a median of 43 days (range 2–192 days) and affected almost exclusively the femoropopliteal segment (12/60 in the CNS cohort vs. 4/100 in the BNS; p = 0.001). Annualized stent thrombosis rates (per 100 person-years) were 12.5% in case of CNS and 1.4% in case of BNS (HR 6.3, 95% CI 2.4–17.9; p = 0.0002). Corresponding major amputations rates were 8.7 and 2.5%, respectively (HR 4.5, 95% CI 2.7–27.9; p = 0.0006). On multivariable analysis, critical leg ischemia and CNS placement were the only predictors of stent thrombosis. Diabetes, critical leg ischemia, femoropopliteal anatomy, long stents and CNS were independent predictors of major amputations.ConclusionsPlacement of long femoropopliteal covered nitinol stents is associated with an increased incidence of acute stent thrombosis and ensuing major amputation. Risks are significantly lower in the aortoiliac vessels

  19. Trauma from occlusion - An orthodontist′s perspective

    Directory of Open Access Journals (Sweden)

    Saravanan R

    2010-01-01

    Full Text Available Orthodontic therapy has a big role in the treatment and prevention of malpositions. The signs and symptoms experienced by patients with occlusal trauma are mobility of teeth, temperomandibular joint pain, pain on mastication and periodontal disease. Early diagnosis, proper treatment plan and correction of malocclusion can lead to a successful outcome. Lack of awareness of orthodontic treatment in patients with occlusal trauma can even lead to loss of tooth structure.

  20. Adult necrotizing enterocolitis and non occlusive mesenteric ischemia

    OpenAIRE

    Zachariah, Sanoop Koshy

    2011-01-01

    Adult necrotizing enterocolitis and non occlusive mesenteric ischemia are rare causes of acute abdomen in adults. Accurate preoperative diagnosis is often difficult in these cases. Here, four cases of massive bowel necrosis with varying segments of small and large bowel involvement are described, all of whom underwent surgery. These cases give an opportunity to review the literature on such lethal diseases including non occlusive intestinal necrosis, neonatal necrotizing enterocolitis and adu...

  1. [Temporomandibular joint, occlusion and bruxism].

    Science.gov (United States)

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Apparent brain temperature imaging with multi-voxel proton magnetic resonance spectroscopy compared with cerebral blood flow and metabolism imaging on positron emission tomography in patients with unilateral chronic major cerebral artery steno-occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Nanba, Takamasa; Nishimoto, Hideaki; Murakami, Toshiyuki; Fujiwara, Shunrou; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Open and Transdisciplinary Research Initiatives, Osaka (Japan); Sasaki, Makoto; Uwano, Ikuko [Iwate Medical University, Institute for Biomedical Science, Iwate (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Iwate (Japan)

    2017-09-15

    The purpose of the present study was to determine whether apparent brain temperature imaging using multi-voxel proton magnetic resonance (MR) spectroscopy correlates with cerebral blood flow (CBF) and metabolism imaging in the deep white matter of patients with unilateral chronic major cerebral artery steno-occlusive disease. Apparent brain temperature and CBF and metabolism imaging were measured using proton MR spectroscopy and {sup 15}O-positron emission tomography (PET), respectively, in 35 patients. A set of regions of interest (ROIs) of 5 x 5 voxels was placed on an MR image so that the voxel row at each edge was located in the deep white matter of the centrum semiovale in each cerebral hemisphere. PET images were co-registered with MR images with these ROIs and were re-sliced automatically using image analysis software. In 175 voxel pairs located in the deep white matter, the brain temperature difference (affected hemisphere - contralateral hemisphere: ΔBT) was correlated with cerebral blood volume (CBV) (r = 0.570) and oxygen extraction fraction (OEF) ratios (affected hemisphere/contralateral hemisphere) (r = 0.641). We excluded voxels that contained ischemic lesions or cerebrospinal fluid and calculated the mean values of voxel pairs in each patient. The mean ΔBT was correlated with the mean CBF (r = - 0.376), mean CBV (r = 0.702), and mean OEF ratio (r = 0.774). Apparent brain temperature imaging using multi-voxel proton MR spectroscopy was correlated with CBF and metabolism imaging in the deep white matter of patients with unilateral major cerebral artery steno-occlusive disease. (orig.)

  3. Arterial Transit Time Mapping Obtained by Pulsed Continuous 3D ASL Imaging with Multiple Post-Label Delay Acquisitions: Comparative Study with PET-CBF in Patients with Chronic Occlusive Cerebrovascular Disease.

    Science.gov (United States)

    Tsujikawa, Tetsuya; Kimura, Hirohiko; Matsuda, Tsuyoshi; Fujiwara, Yasuhiro; Isozaki, Makoto; Kikuta, Ken-Ichiro; Okazawa, Hidehiko

    2016-01-01

    Arterial transit time (ATT) is most crucial for measuring absolute cerebral blood flow (CBF) by arterial spin labeling (ASL), a noninvasive magnetic resonance (MR) perfusion assessment technique, in patients with chronic occlusive cerebrovascular disease. We validated ASL-CBF and ASL-ATT maps calculated by pulsed continuous ASL (pCASL) with multiple post-label delay acquisitions in patients with occlusive cerebrovascular disease. Fifteen patients underwent MR scans, including pCASL, and positron emission tomography (PET) scans with 15O-water to obtain PET-CBF. MR acquisitions with different post-label delays (1.0, 1.5, 2.0, 2.5 and 3.0 sec) were also obtained for ATT correction. The theoretical framework of 2-compartmental model (2CM) was also used for the delay compensation. ASL-CBF and ASL-ATT were calculated based on the proposed 2CM, and the effect on the CBF values and the ATT correction characteristics were discussed. Linear regression analyses were performed both on pixel-by-pixel and region-of-interest bases in the middle cerebral artery (MCA) territory. There were significant correlations between ASL-CBF and PET-CBF both for voxel values (r = 0.74 ± 0.08, slope: 0.87 ± 0.22, intercept: 6.1 ± 4.9) and for the MCA territorial comparison in both affected (R2 = 0.67, y = 0.83x + 6.3) and contralateral sides (R2 = 0.66, y = 0.74x + 6.3). ASL-ATTs in the affected side were significantly longer than those in the contralateral side (1.51 ± 0.41 sec and 1.12 ± 0.30 sec, respectively, p <0.0005). CBF measurement using pCASL with delay compensation was feasible and fairly accurate even in altered hemodynamic states.

  4. Total occlusion of the left main and proximal right coronary artery: case report and review of the literature.

    Science.gov (United States)

    Leon, M N; Abu-Halawa, S; Ramanna, N; Kokotsakis, J N; Treistman, B; Anderson, H V

    1996-11-01

    Chronic total left main coronary artery occlusion at angiography is very rare, and there are only four cases reported with concomitant total right coronary artery occlusion. We describe a case of total left main and proximal right coronary artery occlusion and review the clinical and angiographic characteristics of this condition which represents the most severe from of coronary artery disease compatible with life.

  5. Drug-induced hypotension SEP test and acetazolamide test using sup 133 Xe SPECT in patients with occlusive carotid disease; Selection of candidates for extracranial-intracranial bypass

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Kamiyama, Hiroyasu; Abe, Hiroshi; Takigawa, Shugo (Hokkaido Univ., Sapporo (Japan). School of Medicine); Mitsumori, Kenji; Nomura, Mikio; Saitoh, Hisatoshi

    1991-01-01

    The correlation between the drug-induced hypotension somatosensory evoked potential (SEP) test and regional cerebral blood flow changes after acetazolamide administration was studied. Fourteen patients presenting with transient ischemic attack, reversible ischemic neurological deficits, or minor completed stroke were evaluated. All patients had no or only localized low-density areas on computed tomographic scans, and unilateral occlusion or severe stenosis of the internal carotid or middle cerebral artery on cerebral angiograms. The Diamox asymmetry enhancement (DAE) was studied to detect reduced cerebral perfusion reserve in the affected hemispheres. The DAE was 7.9+-5.8% in seven patients positive in the SEP test, significantly higher than -1.5+-2.9% in patients negative in the SEP test. Postoperative SEP tests were negative in all five patients who underwent extracranial-intracranial (EC-IC) bypass surgery, suggesting that the EC-IC bypass improved the cerebral perfusion reserve in the affected hemispheres. The DAE decreased significantly in four of these patients. This study disclosed a significant correlation between the drug-induced hypotension SEP test and DAE. These parameters are considered important for evaluating patients with hemodynamic compromise and/or suitable candidates for EC-IC bypass. (author).

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

    2009-08-15

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  7. Comparison of the OUTBACK®Elite Reentry Catheter and the Bi-directional Approach after Failed Antegrade Approach for Femoro-popliteal Occlusive Disease.

    Science.gov (United States)

    Kawasaki, Daizo; Fukunaga, Masashi; Nakata, Tsuyoshi; Kato, Masaaki; Ohkubo, Nobukazu

    2017-12-01

    A successful antegrade wire crossing for femoro-popliteal chronic total occlusion (FP-CTO) is still a technical challenge. We attempted to demonstrate the safety and feasibility of the OUTBACK ® Elite reentry catheter and the bi-directional approach for failed FP-CTO cases with the antegrade approach. Endovascular therapy for FP-CTO was performed in 219 lesions from May 2013 to December 2016 at Morinomiya Hospital. We retrospectively analyzed the data of 43 consecutive lesions which underwent endovascular therapy using the bi-directional approach with distal access and the mono-directional approach with the OUTBACK ® Elite reentry catheter for FP-CTO lesions. The antegrade success using a combination of traditional and Intravascular Ultrasound (IVUS) -guided techniques was achieved in 170 lesions out of a total of 219 lesions. From May 2013 to June 2016 (phase 1), the bi-directional approach with distal access was applied to 22 lesions after failed antegrade approaches. From July 2016 to December 2016 (phase 2), the mono-directional approach with the OUTBACK ® Elite reentry catheter was applied to 21 lesions. Clinical and lesion characteristics in phase 1 were not significantly different from those in phase 2. The overall initial technical success rate was 100% in both phases. The total wire number and amount of contrast media were significantly less, and the total procedure time and the total fluoroscopic time were significantly shorter in phase 2 than in phase 1 (p<0.01). Endovascular therapy for FP-CTO using the OUTBACK ® Elite reentry catheter is feasible and safe after a failed antegrade approach.

  8. Quantitative perfusion computed tomography measurements of cerebral hemodynamics: Correlation with digital subtraction angiography identified primary and secondary cerebral collaterals in internal carotid artery occlusive disease

    International Nuclear Information System (INIS)

    Cheng Xiaoqing; Tian Jianming; Zuo Changjing; Liu Jia; Zhang Qi; Lu Guangming

    2012-01-01

    Background: The aim of the present study was to assess hemodynamic variations in symptomatic unilateral internal carotid artery occlusion (ICAO) patients with primary collateral flow via circle of Willis or secondary collateral flow via ophthalmic artery and/or leptomeningeal collaterals. Methods: Thirty-eight patients with a symptomatic unilateral ICAO were enrolled in the study. Based on digital subtraction angiography (DSA) findings, patients were classified into 2 groups: primary collateral (n = 14) and secondary collateral (n = 24) groups. Collateral flow hemodynamics were investigated with perfusion computed tomography (PCT) by measuring the cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) in the hemispheres ipsilateral and contralateral to ICAO. Based on the measurements, the ipsilateral to contralateral ratio for each parameter was calculated and compared. Results: Irrespective of the collateral patterns, ipsilateral CBF was not significantly different from that of the contralateral hemisphere (P = 0.285); ipsilateral CBV and TTP was significantly increased compared with those of the contralateral hemisphere (P = 0.000 and P = 0.000 for CBV and TTP, respectively). Furthermore, patients with secondary collaterals had significantly larger ipsilateral-to-contralateral ratios for both CBV (rCBV, P = 0.0197) and TTP (rTTP, P = 0.000) than those of patients with only primary collaterals. These two groups showed no difference in ipsilateral-to-contralateral ratio for CBF (rCBF, P = 0.312). Conclusion: Patients with symptomatic unilateral ICAO in our study were in an autoregulatory vasodilatation status. Moreover, secondary collaterals in ICAO patients were correlated with ipsilateral CBV and delayed TTP that suggested severe hemodynamic impairment, presumably increasing the risk of ischemic events.

  9. Clinical study of internal carotid artery occlusion

    International Nuclear Information System (INIS)

    Okada, Kyoko

    1989-01-01

    Fourteen patients with internal carotid artery (ICA) occlusion identified by cerebral angiography were studied for clinical features, computed tomographic findings, collateral circulation and risk factors. Eleven patients were males, and at age distribution it occurred more frequently in patients over 50 years to 60 years of age rather than other ages. As for the risk factors of cerebral infarction, smoking was more frequent in patients with thrombosis, and heart disease was more common in those with embolism. Stroke occurred progressively in patients with thrombosis whereas it occurred suddenly in those with embolism. The consciousness was more severely disturbed in patients with embolism than in those with thrombosis. On neuro-radiological findings, in the patients with thrombosis, the infarcted area on CT were small and emerged as deep or watershed types, and on the angiograms, occlusion at carotid bifurcation were found more frequently and the collateral circulation were well developed. In those with embolism, the infarcted areas were large and emerged as cortical types, and on the angiograms, occlusions were observed more frequently in the intracranial portion and collateral circulation were poorly developed. In many patients with thrombosis, platelet aggregation, hematocrit and blood viscosity increased, but in those with embolism did not. (author)

  10. Computerized occlusal analysis in bruxism

    Directory of Open Access Journals (Sweden)

    Lazić Vojkan

    2006-01-01

    Full Text Available Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder. Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, premature loss of teeth due to excessive attrition and mobility, headache, muscle ache, sleep interruption of an individual and problems with removable and fixed denture. Basically, two groups of etiological factors can be distinguished, viz., peripheral (occlusal factors and central (pathophysiological and psychological factors. The role of occlusion (occlusal discrepancies as the causative factor is not enough mentioned in relation to bruxism. Objective. The main objective of this paper was to evaluate the connection between occlusal factors and nocturnal parafunctional activities (occlusal disharmonies and bruxism. Method. Two groups were formed- experimental of 15 persons with signs and symptoms of nocturnal parafunctional activity of mandible (mean age 26.6 years and control of 42 persons with no signs and symptoms of bruxism (mean age 26.3 yrs.. The computerized occlusal analyses were performed using the T-Scan II system (Tekscan, Boston, USA. 2D occlusograms were analyzed showing the occlusal force, the center of the occlusal force with the trajectory and the number of antagonistic tooth contacts. Results. Statistically significant difference of force distribution was found between the left and the right side of the arch (L%-R% (t=2.773; p<0.02 in the group with bruxism. The difference of the centre of occlusal force - COF trajectory between the experimental and control group was not significant, but the trajectory of COF was longer in the group of

  11. Disease-specific questionnaire for quality of life in patients with peripheral arterial occlusive disease in the stage of critical ischemia (FLeQKI) - methodical development of a specific measuring instrument and psychometric evaluation of its validity and reliability. Pt. 1

    International Nuclear Information System (INIS)

    Wohlgemuth, W.A.; Bohndorf, K.; Kirchhof, K.; Olbricht, W.; Klarmann, S.; Engelhardt, M.; Freitag, M.H.; Woelfle, K.

    2007-01-01

    Purpose: To develop a disease-specific measuring instrument for quality of life in German-speaking patients with peripheral arterial occlusive disease in the stage of critical ischemia and to test it in a prospective study for validity and reliability. Materials and methods: We developed a questionnaire compiling items representing subjective disease relevant health states. With 35 of these items, we designed the scales comorbidity (KO), physical pain (SZ), physical functioning (KF), physical state (KS), social functioning (SB), mental health (PB), and therapy-induced limitations (TE). Each item was to be valued as never, seldom, often or always. The scales were standardized with a control group of 40 individuals without peripheral arterial occlusive disease who were interviewed twice in an interval of 6 months using both the FLeQKI and the Medical Outcomes Study Group Short Form 36 (SF-36). Convergent and discriminative validity was determined in 65 consecutive in-patients with peripheral occlusive arterial disease in the stage of critical ischemia who were interviewed with FLeQKI and SF-36 prior to percutaneous transluminal angioplasty (PTA) or bypass operation and 1 month and 6 months after. The internal consistency and test-retest reliability of the FLeQKI were determined in the control group. For statistical analysis, Cronbach's α Test and Pearsons Product Moment Correlation were used. Results: The control group consisted of 21 men and 19 women with an age of 73.4 ± 7.8, and the treatment group was comprised of 35 men and 30 women with an age of 75.1 ± 7.0. In the treatment group, convergent validity reached high values in the scales SB, KF, PB, and SZ (r = 0.41 - 0.70). With their discriminative validity (r = -0.04 - 0.30), TE and KS were independent, specific dimensions of life quality. The control group showed good values for internal consistency (Cronbach's α = 0.54 - 0.93) and for test-retest reliability (r = 0.44 - 0.96). Conclusion: The FLeQKI is

  12. Effects of chronic oral L-arginine administration on the L-arginine/NO pathway in patients with peripheral arterial occlusive disease or coronary artery disease: L-Arginine prevents renal loss of nitrite, the major NO reservoir.

    Science.gov (United States)

    Schneider, Jessica Y; Rothmann, Sabine; Schröder, Frank; Langen, Jennifer; Lücke, Thomas; Mariotti, François; Huneau, Jean François; Frölich, Jürgen C; Tsikas, Dimitrios

    2015-09-01

    Despite saturation of nitric oxide (NO) synthase (NOS) by its substrate L-arginine (Arg), oral and intravenous supplementation of Arg may enhance NO synthesis, a phenomenon known as "The L-arginine paradox". Yet, Arg is not only a source of NO, but is also a source for guanidine-methylated (N (G)) arginine derivatives which are all inhibitors of NOS activity. Therefore, Arg supplementation may not always result in enhanced NO synthesis. Concomitant synthesis of N (G)-monomethyl arginine (MMA), N (G),N (G)-dimethylarginine (asymmetric dimethylarginine, ADMA) and N (G),N (G´)-dimethylarginine (symmetric dimethylarginine, SDMA) from supplemented Arg may outweigh and even outbalance the positive effects of Arg on NO. Another possible, yet little investigated effect of Arg supplementation may be alteration of renal function, notably the influence on the excretion of nitrite in the urine. Nitrite is the autoxidation product of NO and the major reservoir of NO in the circulation. Nitrite and Arg are reabsorbed in the proximal tubule of the nephron and this reabsorption is coupled, at least in part, to the renal carbonic anhydrase (CA) activity. In the present placebo-controlled studies, we investigated the effect of chronic oral Arg supplementation of 10 g/day for 3 or 6 months in patients suffering from peripheral arterial occlusive disease (PAOD) or coronary artery disease (CAD) on the urinary excretion of nitrite relative to nitrate. We determined the urinary nitrate-to-nitrite molar ratio (UNOxR), which is a measure of nitrite-dependent renal CA activity before and after oral intake of Arg or placebo by the patients. The UNOxR was also determined in 6 children who underwent the Arg test, i.e., intravenous infusion of Arg (0.5 g Arg/kg bodyweight) for 30 min. Arg was well tolerated by the patients of the three studies. Oral Arg supplementation increased Arg (plasma and urine) and ADMA (urine) concentrations. No appreciable changes were seen in NO (in PAOD and CAD) and

  13. Iliac artery recanalization of chronic occlusions to facilitate endovascular aneurysm repair.

    Science.gov (United States)

    Vallabhaneni, Raghuveer; Sorial, Ehab E; Jordan, William D; Minion, David J; Farber, Mark A

    2012-12-01

    Concurrent iliac occlusion and abdominal aortic aneurysm is rare. Traditionally, the endovascular approach to these patients has consisted of aortouniiliac devices combined with femoral-femoral bypass. With improved facility of endovascular techniques, standard bifurcated endografts represent an alternative option in these patients. This study examined outcomes of patients undergoing iliac recanalization and traditional bifurcated endovascular aneurysm repair in the face of access vessel occlusion. Outcomes of patients at three academic tertiary referral centers who underwent attempted iliac recanalization of chronic iliac occlusions and concurrent endovascular aneurysm repair of an infrarenal aortic aneurysm were retrospectively reviewed. Patients with acute iliac thrombosis and those with severely stenotic (but patent) iliac vessels were excluded. During a 6-year period, 15 occluded iliac arteries were treated in 14 patients (13 men). Mean age was 67.8 years (range, 52-80 years). Primary indication for intervention was disabling claudication in four patients, size of abdominal aortic aneurysm in nine, and symptomatic aneurysm in one. Seven patients presented with a unilateral common iliac artery (CIA) occlusion, four with a unilateral external iliac artery (EIA) occlusion, three with a unilateral combined CIA and EIA occlusion, and one with bilateral CIA occlusions. Stents had been placed previously in two of the occluded CIAs and in one of the occluded EIAs. Average length of the occluded segment was 7.5 cm (range, 2-17 cm). The occluded CIAs and EIAs had mean diameters of 8.6 and 5.7 mm, respectively. Successful recanalization was achieved in 14 of the 15 vessels (93.3%). One EIA ruptured during recanalization but was easily controlled with a covered stent. A re-entry device was used in two cases. Overall, 13 bifurcated devices were successfully implanted. Bilateral iliac occlusions in one patient were recanalized. One Talent (Medtronic, Santa Rosa, Calif

  14. Comparison of the occlusal vertical dimension after processing complete dentures made with lingualized balanced occlusion and conventional balanced occlusion.

    Science.gov (United States)

    Basso, Michael Frederico Manzolli; Nogueira, Sergio Sualdini; Arioli-Filho, Joao Neudenir

    2006-09-01

    An increase in occlusal vertical dimension (OVD) may occur after processing complete dentures. Although many factors that generate this change are known, no information is available in the dental literature regarding the effect that the occlusal scheme may have on the change in OVD. This in vitro study compared the increase in OVD, after processing, between complete dentures with teeth arranged in lingualized balanced occlusion and conventional balanced occlusion. Thirty sets of complete dentures were evaluated as follows: 15 sets of complete dentures were arranged in conventional balanced occlusion (control) and 15 sets of complete dentures were arranged in lingualized balanced occlusion. All dentures were compression molded with a long polymerization cycle. The occlusal vertical dimension was measured with a micrometer (mm) before and after processing each set of dentures. Data were analyzed using an independent t test (alpha=.05). The mean increase in the OVD, after processing, was 0.87 +/- 0.21 mm for the control group and 0.90 +/- 0.27 mm for the experimental group. There was no significant difference between the groups. After processing, dentures set in lingualized balanced occlusion showed an increase in OVD similar to those set in conventional balanced occlusion. Although the 2 occlusal concepts resulted in similar increases in the OVD after processing, the lingualized balanced occlusion may result in easier occlusal adjustments, as the less complicated occlusal scheme uses a smaller number of centric occlusion contact points.

  15. Treatment strategies for extensive chronic SFA occlusions: indications and results.

    Science.gov (United States)

    Lensvelt, M M A; Reijnen, M M P J; Wallis De Vries, B M; Zeebregts, C J

    2012-02-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit is still considered the gold standard for treatment of long occlusive SFA lesions, endoluminal therapy is gaining territory. Its' minimal invasive character has great advantages in the frail vascular patient population. Percutaneous transluminal angioplasty is first choice in short SFA lesions, but patency rates decrease with longer lesions. When percutaneous transluminal angioplasty is combined with nitinol stent placement patency rates significantly improve. Patency rates of percutaneous transluminal angioplasty combined with covered stents are within reach of patency rates of prosthetic surgical bypasses. Drug-bonding in surgical PTFE bypasses increased patency rates significantly. In the near future drug-eluting and drug-bonded devices might further increase results of endovascular treatment.

  16. Occlusion-Aware View Interpolation

    Directory of Open Access Journals (Sweden)

    Ince Serdar

    2008-01-01

    Full Text Available Abstract View interpolation is an essential step in content preparation for multiview 3D displays, free-viewpoint video, and multiview image/video compression. It is performed by establishing a correspondence among views, followed by interpolation using the corresponding intensities. However, occlusions pose a significant challenge, especially if few input images are available. In this paper, we identify challenges related to disparity estimation and view interpolation in presence of occlusions. We then propose an occlusion-aware intermediate view interpolation algorithm that uses four input images to handle the disappearing areas. The algorithm consists of three steps. First, all pixels in view to be computed are classified in terms of their visibility in the input images. Then, disparity for each pixel is estimated from different image pairs depending on the computed visibility map. Finally, luminance/color of each pixel is adaptively interpolated from an image pair selected by its visibility label. Extensive experimental results show striking improvements in interpolated image quality over occlusion-unaware interpolation from two images and very significant gains over occlusion-aware spline-based reconstruction from four images, both on synthetic and real images. Although improvements are obvious only in the vicinity of object boundaries, this should be useful in high-quality 3D applications, such as digital 3D cinema and ultra-high resolution multiview autostereoscopic displays, where distortions at depth discontinuities are highly objectionable, especially if they vary with viewpoint change.

  17. A pilot study: the effect of healing touch on anxiety, stress, pain, pain medication usage, and physiological measures in hospitalized sickle cell disease adults experiencing a vaso-occlusive pain episode.

    Science.gov (United States)

    Thomas, Linda S; Stephenson, Nancy; Swanson, Mel; Jesse, D Elizabeth; Brown, Sylvia

    2013-12-01

    This pilot study was conducted to determine the effectiveness of Healing Touch on anxiety, stress, pain, pain medication usage, and selected physiological measures of hospitalized adults with sickle cell disease experiencing a vaso-occlusive pain episode. Healing Touch sessions were administered for 30 minutes on four consecutive days, and the self-reported data on anxiety, stress, pain, and the selected physiological data were collected while controlling for music and presence. A parallel-group randomized control trial comparing the effects of Healing Touch with Music (HTM) to Attention Control with Music (ACM). Due to the small sample size, there were no statistically significant changes in any between-group comparisons, except for present pain on Day 4 for the ACM group. For both groups, the within-group comparison showed a nonsignificant reduction in physiological parameters, a statistically significant reduction in anxiety and stress for the ACM group after Day 4, and a statistically significant reduction in stress in the HTM group after Days 2 and 4. The pre- to postintervention reductions in present pain were greater in the HTM group across all 4 days, but the only statistically significant within groups findings were in the HTM group (p < .01) on Day 1. Further research is needed.

  18. Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography in patients with major cerebral artery steno-occlusive diseases

    International Nuclear Information System (INIS)

    Saito, Hideo; Ogasawara, Kuniaki; Suzuki, Taro; Kuroda, Hiroki; Kobayashi, Masakazu; Yoshida, Kenji; Kubo, Yoshitaka; Ogawa, Akira

    2011-01-01

    Adverse effects of intravenous acetazolamide administration for evaluation of cerebrovascular reactivity using brain perfusion single-photon emission computed tomography (SPECT) were prospectively investigated in 100 patients with major cerebral artery, atherosclerotic, and steno-occlusive diseases. All patients underwent two SPECT studies (with and without acetazolamide challenge) at an interval of 2 or 3 days, received a questionnaire immediately after each SPECT study, and returned the answered questionnaire within 7 days after the study. None of the 100 patients studied experienced any symptoms during the SPECT study without acetazolamide challenge. Sixty-three patients (63%) developed symptoms during the SPECT study with acetazolamide challenge, such as headache, nausea, dizziness, tinnitus, numbness of the extremities, motor weakness of the extremities, and general malaise 1-3 hours (mean 1.6 hours) after administration of acetazolamide, and these symptoms lasted for 0.5-72 hours (mean 7.9 hours). Multivariate statistical analysis revealed that younger age (95% confidence interval [CI] 0.896-0.980, p=0.0047) and female sex (95% CI 1.178-16.129, p=0.0274) were significantly associated with development of symptoms with acetazolamide challenge. The incidences of the development of symptoms with acetazolamide challenge were 91% (21/23) and 41% (12/29) in subgroups of women <70 years and men ≥70 years, respectively. Patients should be informed of such adverse effects of intravenous acetazolamide administration prior to the acetazolamide challenge test for evaluation of cerebrovascular reactivity. (author)

  19. Corticosteróide tópico oclusivo no tratamento de manifestações gengivais de doenças vesicobolhosas auto-imunes Topical occlusive corticosteroid for the treatment of gingival manifestations of vesicobullous autoimmune diseases

    Directory of Open Access Journals (Sweden)

    Ana Carolina Fragoso Motta

    2006-06-01

    Full Text Available O tratamento das lesões gengivais de doenças vesicobolhosas auto-imunes constitui grande desafio na estomatologia, principalmente pela natureza crônica das lesões. O tratamento sistêmico é necessário no controle das apresentações mais graves; entretanto, quando possível, o tratamento tópico é preferível. Este artigo descreve uma técnica oclusiva para aplicação de corticosteróide tópico que tem demonstrado ser eficaz no controle dessas lesões, sobretudo em pacientes com manifestações exclusivamente gengivais.Management of gingival lesions of vesicobullous autoimmune diseases is one the main challenges to oral medicine, primarily because of their chronic nature. Systemic therapy is required in most severe lesions, however, whenever feasible, topic corticosteroid therapy is preferred. This article describes a technique to provide topical occlusive corticotherapy that has shown to be effective in controlling these lesions, especially in patients exclusively with gingival lesions.

  20. [Screening for asymptomatic peripheral arterial occlusive disease of the lower limbs by measuring the ankle-brachial index in the general population (Senegal)].

    Science.gov (United States)

    Pessinaba, S; Mbaye, A; Kane, Ad; Guene, B D; Mbaye Ndour, M; Niang, K; Jobe, M; Cazaubon, M; Mathieu, J-B S; Kane, M; Sow, D Diagne; Diack, B; Kane, A

    2012-07-01

    The purpose of this study was to investigate the prevalence of peripheral arterial disease (PAOD) and cardiovascular risk factors associated with the ankle-brachial index (ABI) in Senegalese patients aged 40 years and over. We prospectively studied a random sample of Senegalese aged 40 years and older, residing in the city of St.-Louis, Senegal. The ABI was measured with a portable doppler (DIADOP 50) using 4 and 8Hz dual frequency probes. The standards were: normal ABI 0.9 to 1.3; peripheral artery obstructive disease (PAOD) ABI less than 0.9; incompressible artery ABI greater than 1.3. Cardiovascular risk factors were also studied. Seven hundred and seventy-one subjects (mean age 57 ± 11.2 years, 559 women) were examined. Cardiovascular risk factors were: sedentary lifestyle (76.4%), hypertension (68%), obesity (32.1%), elevated LDL-cholesterolemia (27.8%), diabetes (18.3%) and tobacco smoking (6.9%). Ninety-three subjects (12.1%) had PAOD and 37 subjects (4.8%) had an incompressible artery. PAOD was significantly more common in sedentary subjects (P=0.008), in the elderly (P=0.0006) and in patients with a history of coronary artery disease (P=0.04). Smoking was not strongly associated with PAOD. PAOD is common in Senegalese and is associated with high prevalence of cardiovascular risk factors. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  1. Prevalence, pattern and risk factors for retinal vascular occlusions in ...

    African Journals Online (AJOL)

    Introduction: Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. They are associated with several systemic and ocular pathologies and are significant causes of visual loss. Objective: This study aims to determine the prevalence, pattern and risk factors for retinal ...

  2. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

    International Nuclear Information System (INIS)

    Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Reimer, Peter; Vestring, Thomas

    2002-01-01

    Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective. (orig.)

  3. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Reimer, Peter [Department of Radiology, Staedtisches Klinikum Karlsruhe (Germany); Vestring, Thomas [Department of Radiology, Diakonie-Krankenhaus Rotenburg/Wuemme, Goettingen (Germany)

    2002-05-01

    Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective. (orig.)

  4. [Physiopathology of macular edema in central vein occlusion].

    Science.gov (United States)

    Stanca, Horia T; Manea, Georgiana

    2012-01-01

    Retinal Vein Occlusions are vascular diseases affecting the Central Retinal Vein and its branches causing decreased retinal drainage resulting in significant clinical and functional pathological changes. RVO determines the increase of vascular permeability, with edema and hemorrhage and development of collateral vessels in a few weeks. Among the serious consequences of venous occlusion is the installation of macular edema to which depends long-term visual prognosis. Macular Edema is the accumulation of intraretinal serous fluid in the macular area caused by the breakdown of blood-retinal barrier.

  5. Iron chelation treatment with deferasirox prior to high-dose chemotherapy and autologous stem cell transplantation may reduce the risk of hepatic veno-occlusive disease in children with high-risk solid tumors.

    Science.gov (United States)

    Chueh, Hee Won; Sung, Ki Woong; Lee, Soo Hyun; Yoo, Keon Hee; Koo, Hong Hoe; Kim, Ju Youn; Cho, Eun Joo

    2012-03-01

    We evaluated whether iron chelation treatment during induction chemotherapy could safely reduce serum iron levels and thereby reduce the frequency of hepatic veno-occlusive disease (VOD) during high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) in children with high-risk solid tumors. Children diagnosed with high-risk solid tumors between August 2008 and July 2009 were enrolled. Deferasirox treatment (25 mg/kg/day) was initiated when serum ferritin levels increased to more than 1,000 ng/ml during induction chemotherapy. Patients who were diagnosed with the same disease between April 2005 and June 2007 and treated in the same way without any iron chelation treatment formed the control group. Efficacy and toxicity of deferasirox treatment were compared between the two groups. Eighteen of 20 patients enrolled received deferasirox treatment. Deferasirox treatment was completed as scheduled in 11 (61.1%) of them without dose reduction or discontinuation. The serum ferritin levels prior to HDCT/autoSCT were lower in the deferasirox group than in the control group (median 1,268 ng/ml vs. 1,828 ng/ml, P deferasirox group (P = 0.005). However, renal dysfunction (38.9%) including Fanconi syndrome (16.7%) was a frequently observed adverse effect of deferasirox treatment. Deferasirox treatment during induction chemotherapy reduces the frequency of VOD during HDCT/autoSCT. The development of renal dysfunction should be closely monitored during deferasirox treatment. Copyright © 2011 Wiley Periodicals, Inc.

  6. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

    Taudorf, M; Jensen, L P; Vogt, K C

    2014-01-01

    % at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency. CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting...

  7. Can long-term antibiotic treatment prevent progression of peripheral arterial occlusive disease? A large, randomized, double-blinded, placebo-controlled trial

    DEFF Research Database (Denmark)

    Joensen, J B; Juul, Svend; Henneberg, E

    2007-01-01

    history. Follow-up was performed every 6 months. Primary events were defined as death, peripheral revascularization and major lower limb amputation. Secondary events were thrombosis, stroke, transient cerebral ischaemic attack and myocardial infarction. Change in ABPI was also investigated. Data were......, no significant differences were found. CONCLUSION: Long-term treatment with roxithromycin is ineffective in preventing death, amputation, peripheral revascularization, myocardial infarction, stroke, transient cerebral ischaemic attack, thrombosis and decline in ABPI in patients with an established diagnosis......PURPOSE: The purpose was to investigate in a large, randomized, double-blinded, placebo-controlled trial, whether antibiotic treatment can prevent progression of peripheral arterial disease (PAD). MATERIAL AND METHODS: Five hundred and seven patients were included; all patients had an established...

  8. Temporomandibular Disorders Treatment with Correction of Decreased Occlusal Vertical Dimension

    Directory of Open Access Journals (Sweden)

    Ljuben Guguvcevski

    2017-10-01

    CONCLUSION: Occlusal splint is a part of reversible occlusal therapy in cases with decreased occlusal vertical dimension. After reducing the symptoms related to decreased occlusal vertical dimension definitive prosthetic therapy can be done.

  9. Cephalometric analysis for functional occlusion

    Directory of Open Access Journals (Sweden)

    Ashok Karad

    2016-01-01

    Full Text Available Background: Various elements contributing to good functional occlusion have not been clearly assessed with cephalometrics for the diagnosis of functional problems and their application in clinical practice. The aim of this study, therefore, was to analyze different components of functional occlusion to formulate concise functional cephalometric analysis. Materials and Methods: Eighty-two cases (38 males and 44 females, with class I occlusion and balanced facial profile, were examined based on the selection criteria, and cephalograms were taken in natural head position. All the radiographs were then analyzed using various functional parameters. Results: The mean values of condylar path angle and incisal path angle were 55.83° and 65.67°, respectively, with large deviations. However, both showed positive correlation. The value of the angle of long axis of mandibular incisor with respect to the line joining center of condyle and lower incisor tip was 88.04°. Moreover, the angle between the occlusal plane and horizontal plane was 12.88°. In vertical plane, lower face height (LFH was found to be slightly less than the upper face height. Maxilla contributed around 45% of the LFH while mandible formed about 60%. Furthermore, upper alveolar component (maxillary alveolar height formed more than half of the maxilla (53.79% whereas lower alveolar component (mandibular alveolar height was 74.8% of the mandible. Conclusion: This study has analyzed various components of functional occlusion and formulated a concise functional cephalometric analysis for diagnosis, treatment planning, and assessment of treatment results.

  10. Malignant occlusion of the coeliac axis

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, K.; Wattsgaard, C.; Genell, S. (Malmoe Allmaenna Sjukhus, Malmoe (Sweden). Dept. of Diagnostic Radiology)

    1982-01-01

    Occlusion or extensive stenosis of the coeliac trunk due to malignant tumor are described in three patients. If, at angiography of a patient with a malignant tumor, occlusion of the coeliac trunk is found, tumor or lymph node metastases causing the occlusion must be considered; this may be of importance when intra-arterial chemotherapy of the tumor is planned.

  11. [The occlusal contact mode during lateral excursion].

    Science.gov (United States)

    Sugawara, N

    2000-09-01

    The purpose of this study is to clarify the occlusal contact mode between the upper and lower molars on the working side of group function occlusion during lateral excursion. After the intercuspal position (IP) and two lateral positions (L1, the middle point between IP and L2; L2, the edge-to-edge occlusal position of the molars) on the Gothic arch were defined, occlusal contact relations in these three occlusal positions were recorded, using black silicone. Digital data of real occlusal contacts and visualized data of close (less than 30 microns) occlusal areas, by computer image processing, were analyzed. The conclusions are as follows: 1. Although the numbers of real occlusal contacts and the visualized occlusal area tend to decrease toward L2 during lateral excursion, the former, in some cases, goes up and down. 2. Functional cusps play an important part in occlusal contact at the intercuspal position. 3. Occlusal contact points are on the functional cusps of the upper and lower molars, which can be clinically regarded as certain points, and these points slide on the inclining non-functional cusps of antagonistic teeth during lateral excursion. 4. Each upper and lower molar has 2 to 6 occlusal contact points near the top functional cusps at the intercuspal position, and some of them contact continuously during lateral excursion.

  12. Peripheral artery disease - legs

    Science.gov (United States)

    Peripheral vascular disease; PVD; PAD; Arteriosclerosis obliterans; Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of ...

  13. Carbon dioxide is a cost-effective contrast medium to guide revascularization of TASC A and TASC B femoropopliteal occlusive disease.

    Science.gov (United States)

    de Almeida Mendes, Cynthia; de Arruda Martins, Alexandre; Teivelis, Marcelo Passos; Kuzniec, Sergio; Nishinari, Kenji; Krutman, Mariana; Halpern, Helio; Wolosker, Nelson

    2014-08-01

    Iodine contrast medium (ICM) is considered gold standard in endovascular revascularization procedures. However, nephrotoxicity and hypersensitivity to ICM are causes that limit its indiscriminate use. Carbon dioxide (CO2) contrast angiography has been used as an alternative in patients with formal contraindication to ICM. However, no studies to the present date have compared in a randomized and prospective way, outcomes of revascularization procedures performed with either ICM or CO2 in patients eligible for use of both contrasts. Between April 2012 and April 2013, 35 patients with peripheral arterial disease with arterial lesions classified as Trans-Atlantic Inter-Society Consensus A or B (identified on preoperative angio computed tomography scan) and adequate runoff underwent femoropopliteal revascularization by endovascular technique in a prospective, randomized, and controlled study. Patients were randomized into 2 groups: CO2 group and ICM group, according to the contrast media selected of the procedure. We evaluated the following outcomes in both groups: feasibility of the procedures, complications, surgical outcomes (ankle-brachial index [ABI]), glomerular filtration rate using the Cockcroft-Gault formula, relationship between the volume of injected iodine and postoperative creatinine clearance, quality of the angiographic images obtained with CO2, costs of the endovascular materials, and finally, cost of contrast agents. We were able to perform the proposed procedures in all patients treated in this series (ICM group and CO2). There were no CO2-related complications. No procedures required conversion to open surgery. Clinical results were satisfactory, with regression of ischemia and increased levels of ABI in both groups. Variations in creatinine clearance levels showed a numerical increase in the CO2 group and a decrease in ICM group, however, with no statistically significant difference between the delta clearance in each group. All CO2 arteriograms of

  14. The budget impact and cost-effectiveness of defibrotide for treatment of veno-occlusive disease with multi-organ dysfunction in patients post-hematopoietic stem cell transplant.

    Science.gov (United States)

    Veenstra, David L; Guzauskas, Gregory F; Villa, Kathleen F; Boudreau, Denise M

    2017-05-01

    A Phase-3 study of defibrotide compared with historical controls demonstrated a 23% improvement in 100-day survival post-hematopoietic stem cell transplantation (HSCT) among patients with veno-occlusive disease with multi-organ dysfunction (VOD with MOD). To estimate the budget impact and cost-effectiveness of introducing defibrotide to a transplant center. The authors developed a budget impact model from the perspective of a bone-marrow transplant center. It was estimated that 2.3% of adults and 4.2% of children would develop VOD with MOD following HSCT based on a retrospective hospital database analysis and the effect that treating patients with defibrotide would have on costs for adult and pediatric centers was estimated. A cost-utility analysis (CUA) was also developed to capture the long-term cost-effectiveness of defibrotide. Projected life expectancies in the two groups were estimated based on trial data, transplant registry data, studies of long-term survival among HSCT patients, and US population life-tables. There was an estimated 3% increase ($330,706) per year in total adult transplantation center costs associated with adopting defibrotide, and a cost per patient was $106,928, life expectancy increased by 3.74 years, and quality-adjusted life-years (QALYs) increased by 2.24. The incremental cost-effectiveness ratio (ICER) was $47,736 per QALY gained; 88% probability defibrotide was cost-effective at a $100,000/QALY threshold. The budget impact of defibrotide for a transplant center is relatively modest compared to the overall cost of transplantation. Defibrotide provides an important survival advantage for VOD with MOD patients, and the life years gained lead to defibrotide being highly cost-effective.

  15. Occlusal stability in shortened dental arches.

    Science.gov (United States)

    Witter, D J; Creugers, N H; Kreulen, C M; de Haan, A F

    2001-02-01

    Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a function over time. Occlusal stability indicators were: 'interdental spacing', 'occlusal contacts of anterior teeth in Intercuspal Position', 'overbite', 'occlusal tooth wear', and 'alveolar bone support'. Subjects with shortened dental arches (n = 74) were compared with subjects with complete dental arches (controls, n = 72). Repeated-measurement regression analyses were applied to assess age-dependent variables in the controls and to relate the occlusal changes to the period of time since the treatment that led to the shortened dental arches. Compared with complete dental arches, shortened dental arches had similar overbite and occlusal tooth wear. They showed more interdental spacing in the premolar regions, more anterior teeth in occlusal contact, and lower alveolar bone scores. Since the differences remained constant over time, we conclude that shortened dental arches can provide long-term occlusal stability. Occlusal changes were self-limiting, indicating a new occlusal equilibrium.

  16. Vertex occlusal radiography in localizing unerupted mesiodentes

    Directory of Open Access Journals (Sweden)

    P Chalakkal

    2011-01-01

    Full Text Available The aim was to compare the vertex occlusal projection with the anterior maxillary occlusal projection in localizing the position of mesiodentes. Mesiodentes were observed in an 8-year-old boy with an anterior maxillary occlusal radiograph. A vertex occlusal radiograph was taken to compare it with the former in terms of mesiodentes localization with respect to the maxillary central incisors. The vertex occlusal radiograph provided greater details of the position and proximity of mesiodentes with respect to the long axis of maxillary central incisors in comparison to the anterior maxillary occlusal radiograph. Vertex occlusal radiography is an important diagnostic tool in diagnosing the presence, position, and proximity of mesiodentes with respect to the long axis of normally aligned maxillary central incisors. However, it is not recommended for routine use in a patient as its radiation dose is higher than conventional intraoral radiographic methods.

  17. Thrombophilic screening in retinal artery occlusion patients

    Directory of Open Access Journals (Sweden)

    Valeria Nagy

    2008-10-01

    Full Text Available Valeria Nagy1, Lili Takacs1, Zita Steiber1, György Pfliegler2, Andras Berta11Department of Ophthalmology, 2Division of Rare Diseases, University of Debrecen Medical and Health Science Center, Debrecen, HungaryBackground: Retinal artery occlusion (RAO is an ischemic vascular damage of the retina, which frequently leads to sudden, mostly irreversible loss of vision. In this study, blood thrombophilic factors as well as cardiovascular risk factors were investigated for their relevance to this pathology. Thrombophilic risk factors so far not evaluated were included in the study.Patients and methods: 28 RAO patients and 81 matched control subjects were examined. From blood samples, protein C, protein S, antithrombinopathy, and factor V (Leiden mutation (FV, factor II gene polymorphism, factor VIII C level, plasminogen activity, lipoprotein(a and fibrinogen levels, hyperhomocysteinemia and presence of anticardiolipin – antiphospholipid antibodies were investigated. Possibly relevant pathologies such as diabetes mellitus, hypertension, and ischemic heart disease were also registered. Statistical analysis by logistic regression was performed with 95% confidence intervals.Results: In the group of patients with RAO only the incidence of hypertension (OR: 3.33, 95% CI: 1.30–9.70, p = 0.014 as an average risk factor showed significant difference, but thrombophilic factors such as hyperfibrinogenemia (OR: 2.9, 95% CI: 1.29–6.57, p = 0.010 and the presence of FV (Leiden mutation (OR: 3.9, 95% CI: 1.43–10.96, p = 0.008 increased the chances of developing this disease.Conclusions: Our results support the assumption that thrombophilia may contribute to the development of RAO besides vascular damage due to the presence of cardiovascular risk factors. Further studies are needed, however, to justify the possible use of secondary prophylaxis in form of anticoagulant/antiplatelet therapy.Keywords: retinal arterial occlusion, risk factors, thrombophilia

  18. Cannabis, Collaterals, and Coronary Occlusion

    Directory of Open Access Journals (Sweden)

    Kalpa De Silva

    2011-01-01

    Full Text Available A 51-year-old gentleman, who regularly smoked cannabis, presented with chest pain and diaphoresis. He was haemodynamically stable. ECG showed ST depression, inferiorly, and 1 mm ST elevation in lead aVR. Emergent coronary angiography showed thrombotic occlusion of the left main coronary artery (LMCA, the dominant RCA provided Rentrop grade II collaterals to the LAD. The LMCA was successfully reopened by deployment of a bare-metal stent. Animal heart models suggest that endogenous cannibinoids may cause ischaemic preconditioning. This case suggests that the severity of ischaemia, and hence ECG changes and haemodynamic consequences following an acute occlusion of the LMCA, can be ameliorated by coronary collateralisation and possibly by preconditioning of the myocardium.

  19. Sickle cell vaso-occlusion in an animal model

    International Nuclear Information System (INIS)

    Kurantsin-Mills, J.; Jacobs, H.M.; Lessin, L.S.

    1987-01-01

    Sickle cell disease is clinically characterized with vaso-occlusive painful crisis which is pleomorphic in terms of frequency of occurrence. The intracellular polymerization of deoxygenated hemoglobin S increases the internal viscosity of the sickle cells exponentially, concurrent with binding of hemoglobin S to the membrane and discocyte-drepanocyte transformation. As a result, the red cells in sickle cell disease are heterogenous with cells of varying density and mean corpuscular hemoglobin concentration which alter the rheological features of the blood in the microcirculation. The cellular, physiological, biochemical and rheological factors that contribute to the vaso-occlusive events are not completely understood. Nonetheless, recent clinical studies have demonstrated that a certain fraction of the dense cells disappear during sickle cell painful crisis. In an attempt to elucidate some of the cellular and rheological factors involved in the initiation of vaso-occlusion, the authors have employed intravital videomicroscopy and radionuclide imaging of indium-III labeled sickle cells to determine the dynamics and sites of vaso-occlusion using the rat exchanged-transfused with sickle (HbSS) erythrocytes as a model

  20. Occlusal status among Yemeni children

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    Nabil M Al-Zubair

    2014-01-01

    Full Text Available Objectives: The purpose of this study was to assess the occlusal status in schoolchildren in Yemen, and to compare the results with those of other studies. Materials and Methods: The sample for this epidemiological survey consisted of 3003 primary school students, half of whom were boys and the other half girls, aged 12 years. The subjects were randomly selected, and none had received previous orthodontic treatment. Variables examined included intra-arch irregularities and malalignment (crowding and spacing in the incisal segments of the arch and midline diastema and discrepancies in occlusal contact relationship (maxillary overjet, mandibular overjet, anterior openbite and antero-posterior molar relation. Results: The results showed that about 26.1% of the subjects were still in the late mixed dentition stage and 73.9% presented with a dentition in the early permanent stage. Normal overjet was found in 55% of the sample. Crowding was observed in 31.4% of the subjects and midline diastema in 14.2%. Conclusion: Occlusal status among Yemeni children was characterized by a relatively high frequency of dental crowding, as well as a relatively high frequency of anterior mandibular overjet (Class III malocclusions.

  1. Computerized Angiographic Occlusion Rating for Ruptured Clipped Aneurysms is Superior to Subjective Occlusion Rating.

    Science.gov (United States)

    Al-Schameri, A R; Baltsavias, G; Winkler, P; Lunzer, M; Kral, M; Machegger, L; Weymayr, F; Emich, S; Sherif, C; Richling, B

    2015-09-01

    The computerized occlusion rating to estimate angiographic occlusion of embolized aneurysms is superior to the subjective occlusion rating. In this study, we compared the 2 methods in the analysis of aneurysms clipped after subarachnoid hemorrhage. The pre- and postoperative angiographic images (DSA) of 95 selected patients were analyzed and stratified in 4 grades (grade 0 for 100%, grade I for rating and the computerized (angiographic) occlusion rating. For the subjective occlusion rating, the occlusion rate was estimated; for the computerized occlusion rating, the "occluded" and "nonoccluded" aneurysm areas were automatically calculated in square millimeters after outlining the ideal occlusion line. With the subjective occlusion rating, 75 (78.9%), 12 (12.6%), 7 (7.4%), and 1 (1.1%) and with the computerized occlusion rating 45 (47.4%), 24 (25.3%), 20 (21.0%), and 6 (6.3%) patients had aneurysms stratified to grades 0, I, II and III, respectively. The interobserver variation was significant with the subjective occlusion rating but not with the computerized occlusion rating. The subjective occlusion rating overestimated aneurysm occlusion in 30 (31.6%) patients. Mean values were the following: subjective occlusion rating of 97.5 ± 6.3% and computerized occlusion rating of 93.5 ± 9.7%; P = rating: χ(2), 29.65; P rating: χ(2), 35.57, P rates of clipped aneurysms. The clearly lower interobserver variation of the computerized versus subjective occlusion rating may indicate a superiority of the computerized occlusion rating. © 2015 by American Journal of Neuroradiology.

  2. Physical exercise in peripheral occlusive arterial disease

    OpenAIRE

    Locatelli, Elenir Carlot; Pelizzari, Suélen; Scapini, Kátia Bilhar; Leguisamo, Camila Pereira; Silva, Alexandre Bueno da

    2009-01-01

    A maioria dos pacientes portadores de claudicação intermitente, um aspecto clínico da doença arterial periférica, tem importante limitação nas atividades físicas e redução na qualidade de vida. O objetivo deste estudo foi realizar uma revisão da literatura sobre a intervenção através de exercícios em portadores de doença arterial obstrutiva periférica com claudicação intermitente. Trata-se de uma revisão de artigos científicos consultados nos bancos de dados da BIREME, PubMed e SciELO, atravé...

  3. Occlusive extracranial cerebrovascular disease: diagnosis and ...

    African Journals Online (AJOL)

    collateral circle is very efficient but the arteries beyond this level on the brain itself are of ... 70 - 79% has a risk of stroke of 12%, rising to 26% when the ..... Endarterectomy Trial (NASCET) Group. Risk causes and prevention of ischaemic stroke in elderly patients with symptomatic internal carotid artery stenosis. Lancet 2001 ...

  4. Determination of the occlusal plane using a custom-made occlusal plane analyzer: a clinical report.

    Science.gov (United States)

    Bedia, Sumit V; Dange, Shankar P; Khalikar, Arun N

    2007-11-01

    In fixed prosthodontic procedures, when it has been determined that restoration of all or most of the posterior teeth is necessary, the use of the Broderick occlusal plane analyzer provides an easy and practical method to determine an occlusal plane that will fulfill esthetic and functional occlusion requirements. However, several manufacturers of semiadjustable articulators offer no such occlusal plane analyzers for use with these instruments. This article demonstrates the use of a custom-made Broderick occlusal plane analyzer with a semiadjustable articulator to determine the correct curve of Spee for the occlusal plane.

  5. A Review: Proteomics in Retinal Artery Occlusion, Retinal Vein Occlusion, Diabetic Retinopathy and Acquired Macular Disorders.

    Science.gov (United States)

    Cehofski, Lasse Jørgensen; Honoré, Bent; Vorum, Henrik

    2017-04-28

    Retinal artery occlusion (RAO), retinal vein occlusion (RVO), diabetic retinopathy (DR) and age-related macular degeneration (AMD) are frequent ocular diseases with potentially sight-threatening outcomes. In the present review we discuss major findings of proteomic studies of RAO, RVO, DR and AMD, including an overview of ocular proteome changes associated with anti-vascular endothelial growth factor (VEGF) treatments. Despite the severe outcomes of RAO, the proteome of the disease remains largely unstudied. There is also limited knowledge about the proteome of RVO, but proteomic studies suggest that RVO is associated with remodeling of the extracellular matrix and adhesion processes. Proteomic studies of DR have resulted in the identification of potential therapeutic targets such as carbonic anhydrase-I. Proliferative diabetic retinopathy is the most intensively studied stage of DR. Proteomic studies have established VEGF, pigment epithelium-derived factor (PEDF) and complement components as key factors associated with AMD. The aim of this review is to highlight the major milestones in proteomics in RAO, RVO, DR and AMD. Through large-scale protein analyses, proteomics is bringing new important insights into these complex pathological conditions.

  6. Combined surface and volumetric occlusion shading

    KAUST Repository

    Schott, Matthias O.

    2012-02-01

    In this paper, a method for interactive direct volume rendering is proposed that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The proposed algorithm extends the recently proposed Directional Occlusion Shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. © 2012 IEEE.

  7. [Form and position of occlusion plane in persons with physiological occlusion].

    Science.gov (United States)

    Lisova, T V; Slabkovskaia, A B; Persin, L S

    2006-01-01

    25 subjects aged 19-25 years with normal occlusion were assessed using radiographic and functional methods. Individual differences in occlusion plane form and position and dentofacial muscles functioning were established.

  8. Occlusal risk factors associated with temporomandibular disorders in young adults with normal occlusions.

    Science.gov (United States)

    Wang, Chen; Yin, Xinmin

    2012-10-01

    The aim of this study was to characterize occlusal stability in young adults with temporomandibular disorder (TMD). Thirty-one patients (aged 19-31 years) with complete natural dentition and Angle class I occlusion who exhibited TMD were compared with 31 age- and sex-matched healthy control subjects. The occlusal registrations were performed using the T-Scan II occlusal imaging and analysis system. Center of occlusal force, asymmetry index of occlusal force, maximal movement of COF, premature contacts, clusion time, and disclusion time were recorded. Compared with control subjects, TMD subjects had a significantly higher frequency of premature contacts (16/32, 50.0%) and greater bilateral asymmetry in the occlusal force. Furthermore, prolonged clusion time and disclusion time also were observed in TMD subjects. These results suggest that a significant association exists between occlusal stability and TMD in young adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Occlusal considerations for dental implant restorations.

    Science.gov (United States)

    Bergmann, Ranier H

    2014-01-01

    When placed, dental implants are put into an ever-changing oral environment in which teeth can continue to migrate. Yet, the implants themselves are ankylosed. This can lead to occlusal instability. Teeth may continue to erupt, leaving the implants in infraocclusion. Teeth may move mesially away from an implant, requiring modification to close an open contact point. Friction in the connection between teeth and implants can lead to intrusion of teeth and damage to the periodontal attachment apparatus. Implant occlusion with shallow incisal guidance minimizes lateral and tipping forces. Cross-arch stabilization allows the best distribution of occlusal forces. The choice of restorative materials influences long-term occlusal stability.

  10. Assessment of occlusion curriculum in predoctoral dental education: report from ACP Task Force on Occlusion Education.

    Science.gov (United States)

    Lee, Damian J; Wiens, Jonathan P; Ference, John; Donatelli, David; Smith, Rick M; Dye, Bryan D; Obrez, Ales; Lang, Lisa A

    2012-10-01

    The purposes of this report were to (1) assess the current occlusion curriculum in the predoctoral prosthodontic education of US dental institutions and (2) to examine the opinions of faculty, course directors, and program directors on the contents of occlusion curriculum. The Task Force on Occlusion Education from the American College of Prosthodontists (ACP) conducted two surveys using a web-based survey engine: one to assess the current status of occlusion education in predoctoral dental education and another to examine the opinions of faculty and course directors on the content of occlusion curriculum. The sections in the surveys included demographic information, general curriculum information, occlusion curriculum for dentate patients, occlusion curriculum for removable prosthodontics, occlusion curriculum for implant prosthodontics, temporomandibular disorder (TMD) curriculum, teaching philosophy, concepts taught, and methods of assessment. The results from the surveys were compiled and analyzed using descriptive statistics. The results from the two surveys on general concepts taught in occlusion curriculum were sorted and compared for discrepancies. According to the predoctoral occlusion curriculum surveys, canine guidance was preferred for dentate patients, fixed prosthodontics, and fixed implant prosthodontics. Bilateral balanced occlusion was preferred for removable prosthodontics and removable implant prosthodontics. There were minor differences between the two surveys regarding the occlusion concepts being taught and the opinions of faculty members teaching occlusion. Two surveys were conducted regarding the current concepts being taught in occlusion curriculum and the opinions of educators on what should be taught in occlusion curriculum. An updated and clearly defined curriculum guideline addressing occlusion in fixed prosthodontics, removable prosthodontics, implant prosthodontics, and TMD is needed. © 2012 by the American College of Prosthodontists.

  11. Balloon Occlusion Types in the Treatment of Coronary Perforation during Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Xiangfei Wang

    2014-01-01

    Full Text Available Coronary artery perforation is an uncommon complication in patients with coronary heart disease undergoing percutaneous coronary intervention. However, pericardial tamponade following coronary artery perforation may be lethal, and prompt treatment is crucial in managing such patients. Balloon occlusion and the reversal of anticoagulant activity are the common methods used to prevent cardiac tamponade by reducing the amount of bleeding. Herein, we discuss the pros and cons of currently used occlusion types for coronary perforation. Optimal balloon occlusion methods should reduce the amount of bleeding and ameliorate subsequent myocardial ischemia injury, even during cardiac surgery.

  12. Contemporary Management of Acute Aortic Occlusion Has Evolved but Outcomes Have Not Significantly Improved.

    Science.gov (United States)

    Robinson, William P; Patel, Rupal K; Columbo, Jesse A; Flahive, Julie; Aiello, Francesco A; Baril, Donald T; Schanzer, Andres; Messina, Louis M

    2016-07-01

    Most existing series of acute aortic occlusion (AAO) predate the changes in surgical and endovascular therapy of the last 2 decades. We examined the contemporary management and outcomes of AAO. We reviewed consecutive patients with AAO at a tertiary referral center from 2004 to 2012. Outcomes were stratified and compared according to etiology and procedure performed. AAO in 29 patients was due to in situ thrombosis in 21 (72%) and embolism in 8 (28%) patients. Vascular patients with embolism were on average older (77 ± 7 vs. 66 ± 12 years, P = 0.02) and had higher rates of atrial fibrillation (100% vs. 20%, P = 0.0002) and congestive heart failure (75% vs. 0%, P = 0.0001) in comparison with those with in situ thrombosis. Neurologic deficit was present in 16 (55%) patients. Six patients (21%) presented with bilateral paresis/paralysis secondary to spinal cord or lumbosacral plexus ischemia, and primary neurologic etiology was investigated before vascular consultation was obtained in 4 of these 6 patients. Of the 29 patients, 28 (97%) underwent revascularization including transfemoral embolectomy (n = 6), transperitoneal aortoiliac thrombectomy (n = 2), axillobifemoral bypass (n = 10), aortobifemoral bypass (n = 6), and endovascular therapy including thrombolysis, angioplasty ± stenting (n = 4). In-hospital mortality was 31% and did not vary significantly according to etiology (embolism 38% vs. in situ thrombosis 29%, P = 0.67). In-hospital mortality varied widely according to procedure (transfemoral embolectomy 50%, aortoiliac thrombectomy 100%, axillobifemoral bypass 30%, aortobifemoral bypass 0%, and endovascular therapy 25%, P = 0.08). Major morbidity (59%), length of stay (8.6 ± 8.0 days), and discharge to a rehabilitation facility (50%) did not vary by etiology or procedure. At a media follow-up of 361 ± 460 days (range 3-2014), overall survival was 42%. There were no amputations among 20 survivors of initial

  13. Thrombosis of the mesenteric vein and occlusion of the mesenteric artery

    International Nuclear Information System (INIS)

    Boettger, T.; Jenny, E.; Junginger, T.; Weber, W.

    1989-01-01

    The differentiation between an arterial and a venous occlusion of a mesenteric vessel is difficult. The diagnosis of an occlusion of a mesenteric vessel in general is made preoperatively in every fourth patient only. Typical findings are abdominal pains of unknown origin and a distinct discrepancy between the stated complaints, the poor general condition of the patient and the relatively non-contributory examination findings. A known history of cardiac diseases or an arterial occlusive disease is typically found in the event of an occlusion of the mesenteric artery. Patients with a venous thrombosis present with a frequent incidence of thrombophlebitis, coagulation disorders, abdominal inflammations and traumata, or of a tumour. A reliable preoperative diagnosis in terms of differentiation is only possible by angiography. This is always indicated unless on account of the abdominal findings the indication for laparotomy is given anyway. (orig.) [de

  14. Thrombosis of the mesenteric vein and occlusion of the mesenteric artery. A contribution to clinical differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Boettger, T.; Jenny, E.; Junginger, T.; Weber, W.

    1989-01-20

    The differentiation between an arterial and a venous occlusion of a mesenteric vessel is difficult. The diagnosis of an occlusion of a mesenteric vessel in general is made preoperatively in every fourth patient only. Typical findings are abdominal pains of unknown origin and a distinct discrepancy between the stated complaints, the poor general condition of the patient and the relatively non-contributory examination findings. A known history of cardiac diseases or an arterial occlusive disease is typically found in the event of an occlusion of the mesenteric artery. Patients with a venous thrombosis present with a frequent incidence of thrombophlebitis, coagulation disorders, abdominal inflammations and traumata, or of a tumour. A reliable preoperative diagnosis in terms of differentiation is only possible by angiography. This is always indicated unless on account of the abdominal findings the indication for laparotomy is given anyway.

  15. NONICHEMIC CENTRAL RETINAL VEIN OCCLUSION ASSOCIATED WITH HEREDITARY THROMBOPHYLIA.

    Science.gov (United States)

    Fişuş, Andreea Dana; Pop, Doina Suzana; Rusu, Monica Blanka; Vultur, Florina; Horvath, Karin Ursula

    2015-01-01

    Retinal vein occlusion (RVO) is the second most common retinal vein disease with significant visual loss via thrombus or compression of vein wall. Thrombophilia is the predisposition to vascular thrombosis with the existence of genetic defect that leads to blood hypercoagulability. This report describes the case of a 55 year old male patient, with an active life who presented himself at the emergency room with acute visual lose, insidious and progressive visual field constriction, without any known history of neurological or vascular diseases. The examinations revealed unilateral optic nerve head edema, the fluorescein angiography was specific for nonischemic central retinal vein occlusion CRVO complicated with macular edema. Blood examinations has emphasized the presence of the heterozygous mutation A1298C in the methylenetetrahydrofolate reductase gene (MTHFR), the only one presented from the thrombophilia screen panel and a slightly elevated cholesterol level. During the follow-up period, the patient received anti-VEGF treatment (Bevacizumab, 3x 0.1 ml intravitreal injections) with improved visual acuity and amendment of macular edema. The complex etiology calls for interdisciplinary approach to determine better the cause of this ophthalmological disease. Although studies have found a correlation between some thrombophilia mutations and retinal vein occlusion, more studies that contain a larger number of patients are necessary in order to determine the final role of these gene variants.

  16. [Relationship between occlusal plane and masticatory path in youth with individual normal occlusion].

    Science.gov (United States)

    Lin, Xue-feng; Li, Shao-hua; Huang, Zhuo-shan; Wu, Xia-yi

    2010-06-01

    To investigate the characteristics of and relationship between occlusal plane and masticatory path in young adults with individual normal occlusion, and to provide clinical implications on both morphological and functional reference of occlusal plane location. Forty-three young adults with individual normal occlusion were included. Lateral projections of cephalometric radiographs were taken. The parameters of anatomical landmarks were analyzed. The BioEGN mandibular kinesiography analyzer was used to record the path of incisal edge of mandibular central incisor movement during mastication. The Pearson's linear correlation analysis was performed to analyze the relationship of inclination of occlusal plane and data mentioned above with SPSS13.0 software. The inclination of occlusal plane (the angle between occlusal plane and Camper's line OP-CP) was (2.1 ± 3.8)° in youth with normal occlusion. Means of maximal distances of 3-dimensional masticatory mandibular movement paths were as follow: the vertical length was (20.22 ± 4.28) mm, the anterior-posterior width was (11.42 ± 2.45) mm, and the lateral width was (8.62 ± 1.52) mm. The inclination of occlusal plane was negatively correlated to the lateral width of masticatory path in frontal plane (r = -0.39, P Occlusal plane was approximately vertical to the opening and closing path in the vicinity of intercuspal position during mastication. The inclination of occlusal plane was positively related to occlusal plane-closing angles in the upper segments of closing path during mastication (P occlusal plane (P > 0.05). These results suggest that the sagittal inclination of occlusal plane can influence 3-dimensional morphology of masticatory path.The inclination of occlusal plane has a guiding effect on masticatory movement in the upper segments of closing path.

  17. Analysis of decrease in lung perfusion blood volume with occlusive and non-occlusive pulmonary embolisms

    International Nuclear Information System (INIS)

    Ikeda, Yohei; Yoshimura, Norihiko; Hori, Yoshiro; Horii, Yosuke; Ishikawa, Hiroyuki; Yamazaki, Motohiko; Noto, Yoshiyuki; Aoyama, Hidefumi

    2014-01-01

    Highlights: • The proportion of preserved PE lesions in the non-occlusive group was 76.7% (33/43). • HUs of the iodine map were significantly higher in the non-occlusive group than in the occlusive group. • There was no significant difference in HUs between the non-occlusive and corresponding normal group. - Abstract: Purpose: The aim of this study was to determine if lung perfusion blood volume (lung PBV) with non-occlusive pulmonary embolism (PE) differs quantitatively and visually from that with occlusive PE and to investigate if lung PBV with non-occlusive PE remains the same as that without PE. Materials and methods: Totally, 108 patients suspected of having acute PE underwent pulmonary dual-energy computed tomography angiography (DECTA) between April 2011 and January 2012. Presence of PE on DECTA was evaluated by one radiologist. Two radiologists visually evaluated the PE distribution (segmental or subsegmental) and its nature (occlusive or non-occlusive) on DECTA and classified perfusion in lung PBV as “decreased,” “slightly decreased,” and “preserved”. Two radiologists used a lung PBV application to set a region of interest (ROI) in the center of the lesion and measured HU values of an iodine map. In the same slice as the ROI of the lesion and close to the lesion, another ROI was set in the normal perfusion area without PE, and HUs were measured. The proportion of lesions was compared between the occlusive and non-occlusive groups. HUs were compared among the occlusive, non-occlusive, and corresponding normal groups. Results: Twenty-five patients had 80 segmental or subsegmental lesions. There were 37 and 43 lesions in the occlusive and non-occlusive groups, respectively. The proportion of decreased lesions was 73.0% (27/37) in the occlusive group, while that of preserved lesions in the non-occlusive group was 76.7% (33/43). There was a significant difference in the proportion of lesions (P < 0.001) between the two groups. HUs of the

  18. Custom total occlusal convergence angle sticker fabrication.

    Science.gov (United States)

    Cho, Seok-Hwan; Nagy, William W

    2015-09-01

    This article describes a method of fabricating a custom total occlusal convergence angle sticker with photo editing software and label stickers. The custom total occlusal convergence angle sticker can help clinicians achieve an accurate degree of taper during axial wall reduction of tooth preparation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  19. Occlusal stability in shortened dental arches.

    NARCIS (Netherlands)

    Witter, D.J.; Creugers, N.H.J.; Kreulen, C.M.; Haan, A. de

    2001-01-01

    Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a

  20. The prevalence of questionable occlusal caries

    DEFF Research Database (Denmark)

    Makhija, Sonia K; Gilbert, Gregg H; Funkhouser, Ellen

    2012-01-01

    Questionable occlusal caries (QOC) can be defined as clinically suspected caries with no cavitation or radiographic evidence of occlusal caries. To the authors' knowledge, no one has quantified the prevalence of QOC, so this quantification was the authors' objective in conducting this study...

  1. Oral contraceptive pills: A risk factor for retinal vascular occlusion in in-vitro fertilization patients

    Directory of Open Access Journals (Sweden)

    Rohina S Aggarwal

    2013-01-01

    Full Text Available Retinal vascular occlusion is the most common cause of retinopathy leading to severe visual loss in all age groups. Central retinal vein occlusion (CRVO is usually seen in older age group and is often associated with systemic vascular diseases. Although the exact cause and effect relationship has not been proven, central retinal vein occlusion has been associated with various systemic pathological conditions, hence a direct review of systems toward the various systemic and local factors predisposing the central retinal vein occlusion is advocated. We describe the development of central retinal venous occlusion with associated cystoid macular edema (CME in two healthy infertile women who were recruited for in vitro fertilization cycle for infertility. Predisposing risk factors associated with central retinal vein occlusion are obesity, sedentary life style, smoking, and some systemic diseases such as hyperlipidemia, hypertension, associated autoimmune disorders e.g., antiphospholipid antibody syndrome, lupus, diabetes mellitus, cardiovascular disorders, bleeding or clotting disorders, vasculitis, closed-head trauma, alcohol consumption, primary open-angle glaucoma or angle-closure glaucoma.In our patients, they were ruled out afterdoing allpertaining investigations. The cases were managed with further avoidance of oral contraceptives and intra-vitreal injections of Bevacizumab (Avastin, an anti-vascular endothelial growth factor (anti-VEGF drug and Triamcinolone acetonide (a long acting synthetic steroid. Hence, even if no systemic diseases are detected. Physical examinations are recommended periodically for young women on oral contraceptive pills.

  2. [Occlusal vertical dimension in removable complete dentures].

    Science.gov (United States)

    den Haan, R; Witter, D J

    2011-12-01

    In removable complete dentures, the occlusal vertical dimension is an important factor for patients' satisfaction with aesthetics. An excessively reduced occlusal vertical dimension is especially likely to lead to complaints about aesthetics, whereas an increased occlusal vertical dimension may lead to discomfort and a decision not to wear the complete dentures. There are various methods for determining the occlusal vertical dimension in complete dentures, based on the vertical dimension in the rest position of the mandible or on phonetics. However, none of the methods have proven to be clearly superior, in terms of reliability, than the others. The assessment of the occlusal vertical dimension will become more reliable if several methods are used simultaneously. Moreover, knowledge of the characteristics of the ageing face is essential.

  3. [Veno-occlusive disease of the liver after bone marrow transplantation. Report of the symposium Autograft in France and the group of study of bone marrow transplantation. France Auto-Greffe et le Groupe d'Etude de la Greffe de Moelle osseuse].

    Science.gov (United States)

    Rio, B; Cahn, J Y; Attal, M; Drouet, L; Scrobohaci, M L; Degos, F; Degott, C; Bearman, S I; Grañena, A; Blaise, D

    Hepatic veno-occlusive disease is a frequent complication after high-dose chemo- or radiotherapy after bone marrow transplantation and is a major cause of mortality. During the 3 weeks following transplantation, acute major hepatic vascularization is observed together with portal hypertension and weight gain, ascitis and oedema of the lower limbs due to non-thrombotic obstruction of the centrilobular hepatic veins. This report summarizes the observations presented at a French symposium of France Autogreffe and Groupe d'Etude de la Greffe de Moelle osseuse. Different pathogenic processes are implicated including endothelial mechanisms due to toxic factor related to graft preparations and immunosuppressor treatments (methotrexate, cyclosporin), physical factors related to irradiation, immunological factors related to the expression of class II antigens on endothelial cells and viral factors, in particular cytomegalovirus infection. The incidence of veno-occlusive disease varies greatly from one series to another. Two French groups reported 5 and 3 cases among 1991 and 253 autologous grafts respectively (1.2 and 2.3%) while the Seattle group observed 53% among 355 consecutive grafts, although the same clinical criteria were used. Histological criteria include fibrosis around a non-thrombotic occlusion of the centrilobular veins, cytolysis and congestion of the sinuses. Other methods for diagnosis include transjugular biopsy, the suprahepatic pressure and imaging techniques. Prophylactic continuous infusion of low-dose heparin has been associated with a lower incidence. Trials using anti-tumour necrosis drugs and prostaglandin E1 have also been undertaken and show possible effects towards decreasing prevalence.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. South African Medical Journal - Vol 89, No 12 (1999)

    African Journals Online (AJOL)

    Aorto-iliac occlusive disease in the different population groups - clinical pattern, risk profile and results of reconstruction · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. T E Madiba, M Mars, J V Robbs, 1288-1292 ...

  5. Initial Experience With Covered Endovascular Reconstruction of the Aortic Bifurcation in Conjunction With Chimney Grafts

    NARCIS (Netherlands)

    Dijkstra, Martijn; Goverde, Peter C. J. M.; Holden, Andrew; Zeebregts, Clark J.; Reijnen, Michel M. J. P.

    2017-01-01

    Purpose: To show feasibility of the covered endovascular repair of the aortic bifurcation (CERAB) technique in conjunction with chimney grafts in aortic side branches for complex aortoiliac occlusive disease. Methods: Two European centers and one facility located in New Zealand participated in a

  6. Occlusion for stimulus deprivation amblyopia

    Science.gov (United States)

    Antonio-Santos, Aileen; Vedula, Satyanarayana S; Hatt, Sarah R; Powell, Christine

    2014-01-01

    Background Stimulus deprivation amblyopia (SDA) develops due to an obstruction to the passage of light secondary to a condition such as cataract. The obstruction prevents formation of a clear image on the retina. SDA can be resistant to treatment, leading to poor visual prognosis. SDA probably constitutes less than 3% of all amblyopia cases, although precise estimates of prevalence are unknown. In developed countries, most patients present under the age of one year; in less developed parts of the world patients are likely to be older at the time of presentation. The mainstay of treatment is removal of the cataract and then occlusion of the better-seeing eye, but regimens vary, can be difficult to execute, and traditionally are believed to lead to disappointing results. Objectives Our objective was to evaluate the effectiveness of occlusion therapy for SDA in an attempt to establish realistic treatment outcomes. Where data were available, we also planned to examine evidence of any dose response effect and to assess the effect of the duration, severity, and causative factor on the size and direction of the treatment effect. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2013), EMBASE (January 1980 to October 2013), the Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2013), PubMed (January 1946 to October 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 October 2013. Selection criteria We planned

  7. Functional Aesthetic Occlusal Plane (FAOP

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Câmara

    Full Text Available ABSTRACT Introduction: A reasonable exposure of incisors and gingival tissues is generally considered more attractive than excess or lack of exposure. A reasonable gingival exposure is considered to be around 0 to 2 mm when smiling and 2-4 mm exposure of the maxillary incisor edge when the lips are at rest. Objective: The aim of this paper is to present the Functional Aesthetic Occlusal Plane (FAOP, which aims to help in the diagnosis of the relationships established among molars, incisors and the upper lip. Conclusion: FAOP can complement an existing and established orthodontic treatment plan, facilitating the visualization of functional and aesthetic demands by giving a greater focus on the position of incisors in the relationship established among the incisors, molars and the upper lip stomion.

  8. Functional Aesthetic Occlusal Plane (FAOP).

    Science.gov (United States)

    Câmara, Carlos Alexandre; Martins, Renato Parsekian

    2016-01-01

    A reasonable exposure of incisors and gingival tissues is generally considered more attractive than excess or lack of exposure. A reasonable gingival exposure is considered to be around 0 to 2 mm when smiling and 2-4 mm exposure of the maxillary incisor edge when the lips are at rest. The aim of this paper is to present the Functional Aesthetic Occlusal Plane (FAOP), which aims to help in the diagnosis of the relationships established among molars, incisors and the upper lip. FAOP can complement an existing and established orthodontic treatment plan, facilitating the visualization of functional and aesthetic demands by giving a greater focus on the position of incisors in the relationship established among the incisors, molars and the upper lip stomion.

  9. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

    Liu Xueqiang; Guo Pingfan; Zhang Jinchi; Cai Fanggang

    2012-01-01

    Objective: To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access. Methods: Twenty-seven cases (male 17, female 10; age range 32-89 years) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans, 7 with diabetic foot and 2 with thromboangiitis obliterans. According to the Fontaine staging, 6 cases were classified as Fontaine Ⅱ, 11 were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ. All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment, but in vain. So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery, peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting. Results: The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms. Hematoma at the puncture site occurred in 3 patients, and paresthesia of toes occurred in 1 after dorsalis pedis arteriotomy. No severe perioperative complication occurred. The average ankle brachial index increased from 0.37 ± 0.11 preoperatively to 0.85 ± 0.12 postoperatively. Conclusions: Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access. (authors)

  10. A Study on Growth and Development of Dentition and Occlusion in Children : Changes of Occlusion

    OpenAIRE

    Kaihara, Yasutaka; Saiga, Kaori; Nakae, Hisami; Kuramoto, Meiko; Makihira, Mika; Miyamoto, Yoko; Suzuki, Junji; Amano, Hideaki; Miura, Kazuo; Kawabata, Yasushi; Kozai, Katsuyuki

    2005-01-01

    The purpose of this study was to examine the longitudinal change of occlusion in children. The materials were study models obtained annually from 27 patients (17 boys and 10 girls) aged 4 to 12, having no history of significant tooth decay or orthodontic treatment. The interdental spaces in the primary dentition, the anterior occlusal relationship, the terminal plane, the relationship of the permanent first molar, and the change of occlusion from the primary dentition to the permanent dentiti...

  11. Maximizing mandibular prosthesis stability utilizing linear occlusion, occlusal plane selection, and centric recording.

    Science.gov (United States)

    Williamson, Richard A; Williamson, Anne E; Bowley, John; Toothaker, Randy

    2004-03-01

    The stability of mandibular complete dentures may be improved by reducing the transverse forces on the denture base through linear (noninterceptive) occlusion, selecting an occlusal plane that reduces horizontal vectors of force at occlusal contact, and utilizing a central bearing intraoral gothic arch tracing to record jaw relations. This article is intended to acquaint the reader with one technique for providing stable complete denture prostheses using the aforementioned materials, devices, and procedures.

  12. THE SIGNIFICANCE OF PATTERN ERG IN CENTRAL VEIN OCCLUSION

    Directory of Open Access Journals (Sweden)

    Saša Novak

    2004-12-01

    Full Text Available Pattern electroretinogram (PERG findings were analysed in 30 patients with central retinal vein occlusion. Latency and amplitude values of PERG waves were compared with the results obtained in 30 healthy individuals after sample randomisation. In 15 cases with „hemorrhagic type” occlusion of the central retinal vein significantly reduced N1-P1 wave amplitude was noted (0,369 mV, related to „exudative“ disease type (0,557 mV, as well as to the control group of examines (0,782 mV. PERG was described as the sensitive method and important indicator in damage assessment, ie. ischemia in the ganglional cell layer in central retinal vein occlusion. Ischemia increases anoxia, which influences not only the axons but also the enzymatic and transport processes within the cell bodies, dendrites, axons and axonal terminals. Slowing down of the fast phase of axoplasmatic transport in the axons in ischemic damage blocked transmission impulses which could be evident through different degrees of PERG wave amplitude reduction. With this method the patients can be selected in whom due to severe retinal ischemia there is the risk of neovascular glaucomma and maculopathy, which is the absolute indication for panlaser-photocoagulation.

  13. Percutaneous sharp recanalization of a membranous IVC occlusion with an occlusion balloon as a needle target

    Directory of Open Access Journals (Sweden)

    Michael D. Rivers-Bowerman, MD, MSc, FRCPC

    2017-09-01

    Full Text Available A 50-year-old male with right upper quadrant symptoms and hepatic dysfunction was found to have multiple dilated hepatic veins (HVs with intrahepatic collateralization and membranous occlusion of the intrahepatic inferior vena cava (IVC consistent with primary Budd–Chiari syndrome. Venacavograms depicted drainage of the intrahepatic collaterals through a left-sided HV entering the IVC above the level of the occlusion. Sharp recanalization of the membranous IVC occlusion was performed with an occlusion balloon as a needle target under echocardiographic monitoring followed by balloon angioplasty with restoration of IVC patency. Clinical, laboratory, and venographic procedural success has been demonstrated to 9 months with minimal residual stenosis.

  14. Occlusion Issues in Early Renaissance Art

    OpenAIRE

    Barbara Gillam

    2011-01-01

    Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surfac...

  15. Hyperhomocysteinemia Presenting with Complete Unilateral Intracranial and Extracranial Carotid Occlusion in a Young Patient.

    Science.gov (United States)

    Niazi, Farheen; Rahman, Abdul; Batool, Uzma

    2017-09-01

    Hyperhomocysteinemia has been associated with premature peripheral vascular, cerebrovascular, and coronary artery disease. It has been associated with vascular diseases including cerebrovascular disease, particularly in subjects with significant carotid stenosis. However, hyperhomocysteinemia causing unilateral complete occlusion of whole of internal carotid, common carotid, and external carotid has been rarely reported. We report a case of an adult patient aged 35-year with complete occlusion of right common carotid, internal carotid, both intracranial and extracranial part, presented with recurrent TIAs and stroke and was found to be having hyperhomocysteinemia as the cause of this complete occlusion and showed marked clinical recovery with appropriate treatment. Prompt identification and treatment of hyperhomocysteinemia, as a vascular risk factor especially in young, is of utmost importance especially when its treatment is cost-effective and can save major disability from stroke.

  16. Effect of occlusal plane on smile attractiveness.

    Science.gov (United States)

    Batwa, Waeil; Hunt, Nigel P; Petrie, Aviva; Gill, Daljit

    2012-03-01

    To determine the influence of the occlusal plane angle on smile attractiveness as perceived by a group of adult orthodontic patients and dentists. The first stage utilized a laboratory approach to record changes in vertical tooth position at different occlusal plane angles using a maxillary model mounted on an articulator. In the second stage, photographic manipulation was undertaken, using data from stage 1, to produce a computerized prediction of the appearance of the smile at differing occlusal plane angles (0, 5, 10, 15, and 20 degrees). Finally, the five developed photographs were assessed by participants. Alterations in the occlusal plane angle did affect relative smile attractiveness for both patients (n  =  66) and dentists (n  =  66). For patients, the 10 degree smile was rated better than the 0 and 20 degree smiles (P occlusal plane angle does affect relative smile attractiveness. However, patients were more tolerant of these changes than dentists. This suggests that large changes in the occlusal plane angle would affect relative smile attractiveness, and small changes are unlikely to affect smile attractiveness.

  17. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H

    1983-01-01

    in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured pO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood...... that 99Tcm is as suitable as the 131I- -labelled tracers in estimating the SPP. The SPP is significantly correlated to skin blood flow, to systolic blood pressure, to tc pO2 and to angiographic findings. Correction of SPP for systemic blood pressure changes can be made in proportion with the measured...... variations in systemic mean blood pressure, but only for groups of patients....

  18. Progression of Diabetic Capillary Occlusion: A Model.

    Directory of Open Access Journals (Sweden)

    Xiao Fu

    2016-06-01

    Full Text Available An explanatory computational model is developed of the contiguous areas of retinal capillary loss which play a large role in diabetic maculapathy and diabetic retinal neovascularization. Strictly random leukocyte mediated capillary occlusion cannot explain the occurrence of large contiguous areas of retinal ischemia. Therefore occlusion of an individual capillary must increase the probability of occlusion of surrounding capillaries. A retinal perifoveal vascular sector as well as a peripheral retinal capillary network and a deleted hexagonal capillary network are modelled using Compucell3D. The perifoveal modelling produces a pattern of spreading capillary loss with associated macular edema. In the peripheral network, spreading ischemia results from the progressive loss of the ladder capillaries which connect peripheral arterioles and venules. System blood flow was elevated in the macular model before a later reduction in flow in cases with progression of capillary occlusions. Simulations differing only in initial vascular network structures but with identical dynamics for oxygen, growth factors and vascular occlusions, replicate key clinical observations of ischemia and macular edema in the posterior pole and ischemia in the retinal periphery. The simulation results also seem consistent with quantitative data on macular blood flow and qualitative data on venous oxygenation. One computational model applied to distinct capillary networks in different retinal regions yielded results comparable to clinical observations in those regions.

  19. Occlusion issues in early Renaissance art

    Science.gov (United States)

    Gillam, Barbara

    2011-01-01

    Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surface overlap is often achieved by implementing the principle that an occluding surface occludes anything behind it, so that occlusion perception is enhanced by a lack of relationship of occluding contour to occluded contours. Some well-known figure-ground principles are also commonly used to stratify adjoined figures. Global factors that assist this stratification include the placement of figures on a ground plane, a high viewpoint, and figure grouping. Artists of this period seem to have differed on whether to occlude faces and heads, often carefully avoiding doing so. Halos were either eliminated selectively or placed oddly to avoid such occlusions. Finally, I argue that the marked intransitivity in occlusion by architecture in the paintings of Duccio can be related to the issue of perceptual versus cognitive influences on the visual impact of paintings. PMID:23145262

  20. Depicting Occlusion in Early Renaissance Art

    Science.gov (United States)

    Gillam, Barbara

    2011-01-01

    The artist attempting to give the impression of three-dimensional relationships must convey somehow that one surface is in front of another. There is a large and venerable literature in Psychology on this subject, showing how figure-ground, border ownership and amodal completion and continuation are determined but there is almost no discussion of how artist's have recruited these and other principles to create convincing impressions of occlusion. Even Gombrich (Art & Illusion 1960) only considers the situation in which a figure has to be imagined from very partial cues, not how juxtaposed elements in art are parsed perceptually into occluding and occluded surfaces. In this paper I shall discuss approaches to occlusion present in early Renaissance art and the degree to which the principles now well-known to Psychologists were discovered and used, as artists increasingly depicted naturalistic scenes. Among the preoccupations of these artists, as indicated by their work, were whether and how much to occlude faces (and the related issue of the management of haloes), occlusion of and by architectural features, and the importance or otherwise of transitivity in occlusion relationships within the scene. They also clearly used the ground plane, high viewpoints and arrangements of contour terminations, as well as more conventional figural cues, to disambiguate perceived occlusion or to avoid the confusion of multiple surfaces.

  1. Depicting Occlusion in Early Renaissance Art

    Directory of Open Access Journals (Sweden)

    Barbara Gillam

    2011-05-01

    Full Text Available The artist attempting to give the impression of three-dimensional relationships must convey somehow that one surface is in front of another. There is a large and venerable literature in Psychology on this subject, showing how figure-ground, border ownership and amodal completion and continuation are determined but there is almost no discussion of how artist's have recruited these and other principles to create convincing impressions of occlusion. Even Gombrich (Art & Illusion 1960 only considers the situation in which a figure has to be imagined from very partial cues, not how juxtaposed elements in art are parsed perceptually into occluding and occluded surfaces. In this paper I shall discuss approaches to occlusion present in early Renaissance art and the degree to which the principles now well-known to Psychologists were discovered and used, as artists increasingly depicted naturalistic scenes. Among the preoccupations of these artists, as indicated by their work, were whether and how much to occlude faces (and the related issue of the management of haloes, occlusion of and by architectural features, and the importance or otherwise of transitivity in occlusion relationships within the scene. They also clearly used the ground plane, high viewpoints and arrangements of contour terminations, as well as more conventional figural cues, to disambiguate perceived occlusion or to avoid the confusion of multiple surfaces.

  2. Occlusion Issues in Early Renaissance Art

    Directory of Open Access Journals (Sweden)

    Barbara Gillam

    2011-12-01

    Full Text Available Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surface overlap is often achieved by implementing the principle that an occluding surface occludes anything behind it, so that occlusion perception is enhanced by a lack of relationship of occluding contour to occluded contours. Some well-known figure-ground principles are also commonly used to stratify adjoined figures. Global factors that assist this stratification include the placement of figures on a ground plane, a high viewpoint, and figure grouping. Artists of this period seem to have differed on whether to occlude faces and heads, often carefully avoiding doing so. Halos were either eliminated selectively or placed oddly to avoid such occlusions. Finally, I argue that the marked intransitivity in occlusion by architecture in the paintings of Duccio can be related to the issue of perceptual versus cognitive influences on the visual impact of paintings.

  3. Temporomandibular Disorders Treatment with Correction of Decreased Occlusal Vertical Dimension.

    Science.gov (United States)

    Guguvcevski, Ljuben; Gigovski, Nikola; Mijoska, Aneta; Zlatanovska, Katerina; Arsova-Gigovska, Ana

    2017-12-15

    The term decreased occlusal vertical dimension refers to the reduced distance between two anatomical points while the teeth are in a state of occlusion. The development of this situation is about some parafunctional activities of the masticatory system. To evaluate the value of decreased occlusal vertical dimension in cases with temporomandibular disorder and to follow up the influence of corrective treatment with occlusal splints and definitive prosthetic construction upon the elimination of clinical symptoms. Eight cases with decreased occlusal vertical dimension accompanied with temporomandibular disorders were treated with an occlusal splint, as part of reversible occlusal treatment. After reducing, or complete elimination of the symptoms related to problems of decreased occlusal vertical dimension, the definitive prosthetic therapy was performed. The mean value of decreased occlusal vertical dimension in our patients is 8.5 mm, and the mean value of therapy time with an occlusal splint in these patients was 3.5 months. Occlusal splint is a part of reversible occlusal therapy in cases with decreased occlusal vertical dimension. After reducing the symptoms related to decreased occlusal vertical dimension definitive prosthetic therapy can be done.

  4. Diagnóstico diferencial de trombose aortoilíaca e mieloencefalite protozoária equina: relato de caso Differential diagnosis between aorto-iliac thrombosis and equine protozoal myeloencephalitis: case report

    Directory of Open Access Journals (Sweden)

    P.B. Escodro

    2010-10-01

    Full Text Available Relata-se o caso de uma égua de atividade de polo, que apresentou inicialmente claudicação leve no membro posterior esquerdo, a qual evoluiu para ataxia e atrofia da musculatura glútea do lado esquerdo, com diagnóstico de trombose aortoilíaca (TAI. A paciente foi tratada com suspeita de mieloencefalite protozoária equina, devido à semelhança dos sinais clínicos com essa doença, porém o líquido cefalorraquidiano apresentou-se negativo para anticorpos anti-Sarcocystis neurona. A palpação transretal indicou uma massa na bifurcação aortoilíaca esquerda. Na avaliação ultrassonográfica, visualizou-se imagem hiperecoica aderida ao endotélio vascular, sugerindo TAI atingindo a estenose de 70% da luz arterial.The case of a mare used for polo is reported. The animal showed clinical signs of soft lameness of the hindlimb, evolving to ataxia and gluteal muscle atrophy, with aorto-iliac thrombosis (AIT. The patient was treated with the suspect of equine protozoal myeloencephalitis (EPM, due to the resemblance of clinical signs. Cerebrospinal fluid analysis was negative for antibodies against Sarcocystis neurona. The transrectal examination indicated a mass in the left aorto-iliac bifurcation. In the ultrasonographic evaluation, a hyperechoic image adhered to the vascular endothelium was observed, suggesting (AIT, occupying 70% of arterial lumen. The present article has the objective of pointing out the importance of the differential diagnosis between AIT and EPM in horses with ataxia in hindlimbs and muscular atrophy.

  5. Occlusal Caries: Biological Approach for Its Diagnosis and Management

    DEFF Research Database (Denmark)

    Christina Carvalho, Joana; Dige, Irene; Machiulskiene, Vita

    2016-01-01

    The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries...... process on occlusal surfaces. In addition, it considers the whole spectrum of the caries process on occlusal surfaces, ranging from the molecular ecology of occlusal biofilms to the management of deep occlusal caries lesions. Studies using molecular methods with focus on biofilms in relation to occlusal...

  6. Effect of glove occlusion on the skin barrier

    DEFF Research Database (Denmark)

    Tiedemann, Daniel; Clausen, Maja Lisa; John, Swen Malthe

    2016-01-01

    that the negative effect of occlusion in itself is limited, and that only extensive and long-term occlusion will cause barrier impairment. However, studies investigating combined effect of occlusion and exposure to soaps/detergents indicate that occlusion significantly enhances the skin barrier damage caused...... of this study is to review the literature on the effects of glove occlusion on skin barrier function. The PubMed database was searched up to 1 February 2015 for articles on the association between glove occlusion and skin barrier function, including human studies only and in English. Only experimental studies...... by detergents/soaps in a dose-response fashion....

  7. Compliance with occlusion therapy for childhood amblyopia.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2013-09-17

    Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

  8. Occlusion and occlusal characteristics of primary dentition in North Indian children of East Lucknow region.

    Science.gov (United States)

    Khan, R; Singh, N; Govil, S; Tandon, S

    2014-10-01

    To determine occlusion and occlusal characteristics of the primary dentition in North Indian school-going children of East Lucknow region. A cross-sectional study was conducted on 453 participants in the age group of 3-6 years. Participants were selected randomly and occlusal relationship was assessed based on Baume's classification. Various other occlusal characteristics were also recorded and assessed based on clinical and photographic evaluation. The data were then subjected to statistical analysis. Out of 453 participants examined, results revealed 62.3% had flush terminal plane; 31.3% mesial step molar relationship and 6.4% distal step molar relationship. It was also observed that 91.6% had Class I canine relationship, 93.4% primate spaces, 69.5% physiologic spaces. Amongst other occlusal characteristics, increased overbite and crowding were prevalent. Association of various occlusal characteristics and oral habits with respect to primary molar relation was also assessed. Chi-square test was performed to carry out statistical analysis. p value plane relationship with spacing and Class I canine relationship predominated. Further prospective studies are required to provide an insight into patterns of occlusal relationship and its changes in Indian children.

  9. Influence of mandibular fixation method on stability of the maxillary occlusal plane after occlusal plane alteration.

    Science.gov (United States)

    Yosano, Akira; Katakura, Akira; Takaki, Takashi; Shibahara, Takahiko

    2009-05-01

    In this study, we investigated how method of mandibular fixation influenced longterm postoperative stability of the maxilla in Class III cases. In particular, we investigated change in the maxillary occlusal plane after Occlusal Plane Alteration. Therefore, we focused on change in the palatal plane to evaluate stability of the maxillary occlusal plane, as the position of the palatal plane affects the maxillary occlusal plane. This study included 16 patients diagnosed with mandibular protrusion. Alteration of the occlusal plane was achieved by clockwise rotation of the maxilla by Le Fort I osteotomy and mandibular setback was performed by bilateral sagittal split ramus osteotomy. We analyzed and examined lateral cephalometric radiographs taken at 1 month, 3 months, 6 months, and 1 year after surgery. Stability achieved by two methods of mandibular fixation was compared. In one group of patients (group S) titanium screws were used, and in the other group (group P) titanium-locking mini-plates were used. No significant displacement was recognized in group S, whereas an approximately 0.7mm upward vertical displacement was recognized in the anterior nasal spine in group P. As a result, not only the angle of the palatal plane and S-N plane, but also occlusal plane angle in group P showed a greater decrease than that in group S. The results suggest that fixing the mandible with screws yielded greater stability of the maxilla and maxillary occlusal plane than fixing the mandible with titanium plates.

  10. Immediate Occlusal versus Non-Occlusal Loading of Implants: A Randomized Clinical Pilot Study.

    Science.gov (United States)

    Vogl, Susanne; Stopper, Marlene; Hof, Markus; Wegscheider, Walther A; Lorenzoni, Martin

    2015-06-01

    Immediate occlusal and non-occlusal loading protocols have been discussed and, despite varying success rates, are considered viable in selected cases. Preoperative implant planning and intraoperative transfer are essential to the success of implant-supported reconstructions in partially or completely edentulous jaws. This study was performed to compare clinical outcomes of immediate occlusal versus non-occlusal loading of posterior implants. Of 19 patients with 52 screw-type implants replacing mandibular molars or premolars, nine patients with 21 implants were randomized to a study group that received immediate restorations with occlusal loading, whereas 10 patients with 31 implants were randomized to a control group that received provisional restorations without occlusal loading. Occlusal loading was defined as full loading in maximum intercuspidation. Single-tooth or splinted multiunit restorations were incorporated by screw retention or cementation. Marginal bone defects (MBD), implant survival, and implant success were evaluated 12 months after insertion. Both groups revealed similar MBD levels consistent with previous reports. No implants were lost (overall survival: 100%) or found to fail (overall success: 100%). No significant intergroup differences were noted for any of the evaluated parameters. Immediate restorations in partially edentulous mandibles demonstrated successful clinical and radiographic 12-month results. Larger long-term prospective studies are needed to confirm the final evidence and predictability of immediate functional loading as a standard treatment concept for partially edentulous jaws. © 2013 Wiley Periodicals, Inc.

  11. Management of occlusal canting with miniscrews.

    Science.gov (United States)

    Yáñez-Vico, Rosa Maria; Iglesias-Linares, Alejandro; Cadenas de Llano-Pérula, Maria; Solano-Reina, Alvaro; Solano-Reina, Enrique

    2014-07-01

    A 14-year-old boy with a skeletal Class II malocclusion and open bite whose chief complaint was a posterior crossbite showed a canted occlusal plane with asymmetric gummy smile and mandibular deviation at clinical examination. The treatment with miniscrews focused on the bilateral intrusion of the maxillary posterior teeth and, after resolving the open bite, a new biomechanical technique involving joined miniscrews was applied for an en masse intrusion of the left side. This treatment strategy achieved optimal occlusion with improvements to the sagittal, vertical, and transverse relationships and achieved a harmonious smile.

  12. Occlusal Characteristics of the Primary Dentition Revisited.

    Science.gov (United States)

    Alexander, Stanley A; Askari, Marjan; Lewis, Patricia

    2015-11-01

    The occlusal characteristics of the primary dentition of 130 children 3 to 6 years old were examined. Variables were the terminal plane relationship, primary canine occlusion, spacing, overjet and overbite relationships. The flush terminal plane was the most common finding. A Class I relationship of the primary canine occurred in 85% of the subjects. Spaced dentitions occurred 81% of the time, while the presence of primate spaces occurred in at least one of the four quadrants. The overjet relationship varied from +1 mm to 4 mm in all subjects, and the majority of children were considered to have a normal overbite.

  13. Strain gauge analysis of occlusal forces on implant prostheses at various occlusal heights.

    Science.gov (United States)

    Cho, Young-Eun; Park, Eun-Jin; Koak, Jai-Young; Kim, Seong-Kyun; Heo, Seong-Joo; Park, Ji-Man

    2014-01-01

    The purpose of this study was to evaluate and compare the strain development at different occlusal heights of an implant prosthesis and adjacent teeth through the use of strain gauges. A test model was constructed using autopolymerizing polyurethane resin, artificial composite resin teeth, and an implant gold crown in the mandibular first molar area. The resin block containing the implant and the gold crown was sectioned, and two expansion screws were attached perpendicular to the bottom of the resin block on the buccal and lingual sides. The expansion screws were turned to create a gap. Four groups were created based on the occlusal height of the implant gold crown. Three strain gauges were attached to the buccal surfaces of the mandibular right second premolar, implant gold crown, and second molar. Beef jerky, carrot, and bread were used as test foods. A universal testing machine was used to apply compressive forces of 300 N (beef jerky), 250 N (carrot), and 50 N (bread), and the occlusal force was measured in each group. With 300 N, occlusal forces were concentrated on the adjacent teeth when the occlusal height of the implant prosthesis decreased. With 250 and 50 N, when the occlusal height of the implant prosthesis increased, the occlusal force applied to the implant prosthesis increased, but alterations in the implant crown height had little effect on the adjacent teeth. Different amounts of strain in the implant prosthesis and adjacent teeth were recorded depending on the occlusal height of the prosthesis. With 250 or 50 N of force, an increased prosthesis height affected the implant itself. With 300 N of force, decreased occlusal height of the prosthesis resulted in increased force on the adjacent teeth.

  14. Carotid Artery Stenting in a Patient with Spontaneous Recanalization of a Proximal Internal Carotid Artery Occlusion: a Case Report

    International Nuclear Information System (INIS)

    Kim, Eui Jong; Koh, Jun Seok; Choi, Woo Suk

    2006-01-01

    We report here on a rare case of carotid artery angioplasty and stenting in a patient with spontaneous recanalization after complete occlusion of the proximal internal carotid artery (ICA). The patient initially showed severe stenosis at the left proximal ICA on MR angiography (MRA). Digital subtraction angiography (DSA) performed three days after MRA showed complete occlusion of the proximal ICA. The follow-up DSA after four weeks showed recanalization of the ICA, and then carotid artery stenting was successfully performed. There has been no neurologic complication during more than one year follow-up. cute internal carotid artery (ICA) occlusions may result in profound disability and death (1). An occluded ICA can spontaneously recanalize, but this doesn't happen frequently, and the natural course of a proximal ICA occlusion and its possibility of recanalization, including the exact time of recanalization after occlusion, are not well known (2, 3). A few studies have reported the incidence of spontaneous recanalization of the proximal internal carotid artery, which has mostly occurred in patients with ICA dissections (4 6). A few limited studies have reported a considerable incidence of spontaneous recanalization in patients with underlying atherosclerotic lesion or atherothombotic diseases (2). The possibility of repeated occlusion and repeated cerebral ischemic infarction may exist for the patients exhibiting spontaneous recanalization of the ICA and underlying atherosclerosis. We report here on a case of carotid artery stenting (CAS) in a patient who exhibited underlying atherosclerosis with spontaneous recanalization after complete occlusion of the proximal ICA

  15. [Occlusion of secondary branches after angioplasty of the left descending coronary artery].

    Science.gov (United States)

    Araújo, E C; Sousa, A G; Nicolela Júnior, E L; Cano, M N; Maldonado, G; Feres, F; Mattos, L A; Pinto, I M; Tanajura, L F; Fontes, V F

    1990-05-01

    To evaluate the incidence and clinical presentation of the occlusion of such secondary branches in patients with single vessel coronary artery disease in the left anterior descending artery, who underwent a first elective and successful PTCA. Two hundred and thirteen side branches of 121 patients considered to be at risk. They were divided into group I (GI-85 side branches, 39.9%), if they originated from the atherosclerotic site; and group II (GII-120 side branches, 61.5%), if their origin would be involved during the balloon inflation. In the GI there were 54 septal branches and 31 diagonal branches, and 36& had angiographic evidence of ostium disease. GII was constituted by 77 septal and 51 diagonal branches, and 7.8% of them had evidence of ostium disease. Seven side branches (3.3%) at risk occluded, 4 from GI (4.7%) and 3 (2.3%) from GII. As for the clinical presentation, 57% of them had angina, where as 28.6% showed minor abnormalities in the ECG. No patient elevated its serum CK-MB, and silent occlusion occurred in 43% of them. Occlusion of side branches is a low incidence phenomenon, which happens more often in septal branches with ostium disease that originates from the atherosclerotic site; that about half of the patient had silent occlusion (43%) or mild ischemic manifestations.

  16. [Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration].

    Science.gov (United States)

    Wang, Rong; Xu, Xin

    2015-12-01

    To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced

  17. Crossing Total Occlusions : Navigating Towards Recanalization

    NARCIS (Netherlands)

    Sakes, A.; Regar, E.; Dankelman, J.; Breedveld, P.

    2016-01-01

    Chronic total occlusions (CTOs) represent the “last frontier” of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the

  18. Crossing Total Occlusions: Navigating Towards Recanalization

    NARCIS (Netherlands)

    A. Sakes (Aimée); E.S. Regar (Eveline); J. Dankelman (Jenny); P. Breedveld (Paul)

    2016-01-01

    textabstractChronic total occlusions (CTOs) represent the “last frontier” of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate

  19. Class II malocclusion occlusal severity description

    Directory of Open Access Journals (Sweden)

    Guilherme Janson

    2010-08-01

    Full Text Available OBJECTIVES: It is well known that the efficacy and the efficiency of a Class II malocclusion treatment are aspects closely related to the severity of the dental anteroposterior discrepancy. Even though, sample selection based on cephalometric variables without considering the severity of the occlusal anteroposterior discrepancy is still common in current papers. In some of them, when occlusal parameters are chosen, the severity is often neglected. The purpose of this study is to verify the importance given to the classification of Class II malocclusion, based on the criteria used for sample selection in a great number of papers published in the orthodontic journal with the highest impact factor. MATERIAL AND METHODS: A search was performed in PubMed database for full-text research papers referencing Class II malocclusion in the history of the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO. RESULTS: A total of 359 papers were retrieved, among which only 72 (20.06% papers described the occlusal severity of the Class II malocclusion sample. In the other 287 (79.94% papers that did not specify the anteroposterior discrepancy severity, description was considered to be crucial in 159 (55.40% of them. CONCLUSIONS: Omission in describing the occlusal severity demands a cautious interpretation of 44.29% of the papers retrieved in this study.

  20. Clinical Aspects of Combination of Ceramic and Acrylic Occlusal Surfaces

    Directory of Open Access Journals (Sweden)

    Z. Ozhohan

    2017-03-01

    Full Text Available The objective of the research was to develop and substantiate the methods of constructing the occlusal surfaces when manufacturing aesthetic fixed restorations through the combination of different materials. Materials and methods. The study included 65 patients with ceramic and acrylic occlusal surfaces of aesthetic fixed dental prostheses. Group I included 21 patients with a combination of ceramic and acrylic occlusal surfaces. Group II included 22 patients with a combination of ceramic occlusal surfaces. Group III included 22 patients with a combination of acrylic occlusal surfaces. The patients were observed 3, 6 and 12 months after prosthetic repair. Results. The greatest increase in the occlusal contact surface area of fixed restorations was observed in Group I, that is, when combining dental prostheses with ceramic and acrylic occlusal surfaces. Considering uneven abrasion of the occlusal surfaces, we do not recommend to combine different materials when veneering the occlusal surface of the antagonistic teeth. Conclusions. This study demonstrated the important role of the correct combination of materials when veneering the occlusal surfaces. Physical and chemical properties of materials, namely the abrasion resistance play a significant role in the long-term denture functioning. The smallest increase in the occlusal contact surface area was observed in Group II when combining ceramic occlusal surfaces. It was due to a good abrasion resistance of ceramics as compared to acrylic resin as well as the presence of the glazed layer which prevents the premature abrasion of the occlusal surfaces of the antagonistic teeth due to lower surface roughness. The combination of acrylic resin and ceramics when constructing the occlusal surfaces of fixed restorations in Group I demonstrated the highest rate of the increase in the occlusal contact surface area – 9.93%. It was due to a low hardness of acrylic resin and its high surface roughness. In

  1. Temporomandibular Disorders Treatment with Correction of Decreased Occlusal Vertical Dimension

    OpenAIRE

    Guguvcevski, Ljuben; Gigovski, Nikola; Mijoska, Aneta; Zlatanovska, Katerina; Arsova-Gigovska, Ana

    2017-01-01

    BACKGROUND: The term decreased occlusal vertical dimension refers to the reduced distance between two anatomical points while the teeth are in a state of occlusion. The development of this situation is about some parafunctional activities of the masticatory system. AIM: To evaluate the value of decreased occlusal vertical dimension in cases with temporomandibular disorder and to follow up the influence of corrective treatment with occlusal splints and definitive prosthetic construction up...

  2. [Project to decrease the nasogastric tube occlusion rate in a gastrointestinal unit].

    Science.gov (United States)

    Chen, Jen-Ru; Chen, Mei-Chun; Fang, Yu-Chiung; Kuo, Shu-Hui

    2014-04-01

    When oral intake is inadequate or not recommended for patients with underlying diseases or specific treatments, it is common for these patients to receive nutrition enterally through a nasogastric tube. However, tube occlusion is a common complication of enteral feeding tubes. Data collected at our hospital from January to September 2011 identified 7 nasogastric tube occlusion events. All events were resolved by replacing the original tube with a new tube. The purpose of this project was to reduce the nasogastric tube occlusion rate to 0.31% or less. Implemented interventions included: 1) developing and administering a course for nurses on nasogastric-tube feeding techniques; (2) providing a filter for powdered medications; (3) developing a standard procedure for administering Nexium through nasogastric tubes; (4) updating patient-education pamphlets for nasogastric tube feeding; and (5) enhancing the quality of nurse auditing on nasogastric tube feeding techniques and nasogastric-tube medication-administration techniques. The average nasogastric tube occlusion rate decreased from 0.76% to 0% and the average nasogastric tube feeding technique compliance rate for nurses increased. The accuracy rate for specific medication administration techniques through nasogastric tubes increased dramatically from 16.7% to 100%. The project involved a multidisciplinary team of physicians, nurses, and pharmacists. This team developed a standard protocol for nasogastric tube feeding and specific medication administration recommendations for nasogastric tubes; revised nursing practice standards; and decreased the rate of nasogastric tube occlusion.

  3. [Occlusion: current situation and prospect in view of holistic integrative medicine].

    Science.gov (United States)

    Wang, M Q; Liu, X D

    2017-08-09

    The rise of holistic integrative medicine (HIM) is an inevitable consequence of modern medical development which emphasizes the change from specialization to integration of the most advanced medical knowledge. It does not mean a simple collection of the medical theories, but means the digestion of those theories for the clinical practical application. Because occlusal therapy is characterized as not only a high level of individualization, but also a relation to many stomatology and other disciplines, such as plastic surgery, orthopedics, neurosciences and psychology. It needs the HIM to guide the clinical practice. With undertaking occlusal therapy, to avoid the limitation due to the excessive specialized disciplines, and to provide effective treatment plans for abnormal occlusion induced diseases, it is necessary to develop the discipline of the holistic integrative stomatology.

  4. Occlusal Plane Orientor”: An Innovative and Efficient Device for Occlusal Plane Orientation

    OpenAIRE

    Kuniyal, Harish; Katoch, Nidhi; Rao, P. Laxman

    2011-01-01

    Correct occlusal plane orientation is a prerequisite in Prosthodontic reconstructive treatment therapy as it helps in achieving esthetics and phonetics anteriorly and forms a milling surface posteriorly where tongue and buccinator muscle position the food bolus during mastication. Activity of Muscles during clenching will be least, when the occlusal plane is made parallel to plane of lost natural teeth. Conventionally the ala-tragus line (Camper’s plane) is used as a guide for assessment of t...

  5. Reversal of myopic Anisometropic amblyopia with occlusion therapy ...

    African Journals Online (AJOL)

    Objective: To report a reversal of myopic anisometropic amblyopia with occlusion therapy in a 25 year old. Design: Case report. Setting: Eye clinic of a University Teaching Hospital in a metropolitan city. Participant: an index patient. Intervention: Occlusion therapy. Main Outcome Measure: Post occlusion visual acuity.

  6. Occlusion invariant face recognition using mean based weight ...

    Indian Academy of Sciences (India)

    Features obtained from the corresponding occlusion-free patches of training images are used for face image recognition. The SVM classifier is used for occlusion detection for each patch. In the recognition phase, the MBWM bases of occlusion-free image patches are used for face recognition. Euclidean nearest neighbour ...

  7. Digital assessment of occlusal wear patterns on occlusal stabilization splints: a pilot study.

    Science.gov (United States)

    Korioth, T W; Bohlig, K G; Anderson, G C

    1998-08-01

    If masticatory load distribution is task-dependent, then the pattern of wear on an acrylic resin occlusal splint over time may affect clinical outcome. This pilot study quantitatively assessed posterior wear after 3 months on the occlusal surfaces of maxillary stabilization splints. Subjects with known history of nocturnal bruxism were given heat-cured full-arch acrylic resin occlusal stabilization splints to be worn nocturnally for 3 months. Splint occlusion was adjusted at appliance delivery and was refined at the baseline session 1 to 2 weeks later. No further adjustment of the splint surface was performed during the 3-month study period. Sequential impressions of the splint occlusal surface provided epoxy resin models that were digitized and analyzed through specialized software. Changes in the digitized splint surface from baseline to 3 months allowed comparison of wear facets between splint sides and among tooth locations. Splint wear was asymmetric between sides and uneven between dental locations. For full coverage occlusal splints, the appliance wear phenomenon can be site specific and, if left undisturbed, may yield two extremes of high wear and a zone of low wear in-between.

  8. [Case report of occlusal treatment with full mouth reconstruction].

    Science.gov (United States)

    Oizumi, Makoto

    2008-07-01

    A 70-year-old woman presented with a complaint of masticatory pain and disturbance. She had collapse of occlusal support and vertical dimension decrease. This case used provisional restoration for increasing vertical dimension and reconstruction of anterior guidance. After confirming occlusal stability, she was treated with fixed prosthesis and removable partial dentures. This patient was followed for 6 and a half years with no prosthetic complications, because the reconstruction of bilateral occlusal support and anterior guidance were performed. It is important to reconstruct the occlusal support and anterior guidance in cases of prosthetic treatment of occlusal collapse.

  9. Treatment of Chronic Total Occlusions Using the Avinger Ocelot Crossing Catheter

    OpenAIRE

    Sewall, Luke E.

    2015-01-01

    Peripheral arterial disease is becoming more prevalent as the population ages. In addition, the severity of the disease seems to be progressing from simple narrowing of vessels to chronic total occlusions (CTOs). Treatment of CTOs of the infrainguinal peripheral arteries remains a challenge even for experienced endovascular specialists. Many crossing techniques have been described ranging from standard guidewire and catheter-based techniques including subintimal recanalization to specialized ...

  10. Concepts of occlusion in prosthodontics: A literature review, part I

    Directory of Open Access Journals (Sweden)

    V Rangarajan

    2015-01-01

    Full Text Available Occlusion and its relationship to the function of the stomatognathic system have been widely studied in dentistry since many decades. This series of articles describe about occlusion in the complete denture, fixed partial denture, and implants. Part I and II of this articles series describe concepts and philosophies of occlusion in complete denture. So far, available research has not concluded a superior tooth form or occlusal scheme to satisfy the requirements of completely edentulous patients with respect to comfort, mastication, phonetics, and esthetics. Since then, several balanced and nonbalanced articulation concepts were proposed in the literature. A balanced articulation appears to be most appropriate because of tooth contacts observed during nonfunctional activities of patients. This article discusses about evolution of different concepts of occlusion and occlusal schemes in complete denture occlusion.

  11. [Study on retention and stability of linear occlusal complete dentures].

    Science.gov (United States)

    Zhang, Ping; Xu, Jun

    2003-01-01

    To learn retention and stability of linear occlusal complete dentures by investigating the subjective feelings of patient and the value of retention force. Static retention forces of maxillary and mandibular dentures were measured for 25 patients wearing linear occlusal dentures by using Hz-1 retention dynamometer. The subjective feelings of patients in functional state were gained simultaneously through questionnaire. Linear occlusal dentures demonstrate good retention in static and dynamic state. Among patients with severe resorption of residual ridge (RRR), mandibular linear occlusal dentures (shown good retentive subjective feelings) demonstrate significantly smaller retention force than those with slight or medium degree of RRR. There is no correlation between the subjective feelings and the values of retention forces of mandibular dentures. The subjective feelings of patients wearing new linear occlusal dentures are much better than that of old anatomic occlusal dentures. Linear occlusal dentures improve the performances of dentures by enhancing their stability during mastication movement.

  12. Restoration of posterior teeth using occlusal matrix technique

    Directory of Open Access Journals (Sweden)

    Martos Josue

    2010-01-01

    Full Text Available This article describes a technique for duplicating occlusal surface anatomy using the Biteperf device. Duplication requires an intact occlusal enamel surface and is only indicated when caries lesions are hidden. The occlusal matrix technique allows for preservation of all anatomic details. When the last layer of composite has been placed, the occlusal matrix is forced into the uncured composite to replicate the original occlusal surface, instead of performing manual curing and shaping as in the standard approach. It is technically possible to achieve this effect with any material that is able to copy anatomic details. The main benefits of the occlusal matrix technique, more precisely the Biteperf, are the technical ease of use due to its simplicity and its high accuracy in reconstructing occlusal morphology.

  13. RTSAH Traversal Order for Occlusion Rays

    KAUST Repository

    Ize, Thiago

    2011-04-01

    We accelerate the finding of occluders in tree based acceleration structures, such as a packetized BVH and a single ray kd-tree, by deriving the ray termination surface area heuristic (RTSAH) cost model for traversing an occlusion ray through a tree and then using the RTSAH to determine which child node a ray should traverse first instead of the traditional choice of traversing the near node before the far node. We further extend RTSAH to handle materials that attenuate light instead of fully occluding it, so that we can avoid superfluous intersections with partially transparent objects. For scenes with high occlusion, we substantially lower the number of traversal steps and intersection tests and achieve up to 2× speedups. © 2010 The Author(s).

  14. Handling Occlusions for Robust Augmented Reality Systems

    Directory of Open Access Journals (Sweden)

    Maidi Madjid

    2010-01-01

    Full Text Available Abstract In Augmented Reality applications, the human perception is enhanced with computer-generated graphics. These graphics must be exactly registered to real objects in the scene and this requires an effective Augmented Reality system to track the user's viewpoint. In this paper, a robust tracking algorithm based on coded fiducials is presented. Square targets are identified and pose parameters are computed using a hybrid approach based on a direct method combined with the Kalman filter. An important factor for providing a robust Augmented Reality system is the correct handling of targets occlusions by real scene elements. To overcome tracking failure due to occlusions, we extend our method using an optical flow approach to track visible points and maintain virtual graphics overlaying when targets are not identified. Our proposed real-time algorithm is tested with different camera viewpoints under various image conditions and shows to be accurate and robust.

  15. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    International Nuclear Information System (INIS)

    Haage, Patrick; Schmitz-Rode, Thomas; Krings, Timo

    2002-01-01

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  16. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Haage, Patrick; Schmitz-Rode, Thomas [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krings, Timo [Department of Neuroradiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2002-11-01

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  17. Depicting Occlusion in Early Renaissance Art

    OpenAIRE

    Gillam, Barbara

    2011-01-01

    The artist attempting to give the impression of three-dimensional relationships must convey somehow that one surface is in front of another. There is a large and venerable literature in Psychology on this subject, showing how figure-ground, border ownership and amodal completion and continuation are determined but there is almost no discussion of how artist's have recruited these and other principles to create convincing impressions of occlusion. Even Gombrich (Art & Illusion 1960) only consi...

  18. A Retrospective Study of 1,526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus.

    Science.gov (United States)

    Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

    2015-09-05

    Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Median age and median weight were 4.0 years (range: 0.3-52.0 years old) and 15.3 kg (range: 4.5-91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.

  19. Postural stability and occlusal status among Japanese elderly.

    Science.gov (United States)

    Song-Yu, Xuan; Rodis, Omar M M; Ogata, Sagiri; Can-Hu, Jin; Nishimura, Michiko; Matsumura, Seishi

    2012-06-01

    There are still no data available on the relationship between postural stability and occlusal status among the elderly. To examine relationships between postural stability and occlusal status through a cohort study among elderly Japanese. Oral examination, occlusal status, postural stability and a questionnaire were conducted and given to 87 community-dwelling Japanese at enrolment. The average occlusal pressure of the female group was statistically higher than the male group while average occlusal pressure and postural stability length were lesser in the group with more remaining teeth. Postural stability area and number of remaining teeth showed statistically significant correlations. Postural stability length was lesser in the group with strong occlusal force. Furthermore, the number of decayed teeth was fewer in the good hygiene group. This study identified a close relationship between occlusal status and postural stability of Japanese older individuals. Occlusal hypofunction was observed more in those with occlusal problems, and a decrease in their occlusal functions resulted in postural instability. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  20. A study on occlusal stability in shortened dental arches.

    Science.gov (United States)

    Sarita, Paulo T N; Kreulen, Cees M; Witter, Dick J; van't Hof, Martin; Creugers, Nico H J

    2003-01-01

    The aim of this study was to verify the hypothesis that shortened dental arches constitute a risk to occlusal stability. Using cluster samples, 725 subjects with shortened dental arches comprising intact anterior regions and zero to eight occluding pairs of posterior teeth and 125 subjects with complete dental arches were selected. Subjects with shortened dental arches were classified into eight categories according to arch length and symmetry. Parameters for occlusal stability were interdental spacing, occlusal tooth wear, occlusal contact of incisors in intercuspal position, and vertical and horizontal overlap. Additionally, tooth mobility and overeruption of unopposed teeth were assessed. Influence of independent variables (dental arch category, age, gender, and residence) on the parameters for occlusal stability was assessed by one-way ANOVA and Tukey's multiple range tests. Extreme shortened dental arches (zero to two pairs of occluding premolars) had significantly more interdental spacing, occlusal contact of incisors, and vertical overlap compared to complete dental arches. Occlusal wear and prevalence of mobile teeth were highest in these categories. The category with three to four occluding premolars had significantly more interdental spacing and, for the older age group, more anterior teeth in occlusal contact compared to complete dental arches. Age was consistently associated with increased changes in occlusal integrity. Signs of increased risk to occlusal stability seemed to occur in extreme shortened dental arches, whereas no such evidence was found for intermediate categories of shortened dental arches.

  1. Structured sparse error coding for face recognition with occlusion.

    Science.gov (United States)

    Li, Xiao-Xin; Dai, Dao-Qing; Zhang, Xiao-Fei; Ren, Chuan-Xian

    2013-05-01

    Face recognition with occlusion is common in the real world. Inspired by the works of structured sparse representation, we try to explore the structure of the error incurred by occlusion from two aspects: the error morphology and the error distribution. Since human beings recognize the occlusion mainly according to its region shape or profile without knowing accurately what the occlusion is, we argue that the shape of the occlusion is also an important feature. We propose a morphological graph model to describe the morphological structure of the error. Due to the uncertainty of the occlusion, the distribution of the error incurred by occlusion is also uncertain. However, we observe that the unoccluded part and the occluded part of the error measured by the correntropy induced metric follow the exponential distribution, respectively. Incorporating the two aspects of the error structure, we propose the structured sparse error coding for face recognition with occlusion. Our extensive experiments demonstrate that the proposed method is more stable and has higher breakdown point in dealing with the occlusion problems in face recognition as compared to the related state-of-the-art methods, especially for the extreme situation, such as the high level occlusion and the low feature dimension.

  2. [The impact of occlusal plane orientation method on intercuspal occlusion estimation].

    Science.gov (United States)

    Zhulev, E N; Bogatova, E A; Ershov, P E; Lepakhina, A A

    2013-01-01

    The study was conducted on 50 students with orthognatic bite aged from 17 to 23 years. After taking impressions of the upper and lower dental arches and making cast models these were fixed in articulator Inter-frame space in four ways: by means of facial arch oriented on Camper plane or Frankfurt horizontal, with the help of standard semianatomical table or HIP-analyzer and a table for fixing the HIP-plane. Occlusal contacts were checked with occlusion paper (200 microns, Bausch) in the central, lateral and anterior occlusion and then analyzed using Adobe Photoshop and Universal Desktop Ruler. The most precise results were seen in cases casted by means of HIP-analyzer.

  3. Application of photogrammetry for analysis of occlusal contacts.

    Science.gov (United States)

    Shigeta, Yuko; Hirabayashi, Rio; Ikawa, Tomoko; Kihara, Takuya; Ando, Eriko; Hirai, Shinya; Fukushima, Shunji; Ogawa, Takumi

    2013-04-01

    The conventional 2D-analysis methods for occlusal contacts provided limited information on tooth morphology. This present study aims to detect 3D positional information of occlusal contacts from 2D-photos via photogrammetry. We propose an image processing solution for analysis of occlusal contacts and facets via the black silicone method and a photogrammetric technique. The occlusal facets were reconstructed from a 2D-photograph data-set of inter-occlusal records into a 3D image via photogrammetry. The configuration of the occlusal surface was reproduced with polygons. In addition, the textures of the occlusal contacts were mapped to each polygon. DIFFERENCE FROM CONVENTIONAL METHODS: Constructing occlusal facets with 3D polygons from 2D-photos with photogrammetry was a defining characteristic of this image processing technique. It allowed us to better observe findings of the black silicone method. Compared with conventional 3D analysis using a 3D scanner, our 3D models did not reproduce the detail of the anatomical configuration. However, by merging the findings of the inter-occlusal record, the deformation of mandible and the displacement of periodontal ligaments under occlusal force were reflected in our model. EFFECT OR PERFORMANCE: Through the use of polygons in the conversion of 2D images to 3D images, we were able to define the relation between the location and direction of the occlusal contacts and facets, which was difficult to detect via conventional methods. Through our method of making a 3D polygon model, the findings of inter-occlusal records which reflected the jaw/teeth behavior under occlusal force could be observed 3-dimensionally. Copyright © 2012 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  4. Reading speed improvements in retinal vein occlusion after ranibizumab treatment.

    Science.gov (United States)

    Suñer, Ivan J; Bressler, Neil M; Varma, Rohit; Lee, Paul; Dolan, Chantal M; Ward, James; Colman, Shoshana; Rubio, Roman G

    2013-07-01

    Treatment of macular edema secondary to retinal vein occlusion with ranibizumab has been shown to improve visual acuity compared with macular laser or observation. It is important to determine whether these visual acuity improvements translate into measurable improvements in visual function. To examine the benefit of ranibizumab (Lucentis) on measured reading speed, a direct performance assessment, through 6 months in eyes of patients with macular edema after retinal vein occlusion (RVO). DESIGN Two multicenter, double-masked, phase 3 trials in which participants with macular edema after branch RVO or central RVO were randomized 1:1:1 to monthly sham, ranibizumab, 0.3 mg, or ranibizumab, 0.5 mg, for 6 months. Community- and academic-based ophthalmology practices specializing in retinal diseases. Seven hundred eighty-nine eyes of 789 participants who were at least aged 18 years with macular edema secondary to retinal vein occlusion in the branch vein occlusion (BRAVO) and central vein occlusion (CRUISE) trials. Eyes were randomized 1:1:1 to 1 of 3 groups for monthly injections for 6 months: sham (132 in BRAVO and 130 in CRUISE), intravitreal ranibizumab, 0.3 mg (134 in BRAVO and 132 in CRUISE), and intravitreal ranibizumab, 0.5 mg (131 in BRAVO and 130 in CRUISE). Patients were able to receive macular laser after 3 months if they met prespecified criteria. Reading speed in the study eye was measured with enlarged text (letter size equivalent to approximately 20/1500 at the test distance) at baseline and 1, 3, and 6 months. The number of correctly read words per minute (wpm) was reported. The reading speed test requires a sixth-grade reading level and does not account for literacy or cognitive state. RESULTS In patients with branch RVO, the mean gain for the 0.5-mg group was 31.3 wpm compared with 15.0 wpm in sham-treated eyes (difference, 16.3 wpm; P = .007) at 6 months. In patients with central RVO, the mean gain for the 0.5-mg group was 20.5 wpm compared with 8

  5. A new method of evaluating posterior occlusion and its relation to posttreatment occlusal changes.

    Science.gov (United States)

    Parkinson, C E; Buschang, P H; Behrents, R G; Throckmorton, G S; English, J D

    2001-11-01

    The purpose of this study was to assess the relationship between posterior occlusion and posttreatment changes in other occlusal variables. Pretreatment (T1), posttreatment (T2), and postretention (T3) records were obtained for 49 Class I (n = 23) and Class II (n = 26) extraction cases. Overbite, overjet, mandibular incisor irregularity, right and left molar deviations, midline deviation, and mandibular arch length were measured, and occlusal registrations were made of each set of dental casts. The proximity of posterior occlusal surfaces was measured as the contact or near-contact areas at or below 300 microm thickness, based on the optical densities of scanned images of the posterior occlusal registrations. The treatment changes for overbite, overjet, right and left molar deviation, and arch length were significantly greater in the Class II group, and the reductions in incisor irregularity were greater in the Class I group. No other class differences were found. Overbite, overjet, and incisor irregularity increased after treatment, and arch length continued to decrease, with no significant class differences. Contact and near-contact areas at or below 300 microm constituted 7% of the functional occlusal table for both classes at the end of treatment, having decreased significantly in both groups (21% in Class I and 29% in Class II) during treatment. Because contact and near-contact areas increased in some patients and decreased in others, there were no significant posttreatment changes. Negative correlations were found between contact and near-contact areas at T2 and changes in overjet from T2 to T3, and between contact and near-contact areas at T3 and changes in overbite from T2 to T3. No relationships were found between posterior contact and near-contact area and incisor irregularity. We concluded that (1) the area of actual and near contacts at or below 300 microm decreased significantly with treatment, indicating that, despite excellent treatment results by

  6. Doença arterial obstrutiva periférica e índice tornozelo-braço em pacientes submetidos à angiografia coronariana Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography

    Directory of Open Access Journals (Sweden)

    Sthefano Atique Gabriel

    2007-03-01

    Full Text Available OBJETIVO: Avaliar a prevalência de doença arterial obstrutiva periférica (DAOP em coronariopatas. Avaliar a relação entre Índice Tornozelo-Braço (ITB e doença coronariana, e sua correlação com fatores de risco cardiovascular. MÉTODO: ITB investigado com ultra-sonografia Doppler. Características clínicas pesquisadas: idade, sexo, diabetes mellitus, hipertensão arterial sistêmica, etilismo, tabagismo e obesidade. População: 113 pacientes submetidos à angiografia coronariana. Primeira análise: 2 grupos - ausência e presença de coronariopatia. Segunda análise: 3 grupos - Grupo 1 - ausência de lesão coronariana; Grupo 2 - estenose 70%. Terceira análise: 2 grupos - ausência e presença de DAOP. RESULTADOS: 90,76% dos coronariopatas apresentaram DAOP. Houve diferença significante quanto à faixa etária (pOBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. Population: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis 70%. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76% of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001, hypertension (p<0.001. smoking (p<0.001, body mass index (BMI (p<0.001, systolic blood pressure (SBP (p<0.001, diastolic blood pressure (DBP (p<0.001 and pulse pressure (PP (p<0.001 and ABI (p<0.001 between patients with and without coronary lesion. There were significant difference including age (p<0

  7. Combined central retinal artery and vein occlusion in Churg-Strauss syndrome: case report.

    Science.gov (United States)

    Hamann, Steffen; Johansen, Sven

    2006-10-01

    To describe a rare case of Churg-Strauss syndrome presenting with severe visual loss due to a combined central retinal vein and artery occlusion. A 42-year old man with a medical history of asthma and blood hypereosinophilia developed a sudden loss of vision in his right eye. We describe the clinical features and evolution of the case after treatment. A combined occlusion of the central retinal artery and central retinal vein was diagnosed by the funduscopic appearance of retinal whitening, macular cherry-red spot, papilloedema, retinal haemorrhages in all four quadrants and dilated and tortuous veins. The diagnosis was confirmed by a fluorescein angiogram showing absence of retinal filling and normal choroidal filling. Churg-Strauss syndrome was diagnosed based on the necessary presence of four of six criteria for the disease proposed by the American College of Rheumatology. Corticosteroid therapy was initiated. However, during the following year when tapering off the daily dosage, the patient experienced two relapses, with pulmonary symptoms and hypereosinophilia, and the corticosteroid dosage had to be augmented. The patient presented with neovascular glaucoma 7 weeks after the vascular occlusion and experienced no visual improvement. Combined central retinal artery and vein occlusion can occur in Churg-Strauss syndrome. We suggest that regional vasculitis may be the pathological mechanism underlying the vascular occlusions observed in our case. The condition carries a very poor prognosis for vision, due to the resulting retinal ischaemia, and a poor general prognosis due to the late stage of the systemic disease. Corticosteroids should be instigated promptly in order to prevent further systemic or ocular vasculitis.

  8. A change in humidification system can eliminate endotracheal tube occlusion.

    Science.gov (United States)

    Doyle, Alex; Joshi, Manasi; Frank, Peter; Craven, Thomas; Moondi, Parvez; Young, Peter

    2011-12-01

    Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. The correction of occlusal vertical dimension on tooth wear

    Directory of Open Access Journals (Sweden)

    Rostiny Rostiny

    2007-12-01

    Full Text Available The loss of occlusal vertical dimension which is caused by tooth wear is necessarily treated to regain vertical dimension. Correctional therapy should be done as early possible. In this case, simple and relatively low cost therapy was performed. In unserve loss of occlusal vertical dimension, partial removable denture could be used and the improvement of lengthening anterior teeth using composite resin to improve to regain vertical dimensional occlusion.

  10. The correction of occlusal vertical dimension on tooth wear

    OpenAIRE

    Rostiny, Rostiny

    2007-01-01

    The loss of occlusal vertical dimension which is caused by tooth wear is necessarily treated to regain vertical dimension. Correctional therapy should be done as early possible. In this case, simple and relatively low cost therapy was performed. In unserve loss of occlusal vertical dimension, partial removable denture could be used and the improvement of lengthening anterior teeth using composite resin to improve to regain vertical dimensional occlusion.

  11. Initial experience in perfusion MR imaging of intracranial major artery occlusion with echo-planar technique

    International Nuclear Information System (INIS)

    Tsuchiya, Kazuhiro; Mizutani, Yoshiyuki; Inaoka, Sayuki; Hachiya, Junichi

    1997-01-01

    The purpose of this study was to evaluate the usefulness of perfusion MR imaging using a single-shot echo-planar technique in occlusion of intracranial main arteries. Our patient group consisted of 16 patients with internal carotid artery occlusion (n=9), Moyamoya disease (n=4), and middle cerebral artery occlusion (n=3). We performed the echo-planar perfusion studies with a 1.5-T unit using a free-induction-decay-type echo-planar sequence. With a bolus injection of Gd-DTPA, 30 consecutive scans were obtained at 10 sections every 2 seconds. The data were analyzed in three ways: a time-intensity curves in the territory of the involved artery (n=16); semiquantitative flow map of each section representing signal changes due to passage of Gd-DTPA (n=15); and serial images at a selected section (n=7). The time intensity curves were abnormal in 13 patients. The peak of signal drop was delayed in all of them. Flow maps showed focal flow abnormalities in 11 patients, but they were apparently normal in 4 patients probably due to collateral flow. In serial images, delay in appearance and/or disappearance of Gd-DTPA was noted in 6 patients. In patients with occlusion of intracranial main arteries, MR single-shot echo-planar technique is of clinical use because it can provide information about hemodynamic changes in a short examination time, in multiple sections, and with good temporal resolution. (author)

  12. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    Energy Technology Data Exchange (ETDEWEB)

    Gur, Serkan, E-mail: mserkangur@yahoo.com [Sifa Hospital, Department of Radiology (Turkey); Ozkan, Ugur [Baskent University, Department of Radiology, Faculty of Medicine (Turkey); Onder, Hakan; Tekbas, Gueven [Dicle University, Department of Radiology, Faculty of Medicine (Turkey); Oguzkurt, Levent [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

    2013-02-15

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  13. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    International Nuclear Information System (INIS)

    Gur, Serkan; Ozkan, Uğur; Onder, Hakan; Tekbas, Güven; Oguzkurt, Levent

    2013-01-01

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 ± 5 years; range 42–67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4–25) before the procedure to 20 (range 1–25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  14. Vasectomy occlusion techniques for male sterilization.

    Science.gov (United States)

    Cook, L A; Vliet, H; Pun, A; Gallo, M F

    2004-01-01

    Vasectomy is an increasingly popular and effective family planning method. A variety of vasectomy techniques are used worldwide including various vas occlusion techniques (excision and ligation, thermal or electrocautery, and mechanical and chemical occlusion methods), vas irrigation and fascial interposition. Vasectomy guidelines largely rely on information from observational studies. Ideally, the choice of vasectomy techniques should be based on the best available evidence from randomized controlled trials. The objective of this review was to compare the effectiveness, safety, acceptability and costs of vasectomy techniques for male sterilization. We searched the computerized databases the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Popline and LILACS. In addition, we searched the reference lists of relevant articles and book chapters. We included randomized controlled trials and controlled clinical trials comparing vasectomy techniques. We assessed all titles and abstracts located in the literature searches and two reviewers independently extracted articles identified for inclusion. Data were presented in the text of the review. Outcome measures include contraceptive efficacy, safety, discontinuation, and acceptability. Two trials compared vas occlusion with clips versus a conventional vasectomy technique; both were of poor quality. Neither trial found a difference between the two groups with regard to the primary outcome of failure to reach azoospermia. Four trials examined vas irrigation: three compared water irrigation with no irrigation and one compared water irrigation with euflavine. All of the trials were of poor quality. None of the trials found a significant difference between the groups with respect to the primary outcome of time to azoospermia. However, one trial found that the median number of ejaculations to azoospermia was significantly lower in the euflavine group compared to the water irrigation group. The one trial

  15. Surgical treatment of central retinal vein occlusion.

    Science.gov (United States)

    Berker, Nilufer; Batman, Cosar

    2008-05-01

    The treatment of central retinal vein occlusion (CRVO) is still a subject of debate. Medical therapy efforts, as well as retinal laser photocoagulation, have mostly dealt with management of the sequelae of CRVO, and have shown limited success in improving visual acuity. The unsatisfactory results of such therapeutic efforts led to the development of new treatment strategies focused on the surgical treatment of the occluded retinal vein. The purpose of this review is to summarize the outcomes of commonly reported surgical treatment strategies and to review different opinions on the various surgical approaches to the treatment of CRVO.

  16. Bilateral retinal vein occlusion and rubeosis irides: lessons to learn.

    Science.gov (United States)

    Md Noh, Umi Kalthum; Ahem, Amin; Mustapha, Mushawiahti

    2013-01-01

    Uncontrolled hypertension is well- known to give rise to systemic complications involving multiple central organs. Artherosclerosis leads to damage of the retinal vessels wall, contributing to venous stasis, thrombosis and finally, occlusion. Retinal vein occlusions compromise vision through development of ischaemic maculopathy, macular oedema, and rubeotic glaucoma. Laser photocoagulation remains the definitive treatment for ischaemic vein occlusion with secondary neovascularization. Timely treatment with anti- vascular endothelial growth factor prevents development of rubeotic glaucoma. We hereby report an unusual case of bilateral retinal vein occlusion complicated by rubeosis irides, which was successfully managed to improve vision and prevent rubeotic glaucoma.

  17. Hydrocolloid occlusion for the treatment of neurovascular corns

    DEFF Research Database (Denmark)

    Petersen, Lars Jelstrup; Beck, Jan Walther; Reumert, L N

    1991-01-01

    The goal of this study was to determine the effect of hydrocolloid occlusion on neurovascular corns. The design was an observer-blinded, randomized, controlled study. Thirty consecutive patients participated in the trial. The patients received curettage alone or curettage with hydrocolloid...... occlusion. Six treatments were given over 12 weeks. A follow-up examination was performed 3 months after termination of the trial. Outcome measures were the size of the corns, a discomfort score, and an overall judgment of the trial. The results demonstrated no benefit of occlusion for symptoms or signs...... of neurovascular corns. The patients treated with occlusion were, however, generally more satisfied than the conventional group....

  18. Occlusal wear and occlusal condition in a convenience sample of young adults

    NARCIS (Netherlands)

    Spijker, A. van 't; Kreulen, C.M.; Bronkhorst, E.M.; Creugers, N.H.J.

    2015-01-01

    OBJECTIVE: To study progression of tooth wear quantitatively in a convenient sample of young adults and to assess possible correlations with occlusal conditions. METHODS: Twenty-eight dental students participated in a three-year follow up study on tooth wear. Visible wear facets on full arch gypsum

  19. Treatment of Chronic Total Occlusions Using the Avinger Ocelot Crossing Catheter.

    Science.gov (United States)

    Sewall, Luke E

    2015-12-01

    Peripheral arterial disease is becoming more prevalent as the population ages. In addition, the severity of the disease seems to be progressing from simple narrowing of vessels to chronic total occlusions (CTOs). Treatment of CTOs of the infrainguinal peripheral arteries remains a challenge even for experienced endovascular specialists. Many crossing techniques have been described ranging from standard guidewire and catheter-based techniques including subintimal recanalization to specialized CTO crossing devices. One of the newest technologies, the Avinger Ocelot catheter (Avinger, Inc., Redwood City, CA), employs optical coherence tomography imaging on the tip of a rotating crossing catheter to allow visual confirmation of luminal passage. This article will review this new technology for crossing CTOs, review the results of the multicenter CONNECT II trial, and discuss the potential benefits of direct visualization while crossing occlusions.

  20. Arterial and venous oxygen partial pressure and utilization factor η, resp., and 133Xe muscle clearance after UV irradiation of skin or blood of healthy persons and patients with occlusive arterial disease and psoriasis, resp

    International Nuclear Information System (INIS)

    Scherf, H.P.; Strangfeld, D.; Meffert, H.; Glatzel, E.; Siewert, H.; Soennichsen, N.; Correns, H.J.

    1988-01-01

    In three teams of test persons series of UV irradiations of the skin (λ max 365 nm) and of the blood (λ max 254 nm) were performed, and moreover pseudoirradiations of the blood as placebo and infrared irradiations of the skin were carried out. UV irradiations of the blood increased the factor η (O 2 utilization) in all test persons. In healthy persons and patients with psoriasis UV irradiations of the skin involved a homogeneous, but less distinct effect, this was, however, not the case in patients with vascular diseases. According to the results of the 133 Xe muscle clearance the improved utilization of oxygen does not result from increased peripheral blood supply. (author)

  1. Occlusal wear and occlusal condition in a convenience sample of young adults.

    Science.gov (United States)

    Van't Spijker, A; Kreulen, C M; Bronkhorst, E M; Creugers, N H J

    2015-01-01

    To study progression of tooth wear quantitatively in a convenient sample of young adults and to assess possible correlations with occlusal conditions. Twenty-eight dental students participated in a three-year follow up study on tooth wear. Visible wear facets on full arch gypsum casts were assessed using a flatbed scanner and measuring software. Regression analyses were used to assess possible associations between the registered occlusal conditions 'occlusal guidance scheme', 'vertical overbite', 'horizontal overbite', 'depth of sagittal curve', 'canine Angle class relation', 'history of orthodontic treatment', and 'self-reported grinding/clenching' (independent variables) and increase of wear facets (dependent variable). Mean increase in facet surface areas ranged from 1.2 mm2 (premolars, incisors) to 3.4 mm2 (molars); the relative increase ranged from 15% to 23%. Backward regression analysis showed no significant relation for 'group function', 'vertical overbite', 'depth of sagittal curve', 'history of orthodontic treatment' nor 'self-reported clenching. The final multiple linear regression model showed significant associations amongst 'anterior protected articulation' and 'horizontal overbite' and increase of facet surface areas. For all teeth combined, only 'anterior protected articulation' had a significant effect. 'Self reported grinding' did not have a significant effect (p>0.07). In this study 'anterior protected articulation' and 'horizontal overbite', were significantly associated with the progression of tooth wear. Self reported grinding was not significantly associated with progression of tooth wear. Occlusal conditions such as anterior protected articulation and horizontal overbite seem to have an effect on the progression of occlusal tooth wear in this convenient sample of young adults. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Interventional therapy of atherosclerotic renal artery occlusion

    International Nuclear Information System (INIS)

    Li Jian; Xu Ke; Xiao Liang

    2009-01-01

    Objective: To investigate the effectiveness of interventional therapy for the atherosclerotic renal artery occlusion (ARAO). Methods: During the period of June 2001-Dec. 2007, 16 patients with ARAO (total of 16 occluded arteries) underwent interventional managements, including percutaneous endovascular renal artery revascularization, balloon dilatation angioplasty and stent placement. Follow-up survey was made at regular intervals. The patent condition of the renal artery was evaluated with ultrasonography and digital subtraction angiography. The blood pressure and the renal function were determined and the data were statistically analyzed in order to assess the intermediate and long-term effect of the interventional therapy. Results: Of 16 patients, technical success was achieved in 15 (93.8%) and failure occurred in one. During a follow-up period of 9 - 24 months, 3 patients died. According to the data obtained at each patient's last follow-up survey, the hypertension fell to normal in 3 (25.0%), was improved in 7 (58.3%) and showed no marked change in 2 patients (16.7%), with a clinical efficacy of 83.3% (10 / 12). The renal function was improved in 2 (16.7%), stabilized in 6 (50%) and deteriorated in 4 patients (33.3%), with an effective rate of 66.7% (8 / 12). Conclusion: For the treatment of atherosclerotic renal artery occlusion, the interventional therapy carries high successful rate and can effectively lower the blood pressure level, in addition, it can also protect the renal function in a certain degree. (authors)

  3. Endovascular Management of Central Retinal Arterial Occlusion.

    Science.gov (United States)

    Agarwal, Nitin; Gala, Nihar B; Baumrind, Benjamin; Hansberry, David R; Thabet, Ahmad M; Gandhi, Chirag D; Prestigiacomo, Charles J

    2016-11-01

    Central retinal artery occlusion (CRAO) is an ophthalmologic emergency due to the sudden cessation of circulation to the inner retinal layer. Without immediate treatment, permanent blindness may ensue. Several treatment options exist, ranging from noninvasive medical management to thrombolysis. Nonetheless, ongoing debate exists regarding the best therapeutic strategy. The authors present the case of a 78-year-old woman with a medical history of hypercholesterolemia and rheumatoid arthritis who experienced complete loss of vision in her left eye. Following ophthalmologic evaluation demonstrating left CRAO, anterior chamber paracentesis was performed. Endovascular intervention was performed via local intra-arterial fibrinolysis with alteplase. Her vision returned to 20/20 following the procedure. In general, conventional therapies have not significantly improved patient outcomes. Several management options exist for CRAO. In general, conservative measures have not been reported to yield better patient outcomes as compared to the natural history of this medical emergency. Endovascular approaches are another option as observed with this case reported. In cases of CRAO, therapeutic strategies such as intra-arterial fibrinolysis utilize a local infusion of reactive tissue plasminogen activator directly at the site of occlusion via catheterization of the ophthalmic artery. Although several case series do show promising results after treating CRAO with intra-arterial fibrinolysis, further studies are required given the reports of complications.

  4. Vasectomy occlusion techniques for male sterilization.

    Science.gov (United States)

    Cook, Lynley A; Van Vliet, Huib A A M; Lopez, Laureen M; Pun, Asha; Gallo, Maria F

    2014-03-30

    Vasectomy is an increasingly popular and effective family planning method. A variety of vasectomy techniques are used worldwide, including vas occlusion techniques (excision and ligation, thermal or electrocautery, and mechanical and chemical occlusion methods), as well as vasectomy with vas irrigation or with fascial interposition. Vasectomy guidelines largely rely on information from observational studies. Ideally, the choice of vasectomy techniques should be based on the evidence from randomized controlled trials (RCTs). The objective of this review was to compare the effectiveness, safety, acceptability and costs of vasectomy techniques for male sterilization. In February 2014, we updated the searches of CENTRAL, MEDLINE, POPLINE and LILACS. We looked for recent clinical trials in ClinicalTrials.gov and the International Clinical Trials Registry Platform. Previous searches also included EMBASE. For the initial review, we searched the reference lists of relevant articles and book chapters. We included RCTs comparing vasectomy techniques, which could include suture ligature, surgical clips, thermal or electrocautery, chemical occlusion, vas plugs, vas excision, open-ended vas, fascial interposition, or vas irrigation. We assessed all titles and abstracts located in the literature searches. Two reviewers independently extracted data from articles identified for inclusion. Outcome measures include contraceptive efficacy, safety, discontinuation, and acceptability. Peto odds ratios (OR) with 95% confidence intervals (CI) were used for dichotomous outcomes, such as azoospermia. The mean difference (MD) was used for the continuous variable of operating time. Six studies met the inclusion criteria. One trial compared vas occlusion with clips versus a conventional vasectomy technique. No difference was found in failure to reach azoospermia (no sperm detected). Three trials examined vasectomy with vas irrigation. Two studies looked at irrigation with water versus no

  5. Influence of denture adhesives on occlusion and disocclusion times.

    Science.gov (United States)

    Abdelnabi, Mohamed Hussein; Swelem, Amal Ali; Al-Dharrab, Ayman A

    2016-03-01

    The effectiveness of adhesives in enhancing several functional aspects of complete denture performance has been well established. The direct influence of adhesives on occlusal contact simultaneity has not yet been investigated. The purpose of this crossover clinical trial was to evaluate quantitatively the influence of adhesives on occlusal balance by recording timed occlusal contacts; namely occlusion time (OT) and disocclusion time during right (DT-right) and left (DT-left) excursions by using computerized occlusal analysis. A crossover clinical trial was adopted. Assessments were carried out while participants (n=49) wore their dentures first without then with adhesives. Computerized occlusal analysis using the T-Scan III system was conducted to perform baseline computer-guided occlusal adjustment for conventionally fabricated dentures. Retention and stability assessment using the modified Kapur index and recording of OT and DT-right and DT-left values using the T-Scan III were subsequently carried out for all dentures, first without adhesives and then after application of adhesive. All T-Scan procedures were carried out by the same clinician. Wilcoxon signed-rank test was used to analyze the Kapur index scores and occlusal parameters (α=.05). Stability and retention of conventional dentures ranged initially from good to very good. However, adhesive application resulted in significant improvement (Pstability and retention and a significant decrease in duration of all occlusal parameters (OT [P=.003], DT-right [P=.003], and DT-left [P=.008]). Adhesives significantly decreased OT and DT durations in initially well-fitting complete dentures with fairly well balanced occlusion, and further enhanced denture stability and occlusal contact simultaneity. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  6. Prevalence of stenoses and occlusions of brain-supplying arteries in young stroke patients.

    LENUS (Irish Health Repository)

    von Sarnowski, Bettina

    2013-03-06

    OBJECTIVE: Atherosclerosis is believed to be a minor cause of TIA and stroke in younger and middle-aged patients. However, data from large cohorts are limited. This study investigates the prevalence of extracranial and intracranial atherosclerosis in stroke and TIA patients aged 18-55 years in the multinational sifap1 study. METHODS: From the sifap1 cohort (n = 5,023), we analyzed a subset of patients with complete data from carotid ultrasound studies. Patients with arterial dissections, vasculitis, and mobile thrombi were excluded. Among the remaining 2,187 patients (men: n = 1,319; 18-44 years: n = 744), intracranial arteries were additionally examined with ultrasonography in 1,612 patients (73.7%). Patients were stratified by sex and age groups (younger: 18-44 years; middle-aged: 45-55 years). RESULTS: In patients with ischemic stroke, the overall prevalence of carotid artery stenoses and occlusions was 8.9% (younger: 4.9%; middle-aged: 11.0%), of which 81% were symptomatic. Nonstenotic carotid plaques were more common in men than in women (15.8% vs 7.7%; p < 0.001), and in middle-aged than in younger patients (17.0% vs 4.9%; p < 0.001). Supratentorial intracranial artery stenoses and occlusions amounted to 11.8%. Supratentorial stenoses occurred more frequently in middle-aged patients (13.0% vs 7.8%; p < 0.001), whereas occlusions were equally common (both 3.2%; not significant). CONCLUSIONS: We observed a substantial proportion of atherosclerotic carotid artery stenoses and occlusions in younger stroke patients. Intracranial stenoses and occlusions were even more prevalent than extracranial carotid artery disease. Together with nonstenotic plaques, one-fifth of patients (21.2%) had symptomatic or asymptomatic large-artery atherosclerosis, which should encourage future stroke prevention campaigns to target risk factor modification in young people.

  7. Re-entry devices in the treatment of peripheral chronic occlusions.

    Science.gov (United States)

    Smith, Marcus; Pappy, Reji; Hennebry, Thomas A

    2011-01-01

    Chronic occlusions are present in up to 40% of patients who undergo treatment for symptomatic peripheral arterial disease. The primary difficulty encountered during the treatment of chronic occlusions is inability to re-enter the true lumen after subintimal crossing of the occlusion. Two devices have been designed to mitigate this limitation via controlled re-entry. Herein, we report our experience with the Outback LTD catheter and the Pioneer Plus Catheter PPlus 120 in re-entering the true arterial lumen during percutaneous intentional extraluminal revascularization for peripheral chronic occlusions involving the superficial femoral artery. In reviewing our peripheral interventions performed from February 2006 through February 2009, we evaluated angiograms, patients' characteristics, presentations, types of lesions, procedural successes, complications, and symptom-free intervals. The total study population consisted of 23 patients. The Outback catheter was used in 15 patients and the Pioneer catheter in 8 patients.The procedure was successful in all 8 Pioneer cases (100%) and in 13 of the 15 Outback cases (87%). All 8 (100%) of the patients in the Pioneer group and 12 of the 14 patients in the Outback group (86%) remained asymptomatic at an average of 12 months. Overall, there were no procedural complications, amputations, or deaths. This single-center experience demonstrates that the Outback and Pioneer re-entry catheters are safe and effective in managing peripheral chronic occlusions, with an average symptom-free interval of 12 months. This management strategy proves to be reasonable when standard techniques fail to achieve true lumen re-entry.

  8. Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up

    Directory of Open Access Journals (Sweden)

    Paweł Latacz

    2017-03-01

    Full Text Available Introduction: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. Aim : To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. Material and methods: This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomatic, and 211 in symptomatic individuals. Stenting procedures were performed using a technique and armamentarium which were tailored to the type and anatomy of lesions. Results : There were 6 (1.5% strokes, including 2 (0.5% major strokes, 1 ipsi- and 1 contralateral, and 4 (1.0% minor strokes. In asymptomatic patients there was 1 (0.3% minor stroke. Transient ischemic attacks occurred in 5 (1.2% patients. There were 2 (0.5% non-STEMI myocardial infarctions and 2 (0.5% non-stroke related fatalities. Risk factors of these adverse events were diabetes mellitus, lesions localized in a tortuous segment of the artery, embolic material in the filter and bilateral stenoses of carotid arteries. Additional risk factors in asymptomatic patients were renal impairment and advanced coronary artery disease; and in symptomatic patients, grade 3 arterial hypertension, dislipidemia, cigarette smoking and lesions requiring predilatation. Conclusions : Stenting procedures of extracranial arteries supplying the brain, which are tailored to the type and anatomy of lesions, seem to be relatively safe.

  9. Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

    International Nuclear Information System (INIS)

    Gonsalves, Carin F.; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph

    2003-01-01

    The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices

  10. Vascular occlusion in cut rose flowers - a survey

    NARCIS (Netherlands)

    Doorn, van W.G.

    1995-01-01

    The causes of low water uptake and water stress symptoms in cut rose flowers are briefly reviewed. Low water uptake is due to an occlusion, mainly located in the basal stem end. No evidence has been found for a reaction of the plant after cutting, in the formation of this occlusion. The blockage has

  11. Occlusal Therapy in the Management of Chronic Orofacial Pain

    OpenAIRE

    Bush, Francis M.

    1984-01-01

    Review of the literature indicates that most routine orofacial dysfunctions are characterized by deep pain. Various disorders of the masticatory systems, particularly musculoskeletal conditions, are thought to be triggered by occlusal disharmonies. The pain component develops following a pattern of bruxism, muscle hyperactivity, fatigue and spasm. Treatment for most disorders has been to modify the occlusion, although the rational for doing so appears questionable.

  12. Punctal occlusion with Prolene suture material in the patients with ...

    African Journals Online (AJOL)

    Aim: To analyze the efficacy and outcomes of punctal occlusion with 5-0 Prolene suture material for the treatment of dry eye. Materials and. Methods: A total of 20 patients with moderate and severe dry eyes, recalcitrant to maximal medical therapy, underwent temporary punctal occlusion with 5-0 Prolene suture material.

  13. Mesiodistal tooth angulation to segmental occlusal plane in panoramic radiography

    International Nuclear Information System (INIS)

    Kim, Jae Duk; Kim, Jin Soo; You, Choong Hyun

    2005-01-01

    To evaluate the stability of the segmental occlusal plane and anatomical line as the reference line for measuring the mesiodistal tooth angulation in panoramic radiography and to determine the mean angle and the range of the mesiodistal tooth angulation in Korean population with normal occlusions. Twenty nine subjects (15 men, 14 women) with normal occlusion were selected. A total of 29 panoramic radiograms were taken at normal head position and then 10 images of 5 subjects selected were repeatedly taken with repositioning 2 times at each of the head down (V-shaped occlusion) and up (horizontal occulsion) for evaluation of stability of adopted reference lines by using PM2002CC (Planmeca, Finland). The images were traced with adoption of two test reference lines and the long axes of the teeth. The mesial angles formed by each reference line and the long axes of the teeth were measured and analyzed. With anatomical reference line, the mesiodistal tooth angulations of the molars showed the significant difference by over 5 degree between the normal and each changed head position. With segmented occlusal reference line, deviations of mesiodistal tooth angulations by the two changed head positions were less than 1 degree. The means, standard deviations, and maximum and minimum values of mesiodistal tooth angulations to segmental occlusal reference line on panoramic radiography were determined. It would appear that mesiodistal tooth angulations to segmental occlusal plane as reference line in panograms are predictable as standards of normal occlusion and useful for evaluation of tooth arrangement between adjacent teeth.

  14. Mesiodistal tooth angulation to segmental occlusal plane in panoramic radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk; Kim, Jin Soo; You, Choong Hyun [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    2005-03-15

    To evaluate the stability of the segmental occlusal plane and anatomical line as the reference line for measuring the mesiodistal tooth angulation in panoramic radiography and to determine the mean angle and the range of the mesiodistal tooth angulation in Korean population with normal occlusions. Twenty nine subjects (15 men, 14 women) with normal occlusion were selected. A total of 29 panoramic radiograms were taken at normal head position and then 10 images of 5 subjects selected were repeatedly taken with repositioning 2 times at each of the head down (V-shaped occlusion) and up (horizontal occulsion) for evaluation of stability of adopted reference lines by using PM2002CC (Planmeca, Finland). The images were traced with adoption of two test reference lines and the long axes of the teeth. The mesial angles formed by each reference line and the long axes of the teeth were measured and analyzed. With anatomical reference line, the mesiodistal tooth angulations of the molars showed the significant difference by over 5 degree between the normal and each changed head position. With segmented occlusal reference line, deviations of mesiodistal tooth angulations by the two changed head positions were less than 1 degree. The means, standard deviations, and maximum and minimum values of mesiodistal tooth angulations to segmental occlusal reference line on panoramic radiography were determined. It would appear that mesiodistal tooth angulations to segmental occlusal plane as reference line in panograms are predictable as standards of normal occlusion and useful for evaluation of tooth arrangement between adjacent teeth.

  15. An Investigation of the Posterior Component of Occlusal Force

    Science.gov (United States)

    1994-05-01

    the dental arch across the midline and examined mandibula deformation in subjects with osseointegrated implants . The authors found that, with maximum...the 58 tongue and cheek musculature. Future studies may consider examining interdental forces between a natural dentition and osseointegrated implants ... dental occlusion forces, and 4. periodontal membrane forces. A stable occlusion would purportedly result when balance in terms of the magnitude

  16. Vertical dimension of occlusion in implant dentistry: significance and approach.

    Science.gov (United States)

    Gittelson, Glenn L

    2002-01-01

    Understanding the principles of occlusion as they relate to managing bite forces on implants is extremely important to maintain the longevity of dental implant prostheses. Specifically, altering vertical dimension of occlusion (VDO) scientifically and predictably is critical to the creation of proper tooth form and guidance when fabricating a full-arch implant-supported prosthesis.

  17. A novel experimental design model for increasing occlusal vertical dimension.

    Science.gov (United States)

    Li, Yan; Zhang, Zhiguang; Wu, Shuyi; Qiao, Yonggang

    2010-03-01

    This study aimed to establish a rat model of increasing occlusal vertical dimension (iOVD) using a prosthodontic approach. The OVD was increased by bonding a maxillary, bilateral, posterior dental splint with a bearing ball while the occlusal stops that were made on the stone casts adjusted the occlusion and bonded in the mouths of adult Wistar rats (iOVD group); the controls did not receive a splint. Both groups were subdivided after splint insertion: 3 days and 1, 2, 3, or 4 weeks (n = 6/subgroup). The effects of iOVD were evaluated by radiographs, body weight, and histologic diagnosis of tooth and temporomandibular joints. There were no differences in body weights between the 2 groups; occlusal asymmetric dentition abrasions did not occur in the iOVD rats. The occlusal splints caused the remodeling of the periodontal tissue and condylar cartilage. Overall, an iOVD rat model can be constructed using prosthodontic techniques ensuring a balance of bilateral occlusal height. OVD, occlusal vertical dimension; iOVD, increasing occlusal vertical dimension; TMJ, temporomandibular joint; TMD, temporomandibular disorders.

  18. Immediate occlusal versus non-occlusal loading of single zirconia implants. A multicentre pragmatic randomised clinical trial.

    Science.gov (United States)

    Cannizzaro, Gioacchino; Torchio, Cinzia; Felice, Pietro; Leone, Michele; Esposito, Marco

    2010-01-01

    To evaluate whether immediate non-occlusal loading of single zirconia implants could reduce early failures when compared to immediate occlusal loading. Forty partially edentulous patients who received one single zirconia implant (Z-Systems) at least 10 mm long and 3.25 mm wide inserted with a torque of at least 35 Ncm were randomised to immediate occlusal or non-occlusal loading groups. All patients received provisional acrylic crowns the same day of implant placement. Provisional crowns were replaced after 4 to 5 months by definitive full ceramic crowns. Outcome measures were implant success, any complications and peri-implant marginal bone levels. One year after loading, no patients had dropped out. Five implants (12.5%) failed early: three occlusally loaded and two non-occlusally loaded. Three complications occurred, all after delivery of the definitive crowns: one crown fractured (occlusal loading), one had to be remade after debridement because of hyperplastic tissues (occlusal loading), and one crown decemented (nonocclusal loading). These differences were not statistically significant. Both groups gradually lost periimplant bone in a highly statistically significant way. One year after loading, patients subjected to non-occlusal loading lost an average of 0.7 mm of peri-implant bone versus 0.9 mm in the occlusal group. This difference in bone loss between groups was not statistically significant. There was an association between immediate post-extractive implants and implant failures (P=0.01). Four of the 10 immediate post-extractive implants (40%) failed versus one out of 30 delayed implants (3%). The results of this study do not provide a conclusive answer to whether immediate non-occlusal loading may decrease implant failures. Immediately loaded zirconia implants placed in post-extractive sites had high failure rates.

  19. Occlusal tooth wear in patients of a dental school's prosthodontic department in Xi'an, China

    NARCIS (Netherlands)

    Meng, M.; Zhang, Q.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.; Ma, C.; Zhang, S.

    2014-01-01

    PURPOSE: To assess the relationships between occlusal tooth wear and occlusal conditions, chewing side preference, and occlusal guidance scheme. MATERIALS AND METHODS: A total of 257 Chinese adult dental school patients were categorized according to a hierarchical functional classification system.

  20. [Single- and multi-unit fixed dental prostheses in relation to the occlusal system

    NARCIS (Netherlands)

    Witter, D.J.; Gerritsen, A.E.; Spijker, A. van 't; Creugers, N.H.J.

    2013-01-01

    Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are

  1. Collateral Circulation in Chronic Total Occlusions - An Interventional Perspective

    Science.gov (United States)

    Choo, Gim-Hooi

    2015-01-01

    Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to the myocardial segment at risk. This mitigates the ischemic injury. Clinical outcome of coronary occlusion ie. severity of myocardial infarction/ischemia, impairment of cardiac function and possibly survival depends not only on the acuity of the occlusion, extent of jeopardized myocardium, duration of ischemia but also to the adequacy of collateral circulation. Adequacy of collateral circulation can be assessed by various methods. These coronary collateral channels have been used successfully as a retrograde access route for percutaneous recanalization of chronic total occlusions. Factors that promote angiogenesis and further collateral remodeling ie. arteriogenesis have been identified. Promotion of collateral growth as a therapeutic target in patients with no suitable revascularization option is an exciting proposal.

  2. Collateral Circulation in Chronic Total Occlusions - an interventional perspective.

    Science.gov (United States)

    Choo, Gim-Hooi

    2015-09-09

    Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to the myocardial segment at risk. This mitigates the ischemic injury. Clinical outcome of coronary occlusion ie. severity of myocardial infarction/ischemia, impairment of cardiac function and possibly survival depends not only on the acuity of the occlusion, extent of jeopardized myocardium, duration of ischemia but also to the adequacy of collateral circulation. Adequacy of collateral circulation can be assessed by various methods. These coronary collateral channels have been used successfully as a retrograde access route for percutaneous recanalization of chronic total occlusions. Factors that promote angiogenesis and further collateral remodeling ie. arteriogenesis have been identified. Promotion of collateral growth as a therapeutic target in patients with no suitable revascularization option is an exciting proposal.

  3. Structural equation modeling for alteration of occlusal plane inclination.

    Science.gov (United States)

    Shigeta, Yuko; Ogawa, Takumi; Nakamura, Yoshiharu; Ando, Eriko; Hirabayashi, Rio; Ikawa, Tomoko

    2015-07-01

    Occlusal plane inclination is important to maintain a normal opening closing/biting function. However, there can be several causes that lead to alterations of the occlusal plane. The purpose of this study was to observe variations of occlusal plane inclination in adult patients, and to uncover the factors affecting changes in occlusal plane inclination with aging. Subjects were 143 patients. A cephalometric image was taken of these patients. In this study, our inquiry points were age, 3 variables on intra-oral findings, and 7 variables on cephalometric analysis. To evaluate the possible causes that affect occlusal plane inclination, factor analysis was carried out, and each component was treated as factors, which were then statistically applied to a structural equation model. Statistical analysis was carried out through the SPSS 20.0 (SPSS Inc., Chicago, USA). In all patients, Camper-occlusal plane angle (COA) ranged from -25.7 to -4.9° (Mean±SD: -6.4±5.36). In the 60 patients who had no missing teeth, COA ranged from -11.6 to -4.9° (Mean±SD: -3.3±3.31). From the results of the structural analysis, it was suggested that the occlusal plane changes to counter-clockwise (on the right lateral cephalograms) with aging. In this study, variations of occlusal plane inclination in adult patients were observed, and the factors affecting changes in occlusal plane inclination with aging were investigated via factor analysis. From our results, it was suggested that the mandibular morphology change and loss of teeth with aging influence occlusal plane inclination. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  4. [Gnathosonics study of the occlusal stability of orthodontic patients].

    Science.gov (United States)

    Jiang, Ruo-Ping; Tyson, Kenneth W

    2008-02-18

    To analysis the stability of the occlusion before and after the orthodontic treatment by gnathosonics; To evaluate the reliability of the stethoscope method by comparing the subjective(stethoscopy) and objective(digital occlusal sound recording) methods of checking the occlusal sound. Sixty-four new patients with malocclusion were selected as the before treatment group, these patients were not subject to any previous orthodontic treatment, facial surgery or injury; the treatment complete group included 15 patients who were just debonded the fixed appliance. Both stethoscope and digital occlusal sound recording were used to evaluate the occlusal sound. The occlusal stability before and after orthodontic treatment was compared depending on the results from the objective examination. The stability of the occlusion between different types of malocclusion before treatment was compared also. The veracity and reliability of the stethoscope method were analysis using the objective method as the golden standard. (1) 43.75%(28/64) of the 64 new patients showed unstable occlusal sound. ANOVA test showed that there were no statistically significant differences between the unstable rates in different type of malocclusion. (2) 40% (6/15) of the 15 treatment complete patients had unstable occlusions. (3) There were no statistically significant differences between the unstable rate pre- and post-treatment. (4) The veracity of the stethoscopes was 81.01% (64/79). (5) Kappa test showed that the stethoscopes and the digital recording method were consistent; the Kappa value was 0.488, Pocclusion rate between the two groups, and between the different types of malocclusion before treatment. (2) Using stethoscopes method to check the occlusal sound is reliable. The veracity could be improved significantly with increased experiences.

  5. Post partum occlusion of the hepatic artery

    International Nuclear Information System (INIS)

    Buecheler, E.; Hagemann, J.; Remmecke, J.; Hamburg Univ.

    1980-01-01

    A case of post partum acute thrombosis of the hepatic artery with infarction of the liver is reported. The prognosis depends on the areas of obstruction, on the early development of a collateral circulation and on the contribution to the blood supply from the portal vein. The diagnosis of liver infarction was made by computed tomography. This was characterised by sharply demarkated hypodense areas, which did not enhance with contrast. An important clue is the lack of increase in density in the liver after intravenous injection of contrast when compared with the increased contrast of the spleen. This finding provided the indication for angiography. This confirmed the diagnosis of acute occlusion and made appropriate treatment possible. (orig.) [de

  6. STUDY OF THE DISTANCE BETWEEN LINGULA AND MANDIBULAR OCCLUSAL PLANE IN IRANIAN MALES WITH NORMAL OCCLUSION

    Directory of Open Access Journals (Sweden)

    M GHOREYSHIAN

    2002-09-01

    Full Text Available Introduction. Pain and the need for controlling it is a determinant factor in dental treatment procedures. One of the most common methods of local anesthesia in mandibular area is infra alveolar nerve block which has failure rate of 5% to 15%. The purpose of this study was to locate the optimal needle entrance point in order to achieve a fast, deep and durable anesthesia with minimal anesthetic consumption. Methods. This cross-sectional study has been performed on 38 cadavers of Iranian males with approximate age of more than 17 years. old. They had normal occlusion and at least 2 molars in each quadrant of the mandible if a sample was edentulous in one quadrant of the mandible or in the opposite jaw; or when a severe tilt in mandi bular dentition was present and in the case of mandibular or condylar fracture, the sample was excluded from the study. Distance between lingual and occlusal plane was measured by a device with two parallel plates. The precision of the measurment was 1mm. Data was analysed by the use of SPSS software. Results. On the right side, the average distance between lingual and occlusal plane was 2.4 ± 4.4 (Mean ± SD and on the left side, was 2:r.4.4 which there was no significant difference between right and left sides (P value=0.9. Discussion. In this study the human body is used and the best point for entrance of the needle for inferior alveolar nerve block technique is located at 8mm above the occlusal plane. At this point the anesthetic solution will be evacuated in the nearest position to the inferior alveolar never.

  7. Role of Transthoracic Echocardiography in the Evaluation of Patients with Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    Afsoon Fazlinezhad

    2014-02-01

    Full Text Available Introduction: Retinal vein occlusion  is a common vascular disorder disrupting vision. Two basic types of RVO are branch retinal vein occlusion and central retinal vein occlusion (CRVO.  Retinal vein occlusion is a multifactor process including systemic illness and local retinal factors.RVO may be associated with atherosclerotic risk factors. We analyzed the role of 2 dimensional transthoracic echocardiography (TTE for detecting the cardiac disease in patients with retinal veins occlusion. Materials and Methods:In this cross-sectional study 70 recently diagnosed patients with RVO enrolled in the study. The clinical diagnosis of retinal vein occlusion and its type was confirmed by a vitreoretinal specialist. The Patients were then referred for performing complete TTE. Results: The prevalence of RVO increased with age, but did not vary by sex. The most frequent cardiovascular risk factor was hypertension. The findings of our study revealed that a variety of echocardiographic abnormalities may be presented in patients with RVO. Diastolic dysfunction was the most frequent echocardiographic finding and we found positive correlation between diastolic dysfunction with increasing age and the presence of hypertension. Other findings included mitral regurgitation (52.9%, mitral stenosis (2.9%, mitral annulus calcification (1.4%, mitral valve prolapse (8.6%, aortic insufficiency (22.9%, sclerotic aortic valve (27.1%, tricuspid regurgitation (45.7%, pulmonary insufficiency (8.6%, mild pulmonary hypertension (8.6%, and moderate to severe pulmonary hypertension (4.3% Mild LVH (11.4%, Moderate LVH (8.6%. Abnormality on IAS was defined in these patients, including paten foramen ovale, lipomatosis IAS, exaggerated motion of IAS, and aneurysm of IAS. Conclusion: In our study, the most common echocardiographic finding was diastolic dysfunction which was compatible with the patients' age and the fact that the most prevalent risk factor was hypertension. Other

  8. [A case of occlusal support reconstruction with modification of occlusal plane by fixed prosthetic restoration including dental implant].

    Science.gov (United States)

    Moriwaki, Yoshihiro

    2006-04-01

    A 54-year-old female patient visited our dental office July 1997. The patient's chief complaint was difficulty of chewing due to loss of the right mandibular molars. She had a collapsed occlusal plane with loss extended over a long period of time. This case report describes restoration of the occlusal plane and occlusal supporting area by fixed prosthesis including implant-supported crowns. Anterior guidance and provisional restoration are useful for reconstruction of the occlusal plane. In a dental arch with implant-supported and tooth-supported crowns, periodical dental checkup and occlusal equilibration are very important due to the existence of biomechanically different factors. The patient was very satisfied with the fixed prosthesis including implant-supported crowns. It is thought that implant treatment improves the quality of life of free-end partially edentulous patients.

  9. Embolic intracranial arterial occlusion visualized by non-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Masaaki; Minematsu, Kazuo; Choki, Junichiro; Yamaguchi, Takenori (National Cardiovascular Center, Suita, Osaka (Japan))

    1984-12-01

    A 77-year-old woman with a history of valvular heart disease, atrial fibrillation and a massive infarction in the right cerebral hemisphere developed contralateral infarction due to occlusion of the internal carotid artery. A string-like structure with higher density than normal brain was demonstrated on non-enhanced computed tomography that was performed in the acute stage. This abnormal structure seen in the left hemisphere was thought to be consistent with the middle cerebral artery trunk of the affected side. Seventeen days after the onset, the abnormal structure was no more visualized on non-enhanced CT. These findings suggested that the abnormal structure with increased density was compatible with thromboembolus or intraluminal clot formed in the distal part of the occluded internal carotid artery. The importance of this finding as a diagnostic sign of the cerebral arterial occlusion was discussed.

  10. Influence of the quality of the finished occlusion on postretention occlusal relapse.

    Science.gov (United States)

    de Freitas, Karina Maria Salvatore; Janson, Guilherme; de Freitas, Marcos Roberto; Pinzan, Arnaldo; Henriques, José Fernando Castanha; Pinzan-Vercelino, Célia Regina Maio

    2007-10-01

    In this study, we aimed to evaluate the influence of the quality of the finished occlusion on postretention occlusal stability. The sample comprised 87 patients with Class I malocclusion, treated with extraction of the 4 first premolars and edgewise mechanics; they were divided into 2 groups, according to the quality of their finished occlusions. Group 1 included 44 subjects (23 boys, 21 girls) with posttreatment peer assessment rating (PAR) scores from 0 to 5. The mean pretreatment age was 13.74 years (SD 2.14). The mean treatment time was 1.92 years (SD 0.57), the mean retention time was 1.75 years (SD 0.96), and the mean time of posttreatment evaluation was 5.17 years (SD 1.82). Group 2 included 43 subjects (22 boys, 21 girls) with posttreatment PAR scores greater than 5. The mean initial age was 13.34 years (SD 1.35). The mean treatment time was 2.20 years (SD 0.66), the mean retention time was 1.77 years (SD 0.78), and the mean posttreatment evaluation was 5.47 years (SD 1.60). The PAR and the Little irregularity indexes were measured on the dental casts at pretreatment, posttreatment, and postretention. Intergroup comparisons were made with independent t tests, and the Pearson correlation coefficient was applied to the PAR score for the whole sample at the times evaluated. Well-finished patients had lower posttreatment and postretention PAR scores and greater changes during the treatment and posttreatment periods than did the poorly finished patients. For the Little irregularity index, the only difference between the groups was at the posttreatment stage; group 1 had a smaller irregularity score than group 2. The correlation coefficients showed that the greater the treatment changes, the smaller the posttreatment PAR score and the greater the relapse. But the higher the posttreatment PAR score, the higher the postretention PAR score. It was concluded that the greater the quality of the orthodontic finished occlusion, the greater are the treatment changes and

  11. Hypotensive endovascular test occlusion of the carotid artery in head and neck cancer.

    Science.gov (United States)

    Dare, Amos O; Gibbons, Kevin J; Gillihan, Matthew D; Guterman, Lee R; Loree, Thom R; Hicks, Wesley L

    2003-03-15

    To evaluate the reliability of balloon test occlusion with hypotensive challenge (BTO and HC) as a predictor of neurological complications before internal carotid artery (ICA) sacrifice in patients with advanced head and neck cancer, the authors retrospectively reviewed the medical records of patients presenting to their institutions between 1992 and 1997 in whom this preoperative assessment was performed. Eleven patents who were candidates for extended comprehensive neck dissection (ECND) and potential ICA sacrifice were included in the study. Eight patients tolerated the test and underwent endovascular occlusion or surgical ligation of the ICA before ECND (four patients), preservation of the ICA at the time of surgery (three patients), or palliative therapy (one patient). Of three patients in whom BTO and HC failed, one patient received palliative treatment only; the other two underwent ECND with preservation of the ICA. In the group of patients who passed the test and underwent ICA occlusion or ligation before ECND, fatal thromboembolic stroke occurred within 24 hours of permanent balloon occlusion in one patient, resulting in a combined neurological morbidity/mortality rate of 25% in this subset of patients and an overall complication rate of 9% in this series. The authors found that BTO and HC offers a simple and reliable method of preoperative risk assessment when ICA resection is planned for regional control of disease in advanced head and neck cancer. This management option, however, is associated with a potential for neurological complication that must be weighed against the natural course of the disease and the risks and benefits of other treatment modalities.

  12. Modeling self-occlusions in dynamic shape and appearance tracking

    KAUST Repository

    Yang, Yanchao

    2013-12-01

    We present a method to track the precise shape of a dynamic object in video. Joint dynamic shape and appearance models, in which a template of the object is propagated to match the object shape and radiance in the next frame, are advantageous over methods employing global image statistics in cases of complex object radiance and cluttered background. In cases of complex 3D object motion and relative viewpoint change, self-occlusions and disocclusions of the object are prominent, and current methods employing joint shape and appearance models are unable to accurately adapt to new shape and appearance information, leading to inaccurate shape detection. In this work, we model self-occlusions and dis-occlusions in a joint shape and appearance tracking framework. Experiments on video exhibiting occlusion/dis-occlusion, complex radiance and background show that occlusion/dis-occlusion modeling leads to superior shape accuracy compared to recent methods employing joint shape/appearance models or employing global statistics. © 2013 IEEE.

  13. Object tracking by occlusion detection via structured sparse learning

    KAUST Repository

    Zhang, Tianzhu

    2013-06-01

    Sparse representation based methods have recently drawn much attention in visual tracking due to good performance against illumination variation and occlusion. They assume the errors caused by image variations can be modeled as pixel-wise sparse. However, in many practical scenarios these errors are not truly pixel-wise sparse but rather sparsely distributed in a structured way. In fact, pixels in error constitute contiguous regions within the object\\'s track. This is the case when significant occlusion occurs. To accommodate for non-sparse occlusion in a given frame, we assume that occlusion detected in previous frames can be propagated to the current one. This propagated information determines which pixels will contribute to the sparse representation of the current track. In other words, pixels that were detected as part of an occlusion in the previous frame will be removed from the target representation process. As such, this paper proposes a novel tracking algorithm that models and detects occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Experimental results show that our tracker consistently outperforms the state-of-the-art. © 2013 IEEE.

  14. Occlusion detection via structured sparse learning for robust object tracking

    KAUST Repository

    Zhang, Tianzhu

    2014-01-01

    Sparse representation based methods have recently drawn much attention in visual tracking due to good performance against illumination variation and occlusion. They assume the errors caused by image variations can be modeled as pixel-wise sparse. However, in many practical scenarios, these errors are not truly pixel-wise sparse but rather sparsely distributed in a structured way. In fact, pixels in error constitute contiguous regions within the object’s track. This is the case when significant occlusion occurs. To accommodate for nonsparse occlusion in a given frame, we assume that occlusion detected in previous frames can be propagated to the current one. This propagated information determines which pixels will contribute to the sparse representation of the current track. In other words, pixels that were detected as part of an occlusion in the previous frame will be removed from the target representation process. As such, this paper proposes a novel tracking algorithm that models and detects occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Extensive experimental results show that our proposed tracker consistently outperforms the state-of-the-art trackers.

  15. Genetics Home Reference: hepatic veno-occlusive disease with immunodeficiency

    Science.gov (United States)

    ... Immunodeficiencies Jeffrey Modell Foundation Resource list from the University of Kansas Medical Center: Immune Deficiency ... Sources for This Page Cliffe ST, Wong M, Taylor PJ, Ruga E, Wilcken B, Lindeman R, Buckley ...

  16. Genetics Home Reference: pulmonary veno-occlusive disease

    Science.gov (United States)

    ... and an accumulation of fluid in the lungs ( pulmonary edema ). Certain features commonly seen in people with PVOD can be identified using a test called a CT scan. One of these features, which is seen in the lungs of affected individuals, is an abnormality described as ...

  17. Peripheral occlusive vascular disease: Diagnostic performance of MRA and DSA

    International Nuclear Information System (INIS)

    Krug, B.; Kugel, H.; Harnischmacher, U.; Heindel, W.; Altenburg, A.; Fischbach, R.; Schmidt, R.

    1995-01-01

    In 59 patients with arterial flow disturbances 2-D inflow sequence of the abdominal and lower leg arteries were prospectively obtained on a 1.5 T MR-imager and were compared with additional DSA examinations. Supplementary Phase Contraste RSE ('Rapid Sequential Excitation') sequences were carried out in 29 patients. MRA and DSA angiograms were evaluated in random order by 4 readers using a questionnaire. The assessment of image quality were evaluated by variance analysis. Diagnostic performance of MRA and DSA was assessed by comparison of the readers' diagnostic assessments with reference diagnoses established by a radiologist and a vascular surgeon with full knowledge of all data concerning a patient. Image quality of inflow MRA was considered inferior to i.a. DSA (p [de

  18. Coil Occlusion of the Patent Ductus Arteriosus: Lessons Learned

    International Nuclear Information System (INIS)

    Sanatani, Shubhayan; Potts, James E.; Ryan, Angela; Sandor, George G.S.; Human, Derek G.; Culham, J.A. Gordon

    2000-01-01

    Purpose: To review the clinical outcomes of catheter-directed coil occlusion (coil occlusion) of persistently patent ductus arteriosus (PDA) at a pediatric tertiary care hospital.Methods: A retrospective review of all patients referred to the Cardiac Catheterization Laboratory for coil occlusion at our institution was performed. Twenty-one consecutive patients (12 female) underwent coil occlusion and follow-up between May 1995 and December 1997. We undertook PDA occlusion if: (a) the PDA narrowed to less than 4 mm on echocardiogram and (b) the minimum body weight was approximately 10 kg. Standard right and retrograde left heart catheterization was performed, followed by coil occlusion. Color-flow mapping (CFM) was used intra-procedurally to confirm occlusion of the PDA with a follow-up study several weeks later.Results: The median age and weight of the patients were 33 months and 13.2 kg, respectively. Fourteen patients received one coil, with six requiring a second coil and one requiring multiple coils. Initial follow-up was at a median of 2.4 months. At latest follow-up, 2 patients still have persistent flow at the ductal level. The coils were deployed without complication or embolization.Conclusions: A review of our first 21 cases demonstrated three important lessons: (1) the maximum diameter of the PDA suitable for coil occlusion is approximately 3 mm; (2) CFM must show complete obliteration of flow in the catheterization lab in order to ensure occlusion of the PDA at follow-up; and (3) the Jackson detachable system allows for precise placement of the coil, often within another coil

  19. Detection and tracking of moving objects under occlusion and shadow

    Science.gov (United States)

    Ming, Ying; Jiang, Jingjue

    2005-10-01

    This paper presents a system to detect and track multiple moving objects in the presence of mutual occlusion and shadow. A novel change detection algorithm based on Cauchy distribution is proposed. The ratio of pixel's intensities between two images is used as the feature to model and subtract background. The distribution of the ratio of background pixel's intensities between a current image and a reference image can obeys Cauchy distribution, assumed that some observed temporal intensity variation of each pixel in a background image is caused by white noise. By hypothesis testing whose decision thresholds are related to the false alarm rate, robust change detection can be carried out. We exploit spectral and geometrical properties of shadows to recognize and eliminate them in video sequences. Intensity, hue and saturation in the YCbCr color space is employed to this end. In order to solve ambiguity due to occlusion and recover from intermittent tracking failure, we propose a method to implement tracking of multiple moving objects. The method is based on multi-cue and dynamic templates matching in consecutive frames and motion estimation by Kalman filter. In our system, a fast accurate clustering algorithm based on k-nearest neighbor search is employed and the feature space is constructed by extracting the position, color, shape and velocity information of moving objects. In this paper, occlusions are addressed in two classes, i.e. static occlusion and dynamic occlusion. Depend on the prior knowledge of the background scene and the feedback from objects detection and tracking, the distribution of static occlusion region in the scene can be acquired and updated. The bounding box around a static occlusion region is used as an alarm sign to start the process of static occlusion. Dynamic occlusion event can be detected and processed in terms of the proposed tracking scheme and multi-cue and dynamic templates matching approach. Experiment results demonstrate that the

  20. Research progress of the diagnosis and treatment for retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Bin Wang

    2014-07-01

    Full Text Available Retinal vein occlusion( RVOis a common vascular disease of the retina and is one of the main reasons for blindness. In recent years,there have been some new understanding about the diagnosis and treatment of the disease,especially some new researches about treatment,for example,in the therapy of the intravitreal injection of triamcinolone acetonide and anti-VEGFs as well as dexamethasone implant(Ozurdex.This article will make a brief summarization of the progress about the diagnosis and treatment of RVO.

  1. Transcranial Doppler US as an alternative to angiography and balloon occlusion in estimating risk of carotid occlusion

    International Nuclear Information System (INIS)

    Feaster, S.H.; Powers, A.; Laws, E.R.

    1990-01-01

    This paper demonstrates the reliability of transcranial Doppler (TCD) US in the evaluation of the adequacy of collateral vessel cerebral blood flow in patients being considered for carotid ligation or occlusion. TCD was utilized in 12 patients in an attempt to study collateral vessel blood flow during endovascular balloon occlusion of a carotid artery. This was correlated with TCD measurements performed during manual carotid compression and with cerebral angiography. Changes of blood flow velocity were measured in the ipsilateral MCA and ACA. Excellent correlation was noted between the TCD measurements during manual carotid compression and actual endovascular balloon occlusion. There was also qualitative agreement with the cross-compression angiogram

  2. Preserving esthetics, occlusion and occlusal vertical dimension in a patient with fixed prostheses seeking dental implant treatment.

    Science.gov (United States)

    Al Baker, Abdulaziz; Habib, Syed Rashid; Al Amri, Mohammad D

    2016-10-01

    The preservation of esthetics and occlusal vertical dimension is critical in patients with existing full-arch tooth-retained fixed prostheses. This clinical report describes the provision of a maxillary immediate complete denture in a patient with a maxillary full-arch fixed dental prosthesis over nonviable teeth. The existing fixed dental prosthesis was used in the fabrication of the maxillary immediate complete denture to preserve esthetics. The technique involved recording and preservation of the occlusal vertical dimension and occlusion of the existing prosthesis. The technique is simple, quick, cost-effective and less challenging clinically and technically.

  3. Early experience of endovascular treatment of peripheral vascular disease

    International Nuclear Information System (INIS)

    Ashraf, T.; Yousuf, K.; Karim, M.T.

    2015-01-01

    Atherosclerotic peripheral arterial disease (PAD) is prevalent affecting up to 16% of the population aged 55 years or older. Endovascular intervention for the treatment of limb ischemia has become the first line therapy but in Pakistan it is in embryonic stage due to dearth of trained persons and dedicated centres. This study was conducted to evaluate procedural success and early outcome of endovascular treatment of peripheral vascular disease. Methods: A prospective single arm multicentre study was conducted at the National Institute of Cardiovascular Disease and National Medical Centre, Karachi, Pakistan from January 2013 to June 2014. A total of 25 patients were enrolled in the study that underwent endovascular treatment. Out of 25 patients 23 (92%) had critical limb ischemia (CLI) as per TASC II classification (A to D) and 2 (8%) had carotid lesion with history of TIA. Patients of acute limb ischemia and stroke were excluded. Ankle brachial index (ABI) was classified as normal (0.9-1.3), mild (0.7-0.9), moderate (0.4-0.69), severe (<0.4). Outcome was taken as immediate success and symptoms, amputation of limb among CLI patients and incidence of stroke in patients with carotid artery lesion at end of six months. Results: Among aortoiliac, femoropopliteal and tibioperoneal lesions, tibioperoneal lesions at six months were found to be more symptomatic 6 (86%) and amputation 4 (57%). Two carotid lesions at follow up were asymptomatic without stroke. Conclusion: Endovascular treatment of peripheral vascular lesions, i.e., aortoiliac, femoropopliteal tibioperoneal and carotid lesions were satisfactory in immediate outcome. Tibioperoneal lesions were more symptomatic and limb amputation at six months. (author)

  4. Fetal MRI in experimental tracheal occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Wedegaertner, Ulrike [Department of Diagnostic and Interventional Radiology, Universitaetsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg (Germany)]. E-mail: wedegaer@uke.uni-hamburg.de; Schroeder, Hobe J. [Experimental Gynecology, Department of Obstetrics and Prenatal Medicine, Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany); Adam, Gerhard [Department of Diagnostic and Interventional Radiology, Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany)

    2006-02-15

    Congenital diaphragmatic hernia (CDH) is associated with a high mortality, which is mainly due to pulmonary hypoplasia and secondary pulmonary hypertension. In severely affected fetuses, tracheal occlusion (TO) is performed prenatally to reverse pulmonary hypoplasia, because TO leads to accelerated lung growth. Prenatal imaging is important to identify fetuses with pulmonary hypoplasia, to diagnose high-risk fetuses who would benefit from TO, and to monitor the effect of TO after surgery. In fetal imaging, ultrasound (US) is the method of choice, because it is widely available, less expensive, and less time-consuming to perform than magnetic resonance imaging (MRI). However, there are some limitations for US in the evaluation of CDH fetuses. In those cases, MRI is helpful because of a better tissue contrast between liver and lung, which enables evaluation of liver herniation for the diagnosis of a high-risk fetus. MRI provides the ability to determine absolute lung volumes to detect lung hypoplasia. In fetal sheep with normal and hyperplastic lungs after TO, lung growth was assessed on the basis of cross-sectional US measurements, after initial lung volume determination by MRI. To monitor fetal lung growth after prenatal TO, both MRI and US seem to be useful methods.

  5. Serial dependence promotes object stability during occlusion

    Science.gov (United States)

    Liberman, Alina; Zhang, Kathy; Whitney, David

    2016-01-01

    Object identities somehow appear stable and continuous over time despite eye movements, disruptions in visibility, and constantly changing visual input. Recent results have demonstrated that the perception of orientation, numerosity, and facial identity is systematically biased (i.e., pulled) toward visual input from the recent past. The spatial region over which current orientations or face identities are pulled by previous orientations or identities, respectively, is known as the continuity field, which is temporally tuned over the past several seconds (Fischer & Whitney, 2014). This perceptual pull could contribute to the visual stability of objects over short time periods, but does it also address how perceptual stability occurs during visual discontinuities? Here, we tested whether the continuity field helps maintain perceived object identity during occlusion. Specifically, we found that the perception of an oriented Gabor that emerged from behind an occluder was significantly pulled toward the random (and unrelated) orientation of the Gabor that was seen entering the occluder. Importantly, this serial dependence was stronger for predictable, continuously moving trajectories, compared to unpredictable ones or static displacements. This result suggests that our visual system takes advantage of expectations about a stable world, helping to maintain perceived object continuity despite interrupted visibility. PMID:28006066

  6. Severity of Occlusal Disharmonies in Down Syndrome

    Directory of Open Access Journals (Sweden)

    Danielle Bauer

    2012-01-01

    Full Text Available Objective. To quantify the severity of malocclusion and dental esthetic problems in untreated Down syndrome (DS and untreated non-Down syndrome children age 8–14 years old using the PAR and ICON Indices. Materials and Methods. This retrospective study evaluated pretreatment study models, intraoral photographs, and panoramic radiographs of 30 Down syndrome and two groups of 30 non-Down syndrome patients (private practice and university clinic age 8–14 years. The models were scored via PAR and ICON Indices, and descriptive characteristics such as Angle classification, missing or impacted teeth, crossbites, open bites, and other dental anomalies were recorded. Results. The DS group had significantly greater PAR and ICON scores, as well as 10 times more missing teeth than the non-DS group. The DS group possessed predominantly Class III malocclusions, with the presence of both anterior and posterior crossbites in a majority of the patients. The non-DS group had mostly Class I or II malocclusion with markedly fewer missing teeth and crossbites. The DS group also had more severe malocclusions based upon occlusal traits such as open bite and type of malocclusion. Conclusion. The DS group had very severe malocclusions, while the control group from the university clinic had more severe malocclusions than a control group from a private practice.

  7. Mesiodistal angulation of the lateral teeth to the functional occlusal plane in normal occlusions

    Directory of Open Access Journals (Sweden)

    Hiroshi Ueda

    2016-01-01

    Full Text Available Introduction: Crowding is a malocclusion with irregularly positioned teeth caused by arch length discrepancy (ALD. Its incidence is high compared with the various malocclusions. In a previous study the crowns of the maxillary lateral teeth had erupted mesially in relation to the functional occlusal plane (FOP in patients with Angle Class I malocclusion and highly erupted canines, which had been uprighted by non-extraction orthodontic treatment, yet these results were based on only two cases evaluated by using plaster models. Therefore, the aim of this study was to assess the mesiodistal angulations of both maxillary and mandibular teeth relative to the FOP in normal occlusion by means of cephalograms and identifying the teeth axial factors contributing to the normal dentitions with the least ALD. Materials and Methods: Thirty Japanese young adult patients (6 males, 24 females with normal occlusion were selected to participate in this study; cephalograms were procured from each and the FOP was used as a reference plane for measuring the changes in the axial angulation along with other indicators of vertical growth. Results: Progressive mesial tipping of the maxillary lateral teeth was observed. First premolars tended to express this more than the second premolars but the tipping values were roughly 90° relative to the FOP on the first molars. Conclusion: The maxillary lateral teeth are more mesially angulated compared to the mandibular ones relative to the FOP. Furthermore, progressive mesial tipping of the maxillary lateral teeth was detected, of which axial angulations were significantly correlated to each other, in spite the mandibular premolars and molars being angulated in a similar fashion.

  8. Sickle cell disease : Pathogenesis and biomarkers

    NARCIS (Netherlands)

    Schimmel, M.

    2017-01-01

    Sickle cell disease (SCD) is a monogenetic disease wherein the haemoglobin complex of erythrocytes is affected, resulting in sickle haemoglobin. Sickle cell patients suffer from haemolytic anaemia, recurrent painful (micro)-vascular occlusions, secondary organ damage and early death. The

  9. Central Retinal Vein Occlusion AssociatedWith Sildenafil (Viagra

    Directory of Open Access Journals (Sweden)

    H C Obiudu

    2010-01-01

    Conclusion - Central retinal vein occlusion is a possible adverse effect of sildenafil use. Physicians should be vigilant while prescribing thismedication and avoid its use in patients with elevated intraocular pressure

  10. Avoiding occlusal derangement in facial fractures: An evidence based approach

    Directory of Open Access Journals (Sweden)

    Derick Mendonca

    2013-01-01

    Full Text Available Facial fractures with occlusal derangement describe any fracture which directly or indirectly affects the occlusal relationship. Such fractures include dento-alveolar fractures in the maxilla and mandible, midface fractures - Le fort I, II, III and mandible fractures of the symphysis, parasymphysis, body, angle, and condyle. In some of these fractures, the fracture line runs through the dento-alveolar component whereas in others the fracture line is remote from the occlusal plane nevertheless altering the occlusion. The complications that could ensue from the management of maxillofacial fractures are predominantly iatrogenic, and therefore can be avoided if adequate care is exercised by the operating surgeon. This paper does not emphasize on complications arising from any particular technique in the management of maxillofacial fractures but rather discusses complications in general, irrespective of the technique used.

  11. [Occlusal anomalies in the deciduous and mixed bites].

    Science.gov (United States)

    Legovic, M; Mady, L

    1998-01-01

    In 311 examines (177 boys and 134 girls) with primary dentition and 535 examinees (285 boys and 250 girls) with mixed dentition in Istria--Croatia, the frequency of orthodontic and occlusive anomalies in regard of space plane and premature extraction of c, m1 and m2 are investigated. The orthodontic anomalies are defected in 46.95%, premature loss in 11.25% and occlusive anomalies in 40.85% of examinees with primary dentition, while in mixed dentition the 58.69% of examinees have orthodontic anomaly, the 17.20% premature loss and the 48.97% of examinees have occlusal anomaly. In both phases of dentition the most frequent are occlusive anomalies in the following planes: sagittal, vertical and sagittal-vertical.

  12. Occlusal accommodation and mouthguards for prevention of orofacial trauma.

    LENUS (Irish Health Repository)

    Geary, Julian Lindsay

    2009-01-01

    The aim of this study was to investigate the effect of two types of occlusal accommodation on the arch separation in centric and eccentric arch positions and to assess the opposing tooth contacts in professionally made, thermoformed sports mouthguards.

  13. Image Based Solution to Occlusion Problem for Multiple Robots Navigation

    Directory of Open Access Journals (Sweden)

    Taj Mohammad Khan

    2012-04-01

    Full Text Available In machine vision, occlusions problem is always a challenging issue in image based mapping and navigation tasks. This paper presents a multiple view vision based algorithm for the development of occlusion-free map of the indoor environment. The map is assumed to be utilized by the mobile robots within the workspace. It has wide range of applications, including mobile robot path planning and navigation, access control in restricted areas, and surveillance systems. We used wall mounted fixed camera system. After intensity adjustment and background subtraction of the synchronously captured images, the image registration was performed. We applied our algorithm on the registered images to resolve the occlusion problem. This technique works well even in the existence of total occlusion for a longer period.

  14. Acute complications of percutaneous transluminal coronary angioplasty for total occlusion

    NARCIS (Netherlands)

    S. Plante (Sylvain); G-J. Laarman (GertJan); P.J. de Feyter (Pim); M. Samson; B.J.W.M. Rensing (Benno); V.A.W.M. Umans (Victor); H. Suryapranata (Harry); M.J.B.M. van den Brand (Marcel); P.W.J.C. Serruys (Patrick)

    1991-01-01

    markdownabstractAbstract The incidence of major complications after percutaneous coronary angioplasty (PTCA) of a totally occluded artery was assessed retrospectively. A total of 1649 PTCA procedures were analyzed. After exclusion of procedures for acute myocardial infarction or total occlusion

  15. Shape Recognition in Presence of Occlusion from Fourier Plane Processing

    Science.gov (United States)

    Pohit, Mausumi; Goel, Alpana

    2011-10-01

    A new technique for recognition of objects in presence of occlusion is presented in this paper. The Fourier spectrum of a partially occluded shape differs from that of the whole object shape thereby decreasing the 2D correlation between two images. The present method is based on 1D correlation of Fourier Spectrum slices taken from the 2D Fourier Transform of the reference and the test object. For small occlusion, some of the slices are affected depending on the nature of occlusion. Responses of the rest of the slices are unaffected. This study shows that this method not only identify the object in presence of occlusion but at the same time has good discrimination capability.

  16. Full Body Pose Estimation During Occlusion using Multiple Cameras

    DEFF Research Database (Denmark)

    Fihl, Preben; Cosar, Serhan

    Automatic estimation of the human pose enables many interesting applications and has therefore achieved much attention in recent years. One of the most successful approaches for estimating unconstrained poses has been the pictorial structures framework. However, occlusions between interacting...

  17. Amplatzer vascular plug for rapid vessel occlusion in interventional neuroradiology.

    Science.gov (United States)

    Banfield, Jillian C; Shankar, Jai Jai Shiva

    2016-02-01

    The purpose of this paper is to report different uses of endovascular Amplatzer vascular plug (AVP) treatment for rapid vessel occlusion in the field of interventional neuroradiology. We retrospectively reviewed our interventional neuroradiology database from November 2010 to July 2015 and found nine patients who were treated with endovascular AVP. AVP was used for rapid vessel occlusion of common carotid artery (1 patient), internal carotid artery (5 patients), vertebral artery (2 patients), and internal jugular vein (1 patient). A median of three AVPs were used with almost immediate occlusion and no thromboembolic complications. Use of AVP is feasible, safe, rapid, and potentially cost-effective method for rapid occlusion of larger size vessels in the head and neck region for different indications. © The Author(s) 2015.

  18. Transient basilar artery occlusion monitored by transcranial color Doppler presenting with a spectacular shrinking deficit: a case report

    Directory of Open Access Journals (Sweden)

    Del Sette Massimo

    2010-01-01

    Full Text Available Abstract Introduction We describe the case of a 79-year-old Caucasian Italian woman with a transient basilar occlusion monitored by transcranial Doppler, with subsequent recanalization and clinical shrinking deficit. This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. This case is important and needs to be reported because transient basilar occlusion may be easily diagnosed if transcranial Doppler is performed. Case presentation A 79-year-old woman affected by chronic atrial fibrillation and not treated with oral anticoagulants, cardioverted to sinus rhythm during a gastric endoscopy. She then showed a sudden-onset loss of consciousness, horizontal and vertical gaze palsy, tetraparesis and bilateral miosis and coma. Two hours later, the symptoms resolved quickly, leaving no residual neurologic deficits. Transcranial Doppler examination showed a dampened flow in the basilar artery in the emergency examination and a restored flow when the symptoms resolved. Conclusion This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. We believe that transcranial Doppler should be performed in all cases of unexplained acute loss of consciousness, in particular, if associated with signs of brainstem dysfunctions.

  19. Occlusion-amblyopia following high dose oral levodopa combined with part time patching

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2014-01-01

    Full Text Available Part time occlusion therapy is not reported to cause occlusion (reverse amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

  20. Preprosthetic therapy utilizing a temporary occlusal acrylic splint: a case report.

    Science.gov (United States)

    Badel, Tomislav; Kraljeviç, Sonja; Panduriç, Josip; Marotti, Miljenko

    2004-05-01

    This case report describes the complex occlusal rehabilitation of a patient with signs and symptoms of temporomandibular disorders with utilization of an occlusal acrylic splint as a means of initial treatment for neuromuscular reprogramming and repositioning of the condyle within the mandibular fossa for occlusal stability, thus allowing adaptation to a new occlusal vertical dimension.

  1. Clinics in diagnostic imaging (176). Acute embolic occlusion of the coeliac artery.

    Science.gov (United States)

    Appuhamy, Chinthaka; Kwan, Justin; H'ng, Martin Weng Chin; Narayanan, Sriram; Punamiya, Sundeep

    2017-04-01

    A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus. The patient's symptoms resolved during his hospitalisation and he was subsequently discharged well on long-term oral anticoagulation therapy. Isolated acute embolic occlusion of the coeliac axis is a rare occurrence that may result in end-organ infarction. Treatment options include systemic anti-coagulation, mechanical thrombectomy, catheter thrombolysis or open surgery. Catheter-directed thrombolysis therapy is a feasible and effective option for treating acute thromboembolic occlusion of the coeliac artery. Copyright: © Singapore Medical Association.

  2. Neuroprotective effect of Buddleja officinalis extract on transient middle cerebral artery occlusion in rats.

    Science.gov (United States)

    Lee, Dae-Hee; Ha, Nina; Bu, Yung-Min; Choi, Hyoung Il; Park, Yoo Guen; Kim, Yoon Bum; Kim, Mi-Yeon; Kim, Hocheol

    2006-08-01

    The flower buds of Buddleja officinalis MAXIM (Loganiaceae) are used to treat headache and inflammatory diseases in traditional Korean medicine. In the present study, the neuroprotective effects of the methanolic extract of B. officinalis (BOME) and of its hexane fraction (BOHF) were investigated in a middle cerebral artery occlusion (MCAo, 120 min occlusion, 24 h reperfusion) Sprague-Dawley rat model. BOME or BOHF (100 mg/kg, p.o.) was twice administered 30 min before the onset of MCAo and 2 h after reperfusion. BOME and BOHF treated groups showed infarct volumes reduced by 33.9% and 68.2%, respectively, at 2 h occlusion. In BOHF treated animals, cyclooxygenase-2 and iNOS inductions were inhibited in ischemic hemispheres at both the mRNA and protein levels. Furthermore, in vitro studies showed that BOME and BOHF both inhibited LPS-induced nitric oxide production in BV-2 mouse microglial cells. These results suggest that the anti-inflammatory and the microglial activation inhibitory effects of B. officinalis extract may contribute to its neuroprotective effects in brain ischemia.

  3. The occlusal imaging and analysis system by T-scan III in tinnitus patients.

    Science.gov (United States)

    Di Berardino, Federica; Filipponi, Eliana; Schiappadori, Massimo; Forti, Stella; Zanetti, Diego; Cesarani, Antonio

    2016-04-01

    Several studies have demonstrated that the prevalence of temporomandibular disorders (TMDs) in tinnitus patients ranges from 7% to 95%, and it is reported in literature that idiopathic tinnitus patients should be referred to a dentist to define whether or not the tinnitus is associated with TMD. However, the possible pathophysiological relation between TMDs and tinnitus is not generally investigated in clinical practice. The patterns and forces of occlusal contacts have been studied by means of T-scan III in 47 tinnitus patients (23 suffering from idiopathic tinnitus and 24 affected by Ménière disease [MD]) and 13 healthy subjects. The center of force target was offset in the opposite direction in 15/23 idiopathic tinnitus and in 7/24 MD patients (p = 0.026). No significant variation was found in the occlusal force. Our data suggest that a diagnostic screening method for occlusal stability in the intercuspidal position might be clinically useful in idiopathic tinnitus patients. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  4. The Inflammatory Sequelae of Aortic Balloon Occlusion in Hemorrhagic Shock

    Science.gov (United States)

    2014-04-13

    metabolic profile was significantly different. Clamp occlusion was associated with a significantly higher lactate burden and vasopressor requirement in...balloon occlusion. This was associated with a significant metabolic burden as measured by serum lactate; however, with suitable resuscitation, this...interleukin 10, reduces nuclear factor kB DNA binding, and improves short term survival in lethal endotoxemia . Crit Care Med 2004;32:801. [36] Manning JE

  5. An adaptive occlusion culling algorithm for use in large ves

    DEFF Research Database (Denmark)

    Bormann, Karsten

    2000-01-01

    The Hierarchical Occlusion Map algorithm is combined with Frustum Slicing to give a simpler occlusion-culling algorithm that more adequately caters to large, open VEs. The algorithm adapts to the level of visual congestion and is well suited for use with large, complex models with long mean free ...... line of sight ('the great outdoors'), models for which it is not feasible to construct, or search, a database of occluders to be rendered each frame....

  6. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  7. Branch retinal vein occlusion associated with quetiapine fumarate

    Directory of Open Access Journals (Sweden)

    Siang Lim

    2011-08-01

    Full Text Available Abstract Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.

  8. Plain abdominal film and abdominal ultrasound in intestine occlusion

    International Nuclear Information System (INIS)

    Amodio, C.; Antico, E.; Montesi, A.; Zaccarelli, A.

    1991-01-01

    Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificy of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecistis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echigenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus

  9. Immobilization of nanoparticles by occlusion into microbial calcite

    DEFF Research Database (Denmark)

    Skuce, Rebecca L.; Tobler, Dominique Jeanette; MacLaren, Ian

    2017-01-01

    Binding of nanoparticles (NPs) to mineral surfaces influences their transport through the environment. The potential, however, for growing minerals to immobilize NPs via occlusion (the process of trapping particles inside the growing mineral) has yet to be explored in environmentally relevant...... not influence calcite precipitation at the concentrations used here. Overall, these findings demonstrate that microbially driven mineral precipitation has potential to immobilize nanoparticles in the environment via occlusion....

  10. Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities

    OpenAIRE

    Rehak, Jiri; Rehak, Matus

    2008-01-01

    In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50?60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatm...

  11. Cephalometric Approach to the Occlusal Vertical Dimension Reestablishment

    OpenAIRE

    Zielak, João César; Gulin Neto, David; Cunha, Leonardo Fernandes da; Deliberador, Tatiana Miranda; Giovanini, Allan Fernando

    2014-01-01

    The occlusal vertical dimension (OVD) refers to the length of the face as determined by the amount of separation of the jaws. Its determination is important for the manufacture of restorations. However, defining the correct occlusal vertical dimension for edentulous patients is one of the most important steps for function and esthetics rehabilitation. Cephalometry is a standardized method of assessing dental and facial proportions and their interrelation. Additionally, cephalometric analysis ...

  12. Collateral veins in inferior caval vein occlusion demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.

    1983-01-01

    CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathway are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava. (orig.)

  13. Cardiovascular responses to strength training under occlusive training

    OpenAIRE

    Sergio Benito Hernández; Iván Chulvi Medrano

    2013-01-01

    Occlusive strength training is shown like an alternative to intensive training. Present study shown cardiovascular responses to this training. 10 subjects were subjected to two occlusion training protocols, differentiated by the weight lifted (30 % of maximum weight lifted, post30, and 70 % of maximum weight lifted, post70). The values of arterial systolic tension (TAS), diastolic (TAD) and heart rate (FC) were recorded. The results showing a significant decline in TAS and TAD after post30 of...

  14. Pathophysiological aspects of sickle cell vaso-occlusion

    International Nuclear Information System (INIS)

    Nagel, R.L.

    1987-01-01

    This book contains over 30 selections. Some of the titles are: An Animal Model for Sickle Cell Vaso-Occlusion: A Study Using NMR and Technetium Imaging; Sickle-Cell Vaso-Occlusion in an Animal Model: Intravital Microscopy and Radionuclide Imaging of Selective Sequestration of Dense Cells; Magnetic Resonance Imaging, Percentage of Dense Cells, and Serum Prostanoids as Tools for Objective Assessment of Pain Crisis: A Preliminary Report; and Painful Crisis and Dense Echinocytes: Effects of Hydration and Vasodilators

  15. Systemic effects of the occlusal destruction in guinea pigs.

    Science.gov (United States)

    Azuma, Y; Maehara, K; Tokunaga, T; Hashimoto, M; Ieoka, K; Sakagami, H

    1999-01-01

    Although there is an increasing amount of information pertaining to the systemic effects of malocclusion, its mechanisms still remain unclear in many ways. This study was conducted to find out the systemic effects of the occlusal destruction in guinea pigs. The animals showed an abnormality in posture and a reversal of the T wave in electrocardiogram (ECG) about 6 days after the grinding of all molar teeth. All the animals died about 7 days after the occlusal destruction. We established the optimal condition of occlusal destruction for the induction of the above symptoms in guinea pigs: at least 6 molars, both side premolar, 1st and 2nd molar of upper jaw, because of the ease for repair. The following results were obtained: 1. The experimental group died about 5 days earlier than the fasting group. 2. The animals could not hold their head positions and dropped the head to the earth. 3. The animals died about 12 hours after the onset of postural abnormality. 4. Ninety percent of the animals with postural abnormalities showed T wave inversion on ECG. 5. None of the above symptoms occurred with bite rising. These results indicate that occlusal destruction affects head position, preventing the animals to hold their head positions and causing the head to drop to the ground. Occlusal destruction may also cause abnormality of the masticatory muscles, which control posture and modulate cardiac function via the trigeminal system. This experimental model is suitable for the analysis of the systemic effects of occlusal destruction.

  16. Prefrontal Hemodynamic Changes Associated with Subjective Sense of Occlusal Discomfort

    Directory of Open Access Journals (Sweden)

    Yumie Ono

    2015-01-01

    Full Text Available We used functional near-infrared spectroscopy to measure prefrontal brain activity accompanying the physical sensation of oral discomfort that arose when healthy young-adult volunteers performed a grinding motion with mild occlusal elevation (96 μm. We simultaneously evaluated various forms of occlusal discomfort using the visual analogue scale (VAS and hemodynamic responses to identify the specific prefrontal activity that occurs with increased occlusal discomfort. The Oxy-Hb responses of selected channels in the bilateral frontopolar and dorsolateral prefrontal cortices increased in participants who reported increased severity of occlusal discomfort, while they decreased in those who reported no change or decreased occlusal discomfort during grinding. Moreover, the cumulative values of Oxy-Hb response in some of these channels were statistically significant predictive factors for the VAS scores. A generalized linear model analysis of Oxy-Hb signals in a group of participants who reported increased discomfort further indicated significant cerebral activation in the right frontopolar and dorsolateral prefrontal cortices that overlapped with the results of correlation analyses. Our results suggest that the increased hemodynamic responses in the prefrontal area reflect the top-down control of attention and/or self-regulation against the uncomfortable somatosensory input, which could be a possible marker to detect the subjective sense of occlusal discomfort.

  17. Occlusal concepts application in resolving implant prosthetic failure: case report.

    Science.gov (United States)

    Jamcoski, Vanessa Helena; Faot, Fernanda; de Mattias Sartori, Ivete Aparecida; Vieira, Rogéria Acedo; Tiossi, Rodrigo

    2014-04-01

    The prosthetic management of a poor implant treatment is presented in this case report. The recommended occlusion concepts for implant-supported prostheses were applied for the resolution of the case. The rehabilitation of the posterior segments provided a mutually protected occlusion with adequate distribution of the axial and lateral bite forces with stable posterior occlusion. The clinical exam indicated the need for modification in the vertical dimension of occlusion. Sufficient interocclusal rest space was present to test the alteration in the vertical dimension. The aim was to achieve an occlusion scheme that followed four specific criteria: (1) centric contacts and centric relation of the jaw-to-jaw position; (2) anterior guidance only; (3) shallow anterior angle of tooth contact; and (4) vertical dimension of occlusion with acceptable tooth form and guidance. The success of an oral rehabilitation relies in following the aforementioned criteria, appropriate interaction between the dental laboratory technician and the clinician, careful elaboration of the provisional rehabilitation with all the desired details to be reproduced in the final prosthetic restoration and sufficient follow-up time of the provisional prostheses before placing the final restoration.

  18. [Occlusal evaluation and design of dental implant therapy in defect dentition].

    Science.gov (United States)

    Li, Y

    2016-04-09

    Implant prosthesis of dentition defect is characteristic of remaining teeth and implants exist at the same time, so the remaining teeth occlusal conditions related to the final occlusal design is to maintain, adjust or re-establish the original dentition occlusion. Therefore, full evaluation of remaining teeth occlusion before restoration, clear prognosis, balancing the occlusal force distribution of natural teeth and implants, and carrying out the predictable occlusal design in the entire process of implant prosthesis can minimize the adverse events after implant prosthesis. Based on the typical cases in this paper, three occlusal design types of occlusal maintain-implant restoration, occlusal adjustment-implant restoration and occlusal reconstruction-implant restoration will be expounded respectively.

  19. Percepção da doença arterial obstrutiva periférica por pacientes classe I ou II de Fontaine de um Programa de Saúde da Família Perception of the peripheral arterial occlusive disease in Fontaine class I or II patients included in a Family Health Program

    Directory of Open Access Journals (Sweden)

    Juliana Nogueira Diniz

    2010-09-01

    Full Text Available CONTEXTO: A doença arterial obstrutiva periférica (DAOP se destaca por deteriorar a qualidade de vida dos pacientes, quando associada a elevado risco de eventos cardiovasculares e cerebrovasculares. O diagnóstico clínico é sensível e específico, por meio do índice tornozelo-braquial (ITB, que, se precocemente detectado, otimiza o controle dos fatores de risco. OBJETIVO: Avaliar a percepção da DAOP em pacientes classe I ou II de Fontaine assistidos pela Estratégia de Saúde da Família em Pará de Minas (MG, analisando características socioeconômicas e determinantes da qualidade de vida. MÉTODOS: Após cálculo amostral estratificado por gênero e idade, um questionário elaborado para o estudo foi respondido por 123 indivíduos com diagnóstico de DAOP classe I ou II de Fontaine. Para as associações, utilizaram-se testes do c² e exato de Fisher (pBACKGROUND: The peripheral arterial occlusive disease (PAOD is characterized by the deterioration in the quality of life of patients when associated with high risk of cardiovascular or cerebrovascular events. The clinical diagnosis is sensitive and specific, by means of the Ankle Brachial Pressure Index (ABPI, and, when there is early detection, the control of risk factors is optimized. OBJECTIVE: To assess the perception of PAOD in Fontaine class I or II patients by means of the Family Health Strategy in Pará de Minas (MG, Brazil, through an analysis of the socioeconomic characteristics and life quality determinants. METHODS: After the sample calculation, stratified by genre and age, a questionnaire elaborated for the purposes of this study was applied to 123 individuals who were diagnosed with Fontaine class I or II PAOD. Aiming at the associations, the c² and Fisher's exact tests were used (p<0.05. RESULTS: Among the participants who answered to the questionnaire, 96 (78% were women and had low schooling. An association between intermittent claudication, the most common symptom

  20. Analysis of occlusal characteristics of identical homozygous twins

    Directory of Open Access Journals (Sweden)

    Kučević Esad

    2017-01-01

    Full Text Available Background/Aim. Functionally stable occlusion is characterized by optimal and orthopedic stable position of the condyle, harmonious contact ratio of upper and lower teeth in the final occlusal position of the mandible, optimal relationship of dental arches at the eccentric movement of the lower jaw and stable interocclusal space in physiological position. As there are no ideal order of teeth and absolute intermaxilar harmony nor individually acceptable standards or prototype of functionally optimal occlusion, the aim of this study was to analyze occlusal characteristics of identical twins. Methods. This clinical epidemiological and functional study involved 30 pairs of identical twins, both males and females, aged 20 to 40 years. The main criterion for the selection of participants was preserved function of orofacial system, as a precondition for application of the Peer Assessment Rating (PAR index, which is the most reliable tool for diagnosing malocclusion and evaluating occlusal parameters: the distance between the contact points of agonists of front segments of the dental arches, side occlusion of the sagittal, vertical and transversal position, overjet, anterior crossbite, deep and open bite, overbite of incisors and relationship of middle dental arches. Results. Using t-test for independent samples, no significant difference in the values of PAR index, according to gender, was established. The average difference of 0.833 between the twin groups (for male twins: x¯ = 7.97, SD = 6.625; for female twins: x¯ = 7.13, SD = 5.606 was not statistically significant [t (58 = 0.526; p = 0.601; 95% confidence interval: -2.339–4.005]. Conclusion. The lack of significant differences in occlusal PAR index analysis in both the same and different twin groups, implies the dominance of hereditary factors.

  1. The association between Occlusion Time and Temporomandibular Disorders.

    Science.gov (United States)

    Baldini, Alberto; Nota, Alessandro; Cozza, Paola

    2015-02-01

    Recently, some published studies show there is a multifactorial origin for Temporomandibular Disorders, but the dental occlusion's contribution to the development of Temporomandibular Disorders, and how it may influence the adaptive capacity of the Stomatognathic system, it's still unclear. The aim of this study is to evaluate the correlation between the Occlusion Time and Temporomandibular Disorders. A total of 54 patients were enrolled in the study (24 males and 30 females, mean age 27.94 ± 8.21 years). The TMD group (8 males and 10 females) consisted of subjects who presented with at least 1 of the following signs of Temporomandibular Disorders: Temporomandibular Joint sounds (clicking or crepitation), Temporomandibular Joint locking episodes, limited mandibular opening, painful limitation of mandibular movements, pain to palpation of the Temporomandibular Joint or of the masticatory muscles. The control group (16 males and 20 females) presented as free from Temporomandibular Disorders. The T-Scan III computerized occlusal analysis system was to record the subjects' Occlusion. Times during eight mandibular opening-closing movements. The two-ways ANOVA test analyzed the variations for group and sex, showing that the TMD group mean Occlusion Time (0.64 ± 0.21s) was statistically significantly longer than the control group mean Occlusion Time (0.45 ± 0.17s) (p<0.001). Significant differences were also found for gender where the mean OT of female subjects was longer than males one with statistical significance (p-value<0.01). The computerized analysis of the Occlusion Time in patients affected by TMJ problems has to be carefully considered as adjunctive instrumental device. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Dental occlusion influences knee muscular performances in asymptomatic females.

    Science.gov (United States)

    Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis

    2014-02-01

    Some authors claim that occlusal appliances can enhance athletic performance. Therefore, this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age, 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to 3 randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60 and 240°·s in concentric and 30°·s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). In contrast, in the eccentric trials related to quadriceps performance, significant differences (p ≤ 0.05) were observed between the resin condition and the 2 other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p ≤ 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection.

  3. Effect of occlusal vertical dimension on lip positions at smile.

    Science.gov (United States)

    Chou, Jang-Ching; Thompson, Geoffrey A; Aggarwal, Harshit A; Bosio, Jose A; Irelan, Jon P

    2014-09-01

    In complete mouth reconstructive dentistry, the occlusal vertical dimension may be increased to provide adequate restorative space or to improve esthetics. The effect of increasing the occlusal vertical dimension on the smile is not well understood. The purpose of this study was to evaluate the effect of increasing the occlusal vertical dimension on the dimensions of the smile. Thirty dental students, 12 men and 18 women between the ages of 21 and 30 years old, participated in this study. Polyvinyl siloxane occlusal registrations 2, 4, 6, and 8 mm in thickness were fabricated from articulated stone casts. Posed smile images at occlusal vertical dimension +0, +2, +4, +6, and +8 mm were made with a digital single lens reflex camera mounted on a tripod. A wall-mounted head-positioning device, modified from a cephalometric unit, was used to stabilize the head position. Interlabial gap height, intercommissural width, incisal edge to upper lip, and incisal edge-to-lower lip measurements were made with computer software. The smile index was obtained by dividing width by height. The display zone area was measured by using computer software tracing. One-way repeated measures ANOVA (α=.05) was used for statistical analysis. With an increase in the occlusal vertical dimension, the interlabial gap height, incisal edge to lower lip distance, and display zone area increased significantly (Pocclusal vertical dimension. The smile index decreases with increased occlusal vertical dimension. However, the width of the smile and the length of the upper lip tend to remain unchanged. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  4. Pig specific vascular anatomy allows acute infrarenal aortic occlusion without hind limb ischemia and stepwise occlusion without clinical signs.

    Science.gov (United States)

    Haacke, N; Unger, J K; Haidenhein, C; Russ, M; Hiebl, B; Niehues, S M

    2011-01-01

    In a porcine, aortic graft model we found 5 animals to develop and survive unnoticed, complete infrarenal aortic occlusion and 2 pigs with an acute occlusion but rather unspecific clinical symptoms. We investigated the pigs' vascular system to classify the anatomic capabilities to compensate for an acute abdominal aortic occlusion. Retrospective analysis of CT scans and clinical data to specify unexpected results in a case series of infrarenal occlusion in a porcine model. Collaborative study of experimental and clinical departments. Fifteen healthy female minipigs. All pigs underwent an infrarenal aortic graft intervention. Anesthesia and perioperative management of the animals were preformed along the standard operating procedures of the local Department of Experimental Medicine. All animals received perioperative antibiotics, ASS, and carprofen for postoperative analgesia. Arterial pressure, heart rate, body temperature, and diuresis were monitored during surgery and therapeutic interventions. Contrast media based computed tomography (CT) with total body scans were performed at 1, 4, 10, 12 weeks after surgery. Comparable scans of cardiovascular healthy subjects (humans and pigs) and patients with a Leriche's syndrome were analyzed. Neither acute (within the first 12 h after surgery) nor stepwise total aortic occlusion show unmistakable clinical signs. In pigs, the epigastric artery (EGA) - which is in connection with suprarenal lumbal arteries, subclavian and external iliac artery - is highly developed associated to the high number of mammary glands of about 7 on one side. In humans, the ratio of aortic to EGA-diameter is 1 : 0.15. In minipigs we found a ratio of 1 : 0.43 which changed during aortic occlusion resulting in a ratio of 1 : 0.58. Pigs with a slowly developing occlusion demonstrated an enlargement of the ureteric artery of about 210% completing a sufficient collateral system. While in the human Leriche's syndrome months are needed to enlarge the

  5. Cerebral haemodynamic and metabolic changes in carotid artery occlusion: a PET study

    International Nuclear Information System (INIS)

    Samson, Y.; Loc'h, C.; Ottaviani, M.; Baron, J.C.; Bousser, M.

    1984-09-01

    Using the positron emission tomography, with the O 15 inhalation technique, the cerebral blood flow (CBF), the oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO 2 ) were studied in 37 patients with internal carotid artery (ICA) occlusion. In the territory of the occluded ICA, two pattern of focal anomaly have been observed: a CBF decrease with a ''compensatory'' OEF increase or a matched CBF and CMRO 2 decrease. On the other hand, as compared to age matched control values, CMRO 2 is significantly decreased in the territory of the occluded carotid only in patients with extensive neck vessels obstructive disease

  6. Anti vascular endothelial growth factor (bevacizumab) in central retinal vein occlusion: an interventional case series

    International Nuclear Information System (INIS)

    Jan, S.; Khan, M.N.; Karim, S.; Khan, M.T.; Hussain, Z.; Khan, S.; Nazim, M.

    2010-01-01

    Vascular endothelial growth factor plays major role in ocular angio genesis and retinal edema production and is a step forward in the management of ocular neovascularization and retinal edematous pathologies. To determine the efficacy and safety of intra-vitreal Avastin (Bevacizumab) in cases having central retinal vein occlusion. All patients with central retinal occlusion occurring in the past 3 months and seen between the study period were included in the study. Diagnosis of central retinal vein occlusion was made clinically by slit lamp biomicroscopy with 78D examination Patients who had received any treatment for and eyes which already had developed Anterior Segment Neovascularization, Neovascularization elsewhere or Neovascularization on disc at presentation were excluded. Dose of 0.05 ml (1.25mg) of Avastin (Bevacizumab) was used as intra vitreal injection every month for 3 months in cases that presented within a month of occlusion and less injections were given in dose presenting later. Follow-up was done at 30th, 60th, 90th and 120th day after the onset of disease. Visual outcome was defined as Snellen's or LogMar Best Corrected Visual Acuity at final follow up, of 120th day, compared to the visual acuity at presentation. Data were analyzed by SPSS version 17. Total of 17 eyes of 17 patients were included in this study. Eleven (64.7%) patients were males while 6(35.3%) were females. Total of 40 intra-vitreal injections of Avastin were given to patients with a mean of 2.35 injections per eye. Good visual outcome was achieved in 10(58.8%) eyes, while 7(41.2%) had stable visual outcome. Mean initial Best Corrected Visual Acuity (LogMar) in all 17 eyes was 1.79(SD+0.87) which significantly improved to a mean of 1.18 (SD+0.77) at final follow up. Mean improvement in Best Corrected Visual Acuity (LogMar) after paired sample test in all patients at final follow up on day 120 was 0.61(SD+0.84). Retinal hemorrhages and macular edema decreased clinically on

  7. An occlusal plaque index. Measurements of repeatability, reproducibility, and sensitivity.

    Science.gov (United States)

    Splieth, Christian H; Nourallah, Abduhl W

    2006-06-01

    To evaluate a new, computerized method of measuring dental plaque on occlusal surfaces which exhibit the highest caries prevalence. In 16 patients (6-9 years of age), plaque on the occlusal surfaces of permanent molars was stained (Mira-2-Tone) and photographed with an intra-oral camera. In a conventional picture editing program (PC/Adobe PhotoShop 6.0), the occlusal surface and plaque were measured in pixels and the relative proportion of occlusal plaque was calculated (ANALYSIS 3.0). The repeatability and reproducibility of the method were analyzed by re-taking and analyzing four images by two examiners four times via intra- and inter-examiner correlation coefficients and by re-analyzing 10 images. Sensitivity was tested by re-taking and analyzing the images of the same occlusal surfaces in all patients after instructed brushing with an electric toothbrush. Intra- and inter-examiner correlation coefficients for repeatability and reproducibility of the analysis were excellent (ICC> 0.997 and ICC=0.98, resp.; 95% confidence